Debates of May 1st, 2008

Canada Consumer Product Safety Act

[The Deputy Speaker, NDP, Bill Blaikie]

Is the House ready for the question?

[Some hon. members]

Question.

[The Deputy Speaker, NDP, Bill Blaikie]

The question is on the motion. Is it the pleasure of the House to adopt the motion?

[Some hon. members]

Agreed.

[An hon. member]

No.

[The Deputy Speaker, NDP, Bill Blaikie]

All those in favour of the motion will please say yea.

[Some hon. members]

Yea.

[The Deputy Speaker, NDP, Bill Blaikie]

All those opposed will please say nay.

[An hon. member]

Nay.

[An hon. member]

On division.

[The Deputy Speaker, NDP, Bill Blaikie]

I declare the motion carried. Accordingly, the bill stands referred to the Standing Committee on Health.

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

Message from the Senate

[The Deputy Speaker, NDP, Bill Blaikie]

I have the honour to inform the House that a message has been received from the Senate informing this House that the Senate has passed the following public bill, to which the concurrence of the House is desired: Bill S-219, An Act to amend the Public Service Employment Act (elimination of bureaucratic patronage and establishment of national area of selection).

The House resumed from April 30 consideration of the motion that Bill C-51, An Act to amend the Food and Drugs Act and to make consequential amendments to other Acts, be read the second time and referred to a committee.

Food and Drugs Act

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, I am pleased to speak this afternoon to Bill C-51.

As always, the Liberal Party aims to improve the safety and health of Canadians.

We support measures that strengthen the regulatory process so that Canadians can have access to the safest and best foods and therapeutic products.

The drugs on the market are not a great risk for the health and safety of Canadians.

That being said, we see this bill and the other bill as a huge missed opportunity. As often happens with the government, it is what is not in the bill that is remarkable, including just taking out the whole section of the bill on the pride of Canadian health policy, which is the interdiction against directed consumer advertising.

We look again to a government that seems to be more interested in business than in patients. Although we believe there is a need for the minister to have the ability to take unsafe health and consumer products off the market if the companies are unwilling to do so, the powers given to the minister in this bill are unbelievably unreasonable. It is not putting in place the kind of scientific advice that would be very important in terms of a minister being able to administer the Food and Drugs Act based on evidence in science and not ideology, and the way the government's friends in business are behaving on just about everything else.

It is important that the Food and Drugs Act be updated. Up until now, as everyone knows, the product safety system has functioned purely on a voluntary basis. If a product is dangerous or poses a health risk, corporations can issue a recall.

This bill would grant the minister the power to enforce the recalls rather than depend on the voluntary system. Certainly, those of us in the health committee have heard this from many witnesses, including the department itself, that these are powers that the minister must have in the event of a recalcitrant company.

The bill would also grant the minister the power to seek an injunction, to enforce regulatory compliance through the Federal Court. This is a faster avenue for enforcement rather than the current system which fills up the courts by addressing each non-compliance matter at trial.

As well, the bill would improve the surveillance of therapeutic products both before and after they reach the market. This could have the effect of helping critical drugs, such as cancer therapies, get to the market quicker and yet remove them just as quickly if significant adverse reactions or incidents are reported. This has been very much the wish of a number of the groups, from cancer to HIV-AIDS, to both the providers as well as the patients.

As we have heard in committee many times, people are very concerned about hurrying and having less safeguards because we are now going to commit to doing a much better job post-market. We need to be very clear and it is the reason for the kind of scrutiny this bill would require, to make sure there is absolutely no less safe drugs coming on to the market because of this hurry up approach that is important in these very special drugs.

Because of the substantial regulatory powers the minister would have, it is obviously going to be important to study these powers to ensure transparency, effectiveness and accountability. We will see, in some aspects of this, that it seems a bit remarkable that the minister would be able to stop a clinical trial midway through without having information from the very people running the trial. There are things that just do not make a great deal of sense unless we in committee find out exactly how the government expects to carry this out.

The idea is that the Minister of Health can suspend a clinical trial authorization or the terms and conditions other than a prescribed term or condition or the suspension to prevent injury after giving the holder of the authorization an opportunity to make representation, and to suspend a clinical trial authorization if the minister is of the opinion that an immediate suspension is necessary.

