Health Committee on Dec. 13th, 2016

[The Chair, Liberal, Bill Casey]

Thanks very much.

Now we have a motion on the floor. Do we have debate?

Madam Minister, if you need to go, you are free to go, because we arranged that.

First is Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Chairman, I am now going to proceed to take my seven minutes to ask the minister questions on the opioid crisis, the reason for which she is here.

Minister, first of all, I would like to thank you for publicly stating once again that addiction ought to be treated most properly as a health issue—

[Len Webber, Conservative, Calgary Confederation, AB]

I have a point of order, Mr. Chair.

There's a motion on the floor, is there not, Mr. Chair? Should we be discussing the motion on the floor?

[The Chair, Liberal, Bill Casey]

He asked to speak. He has chosen to do this, but it is not pertaining to the motion, so would you address the motion? We have to address the motion.

Are you done?

[Don Davies, NDP, Vancouver Kingsway, BC]

No, I'm not done, Mr. Chair.

I will address the motion when I get around to the thalidomide issue, but for the moment I'm going to direct my question—

[The Chair, Liberal, Bill Casey]

No, we have to deal with the motion.

[Don Davies, NDP, Vancouver Kingsway, BC]

Well, Mr. Chair, I am not restricted to dealing directly with the matter at hand; I'm allowed to raise peripheral issues.

I will eventually come to make a connection between the devastating impact of opioids and the devastating impact on the thalidomide victims, but I would ask that I be given some latitude to do so.

[The Chair, Liberal, Bill Casey]

Fire away.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

I'd also like to thank the member for restoring harm reduction as a key pillar of this issue. As my honourable colleague just talked about, there are a number of different conditions that affect Canadians, from the devastating impacts of thalidomide to the current problem of opioid addiction in this country.

Minister, as you know, in 2015 the Liberal Party publicly stated that the Conservative Bill C-2 was a deliberate barrier to opening safe injection sites. Of course, it was, because we know that not a single safe injection site has been opened since that legislation was passed.

Many stakeholders have called on your government to repeal Bill C-2 for over a year now, and this is not purely of academic concern. In the last year alone, over 2,000 Canadians, as you pointed out, died from drug overdoses, mostly from opioids—as people have died from thalidomide.

Now, in the last week of Parliament of 2016, you've introduced legislation to streamline Bill C-2, and I congratulate the government on doing that. Of course, since it is the last week before Parliament adjourns for Christmas, this bill will not be dealt with until February of 2017 and not passed until spring of 2017 at the earliest. That's months from now.

The Minister of Health for British Columbia last night said that the opioid crisis in B.C. is “like a war” and that they can't wait for this legislation to be passed. I think Dr. Perry Kendall, the public health officer in British Columbia, said the same thing—that they're not waiting—and you've pointed out, I think with some power, the impact in my home province of British Columbia of these opioid deaths: almost 700 British Columbians will die this year.

Pop-up clinics are operating right now in British Columbia to provide emergency services, and they're either illegal or operating in a legal grey zone.

As you know, this committee conducted an emergency study into the opioid crisis, and the very first recommendation that this committee made to your government, with all-party support, was to declare this a national public health emergency, as the thalidomide issue was. The reason for this is that it would give the public health officer of Canada extraordinary powers to act immediately while your legislation works through the House over the next three or four or five months, including opening emergency clinics now for safe consumption, for naloxone administration, or for drug testing—whatever these emergency clinics could be used for right now to save lives.

My first question to you, Minister, is why don't you declare a national public health emergency to give the public health officer of Canada these extraordinary powers in the next 90 days so that we can start saving lives now, while your legislation takes time to work through the process?

[The Chair, Liberal, Bill Casey]

Do you have a point of order?

[John Oliver, Liberal, Oakville, ON]

It's a bit unusual, but I'm not sure that witnesses are allowed to participate in a debate on a motion.

[The Chair, Liberal, Bill Casey]

That's a good point. Do we have a decision on that?

It's the option of the witness to comment on the question.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

I would think it unusual that the Minister of Health could not participate in a debate on an issue concerning a thalidomide or opioid crisis.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

Thank you.

Mr. Chair, I gather you would like me to respond to the most recent intervention?

