Debates of Sept. 18th, 2001

Supply

[The Speaker]

In my opinion, the nays have it.

And more than five members having risen.

(The House divided on the motion, which was negatived on the following division:)

[The Speaker]

I declare the motion lost.

[Don Boudria, Liberal, Glengarry—Prescott—Russell, ON]

Mr. Speaker, I rise on a point of order. Now that we have disposed of the motion that was before the House, I wish to seek unanimous consent for the following motion.

I move that the House mandate the Standing Committee on Justice and Human Rights to study the matter of anti-terrorism legislation and report at the earliest opportunity with recommendations for legislation.

[The Speaker]

Does the government House leader have unanimous consent of the House to present the motion?

[Some hon. members]

Agreed.

[Some hon. members]

No.

[The Speaker]

There is no consent. It being 6.00 o'clock, the House will now proceed to the consideration of Private Members' Business as listed on today's Order Paper.

Adverse Drug Reactions

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

moved:

That, in the opinion of this House, the government should immediately, in consultation with provincial and territorial governments, establish a system for the mandatory reporting of adverse drug reactions.

Mr. Speaker, it is very hard to initiate this debate following two days of very critical discussion in the House around a most extraordinary turn of events in our society. It is very hard to clear our heads and focus on another issue. It is certainly hard to set aside our thoughts and emotions surrounding the terrorist attacks in Washington and New York City one week ago today.

We have set aside the ordinary business of the House to deal with extraordinary events and so we should have. All of our thoughts today are with the families, friends and co-workers of those who died, who are lost or who perished in those destructive acts of horror perpetrated against the people in the United States, but which also affected many Canadians and people around the world.

Our thoughts today are with the people affected by this tragedy. All of us in the House share the sentiments of sympathy expressed by our constituents. Certainly the people of Winnipeg North Centre are no exception. They would want me to extend their condolences to everyone affected by that tragedy and to share their feelings of grief, sorrow, anger and uncertainty around those terrorist activities.

They would also want us to return to normal business, to carry out the priorities of Canadians while still being vigilant in pursuing the eradication of terrorism. We attempt to do that now, to make the transition to regular ordinary business of the House on other issues of significance for Canadians.

The matter before the House today pales in comparison to the events we have had to deal with over the last week. However, the motion is a matter of significant public policy that ought to be addressed very seriously by members in the House today.

The motion addresses the question of the health and well-being of Canadians. It seeks to find a way to end preventable deaths in our society. It seeks to ensure that the medications people are required to take because of illness are safe beyond a reasonable doubt. The motion is quite simple. It calls upon the government in co-operation with provincial and territorial governments to put in place a system of mandatory reporting of adverse drug reactions.

It is estimated that approximately 10,000 people a year die of adverse drug reactions in Canada. It is difficult to ascertain the precise number of deaths that occur because of adverse drug reactions, but it is fair to say that the numbers are very high and many could be prevented.

I am not so naive as to believe that 10,000 deaths a year could be prevented by simply putting in place a system of mandatory reporting of adverse drug reactions. However, I am convinced, as are many others, that if we take steps to require a systematic way of sharing information on adverse reactions, if we require our physicians and our hospitals to report any problems associated with drugs and their interaction with other drugs or with foods, then we will have made a big difference. We probably would help prevent unnecessary deaths, unnecessary illness and difficult circumstances caused by this situation.

The issue crystallized for many of us when we learned about the death of Vanessa Young in March 2000. Vanessa Young was a 15 year old teenager from Oakville, Ontario who died because of the drug she was prescribed, called Prepulsid. That drug was prescribed for the wrong circumstances. By all accounts it was a preventable death. Her father, Terence Young, has carried on with a mission since his daughter's passing to ensure that we as a society learn the lessons of Vanessa's death. It compels us to take action today.

We certainly became much more aware of the problems associated with adverse drug reactions and the absence of policy in this area as a result of Vanessa's death. We owe it to her to ensure that her death is not in vain, that we learn lessons from this tragedy and ensure that people in similar circumstances are not affected by something that is so preventable and so easy to grasp in terms of solutions.