My experience is that this only comes to the minister from the people supervising the trial, who are scientists. I hope we will hear in committee exactly how the minister is planning to carry this out.

It is interesting that time and time again these powers to the minister do not seem to have any provisions within the act to find out what science or which scientists the minister would be relying on in order to exercise these substantial new powers as given to him in the bill.

From licences to the discontinuing of clinical trials, to the disclosure of personal information to a person or government that carries out functions related to the protection or promotion of human health without the consent of the individual to whom the personal information relates, if the disclosure is necessary, is worrying. We will need to know from both privacy experts and from many other witnesses, particularly, I would hope, patient groups, what they think of that, as well as what they think about disclosing confidential business information to a government or to the following persons without the consent of persons to whose business or affairs the information relates without notifying that person. This is something the committee will have to look at very seriously.

Even in clause 24, it says that the minister can recall a therapeutic product or cosmetic. It also says that the minister may authorize a person to sell a therapeutic product or cosmetic even if the minister has directed a person to recall it. This will somehow need a great deal of explanation at the committee. I look forward to that.

We are prepared to allow the bill to go to the committee, but it is extraordinarily important, yet again, that the stakeholder reaction to the bill is very much around the elimination of the prohibition on direct to consumer advertising.

Barbara Mintzes, the health policy expert and professor at UBC Centre for Health Services and Policy Research, has stated clearly on the website, straight.com, that the amendment would introduce a loophole that could allow pharmaceutical companies to directly advertise drugs to consumers, a practice that is currently illegal in Canada. The proposed new wording of the bill tabled in Parliament on April 8 says:

No person shall advertise a prescription therapeutic product to a person other than a practitioner unless they are authorized by the regulations to do so.

In the bill there is a general prohibition that covers direct to consumer advertising for drugs. That prohibition is now gone, which means the barrier of introduction of direct to consumer advertising through the regulations, because there is a sort of general prohibition in the bill, is gone, according to Barbara Mintzes.

Direct to consumer advertising and that prohibition has set Canada apart from our neighbours to the south in a very proud way. I am not sure why the minister is now trying to turn this around. Anyone who accidentally watches American television sees that barrage of advertising. It means people go to their doctors thinking that a certain drug will have a certain benefit, and we know that this increases the likelihood of harm as we learned the hard way with the Vioxx case.

Vioxx was brought on to the market for a very special group of patients, patients who had arthritis, but also had serious problems with their stomachs. The drug was to be just a boutique drug to deal with the patients with serious arthritis, but also for whom those drugs were too hard on their gastrointestinal tract. Instead, the drug was marketed widely to the whole population and people with arthritis thought they should be on that drug. That is when we found the drug had serious cardiac effects.

This would be a risk that one would take based on perhaps an equally serious gastrointestinal side effect for people whose ability to function would be improved by Vioxx. However, this was not the intent of the drug when it was put on the market in the first place. Now because of the serious increased risk of heart attack and stroke, it ended up causing much concern in terms of both life and disability.

It is so clear that the newer, better drug can have an effect on patients when there are cheaper, older drugs that are better, safer and have the same effect. From antibiotics to antidepressants to the kinds of drugs that are used around cholesterol, we want to ensure that physicians and patients have a real conversion about what really is the best and are not unduly influenced by television advertising. This is evidence based practice. Yet, again, we are finding the government preferring ideology and business over evidence. The evidence is that direct to consumer advertising is wrong and bad for patients. The bill would eliminate this serious prohibition on the evidence based policy and evidence based practice.

It is important therefore that we look to what other structures need to be placed around these undo powers to the minister. We need to look very seriously at the kind of advice the minister gets in order to do his best job. I have long been a believer in the fact that ministerial advisory committees need to give transparent advice to the minister. Whether it is the scientists that list endangered species, it is very important that politicians do the politics, scientists do the science and that the transmission of information from the scientists to the politician must be done in a transparent way such as the citizens of Canada can understand.

I believe people can understand why a minister might not list all 11 species on an endangered species list or species at risk list because of the politics, the economy and the reality in a certain community. However, politicians have to do their job and explain why they have made that decision when the scientists have said X and the politician or the minister has decided to do a version of X or even Y.

It is really important that we look to the models like NICE, the National Institute of Clinical Excellence in Britain, and the way in which it has involved citizens in the decisions. The bill very definitely needs resources to explain how the minister will do this.

