Debates of March 4th, 1999

Legalization Of Marijuana For Health And Medical Purposes

[Elinor Caplan, Liberal, Parliamentary Secretary to Minister of Health]

Madam Speaker, as I rise today to participate in this debate there are several members in the House whose work on this topic should be acknowledged. I would like to begin by acknowledging the member for London West for the work that she has done in this area since 1997. I would also like to acknowledge the member for Rosemont, the member from Okanagan—and I regret that I cannot remember the correct name of the riding—and other members who have spoken to me.

This government is aware that Canadians are suffering who have terminal illnesses and who believe that using medical marijuana can ease their symptoms and we in the government want to help them.

I emphasize that those Canadians who are struggling to find new and better ways to maintain and improve their health have no interest in this topic, and to all of those who are healthy I would say that I hope this is a topic that will never be of interest to them and that they will never need to come forward to ask for this product.

The concern we have is that there are those who are suffering. As the Minister of Health said in the House yesterday, he has asked his officials to develop a research plan that will include clinical trials for medicinal marijuana, appropriate guidelines for its medical use and safe access to the supply of this drug. This will allow the government to get the information it needs so it can share that with Canadians. We want a flexible approach that will help Canadians and protect the health and safety of Canadians.

In order to truly assess the value of marijuana as a drug it is essential that we have reliable scientific evidence. We know there is much anecdotal evidence. We heard the member in his opening remarks refer to that evidence, but to date there is no reliable scientific evidence. Therefore, as I have stated, the Minister of Health has asked his officials to develop a plan that will include the kind of information gathering, research and development of clinical guidelines for the appropriate use of medical marijuana.

What we want to do is facilitate the development of these guidelines so that those people who are suffering and in need of help will have access to something that may be beneficial and that may assist them. Many are terminally ill, many are in pain, many are suffering from symptoms which they believe, and there is anecdotal evidence to suggest, could be helped in this way.

We want to get the facts. We want to know whether this is effective. But we also want to be able to use sections of existing federal legislation to give those people the opportunity to have access to a safe supply of medical marijuana that could be helpful to them.

The interesting thing that most people would not know is that Health Canada has already explored the possibilities of securing a medicinal quality source of marijuana for use in its research projects. As well, it has looked at ways of promoting research within this country. We would provide patients with access to medicinal marijuana in a controlled setting as part of clinical trials.

However, it is important to note, and I particularly address people who have expressed concern about access to the program, that the current Canadian drug regulatory framework and international control framework create a scheme by which medical quantities of marijuana could be legally available for medicinal purposes like any other therapeutic drug.

In other words, the distribution of marijuana as a medicine could already be possible provided that the product, the quantity and the supply, is of good quality and originates from a legal or licit licensed supplier as opposed to an illicit supplier. That is very important. It is also very important under the existing law that this be used in the proper research context.

The announcement by the minister dealt with the concerns that have been raised by many in this House: access for those who are suffering and in need, those who need help, but access within a controlled clinical environment of research with appropriate guidelines to ensure quality and safety and to ensure that the access to the supply of this drug is of good medicinal quality.

I want to state very clearly that physicians would be and must be very involved in the development of these research projects. The government wants to help Canadians who are suffering, but it wants to make sure they have the very best of advice and assistance.

While we will be developing a research agenda which will include clinical trials to gather evidence and needed documentation on both the risks and the benefits of the medicinal use of medical marijuana, we want a flexible approach that will provide patients with access to medicinal marijuana at an early stage of the research and in a setting that includes the support of qualified physicians. That is very important.

I heard the member opposite use the term legalizing of marijuana. People should know that we are not talking about the legalizing of marijuana.

What this does is it creates a research environment where we can do the research, gather the evidence and in that environment, just as we would with any other drug, make it available to people in a research context. During the research setting, people would have access to the drug. We would also be sure to develop appropriate clinical guidelines to make sure that it was used appropriately.

It would allow us to respond in a sensitive and compassionate way to those who are terminally ill, who are suffering and are coping with symptoms where the anecdotal evidence would suggest that medical marijuana might be helpful to them. We want to find solutions for Canadians who are suffering. We want to help Canadians. We want to do it in a way that is appropriate.

