Debates of Feb. 16th, 2005

The House resumed from February 10 consideration of the motion that Bill S-2, an act to amend the Citizenship Act, be read the second time and referred to a committee.

Citizenship Act

[The Acting Speaker (Hon. Jean Augustine)]

Pursuant to an order made earlier the House will now proceed to the taking of the deferred recorded division on the motion at second reading stage of Bill S-2 under private members' business.

Call in the members.

And the bells having rung:

[Derek Lee, Liberal, Scarborough—Rouge River, ON]

Madam Speaker, I rise on a point of order. I realize you are dutifully following the procedure for a roll call vote, but I look around the House and sense that this measure might be adopted on division without a roll call vote. I wonder if you would seek the view of the House as to whether or not this measure could be adopted unanimously.

[The Acting Speaker (Hon. Jean Augustine)]

Does the hon. member for Scarborough—Rouge River have the unanimous consent of the House to proceed in this fashion?

[Some hon. members]

Agreed.

[The Acting Speaker (Hon. Jean Augustine)]

I declare the motion carried. Accordingly the bill stands referred to the Standing Committee on Citizenship and Immigration.

(Motion agreed to, bill read the second time and referred to a committee)

Alzheimer's Disease

[Susan Kadis, Liberal, Thornhill, ON]

moved:

Motion No. 170

That, in the opinion of the House, the government, in consultation with the provinces and territories, should develop a national strategy on Alzheimer's disease and related dementias to ensure a nationally coordinated and comprehensive approach to these health issues.

Madam Speaker, I am pleased to rise in the House today to speak to this private member's motion. The motion calls upon the federal government to initiate consultations with the provinces and territories to develop a national strategy on Alzheimer's disease and related dementias.

The central purpose is to put in place a coordinated comprehensive approach by providing an opportunity for shared learning, the development of best practice models of care across jurisdictional boundaries, and the adoption of a strategic and cost effective response to Alzheimer's disease.

Recently the National Advisory Council on Aging released a position paper on Alzheimer's disease and related dementias. The report presents a strong and undeniable case for Alzheimer's disease as a national health priority for Canadians. It indicates that a national strategy is needed, is feasible, and the need for leadership on a national level is recommended.

Some of the key recommendations include research, information, education, access and equity, quality, integration, a continuum of care, and workforce development and training. Similarly we already have models of nationally integrated and coordinated strategies to address other chronic diseases like diabetes, stroke and cancer. Our demographics clearly show that there is a looming need for collective action on Alzheimer's disease now.

As a daughter whose father passed away from Alzheimer's disease, I have experienced the full range of consequences resulting from this devastating disease. There are no adequate words to describe what it is like to stand by and watch the disintegration of a once thriving contributing individual, a loved one, literally slip away day by day.

Imagine someone like my dad, Vic, who fought for Canada in World War II, working all his life, supporting his family, putting his kids through school and then getting to retirement age, a time when he should be enjoying his spouse and grandchildren, and instead a descent into the darkness of cognitive impairment begins. A person's spouse, family and caregivers watch this relentless disease take hold as death in slow motion begins.

Alzheimer's disease is a progressive, irreversible, degenerative disease of the brain. In essence, it attacks and destroys brain cells, ravaging the mind, often brilliant minds, by impairing one's memory, insight and judgment. In its wake is left a monumental far-reaching effect on families across our country. Over 70% of informal caregivers are women, most often wives, 24%, or adult daughters, 29%. Current estimates indicate that one Alzheimer's patient affects a minimum of 10 to 12 people, whether it is family, caregivers, neighbours or close friends.

Current statistics indicate that there are 420,600 individuals who suffer presently from Alzheimer's and dementia in Canada. This figure represents approximately 8% of all our seniors. In 2005 there will be an estimated 94,270 new cases of dementia, the majority being Alzheimer's. By 2011 new cases of dementia are expected to reach 111,560 per year, of which 67,680 will be women and 43,880 will be men.

It is estimated that by 2031 approximately 750,000 Canadians are expected to be affected by this dreaded disease. That is three-quarters of a million Canadians. Over the age of 65, people's odds are 1 in 13 to be affected by Alzheimer's.

The statistics on Alzheimer's disease, while significant on their own, can only begin to tell the story of the far-reaching impact of this disease. There are a growing number of organizations, like the Alzheimer Society of Canada and its provincial and community counterparts, working diligently in an effort to meet the needs of patients, families and caregivers. Key stakeholders have formed community partnerships to initiate and implement policies and services to fulfill the needs of patients, their families and their caregivers. I heartily applaud the work being done today across our country.

I am also acutely aware that as the number of Canadians diagnosed with Alzheimer's increases as a result of our aging population, we must act decisively and strategically to beat this catastrophic illness and to improve our ability to better cope with the impacts while we do so. An increasing number of baby boomers are now finding and will find themselves becoming a part of a caregiver network to parents, relatives and friends with dementia.

Statistics clearly show the correlation in the development of chronic health problems as a significant factor among informal caregivers who are caring for people with dementia. Of all groups researched, spousal caregivers use fewer support services than any other, yet it is precisely those spousal caregivers who are more likely to be giving care to those with Alzheimer's.

Aside from the overwhelming human costs, the financial costs associated with Alzheimer's disease are startling in themselves. Health care, paid and unpaid caregiving, of which there is much, combined are estimated to be $5.5 billion per year. The social costs to families, caregivers and society at large are enormous, for example, unpaid caregiving, stress, illness, depression and career interruption.

The costs to our society are incalculable. There is no doubt that these costs will rise exponentially if current projections remain unchanged and appropriate steps are not taken now. In fact, some analysts believe that over the next 25 years, Alzheimer's disease combined with other forms of cognitive impairment will rise to have the highest economic, social and health cost burden of all diseases in Canada.

The implications are clearly something that cannot be ignored. This is a sleeping giant. The need to enhance, coordinate and expedite the needed support services and research cannot be overstated.

Our knowledge of Alzheimer's is increasing. However, more definitive research is necessary now. Many researchers feel that the risk of developing Alzheimer's disease and related dementia may be reduced or delayed by certain preventative factors. We are beginning to understand there are things that we can do which may reduce the risk of Alzheimer's disease. This must be pursued vigorously. In addition, if research can develop the means of diagnosing people with Alzheimer's disease earlier, with more precision prior to significant brain damage, improved intervention would be able to actually halt the progression of the disease, avoiding it in its most severe forms.