As a family physician who did obstetrics, I quite often was at the hospital waiting for a baby to arrive during the national news. It would be quite clear that a drug would be recalled while I was not watching the news. The patients would arrive the next morning and tell me they were on whatever drug had just been recalled. I would have no information about it. A letter would arrive from Health Canada three days later telling me the drug had been recalled.

We have to get into the 21st century. If the minister is to have the powers to recall a drug or product, then the minister has to be able to communicate with the people who prescribe the drugs, not three days later after someone has lost his or her life because in that 72 hour window the doctor accidentally prescribed the recalled drug.

It will be extraordinarily important that the databases and the kind of two way communication between provinces and the federal government exist. Who actually is in charge of speaking to the doctors of the country about these products at risk? How do we get in touch with them? Until we have the resources for the infostructure, how will we get the minister and the ministry into this century to communicate with the people who count on him for timely advice on things as important as this?

It will be extremely important for the government to look at what the federal drug agency does in the United States and why that is a free-standing agency. The health protection of our country is half the people at Health Canada now. We have to decide whether we want to put a science based and a real structure in place for the drug evaluation post-market surveillance, working toward a common formulary.

Our national pharmaceutical strategy is in disarray. There are a few working groups, but there is really very little action toward the part of the 10 year commitment for health, which was in a national pharmaceutical strategy in the 2004 accord with the provinces.

The health minister has cancelled the next meeting of his counterparts supposedly for June. I do not know how we can do any of these things unless the provinces, territories and their health ministers feel they have a partner with the federal government. It will be extraordinarily important that we look at this, like we did in the very sensitive bill on reproductive technology, to ensure that any regulation must come back to the health committee so we understand the nuances and the decisions taken in the regulations, which can be so important to people's lives. It must come back the committee that has studied the bill and has now done this important study.

It is a bit rich, in the middle of a study on post-market surveillance, that the government has decided to table the bill without the information, without the recommendations of the very committee that has studied this. It was a bit shocking to hear that even the working group on the national pharmaceutical strategy, the working group on real world drug safety, was not even consulted in what should be in the bill. Yet again we have this top-down, “father knows best, take it or leave it, trust us you will like it” approach from the government. It is extraordinary that when all of the witnesses came, when all the provinces and territories and working groups existed, that the government would not take counsel from these people who study this and who know it.

Also, almost every member of Parliament over these last weeks, since the bill was tabled, have been inundated by calls to their constituency offices on the natural health product risk. People using these products are worried again that their products are not understood because of the issue around health claims. We need to seriously look again at what the minister is considering in terms of natural health products and how we regulate these things. Some products have been used for thousands of years, but without a clinical trial. It is not evidence based, but Canadians have the right to be wrong on these things. They also have the right to be right in terms of the products that work for them. In studying the bill we want to ensure people have patient and client freedom.

These changes are just not good enough. Canada needs a national food policy. At the same time as we get this tinkering around the edges, we have from melamine in dog food, to re-labelled snap peas from China, to mushrooms from China called “product of Canada” because they have been sliced here. We have orange juice called “product of Canada” because Canadian water was added to it.

The government needs to sit down with all government departments that deal with food in this country, such as agriculture, fisheries, industry and international trade, and with the producers and the food security people.

We need a national food policy. We cannot even tinker with things in this bill unless we can actually have a commitment from the government to get on with it and protect the health and safety of all Canadians.

[Mario Laframboise, Bloc, Argenteuil—Papineau—Mirabel, QC]

Mr. Speaker, first of all, I really enjoyed my colleague's presentation.

However—I hope she will agree with the Bloc Québécois—it is important for us that this bill be sent to committee so that we can call in as many experts as possible to fully explore this. I know that the member has experience in the health field, and so I would like to ask her a question.

Just replacing “drugs” by “therapeutic products” and adding to the terms “therapeutic products”, “drugs, devices, cells, tissues, organs” and so on, will probably result in a debate.

Is the member comfortable with the proposed definition for “therapeutic products”, or does it warrant a debate in committee?

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, that is a good question. Semantics are very important. The words “therapeutic products” are possibly clearer. I appreciate your suggestion, and I will share it with the committee.