Therefore, I am pleased to say that I intend to amend the motion. At the appropriate time I will move an amendment to the motion. I would like to give members notice of what I plan to move.

I will be saying that the motion should be amended by deleting all the words after the word “should” and substituting the following “take steps immediately concerning the possible legal medical use of marijuana including developing a research plan containing clinical trials, appropriate guidelines for its medical use, as well as access to a safe medicinal supply and that the government report its findings and recommendations before the House rises for the summer”.

The member opposite and others have asked are we prepared to put forward a timeline for this plan that the minister has asked his officials to develop. I say to members of the House as part of this debate that it is the government's intention to do this work on a rapid basis so that we can have in place the plan to develop the research and give people access as expeditiously as possible. We know that the House rises for the summer in June. Before that time the minister is making a commitment. We hope all members will support the amendment. I know that there is support in all parties.

In the time I have remaining, I would like to thank all of the members who have spoken and who will be speaking on this, those who spoke in private and those who sent notes to the minister letting him know of their support for this initiative. I want to emphasize again that this is not the legalization of marijuana. This is treating marijuana like a drug that may be helpful to some. We want to find out if it is. We want to provide the conditions for access in a controlled clinical environment with appropriate clinical guidelines.

Therefore, I move:

That, the motion be amended by deleting all the words after the word “should” and by substituting the following:

“take steps immediately concerning the possible legal medical use of marijuana, including developing a research plan containing clinical trials, appropriate guidelines for its medical use, as well as access to a safe medicinal supply and that the government report its findings and recommendations before the House rises for the summer.

I have this available in both official languages and will be presenting it to the chair to further this debate and discussion.

[The Acting Speaker (Ms. Thibeault)]

The Chair will take the motion under advisement and get back to the House with a ruling later.

[Gurmant Grewal, Reform, Surrey Central, BC]

Madam Speaker, I am pleased to speak to private member's Motion No. 381 which reads “That, in the opinion of this House, the government should undertake all necessary steps to legalize the use of marijuana for health and medical purposes”.

I heard the amendment. On the face of it the amendment appears to be okay as long as this is not a backdoor entry for legalizing marijuana smoking. As long as a firm guideline is established, probably it should be supported.

I have only recently undertaken the role of the official opposition's deputy critic for health. My constituents and my colleagues are proud to have me speak to Motion No. 381 and express our compassion for the predicament faced by those Canadians suffering from the diseases and conditions that cause them to turn in desperation to marijuana to ease their symptoms.

Looking through the lens of compassion, my efforts on this issue are dedicated first and foremost toward the thousands of Canadians who are desperately seeking medicinal therapy for various illnesses. These Canadians admittedly are frustrated at being in a situation where the only source of relief from their illness comes from smoking a substance that carries many extremely harmful side effects.

With them I seek less harmful alternatives. It is very important to look through the sympathetic consciousness of others' distress together with a desire to alleviate it. Therefore, I will continue to be outspoken on behalf of Canadians who are sick and seek safe medicine.

Historically, the use of marijuana goes back centuries. The remains of a woman from the fourth century were discovered. The woman had died giving birth. There were marijuana leaves found near her dead body at the site. Apparently she was inhaling marijuana, relieving her pain all those hundreds of years ago.

To review the pros and cons, let us see how various professionals look at this issue. Medically, THC, the drug in the marijuana plant, is known to be helpful to treat symptoms of cancer, AIDS, glaucoma, epileptic seizures, multiple sclerosis and migraine headaches.

In the United States there are people who would like to have marijuana moved from schedule 1 substances where it is deemed to have no therapeutic use, to schedule 2 substances which are useful drugs that can be prescribed by doctors. There are people who would like to see it treated as a herbal remedy instead of a drug.

Talking of support for legalizing marijuana for medical purposes, in a national U.S. survey, 50% of cancer therapists said they would prescribe marijuana if it were legal and 44% said they are already suggesting it. It is far less addictive and far less subject to abuse than other drugs used as muscle relaxants, hypnotics or analgesics, according to the survey.

According to Harvard University, the chief concern about the use of marijuana is the effect on the lungs of smoking it. Cannabis smoke carries even more tars and other particulate matter than tobacco smoke. Water pipes may reduce but cannot eliminate the side effects.