[The Chair, Liberal, Bill Casey]

It's your option.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

Okay. Thank you.

As time is running short in terms of my availability, I will speak very briefly to the motion that was mentioned, but I would also like to comment on what's been brought to me by the first intervenor on the motion. I'll start there.

As members know, I was invited on the basis of a motion to come and speak to the opioid crisis, so I do want to make sure I comment on what's been most recently said. You brought up a number of issues, and I think the one that you were asking most directly for was to declare a national emergency on it. I think it's important to speak to that.

The mechanisms available to the federal government on the declaration of an emergency are somewhat different from the powers that are vested in provincial governments for a declaration of an emergency. British Columbia effectively declared a public health emergency, and I have found it helpful to provide them with tools they didn't already have.

Under federal legislation, there is currently an Emergencies Act. It is a modernization of the previous War Measures Act, which was implemented on three occasions: World War I, World War II, and the October Crisis. The current Emergencies Act has never been implemented. I have asked my department, including the Public Health Agency of Canada, to investigate whether a declaration of an emergency would be appropriate under the Emergencies Act.

To do so, we would have to have exhausted all other possible resources, and it would essentially take over powers that are currently vested in provincial governments to be able to act on public health. The analysis of the department to date has been that it is not deemed to be appropriate under the circumstances.

That in no way is an indication that we don't recognize the seriousness of the opioid crisis. I have continued to say that if we felt that declaration of a national emergency would give us tools we don't already have, then clearly we would have a responsibility to do so. To date we feel that the lack of declaration of an emergency has not impeded us from using all tools at hand. That said, we have looked for other alternatives outside the Emergencies Act to be able to bring further resources and mechanisms to the table.

I know British Columbia used their declaration as a way to be able to get better data and surveillance. One of the things that the chief public health officer would be able to speak to if we had the time would be that he has taken steps to open a new special advisory committee.

We have decided to look at the opioid crisis in the same frame that we would look at an infectious disease epidemic. The special advisory committee tool has been used in things like the H1N1 crisis and the Ebola crisis, and it was also used in response to the Syrian refugee crisis. It gives the chief public health officer the opportunity to work with medical officers of health in the public health network across the country to be able to do a much better job than we're doing now, getting as close as possible to real-time information on data and surveillance.

I don't know whether you want me to take the time, but the chief public health officer could give you information. I believe he is meeting tomorrow with medical officers of health and public health officers across the country to talk about getting that kind of information. Thank you for raising this issue.

The other thing the committee recommended was a task force, and I'm happy to say we do now have a task force within Health Canada, as was recommended by the committee. These are examples of things that we're doing to be able to pursue this issue.

I should respond specifically to the motion on the table, and I'd be very pleased to have a conversation with Mr. Brown about this at another time in recognition of the fact that we're here to talk about opioids. I think he's put forward an interesting motion to essentially evaluate a mechanism that was proposed by the previous health minister, who is now Leader of the Opposition.

The process that is currently in place for people who were potential victims of thalidomide was put in place by the previous government, the mechanisms by which people would be compensated and by which those who didn't meet the criteria would have the opportunity to be able to respond to that.

I am pleased that Crawford & Company has been able to identify, I believe, a further 26 individuals, and there was one who actually met the criteria as recently as last week. It continues to identify new people who have suffered as a result of thalidomide.

Having said that, if the committee feels it's appropriate to examine the process that the previous government put in place and to assess whether in fact that was a fair process, obviously it's completely the committee's jurisdiction to examine that.

[The Chair, Liberal, Bill Casey]

Okay.

I'm going to to move to Mr. Oliver.

Before I go to Mr. Oliver, I just want to say something to Mr. Brown. Obviously you're really involved with this and have a great deal of compassion and concern about it. One of those last ones who was approved by Crawford & Company was in my riding. There was a lady who had tried to get compensation for decades and couldn't get it, but she did under the new system.

I just want to say that this committee has considered motions by opposition members many times. They've been dealt with really well, I think. I understand how concerned you are and your compassion for this case. We all do. Everybody at this table does. We did want to hear from the minister, but anyway, if there are issues, we'll deal with them. I just want to say that.

Mr. Oliver, you're up.

