Mr. Chair, it is a great pleasure and an honour for me to participate in this debate this evening. The tone of the debate, which was set initially by the minister and by members from all parties, has been very good, very constructive. We all want to meet a similar objective and I am very pleased by the will of everybody to continue in a constructive way.
Like all my colleagues I have been touched by the heart-rending stories of personal suffering from individuals who have contracted hepatitis C through the blood supply. As a government and a society, we have the duty to help victims of hepatitis C as generously as we can to ease the burden of that disease which for some may be with them for the rest of their lives.
I am happy to report that advances in treatment, particularly over the past five years, have eased that burden significantly for many. For the most persistent strain of the infection, new treatments can reduce the level of the virus to undetectable levels in the blood by up to 50%. For some this is tantamount to a cure, meaning they have been able to resume their normal lives and careers. We are also making great strides in research, such as the development of an animal model, a mouse for hepatitis C research that is facilitating progress in important areas such as treatment and vaccine development.
There is no doubt that hepatitis C remains a serious problem and a challenge to our society. It is estimated there are about 250,000 persons currently infected, with 5,000 new infections occurring each and every year. Every year about 1,000 Canadians die from hepatitis C related illnesses.
This is why the Government of Canada has committed $1.4 billion to address the unique needs of people living with this terrible disease, as well as on research in improving the blood supply in Canada so that such a tragedy will not be repeated in the future. Today Canada's blood supply is among the safest in the world.
As you know, in the late 1990s, the Government of Canada adopted two distinct funding streams to help people infected with hepatitis C: one that directed financial compensation to people who contacted hepatitis C through the blood supply between 1986 and 1990, and one for those who became infected either before or after that four-and-half-year window.
This approach made sense at the time, and it makes sense today.This government tacitly acknowledged a responsibility toward people infected between 1986 and 1990 and offered them a financial compensation package that, over their lifetimes, will be worth a total of $1.1 billion. Of that, $875 million came from the federal government.
This period was singled out because it bracketed the starting date in which surrogate tests, which were not always reliable, began to be used by U.S. blood bank operators, and the date Canada instituted a specific hepatitis C screening test, which became available in 1990 and was more reliable than the surrogate test.
It is important to note that the unprecedented compensation package resolved the largest class action suit ever launched in Canada and spared victims of hepatitis C perhaps up to a decade in litigation in the courts. The government also recognized that regardless of when people contracted hepatitis C through blood they too were suffering and required assistance.
In September 1988 the federal government announced a comprehensive $525 million hepatitis C strategy that included strengthening the safety of the blood system and supporting prevention and treatment through community based initiatives and scientific research. The largest share in the federal investment involved the transfer of $300 million over 20 years to the provinces and territories. The purpose of this undertaking was to ensure that people infected with hepatitis C before 1986 and after July 1, 1990 did not incur financially crippling out of pocket expenses for medical treatment.
The initiative was called “Cash, Not Care” and was not meant to be given directly to hepatitis C victims but to help provinces and territories pay for health care services to victims, such as liver transplants, nursing care, laboratory services and drug plans.
The federal government is required to conduct an evaluation of this program’s effectiveness every five years, and we intend to follow through on that undertaking. Some provinces and territories signed the undertaking agreement in 1999, so the first of those reviews will be conducted later this year. Since 1999, we have been monitoring and collecting information on access, types of services, drug plans and formularies, and complaints from individuals.
This year, we have conducted informal telephone interviews with hepatitis C officials from every jurisdiction. The information gathered will be used by Health Canada in its reviews.
So, this government has put in place a generous and comprehensive plan to help all hepatitis C sufferers, as well as programs designed to combat spread of the disease and help research to improve treatment and find a cure.
We are not deaf and unsympathetic to those voices that say the initiatives are not working as well as intended or that the situation has changed since the agreements with the provinces and territories were signed. We are not unsympathetic to the suffering of victims, both physical and in some cases financial.
For instance, the extremely high cost of hepatitis C health services may have eroded the effectiveness of the $300 million package. In 1998 interferon was the only licensed hepatitis C drug therapy and it cost about $7,000 per year, per person. Today a combination of drugs that are much more effective is available but the cost is about $24,000 for a 48 week course of treatment.
Meanwhile, there are indications that there might be a surplus in the $875 million federal fund that is being used to compensate persons who became infected in the 1986 to 1990 period. The reasons are varied.
First, the money deposited by the federal government has been well invested and in spite of payments of about $388 million to over 9,000 claimants so far, the fund still contains $865 million as of March 31, 2004.
Second, as treatments of hepatitis C become more effective in restoring the health of many sufferers, fewer and fewer victims are eligible to receive the higher levels of compensation meant for those most adversely affected.
I must make it clear that this so-called surplus—and it will be up to the courts to determine if there is one in June 2005, after considering that payments to victims may continue for as long as 70 years—is not the government’s surplus.
It belongs to the beneficiaries of the trust that was established by the courts under the settlement agreement with those individuals.Opening up the trust to share with pre-1986 and post-1990 victims would require the agreement of the trust’s beneficiaries, the provinces and territories, as well as the courts in British Columbia, Ontario and Quebec.
In conclusion, I want to assure everyone in the House that this government continues to generally support victims of hepatitis C in a variety of ways, as well as helping finance advances in prevention, treatment and search for a cure.
I also want to stress that we are aware that circumstances for victims have changed, and I might add thankfully in most cases they are for the better and they are continuing to change. We are always exploring ways to adjust and improve services to meet the unique needs of Canadians still living with this terrible disease.