Over the past year I have raised in the House on a couple of occasions the issue of Vanessa Young in particular and the question of adverse drug reactions in general. Our concern really emerged from the knowledge that prior to Vanessa Young's death in March 2000 there were reports of adverse reactions to that drug. Certainly deaths were already associated with the taking of Prepulsid, yet we failed as a government and as a country to convey that information, to share that knowledge and to ensure that all physicians and all pharmacists were aware of the dangers of that drug when prescribed under certain conditions.

I raised with the House at that time that Health Canada had information it could have shared and acted upon many months before the death of Vanessa Young but it failed to do so.

The point of today's debate is not to lay blame but to find solutions. As a result of Vanessa's death there was a coroner's inquest and the jury made a number of recommendations. One is the mandatory reporting of adverse drug reactions within 48 hours of the incident taking place. That seems to be a very responsible and reasonable solution to a serious problem and one on which there is no reason to delay and to avoid action.

During the coroner's inquest, Health Canada officials were reported as saying that they thought it was a good idea but it was beyond the jurisdiction of the federal government. It is quite apparent today that the establishment of a system to require mandatory reporting of adverse drug reactions is well within federal jurisdiction. Certainly it is part of the responsibility that is handed to government through the Food and Drugs Act and requires action and implementation.

It would be a great disservice to Canadians for anyone to argue that this matter is beyond the jurisdiction of the federal government and on which there can be no immediate action. Not only is there the authority under the Food and Drugs Act for the government to act immediately, but there are also models from other jurisdictions on how a system could work. In countries like Britain and France there are models of mandatory reporting that work and which could be employed here in Canada.

Previously there have been pilot projects in Canada that show the idea can work and ought to be developed here. The Ontario Medical Association conducted a pilot project for the Canadian Medical Association about 10 years ago with great success.

Today we propose that precise idea. We hope that the government will see it as a valuable contribution to a very important area and that it will act upon it as soon as possible.

Many concerns have been expressed over the last number of years about changes in drug safety policies in Health Canada, about reduced resources, about an inability on the part of officials to track adverse drug reactions and to get that information out to the appropriate professionals in our society.

The problem was identified clearly in the coroner's inquest. Not only was the question of voluntary reporting outlined as a serious problem but so too was a lack of resources and communication on the part of Health Canada officials. These problems are manageable. They can be corrected without a lot of effort or cost, and this would save lives.

In developing my material for today's debate we spoke with Vanessa Young's father, Terence Young, who is continuing his battle to ensure that justice is done and changes are made in light of the lessons learned from Vanessa's death.

One of the comments he made about mandatory reporting was that it is “the only way to break the conspiracy of silence which the drug companies have created and nurtured, Health Canada has condoned and to which doctors have acquiesced”. That is a strong statement based on the reality he had to face with the death of his daughter. They are words we should listen to carefully and take seriously.

We know that over the last 10 years the use of drug therapy as an important part of our medical system has increased dramatically. However we know at the same time that our systems, resources and policies for dealing with the dramatic increase in the use of drug therapies has not changed or increased.

We are asking the government to recognize that pharmaceuticals play an important part in our medical system, in treating illness and in protecting health and well-being.

However for goodness' sake let us recognize the hazards that come with drug therapies. Governments must employ vigilance to ensure safety is preserved and protected at all costs.

I will conclude by citing again the information we have regarding deaths associated with adverse reactions. I mentioned at the outset that there are estimates of approximately 10,000 people a year dying from adverse drug reactions. That is a tremendous toll on our society that should be addressed. We know from other studies that the problem is real and that the estimates are in line with experience and knowledge.

A study in the United States has shown that in a sample of 10 drugs pulled off U.S. markets for safety reasons between 1997 to 2000, 10% of the adult population in the U.S. had at one time taken the medications. We also know that the number of adverse reactions reported to the FDA almost doubled between 1993 and 1999.

We know from studies in Canada, in particular a 1999 study by Joel Lexchin, an expert in the field of drugs and pharmaceuticals, that in that year there were 2,900 deaths from adverse reactions in Ontario alone.

The toll is great. The costs to our health care system are large and could be prevented. This is a matter that falls within federal jurisdiction. The federal government has the ability under the Food and Drug Act to take action. It is responsible for ensuring the safety of drugs for all Canadians.