We are fast approaching the 21st century. We need to look into more advanced research to reap any benefits the drug can offer without side effects. Perhaps a technological inhalation of cannabis vapours could be developed, an inhaler for example, or something else which could deliver the contents of marijuana.

The question for us to consider is if it is ethical to deny people who are in pain something that will relieve their pain.

The result of Dr. Corigall's research at the University of Toronto dealing with the effects of canna-binoids on the brain predicts that there could be a creation of a synthetic form of marijuana. In arguments against legalizing marijuana for medical purposes, Dr. Corigall says that the dosage of marijuana as an analgesic cannot be regulated and ultimately people should not resort to smoking it to relieve their pain.

We already know that smoking is bad for us because of all the carcinogens that come with it.

Again on the negative side of the issue, a retired U.S. Drug Enforcement Agency official said in 1996 since there are better medicines with less harmful side effects than marijuana available for the diseases for which it is touted, medical marijuana is a cruel hoax. It does not help. It does more harm than good.

In another study, the chairman of the International Drug Strategy Institute two years ago said, “suggesting that marijuana be smoked as a medicine would be like proposing tobacco be used for anxiety and weight loss”.

The National Institute of Health determined that crude marijuana adds nothing to currently available medicine and indeed creates increased risk to patients. The U.S. National Institute of Health also says that a marijuana cigarette contains a complex mixture of over 400 different compounds, including carcinogens. This would be a concern for anyone but especially for patients with chronic disorders or impaired immune systems.

The U.S. National Eye Institute fact sheet on the therapeutic use of marijuana for glaucoma states that none of the studies demonstrates that marijuana or any of its components could safely and effectively prevent optic nerve damage from glaucoma. Also, there are about 24 FDA approved drugs for the treatment of glaucoma.

The U.S. National Cancer Institute notes that inhaling marijuana smoke is a health hazard. It has a long list of agents that are more useful than marijuana.

We need to look as well at the positions put forward by different professionals.

Lawyers have said through the Canadian Bar Association that the government's drug policies are misguided. They are in favour of decriminalizing marijuana because to continue the government's approach is doing more harm than good. The damage inflicted by the legal system seems disproportionate to the offence.

In 1993 the Canadian Police Association recommended making simple marijuana possession a ticketable offence, similar to speeding. The Ottawa police chief said that the risk of things going wrong during marijuana busts are too high.

In 1995, 43,000 Canadians were charged with 62,000 drug offences, and 71% of them were for marijuana. In the past 20 years, 700,000 Canadians were arrested on marijuana charges. Since 1995 in British Columbia, B.C. police have been advised to stop laying marijuana charges because of court backlogs.

Let us look at what the medical community says. The World Health Organization treats drug abuse as a health issue. In those countries that treat drug abuse as a health matter rather than a criminal matter, people are not afraid to seek help. Drug abuse declines and remains at lower levels in those countries.

Providing treatment for drug abusers makes more sense than prison terms. The goal is a healthy population.

With these things in mind, we should study using marijuana for health and medicinal purposes.

In conclusion, I would say what is important to me is compassion. If nothing else works for the diseases and suffering, I do not see anything as a barrier.

I would expect to have more research done. Through research and innovation, harmless methods may be found to benefit from the medicinal use of marijuana.

Reform is concerned with substance abuse of any kind, whether it is drugs, alcohol, cigarettes or marijuana. I warn Canadians that the Liberal government may use this issue of the medicinal use of marijuana smoking to legalize it through the back door.

As long as it sticks to the amendments and as long as it has a reasonable plan we will probably be supportive.

[The Acting Speaker (Ms. Thibeault)]

The amendment presented by the member earlier is in order.

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Madam Speaker, I would like to start by congratulating the hon. member for Rosemont for this initiative and for the role he has played in encouraging the federal government and the Minister of Health to take steps to allow the legal use of marijuana for health and medical purposes.

I would like to offer my support for this resolution, which states very clearly:

—the government should undertake all necessary steps to legalize the use of marijuana for health and medical purposes.

Many of my colleagues in the NDP caucus have also worked very hard on this issue but I want to acknowledge many in our party who have come before us and have been quite outspoken on this matter over the years. All of us in our own ways have tried to find ways to put pressure on the federal government to act on behalf of persons who need to use marijuana for medical purposes, who need to find some relief from pain and suffering or to deal with the symptoms of chronic or terminal illnesses.

