Debates of Sept. 18th, 1995

Questions On The Order Paper

[Diane Marleau, Liberal, Minister of Health]

The following information is based on current information on the relevant tick vectors in Canada. The most significant of these ticks from a human health perspective are Ixodes scapularis and Ixodes pacificus . Although I. scapularis have been identified in different regions of Canada, the only place in Canada where this tick species has been shown to be endemic at present is Long Point in southern Ontario which is an identified Lyme disease endemic area. Similarly, the important tick vector I. pacificus is endemic in parts of British Columbia and these have been identified as Lyme endemic

areas. If reports of the Lyme disease bacterium in other ticks species can be substantiated these endemic areas will be expanded.

A disease is made nationally "notifiable" on the recommendation of the advisory committee on epidemiology, ACE. In 1988 a subcommittee of ACE recommended 12 criteria to determine the importance of a disease for making it nationally notifiable. On the basis of these criteria a number of diseases were scored high enough to be included in the list of nationally notifiable diseases; however, lyme disease was not included in this group. The methods, criteria and list of diseases were published in the Canada Communicable Disease Report in 1991, 20 April; vol 17-16.

The process used by ACE recognised that "notification" was not always the most appropriate method for studying the epidemiology of a particular disease and that other approaches such as the use of sentinel reporting sites or laboratory based reporting might provide more meaningful information in some circumstances.

For question (c):

Alberta-3 New Brunswick-9 Quebec-1 Ontario-210 Manitoba-17 Saskatchewan-1 British Columbia-14

The Canadian consensus conference of Lyme disease published in two venues-the Canada Communicable Disease Report and the Canadian Journal of Infectious Disease-initially provided guidelines. Updated information when available has been published in the Canada Communicable Disease Report.

The legal mechanism to ensure reporting of a specific disease is to make it "reportable" and the legal mechanisms for doing this reside at the provincial government level. For a disease to be nationally notifiable requires each jurisdiction to legislate separately for the disease to be "reportable" within that jurisdiction.

Information is made available to the public from health units in the known endemic provinces of British Columbia and Ontario. The Ontario fact sheet is currently being updated.

Question No. 212-

[Murray Calder, Liberal, Wellington—Grey—Dufferin—Simcoe, ON]

Concerning the Consensus conference on Lyme disease (1991), why has the statement not been updated with regard to ( a ) identification of endemic areas for Lyme disease in Canada, ( b ) identification of symptoms, and ( c ) methods of diagnosis by newer, more effective antibiotics?

[Diane Marleau, Liberal, Minister of Health]

The consensus statement is the joint summary of opinion of all participants and as such stands on its own. Consensus conferences do not often have further updates to them and there has been no update to the Lyme disease conference. However there has been some addition information published in the Canada Communicable Disease Report on the identification of British Columbia as an endemic area for Lyme disease in Canada.

In addition isolation of the Lyme disease bacterium from ticks collected near Thunder Bay, Ontario and Alberta has been reported in the Canada Communicable Disease Report and isolation of the Lyme disease bacterium from ticks in Prince Edward Island has been reported in an international journal as well as at an international borreliosis conference in Vancouver organized by the Vancouver, B.C. Lyme Borreliosis Society.

These latter reports do not provide evidence that Lyme disease is endemic in Alberta, Northern Ontario or Prince Edward Island since the currently recognized relevant tick vectors have not been shown to be endemic in these regions but they serve to show that there may be a low level of risk for humans to contract Lyme disease in these areas.

There has been no update on the topic of symptoms but the concensus conference statements are still basically applicable. As noted in the concensus conference statement, Lyme disease is an illness with dermatological, neurological, cardiac and/or rheumatological features. There may be localized manifestations of Lyme disease which relate to the erythema migrans rash, an expanding, erythematous skin lesion commonly seen at the site of the tick bite of many patients. In addition disseminated Lyme disease may include neurological forms of disease such as Bell's palsy, cardiac manifestations and arthritic involvement characterized by recurrent, brief attacks of large joint swelling in one or a few joints.

Recommendations for the treatment of Lyme disease do change with time but the basic recommendations for treatment involve the use of various beta-lactam-pencillin family-and tetracycline antibiotics. Treatment regimes will vary depending on factors such as the stage of Lyme disease, the age of the patient, and the specific clinical manifestations of the patient. The topics of methods of diagnosis and antibiotic treatment have been further addressed by the Canadian Paediatric Society which published a position paper in the Canadian Medical Association Journal Volume 147 pages 169-172, 1992.