Today we ask the government to exert that authority, take responsibility for this serious issue and move as quickly as possible to address the concerns we have enunciated today. These concerns became apparent during the coroner's inquest into the death of Vanessa Young and are very much a part of public policy debate in Canada today.

We ask the government to move seriously on this recommendation and implement, as expeditiously as possible, a system of mandatory reporting of adverse drug reactions.

[Bonnie Brown, Liberal, Oakville, ON]

Mr. Speaker, I congratulate the member for Winnipeg North Centre on her initiative in bringing forward this motion. All Canadians want to know that the prescribed medications they take are safe. They place tremendous confidence in the ability of Health Canada to provide health care professionals with up to date drug safety information. Health Canada is open to suggestions or new activities that could increase its capacity to detect drug safety problems and thereby avoid serious adverse reactions to drugs taken by Canadians.

The government welcomes the motion by the NDP health critic that it should immediately, in consultation with provincial and territorial governments, establish a system for mandatory reporting of adverse drug reactions. Such a system should address not only the quantity but the quality of reports received.

This follows up on one of the 59 recommendations that came out of the coroner's inquest into the death of Vanessa Young who died at the age of 15 while taking the prescribed drug prepulsid. Her death was a sad event in my home riding of Oakville. I was fortunate enough to have known Vanessa Young and her parents. I saw the community grieving at her death. It was a tragedy.

Evidence presented at the inquest showed that the current system for reporting adverse drug reaction in Canada is not organized to its full potential. The inquest identified the need to implement improvements that would enable Health Canada to compile information on drug safety more quickly and thereby act faster on potentially dangerous situations once they are identified.

The jury recommended that it be mandatory for health care professionals to forward information to Health Canada on all serious adverse drug reactions within 48 hours. The inquest used the same definition of serious adverse reaction that is currently found in our food and drug regulations.

Before discussing the many issues pertaining to mandatory reporting I will give a bit of background on the approval and post-market surveillance programs of Health Canada.

First, no drug is authorized for sale in our country before it has gone through a rigorous review process. Once a drug is on the market Health Canada continues to monitor it for adverse reactions, investigate complaints or reported problems and update conditions of its use via changes to the product monograph. If necessary it can remove a drug from the market.

As well, the product licensing framework that will soon be implemented has defined mandatory reporting requirements regarding emerging safety issues in other countries.

Another current initiative is the collaboration between Canada and the U.S. in a shared adverse events reporting system. Once implemented such a database would enable earlier detection of drug safety problems than is currently possible.

A mandatory system for adverse drug reaction reporting has great potential as an improvement to the current system. However all aspects of such reporting must be carefully weighed.

For example, if mandatory reporting generated a higher number of quality reports of drug safety problems it would increase the ability of Health Canada to determine such problems. However at present Health Canada has no clear evidence that mandatory reporting would result in the submission of quality information and thereby substantially increase its capacity to detect drug safety issues.

Other countries have reported success with mandatory reporting. France has mandatory reporting yet does not seem to have a significantly higher number of reports than countries without it. Nor does it detect drug safety signals at a higher rate than countries that do not have mandatory reporting. France has also found it problematic to enforce mandatory reporting. Because of issues of patient confidentiality it is difficult to gain access to physicians' offices where much of the reporting is done.

I support the motion as a means of strengthening Health Canada's ability to generate drug safety signals. However there are aspects of it that require further clarification and discussion.

First, who is expected to report? Should it only be doctors or should pharmacists, nurses or other health care professionals report? What about the time frame for reporting? In addition, what about issues of patient confidentiality? The implications of mandatory reporting need to be thought out and its scope and expectations clearly defined so that informed decisions can be made in moving this motion forward into action.

Some of the other initiatives aimed at strengthening the post-market surveillance capacity of Health Canada are the adverse event reporting system currently used by the United States and the plans of Health Canada to partner with the U.S. in this system. It is among one the largest databases of its kind in the world and is specifically designated to assess the risks associated with drugs that are approved for sale. The U.S. has several years of experience using it. It contains close to three million adverse drug reaction reports. Each year about 300,000 new adverse reactions are entered. We think that partnering with the FDA and the use of this database will provide a powerful tool to enable Health Canada to detect potential drug safety issues in a more timely manner than is currently possible.