As mild cognitive impairment is a risk factor for Alzheimer's disease, it is now an important and promising area of dementia research. In biomedical and psychosocial research, Canada has made considerable contributions to Alzheimer's disease. However, we do lag behind our American and European counterparts in developing a coordinated national research program.

Scientists have made great advances in better understanding Alzheimer's disease in the last 20 years, but this success has not always translated into the politics of health policy. It is now clear that early intervention with the appropriate services and treatment can delay the onset of this disease. While the Canadian Institutes of Health Research, which includes the Institute of Aging, has been a very important component of health research in Canada, very simply put, the incidence of Alzheimer's disease and its impact is growing at a faster rate than increases in research.

In several key areas related to diagnosis, treatment, care and possible cure of Alzheimer's, we must do a lot better, and we can. Increased funding is only part of the answer in this race against time. Although we find many individual situations where quality care exists, there are many more where this is not the case. There is no doubt they would benefit significantly from a comprehensive coordinated approach of sharing best practices. There is no doubt.

The aim of a national strategy would be to enhance the quality of life for people living with Alzheimer's, their families and caregivers, and where possible, prevent or delay the onset of this dreaded disease. While much of the implementation would occur at the provincial, territorial, regional and community levels, the federal government can and must play a key role, both in terms of leadership and funding.

There are countless Canadians taking care of loved ones with Alzheimer's disease. Surprisingly, only one in four people caring for a person with dementia receives formal home care services to assist them in caring for their family member, often after five years. This is a result of many factors, including inconsistent funding, lack of care and support services across the country, and a lack of knowledge often that there are services available. A national Alzheimer's strategy would unquestionably provide the much needed focus to address serious issues, each of which holds tremendous potential to improve the quality of life of Canadians with Alzheimer's disease and their families.

This bold essential step of establishing a national strategy has the potential to change lives now and in the future.

In a 2002 Ipsos-Reid poll, Canadians showed they are highly aware of Alzheimer's, with almost 90% indicating they are equally and especially concerned about the cost to our health care system now and in the future as our population ages. The same percentage also felt that more money should be spent on Alzheimer's research. Over 52% of Canadians know someone with Alzheimer's disease. In fact, almost 25% of Canadians have someone with Alzheimer's in their families.

The fact is Canadians expect action by their governments regarding Alzheimer's disease. I believe we have an absolute obligation to our parents, ourselves and the next generation to do everything possible to confront this cruel killer at every turn, to prevent it, delay it, and finally stop it in its tracks. We have a responsibility also to make this journey as dignified as possible for those who suffer from it and those around them.

This formidable enemy has claimed far too many victims in the cruelest way possible and it warrants an equally fierce national comprehensive plan of action, a collective action. We must take the necessary steps now to put in place a system that will respond to the unprecedented challenges that await us surely in the coming years.

The establishment of a national strategy on Alzheimer's disease would signal an important recognition of the impact that this disease has on all aspects of our health care system, our communities and our society. It should take a long term approach, build momentum, build on our current successes, with the aim of developing and adding capacity so that we can move to close the gaps that currently exist.

As I mentioned earlier, the establishment of a national strategy on diabetes several years earlier is a perfect case in point that developing a national action plan can become and will become a catalyst in moving forward. Incidents of diabetes have become more and more prevalent in our society, in fact reaching epidemic proportions. In establishing the national diabetes strategy there was a concentrated collaborated effort which elevated the level of awareness, research and programs available and being developed to combat this rapidly escalating disease.

In developing a national strategy on Alzheimer's disease, I believe this proactive step would be instrumental in leveraging existing as well as new resources from all partners so that concrete steps can be taken to tackle this disease effectively. This historic commitment would certainly go a long way in identifying and extracting the maximum benefit possible from the resources we are already committing and would lay the groundwork for the years ahead which could be very difficult.

Working in conjunction with the provinces and territories, we have made great strides on numerous fronts, like our 10 year health accord, moving forward with the national home care plan, and the development of our healthy living strategy to manage and improve our health both now and in the future. Although all these investments are very valuable pieces in the puzzle in the diagnosis and treatment of, and hopefully an ultimate cure for Alzheimer's, there is still a critical need for an all-encompassing strategic plan for the future.

Alzheimer's disease and related dementias are complex problems that cannot be undertaken by one government or one sector of society. This disease does not acknowledge jurisdictional boundaries. In committing to a national strategy on Alzheimer's disease with our other key partners we would be able to weave together the threads of policy initiatives, programs and services across our country to focus on the prevention, treatment and cure of this disease.

To all my colleagues, I ask that they join me today in recommending the development of a national strategy on Alzheimer's disease and related dementias to prevent the worst effects of this disease in the years ahead. We are poised for a breakthrough. Let us not drop the ball now. It is within our reach.

[Robert Thibault, Liberal, Parliamentary Secretary to the Minister of Health]

Madam Speaker, I would like to commend the member for all the fine work that has been done by her on this file and the obvious compassion she has for the people who are afflicted with this disease, not only the patients, but also the families, the communities and everyone concerned. It is important that we work toward such a strategy.

I know the member has firsthand knowledge of the effects of such a disease on families and friends. I know she is in contact with the Alzheimer's society. She would be aware of the research. The research side is important.

Perhaps she could enlighten the House as to what she would see as the priorities for such a strategy that would help immediately the families, as well as those individuals who may become afflicted with this disease in the future.

[Susan Kadis, Liberal, Thornhill, ON]

Madam Speaker, I think the key is to pull together the threads, all the expertise that currently exists across the country in a way that we help to provide a focus. Once we provide the focus, services will improve and issues of money can be dealt with at that time, once it is known what the focus is. We cannot actually know what true funding we need to allocate if we do not first create that focus and true understanding of what currently exists.

[Yasmin Ratansi, Liberal, Don Valley East, ON]

Madam Speaker, I ask the member for Thornhill, why is it necessary to develop a national strategy and how will the provincial and territorial counterparts assist in it? I know the member has made an effort. She talked about providing a focus, but could the member elaborate on the importance of a national strategy versus what is happening now?

