Health Committee on Nov. 23rd, 2020

[Luc Thériault, Bloc, Montcalm, QC]

I want to move a motion that concerns the Standing Orders. I sent out the motion in English and French. Everyone received the notice of motion regarding the vote.

[The Chair, Liberal, Ron McKinnon]

Monsieur Thériault, when you get the floor, you certainly are entitled to move that motion, but I'm hopeful that we can get some motions, some decisions, made on some of these meetings before we get ourselves occupied with motions. Would that be acceptable to you?

[Luc Thériault, Bloc, Montcalm, QC]

No, I disagree.

I have a point of order. I want to move my motion in accordance with the practices governing the proceedings of Parliament. I raised my hand to speak earlier. I think that I was the first to do so.

[The Chair, Liberal, Ron McKinnon]

You are certainly first on the list. Go ahead.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Chair, I have a point of order. We're going to have to get control of how people get recognized.

With great respect to my colleague Mr. Thériault, he just seized the floor by interrupting you and starting to move a motion. You didn't recognize him. You were in the middle of speaking. It is not going to work if the ability to speak is determined by whoever hits their microphone and starts talking.

You were talking about the subject under discussion, which is the future business of this committee. Now, if Mr. Thériault has a point of order, then he can interrupt you and you can recognize him and he can state his point of order, but he can't interrupt you and seize the floor to move a motion. That has to be when you recognize people.

If Mr. Thériault is next, that's fine. When you are ready to recognize speakers, you may recognize him, but I think it's important.... I'm not picking on Mr. Thériault on this point. I think we've all maybe been guilty of this, but we're going to have to respect a fair process: We only interrupt and hit our microphones when we have a point of order. Otherwise, I think we have to respect your role as chair and wait for you to recognize people, or I don't see how we're going to have an orderly set of meetings.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Davies, I certainly appreciate your intervention. I agree with it.

I'm giving the floor to Mr. Thériault at this point because certainly he made a valid point. It would have been better to wait until I was finished doing the set-up, but we're not going to be able to move forward as long as this question about voting order is outstanding. I do appreciate your intervention, Mr. Davies.

Mr. Thériault, please go ahead.

[Luc Thériault, Bloc, Montcalm, QC]

I also want to thank Mr. Davies for his comments, Mr. Chair. I thought that you had finished and that you wanted to move forward with the analysis and discussion regarding the proceedings. If I interrupted you, I apologize.

I want to move the following motion: That, in accordance with the practices governing parliamentary committee proceedings, recorded divisions be conducted in alphabetical order of committee members and by party affiliation in the following order: Liberal Party, Conservative Party, Bloc Québécois and New Democratic Party.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Thériault.

Is there any discussion on this motion?

I see that Mr. Davies and Mr. Van Bynen have their hands up. Is that on this motion?

If you wouldn't mind, Mr. Davies, I will give you first up after we deal with this, followed by Mr. Van Bynen.

Is there anyone else who wishes to speak to this motion?

Monsieur d'Entremont, go ahead, please.

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

Thank you very much, Mr. Chair.

I think this is a reasonable request, because I think what happens is that as we go into any one of our votes or discussions, Mr. Thériault has to go first, not knowing, maybe, where government is going or fully what the decision is, or, even worse, his translation isn't complete before he has to make a decision on whether or not to support something. I think this is reasonable in that it is the practice of other committees that I have participated in at this point and of course in the House of Commons. I think this is a reasonable move forward that is being presented by Mr. Thériault.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. d'Entremont.

We have Mr. Fisher next, please.

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

Thank you, Mr. Chair.

In response to what Mr. d'Entremont said, “not knowing maybe where government is going”, the way I read this, and with all due respect to Mr. Thériault and Mr. d'Entremont's comments, it was the purview of the chair to determine how to move forward with votes.

I'm content to let you make that decision, but as far as knowing which way the government goes, I don't see this as a huge problem. I want to make sure that we fully recognize the importance of bilingualism. If there's any way to do that to the fairness of the entire committee, we have to make sure that everything is done just perfectly to recognize the importance of bilingualism by this committee.

I will listen to the debate on this issue, but I don't know whether I agree with Mr. d'Entremont that someone should be able to see the direction of the government during the voting process. I will leave that to the rest of the debate.

[The Chair, Liberal, Ron McKinnon]

Mr. Maguire, please go ahead.

[Larry Maguire, Conservative, Brandon—Souris, MB]

On a point of order, Mr. Chair, Mr. Thériault tabled his motion. I don't think we have called for debate on it yet. He just wants to table it. I could be wrong, but I will leave it at that.

[The Chair, Liberal, Ron McKinnon]

He gave notice of motion last week, so he is able to move it. Maybe I'm mistaken, but I thought he did move it.

Mr. Thériault, you moved this motion, did you not?

[Luc Thériault, Bloc, Montcalm, QC]

Yes.

[The Chair, Liberal, Ron McKinnon]

Then we are engaged in the debate on this motion. Thank you for your intervention. Did you have more to say on this, Mr. Maguire?