Another initiative is the creation of a joint committee between Health Canada and provincial and territorial health professional groups to examine the effectiveness of the risk information delivery system among all concerned parties.

In addition to their input to the issue of mandatory adverse drug reaction reporting, this joint committee will be asked to evaluate risk communication tools and techniques used to inform health care professionals and the general public with a view to improving their effectiveness. Ultimately this committee will report its findings, including any recommendations for improvement, to the coroner within one year of the date of the Vanessa Young verdict, which will be April 24, 2002.

Health Canada has also had discussions with the Royal College of Physicians and Surgeons and the Canadian College of Family Medicine as to their interest in incorporating new drug risk information into their maintenance of competency programs for physicians. This initiative will help ensure that physicians keep current on drug risk information disseminated by Health Canada or other reputable information sources.

I wish to assure members of the House and all Canadians that Health Canada is actively seeking more effective ways to identify drug safety problems and to manage them in a timely manner. Health Canada values the health and well-being of Canadians above everything else. Our country has a good safety record with respect to drugs.

The motion to establish a mandatory reporting system is one potential step toward improving the availability of drug safety information and in identifying risks that could pose life threatening situations.

Identifying risks posed by drugs and communicating such risks in a timely manner is what Canadians want. I know I can call on the members of the House to support our future initiatives to improve the post-market surveillance activities of Health Canada among which mandatory reporting is one.

[Keith Martin, Canadian Alliance, Esquimalt—Juan de Fuca, BC]

Mr. Speaker, I too congratulate the member for Winnipeg North Centre for the intent of her motion. She is dealing with an issue that I struggle with as a physician.

Some of our patients have adverse reactions from time to time through no fault of their own and through no fault of ours. It is an unfortunate side effect of practising medicine. All that we can do to prevent other tragedies like Vanessa's from happening needs to be implemented.

The motion put forward today would initiate an immediate consultation with provincial and territorial governments to establish a system for the mandatory reporting of adverse drug reactions. While the intent is worth while, practically speaking it is impossible to do.

The member would be wise to separate out and focus the motion on the particularly tragic situation of Vanessa Young as being the worst possible case in that someone dies as a result of taking medications.

If we focus the motion on having mandatory reporting for fatal or near fatal drug reactions, the motion has a lot of merit and is doable. However to merely say that the motion would deal with adverse drug reactions would be impossible.

When a patient is having a reaction we do not know whether that reaction is in fact due to a drug, a disease, or whether it is due to something else entirely, so we are unsure.

If we are trying to prevent fatal reactions then mandatory reporting and transmitting the distribution of the information on drugs that may be causing fatal or near fatal problems is absolutely important, and historically we have been able to do that.

The fact that this happened with prepulsid is important because all practitioners knew that it had taken place very quickly. I would like to draw to member's attention to a number of other issues. The question is how much of a problem is it.

Some people quote that 10,000 people die from adverse drug reactions. If we look at the statistics it shows something very different. For example, in Ontario between 1992 and 1997 there were 16,300 admissions per year for adverse drug reactions. How many people died? About .05% of the people actually died from adverse drug reactions. If we look at the country that amounts to about 1,824 deaths per year. That is a lot of people.

However, given the number of people taking drugs and medications, it demonstrates that a lot of people are taking medications and the numbers are a lot smaller than has been actually described at times. Approximately 1,824 people per year died unnecessary deaths. If we can do other things to lessen our mortality figures then we ought to do it.

One thing that we can do is to publish where there have been fatal drug reactions in something like The Canada Gazette . This is a public document to which all Canadians can have access. A good modified motion would include that information about fatal or near fatal drug reactions be published in The Canada Gazette . It would give everyone a red light.

Another thing we need to look at is how drugs are assessed to determine when they are a danger to society or to the patient. As the government has removed a lot of money from the health protection branch of Health Canada, we need to look at the manner in which the safety of drugs is determined. We have some serious questions on whether that has been eroded over the last few years.

The government should make a transparent investigation into the health protection branch to determine the method by which drugs are assessed as to their effectiveness and whether they pose a danger to patients. This examination must be made public.

We should also look at drug costs and how they are passed. We know that the cost of drugs to the public coffers is actually quite large and we need to determine ways in which we can lessen that.

As we age there will be a greater need for medications. With the cost of medications rising, we need to look at ways in which we can decrease costs.

