Madam Speaker, the motion before us states:
That this House urges the government to act on the recommendation of Justice Horace Krever to compensate all victims who contracted Hepatitis C from tainted blood.
The motion raises fundamental questions and merits careful and thoughtful analysis, but let me say at the outset that as a physician before I became a member of parliament I share the pain and anguish of all patients with hepatitis C. In fact I have always shared that philosophy as a medical doctor.
The compensation package announced jointly by the federal, provincial and territorial governments last March 27 for Canadians infected with hepatitis C through the Canadian blood system from January 1, 1986 to July 1, 1990 amounted to $1.1 billion: $300 million from the provinces and territories and $800 million from the federal government. The federal contribution represents 73% of the total compensation package.
Let me at once say that the government has not abandoned hepatitis C patients infected before and after this period, just as we would not abandon other patients whose diseases are also a result of treatment procedures, which always carry elements of risk. Our health care system will continue to look after them as the various levels of government across the country are committed to deliver the health care service we are proud of.
We will continue to be imaginative and perhaps we can challenge the Medical Research Council of Canada to conduct focus research to accelerate the discovery of a treatment for hepatitis C, to challenge our medical scientists and to provide them with the resources to do the particular type of research.
I am confident that provincial and territorial governments across the land will not sit idly by. They will be challenged even more to hasten their positive considerations of enhancing home care and pharmacare programs that will benefit hepatitis C patients as well as all other patients suffering from any type of illness.
The motion before us suggests that we should adopt the recommendation of Justice Krever to implement a no fault scheme for this group of patients with hepatitis C. Let me call to the attention of the House that Mr. Justice Krever made this recommendation for hepatitis C patients not because he did not care or neglected other non-hepatitis patients. Mr. Krever in fact made this recommendation for hepatitis C patients only because, as he said in his report on page 1045:
I acknowledge the force of argument made by among others the Pritchard Report that it is difficult to treat blood related injury compensation differently from compensation for other health care injuries. Given my terms of reference, however, it is not for me, here, to consider for any injuries other than those that are related to blood therapy.
It is clear from this statement by Justice Krever that what Justice Krever was suggesting was a no fault scheme not only to compensate patients with hepatitis C but also non-hepatitis C patients as long as their diseases are a consequence of tainted blood.
Earlier this morning I heard arguments from the opposition that it will not open the floodgates as though they were arguing that let us not worry about the other kind of patients. Let me state very clearly that even Justice Krever would like a no fault scheme for all those other types of patients without hepatitis C. Justice Krever said so in his concluding statement also on page 1045 in chapter 39 entitled “Financial Assistance For Blood Associated Injury” of his report:
I recommend that, without delay, the provinces and territories devise statutory no fault schemes for compensating persons who suffer serious adverse consequences as a result of the administration of blood components or blood products.
Canadians will note from that quotation, and we in this House have a duty to particularly make this observation, that Justice Krever's challenge for such a plan is addressed to the provincial and territorial governments. He did not include the challenge in the challenge to the federal government as quoted in his report. The basis for this argument is to reduce the impact of blood related tragedy on Canadian citizens “to give some thought to the question of appropriate relief for those affected by the inevitable events”.
I am inclined to support such a recommendation. I am persuaded that in our current legal system the primary mechanism for compensating someone who has been harmed through the fault of others is a civil action for damages and that those in breach of duty to exercise reasonable care resulting in harm are negligent and therefore have a duty to pay. That civil tort process is a lengthy one.
I must underscore again that Justice Krever's recommendation is for all types of patients, not only hepatitis C patients who suffered injury as a result of the administration of blood components or blood products.
This House has not made a policy decision on this fundamental recommendation of Justice Krever. To make a no fault policy change only for hepatitis C patients, desirable as it might be from my perspective or from the perspective of others, is premature and would be unthoughtful of other non-hepatitis C patients equally injured by the blood system and perhaps injured by treatment procedures other than through the blood system. We have not in this House held that debate.
If members opposite would only be respectful and listen to the debate I am quoting from Justice Krever hopefully they will gain some pearls of wisdom. When they are worried about the rationale of this debate they begin to distract me but they cannot distract this member of parliament because the truth speaks for itself.
We cannot be selective for hepatitis C patients only because this is the group of patients who have captured the public consciousness at this time. Where were they before? Did we hear from the opposition before on this issue?
Let me come to the testing of blood donation for alanine aminotransferase, ALT, as noted in Justice Krever's report, volume I. The use of ALT to reduce the incidence of post-transfusion non-A, non-B hepatitis, most of which would later prove to be what we now know as hepatitis C, by 40% was first reported by the New England Journal of Medicine in April 1981.
But in June of the same year the Krever report stated: “The United States National Heart, Lung and Blood Institute's ad hoc committee on ALT testing recommended against the implementation of ALT testing in favour of further study of its efficacy”.
It was only in February 1986 in the same report that: “The United States Food and Drug Administration's blood products advisory committee recommended that all blood donations for transfusion be tested for both ALT and anti-HBc, an antibody to the core of the hepatitis B virus, as surrogate, that is substitute, tests for non-A and non-B hepatitis”.
Madam Speaker, since my colleague shared his time with me and he only used seven minutes, perhaps you can give me the additional three minutes beyond my time.
I should also note from Justice Krever's report that it was only in July 1984 that the German regulatory authorities required that all products distributed for use in Germany be manufactured from ALT tested plasma.
Consideration of ALT testing in Canada had not been ignored. But Justice Krever noted in his report the editorial in the December 1984 issue of the Annals of Internal Medicine by Dr. Alter and Dr. Holland who were investigators in the United States National Institute of Health study, and I quote from his report on page 642: “They did not, however, endorse the recommendation that ALT testing be implemented, and they said that the true efficacy of surrogate testing could be proved only by a randomised trial that compared tested and untested blood. By 1986, however, no such study had been undertaken”.
I would like to get unanimous consent to continue.