That, in the opinion of this House, the government should consider making it mandatory for health care professionals to forward to Health Canada information on all “serious” adverse drug reactions within 48 hours of their occurrence.
Madam Speaker, it is a pleasure for me to be able to introduce a motion in the House. It is a very important issue because it needs to do two things. We need to raise awareness of a very serious problem in Canada, something I have had a researcher on for the last three years. It is something I have a tremendous amount of information about and we have seen a lot on about it on the CBC news this week with its reporting of exactly what is going on. Canadians are starting to wake up to the issue and this is an attempt to wake the House up to this issue and actually do something about it.
Not only do we need to raise awareness, but we also need to make sure that we put into law the awareness we are trying to raise of the number of adverse drug reactions. We actually must have mandatory reporting of those serious adverse reactions from our professionals in the health care system, our doctors, nurses, pharmacists and other health care workers.
It is important that we raise awareness of these issues. The CBC has done a very good job of that. Actually it has tried for the past five years to get information on the database that Health Canada has with regard to the number of adverse reactions that are being reported in the country. The CBC was able to get this information only through an access to information request. Now they have 162,000 recorded cases on a website, so Canadians from coast to coast to coast will be able to go to the website to try to determine this and see for themselves some of the reactions that are happening.
It is very important because we see skyrocketing numbers of cases in Canada. Some of the numbers disclosed this week involve kids. Serious reactions in that group have tripled in the last couple of years, but Health Canada has no ability to be able to deal with trends for this information.
That is another thing that has come forward. Even if Health Canada had all the reporting in place right now, we have to understand that it does not have the wherewithal to be able to deal with the actual trends taking place before our eyes. It is understaffed and underfunded. Not only are we going to have to be able to deal with awareness and mandatory reporting, but then we have to deal with what we are going to do with that information and how we are going to protect Canadians because of it.
In March 2000, this all came to a head when Vanessa Young, a 15 year old girl from Oakville, died in front of her father because of the inappropriate use of a drug called cisapride, also known as Prepulsid. The two names mean the same drug. Health Canada knew about this back in 1996, long before this child died, and the United States had flagged it as well. There were 14 deaths from this drug in Canada prior to this time and numerous other deaths in the United States. Why was it allowed to happen in Canada before our eyes? Why is it happening today? We have to ask ourselves those questions.
The coroner's inquest actually brought this to light. There were actually 59 recommendations coming out of that inquest as to how we could deal with the problem, 14 of them levelled right at Health Canada. One of them was the mandatory reporting of adverse or very serious reactions to medication within 48 hours. Therein lies what this motion is all about, which is to make sure that this actually happens.
In fact, the inquest went one step further and actually defined what “serious” means. It means that which results in “significant disability or incapacity, is life-threatening or results in death”. It is a very clear, very simple definition of exactly what we are talking about.
We have to ask why this was not acted on before now. Why is Health Canada dragging its feet on this one? This is not the first time that this idea has been introduced in the House. There was another very similar motion introduced by the member for Winnipeg North Centre in September 2001. At the time it was introduced to the House, it was discussed and supported by all sides of the House. One would have thought that would send a serious message to Health Canada but it did not, because there was no vote on it and no actual direction from the House to make sure it would take place.
So now we are seeing a much more serious problem as it escalates. We have an opportunity to send a very serious and very strong message to Health Canada and to the Minister of Health so that we will be able to deal with the issue.
How big an issue is it? How big a problem do we actually have out there? I think we need to ask ourselves that.
A study done in the United States in 1998 estimated that, annually, 2.2 million individuals were hospitalized for serious adverse drug reactions. There were an additional 106,000 fatal adverse drug reactions in that same year.
We can compare the data. There are 300 million people in the United States and 31 million in Canada. That translates into a little over 10,000 deaths in Canada on a yearly basis due to adverse drug reactions. These are significant numbers. A 1999 report in the Canadian Medical Association Journal estimated that there were approximately 1,825 deaths due to adverse drug reactions. The doctors themselves came forward with these numbers. Researchers David Rosenbloom and Christine Wynne estimated that the number of deaths due to adverse drug reactions was around 7,600.
The numbers are all over place, but just using those numbers, adverse drug reactions translate into being the seventh leading cause of death in Canada. That increases the number of days for a hospital stay to 4.6 days more per individual and costs our health care system about $300 million annually.
We can play with the numbers all we like, but it does not really matter how big we make them. We have to understand that the numbers are really there. In fact, Health Canada said that in 2001, 54,000 Canadians experienced adverse drug reactions. That would translate into about 3,800 people who died in that year.
We have to say, then, that this is a very serious problem and it is getting worse all the time. Why are professionals not reporting adverse reactions? The number of reported incidents is estimated at somewhere between 1% and 10%. Why is that? We have to understand the stress that some of our physicians are under right now. There is no incentive for them to do so. A lot of them do not even know where the form is to report adverse reactions, and it is a lengthy form. We have to look at some of the solutions to this.
This is not about attacking physicians. This is not about attacking professionals. This is not about attacking pharmaceuticals. This is about bringing awareness to the issue and then looking at how we are going to deal with it.