[Susan Kadis, Liberal, Thornhill, ON]

Madam Speaker, I think the issue I raised about a looming, aging population, mandates us to go forward collectively on this issue. I believe we all have a role to play here. I believe there should be leadership from the national level. We already have a lot of positive initiatives taking place, very innovative ones in many ways.

I believe it is only through this collaborative effort that we will see this breakthrough. The reality is that we are very close to a breakthrough. We have already seen that we can delay the onset. This is very unusual and it is due to a lot of our research.

We have an opportunity for a breakthrough, rather than a crisis. When we know we can take advantage of this potential, we cannot afford to relegate it to the legacy of lost opportunities.

[Mark Holland, Liberal, Ajax—Pickering, ON]

Madam Speaker, I am pleased to rise today in support of this initiative. I would like to commend the member for Thornhill for the work she has done and the comments that have been made just now.

I think it is relevant to the debate to start with a comment on the findings of the National Advisory Council on Aging. It states:

Alzheimer Disease, and other forms of cognitive impairment, will have the highest economic, social and health cost burden of all diseases in Canada over the next 25 years.

This is a matter that is of great concern to all Canadians, and I will touch on this later in my speech. All of our lives have been touched by this particular disease or we know someone who has been touched by this disease.

The question of whether or not we develop a national strategy to tackle this horrible ailment is what role the federal government will play. I understand there are questions of jurisdiction and that many people believe this is a provincial matter and the federal government should not intervene. However I do think there are many ways that the federal government can intervene.

Would the hon. member specifically indicate some of the areas nationally that would be touched upon and dealt with by the federal government?

[Susan Kadis, Liberal, Thornhill, ON]

Madam Speaker, I think our role, first and foremost, will be to show that leadership and to liaise with the provinces, territories and regions.

We are already actively engaged, as everyone knows, with the health accord. We are working on a national home care strategy as well. All the pieces are in place and the stage is set. The last piece is for us, as the federal government, to take the lead in sending that message to everyone working in the field, pulling it together in a consolidated way. I have total confidence that this will lead to an improved quality of life, a great opportunity for a cure and, if not a cure, at least a much better and more reasonable management of this disease.

[Nicole Demers, Bloc, Laval, QC]

Madam Speaker, as a member of the Standing Committee on Health and critic for the family and caregivers, I want to express my opinion on this motion.

I would like to begin by reminding the House that January is Alzheimer Awareness Month, as my hon. colleague surely already knows.

In Canada, 280,000 people over 65 years old are affected by Alzheimer disease. That is, one person in 20. It is predicted that, by 2031, more than 750,000 people will have Alzheimer disease or related dementias.

In addition, it is a degenerative disease that causes lesions in the brain. The brain cells shrink or disappear and are replaced by irregular spots called plaques. This disease causes a gradual and irreversible degeneration of cognitive functions such as memory, orientation, judgment, language, and the ability to learn new things. The most terrible aspect of this disease is that one becomes the parent of the person, no longer their child, and worse, unable to express love for that person, who no longer understands.

Every year, $5.5 billion is spent in Canada on persons with Alzheimer disease and related dementias. The annual social cost of caring for an individual varies from $9,000 for a person with the mild form of the disease to $37,000 for a person with the severe form. Those are annual figures.

There is talk here of creating a national strategy on Alzheimer disease. Here is another federal attempt at encroaching on provincial jurisdictions, by acting directly in a field related to health. The Liberal government must understand that health is a provincial matter and that, at present, Quebec and the other provinces have considerable expertise in the field and have succeeded in developing unique forms of care.

A national policy is not what residential care centres need; they need funds to apply the strategy that experts in the field have already developed. The same is true for caregivers, who ought to receive more recognition for their work, and who ought to receive a tax credit, for example, which would compensate them for their great devotion. The only way to achieve this is to return money for health to Quebec and the provinces in order to enable them to provide the best possible care for people suffering from this terrible disease.

To come back to caregivers, 50% of people suffering from dementia live at home and not at a home care facility; 97% of these people receive help from a caregiver—often the caregivers are women—while 30% of caregivers have a full-time job. I should also mention that 50% of these caregivers are over 60 and 36% are over 70. When I talk about caregivers over 70, I mean people who have been caring for a person with the illness for at least five years.

Spouse caregivers are less likely to have back-up support than others and yet are more likely to be caring for a person with dementia. Only 3.4 per cent of caregivers use the respite care designed to give the caregiver a break for a few hours.

I want to explain a little more about the various stages of the disease to illustrate how devastating it is and what it demands of the caregiver.

At the first stage there is no cognitive decline. The person receives the diagnosis but experiences no problems in daily living.

At the second stage there is very mild cognitive decline. The person starts to forget names and locations of objects. In some cases, they may have trouble finding words.

At the third stage there is mild cognitive decline. The person has difficulty travelling to new locations and handling problems at work.

At the fourth stage there is moderate cognitive decline. The person has difficulty with complex tasks such as finances, shopping, planning dinner.

At the fifth stage moderately severe cognitive decline sets in. The person needs help to choose clothing and needs prompting to bathe.

This is the stage at which major aggression develops, because the individual is aware of his or her cognitive losses and frustrated at needing someone else's help to accomplish these tasks.

By the sixth stage, the individual needs constant supervision, because more advanced cognitive problems are developing. He or she needs help in dressing and bathing, and has problems getting to the toilet. Incontinence may start developing.

Finally, in the seventh stage, when cognitive problems are now advanced, the individual is reduced to a limited vocabulary or to one-word answers, loses the ability to walk and to sit, along with the ability to smile. There is a total loss of autonomy.

Not surprisingly, caregivers develop chronic health problems. Depression is almost twice as frequent in caregivers of Alzheimer's patients as it is in other caregivers.

The caregivers are often elderly and have neither the ability or the means to look after a relative in stages five to seven of the disease. This is the point at which most start thinking about finding a placement for the individual.

Fortunately, Quebec has developed some advanced services tailored to these specific needs. The long term care hospitals, for instance, have special care units, and there are special residences such as Carpe Diem in Trois-Rivières.

The special care unit concept is designed especially for residents with Alzheimer's to help them adapt and retain their physical, psychological and social integrity as long as possible, by including them in daily living activities, with the amount of support appropriate to their stage of disease. The people in these units are treated with respect and dignity, moreover.