We all know that these people who are speaking out and asking for action are already in a poor physical state and are being forced to purchase marijuana illegally and with the risk of arrest.

We are here today to join with the Bloc and with all members in the House who support this view to urge the Liberal government today to take a brave step to overcome the history and associations of marijuana and recognize its value to the medical community as a part of legitimate treatment options.

We urge the Minister of Health, in the commitment that he made yesterday, to work with the Minister of Justice to ensure that people who use marijuana for medical purposes are never subject to prosecution.

Today we have before us this resolution from the Bloc now amended by the Parliamentary Secretary to the Minister of Health which will require some study and deliberations before we are prepared to indicate our support for the amended motion. Our major concern will be whether the intentions of the government, as stated today, will in any way inhibit access for those people who are suffering today.

It is one thing for the government to announce a plan of action to move on this very critical issue. It is another thing for individuals suffering from AIDS and other illnesses to wait four or five months before they will know whether there will be access.

It certainly does not answer the question about all those individuals who have been charged as a result of possession of marijuana for medical purposes, nor does it address the question of whether individuals currently under doctor's orders to access marijuana will be charged in the first place.

We have many questions that must be addressed. I think for all of us here today our concern is with trying to find a way to immediately alleviate the pain and suffering of individuals for whom marijuana prescribed on a medical basis is an important solution, an important alternative.

Members of the Reform Party have presented different positions to us and they are certainly going through a great deal of soul searching about where they stand on this issue. There are broader issues to be addressed. I think for today it is important for all of us to say that we must address this issue from the point of view of compassion and we must do it on the basis of a great deal of urgency.

I do not have to repeat the many arguments that have been presented to the House about the medical value of marijuana. I think it is important to simply summarize some of the information that has come from the medical and scientific community.

We know from studies that marijuana has been proven to be effective in reducing pressure in glaucoma. It has been proven to be successful in reducing vomiting and nausea associated with chemotherapy. It has been clearly identified as stimulating appetite in patients with AIDS wasting syndrome. It has been found to be useful in controlling spasticity associated with spinal cord injuries and MS. It has been found to decrease suffering from chronic pain. It has been found to be useful in controlling seizures in seizure disorders.

Marijuana is also considered to have a potential for a number of other conditions such as emphysema, because it dilates the bronchioles in lungs and in migraines. It has a wide margin of safety and by all accounts is non-lethal.

The other important factor in all this is that marijuana used for medical purposes does not have many of the side effects that so many other treatments entail, side effects that sometimes are so serious that patients stop using the medications despite their suffering.

I refer members to a 1997 editorial in the prestigious New England Journal of Medicine which refers to the parallel American prohibition as “misguided, heavy handed and inhumane”. It also states: “To demand evidence of therapeutic efficacy is equally hypocritical. The noxious sensations that patients experience are extremely difficult to quantify in controlled experiments. What really counts for a therapy with this kind of safety margin is whether a seriously ill patient feels relief as a result of the intervention, not whether a controlled trial proves its efficacy”.

Many scientists who are convinced of the value of marijuana in terms of its medical significance are advising patients to use it despite the legal risks.

I point to another study quoted in the national news on September 24, 1998: “Science is assembling convincing evidence that Queen Victoria was not merely catering to royal whim when she used marijuana to numb her menstrual cramps. “Researchers at the University of California have discovered that cannabis triggers a pain suppressing circuit in the brains of rats, which demonstrates that the drug is indeed a pain killer”.

The article outlines significant scientific and medical information to lead us to believe that study and research have been done on this issue. We may be just delaying the need to act by talking about clinical trials and further study before moving as quickly as possible on this matter.

I remind members of the most recent letter from the Canadian AIDS Society which urged all of us to support the resolution put forward by the hon. member for Rosemont: “As a result of the illness facing people with HIV and AIDS individuals often suffer severe nausea and an inability to eat. Wasting, which is a lack of body fat and muscle mass, is one of the leading causes of death for people with HIV and AIDS. Many of the current drug regimes that individuals are prescribed include strict timetables of when they can and cannot take the medication as well as whether the medications need to be taken with food or without. The side effects of these medications often include nausea”.

There is ample evidence of the benefits of marijuana use on a medical basis. There have been significant studies and clinical trials. I think the time is now for action.