The patent protection that exists now has roughly existed for 20 years throughout the west. However there are a number of loopholes where patents on medications can actually be lengthened. Just before a patent expires, an infringement lawsuit can be brought by a non-generic patent company that would extend a patent for up to 30 months. They can also extend it for periods of six months by changing the patent slightly, such as changing the colour of the pill or some other superficial change to the medication which would actually extend the patent protection over and beyond the expiry of the patent.

Those loopholes need to be closed off because that is not what patents were intended to do. When we allow loopholes, the public pay a much higher cost because they do not have access to the generic medications in a timely fashion.

Serious issues took place when certain companies in the U.S., and I am sure they were in the minority, paid generic companies not to manufacture generic drugs, which extended the control of patent drug companies over a drug. This is also collusion, which is illegal under the laws of the land. We have also seen applications by brand name companies that have actually pushed their control over and beyond what was its intent.

The issue of adverse drug reactions is something that is very much of concern to all health care practitioners as well as the public. As the member for Winnipeg North Centre has put it, the intent is to ensure that the drug reactions that occur and put people in danger are known, not only to the public, but also to health care practitioners and that it is stopped at source. Again, a motion should be put forth that deals with fatal and nearly fatal drug reactions. This information should be displayed to physicians and to the public in a central location. We also need to look at the relationships between drug companies and Health Canada and how drugs are approved.

I have just returned from a trip to West Africa where I had the opportunity to distribute a number of medications to people in dire need in one of the poorest countries of the world. I would like to take this opportunity to thank the research based drug pharmaceutical companies that donated more than $5,000 worth of medication. I publicly thank them for this generous gesture. It is a program that enables physicians travelling abroad to distribute drugs to some of the most impoverished people in the world who essentially have nothing.

[Réal Ménard, Bloc, Hochelaga—Maisonneuve, QC]

Mr. Speaker, I too would like to thank and congratulate our colleague who sat with us on the Standing Committee on Health, for her excellent initiative, in principle.

I believe it would have been advisable for our colleague to have had more to say on how all this would operate. I think we have no great difficulty in subscribing to the principle of providing the maximum information on the effects of drugs, particularly prescription drugs, but this could also apply to over-the-counter medicines.

As for knowing how this is going to be put into practice, we must admit that our colleague was not too forthcoming with details.

For example, Canada has a system of mandatory reporting of certain diseases. Taking AIDS as my example, when someone dies in hospital of acquired immune deficiency syndrome, the health professionals, the physicians, are required to report it. There is a national registry.

This gives the Canadian centre for epidemioliogy an idea of the number of deaths from AIDS, obviously so that they may have some understanding of the face of the epidemic. When they do, they will have a better grasp of the situation.

In the area of concern to us here, we are told that every year, people, apparently some 10,000, die from a drug reaction.

This immediately raises two questions. Does this mean that, by authorizing use of the drug, starting as a new experimental drug that has been approved under the regulations within a known process requiring clinical tests and the provision of monographs, a process that seems to be pretty rigorous, Health Canada has failed in its statutory obligations and allowed a drug to be sold that has harmful effects?

Does this mean that, in prescribing a medication, a health professional, a physician, has improperly assessed the bio-availability and bio-reactivity of the various individuals taking that drug?

This is where it is not easy to draw the line. Would a better information system make it possible to avoid situations like the one described to us by the hon. member for Winnipeg North Centre? Perhaps. But I believe questions need to be asked about the share of the responsibility that lies with Health Canada, the health professionals, and the physicians.

Second, I believe that if we are to analyze or study a motion such as the one before us, we need to situate it in a much broader context. Of course we must investigate the drug certification system, to model it after the system of reportable diseases, but we must also look into the whole issue of drug costs.

In this regard, I agree completely with the previous speaker's comments, and I would like to share some figures on this.

In researching this speech, I reread what was written by the National Forum on Health. Members will remember that the Prime Minister set up the National Forum on Health in 1995. The forum's report was tabled in 1997.

The report reminds us that between 1975 and 1995, drug costs in Canada climbed from $1.1 billion to $9.2 billion. These are the figures available from 1994, so we can expect that the numbers have grown even more since then.

