Mr. Chair, I am very happy to participate in this debate no matter how late it is. It is a critical issue that needs thorough discussion. A consensus from this place needs to be presented to the Minister of Health so we can finally see some action on a very important issue.
It is interesting that we have heard tonight that the government will be presenting legislation. It has talked about this for a long time. We are still waiting to see what that legislation and the package of initiatives will be to address the matter of cross-border sales of pharmaceuticals. Would it not be nice for once if the Minister of Health instead of saying that there was a problem and that the government was going to do something, actually said that the government is doing something and said what it is doing.
Let us put this in perspective. If there ever was an issue that identified just how ingrained that culture of dithering is, it would be on the matter of Internet pharmacies. This issue has been around for a long time. I went through my files and I have mail going back to 2003. Perhaps if I went back further, I would find there were concerns raised even before then.
Here we are three years later in a debate that is very important, but the government has dragged its feet and we are still waiting for legislation. Perhaps tonight we will actually generate some good suggestions for the minister. Perhaps he will make sure that he brings forward a package of initiatives that deal decisively and creatively with the problems we are talking about.
I am glad to participate in this debate because it is an issue that has very clear and strong importance for people in Manitoba and particularly in my constituency of Winnipeg North. The Internet pharmacy business is a major part of the Manitoba economy. It brings in sales in Canada of $690 million. For a province that is a big player in this area of the economy that is significant revenue. It is estimated that about 2,000 residents of Manitoba work in this particular sector of cross-border drug sales. There are many benefits for the economy. Some would say they are as high as $1 billion per year in terms of trade revenue.
It is a matter of significance to many people who work in this industry. Many of my constituents have expressed concerns about their future, about whether or not the jobs they now hold will be there in the future and whether they will be able to provide for their families in the future, given the concerns and issues that have been raised.
However, there is another side to the issue. It is not simply a question of business gains and job opportunities for Manitobans, or Canadians anywhere in the country for that matter. Whatever we do in terms of addressing the issue of cross-border sales of pharmaceuticals, we have to be comfortable and confident that our drug supply is safe, secure and affordable for Canadians, first and foremost. That is an absolute requirement for public policy changes in this area.
It is clear that whatever we do in this field, we have to ensure that we have a made in Canada solution to an international issue. We have to be sure that we do what is in the best interests of Canadians, what is good for our economy, what is good for people who depend upon a safe, affordable supply of drugs and what is good for our health care system as a whole.
I mention the last point because drugs are the fastest growing segment of our health care system. It is the most costly part of our health care system. It has in fact exceeded the costs incurred to our health care system by doctors' fees.
Knowing all of that, it is clear that we have a lot of work to do any time an issue like this is raised. In this case I want to be clear that I join with others in the House in commending the minister for taking some preliminary steps in banning the bulk export of drugs. I want to be clear that I join with others in the House in terms of his efforts regarding doctors having signing responsibility for prescriptions filled in Canada.
I want to mention a few other concerns raised by people in my constituency and in my province. Some pharmacists in Manitoba do not feel that all of their concerns have been addressed. They applaud the government for some of the initiatives taken but raise other concerns.
I put them on the table tonight because we still have time. We are not dealing with legislation yet. We do not have a package of responses from the government. Obviously, the government has taken three years to get to this point and it is still working on the package. Perhaps some of these suggestions will be useful.
I want to raise a couple of concerns presented to me by two individuals in Winnipeg, Manitoba. The first is a pharmacist by the name of Archie Orlikow who happens to be the brother of David Orlikow who was a member of Parliament for many years. Until very recently he held the record for holding office for the longest period of time on a consecutive basis. That record was recently surpassed by my colleague the member for Elmwood—Transcona who now holds that title and that honour and who is, as we all know, the dean of the House.
Archie Orlikow is a pharmacist who has been involved in this area for many years and was one of the pioneers of the Manitoba Formulary. He has been raising concerns about Internet pharmacies for years. He has been a regular voice in this place through his letters, faxes and e-mails. He has done an admirable job of bringing some very serious concerns to our attention. I want to mention a couple of those concerns and make sure that the Minister of Health includes them in his package of solutions.
First, Mr. Orlikow talks about the possibility of increased costs to consumers and to patients if we do not deal with the issue of cross-border sales in a decisive way. He says it is clear that Canadian price controls through the Patented Medicine Prices Review Board are working effectively but that there is some evidence of deductibles going up in pharmacare programs and some evidence of the cost of drugs rising as a result of this whole phenomenon of Internet pharmacies. He also talks about the additional cost to traditional pharmacies that are trying to compete with the fairly massive Internet pharmacies that are able to compete for trained pharmacy personnel. That is one concern.
The second concern has to do with the availability of prescription medications. Archie Orlikow and Charles Cruden, the other person who signed the letter, indicate that there may be some evidence of some prescriptions not being filled completely because of a short supply. They question why that is and how we ought to address it. They say that some prescriptions are not available and there is a necessity sometimes to substitute another medication and they give some examples. They also say that it has been reported that prescribed medications are being purchased from different countries and they want to be sure that Canadians are receiving authentic medications.
The final area of concern has to do with patient safety and physician ethics. The authors of this letter acknowledge the promise made by the government to actually require Canadian doctors to have signing responsibility for prescriptions filled in Canada, but they raise questions for example with the communication for prescriptions by electronic means, how can there be assurance that the request is bona fide.
Mr. Orlikow raises questions around prescribing medications that are being purchased from different countries and how Canadians can be sure they are receiving authentic medications.
He raises these issues looking for assurances from a government that ought to have a complete handle on the question of safety and affordability of medications, because they are vital for the health and well-being of so many in our society.
It is such a centrepiece of any kind of health care prevention model that we have to be absolutely clear about any impact of a policy pertaining to Internet pharmacies. We have to be absolutely certain that we have done our utmost in Canada through our federal government to ensure that safety of all drugs is guaranteed, that there is no shortfall in supply and in fact that Canadians will never have difficulty accessing the drugs they need when they need them.