Then there are the community organizations specializing in services to patients and families. In Laval, for instance, we have the Alzheimer's Society, under the enlightened leadership of Mariette Chalifoux, which has developed a broad range of services for raising public awareness and providing information and training.

There is also the Baluchon Alzheimer respite service, which enables caregivers to take a break with peace of mind for a week or two, without having to move their relative to a different environment. A live-in caregiver comes to the home of the person and takes that opportunity to perform an assessment using various intervention strategies. In addition, we must not forget the significant contribution of the staff at Laval's Coopérative de soutien à domicile, who, through the technical support and the housekeeping, groceries, and laundry services they provide, support the caregiver, freeing up more time to spend with the person being cared for.

As hon. members can see, we already have a service strategy for Alzheimer's in Quebec. What would help, though, would be new money, because facilities like Carpe Diem and respite services are terribly short of money and are often underfunded because of the growing costs of health care.

A national policy whereby the same standards would be applied to the care of patients from coast to coast is not what we need; what we need is funding transfers to allow the provinces to implement their own solutions and, in particular, to enable them to provide personalized care, as required by the circumstances.

In this context, the Bloc Québécois is demanding that the Prime Minister's government correct the fiscal imbalance that is limiting the ability of the governments in Quebec and the provinces to invest more in residential care and caregiver services for people with Alzheimer's.

Tax fields have to be divided more equitably between Ottawa and Quebec and the provinces. This would enable the governments of Quebec and the provinces to diversify their own source revenues, fully assume their exclusive responsibility over health care and ensure that all Canadians receive the services they need.

Hon. members have no doubt gathered that we denounce the numerous intrusions in health care by the federal government. Therefore, while we believe that the federal government should make an extra effort in the areas of health care and medical research, we demand that additional approved funding be given to the governments of Quebec and the provinces with absolutely no strings attached.

That is why the Bloc Québécois is totally opposed to a national policy on Alzheimer's, and I encourage all my hon. colleagues to vote against this motion.

[Lynne Yelich, Conservative, Blackstrap, SK]

Madam Speaker, I am pleased to speak to this worthy motion in front of the House.

First, I would like to applaud the member for Thornhill for bringing the issue to the fore and, more important, for recognizing the need for the federal government to develop a national strategy on Alzheimer's disease and related dementias.

Alzheimer's disease typically affects older Canadians, attacking and destroying brain cells. This disease ravages the mind. As a result, it impairs memory, insight and judgment.

Current statistics indicate that there are over 420,000 Canadians who suffer from Alzheimer's. That is nearly one out of every 10 seniors. In my home province of Saskatchewan, approximately 18,000 residents are currently suffering from Alzheimer's or a related dementia. Furthermore, as our population ages, these numbers will likely triple in upcoming decades. The cost of this debilitating disease to society has been and will continue to be immeasurable.

However, the cost is not only a monetary one. Alzheimer's disease brings with it a much greater emotional cost. As anyone who has witnessed the effects of Alzheimer's disease on a loved one will say, there are few afflictions which cause such heartbreak. According to recent studies, the effects of one individual with Alzheimer's will reverberate on the lives of 10 to 12 family members or friends.

The impact that Alzheimer's disease has on the family of the individual diagnosed is, in a word, devastating, for not only does it contribute to a slew of physical ailments, it takes away the most vital mental capacities of a loved one: their judgment and their memory.

The slow pace at which Alzheimer's begins to take over an individual is especially heartbreaking. The life expectancy for those with Alzheimer's is typically 8 to 10 years after the first symptoms have been detected. Patients usually do not die from the disease itself but rather from secondary infections like pneumonia that take over as the body's organs decline. Immediately before death, patients are mute, bedridden and exhausted.

Watching one's own mother or father, husband or wife slowly slip away into the darkness takes an immense emotional toll on loved ones. It alters the normality of everyday life so that nothing seems normal again.

As there are so many affected by this disease, I would like to address the impact that Alzheimer's has on the everyday lives of those who serve as primary caregivers. These caregivers are typically family members: daughters, sons, husbands, wives, brothers or sisters, people with a deep personal connection with the individual affected by Alzheimer's, people who have the ability to read their every slight sign or movement. These people do not apply for the job of caregiver. There is no financial reward. This is truly a labour of love.

The demands on them are great. The caregiver's role constantly changes. They are at various times a teacher, a nurse, a maid, a cook, a cleaner and a chauffeur. The everyday routine of life we take for granted is interrupted. For instance, late at night when most of us are fast asleep, caregivers are tending to a loved one who may be waking up constantly, confused and scared, needing a steady reassurance to calm their fears.

The caregiver's life is engrossed in servicing the needs of the individual. Little time remains for one's own personal life, leisure, activities or holidays. To cope with these challenges requires one to push one's inner physical, mental and spiritual strength to the limit.

Over time, the caregiver is steadily robbed by Alzheimer's disease of the one thing they want from their loved one: recognition. As the disease erodes the mental capabilities of the patient, the caregiver is often given a blank stare of bewilderment from a person they have known and loved for most of their lives, such as a wife looking at her husband of 50 years knowing that he does not even know her name anymore.

Even more distressing for the caregivers is the realization that for all their efforts the end result is predetermined. The father, mother, husband or wife they have spent a lifetime with will become increasingly distant, a shell of their former selves. Few things in life are conceivably as heartbreaking as such a painful realization, yet thousands of Canadians are caring for loved ones with Alzheimer's, enduring much sacrifice and emotional strain.

Understanding the experience of those affected by the disease and their caregivers is but one step. It is imperative to examine and to build upon existing initiatives throughout the country in order to have a national strategy for Alzheimer's. This strategy should ensure that sufficient funding and other measures are available at provincial and regional levels.

This national strategy must encompass a variety of issues relating to Alzheimer's. For instance, there are many financial implications for someone who assumes the role of caregiver. They may have to give up employment while still having to pay a mortgage and support their family. A national strategy should examine programs at the federal level to see if they could be improved to meet the unique requirements of caregivers.

Those suffering from this disease, their caregivers, doctors and other health care professionals must be at the forefront of the consultation process in developing a comprehensive strategy to combat Alzheimer's disease.