[Nicole Demers, Bloc, Laval, QC]

Mr. Speaker, I am pleased to rise again in this House to discuss another health bill. Health is a very important subject to me. I am particularly interested in it because I know just how important and necessary health is to living with dignity.

Although Bill C-51 is very important and long overdue, although we have been calling on the government to review the whole issue of medicines, drugs and therapeutic devices for a long time, and although we have called on the government to do so a number of times, we will vote to send this bill to committee to be thoroughly examined. As my colleague said earlier, and as our other colleague who worked on the health file a long time said, this is much too important to let a few people decide the fate of thousands of human beings, Canadians and Quebeckers, who will rely on our decisions to keep them in good health.

A few things in this bill, or at least the draft we received, worry me. I am almost positive that some things worry a number of my colleagues as well. For example, the bill states that the Minister of Health would have the authority to pre-approve health products that have not yet received final approval. That worries me. It gives a lot of power to a minister, to one individual.

Bill C-28, which was passed a few years ago, had the same provisions for other products, such as pesticides. I do not know what became of that act, if the Minister of Health has had the opportunity to grant special permission to companies to put pesticides on the market before they should be. However, recently, pesticides have been found to be very hazardous to our health, to the health of our children and young people, whom we thought were safe playing outside during the summer. We thought that Health Canada had taken all the precautions to ensure the products were healthy, safe, and harmless.

If we are going to give the Minister of Health that much power, we have to make sure that we provide a strong framework for exercising that power in this bill. We have been hearing about amending the terms. These days, with so many advances in biotechnology and life sciences, we agree that we need to ensure that our health and health products legislation reflects these new realities. People with specific needs, such as those with HIV, might benefit from new experimental drugs. These drugs should be made available to them as quickly as possible, because in many cases, it is a matter of life or death.

Although we recognize the importance of reviewing the entire Food and Drugs Act, we want to be absolutely sure that the act contains provisions to ensure that the health of our fellow citizens will be taken into account responsibly.

There are some other things about this bill that bother me, and once again, I am sure that my colleagues from Québec and Verchères—Les Patriotes will see to it that these things are considered and debated by the Standing Committee on Health and that the people who have something to say about it will be invited to testify before the committee.

There is more to this than inviting experts in pharmaceuticals, doctors, parliamentarians, and departmental officials to debate this bill. The people this will affect—groups representing patients, hospitals and pharmacists—must be involved and consulted to develop the most comprehensive bill possible for health and therapeutic products.

There is something else in this bill that I am worried about. As my colleague said earlier, “therapeutic product” means

(a) a drug,

(b) a device,

(c) cells, tissues or organs that are distributed or represented for use in

(i) the diagnosis, treatment, mitigation or prevention of a disease, disorder or abnormal physical state, or its symptoms, in human beings or animals, or

(ii) restoring, correcting or modifying the body structure of human beings or animals or the functioning of parts of the bodies of human beings or animals, or

(d) a combination of two or more of the things referred to in paragraphs (a) to (c);

A few years ago, there was an epic battle over breast implants. At the time, breast implants fell into the category of specialized medical devices. Now they are in with therapeutic products. It was already very complicated and we did not have much information on the ingredients and the safety of breast implants. Now they are being put in with all therapeutic products or devices.

When they talk about cells, are they talking about stem cells? What are they talking about? When they talk about tissue, are they talking about the new grafts that can be made with one’s own tissue? There clearly need to be a lot of very apposite, very transparent rules on this.

I think that the health minister would have far too much power. The bill says that the health minister would have the power to modify the regulations. That is saying a lot because all the definitions in this bill are basically regulations. The health minister would have the ability, therefore, to change the regulations without coming before Parliament. That is very serious and we should be very worried about it.

There are also things that the minister could change not just in the regulations but also in regard to product labelling, purity standards, the way in which clinical trials are conducted, and the exemption of various products from the legislation.

I think that this means giving a tremendous amount of power to the man or woman holding the position of health minister. It means giving an awful lot of power to someone when we know we do not presently have a health minister who is very far to the left or very suited to making such decisions. After all, what is at stake here are the lives of our fellow citizens.

I am very concerned when I see a Minister of Health rise to vote against a motion asking Canada to recognize and abide by its commitment, as it has always done, to people sentenced to death in other countries. I am still very concerned about that. I thought that health ministers were supposed to be worried about the health of people and their survival.

