Health Committee on March 26th, 2021

[Kimberley Hanson]

Implemented the way that we have recommended, which is just one possibility, it would take us seven years. It would cost a total of $150 million over that seven years. It would return savings to our economy of $20 billion in that same time frame, $11 billion of which would be to health systems and $9 billion of which would be to Canadian employers.

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

How many meetings have you had with either ministers or parliamentary secretaries over the years to try to bring this message to them?

[Kimberley Hanson]

More than I can count.

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

All right. I hope the PS is listening here too.

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. d'Entremont.

We'll go now to Ms. O'Connell.

You have one minute.

[Jennifer O'Connell, Liberal, Pickering—Uxbridge, ON]

Thank you, Mr. Chair.

Thank you, everyone, for being here.

Julia, in particular, thank you for sharing your story about the stigma, because I think we can't lose sight of that.

I have very limited time.

I want to follow up on the previous comment about why not just have the government implement it. Well, then why not just get rid of private members' bills? It is absolutely a member's prerogative to move forward with issues that are important to them and their constituents. I think that's what we should be debating here today.

This question is for any of the witnesses who want to jump in. Is there a country with a framework that you think has done it quite well and how has it been implemented?

Maybe you could speak to some of the comparators around the world.

Ms. Sidhu, thank you and congratulations on bringing a PMB forward.

[Kimberley Hanson]

That's an excellent question, MP O'Connell. Maybe I can start and, Dave, you can add.

There are a number of countries—I'm thinking specifically of Sweden, Denmark, Finland, the U.K., New Zealand—that have parts of these nationwide diabetes approaches and are experiencing much better rates of prevalence and lower costs than we are as a result. In fact, Canada is in the worst third of OECD countries for prevalence and cost of treating diabetes, largely because we haven't had such an approach. Even countries such as Portugal and India have more coordinated approaches and better experiences of diabetes according to many metrics than Canada does.

As I mentioned in my earlier remarks, it's a recommendation of the World Health Organization that every country have a nationwide approach, and it's one that I think Canada should seriously heed.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. O'Connell.

Mr. Thériault, you have one minute.

[Luc Thériault, Bloc, Montcalm, QC]

Basically, all of my earlier questions were related to the announced legal framework. Earlier, Mr. Prowten said that it would be interesting for research and that data collection would be even more efficient. That's fine. I also understood from the testimony of Ms. Hanson and Ms. Benoît that this would also help us update all the thinking and strategies that have been around for a while, such as the Diabetes 360 program.

I understand that the bill will be, as Ms. Sidhu put it, the pathway to the $150 million that will allow us to save $20 billion.

So let's go for it. Everyone is in agreement with this initiative, no one can be against it. Now, what remains to be done is to bring all these good intentions into reality. We'll soon have a fairly broad legal framework, but full of good intentions. Everyone has supported it. I'm relying on the testimony of people who have been in the field for years.

Personally, I'm ready to be pleased with this initiative, and I congratulate Ms. Sidhu on her objective.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Thériault.

We will go to Mr. Davies for one minute, please.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

I just want to take a moment to congratulate Diabetes Canada and JDRF Canada for the wonderful work [Technical difficulty—Editor] in explaining the public policy reasons. From my understanding, implementing the diabetes 360° strategy will not only save our country money in the health care system over time, but it will also save Canadian lives.

I know that the Canadian Federation of Nurses Unions found that cost-related non-adherence results in deaths of some 270 to 420 Canadians with diabetes every year. We know that many children can get access to the tools they need. I think these are known.

If I understand Ms. Sidhu correctly, she suggests Health Canada will have to do some consultation on this bill.

Ms. Hanson, do you see any real areas of uncertainty or consultation that are still required that would justify the government not being able to move on this right away?

[Kimberley Hanson]

It would be my hope, MP Davies, that consultation would be focused on clarifying governance structures for carrying forward the implementation of this framework, as well as defining the specifics of how all levels of government can collaborate in implementing it.

