Health Committee on March 21st, 2017

[The Chair, Liberal, Bill Casey]

Shall I report the bill as amended to the House?

[Some hon. members]

Agreed.

[The Chair, Liberal, Bill Casey]

Shall we reprint the bill as amended?

[Some hon. members]

Agreed.

[The Chair, Liberal, Bill Casey]

Perfect, congratulations. I want to thank the committee for the help going through this. That was a nice piece of work.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Thank you, Chair. Well done. Thank you so much.

[The Chair, Liberal, Bill Casey]

You're welcome. Thank you for doing it.

We're going to try to report this on Thursday morning. We tried to get the budget moved, but they wouldn't do it.

We have some time, and I have some business that we should go over.

First of all, I want to say that this is our eighth report that we'll be tabling. I think that's quite productive, and I'm very pleased to be able to report it.

I want to advise the committee that the minister and her officials will appear on April 6. That's confirmed. I also want to tell the committee that I'm going to ask the PBO for a definite date for the report. We're anxious to get that report, and we don't want it to drag out too far. If I don't get a satisfactory answer from the PBO, we'll call him to the committee to see if we can't get a proper date.

Ms. Sidhu, you have a motion that you'd like to present.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair.

I'm pleased today to table my motion:

That, pursuant to Standing Order 108(2), the Committee dedicate at least three meetings, by December 2018, to study anti-diabetes strategies in Canada and in other jurisdictions; that, in relation to this study, the Parliamentary Budget Officer provide a cost analysis on the current fiscal impact of diabetes and future projected costs to the Canadian healthcare system; and that the Committee report its findings to the House.

[The Chair, Liberal, Bill Casey]

Thanks very much. I need some direction from the committee. .

Yes, Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

I'm wondering if I could ask Ms. Sidhu something.

I'm supportive of the motion that she's put forward. I am wondering if she'd take a friendly amendment. She mentioned “the Parliamentary Budget Officer provide a cost analysis”. I am wondering if we could say “in advance”, because before we do the study, we run into this issue with pharmacare.

I think it would be prudent for us to ask for the information. It might help us to frame the study a little more efficiently if we ask for that in advance and avoid the challenges we've had with pharmacare on that.

[Sonia Sidhu, Liberal, Brampton South, ON]

I think there are other issues that are important. That's why this study is very flexible—until November 2018.

I don't know if PBO has the time or not. That's up to PBO. I know this is a very important issue in Brampton. One in seven Bramptonians has prediabetes. It's a hub of diabetes, and as a previous diabetes educator, it's close to my heart. I really want to do something.

I know there are other important issues as well. We have to do pharmacare, and there are other important studies. That's why I'm very flexible in time. I don't know if PBO has the time before...not because we have other matters to address.

[The Chair, Liberal, Bill Casey]

Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

I want you to know that I'm supportive of your motion, and I do appreciate the passion that you have for this issue. I have family members with it, and I know that our first nations community is really challenged by diabetes, so I think this is a really excellent thing to do.

My only concern is to get the most efficient study done. If we ask the parliamentary budget officer to provide a cost analysis, perhaps if we could get that in advance it might be a better thing.

We know with the pharmacare program that we've asked him for his analysis, which is going to be important for us in how we move forward with pharmacare. But that's going to be taking time, and if we had that in advance, I think it would have been a more efficiently run study.

So I'm just asking if, in relation to the study, the PBO will give a cost analysis “in advance” on the current fiscal impact and future projected costs to the Canadian health care system, just so that we know upfront what we're looking at. I would really just want to add those two words so we have that information before we start the study.

[The Chair, Liberal, Bill Casey]

Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Just judging by our experience with the parliamentary budget officer with respect to pharmacare, it seems to me that in order for the PBO to do accurate work, his office needs a lot of parameters and information defined by this committee as to what exactly we mean. So I have difficulty understanding how we can task the PBO with costing out something that this committee hasn't looked at and for which we can't provide any of those parameters.

I also think it's quite unusual for the PBO to be asked by committees to cost out their proposed programs. I thought it was a creative suggestion, I think from Mr. Kang, that we do it in the pharmacare study. I thought it was creative and worthwhile.

