Health Committee on May 27th, 2024

[The Vice-Chair, Conservative, Stephen Ellis]

Go ahead, Mr. Julian.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Thank you, Mr. Chair.

I'll be voting against this amendment. It is actually in contradiction to the other CPC amendments, which are intended to create that patchwork of care. I think the language that is in the bill is very clear, and we should hold to that.

I'll be voting no on CPC-11.

[The Vice-Chair, Conservative, Stephen Ellis]

Thank you very much, Mr. Julian.

Mr. Naqvi, you have the floor.

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

Thank you, Mr. Chair.

We will be also voting against this motion, because I think the language is fairly clear in the bill when it talks about consistency in Canada. To me, what is meant is very clear from a statutory drafting perspective. Adding anything more to it, as is being suggested, is redundant and doesn't add any more clarity whatsoever.

The way we see the wording is appropriate. Therefore, there's no need for this amendment.

Thank you.

[The Vice-Chair, Conservative, Stephen Ellis]

Thank you very much, Mr. Naqvi.

Mrs. Goodridge is next.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you, Mr. Chair.

I actually think it is important to have this in order to avoid a patchwork of care. This is part of the problem that has been identified, as we heard in witness testimony. It's a space where I appreciate they want clarity. It's a four-page pamphlet. It's not a pharmacare bill, as we've pointed out and will probably continue pointing out, time and time again.

I think it is incumbent upon us to show Canadians that the intent is to avoid a patchwork of care. However, if both the Liberals and NDP have already decided they are comfortable having a patchwork of care, I guess they can vote against this amendment.

[The Vice-Chair, Conservative, Stephen Ellis]

Thank you very much, Mrs. Goodridge.

Mr. Julian, you have the floor.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Thank you, Mr. Chair.

Just to be very clear on this, there seems to be a contradiction between the Conservatives saying that this is a pamphlet but also admitting that this is going to have a real impact on people's lives in a positive way.

I note that contradiction. People who are watching this committee see that contradiction. The reality is that passing this bill is going to make a difference in the lives of millions of people, and the language that is already in the bill is very clear in having consistent coverage across Canada, including the previous amendments that we have rejected. It is to keep the bill actually doing the effective work that the bill will do once it's passed by Parliament and the Senate, hopefully, and then, moving from there, to the minister having negotiations with the provinces and territories.

For those reasons, I will vote no.

[The Vice-Chair, Conservative, Stephen Ellis]

Thank you very much, Mr. Julian.

Go ahead, Mr. Doherty.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Let's be very clear: The reason our colleague from the NDP is voting no is because he's been told by his coalition that this is the way they want it. This is the way that he is to vote with respect to any CPC amendment. It's the same old, same old that we hear time and again when it comes to legislation that we've been told time and again in the House...

The government tells you, “Just let it get to committee, and we'll work in good faith. Amendments will be taken in, and we'll work with great collaboration with all parties to get this bill right.” Look where we are today with a piece of legislation that really isn't... It's being called pharmacare. It really isn't pharmacare.

This is the line that we're talking about, so that Canadians are fully aware of what we're talking about here. It is page 3, subclause 4(a), and the last sentence reads “in a manner that is more consistent across Canada.” What is being proposed is “that is more consistent across Canada, in order to avoid a patchwork of care”.

The whole argument that we hear from our colleagues down the way is that there are millions of Canadians who do not have... There are some who do have care. They have programs and access to medications. There are some Canadians who don't. For me, that would be a patchwork of care that we're experiencing and that Canadians are experiencing. If you want to believe what our colleagues are saying, the government is trying... Bill C-64 is all about making sure we're eliminating the patchwork of care. Why not put that in the bill? It's no different from what we said earlier on.

We talk about the heart medication. We have cardiac patients and constituents who have cardiac issues. Our colleague from the NDP has brought up a number of times that his constituent faces $1,000 per month because of the patchwork of care that we have in our country, yet he still didn't negotiate, when he was sitting at the table with his coalition partners, to have cardiac medication in here.

There is another rare disease that was not mentioned here. I don't believe it was mentioned in any of the testimony either. It's ALS, and thousands of Canadians are afflicted with this horrible disease. I remember one of my constituents who was struck down at the age of 28. He was a soldier with our Canadian Armed Forces. “The best of the best”, his commanding officer said. At the age of 28, with his future right in his hands, Deane Gorsline was struck down with ALS. He lived the remainder of his life much like my former employee, Brett Wilson, who passed away last August, nine months after his dad Rick passed away from ALS as well.

After their diagnosis, both Rick Wilson and Deane Gorsline lived the remainder of their days fighting for Canadians who were struck with ALS. They were better people than I am. They turned their attention to ensuring that the next Canadians who would be diagnosed with ALS had access to those drugs that could prolong their lives, in the hope that they could walk back the impacts of that terrible disease.

We don't have a rare disease strategy in this country. When we talk about this national pharmacare plan, that's what our colleagues suggest Bill C-64is, and it does none of this. It doesn't provide greater access for those Canadians who are struggling with rare diseases such as ALS.

I think about that when we're talking about this bill. Due to the size of our country, and in some cases the comparatively small population of Canadians who are afflicted with certain diseases, Canadians struggle to have access. Pharmaceutical companies will not look at Canada in a favourable way to provide access for the small groups of Canadians who are afflicted with such illnesses as ALS. They are forced to lobby and forced to do whatever they can, even though their days are limited before this terrible disease takes over.