It makes me wonder when I see that and then see a bill giving these people so much power. As a citizen, first of all, and as a user of medications and therapeutic products, I have a right and duty to wonder about these things. Do we really want to give one person the authority to approve a medication that has not been proven so that it can be marketed more quickly because it supposedly has more benefits than adverse side effects?

We saw this with Celebrex. It is still on the market because it supposedly has a greater upside than downside. However, people died of it before we knew why. We often see that. We did not use to see any advertising for drugs in Quebec and Canada. Under this legislation, though, there are some grey areas, some aspects that are incredibly hazy, and we could see more and more advertising. I am also very concerned about that.

To relax, we probably all watch television in the evening when we get home. In the course of the evening—in the space of maybe two hours—we will see at least two or three ads for Viagra or Cialis. That is what we see. To my way of thinking, these are drugs. Why is it that we see these ads when they are supposed to be prohibited? Various television stations agree to run them because Health Canada does not do any monitoring to determine whether various companies' and pharmaceutical firms' ads meet the criteria, which are, or were, clearly set out.

Now, with this new bill, the criteria would be much less clear. Pharmaceutical firms would have much more freedom and latitude to promote their products. This worries me. Many people are influenced by advertising messages. Our Conservative friends keep telling us that we are wrong, we are crazy, we are not listening, we do not understand, we will never accomplish anything, we are impotent. They know that repeating a message drives it home. In the same way, people who watch television are influenced by repeated messages: “Cialis will make you happy”, “Alesse will make you happy”, “This will make you happy”. We come to believe these statements and we ask our doctor for a prescription, even if we do not need the drug. We ask for the drug because it looks so wonderful to be able to skip down the street singing and arrive home to be greeted by our smiling wife. We want the same treatment.

We will have to be very careful about the decisions we make regarding this bill. While we agree that it should be referred to committee, I can assure the House that we will do our duty responsibly and make every effort to amend the clauses that could result in harm to the health of Quebeckers and Canadians.

[Wayne Marston, NDP, Hamilton East—Stoney Creek, ON]

Mr. Speaker, I appreciate the Bloc member's analysis of the bill. One of the concerns she spoke to is the fact that the regulations, which will allow for advertisements, also in my mind could open another door, and that is for lobbying of the cabinet. It is around the cabinet table where these decisions may well be made and that is a cause for grave concern about the kind of negative influence that could happen in regard to our government.

We all know what it has been like on the Hill for a number of years with regard to lobbying, and we all know how the government of the day has come in with the promise of accountability and being very straightforward. It strikes me as strange that we now have this bill which would allow those who are around the cabinet table to make such a serious decision. Would the member concur with that idea?

[Nicole Demers, Bloc, Laval, QC]

Mr. Speaker, as I was saying earlier, we absolutely must make sure there is as little advertising as possible about drugs and their derivatives.

Again, young girls have acquired a certain drug, a birth control pill, because they saw reports and ads on a product, Diane-35, which is extremely harmful and has contributed to the death of a number of people in Europe. This product has been banned in Europe and is no longer sold there. However, it is not banned here and is still available for sale. Despite all the precautions we should be taking, it is still available here.

This product is advertised in bus shelters, at bus stops and in all the magazines. They are reminder ads, since that is allowed, as is advertising the price, the quantity and the name of the product. Nonetheless, when both types of ads are put together a few days apart—or weeks in the case of magazines—people are smart enough to make the connection quite quickly and easily.

It has been proven that the drugs advertised the most on television are the most requested at the doctor's office. Doctors prescribe more of those drugs. There is an immediate cause and effect relationship that is very easy to see. Our government must not allow this indulgent and negligent approach. Rules absolutely must be established to stop this from happening.

[Meili Faille, Bloc, Vaudreuil—Soulanges, QC]

Mr. Speaker, I would first like to thank my colleague for her analysis of the bill. This afternoon, I received a letter from one of my constituents in Vaudreuil-Soulanges talking about the need to make sure that products entering Quebec and Canada meet standards that are similar to the ones that are applied here in Canada.

I have a question for my colleague concerning the need for transparency in relation to products. Consumer protection associations have told us that at present, the registry used to record complaints would only be for health care institutions and the public could not contribute to it and have their complaints addressed. As well, we are concerned about the Minister’s power to change the bill as he pleases without having to go through the House.