A number of witnesses told us that among the most expensive costs in health care, it is drug-related costs that have gone up the quickest.

It is not unusual to observe that for many governments, whether it be the governments of Quebec, Ontario and likely Manitoba as well, health care spending represents 12, 13, 14 or 15% of their budgets, and in some cases more.

Mr. Speaker, you seem very informed on these issues. According to figures published by the National Forum on Health, we spent on average 12.7% in 1994; that figure is probably much higher today. Would it not be wise to refer to the Standing Committee on Health measures that would enable us to see how we could better control drug costs?

Some time ago, the government of Quebec held a parliamentary commission. The commission, known as the Good Samaritan was made up of a group of doctors. They proposed a certain number of solutions that I would like to share with my colleagues, and study in parliamentary committee.

The balance between brand name drug and generic drug industries is not easily called into question. Before the summer adjournment, we passed a bill from the other place, Bill S-15, a decision by the World Trade Organization whereby Canada has to provide all Canadian patents the same protection, be they on intellectual property, copyright or drugs. That means that Canada has little manoeuvring room to review the Patents Act, since the WTO rendered a decision.

However, could we not approach things in a way that would allow us to make broader use of our generic drugs industry while not losing sight of the fact that each time a new drug comes onto the market, hundreds of millions of dollars are required for research?

The first solution proposed by the Good Samaritan Commission was to recommend to the government of Quebec that it permit, as other provinces do, the expanded sale of generic drugs. The commission considered the abolition of this rule would mean an immediate savings of $45 million annually.

Second, and this ties in with our NDP colleague's concerns, it is public knowledge that physicians prescribe drugs much too generously.

The example was given of antibiotics prescribed for the flu. The commission said that if doctors received better training, we are talking about training in connection with the writing of prescriptions, there could be savings of 10%. The Good Samaritan commission, composed of doctors, estimated that if health professionals, particularly doctors, were given better training, 10% of the $1 billion in drug costs could be saved. This would save the public treasury, in this case the government of Quebec, $100 million.

The commission also talked about prescribing less expensive drugs. One extremely interesting example was given. The commission said that doctors prescribe drugs that are far too expensive because they themselves, as health care professionals, are often unaware of the cost of drugs.

The example of ulcers was given. I hope that I myself will not be too responsible for giving you ulcers, Mr. Speaker, but should anyone in the House have them, three drugs were mentioned: Losec, Acinétidine, and Raniditine.

Losec costs $2.20 a tablet, Raniditine 40 cents a tablet, and Acinétidine nine cents a tablet. These drugs are used for similar therapeutic purposes. If all doctors whose patients had ulcers were to prescribe the least expensive drug, $50 million annually could be saved.

I know that my allotted time is up, but I will conclude by saying that these are issues the Standing Committee on Health should take a serious look at.

[Bill Casey, Progressive Conservative, Cumberland—Colchester, NS]

Mr. Speaker, I am pleased to enter into the discussion on the motion made by the member for Winnipeg North Centre. It proposes to put into place a system of mandatory reporting for adverse drug reactions.

My first reaction is surprise that it is not already in place, but one thing about our job is that we often get surprises and this is a surprise to me that there is no mandatory requirement for that. I noticed in reading the minutes of the subcommittee on private members' business that I am not the only one who is surprised.

The Liberal member for Hull--Aylmer was also very surprised. He asked if there is not anything through Health Canada that is compulsory. The member for Winnipeg North Centre replied, no, stating that is why it was raised.

The member for Hull--Aylmer again asked if there was no system whatsoever. There is no system whatsoever to require reporting of an adverse drug reaction and that is why this is a very appropriate matter to bring before the House and is something that we should be considering in the way we are, and perhaps even as a motion.

It is an important matter. I thank the member for Winnipeg North Centre for bringing it to our attention.

In her appearance before the subcommittee on private members' business shortly before the summer recess, the hon. member spoke of the tragic and unfortunate death of Vanessa Young, who passed away after taking Prepulsid. She said that was one of the reasons that pushed her to bring the motion forward. Indeed, seemingly preventable incidents such as this one clearly reveal the need to review departmental regulations regarding the reporting of adverse drug reactions. It only makes sense.

