Health Committee on Oct. 26th, 2020

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Davies.

We go now to Mr. Fisher.

Mr. Fisher, go ahead.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Thank you, Mr. Chair.

I'm not sure whether Mr. Davies was moving an amendment or just making a suggestion on how we might proceed, assuming that we have support for this. I'm happy to support Mr. Thériault in this. I understand the points that Don made, and some of them certainly will be impacted by the outcome of today's vote.

Mr. Thériault's motion talks about the regulations from June, and I wonder whether Mr. Thériault wants to look at the regulations in the new guidelines that were released on Friday, as some of them have changed. Two of them have changed.

Do you want to go back to June? Do you want to stick with the ones that were released in June and not the new ones that were released on October 23?

Mr. Chair, is it okay if I ask that question of Mr. Thériault?

[The Chair, Liberal, Ron McKinnon]

I believe you can ask him on a point of information and keep your speaking order.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Okay.

[The Chair, Liberal, Ron McKinnon]

Monsieur Thériault, did you wish to respond to Mr. Fisher's point of information?

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Chair, when I read the motion earlier, where the old version said June 15, I said “issued on October 23, 2020”. That's what I moved this morning. I didn't say June 15. I said October 23, 2020.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Thank you very much for that, Mr. Thériault. I appreciate that. When you read the motion, I was listening through the French to the English translation and I didn't catch that. Thank you for this.

I am happy to support this. Don said that he had gone over the new changes quite closely. I was also on that great Zoom meeting on Friday, as he said, with probably 20 or 30 parliamentarians, but I haven't had a chance yet to dig through the details of the changes that were made—just the few major changes that Don and Elizabeth May and I talked about on Friday.

I will support this motion. I want to thank Mr. Thériault for bringing it forward. What he is asking here is something that is not only important, but also framed in a way such that we are seeking the information we want to get.

I'm glad to see that, although I'm very disappointed that once again we didn't get a chance to talk about Mr. Van Bynen's very important motion on mental health as it pertains to COVID-19. I'm an eternal optimist, and I do hope that we will make sure, as Mr. Maguire said, that we give a high level of discussion on that topic in this committee in the future.

Mr. Thériault, I am happy to support this. Thank you, my friend.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Fisher.

We will go now to Dr. Powlowski, please.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Thank you very much, Mr. Chair.

I certainly support this motion. I welcome a return to discussions regarding health care rather than politics. There has been a lot of talk lately about our filibustering. I just want to point out that in the last few meetings [Technical difficulty—Editor]. I'm someone who naturally likes to talk a lot and very slowly. You can ask my wife about that.

Let's get back to talking about health. I do like this subject. It's a very interesting one. Apparently, in Canada we have some of the highest prices for patented drugs among all developing countries, but the issue of patent protection for medications, especially essential medications, is a very complex issue.

I heard a number a few years ago that in order to recoup the cost of developing a drug, I was told that pharmaceutical companies have to be able to sell about a billion dollar's worth of a medication. That's not just for that one medication. For every medication they come up with that they can market, there's a whole bunch of other medications that don't get that far, so it's really important to allow pharmaceutical companies to charge an adequate amount for their products. Otherwise there's no incentive to carry on research, and we have seen that, for example, with Trikafta. It's a medication that can substantially help a lot of people.

We certainly want to ensure that the incentive for pharmaceutical companies to carry out research remains, and that means allowing them to charge adequate prices for medications. However, it's also important to allow people both in Canada and globally to access essential medications.

This battle between two opposing concerns—allowing pharmaceutical companies to make adequate money to compensate for the development of drugs versus allowing people to access affordable medications—played out a number of years ago in Africa in relation to access to antiretrovirals for the treatment of HIV/AIDS.

I don't know if you remember, but back then antiretrovirals were exceedingly expensive. Africa was being devastated by the HIV pandemic. This issue came before the World Trade Organization at that time, and the WTO reaffirmed what's called the TRIPS flexibility. TRIPS is trade-related aspects of intellectual property, whose flexibilities allow poor countries to access medications that are still under patent and to make those medications affordable when a country needs to for the sake of the public health of its citizens.

This battle has been played out. There are certainly competing interests. I think with respect to the actual changes to the Patented Medicine Prices Review Board, we see a lot of these same sorts of considerations taking place. I do agree that it is something worth studying. It's a complex issue, and I welcome spending some time doing it. I think the suggestion already made as to how we do it concurrently with continuing studies of COVID is something that is certainly desirable.

Since I have the floor, Mr. Chair, I would ask whether now would be the time to propose a new motion or when I can propose a new motion.

[The Chair, Liberal, Ron McKinnon]

The motion would not be in order at this time since we are engaged in debate on Mr. Thériault's motion, but I can put you on the list once we dispose of this motion.

Are you done?

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Yes, I'm done.

[The Chair, Liberal, Ron McKinnon]

Thank you.

Ms. Rempel Garner, please.

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

Thank you, Chair.

I was just wondering if, similar to what happened before, I could ask Mr. Thériault a point of clarification related to some of the suggestions that have come up from both Mr. Fisher and Mr. Davies. Specifically, I was wondering if Mr. Thériault would be amenable to allowing....