[Larry Maguire, Conservative, Brandon—Souris, MB]

I think it's very reasonable. All of the votes in the House start in the way that Mr. Thériault has presented his motion. It's normal, so I would support him on it.

[The Chair, Liberal, Ron McKinnon]

Is there any other debate on this motion?

(Motion agreed to: yeas 6; nays 5 [See Minutes of Proceedings])

Very well. Thank you, Mr. Thériault. Congratulations. We will mend our ways and carry on as you describe.

Let us go back to the matter of the PMPRB.

Mr. Thériault, please go ahead.

[Luc Thériault, Bloc, Montcalm, QC]

Regarding the proceedings, we've received a significant number of briefs since Thursday. We had until Wednesday to send in our lists and the topics—

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Chair, I have a point of order.

I'm sorry to interrupt again, but Mr. Thériault was first in line, and he used his place in the order to move his motion. I was next in line, as you already confirmed, and you confirmed that by stating you would come to me next when we returned to the order of business, which is determining our PMPRB order of business.

Again, with respect to Mr. Thériault—it's not his fault—I believe that I am next on the speaking list. You can't go back to the same person twice in a row. He can't be first twice.

[Luc Thériault, Bloc, Montcalm, QC]

Sorry, Mr. Chair, but I think that there's some confusion.

I raised my hand. I told you in my first comment earlier that I did so to speak about the proceedings. I thought that you had finished, so I did what I was supposed to do. I turned on my microphone and raised a point of order, but at the wrong time. However, I did raise my hand earlier.

[The Chair, Liberal, Ron McKinnon]

Thank you, Monsieur Thériault.

I believe that Mr. Davies is correct. I've kind of lost track of the hand raises on the participant panel. We have to figure out a better way of doing this. I believe that with your hand raise that was there, you dealt with your motion, so as I formerly agreed—and I apologize—I'll give Mr. Davies the floor.

Monsieur Thériault, if you wish to carry on with this point, you can raise your hand again. Thank you.

Go ahead, Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair, and thank you, Mr. Thériault.

I'm very pleased the committee is finally getting to work on business. I think all of us are feeling some sense of relief and satisfaction that we are getting witnesses before our committee to do the work that we are supposed to do. I think I speak for all of us, and certainly for myself, when I say that it feels good to be doing that. Really, we need to continue the good work we did last meeting, making progress in working together to determine an orderly calendar of business in front of us.

As you pointed out very helpfully, Mr. Chair, we basically have four meeting after this week. This meeting and I think Friday are essentially allocated. We really have four meetings before the seasonal break in December. I think we can even look beyond that. I would suggest that with those four meetings, we allocate at least the first three to the COVID study. In the fourth meeting we can come back to the PMPRB study and pick that up. I say that for the following reasons.

We haven't heard from a single witness on COVID this fall. I think Canadians would be very surprised to know, given that we're in the middle of a raging crisis across this country, that their health committee at the national level is not meeting and discussing what is clearly the number one health priority facing Canadians. People are dying every day.

Two, this isn't just any old motion. This motion came from the House of Commons. We were directed, by a majority vote in the House, to study this matter.

Three, we have submitted our topics. We had all submitted our priority topics by Wednesday of last week. We have topics ready to go. I think that gives the analysts a chance for us to submit witnesses and then schedule those witnesses starting next week and the week after.

I would point out that given our start on the PMPRB study today—we've had half a meeting today and we have another half-meeting on Friday—by the end of this week we will have had the equivalent of one meeting on PMPRB. I don't want to read Mr. Thériault's mind, but he started to say something important, I think, which is that we have received a number of submissions on PMPRB. I have just started to wade through them. That's why I would like a chance to actually read those submissions and digest them to help me focus my questioning on PMPRB. If we proceed with COVID next week and have the first two meetings on COVID and then maybe the following meeting on Monday on COVID, that leaves us with our final meeting on Friday. It gives us two weeks to do justice to those submissions and determine who the witnesses will be and how we want to home in on that topic.

We also just heard from Mr. Clark and Mr. Levine on the PMPRB study. I think we're all getting a sense of where the essence of the dispute is, but there is no question that there has been extensive consultation. Patient groups want their voices heard, and I think that's important. Patient groups and patients have to have their voices heard at this committee, but it's not correct to say that they have not been consulted or that they have not had an opportunity to make their views known to the government. This is a process that's been going on since 2015. It was either Mr. Levine or Mr. Clark who detailed the process that has happened so far, with the plan in 2015, and then a discussion paper, and then a white paper, and then consultations over the last year, and then more consultations since the guidelines have been published.

That's not to minimize the importance of having those voices heard. It's meant to help put it into perspective that this is not a situation of groups who want to comment on PMPRB not having an opportunity to do that. They have. That's just a fact.