What does the amendment put forward by the government today mean in terms of legal ramifications for people who are either charged now with illegal possession or are perhaps facing charges? I suggest to the minister that there is provision now within our Food and Drugs Act for actually ensuring that under the emergency relief program we can ensure reasonable and responsible access to marijuana for treatment in keeping with the requirements of Canadian law pertaining to the use of marijuana as a new drug under the Food and Drugs Act and as a controlled substance under the Controlled Drugs and Substances Act.

We will study very diligently the amendment of the government but we strongly support the motion put forward by the Bloc member and we urge the government to move quickly. We may need more clinical trials, more studies and more research but we also need to act immediately to deal with the pain and suffering of many individuals for whom there is no other reasonable alternative.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Madam Speaker, the debate today really centres around the word compassion. I want to read the motion so that the viewing audience has a chance to hear it once again:

That, in the opinion of this House, the government should undertake all necessary steps to legalize the use of marijuana for health and medical purposes.

Those are the key words, health and medical purposes. We are talking about a compassionate use of a substance which is illegal.

The debate today could be taking place on any number of substances used for pain relief in medicine, prescribed by doctors on a timely basis in cases where they are needed.

Let us imagine for a minute whether we should be debating the use of morphine. Should we not be talking about the use of codeine, morphine or heroin? What we are talking about is the use of a drug to relieve pain in those who are suffering.

I think that is very commendable. We are not talking about the legalization of the product for recreational or casual use. We are talking about a drug prescribed by doctors to help patients deal with the threshold of pain and suffering. In many cases we are talking obviously of terminally ill patients.

The Canadian Medical Association, which I consulted on this, has some interesting observations. I think it is worth putting these on the record as well. It is not cut and dry. Certain considerations have to be made any time a substance is used for medicinal purposes. Some of these are outlined very clearly by the CMA.

I quote a letter to me from the CMA which says the CMA has advocated the decriminalization of the possession of marijuana for many years. I think that position goes back to 1981.

The position of the Canadian Medical Association is:

That the Canadian Medical Association recommend to the federal government that the jurisdictional control of marijuana be moved from the Narcotics Act to the Food and Drugs Act and that all past criminal records related to simple possession be erased.

It has a very strong position on the decriminalization of the use of marijuana. However, when it comes to the medical use of marijuana, it is quite ironic that it has concerns, some of which I will outline.

The CMA is concerned that as a herbal medicine it cannot be patented. It says that exploitation of research is therefore precluded.

It is concerned that the chemical content can vary considerably from plant to plant.

It is concerned that the standardization and reproducibility of clinical trials is problematic as the plant and its delivery system is unique and, therefore, it would be almost impossible to conduct blind trials.

Another reservation is that the delivery system is not reliable from patient to patient as the dose received depends upon the delivery technique.

Another concern is that there is almost no independent quality research available, such as randomized control trials, to guide decision making on the appropriate and effective medical use of marijuana or the side effects and risks associated with its consumption.

I think that everyone in this House would agree with some of those concerns. Basically, it boils down to the consistency of the product being used.

We heard from some members in this House as to whether or not it is really effective. However, if it is working on some patients and not on others, it is probably not unlike any other drug. Different drugs have different effects on people because of the chemistry of the human body. I think that is to be expected.

Part of it, probably from the patient's perspective, is what they believe. It is like the individual who wears a copper bracelet for rheumatism or arthritis. I guess if they believe that it works and they say that it works, it probably does work.

This has been a hotly debated topic. I want to quote from the transcript of a program by Dr. David Suzuki. I think most of us from time to time have watched—

[The Acting Speaker (Ms. Thibeault)]

I am afraid that I must interrupt the member at this point. However, I wish to tell him that the next time this bill comes before the House he will have approximately four minutes if he wishes to use that opportunity.

The time provided for the consideration of Private Members' Business has now expired.

[Gar Knutson, Liberal, Elgin—Middlesex—London, ON]

Madam Speaker, I rise on a point of order. I think you would find unanimous consent to allow the member to finish the four minutes.

[The Acting Speaker (Ms. Thibeault)]

Is there unanimous consent for the member to finish?

[Some hon. members]

Agreed.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Madam Speaker, the House is being very generous tonight and I appreciate it because we did start early.