Ideally the consultation process should identify areas Canadians can work on to ensure that the best possible care and support are available for those dealing with this disease. Working together in partnership with all relevant stakeholders, an effective response could be developed.

Furthermore, as the groundwork is laid for a national strategy, we must look at ways in which the federal government can work with the provinces and territories in a variety of areas like support for caregivers, increasing public awareness and scientific research.

Similar consultation processes are already beginning on a smaller, more local level. Communities are getting together to share ideas and strategies to assist those with Alzheimer's and their caregivers. For instance, in the next few months, the Alzheimer Society of Saskatchewan will be conducting retreats designed to achieve such goals. These are initiatives that should be commended and encouraged under any program.

It is time for Canada to recognize the growing need to address this serious disease and develop a national strategy to combat Alzheimer's. I urge all members of the House to support the motion.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Madam Speaker, it is a real honour for me to rise tonight and speak on this motion.

I would have thought that there were certain issues in this House beyond the cynical take the money and run politics of the separatists, but obviously not. I do believe that this is an issue that rises above party politics. It rises above the provincial bickering that we see time and time again, because we are speaking about an issue that we need a national strategy for. I do not think it is a strategy that we are talking about putting a name to simply to say “we support this”. We need a comprehensive strategy to deal with Alzheimer's. It has to bring together the provinces. It has to bring together the national government.

It strikes us on so many fundamental levels. For example, a national strategy must look at pharmacare. It must look at the access to drugs, especially for low income people.

It has to look at accessibility to home care and the lack of home care we see in communities where old people are left without anyone to come in and see them.

We have to talk about tax credits. We have to talk about the financial impacts on families, which they are suffering day after day. Tax credits are part of that strategy.

We also have to talk about research. Research is something that we do need on a national level, because the impacts of this disease and the cause of this disease are what we have to look at.

I would like to say that for my own part in my riding of Timmins--James Bay I have been very active, as has my provincial counterpart, with the elder abuse awareness program in the Cochrane district, because we know that the devastating emotional impact Alzheimer's has on families is intricately tied to elder abuse.

In our region we brought together numerous stakeholders. I think it is a good example of where we can go in terms of who has to be brought into this. We are working now with the VCARS organization, community home care, the Red Cross, the Ontario Provincial Police, Timmins Community Policing, and the Golden Manor, which is an old age home in our region.

We have the legal clinics involved now. One of the fundamental aspects of elder abuse is financial abuse because elders are no longer able to look after their own resources. Now we are asking to bring in the banks, because it is a fundamental job of the banks, a fiduciary obligation, I would suggest, to play an important role in protecting the assets of people suffering from Alzheimer's and dementia.

We are trying to coordinate a strategy at our local level with these various groups. My office is very active and involved. I would support in any way I could moves by the government to bring in a national Alzheimer's strategy.

I would like to speak about this from a personal level. I spent my afternoons sitting in a room where the lights were always on, a room that smelled of cleanser and madness and loneliness. I spent those days with my grandfather, who was probably one of the biggest figures in my life, a man who had no formal education but a fantastic intelligence.

My grandfather spent 40 years working in the McIntyre gold mine in Schumacher, Ontario, where they pioneered the principle of forcing men to breathe aluminum dust every single day they went to work as a condition of employment. The aluminum dust was sent into their lungs as a way of coating their lungs; they said it was to protect against silicosis, but we knew that was not true. We knew that the coated lungs did not show up on the x-rays.

Thirty-five thousand miners across Ontario were forced to breathe aluminum dust for a period of 40 years. What are the effects of that? We do not know. I do not know if the damaged syntaxes in my grandfather's mind had anything to do with the aluminum he was forced to breathe, but again, this is where the area of research is so important.

In my short life, I have seen people die. I have been there for many people I have known, for family and friends, but I have never seen a death as lonely as an Alzheimer's death, because with Alzheimer's one lives alone and dies alone. It does not matter how much of the family is there; one is left alone because of the condition of the disease. With my grandfather, the worst was that he never succumbed to the balm of forgetfulness. He was acutely aware every single minute of the day of where he was: he was not where he should be.

My grandfather would sit in the old folks home and watch people sitting in chairs waiting. He wondered what they were waiting for. They were waiting to die. He used to think I was his cousin, and we were working on the day shift at the gold mine. One day he thought he was sitting in a bus station. He thought we were in Sydney to see the family and we were on our way back to Timmins. I saw him rifling through his pant pockets because he realized he did not have a ticket, nor did he have any money. He was in terror. He lived in terror in his final years and months because he never knew where he should be.

We see the effects of this disease on the family. I saw the effect it had on my grandmother and my mother, who spent so much of her life looking after this man. There was very little support. Fortunately we had a very good hospital where he finally ended up, but it was very difficult for our family to even send him there.

For families who do not have two caregivers at home or who do not have the financial support, the effects of this disease are devastating. We know that as the population ages, it will get worse. We know the change in our families with our 24/7 lives. We know we do not have the community supports that we had before to handle people with dementia.

When we talk about a national strategy on Alzheimer's, we are talking about a need to address a fundamental obligation of our society to protect and respect our elders.

I worked in the first nation communities of northern Quebec. I saw how important the elders were in that society. I see that among the people of the Mushkegowuk Cree where I work now as a member of Parliament. Respect for elders is a fundamental principle of their society and it should be a fundamental principle of ours. No one should be left alone to die of a disease like this, and no family should be left without supports.

Is this simply a matter of giving money to the provinces, then letting them go off and do their thing? I do not think so. We are dealing with a much bigger and broader issue. We need to come together on this. The New Democratic Party supports a national strategy for Alzheimer's. We need to work and bring as many people together as possible to make this work.

[Robert Thibault, Liberal, Parliamentary Secretary to the Minister of Health]

Madam Speaker, on behalf of the Minister of Health, I am very pleased to have the opportunity to address the proposed Motion No. 170, a national Alzheimer's strategy. The scope of the proposed motion is indeed broad and it challenges us to address the plight of many Canadian seniors and their families who are affected by Alzheimer's disease.

Globally, about 18 million people currently have dementia. In Canada over 420,000 people over the age of 65 have Alzheimer's disease or a related dementia. Within 25 years, there will be almost 600,000 seniors with dementia. Within 30 years this number will rise to reach three-quarters of a million people.

