Health Committee on March 26th, 2021

[Tony Van Bynen, Liberal, Newmarket—Aurora, ON]

Thank you.

A problem well defined is a problem half solved.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Van Bynen.

We're going to continue with Mr. Thériault.

Mr. Thériault, you have six minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

First of all, I would like to tell Ms. Benoît that her presentation was very interesting. It's important that she took the time to testify about what she and many other young children and adults are going through. I was very touched by it.

Chronic diseases are diseases that people learn to live with. But because people learn to live with them, we seem to lose sight of them. They are insidious, they settle in our daily lives. Indeed, when someone has type 2 diabetes, it's a whole lifestyle process. It seems that at that point, the patient, or the victim, is made responsible.

We were talking about stigma earlier. Often, the person with the disease is blamed for the fact that they may have a bad lifestyle. That may be true, but we still need to do all the prevention and all the education upstream to avoid this kind of situation. I think that's what's constantly missing, and it's related to the fact that when diseases aren't as dramatic as a heart attack, for example, it strikes less of a chord. We know how striking a heart attack is, but we also know that many heart diseases often have diabetes as a determining factor. Because chronic diseases are less obvious, you get used to living with them and you lose sight of them.

What I find interesting in the approach taken by my colleague Ms. Sidhu is that we know that there have been discussions for years on national strategies and strategic frameworks. There have been since 2005, and there were discussions in 2018 around Diabetes 360. Today, we're being told that we need a bill, that we need to put all this in a legislative intent.

Very briefly, Ms. Sidhu, could you tell us why this is happening today rather than in 2005 or 2018? Why do we think it is essential that all these intentions be reflected in a legislative framework?

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Thériault.

Why it is important is, as I mentioned even in my speech, in my home riding of Brampton, one in six Bramptonians are living with diabetes. Many more are prediabetic or undiagnosed. As you know, Brampton is home to a large South Asian population that is impacted by diabetes. We also have a large Black community, which is twice as likely to have diabetes.

The number of people in Peel Region living with diabetes doubled between 1996 and 2015. That's what the data shows there. That is why Brampton city council is very supportive. They know what's happening on the ground, and that is why they endorsed my bill. It is so important. The programs are not working well. We need this strategy.

Mr. Chair and Mr. Davies were there last term when we did a diabetes study in the last HESA. We made recommendations. There are always other factors like genetics and environment, but type 2 diabetes is often preventable with healthy eating, active living, education and awareness. That is why, if someone is aware of the early signs, they can maybe prevent this disease or maybe they can delay onset of the disease. Long-term consequences are more dangerous. Cultural sensitivity is another thing. That is why it's so important to bring this strategy now.

[Luc Thériault, Bloc, Montcalm, QC]

But this was surely the case in 2005 and 2018. It's now 2021, thankfully, but I wanted to talk more about the legal framework because the bill calls for a national framework.

What do you think is the difference between a national framework and the national strategies that have been developed in previous years?

[Kimberley Hanson]

Yes, thank you, Monsieur Thériault.

I think there's no difference between a national framework and a national strategy. When we were drafting diabetes 360°, we debated strongly which words to use to describe what we were trying to accomplish. It is Diabetes Canada's fervent hope that when Bill C-237 passes into law, the framework that it requires to be tabled before Parliament will be heavily inspired by or informed by the diabetes 360° strategic framework.

I can't speak to why we find ourselves in the position that we do in 2021, but I can say that we've seen in the case of other illnesses or disease groups—such as cancer—that when we take a coordinated approach, when we help facilitate information sharing and the sharing of best practices across jurisdictions, we can materially improve the health care of Canadians and really make a difference in reducing the impact of these diseases. I would definitely agree that it's past time that we acted, but the only time we have is now, so let's act now to embrace this bill and move forward.

[Luc Thériault, Bloc, Montcalm, QC]

In conclusion, that's why a legal framework is needed now.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Thériault.

We'll go now to Mr. Davies.

Mr. Davies, go ahead, please, for six minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

I'd like to thank all the witnesses for being here today.

Ms. Hanson, I think it was you who mentioned that the funding for the diabetes 360° has been recommended three times in a row, and I understand that it's being recommended again in the 2021 budget. Has the federal government approved funding for the diabetes 360° strategy yet?

[Kimberley Hanson]

Not as of yet, MP Davies, no.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

You're familiar with the HESA recommendations from our study. I think those recommendations were unanimous by this committee in the last Parliament. Have any of those recommendations, as a result of the diabetes strategy, been implemented by this government yet?