Consumers’ associations in Quebec and Canada are also asking for clarification regarding the confidential business information aspect.

I would like my colleague to remind us once again how important it is to be transparent when it comes to labelling and product content, and how important it is to give consumers an opportunity to file complaints.

[Nicole Demers, Bloc, Laval, QC]

Mr. Speaker, I thank my colleague for her question.

In fact, that is a subject I did not address: the subject of confidentiality and everything relating to drugs that are approved, not approved and awaiting approval. There again, there are major roadblocks for ordinary consumers and people who want to know what they are consuming, who want to know how and why they consume it, and most importantly, if it is a drug, a therapeutic device or a surgical device, whether it is harmless or not.

Some day, and I hope that day comes soon, we are going to have to adopt some clear rules. There is a lot of talk about transparency, but we are going to have to get beyond talking and have some actual transparency.

We have been talking about transparency since I first came to this House, but everything is just as opaque everywhere, in all fields, as if no one had ever talked about transparency. People have to know, they have to be aware, they have to be sufficiently educated and informed about all the drugs and products they may take so they can make informed choices.

It is exactly the same thing with GMOs and therapeutic products. I referred earlier to essential oils in relation to Bill C-52. It is the same thing. Consumers have a right to know. Consumers seem to be very wise, because it is letters from consumers that are telling us to be careful and not let a minister do the work by himself and make decisions about a bill by himself.

This may not relate directly to the bill itself, but rather to the direction taken in the bill. If the minister can change the direction taken by a bill once it has been agreed to and passed, what point is there in sitting in this House, doing the essential work and drafting a bill like this to ensure that our fellow citizens, and consumers, have access to quality drugs and that their health is not in danger?

What point is there in doing all these studies and all this research, in bringing thousands of witnesses here, if the Minister of Health can ultimately get up one fine morning and say he no longer agrees with the direction taken in the bill and decide to change it? I think my colleague is right to be worried.

[The Deputy Speaker, NDP, Bill Blaikie]

It is my duty pursuant to Standing Order 38 to inform the House that the questions to be raised tonight at the time of adjournment are as follows: the hon. member for Saint-Bruno—Saint-Hubert, Ethics; the hon. member for Davenport, Arts and Culture.

Resuming debate, the hon. member for Victoria.

[Denise Savoie, NDP, Victoria, BC]

Mr. Speaker, it is my pleasure to speak to Bill C-51, which is being presented in tandem with Bill C-52, which I spoke to earlier.

Bill C-51 seeks to amend the Food and Drugs Act. It has some positive aspects. A bill to better protect consumers is long overdue. Canadians have suffered harm from recalled products and death from drugs that were approved for sale too quickly.

The Food and Drugs Act has been eroded over long years of the former government. Canadians, it seems to me, have lost confidence in the government's ability to protect their health. Perhaps it has to do with the former government's big love affair with large pharmaceutical firms, but whatever the cause, Canadians feel that their health is not being protected, and this is what we must address.

In its present form, the bill is hugely inadequate and there is much that is worrisome about it. I have received literally hundreds of emails and letters about the bill. I would like to read some of them because they provide some interesting insights on how Canadians feel right now.

The official intent of Bill C-51 is to fill in gaps in health protection and to ensure the safety of Canadians. To that end, the bill proposes to implement sweeping changes in how Health Canada will regulate drug products.

As I have said, there are fundamental aspects that are problematic and that will keep the bill from doing what it purports to do, which is protecting Canadians. Instead, some of what is in the bill could likely have an adverse effect on Canadians' health.

I would like to touch on a few subjects that the bill addresses. The first one relates to advertising. In the modification that the bill proposes, it would likely have the effect of providing an opportunity for drug manufacturers to bypass the advertising bans by applying for exemptions. This simple change is disturbing in that it would render the government vulnerable to lobby pressure by large pharmaceutical multinationals.

It is important for Canadians to have clear information about the health product they take. We should not reasonably expect companies to advertise their products and expect that they will do so to educate Canadians.