Question No. 213-

[Murray Calder, Liberal, Wellington—Grey—Dufferin—Simcoe, ON]

How much money has the government of Canada spent on Lyme disease research since 1985 and what are the titles of the resulting studies?

[Diane Marleau, Liberal, Minister of Health]

Since 1985 Health Canada, through the national health research development program, NHRDP, has granted funding of $209,544 for one study on Lyme disease.

The study was done by Dr. Ian Barker of the University of Guelph, and was entitled "Factors Influencing the Distribution of Lyme Disease". The funding per year was as follows:

1989/90-$22,068 1990/91-$46,610 1991/92-$42,914 1992/93-$63,152 1993/94-$24,800 1994/95-$1,000 1995/96-$9,000

Question No. 217-

[Roger Simmons, Liberal, Burin—St. George's, NL]

What action will the government take in reference to the claim made by the Auditor General in his May 1995 report to Parliament that, with respect to the Drugs Directorate and Medical Devices Bureau, (a) "key issues identified in past studies still remain outstanding", and ( b ) ``many of the changes recommended-are still not fully implemented'', and what specific measures are being developed to deal with high risk products and devices?

[Diane Marleau, Liberal, Minister of Health]

Regarding drugs, there have been a number of studies over the last ten years with many recommendations and many of them contradictory. Consequently, two years ago the drugs directorate developed a major re-engineering initiative called drugs directorate renewal and has been pursuing an intensive process in which all aspects of its operations have been reviewed and streamlined within an environment of scarce resources. Over that period of time the directorate has consulted fully with all stakeholders. The drugs directorate has made many changes to its programs and policies with the aim of streamlining operations and fixing "known" problems. While the auditor's report recognizes the strengths of this renewal exercise, it does not adequately recognize the progress made in several areas.

The drugs directorate regulates a wide range of drugs, including radiopharmaceuticals, biologics and narcotics. These products represent different risks and the drugs directorate systems are designed according to these risks. Specifically in the area of high risk drugs, the drugs directorate has significantly improved its review performance without jeopardizing the well-being of Canadians. Approval times for submissions received and approved since January 1993, when a new policy was implemented, show substantial decreases in time taken.

The government was and is continuing to take action with respect to the key issues identified in past studies and on specific measures to deal with high risk medical devices.

As part of the review of federal regulatory program, the Minister of National Health and Welfare established in 1992 a medical devices review committee, known as the Hearn committee, to review the existing infrastructure and make recommendations on the regulation of medical devices in the future. The committee's report, "Direction for Change", was released in August 1992. The report identified the key issues as well as made recommendations with respect to regulation of medical devices. The minister accepted the committee's recommendations in principle. Subsequently the health protection branch, HPB, developed a strategic implementation plan entitled "Development Plan for Improved Medical Devices Program" which was endorsed by the Hearn committee in April 1993.

In accordance with the recommendations of the development plan, the following key issues have been addressed or are in process.

Regarding re-engineering of the medical devices program, a separate "medical devices bureau" was established in September 1993. To improve the level of service to its clients, the medical devices program was further consolidated by functionnally linking medical device staff in the five HPB regional offices to the bureau. Key management and staff positions have been filled within the bureau. An improvement in service has been achieved by developing and implementing internal standards operating procedures. The backlog of submissions awaiting review has been eliminated.

Regarding risk based approach to manage medical devices in the Canadian market place, with the help of an advisory committee comprising medical devices stakeholders, a risk based classification system, RBCS, for medical devices has been developed. The intent of the risk based classification system is to ensure that a device is given an appropriate level of scrutiny based on the risk it presents to its user.

A set of proposed regulations based on the risk based classification of devices has been developed and released to the program's clients for their input.

Regarding cost recovery initiative the cost recovery initiative received approval from the Treasury Board on May 18, 1995. The program will charge a range of fees commensurate with level of the services provided to the medical device industry. The proposed fee schedule has been published in Canada Gazette I, June 10, 1995.

Regarding improved communications with clients of the medical devices program, managers of the program now meet with representatives of medical device industry regularly to discuss matters of common interest.

Consultation sessions are being held with the program clients to obtain their input in developing new regulatory requirements and in implementing cost recovery.

In addition to the existing publications, information letters, medical devices alerts, dear doctor letters, it is your health, a newsletter entitled "medical devices bulletin" has been introduced to enhance external communications. The first issue was published in June 1995.

A medical devices bulletin board service has been established to provide program related information to medical device clients electronically.

A communication plan for the program is being developed with the help of a consultant.

A new computer system has been installed to operate the program's various databases. Program clients have access to these databases.