Alzheimer's disease is a devastating condition that involves more than the clinical loss of memory. It causes the deterioration of cherished bonds with families and loved ones and the victim's sense of unique personal history and identity.

In the words of one senior who learned she was in the early stages of Alzheimer's disease just as she was beginning to enjoy her recent retirement, “It's like having cancer of the mind”.

There is no known cause or cure for Alzheimer's disease, however, there are treatments to alleviate some of the symptoms and to delay progression of the disease, as was mentioned by the member for Thornhill. Beyond the numbers, we have to consider the human suffering. The extra years that Canadian seniors are now living are compromised by the growing likelihood of developing Alzheimer's disease. Indeed over one senior in every three over age 85 is afflicted by dementia. The consequences of this incurable disease for families or persons with dementia can be devastating physically, emotionally and financially.

The hon. member for Thornhill should be congratulated on raising this issue for debate in the House of Commons. The purpose behind Motion No. 170 is laudable and the questions it raises deserve special attention.

Perhaps the introduction of Motion No. 170 was speeded up somewhat by the recommendations made to the Minister of Health by the National Advisory Council on Aging and endorsed by the Alzheimer Society of Canada.

The council is a group of independent, very credible citizens who have been advising the government for over 20 years on all matters related to the aging of the Canadian population and the quality of life of seniors. The council's role is to encourage reflection and discussion so that Canada adapts quickly and appropriately to the increased number of seniors in our society.

The council has presented 30 recommendations concerning Alzheimer's disease and related dementias. These recommendations cover a wide range of fields, including research, prevention, treatment and support. Alzheimer's disease and related dementias create complex problems that have an impact on many sectors of society.

The Minister of Health welcomes the advice of the National Advisory Council on Aging, and is studying these recommendations carefully as he considers all the council's advice in the area of health. Issues associated with an aging population are complex, with many ramifications across sectors and government. Complex problems call for carefully considered solutions.

Our current knowledge about Alzheimer's disease in Canada is the result of forward looking investments in health research, which the Government of Canada has already made.

In the past 15 years or so much has been learned about the prevalence and incidence of dementia, and factors that increase risk or protect people from the disease, as well as underlying biological mechanisms. We have learned more about the care and support for persons with dementia and the challenges faced by families who care for seniors with Alzheimer's disease.

Thanks to the intensive research across Canada, we can detect dementia earlier than before and we can sometimes delay the progression of the disease to preserve a better quality of life for seniors with the disease and their families. We are now more aware of some ways to reduce the risk of developing dementia. This research on dementia is vital, and the government continues to support it through funding by the Canadian Institutes of Health Research.

Throughout the country, people with dementia in their families rely on local chapters of the Alzheimer's Society of Canada for education, advice, support and care. We applaud the ongoing work of the over 150 national, provincial and local Alzheimer's associations or organizations in Canada.

Thanks to the Alzheimer's Society of Canada, advances in Alzheimer's research are shared and promoted, and new programs and services are developed for people with the disease. The society provides effective strategies and techniques for family members and professional caregivers supporting persons with dementia. One of the most important functions of the society is to support people affected by the disease and to communicate to Canadians the reality of living with Alzheimer's disease.

Health Canada has long supported the Alzheimer Society, by granting it transitional funds, funding its community projects that assist seniors and caregivers, and supporting its annual national conference.

In each province and territory, governments, health professionals and volunteers are creating and implementing initiatives to care for individuals with Alzheimer's or related dementias. The aim of these numerous initiatives is to educate the public and professionals, improve diagnosis, care and treatment, and implement community programs and services.

Actions are now being taken at the local level to meet the needs of people suffering from dementia and their families. Instead of making current funding do double duty, the Government of Canada is making a substantial contribution to the provinces, to help them provide health care services that meets the needs of seniors and their families. Numerous efforts are being deployed throughout Canada to adapt health care to local needs and ensure that such care is sustainable.

The provinces and territories are resolute in their efforts, with the assistance of the Government of Canada, to provide Canadians with quality health care.

Accordingly, primary health care reform is underway in all jurisdictions to provide timely access to family and community care.

Seniors with intellectual impairments need to be assessed and cared for by qualified health professionals, including generalist and specialist physicians, nurses and pharmacists. To ensure an adequate supply and appropriate mix of health care professionals, all jurisdictions are continuing or accelerating their work on health human resource initiatives. These include plans to train, recruit and retain health professionals.

Drug therapies constitute the best treatment for Alzheimer's disease at the present time. Thus, persons with dementia are well served by the development of a national pharmaceuticals strategy that is taking place under the direction of federal, provincial and territorial ministers of health.

Of particular benefit to persons with dementia who depend on drug therapies, the strategy will include the following actions: first, establish a common drug formulary for participating jurisdictions; second, improve the drug approval process to accelerate access to breakthrough drugs; third, create purchase strategies to obtain the best prices for Canadians for drugs; and fourth, enhance action to influence the prescribing behaviour of physicians so that the right drug is used at the right time for the right problem.

The Government of Canada, in partnership with other governments, is renewing and strengthening health care so that it responds appropriately to the needs of a growing population of seniors, including seniors with Alzheimer's disease and related dementia. The Minister of Health is committed to the present course of continued investments and partnerships that support the health of seniors.

The Government of Canada is aware of the enormous impact on family members responsible for providing care to seniors suffering from Alzheimer's or any other infirmity. Most families accept this task with love, but it is physically and emotionally draining.

Health problems, feelings of social isolation and depression are shared by all those who care for a senior suffering from dementia or a disabling disease. Yet, families provide at least 80% of care to dependent seniors.

Given this growing problem, the Government of Canada is introducing proactive measures. It has created the portfolio of Minister of State for Families and Caregivers, which will work in collaboration with the Department of Social Development.

On behalf of the minister, I want to congratulate the member for Thornhill for her initiative, and I thank the members of all parties for their speeches in support.

[Wayne Easter, Liberal, Parliamentary Secretary to the Minister of Agriculture and Agri-Food (Rural Development)]

Madam Speaker, I am pleased to rise in support of my colleague, the member for Thornhill, in terms of the motion to develop a national strategy on Alzheimer's disease and related dementias. I also want to congratulate the member for pushing the issue in the House. We can see by some of the debate tonight that there is very strong support for pushing ahead and calling on the Minister of Health and the cabinet to move forward with a national strategy on Alzheimer's.