I want to refer to some testimony that was given at committee by an independent drug policy researcher from my city of Victoria. I stress “independent” because often when presentations are made at committee they are made by people who either have ties to pharmaceutical companies or push for policies that improve the profits of the companies. It is important to mention that this researcher, whose name is Alan Cassels, is an independent researcher. He made the following comments at committee recently:

The pharmaceutical industry spokespeople will tell you that they should be involved in the education of consumers about drugs, but let me show you how they choose to educate consumers. This “toe tag” ad appeared in many magazines and major newspapers across Canada. This one came from the National Post of February 20, 2004. It shows a toe tag hanging off a corpse with the headline, “What would you rather have, a cholesterol test or a final exam?” Here's another example, from Maclean's magazine, of the same ad.

These ads are probably the most egregious example of disease-mongering that this country has ever seen. The ads, which ran in both France and Canada, were the subject of a letter from the World Health Organization to the medical journal The Lancet, complaining that this kind of advertising is undoubtedly driving the inappropriate use of cholesterol-lowering drugs around the world.

This proposed policy would be a policy basically on disease-mongering. It is important to maintain our current ban on direct to consumer advertising of pharmaceuticals but we need to go further than that. We actually need more strict control on the advertising of diseases. The industry might call it disease awareness but it may be closer to the truth to call it disease-mongering.

One place to start would be to ask Health Canada some hard questions. What is our policy around this so-called industry advertising? Do we collect data if this kind of advertising is driving the inappropriate use of pharmaceuticals? What research into this kind of approach has been commissioned? What other steps is Health Canada taking to control it? Instead of trying to deal with patients who may be dying from prescription drugs, how can we stop people from taking drugs they do not need in the first place?

The last question, a question that Mr. Cassels raised in committee, is very important. This is an aspect of proactive health, which we just do not do in Canada, that is inadequately funded and has not received enough resources, energy and thought.

We should not be allowing any shortcuts to advertising. Instead, we should be providing better information for patients. There is a dire need for Canadians to receive approved and regulated information provided by an independent, objective source that is free from profit driven industries that sell drugs. This bill would not do that.

At committee, the NDP will be seeking to ensure that there is no direct to consumer advertising and that it will be completely removed from the bill. We cannot allow that to happen.

Another aspect of the bill that is of concern is that it takes a radically different expedited approach to the drug approval process, which the government calls progressive licensing. Progressive licensing would have the effect of speeding up the process of new drugs to the Canadian marketplace. It sets up an ongoing life cycle approach without any new improvement to the pre-market testing of new drugs.

This is the first time a bill of this sort codifies the trade agreements, like NAFTA, for grounds for refusing to release information about safety and efficacy that companies submit in order to get their products approved. This clause is absolutely objectionable and needs to be removed and replaced by making transparency the default option.

If we want Canadians to take responsibility for their health, they must be able to make better informed decisions and that comes about with more awareness about what particular drugs do and having some choices in the drugs they are allowed to take.

One needs to ask whether this new provision would prevent similar recalls as occurred under Vioxx. Will it prevent another Vioxx type of recall? It appears highly unlikely. Therefore, my colleagues and I will be looking for dramatic changes on this aspect at committee as well.

Bill C-51 also raises the question about the speed with which drugs will be moved through the approval process. This really relates to parliamentary oversight and the kind of parliamentary oversight we should be requiring. The provisions in the bill would make it possible to grant conditional approvals, thereby getting new drugs to market faster than is possible under the current regulations. Pre-market safety requirements may be less stringent or even be bypassed all together according to the stipulations of the bill.

There also is no commitment in the bill to making the results of post-marketing studies public, which is another concern.

Another troubling aspect of the bill is that it would provide the Minister of Health and Health Canada with considerable discretionary authority that falls outside the purview of Parliament. In other words, Bill C-51 could effectively remove democratic oversight, bypassing elected officials in favour of allowing bureaucrats to enforce regulations that fall short of the standards Canadians deserve.

I spoke a little about the kind of information that is really important for Canadians to access in order to make crucial health decisions on the safety of the products they are taking. Perhaps the most onerous change that is being proposed in the bill relating to the Food and Drugs Act involves the provisions regarding natural health products. Many Canadians prefer to look for complementary strategies to stay healthy. I myself benefit from such products and it does help me to stay much healthier.

The provisions in the bill are worrisome because among the modifications proposed by the bill are radical changes to key terminology, for example, replacing the word “drug” with “therapeutic products” throughout the bill and therefore bringing the natural health industry under the scope of the Food and Drugs Act and Health Canada. This far-reaching change would give the Minister of Health broad powers to regulate all natural health and plant derived products and, in the process, restrict access to these products for Canadians.