[Kimberley Hanson]

Not that I'm aware of, sir.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Ms. Hanson, when you appeared at this committee on October 2, 2018, for that study, you pointed out very clearly the out-of-pocket expenses that many people suffering from diabetes have to pay. In fact, it's over $1,500 a year, which has been deemed catastrophic. What proportion of Canadians living with diabetes cannot adhere to their therapies because of cost?

[Kimberley Hanson]

According to some research that we have done, at least 30% of Canadians living with diabetes report being unable to adhere to their prescribed treatment regimen due to its costs. I see that this problem is only really being exacerbated as time goes on. The gap between people who can afford, by virtue of private insurance or other means, the best therapies and those who cannot afford anything but the most basic therapies is only growing. That's why, according to Diabetes Canada, it is critical that every Canadian living with diabetes have access to the care, certainly, but also the medications, devices and supplies they need to live well and protect their health.

[Don Davies, NDP, Vancouver Kingsway, BC]

You say that it's about 30% of people living with diabetes who have difficulty meeting those needs.

[Kimberley Hanson]

Yes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Prowten, I and other members of this committee have all had extensive dealings, I think, with juvenile diabetes, and you've done an excellent job of bringing the realities to our attention. I know that there are children who have to check their blood glucose levels an unbelievable number of times—every five minutes—so I know that continuous glucose monitors, insulin pumps and insulin are critical.

Given that 2021 marks the 100th anniversary of insulin in Canada, do you believe that we should mark this occasion by ensuring that insulin and the other necessary equipment—like pumps and monitors—are available to every Canadian through a national pharmacare program?

[Dave Prowten]

There's no doubt that everybody should have exactly what they need to manage their disease. I would then say we need to do more research to find the next level of treatments in essence to cure this disease. There are a lot of people who need better care right now.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

My next question is for Ms. Sidhu.

I have a couple of things. I totally congratulate you on this bill and I admire your initiative, but I must say that delivering the diabetes 360° framework, funding it and making sure that all diabetics and frankly every Canadian who needs access to medication have it is something your government can do.

I'm just wondering if you have gone to the health minister and asked her to simply implement the diabetes 360° program instead of having this have to be pushed through a private member's bill. We all know that can take a lot longer and may or may not get us to where we want to go quickly enough. Your government has the power to do this now. Have you brought that to the health minister's attention and asked her to do so?

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Davies.

First of all, I thank you for your support.

I personally fully support 360°. I know as the chair of the all-party diabetes caucus that we work together. Last term when we studied the diabetes issue, we all supported that 360°. The government, of course, needs to conduct their own consultation and stakeholders engagement, but Diabetes Canada has done great work in putting together their 360° strategy.

[Don Davies, NDP, Vancouver Kingsway, BC]

Can I just interrupt you, Sonia. Why isn't your government implementing it then?

[Sonia Sidhu, Liberal, Brampton South, ON]

That is why Bill C-237 is a pathway towards a strategy. Diabetes 360° is an example of such a strategy.

It isn't appropriate to tell Health Canada what should be implemented at this point, but I [Technical difficulty—Editor] and research plan, and we must let Health Canada look at it for implementation. That is why it's a pathway. I know Diabetes Canada is working well together with us. That is why I brought forward Bill C-237.

We need that strategy. I personally support diabetes 360° and the next level. That is why I brought forward Bill C-237. We need a strategy.

[Don Davies, NDP, Vancouver Kingsway, BC]

I understand, Ms. Sidhu, but that's not the question. I understand you support it. The question I'm asking is why your government doesn't, because they could clearly implement this now. For the record, the NDP believes this should be implemented now. Consultation is not necessary. These are excellent recommendations. People are dying and living with a lot of pain that is unnecessary, and we believe this should be implemented right now.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Davies.

That brings our first round to a close. I really don't think we have time for a second round. Is there any will for a one-minute round for each party?

I see Mr. d'Entremont is nodding his head.

Let's do that. Let's give everybody a one-minute round.

We'll start with Mr. d'Entremont.

[Chris d'Entremont, Conservative, West Nova, NS]

Let's ask a quick question on that one.

This question is for Ms. Hanson.

How much did diabetes 360° cost in today's dollars? I know it's been around for a number of years. How much would it cost Diabetes Canada to implement such a strategy?