The process for this motion to roll out is that the committee would request written briefs to be submitted by November 6 or somewhere thereabouts. Then we would schedule witnesses based on the written briefs.

This is just from the reality of potentially running two studies at once and realizing that opposition members have, like, two or three staff. You government members get a lot more than that.

It's more a way of facilitating our work. That's what we were kind of hoping he would be amenable to do. I think it's what Mr. Davies had asked for clarification on.

I was just hoping he could speak to that.

[The Chair, Liberal, Ron McKinnon]

I will ask Mr. Thériault if he wishes to speak to that.

I would point out that if this motion passes, we can decide on how to proceed accordingly. We will have more committee resources available to us after this week.

Mr. Thériault, did you wish to respond to Ms. Rempel Garner?

[Luc Thériault, Bloc, Montcalm, QC]

Yes, Mr. Chair.

The important thing for me is to adopt the motion today. In terms of how we proceed, I'm open to ideas.

In any case, the various interest groups are already prepared, since they've already submitted briefs. The important thing today is to give people the opportunity to speak. I should point out that the consultations were conducted in writing and in a very closed manner. Some people want to speak, and I think that we must hear from them as soon as possible.

Of course, I'd like us to hear from all the people who want to meet with us. There aren't that many people. They're all part of groups, such as patient associations, industry groups, or research and life sciences groups. There are also economists who are a little more neutral. These economists are currently having a very difficult time measuring the real impact of these guidelines, not only on the introductory ceiling price of drugs, but also on patients' access to innovative therapies over the coming years, particularly in immunology and oncology. Trikafta is a good example of this.

In short, I want us to move forward. We'll be able to hold discussions and make adjustments as we discover things. I gather today that everyone has agreed to move forward. Based on what I'm hearing from both sides, I'm confident that we'll work well together on this study. I'm very optimistic.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Thériault.

That was on a point of clarification from Ms. Rempel Garner.

Ms. Rempel Garner, you still have the floor.

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

Great.

Well, in a positive way for the health committee, I think we have some consensus on how we can move forward, and I want to thank Mr. Thériault for that. I'm also sensing some desire to put some clarification around the timeline for both stakeholders and committee members to be able to plan work schedules, especially in light of the COVID-19 study.

What I would like to do, and I will look to Mr. Thériault for whether he wants to support this...but I think there's a desire to amend the motion to clarify the written brief submission.

The amendment I would move would come after the words, “if the committee deems it necessary”, and would read:

that the committee issue a request for written briefs and for requests to appear by the end of the week with a submission deadline of November 6, 2020.

Here are my thoughts on this for Mr. Thériault. First of all, my understanding is that at this point in time, today's meeting is the only currently scheduled for the health committee this week. Then we'll have meetings next week should the motion on COVID pass in the House. I'm assuming that one of those meetings, at the very least, would be an organizational meeting to get ready for the House of Commons direction on COVID.

I don't want two weeks wasted, such that we wouldn't be scheduling witnesses for Mr. Thériault's study until the end of November. This amendment would be a very clear signal to the stakeholder community to augment this. What we would be saying is, please submit written briefs for consideration by the end of next week so that there's movement on the study, and the clerk can start considering this information. Then we would start scheduling witnesses once we have some clarity from the House on when additional resources could be provided.

Here's the other thing that I'm thinking about, Mr. Thériault. The week following November 6 is a recess week for the House. I'm assuming there's not as much of a drain on resources that week. As we're doing a concurrent study, it would allow us to schedule witnesses that week and plan out work.

I'm hoping that Mr. Thériault would be amenable to that.

The reason I'm moving it now is that I'm not sure when we're going to have another meeting to discuss the work plan. I would hate to see his motion not get scheduled until the end of November. It's more of a help for him. If we give direction on this today, we can start asking stakeholders for briefs and start the work right away, and then our stakeholder community would be happy with us.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Rempel Garner.

Are you moving an amendment?

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

Yes, I moved it.

[The Chair, Liberal, Ron McKinnon]

Okay.

The debate at this point is on Ms. Rempel Garner's amendment.

Next on my list, I have Monsieur Thériault.

Monsieur Thériault, please go ahead. You are speaking on the amendment.

[Luc Thériault, Bloc, Montcalm, QC]

We can look at the text later. However, I gather that people would first be asked to submit briefs and show their desire to appear. This is the clarification that we want to add. That way, we wouldn't need a subcommittee and we could proceed immediately. This is exactly what I expect, meaning that we would move forward. So I fully agree. I'm even prepared to put this in the motion to speed things up.

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

On a point of clarification, Mr. Chair, if you'll just beg the indulgence—

[The Chair, Liberal, Ron McKinnon]

Yes, go ahead.

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

That was exactly the intent of the amendment. Of course, we're going to have witnesses, but this would allow the committee to start work concurrently without having to wait for a meeting to be scheduled to deal with scheduling at a date unknown.

[The Chair, Liberal, Ron McKinnon]

Thank you for your clarification, Ms. Rempel Garner.