Maybe Dr. Carrie can explain to me how we would give the parameters to the PBO before the committee has studied the issue and understands what exactly we would want him to look at.

[Colin Carrie, Conservative, Oshawa, ON]

Thanks, Don, for the opportunity to explain the rationale here.

The way I read it, the actual motion I think gives the parameters, because we're asking the parliamentary budget officer to provide a cost analysis of the current fiscal impact of diabetes. I think he could do that without our giving him any further parameters, and give the projected cost to the Canadian health care system. I think he could do that without further direction from the committee. I think it's right in the motion.

[Sonia Sidhu, Liberal, Brampton South, ON]

In the motion I called for three meetings to have a better chance to listen to the witnesses. I know there is more on how the research.... When the witnesses are here we will have more of an idea of what we are going to do, and then we can [Inaudible-Editor] register a strategy. We can report that back to the House, and then we have more ideas to do more.

[The Chair, Liberal, Bill Casey]

This is one of those cases in which I think everybody agrees in principle, but it's just a matter of the details. Are you moving a subamendment, or are we just discussing this?

[Colin Carrie, Conservative, Oshawa, ON]

I would hope to move a friendly amendment, and I agree with Sonia. She mentions at least three meetings. I could see this study going a little bit longer than that.

Let's just say we wait until December 2018 to start it, we could have a couple of meetings. Maybe we would come up with something else we'd want the PBO to study, but knowing what we know from pharmacare, it could take them six months to do it, and then the election is here.

I'm just saying maybe we could write a friendly letter to him in advance saying, look, we're going to be doing this study. Could you do a cost analysis on the current fiscal impact of diabetes?

I think he probably has the data to do that, and when you're looking at projected future costs, it is something that does take a little bit of work, but I think within your motion you wrote it well. I think by just asking him that, we could get that information ahead of time and give him a step ahead so that we would be able to complete the study before another election, or something like that.

[The Chair, Liberal, Bill Casey]

Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thanks.

Maybe Ms. Sidhu can explain more about what she meant by this, because my confusion about the motion is that it says:

...the Committee dedicate at least three meetings, by December 2018, to study anti-diabetes strategies in Canada and in other jurisdictions; that, in relation to this study, the Parliamentary Budget Officer provide a cost analysis on the current fiscal impact of diabetes and future projected costs to the Canadian healthcare system...

I hear what Dr. Carrie is saying; that makes sense. I'm unclear about whether the parliamentary budget officer's costing is limited to the current fiscal impact of diabetes or whether Ms. Sidhu wanted the PBO to study the projected costs of anti-diabetes strategies in Canada in the future. That's my first question.

Second, if my reading of it is incorrect and all that is intended is for the PBO to provide a cost analysis of the current fiscal impact of diabetes, then is the part about future projected costs...? Do you mean the future projected costs if we do nothing, or assuming that we have strategies?

What I would find useful as we do this study is to ask the PBO to not only study the current costs of diabetes in our society, but also to cost out, once we know what anti-diabetes strategies might be available to us, what the impact of those might be on the costs.

I'm not sure what Ms. Sidhu meant, and I'd like to know. Maybe we could consider what exactly we want the PBO to cost.

[Sonia Sidhu, Liberal, Brampton South, ON]

If you said anti-diabetes strategies, that's what I meant, as well as future strategies and other jurisdictions. Then we can make a report back to the House. That's what I meant.

[The Chair, Liberal, Bill Casey]

Mr. Kang.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Thank you, Mr. Chair.

There's no clarity here. Maybe Mr. Davies is looking for clarity. What do we do with the study—the costs at present and the future projected costs? Are we going to have the strategy after we get the projected costs? I think that's where clarity is missing.

We do the study now, what it's costing, and then the projected costs, and then after that are we going to come up with a strategy on how to deal with it? Is that what you're getting at, Sonia?

[Sonia Sidhu, Liberal, Brampton South, ON]

We have three meetings, and in the meantime, the PBO can give us the present cost analysis, and then when we make a strategy, what the future projected costs of that strategy would be. That's what I meant.