I would hope that the extensive work that JDRF and we have done to bring the community together to define what should be in the framework can stand, and therefore the focus in the months after this bill passes into law can be on how we can actually start implementing it as quickly as possible. We can't wait really another moment.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Davies.

That brings our questioning to a close.

I thank you all. I thank the witnesses in particular for their testimony today and for sharing their expertise and time with us.

With that, we will suspend and invite the witnesses to withdraw. We will proceed shortly to clause-by-clause.

[The Chair, Liberal, Ron McKinnon]

Pursuant to Standing Order 75(1), the consideration of clause 1, short title, and the preamble are postponed.

We will go to clause 2.

(On clause 2)

I understand there is an amendment for clause 2.

I would invite Mr. d'Entremont to move that amendment.

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

Mr. Chair, I move that Bill C-237, in clause 2, be amended by adding after line 21, on page 2, the following:

(f) ensure that the Canada Revenue Agency is administering the disability tax credit fairly and that the credit, in order to achieve its purposes, is designed to help as many persons with diabetes as possible.

Simply put, there has been an ongoing challenge for people with diabetes to qualify for the disability tax credit. A number of organizations have expressed the difficulty of that. I can attest as a parent that it was probably the third try before we were able to get it for André. I can imagine for individuals who are not as lucky as we are to be able to work for themselves and get these kinds of things done....

It's simply to try to facilitate the work and to acknowledge that there is a disability tax credit there. I think it's a very easy and calming kind of resolution, without changing the intention of the bill.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. d'Entremont.

We will carry on with the debate.

We have Ms. Sidhu. Please go ahead.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you [Technical difficulty—Editor].

I do not oppose Mr. d'Entremont's amendment, but would remind committee members that the CRA is an arm's-length agency for a reason. [Technical difficulty—Editor] to be dictating this type of decision.

I do not believe that DTC regulations mention any specific disease or condition. My understanding of DTC is that it is meant to help people with a disability that impairs their ability to work or takes a lot of time to manage, like significant physiotherapy. Not all individuals with diabetes meet this threshold.

Regardless of whether an individual is eligible for the DTC, tax relief for medical expenses, such as the cost of insulin, insulin pumps and other supplies, may be available through the medical expense tax credit, with additional support for low-income working Canadians provided through the refundable medical expense supplement.

Diabetes can be expensive for some people to manage. I know that personally. As providers of health care, it should be the provinces that help to fill that gap. That is why government will need to work closely with the provinces and territories to ensure there is clarity about what each level of government is responsible for and that they are putting resources into the right program.

I once again thank Mr. d'Entremont for his input and feedback.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Sidhu.

Mr. d'Entremont.

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

I appreciate what Ms. Sidhu had to say; however, when it comes to the disability itself, I think there are a number of occasions where a person with diabetes has to take time off from work to attend doctor's appointments and treatments. If they get sick, they have to take time off from work.

There is a tremendous cost to diabetes beyond just the purchase of insulin or tests or those kinds of things. It's simply a friendly amendment to acknowledge that diabetes is a disease that requires a fair amount of time for the sufferer to be able to go forward.

The other challenge that we have is a problem that JDRF identified back in 2017. There are still challenges for people trying to get the DTC. This is a diabetes-specific issue, and I hope that we can all support this as it goes forward.

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. d'Entremont.

Ms. Rempel Garner, please.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Chair, I want to speak in favour of the amendment. I think it's common sense. Certainly everyone in this meeting today would have had constituents call in with casework on this issue. It shows a good commitment to move forward on the issue. Certainly, a colleague of mine, Julia Parsons, has made me very aware of this issue.

I thank you, Mr. d'Entremont, and I certainly will be supporting your amendment.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Rempel Garner.

I see no other speakers so we will carry on with the vote on the amendment.

Mr. Clerk, would you please conduct the vote?

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

Mr. Chair, could you please read the amendment back to me, for clarity?

[The Chair, Liberal, Ron McKinnon]

I'll ask Mr. d'Entremont to do so.