In light of the preventability of harm caused by these adverse affects, and in light of the increasing reliance on drugs in our health care system, this is clearly a matter worthy of the attention of the Department of Health and, indeed, the health minister. Measures such as the one proposed by the hon. member for Winnipeg North Centre are important because they go to the very heart of the issue of informed choice. This is about giving consumers and patients the information they need to make wise decisions about their health and the health of their families.

My party has long recognized the contribution of Canada's pharmaceutical industry to economic growth and innovation. The proof, as I have pointed out, is in the growing importance of drugs and the delivery of health services.

What is important now is for the government to provide the necessary regulatory framework to ensure that Canadians are best able to benefit from the advancement in pharmaceuticals but at the same time are protected from some of the potential dangers.

I believe this initiative moves the debate in the right direction. I encourage the member to pursue her efforts in bringing this issue to the attention of the government again and again. If a private member's bill is ever brought to the House, it is my hope that it will be chosen as votable. To be sure there are important questions that need answers, such as how much a system like this would cost, who would implement it and what the federal-provincial ramifications are of any such regulations.

I encourage the hon. member to toughen the language of any future motion or bill when it comes to federal-provincial co-operation. Simply put, when it comes to the government, consultation is just not enough. The government has shown itself perfectly capable of talking the talk of collaborative federalism while developing policies as it, and only it, sees fit.

If this comes back as a private member's bill I can assure the member for Winnipeg North Centre that I will be supporting the initiative and I thank her for bringing it forth.

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

Mr. Speaker, first let me say how much I have appreciated the seriousness with which members of parliament have taken this issue. I have appreciated the input from the members of all parties who have spoken in the House today.

It is clear that there is a general consensus in this place for action with regard to adverse reactions caused by pharmaceuticals in our society today. There are obviously differences in approach. Various suggestions have been made about how we can pursue this matter. I have listened seriously and will come back with further suggestions and recommendations based on that advice.

I am certainly encouraged by the words from the member from Oakville, the chairperson of the health committee, who I understand has spoken on behalf of the government and has given us a very clear indication that the present government is taking this recommendation very seriously.

At the end of my remarks I was going to move the usual motion to seek unanimous consent to make this motion votable. I will not do that today given the words from the government side and the clear indication of support from the member from Oakville who has said the government will be taking this under advisement, looking at it very seriously, and making recommendations before the year since the inquest into Vanessa Young's death has passed.

That means we can expect action on this matter no later than April 2002. Mr. Speaker, you can be sure we will be holding the government to account for those intentions and pursuing every avenue we can to make that a reality.

A couple of other suggestions were made that deserve quick comment. The member for Esquimalt--Juan de Fuca has indicated that perhaps we should look at a system that separates out fatal or near fatal reactions from this broad request for mandatory reporting. I will pursue that carefully, but I want to stress that I think the purpose of this motion is to take every precaution we can to ensure that people do not experience death or near death experiences.

I think a broader mandate is required in this instance and I have yet to hear any substantive arguments for why this would be so difficult to implement. In fact the suggestions made from others in the House indicate that it is a feasible idea that could be implemented fairly quickly.

I want to also say to my colleague from the Bloc, the member for Hochelaga--Maisonneuve, that he raises a very important issue about the House looking at the whole issue of drug costs, which is indeed the fastest rising element of our health care system. We know in fact that drug costs have risen over 87% in the last decade.

As a parliament and as a health committee we need to look at the reasons for those cost increases. We need to look at patent protection. We need to look at over prescribing. We need to look at people not filling prescriptions because of a lack of resources to buy expensive drugs. We need to look at the whole range of issues that are driving up the costs of our health care system and in fact putting our whole medicare system on a very weak footing. It is a very important issue that we have to pursue.

In the meantime, today we look to addressing one part of the problem facing our health care system and that is the serious costs in terms of human health and sustainability of our system because of adverse drug reactions. We can do something about that. It takes not only reporting of those incidents, it requires good quality reporting, sharing of the information and action on the part of the government.

Let us not forget that with regard to the death of Vanessa Young mandatory reporting was part of the problem, but more critical was the inaction of the government when it knew that there were adverse drug reactions, that there were serious illnesses associated with the use of this drug Prepulsid and that there were deaths occurring because of Prepulsid being available on the market.