As mentioned by the member for Thornhill earlier, a report released in 2004 by the National Advisory Council on Aging called for the development of such a strategy involving not only the provinces but all stakeholders involved in addressing this serious issue.

The report put forward some 28 recommendations and a couple of key recommendations relate to my own province of Prince Edward Island. I want to go to that report for a moment because this is one of the key recommendations in the report.

The report recommended that the federal government ensure that the catastrophic drug coverage plan include coverage of people with Alzheimer's disease and related dementias. According to the report, P.E.I. is one of four provinces where “Medications approved by Health Canada to treat Alzheimer's disease are not available”. The other provinces are British Columbia, Nova Scotia and New Brunswick.

It is essential that, as advances are made in the treatment of Alzheimer's disease and effective medications are approved by the federal government, all provinces make these medications available through their drug benefit plans. We have experienced that before in my province of Prince Edward Island with other drugs that are covered by other provinces. It really puts the citizens in that province at an even worse disadvantage.

It further recommended that the federal government collaborate with provincial and territorial governments through the common drug review to make approved medications for Alzheimer's disease and related dementias accessible to all Canadians in all provinces by ensuring these drugs are part of provincial drug formularies and that the criteria to assess them are appropriate and consistent, meaning from hospitals, long term care institutions and home care, et cetera. That is a strong recommendation that leadership in my own province needs to take into consideration.

The other recommendation, on a more positive note as it relates to Prince Edward Island, is that the federal and provincial governments work to establish a common national definition of a set of home care services and that those services be fully insured under the Canada Health Act.

One of the areas where we are making progress in Prince Edward Island on Alzheimer's is with the Alzheimer's Society of Prince Edward Island. It is a leader, not only nationally but internationally, in the area of elder care medication. This is a pioneering and innovative program designed in Prince Edward Island and provided to families with Alzheimer's victims free of charge which, through the assistance of a mediator for the family, assists families through the difficult experience of caring for a member of the family suffering from Alzheimer's. This is the kind of initiative that we believe should be incorporated within a national strategy.

I congratulate the Alzheimer's Society of Prince Edward Island for that move because it is an appropriate move. As was mentioned by numerous speakers here tonight, the difficulty with Alzheimer's disease is not only for the individual with the disease, but the stress and the effects on the family as well.

To conclude, the member for Thornhill spoke of her personal experience when the disease hit close to home. Others have spoken about that here tonight as well. I am fully supportive of the endeavour and encourage all members to support the member in developing and pushing for this national strategy.

[The Acting Speaker (Hon. Jean Augustine)]

The time provided for the consideration of private members' business has now expired, and 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.

[Steven Fletcher, Conservative, Charleswood—St. James, MB]

Madam Speaker, on Monday of this week I raised the issue of hepatitis C compensation. The response from the government dealt with on-line pharmacies and of course there is no connection. It again suggests the lackadaisical attitude the government has toward this very serious issue that is vital to thousands of Canadians.

My office receives calls and letters every day from victims of tainted blood with very sad stories. Their lives have been ruined by hepatitis C.

It is incomprehensible to me that a government elected by Canadians could turn its back on them when they need the help of government most. The government has blatantly discriminated against Canadians who pay taxes, have families and are contributors to our society.

The government has completely dropped the ball on hepatitis C all for political gamesmanship. It overestimated the number of victims and put a large sum of money into a fund which pays more in administrative work than it does to the victims the fund was set up to help. The government has utterly turned its back on the people whose lives it should have protected, but it has destroyed their lives instead.

There was a vote in the health committee recently. The Conservative Party brought forward a motion to compensate the victims of hepatitis C. I understand that the motion has not had much success in the past, but this time around it did pass in the health committee.

When we brought it to the House to get approval from all the members of all the parties, because it is the right thing to do after all, we had support from all the parties except the Liberal Party. It used procedural tricks and ran out the time, which I expect the hon. member to do today when he answers the questions that I have. He will run out the time without actually answering the questions.

However, having said that, it is just another example of how the Liberal government is not willing to deal with the compensation for the people who have contracted hepatitis C through tainted blood.

We have a minister who has at least acknowledged that compensation is appropriate, but then he flip-flops and says it may or may not happen. We are waiting for actuarial reports that will apparently come in June. In the meantime people are dying and people are suffering. He had said that he would speed up the process.

I have the following questions. Will the government compensate all the victims who contracted hepatitis C from tainted blood? Will they be compensated in a timely manner in a manner that does not play with people's lives? Will the government stand up and take responsibility and compensate these people instead of playing political games? These people deserve help and the government should provide it. Do it now. Do the right thing.

[Robert Thibault, Liberal, Parliamentary Secretary to the Minister of Health]

Madam Speaker, many points have been raised by the member in this valid question.

He alluded to his question earlier this week during late show proceedings. I have only been here for four years, but I understand it is a tradition of the House that if, after question period, a member is unsatisfied with the fullness of an answer given by a minister, he or she can advise the Table of that fact and a question is put forward in late show proceedings at a future date. That occasion for the member opposite came this week.

As I mentioned in the late show proceedings yesterday, I was in Halifax with the Prime Minister making a historic announcement for the good of the people of Nova Scotia and Canada. The member put forward a question that was completely different than the question he had submitted to the Table.

The member for Richmond Hill, who was representing me and is a very good member of Parliament, had been prepared to answer on another point and was distracted. I was disappointed to learn that the member opposite would contact citizens and say it was because that member did not care. The member today remedied that by speaking to the individual and indicated what had happened. The individual understood that very well and I am pleased that he does. The member raised that point, so I will raise it.

To say we do not care about the victims of hepatitis C is completely wrong. The federal government entered into negotiations with the provincial governments, had discussions with the people who had the ailment, and created a trust account, a fund of $900 million, to assist those people. Outside of that, it worked with the provinces to create another fund for a little over $500 million for people who fell outside of the negotiated settlement area.

The fund that was created for the people within the settlement time period is managed by experts, as any fund should be. These experts know the market, disburse the funds in accordance with the agreement reached, and are authorized and approved by the courts of three different provinces in the country.