It is absolutely horrific to see and watch. I think about cancer patients within our country for whom this bill does nothing in terms of access to more medications and treatments. If it was a true pharmacare bill, we should have noted that. Maybe it would have been brought up. It's disappointing. This CPC-11 is a non-partisan amendment that simply clarifies, or adds to the line, and again, I'll read it out. After “in a manner that is more consistent across Canada”, it simply adds, “in order to avoid a patchwork of care”, which is exactly what we're talking about.

Mr. Julian's got his hand up, so he'll continue his NDP filibuster in the next little bit here, and he'll go on and on about how Conservatives are ragging the puck and filibustering this bill, but at every chance, he's on that speakers list, Mr. Chair, speaking as much as Conservatives members.

With that, Mr. Chair, I will cede the floor so that we can get to the vote on CPC-11, unless Mr. Julian wants to continue his filibuster.

[The Chair, Liberal, Sean Casey]

Go ahead, Mr. Julian, please.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Okay.

[The Chair, Liberal, Sean Casey]

You have the floor, Mr. Julian.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Yes. I'm going to time myself, because Conservatives are spreading a lot of disinformation. They talk for 15 minutes and somebody else talks for 20 seconds and then they say it's the other parties that are doing the filibuster. We all know who is blocking the bill and why three and a half hours have passed at the cost of thousands of dollars and with votes on only two amendments.

I just wanted to flag one thing, Mr. Chair, and that is Bill C-213. If Mr. Doherty was right that they want something comprehensive, that they don't want to have a patchwork but want a comprehensive pharmacare plan, on my bill, Bill C-213, three years ago and about three months ago, every Conservative except for Ben Lobb—and I think Ben Lobb actually listened to his constituents—voted against that. I find the pretensions about a patchwork of care a little rich, given the Conservative track record.

It took me 59 seconds to intervene, Mr. Chair.

[The Chair, Liberal, Sean Casey]

Are there any interventions with respect to CPC-11?

If not, are we ready for the question?

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

I'll request a recorded division, please.

[The Chair, Liberal, Sean Casey]

We'll have a recorded division on CPC-11, please.

(Amendment negatived: nays 7; yeas 4)

That brings us to CPC-12, in the name of Dr. Ellis.

Would you like to move CPC-12, Dr. Ellis?

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Chair, nothing would give me greater pleasure.

Amendment CPC-12.... Sorry, my notes are a bit mixed up since I was sitting in the chair in your absence.

[An hon. member]

He is a physician and he can't read his own handwriting.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

I probably need to put my glasses on, which I don't want to do.

This amendment speaks about “respecting the autonomy of Canada's highly trained health care practitioners”. This is exactly what I had talked about previously. I find it unusual that this subclause exists in the first place.

Perhaps we'll start off by asking the experts why this is part of the bill's original form:

...the appropriate use of pharmaceutical products—namely, in a manner that prioritizes patient safety, optimizes health outcomes and reinforces health system sustainability—in order to improve the physical and mental health and well-being of Canadians...

CPC-12 would add “while respecting the autonomy of Canada’s highly trained health care practitioners”, and it goes on.

Why do we need this particular paragraph—“support the appropriate use of pharmaceutical products”—in there anyway? When you think about it, it would suggest that at the current time, there is significant inappropriate use of pharmaceutical products.

I could make a bunch of assumptions that you are therefore against so-called safe supply, which, in my mind, would be an inappropriate use of pharmaceutical products. Then “namely, in a manner that prioritizes patient safety” would lead me to believe that this NDP-Liberal costly coalition doesn't believe that Canada's highly trained health care practitioners are practising with the safety of Canadians in mind or with the objectives of optimizing health outcomes or being good stewards of the health system—which, sadly, in the words of one former president of the Canadian Medical Association, Katharine Smart, is on the brink of collapse.

Maybe I'll start with Ms. Boudreau or Mr. MacDonald. I'm not entirely sure what the conversations were with respect to the need to insert this paragraph. I just need to reiterate that it talks about prioritizing “patient safety”, optimizing “health outcomes” and reinforcing “health system sustainability”.

Is this bill, in this particular paragraph, suggesting that this is not the case at the current time?

[Michelle Boudreau]

I'm sorry for the pause. I'm just trying to find the exact spot.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

I can provide that for you, if you'd like. It's on page 3. The paragraph I'm referencing is under “Principles”, in proposed paragraph 4(c). The amendment would add a different line 29. Is that helpful?

[Michelle Boudreau]

Yes, thank you.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Great.

[Michelle Boudreau]

You're quite right to point out, as you just did, that it is one of the principles the minister would be required to consider when moving forward on national universal pharmacare.

With regard to the others—proposed paragraphs (a), (b), (c) and (d)—and then speaking specifically about appropriate use, one of the reasons that this wording is there is that there are numerous studies to show that in fact there are issues with improper prescribing or over-prescribing, and you're probably aware of a lot of efforts around de-prescribing, in particular with older patients.

The idea behind the mention of “appropriate use” is to ensure the safety of patients. When the right drug is given to the right patient at the right time, it can also bring some savings, both for the system and for the patient.

The other thing I'll note is that the reference is also made in the context of the work that would be done by the CDA. A similar reference is made in proposed section 7 of the legislation, and then, of course, there's the work that would be done by the CDA to produce the appropriate use strategy.

Finally, just to close, I mentioned earlier that in working toward the CDA, there was the CDA transition office, and as part of that, there has been a fair bit of work done already in the context of appropriate use strategy, and there will be a publication of that recommendation from that expert committee very shortly.

Thank you.