Regarding international harmonization the risk based classification system and proposed regulations were developed keeping international harmonization in mind.

Mutual Recognition agreements are under consideration. Canada is negotiating with the European Union, EU, to ease market access for Canadian products into Europe and vice versa. The proposed agreement would enable Canadian manufacturers to meet EU regulatory requirements in Canada in a cost effective manner and simplify the process for Canadian exporters to get needed EU approval based on mutual recognition of testing and certification procedure.

Similar negotiations are being initiated with the United States of America.

Question No. 219-

[Roger Simmons, Liberal, Burin—St. George's, NL]

With respect to the family violence initiative, ( a ) why did Health Canada choose not to renew the Initiative in March 1995, ( b ) what will happen to the community projects which were largely funded through grants under the Initiative, ( c ) what specific areas were deemed priorities following the federal-provincial consultation on ways of combating family violence, and ( d ) is Health Canada planning to develop a new policy on family violence in 1995-1996?

[Diane Marleau, Liberal, Minister of Health]

Activities to reduce family violence have been extended for 1995-96 with resources of up to $30.28 million government wide. During the year the government will ensure that action is effective, focused and integrated into a broad federal strategy to reduce all types of violence, including family violence.

About 74 per cent of the resources for 1995-96 will be used to support shelter housing, services for on-reserve First Nations and Inuit communities, and community action projects. As well, the National Clearinghouse on Family Violence will continue serving as a national resource centre for communities across the country.

Twelve million, three-hundred thousand dollars of the $30.28 million is being allocated to First Nations and Inuit communities. The funding will be used to help First Nations and Inuit communities continue prevention, intervention and treatment, research, evaluation and professional training to reduce family violence.

Provincial/territorial governments, non-governmental organizations and other stakeholders have acknowledged that federal leadership is needed to co-ordinate a national, cross sectoral response to family violence. The federal government will continue to play a leadership role on family violence within the resources allocated for the year, through co-ordinated, strategic activities. One of the federal government's objectives is to determine how best to integrate family violence work into a broader strategy to reduce all violence in Canadian society. The federal government, primarily through the justice department, will lead this activity. In addition, the federal government will continue to work with other levels of government, non-governmental organizations and the private sector to build on the work to date on family violence.

During 1995-96 the federal government will support shelters for battered women and children, community based action, services for First Nations on-reserve and Inuit peoples, criminal justice reform, training of RCMP members, treatment programs for federal offenders, and the activities of the National Clearinghouse on Family Violence.

Also during 1995-96 the government will review its family violence activities to ensure they are effective, focused and integrated into a broad, federal strategy to reduce all types of violence, including family violence.

Question No. 220-

[John Cummins, Reform, Delta, BC]

With regard to the turbot fishery off Canada's east coast and NAFO allocations or quotas, ( a ) what percentage of this years total allowable catch (TAC) is to be caught by Canadian vessels, ( b ) what percentage of the Canadian allocation or quota is to be caught by Canadian vessels, ( c ) what percentage of the TAC is to be caught by Russian vessels, ( d ) what percentage of the Canadian allocation or quota (northern zone) is to be caught by Russian vessels, ( e ) what percentage of the TAC (northern zone) is to be caught by French vessels, ( f ) what percentage of the TAC (southern zone or nose and tail of the Grand Banks) is to be caught by French vessels; other European Union vessels; Japanese; Russian; Korean; or flagged vessels of other NAFO states, ( g ) is the French catch as provided for in the recent Canada-France agreement counted as part of the EU or Canadian allocation-if Canadian, why is it treated as part of the Canadian allocation as opposed to the EU allocation?

[Brian Tobin, Liberal, Minister Fisheries and Oceans]

(a) 37 per cent of the 1995 total allowable catch of Greenland halibut in subareas 2+3 is allocated to Canada; (b) 99.33 per cent of the Canadian allocation is to be fished by Canadian vessels, (see e); (c) 11.85 per cent of the TAC is to be fished by Russian vessels; (d) 0 per cent of the Canadian allocation or quota in the northern zone 2+3K is to be fished by Russian vessels; (e) 3.5 per cent of the subarea 2 part of the northern zone, 2+3K, 210t in 1995, is allocated to France; (f) 0 per cent of the TAC of the southern zone, 3LMNO, is allocated to France, 50 per cent to the European Union, 13 per cent to Japan, 16 per cent to Russia, no part of the TAC has been specifically allocated to Korea, 7.5 per cent allocated to other NAFO members including Korea; (g) the French catch is counted as part of the Canadian allocation as it is provided for under the Canada-France fisheries agreement.