We have to call for vigilance on all fronts. Again I thank all members for sharing in this very important debate and for their valuable advice.

[The Acting Speaker (Mr. Bélair)]

The time provided for the consideration of Private Members' Business has now expired. As the motion has not been designated as a votable item, the order is dropped from the Order Paper.

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

[Bill Casey, Progressive Conservative, Cumberland—Colchester, NS]

Mr. Speaker, I appreciate the opportunity to raise again the question on the softwood lumber industry in Canada. I raised it several months ago. It is now even more urgent since the September 4 decision by the U.S. department of commerce to impose a 19.3% countervail charge against the softwood lumber industry.

The industry is hurting very dramatically right now because of this incredible countervail charge. Many jobs are being lost and businesses are closing. Today I met with members of the Canadian Lumber Remanufacturers Alliance. Because of the nature of their business they are hurting more than others. They are a value added industry, which means that the countervail is charged not only on the price of raw material, not only on the mill gate price, but on the border ready price, after the value added, after the labour and after the Canadian content has been put on. It results in a doubling of duty for the Canadian Lumber Remanufacturers Alliance members.

It is extremely serious for them. The impact will mean closures and failures in the industry. They are seeking an exemption in the short term. They are seeking a long term resolution to resolve this ongoing issue which pops up every five years. The industry has to go through tremendous turmoil and aggravation. They want it resolved, as does the entire industry.

Two weeks ago I had the honour of accompanying the right hon. member for Calgary Centre to a meeting. We met with the vice-president of the United States about this very issue. We informed him of our concerns and also of the intention of new British Columbia premier Gordon Campbell to reconsider their marketing approach, which has been part of the excuse used by the U.S. industry to cause the government to impose these countervail charges and anti-dumping charges that are still pending.

We provided the vice-president with material given to us by Premier Campbell which indicated that they have the intention of moving toward a more market driven pricing initiative or regime. He welcomed this initiative and he was very encouraged by it. He and his officials acknowledged that this would help remove the excuses and the tools that the U.S. industry uses to pry the government into imposing these taxes.

We want to applaud the premier of British Columbia for these efforts. We encourage him to move ahead toward a more market driven price as he has proposed. We think that after these consultations with the Americans, by moving to a more market driven pricing schedule many of the excuses used by the Americans would disappear. The administration would then move to resolve the issue and move to a free trade regime.

At this very important time, Canadian officials from the department and also from industry are meeting with American officials. I ask the hon. parliamentary secretary, in these discussions with the U.S. department, is the government also working with the government of British Columbia to help move them toward a more market driven price regime for their raw materials?

[Pat O'Brien, Liberal, Parliamentary Secretary to the Minister of International Trade]

Mr. Speaker, at this time Canadians are very much united in grief with the United States and are determined to help bring the criminals of the recent terrible atrocity to justice. In the midst of that kind of outpouring of unity with our American friends, neighbours and relatives, we do realistically find ourselves with some bilateral problems that have to be addressed.

My hon. colleague, the member for Cumberland--Colchester, has been very determined in highlighting these questions and raising these concerns.

Canada is acting on several fronts to try and resolve this unfortunate dispute. As he noted, it rears its ugly head every five years and Canada has to reprove its case. As you know, Mr. Speaker, since you represent a riding with tremendous lumber interests, we reprove the fact that we do not subsidize our softwood lumber, that in fact everything on our side is being done above board.

We call upon our American friends and neighbours to respect the desire for free trade in softwood lumber.

We are acting on several fronts, at the WTO, at NAFTA. As my colleague has mentioned, discussions are going on in Toronto today and over the next couple of days between Canadian and American officials to try and find the root causes of this problem, to find a solution outside litigation. We hope that will be the case.

As my colleague knows, the Prime Minister has personally raised this issue with President Bush. Just before the atrocity in Washington, the Minister for International Trade was there to speak personally with Mr. Zoellick and Mr. Evans. We will continue to move in every possible way to try and resolve this issue as amicably and as quickly as we can.

[The Acting Speaker (Mr. Bélair)]

The motion to adjourn the House is now deemed to have been adopted. Accordingly, this House stands adjourned until tomorrow at 2.00 p.m., pursuant to Standing Order 24(1).

(The House adjourned at 7.02 p.m.)