[John Oliver, Liberal, Oakville, ON]

I just echo what you said, Mr. Chair. We certainly all heard the very impassioned plea for review of the program and what the issues were, but we have set our committee agenda for this meeting. We have a number of other priorities that we have set as a committee. At this juncture I would move that we suspend the debate on this motion and return to our scheduled committee work. We can discuss this motion at a later date.

[The Chair, Liberal, Bill Casey]

That's a motion to suspend the motion.

[John Oliver, Liberal, Oakville, ON]

Sorry. I would adjourn the debate.

[The Chair, Liberal, Bill Casey]

It is moved that we adjourn the debate on this motion.

I'm going to put that to vote, but I just want to assure you that this will not go away. We'll deal with it again. We'll be glad to hear from you again.

All those in favour of the motion to adjourn the debate on the thalidomide issue at this moment? All opposed?

(Motion agreed to)

We're going to return now to the opioid study. Where are we on the speakers list?

Go ahead, Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chairman.

Thank you, Minister.

Now we'll go back to the opioid crisis.

This committee heard from many witnesses who told us directly that there's a profound lack of detox and addictions treatment facilities for Canadians and that this is a critical piece of helping deal with opioid addiction, and therefore death in Canada. We know that the people dying on the streets are primarily opioid addicts. Therefore, from a preventive point of view, making sure that all Canadians have access to publicly funded, accessible addictions treatment is a key part on the demand side of the question.

Accordingly, this committee made three separate recommendations in our report to your government that calls for significant new funding for public, community-based detox and addictions treatment for Canadians.

In your cover letter to the Canadian drugs and substances strategy issued yesterday, you said, and I quote:

I am confident that the proposed authorities, combined with the numerous federal and provincial actions and commitments to date, will help us to address the current crisis of opioid overdose and death in a comprehensive, compassionate, and evidence based manner.

Minister, we have not seen a commitment from your government for a substantial investment in addictions treatment in Canada. How can you say that you're strategy is comprehensive, without that?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

I thank you for the question. It's an excellent one. You're absolutely right that our response to the opioid crisis has to be comprehensive.

The content of yesterday's bill spoke in large part to one particular mechanism of treatment, that being the possibility of further measures of harm reduction. It was intended to address the currently onerous process that's required by communities who are looking to open supervised consumption sites.

There were other pieces in the legislation, as you know, that contribute to the comprehensive strategy on opioids. It addressed our need to make sure that we reduce access to unnecessary opioids, and in particular illicit substances. There's a large part of the bill that related to that.

I'm glad you brought up the topic of treatment, and I know this has been raised repeatedly here. I can tell you that when I meet with first responders, for example, and when I meet with health providers who are dealing with this, treatment is one of the most pressing matters.

This is an area where I hope we can find ways to work with our partners to do better treatment services that fall largely in the jurisdiction of the provinces and territories. This is an area where I believe provinces and territories need to do work to open more facilities and make those facilities more available.

For instance, you know we are in the process of negotiating a health accord with the provinces and territories. I have made it very clear to them that issues of mental health and addiction are very important to us as a government, that we would actually like to be able to invest to provide further support for them to do better in terms of providing mental health care and addiction.

We could hear more from the provinces and territories about how we can help them and what their plans are to open more treatment services. That would give us an opportunity, hopefully through the health accord and our commitments to mental health, to be able to invest in better supports for people, both in terms of preventing addiction by treating mental illness at its roots, but also by providing addiction services.

I hope you will hear more on that soon.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Minister.

Your government has commendably made a substantial increase in funding to the Global Fund to address HIV and AIDS on the international stage. Unfortunately, your government has recently denied or cut funding to many HIV support organizations that provide services here in Canada, including some that are key players in responding to the opioid overdose crisis.

Will you commit to reversing these cuts and ensure that every group that has historically received funding under the community action fund gets that funding? A short answer would be appreciated.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

I think you are aware that we have been working with agencies that were potentially going to have an interruption of their funding through the community action fund. I asked the Public Health Agency of Canada to speak directly to each of those organizations and to continue their funding. We are committed to continuing to support those organizations through to 2018.

In the meantime, I am seeking further resources to be able to expand our federal approach to sexually transmitted and blood-borne infections, including the community action fund. It's my hope that we will find mechanisms to continue to support these excellent agencies.