Dr. Suzuki in his program was talking to his listening audience about marijuana and its use. He was talking about a gentleman who had a sick son. I want to put this on the record because it spells out pretty clearly the effects and how positive it can be when used for the right reasons.

A gentleman by the name of Lester Grinspoon was speaking. He said:

My son who in 1967 was diagnosed as having acute lymphatic leukaemia, he was 10 years-old then. By the time he reached the age of 13, was beginning to get some of the cancer chemotherapeutic substances which cause severe nausea and vomiting. He would vomit for about eight hours or have the dry heaves for eight hours. He would vomit in the car on the way home from the hospital and just lie in his room with his head over a bucket on the floor.

That is a very common experience for any of us who have had relatives and loved ones who were sick and receiving chemotherapy. It is not unusual for that to happen.

He went on to say that he and his wife were at a dinner party and a doctor recommended the use of marijuana for this young boy. He said:

On the way home from that dinner party my wife Betsy said “Well, maybe we should get some marijuana for Danny”. I'm ashamed to say it, I said “No we can't do that. It's against the law and we don't want to embarrass the people at the Children's Hospital who are taking such great care of Danny”. His next chemotherapy was due a couple of weeks later and Betsy and Danny smoked in the parking lot outside of the Children's Hospital. I couldn't believe what happened because not only did he not have any nausea but he even asked his mother “Could we get a submarine sandwich on the way home?” And I then called Dr. Jaffy who was the doctor who was directly involved in Danny's care and said to him “Look”, I told him the story, I said “I'm not going to stand in the way of his using marijuana this time”.

The story goes on in quite a bit of detail. Basically what it is saying is that it does work under controlled circumstances. I believe that the House has to consider that.

Again, going back to the very nature of this bill, we are talking about the word compassion. In relation to other substances out there let us give it a try under controlled conditions, under doctor's orders. If we could do that we would be prepared to support this bill.

[Elinor Caplan, Liberal, Thornhill, ON]

Madam Speaker, I rise on a point of order. I want to correct the record. The correct name of the riding I was referring to is Okanagan—Coquihalla.

[The Acting Speaker (Ms. Thibeault)]

The time provided for the consideration of Private Members' Business has now expired. Pursuant to Standing Order 93, the order is dropped to the bottom of the order of precedence on the order paper.

A motion to adjourn the House under Standing Order 38 deemed to have been moved.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Madam Speaker, it gives me great pleasure to rise on behalf of the PSAC workers, especially the blue collar workers of Nova Scotia and those across the country. Probably one of the most discriminatory policies of this current government is its policy on regional rates of pay.

In 1993 the Liberal government stated “The time to end regional rates is now and if elected we will eliminate that”. The government is now six years into its mandate and the President of the Treasury Board stated that he thinks regional rates of pay is a good policy.

I would like to read a card that was written in 1995:

In the opinion of this House, the government should seriously consider abolishing regional rates of pay now enforced for certain federal government employees, in accordance with its stated policy of pay equity.

That was from a formal Liberal member of parliament, Ronald MacDonald.

The current member of the House from Kenora—Rainy River stated:

The motion is a very good one and should be supported by the government and all members opposite to give people work and pay based on their abilities, their seniority and their classifications, not on where they live.

The key part of that statement is “not on where they live”. In the previous House that member was the parliamentary secretary to the minister of human resources.

No truer words have ever been spoken. The only problem is that the government has completely ignored them.

I quote the Ottawa Citizen from March 2:

The Liberal government seems intent on “breaking the back” of its unions with “hardball” labour policies that have left rank and file public servants underpaid, demoralized and facing poor working conditions, says the chairman of the Senate finance committee.

Terrance Stratton, who headed the committee's year long investigation into the brain drain in the public service, warns that the government's hardline position on capping salary increases at two per cent a year will accelerate the flight of experienced talent to the private sector. It does not help matters that, at the same time, senior executives [of the government] got raises of up to 20 per cent, plus bonuses.

Gilles Paquet, director of the centre of governance at the University of Ottawa, stated that the committee's report underscores that the Liberal government has no agenda for its public service other than the one driven by the finance department to cut costs and save money: “The government doesn't give me the feeling that it respects the public service. It ended the notion of a career public servant and then turned around and asked them for more and more loyalty. Give them less and less money and more and more work. It just doesn't add up”.