Up to 60% of the natural health products currently on the market would be outlawed as a direct result of the enactment of Bill C-51. This would remove a lot of choices for Canadians.

From some of the many letters I have received, there is one from a medical doctor who says, “I'm a medical doctor and a doctor of Chinese medicine living and working in Victoria. I'm becoming concerned that the new Bill C-51 introduced by the health minister might affect the public's and my patients' access to natural health products in Canada”.

Indeed, the clauses in this bill would have a serious limiting effect.

It is not by succumbing to the big pharma lobby that we will achieve balance in better regulating natural health products. That is an important piece: we must have a better balance. Perhaps we can do it by creating a third category. This something that the natural health industry has been calling for. Instead of buckling under to the big pharmaceutical lobby, it would simply have its own category, by itself, and regulations that do achieve that balance.

Another comment I have received which has concerned me is the following: “I and my family are opposed to Bill C-51 as it will restrict access and increase prices of natural health products we use regularly”. I think we are all aware that right now Canadians are having a more difficult time. Our economy is in decline. Many people are struggling to make ends meet and are using natural health products to stay healthy. Increasing the prices at this time would certainly not be helpful.

Another comment from one of my constituents states: “Regulations of natural health products should be separate from pharmaceuticals”. This is something that I think we will be asking the committee to look at.

Another comment that has been made is in regard to concern about how quickly this bill is being pushed through the process, disregarding recommendations made by many consumer public forums, health coalitions, and so on.

For the many people who suffer from chronic illnesses of various kinds, I think access to natural health products really keeps them functioning and protects their quality of life. This is what they are asking us to do. I will be asking members of the committee to look at this aspect of the bill very seriously to see if the draconian measures being proposed really warrant what is being asked. Merely selling garlic to someone would make it a drug product under this new definition. Does that make any sense? There are many other examples like that.

I see that I am running out of time, so I will conclude simply by saying that Canadians want to be able to use natural products to keep their families in good health as one of the many ways used to maintain health. Being forced to use a pharmaceutical option is not the way to go. That is something I am going to oppose.

I hope the committee will look at making these much needed amendments while protecting the overall purpose of the bill, which is to ensure that products sold to Canadians are safe.

[Nicole Demers, Bloc, Laval, QC]

Mr. Speaker, I thank the hon. member for delivering such an eloquent speech on Bill C-51.

She explained very clearly a number of problems that are found in this legislation. I wonder if she could tell us more on the issue of drug advertising which, under the bill, would be authorized to a much greater extent than is currently the case. The fact is that this already creates a problem.

I would also like her to tell us a bit about the fact that the minister would really have a great deal of latitude to decide by himself whether he wants to change the thrust of the bill, or whether he is prepared to keep it as reviewed and probably amended by the Standing Committee on Health,.

I wonder if the hon. member could give us her thoughts on this.

[Denise Savoie, NDP, Victoria, BC]

Mr. Speaker, I thank my hon. colleague for her questions. The two issues she raised are indeed of great concern to me.

First, there is the issue of advertising. We can already see some television ads. Under the current legislation, the reasons behind such ads cannot be discussed. Under Bill C-51, however, exemptions or special permission may be sought.

Earlier, I gave the example of an absolutely appalling ad promoting a certain drug whose name escapes me, but the ad basically gives you a choice between keeping your cholesterol in check with that drug or dying. That is so far-fetched that it makes no sense.

What Canadians need is more awareness-raising, real information provided in a transparent fashion.

Currently, our physicians across the country are provided information by the pharmaceutical companies. Where does the government stand on protecting the health of Canadians? Do doctors have the time to look after that? We are all aware of the shortage of doctors. They are already rushed. Will they have the time to read up on all these new drugs, each new one being advertised as better than the last? Do they have enough time for that?

The proposed amendments should really include an objective way to provide this kind of information first to our doctors, and then to the general public.

As for the second question, I really have not looked into the matter much. Nonetheless, it is important that Parliament, this House, the elected representatives maintain authority over that aspect. From the moment that we forfeit the responsibility we have been given by the people of Canada, we limit the information the minister will take into consideration. So, it is important that, as elected representatives, we continue to ensure that this responsibility is maintained.