Questions Passed As Orders For Returns

[Peter Milliken, Liberal, Parliamentary Secretary to Leader of the Government in the House of Commons]

Mr. Speaker, if questions Nos. 145, 199, 200 and 221 could be made orders for return, those returns would be tabled immediately.

[The Speaker]

Is it the pleasure of the House that questions Nos. 145, 199, 200 and 221 be deemed to have been made orders for return?

[Some hon. members]

Agreed.

Question No. 145-

[Alex Shepherd, Liberal, Durham, ON]

Regarding the proposed registration of firearms, would the government, ( a ) provide a detailed and comprehensive accounting showing the projected cost of the administration of such a system, with all costs both incidental and specific to be taken into account, ( b ) allocate these cost projections between those costs to be absorbed or recovered from legal gun owners and those to be borne by the general public, ( c ) provide all statistical assumptions taken into consideration in arriving at these projections and ( d ) in the case of the general public's allocation, show this cost on a per taxpayer basis?

(Return tabled.)

Question No. 199-

[Jan Brown, Reform, Calgary Southeast, AB]

For the period from October 1993 to the present, what are the detailed breakdowns of funding from the Cultural Initiatives Programs in the Department of Canadian Heritage, exactly what was each project, what individual or organization received it, if it was specifically in a riding which riding was it in, exactly how much was each allocation of funds, what was the date of application for the funding and what was the date of approval?

(Return tabled.)

Question No. 200-

[Art Hanger, Reform, Calgary Northeast, AB]

How many Minister's Permits were issued by the Department of Citizenship and Immigration in 1994?

(Return tabled.)

Question No. 221-

[John Cummins, Reform, Delta, BC]

With regard to fishing activity within the 200 mile exclusive economic zone, ( a ) what NAFO nations will Canada allow inside the 200 mile exclusive economic zone on the east coast in 1995-96 to catch national allocations, and for which species of fish, ( b ) what nations will Canada be allowing to fish inside the 200 mile exclusive economic zone on the west coast, and for what species, ( c ) to the government's knowledge, what other nations allow foreign countries to fish inside their 200 mile exclusive economic zone?

(Return tabled.)

[Peter Milliken, Liberal, Kingston and the Islands, ON]

I suggest that the other questions be allowed to stand.

[The Speaker]

Is that agreed?

[Some hon. members]

Agreed.

Request For Emergency Debate

[The Speaker]

I have a request for an emergency debate. The hon. member for Roberval has today, prior to this afternoon's sitting, sent me a letter describing the matter he wishes to discuss today.

[Michel Gauthier, Bloc, Roberval, QC]

Mr. Speaker, in accordance with our Standing Orders, my comments will strictly concern the contents of my letter. Under Standing Order 52, I request leave for an emergency debate on the federal government's recognition of the legitimate right of the people of Quebec to decide, in the forthcoming referendum, on their political future.

This request is particularly timely, considering the ambiguity that remains after today's Question Period. On September 12, 1995, the Minister of Labour made contradictory statements about the federal government's recognition of the referendum results.

The Prime Minister of Canada, on the other hand, did not clearly express the position of the federal government in this respect nor did he clarify satisfactorily what was said by the minister. A very substantial doubt remains, and the people of Quebec and Canada need to know the real position of the federal government regarding the results of the referendum exercise in Quebec. Disturbing comments made by the Prime Minister during Question Period lead us to conclude that his position would be not to accept the results of the referendum in Quebec.

Considering the importance of what is at stake, you will understand, since it is impossible to consider, on short notice, another occasion on which the matter could be put before the House, I think it is in the public interest that parliamentarians should have a chance to discuss this fundamental question and express their views to the government as soon as possible. I wish to stress the urgent nature of this debate.

In concluding, I simply wish to say I did some quick research and found that in 1977, Prime Minister Pierre Trudeau moved a motion for debate on Canadian unity. The motion was accepted, and the debate was a very important one. After the speech from the Throne in April 1980, there were seven days of debate on the issue of national unity, and I found that the people who took part in these discussions stressed their importance at the time.

In this perspective and considering what is now happening in Quebec, I think it would be important for the House of Commons to obtain approval for an emergency debate. Thank you.

[The Speaker]

First of all, I wish to thank the hon. member for this letter. I paid close attention to what he said today. As one might expect, it goes exactly along the lines of the letter.

In my opinion all of the criteria are not met at this point to have an urgent debate on this. My ruling would be that at this time it is not necessary for an urgent debate on this particular matter.

The House resumed consideration of the motion.