What people have not had a chance to do is to comment on the second wave of COVID that is ravaging our country right now. I think we as the health committee need to follow the directions of the House and get to work on the first topic that has been provided by the Liberal Party. We'll have to determine how many meetings we want to allocate to that.

My final point is that there is no emergency on PMPRB. These changes are going to come into force in January, but nothing our committee is going to do is intended to stop them from coming into force. That is not the purpose of our committee. We are not rushing to do a quick study of PMPRB so that we can stop the implementation of the PMPRB changes slated for January. Instead we need to have a considered, thoughtful approach to understand these changes and to understand how they're going to operate, because I think we're going to have to follow them closely for the next several years to determine how they are acting and to ensure that they don't have the unintended consequences, which many people fear, of restricting access to life-saving drugs. None of us wants that to be the case. We want to make sure all patients get access to the drugs they want. That's what I'm going to suggest.

I'm also going to suggest that we have until Wednesday, and I will put that in the form of a motion if necessary. I think today we should allow the Liberals to name the topic they want to study. Then by Wednesday we can submit our witnesses. The House has already told us that there will be equal witnesses, so each party has to come up with one witness for next Monday, one witness for the following Friday and one witness for the Monday after that. That gives the analysts some time to start scheduling these witnesses.

I want to stop and say for a moment that we have not been fair to our analysts. We all know, sitting on committees, that it's difficult for the analysts to contact these witnesses and get them arranged and scheduled. We need to give them acceptable lead time to do this. By choosing the next four meetings after next week, we give the analysts the ability to move these witnesses around. Some might not be able to come on the Monday—maybe it's the Friday—and this gives the analysts some flexibility with the witnesses over those three meetings to make sure we can get the witnesses the parties want, if not necessarily on the day in question.

I think that's another really functional reason why we need to deal with that. Also, it will give us a change. Therefore. I would say by Wednesday or maybe by Friday, we should submit the names of the witnesses we want for the PMPRB study when we pick it up two Fridays from this Friday.

My final point will be this, and if need be, I will put it into a motion as well. I think it's very important that all witnesses who appear before this committee on the PMPRB study declare any potential conflicts of interest. I'm going to ask the analysts to provide a standard document that is very commonplace in the medical and scientific profession.

Often we have heard doctors and other people—researchers—who appear before our committee make a brief 10-second statement at the beginning of their testimony to declare whether they have any conflicts or potential conflicts, including whether they're receiving money from any particular group. That may be important for us in weighing their testimony.

We know that the pharmaceutical industry is very strongly against the PMPRB changes, and we know—we just heard testimony, and it stands to reason—that one of their main concerns is about the economic impact the changes are going to have on them. We also know that many groups in this country receive funding, sometimes not transparently, from the pharmaceutical industry. I think we need to consider that as we are weighing testimony.

It doesn't necessarily mean that the opinions of anybody receiving money aren't as valid, but knowing about that will help us to objectively weigh the evidence we're going to hear. In fact, I would probably argue that a basic conflict screen should be a standard affair for every witness who appears before our committee on any subject. It would probably be a good practice, and I'm happy to do that. I don't want to single out this study or this particular.... We do know that this is absolutely a real issue with respect to the PMPRB changes.

If you want, here is the motion.

I move that we have three meetings starting next Monday, the first three on our COVID study and the fourth on PMPRB. We will proceed with the first order of business as determined by the Liberal Party. We will then determine how many meetings we will allocate to that first topic proposed by the Liberal Party. We will submit our witnesses for the COVID study by the close of business this Wednesday and we will submit our witnesses for the PMPRB study. Again, it will be one per party for the PMPRB study meeting two weeks from this Friday. Finally, all witnesses who appear before this committee on the PMPRB study will declare any potential conflicts of interest and fill out a standard document as may be provided by the analyst to them.

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you for your intervention. It's very comprehensive, absolutely. I think it's very helpful.

Really, what I want to achieve today is to know who our witnesses are going to be for Monday, certainly, and Friday. If we can go beyond that, awesome.

You have a motion on the floor. The debate now is on that motion.

Mr. Thériault, if you've spoken already and your hand is still up from before, please take it down. If you wish to speak again on this motion, I think we have—

[Luc Thériault, Bloc, Montcalm, QC]

I have a point of order, Mr. Chair.

I was a good sport earlier. I accepted the fact that you interpreted things that way. That said, I don't think that all issues regarding the Standing Orders require us to raise our hands. I raised my hand before everyone else because I wanted to exercise my right to speak about the organization of the proceedings. I was a good sport about letting Mr. Davies speak. Concerning the organization of the proceedings, you asked me to put my hand down if I didn't want to say anything about the comment. However, I left my hand up because I wanted to speak without being last to do so.

I urge you to reconsider your interpretation. I've been a good sport, but I won't be taken advantage of. I had my right to speak from the start. However, to ensure cohesion within the group, I gave it to Mr. Davies. His statements show that he has already decided that there won't by any meeting on the PMPRB and that this won't be an issue at all. This isn't how I see things, Mr. Chair. I urge you to consider this now.