Again, no finer words have been spoken in such a long time when it comes to the issue of pay equity, regional rates of pay and the quality of life and work for our federal public service, especially the blue collar ones.

The fact is regional rates of pay are discriminatory. Just because you live in Halifax does not mean you should be paid less than if you live in Vancouver. Ninety-seven per cent of all public servants in this country, RCMP, military, members of parliament, all get paid the same base salary no matter where they live, whether it is Whitehorse, Inuvik, Vancouver or Sheet Harbour in Halifax. It does not matter, they get paid the same except when it comes to the lowest paid workers of the public service, the blue collar workers, the warehousemen, the electricians, the plumbers. It is an absolutely discriminatory policy.

It just does not fly for the Treasury Board president to say that it is because of provincial legislation and provincial responsibilities that he does not want to end regional rates of pay.

[Elinor Caplan, Liberal, Parliamentary Secretary to Minister of Health]

Madam Speaker, I am aware that some hon. members wonder why the Government of Canada does not get rid of regional pay rates for its blue collar workers and simply pay the same scale nationally. There are good reasons behind the present practice, some very good reasons to continue it.

Those who know the history of the House know that regional rates were put in place in 1922. In those days the Government of Canada recognized that wages paid to certain trades were determined by local and regional market realities, realities that have remained unchanged and realities the Government of Canada cannot ignore.

I remind the House that in 1962 the Glassco royal commission recommended regional rates be maintained as a compensation policy where markets are regional or local. Thus in 1967 the government set forth its recommendation when it instituted collective bargaining processes within the federal civil service. If we had decided to go with a uniform rate rather than a regional rate that reflected local realities what would have happened? Quite simply we would have created local inequities in pay scale that would have engendered instability in local labour markets especially for private sector employers seeking to hire at rates that reflected the local market realities.

We must all recognize that incomes vary from place to place as a function of cost of living and other factors. I remind the member that representatives of the government and the unions are currently at the negotiating table. We all hope for a positive outcome and we value the important work that all members of the public service provide to the people of Canada.

[Paul Szabo, Liberal, Mississauga South, ON]

Madam Speaker, in February 1999 the advisory council on health infostructure presented its final report to the health minister entitled “Canada Health Infoway: Paths to Better Health”. Over the course of 18 months the 24 member advisory council met and worked with a number of collaborators, including the provinces, territories and other federal departments and various health stakeholders across Canada.

One of its recommendations was the subject of a question I posed last week to the Parliamentary Secretary to the Minister of Health. It has to do with report cards on our health system. One of the key recommendations was that the government support evaluative analyses and consensus building to develop yardsticks and fair measures of health care system performance and health status of Canadians.

These analyses would form a basis of report cards to the public that will improve the overall accountability of the health care system.

I would like to repeat the question I posed to the parliamentary secretary in French, as I tried to do in question period.

One of the main recommendations in the final report of the advisory council on health infrastructure is the provision of a public report card so as to improve the general accountability of our health care system.

Since the Government of Canada is responsible for health care standards, does the department support this recommendation and will it undertake discussions with the provinces and territories with the aim of implementing this method of accountability?

Basically Canadians value our health care system and they need this kind of information. They need to know about how our health care system is performing. They also need to know that the dollars that are invested in our health care system are being used widely in every province and in every territory.

I raised the question with the parliamentary secretary with a view to getting a little more information about how this would work, whether or not the government was supportive of it and whether or not there was more information she could give us on report cards on our health care system.

[Elinor Caplan, Liberal, Parliamentary Secretary to Minister of Health]

Madam Speaker, I acknowledge the interest of the hon. member for Mississauga South and thank him. Thirty-five seconds in question period does not allow for a full answer.

This evening I would like to tell the member that the advisory council's final report called the Canada Health Infoway: Paths to Better Health was presented to the Minister of Health and made public on February 3.

The report contains a number of recommendations relating to the development of a Canada health infoway including protecting the privacy of health information, empowering the public, strengthening and integrating health care services, creating information resources and building an aboriginal health infrastucture.