Whether it is 400, 4,000 or 10,000 deaths is probably not really the issue. We have to understand that every one of those deaths translates into real people, real families and real friends, and every one of those deaths was preventable. If they were not preventable, they should have at least raised a flag so the same mistake could not happen to any other individuals. We owe at least that to those who fall victim to adverse reactions.
Where do we go from here? Why should we have mandatory reporting? Because we see the amount of drugs being used in this country. In 1992 Canadians spent $8.5 billion on pharmaceuticals. In 2002, a decade later, Canadians spent $18.1 billion. That is a $10 billion per year increase. With those kinds of numbers and the amount of drugs being used, we have to say that we have a serious problem and it is going to get worse.
The baby boomer generation is now closing in on 55 to 65 years of age and the consumption of medication is going to increase. We have to deal with the problem now. We have not seen anything yet when we realize what is coming down the road at us.
Let us get serious about this problem. Let us get serious and do something about it. We need mandatory reporting of pharmaceuticals by doctors, pharmacists, health care professionals and consumers. That is one way we can help this situation along.
This is not the first time a flag has been raised in Canada. Colleen Fuller is an individual who fell victim to an adverse reaction and became interested in doing some research on this. The Krever inquiry also raised a flag about mandatory reporting of adverse reactions. Vanessa Young's coroner's jury is another example.
Not only that, Canada's Auditor General said in a report in December 2000 that we cannot get to the bottom of the actual numbers and know what is going on because reporting is not mandatory. It is just voluntary. If it is just voluntary, then we do not know what the numbers are.
As I said before, only 1% to 10% is actually being reported, so there is a 90% error and guesswork is going on around this whole issue. We have to do something about it.
It is absolutely critical that we get serious about dealing with this issue. We also have to ask why it is not happening, why it is that the reporting is not going on. We have to realize what our physicians and nurses are dealing with. They have two of the most highly stressed jobs in the country. In fact, the sickest workplace we have in the country is our hospitals. Our nurses are stressed to the max. They take more sick days than any other occupation, any other professional group of individuals. When it comes to doctors, we understand that 75% of them are refusing to take on more patients because they are so stretched and so worked to the max. This is not an attack against them. This is an attempt to be able to give them the tools to be able to deal with this in a more appropriate way.
Why are they not reporting it? Number one, they have no incentive. They have no time. Family practitioners are only paid for a 10 minute visit.
We have to give them some of the tools. Maybe we do not have to use a long form. Perhaps we could use BlackBerry technology or another reporting system that could give them the ability to report in a way that is not cumbersome, in a way that is streamlined so they can do it. We have to engage them in that process. We have to ask them how they would like to be able to come forward with mandatory reporting and how we can work collaboratively with them.
That is where we need to go with this motion. This makes it mandatory, but it does not bring forward the actual tools so that we are able to do it. That is why I did not bring forward a private member's bill, which would bring down the specifics. What we want to do is raise awareness, engage in debate, and give a direction from the House that we will not take it anymore, that Health Canada has to act, and that we have to make sure something is done for the betterment of our citizens.
It is also not an attack at all against the drug companies. Many of the medicines that we use are wonderful technologies. They do a great amount of good, but there is also a great amount of harm. We know that. Some of the information from research I had been doing in my own office pointed me to some of the problems that are going on in this country, so we initiated a study that was done by the Standing Committee on Health. We travelled from coast to coast this fall dealing with the pharmaceuticals and the adverse reaction to these medications. Some of the testimony that came forward was absolutely amazing.
One professor who teaches university students came forward and said that 50% of individuals hospitalized in this country have an adverse reaction or there is a medical error before they are discharged. If those numbers are anywhere close to being true, we have a very serious problem on our hands and we have to deal with it.
I questioned those numbers, so I asked the next witness who came along and who I thought would have some information on this if he agreed with those numbers. In his testimony, the individual said that he could not refute those numbers, that they were probably very close to being accurate, if not underestimated.
We have a serious problem when it comes to this. We have to look at where we are as a nation. We are rated by the United Nations as the 30th best health care system in the world. The United States, by the way, is 37th, so we should not be looking to the United States for an example, but there are 30 nations that are better than we are. We had better start looking at what those 30 have to offer in giving us some information as to how we can deal with our health care system in a better way.
There are another 11 countries that have mandatory reporting of adverse reactions. The number one health care system in the world is France. France has mandatory reporting, but some people will probably get up and argue about whether it has really worked in France. It has not increased reporting that much more, but we can learn from them and understand how we can streamline the system to make it a lot easier for our professionals to be able to actually come forward to report the adverse reactions.
We have to look at what we can find out from these other countries in order to be able to dialogue with our professionals and to bring forward the actual piece of legislation and the way this has to be done, but we have to kick Health Canada in the backside to make sure it actually happens. That is what we have to do. It is absolutely important that every member of the House understands the opportunity before us: that on our watch, while we are here in the House, we have the opportunity to do something about it. We cannot delay. We absolutely have to vote for this motion so we can give the proper and appropriate direction to Health Canada.
This is long overdue and I encourage all members of the House to consider it. Saskatchewan put forward this kind of legislation in its province. We had to dialogue with the rest of the provinces to make this happen.