That fund may continue over a 70 year period and according to six levels of payments depending on the ailments and the incapacities of the people suffering from hepatitis C. Now we have to know whether we have a surplus, and if we do, at what level. That is called an actuarial surplus. That is a surplus of money which we can expect to earn on the market and what we can expect by professional analysis will be the payouts in the future.

Once that is done, in accordance with a motion of the health committee which was supported by all parties, the minister will enter into the proper negotiations with the people involved in that fund to include a wider scope of people for payment, people who fell outside of the compensation area. The minister does that willingly, with a very generous heart.

[Steven Fletcher, Conservative, Charleswood—St. James, MB]

Madam Speaker, that was a really sad answer. The only thing sadder is what is happening today with the people who need this compensation.

I hope the experts he is referring to are more qualified than the member who answered the question on Monday night. The question clearly talked about hepatitis C and his response had nothing to do with the issue at hand. That is shameful. He should know that these people deserve compensation. It is indicative of the government being unable to care.

Instead of giving us mumbo-jumbo, will the member tell us when these people can expect compensation? This has not been going on for a month or two. It has been going on for years, almost a decade. Please compensate these people. Do not go on with these administrative mumbo-jumbos. Compensate them. They deserve it.

[Robert Thibault, Liberal, West Nova, NS]

Madam Speaker, there is a common, well known principle in the computer industry, as in many other industries, called garbage in-garbage out. If one starts with mumbo-jumbo, one might get mumbo-jumbo. If one does not treat people respectfully, one might not always get the answer one wants.

To cast aspersions on the member for Richmond Hill after the member had wilfully changed the topic of the question and to talk about a member as other than a professional member of the House is not acceptable.

As far as compensation is concerned, the minister has been very clear. The process is underway. The wish is to include these people. The actuarial surplus will be reported. The amount for this year was foreseen by experts from the private sector. They were selected and approved by people with hepatitis C and other diseases and by the courts in the three provinces, Quebec, Ontario and British Columbia. I cannot think of a better, more professional way to proceed.

[John Duncan, Conservative, Vancouver Island North, BC]

Madam Speaker, my question tonight is further to the question I asked regarding Sable Island.

The government has been quite schizophrenic in its handling of Sable Island. The costs of maintaining a human presence on Sable Island are not large but the benefits are huge.

There has been human habitation on Sable Island since 1802, who were originally from the colony of Nova Scotia. Since Confederation the federal government has retained that mandate. However in the 1990s it offloaded it, which is part of the reason that I call this a schizophrenic arrangement.

The government offloaded its responsibility and succeeded offloading it on to a preservation trust. This arrangement was failing because of the funding partners and so it offloaded part of the funding on to industry and so on. This whole arrangement was falling apart and as of March 31 nobody was going to be left on the island.

The official opposition started to ask questions and generate media attention. We got the government's attention to do something to correct the situation, rather than continuing the dithering it had been doing for a great many years.

Sable Island cannot be treated like a rental car. It is a core asset and one that needs authorization to establish a presence there in order to maintain our sovereignty and derive the benefits that will come with it.

I had the opportunity a couple of weeks ago to attend a presentation by Zoe Larsen from the Ecology Action Network at the Museum of Nature in Ottawa. She has spent 30 years researching Sable Island. The institutional memory and the stewardship that was displayed in her presentation was amazing.

We need a long term, sustainable commitment to this place. It extends Canada's economic zone outward for hundreds of kilometres. It also extends our reach for search and rescue operations, for the military, et cetera. Sable Island is vitally important.

There is a long identified problem of multiple federal departments benefiting from the station, yet the costs being borne disproportionately by DFO, which is why we had the offloading situation. The Ministers of the Environment and Fisheries and Oceans finally made an announcement on January 31 saying that the government was committed to maintaining a human presence but that it was still leaving us with a shortfall in funding, which it was going to put in place for the next year or two while it revisited some other options.

My questions are simple. As there is no authorization by statute to guarantee a human presence on the island, when can we expect that? Two departments are covering the funding in the short term but a long term arrangement is needed. When can we expect that? All the government's arrangements to date have been quite myopic. I would like an expansion on the original answer to this question.

[Shawn Murphy, Liberal, Parliamentary Secretary to the Minister of Fisheries and Oceans]

Madam Speaker, on behalf of the Minister of Fisheries and Oceans, I appreciate the opportunity to rise in this House to say a few words on the important debate about the status of Sable Island.

Like the member opposite, I fully appreciate the importance of this extremely unique island. Sable Island is home to a number of migratory birds, seals, and of course, the most famous of the island's fauna, the wild horses. Many birds, including some species at risk birds, use the island as a breeding ground and several other animals that call the island home are protected under the Species at Risk Act.

One other item that this island is home to and which is of interest to all Canadians is Captain Cook's long-lost treasure.

The island is important for other reasons too. Environment Canada has a weather station on the island and monitors pollution. Fisheries scientists regularly conduct research into the island's grey seal population. For the Province of Nova Scotia, the island is of key historical and environmental interest, and Canada's oil and gas industry has taken a very keen interest in the fuel reserves off the island's coast.

Clearly, managing all this activity while ensuring the protection of the island's fragile environment and the many species that call this island home is a very complex task. That is why in recent years the Government of Canada has taken a partnership approach in managing this island. Since 2000, the Sable Island Preservation Trust has managed the island under a joint agreement with Environment Canada and DFO. With support from the private sector and the provincial government, they have come together to chart a course for the future.

The Government of Canada announced the creation of a senior level committee to establish an approach for the management of Sable Island going into the future. The committee met in November to discuss the options available to it. Its recommendations have been made to both the Minister of the Environment and the Minister of Fisheries and Oceans.

While no decision has been made yet with respect to a long term solution for the administration of Sable Island, the hon. Minister of Fisheries and Oceans has stated on many occasions his commitment to the protection of this unique environment and the many species that call the island home. He is also committed to ensuring that the concerns of all stakeholders are considered as we move forward on this issue.

It is for this reason that the minister recently joined the Minister of the Environment to announce the Government of Canada's plans to continue--and I repeat it here for the benefit of the hon. member--a year-round human presence on Sable Island and to directly manage the island's weather station. This will allow the Sable Island Preservation Trust to focus its energies on the vital tasks of public education, research and conservation until the question of a long term approach is settled once and for all.