The report presents an exciting, positive, future vision of a Canada's health infoway, a vision which the Minister of Health and the Government of Canada strongly endorse. The 1999 budget provided the needed support toward actualizing the vision. We have committed $328 million over three years for improving the gathering, sharing and analysis of information about health and Canada's health care system.

The advisory council acknowledges in its report that developing a Canada health infoway will require collaborative efforts with all stakeholders, particularly the provinces and the territories. In fact, the Canada health infoway is to be built on the foundation already being designed or implemented by provinces and territories. Without their participation and support there can be no Canada health infoway.

Accordingly, the Minister of Health has already initiated discussions with provincial and territorial counterparts to seek consensus on how they can move forward together in these directions and build on current collaborative efforts.

As I said to all members of the House, we believe there needs to be greater accountability by all governments, not to each other but to Canadians, and the health infoway will help us to achieve that goal.

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Madam Speaker, on November 30 I raised a concern about the apparent change in name of the health protection branch to the management of risks to health branch. It is impossible to find in any official document from the Department of Health any reference any longer to the Health Protection Branch. The HPB is out; MRH is in.

The question for all of us is does this mean anything. It would seem to me that it does mean something, using the old adage that if you change the name you change the game. I believe that is what is actually happening with the government. The health protection branch was supposed to be responsible for guarding public health: the safety of the food we eat, the medicines we take and the toys our children play with. These all depend on the investigative strength of this important arm of government.

Something has gone terribly wrong. The federal government has been closing labs. We have the RCMP investigating in terms of blood and breast implants. We have had scientists appear before the Senate committee expressing concerns about the approval process for bovine growth hormone. More recently, we have had evidence of blood coming from prisons in the United States into this country without proper regulation.

We have had the minister refuse to take action on scientific studies showing toxins in bags that contain blood products. We have had as recently as today officials of the department promoting a risk management approach when it comes to organs and tissues. I think we have a critical situation. The whole way of doing business has changed under this government.

The most important question for all of us, the question that sets the tone for the entire safety process, has to do with the burden of proof. Canada's health safety system has always required the makers of new or questionable products to prove that their products are safe before they are released to the public. The public has always been confident in the knowledge that long before they ate their roast, swallowed their pill or sprayed their lawn, the makers of those roasts, pills and sprays had to prove to someone that the product was safe. Someone was looking out for their well-being.

Now under this government it is all changing. The burden of proof will be on government regulators at HPB to prove that the products are harmful. Our system has been successful because it was based solely and solidly on the precautionary principle. The government seems to be now sacrificing that for a corporate friendly system of risk management.

This in our view is intolerable. We will fight it at every opportunity. Any risk is too high.

[Elinor Caplan, Liberal, Parliamentary Secretary to Minister of Health]

Madam Speaker, the mandate of the Health Protection Branch is to protect Canadians against current and emerging risks to health. These risks come from prescription drugs, medical devices, consumer products, food and water contaminants, air pollution, radiation, chemical hazards, tobacco diseases, and natural and civil disasters.

Risk management is a decision making process for dealing with health risks. The health protection branch uses a formal method called a framework that lists all steps in the risk management process.

I want to tell the member what these steps include: identifying and assessing risks; developing, analysing and choosing options for managing the risks; implementing the selected options; and monitoring and evaluating the results.

This approach is used by provincial, territorial, national and international health organizations. The risk management framework was adopted in 1993. It has helped to ensure consistency and thoroughness in the way that risks are assessed and decisions are made.

It also results in a more understandable and transparent process. It promotes the use of best available scientific and technical information. It clearly identifies roles and responsibilities. It ensures that those who are affected by risk management decisions are properly consulted.

The health protection branch is one of the department's organizations that contributes to the management of risks to the health business line. I would like to take this opportunity to reassure the member that the health protection branch has not been replaced by an entity called the management of risks to health.

Earlier this year the minister launched a process called transitions which includes improving the risk management framework for the 21st century. At the present time this is a process of review. It is open and transparent consultation which hopefully will lead to an era in the new millennium so that even the member will have confidence and stop saying such nasty things about the renewed health protection branch.

[The Acting Speaker (Ms. Thibeault)]

The motion to adjourn the House is now deemed to have been adopted. Accordingly, this House stands adjourned until tomorrow at 10 a.m., pursuant to Standing Order 24(1).

(The House adjourned at 6.38 p.m.)