Debates of June 10th, 2008

Food and Drugs Act

[Peter Julian, NDP, Burnaby—New Westminster, BC]

Mr. Speaker, I am proud to follow my colleague from Winnipeg North on Bill C-51. She has been very eloquent on this bill and has been, I think, by far the best speaker thus far in terms of exposing what really seems to be at work here regarding the agenda that the government has put forward. I am pleased to speak in opposition to Bill C-51.

As with a number of other initiatives from this Conservative government, what it says it is trying to do is quite different from what it actually tries to do when it is seen in legislation. We have seen this time and time again, that essentially what the Conservatives try to use is a smokescreen, political spin. It takes scrutiny, particularly from the NDP corner of the House, to scrutinize very carefully the actual legislation to find out what indeed is the intent of the Conservative government.

Here again is a case where the Conservatives announced, with a great deal of political spin and marketing, that somehow they were trying to add to safety in our health care system with health care products and pharmaceutical drugs.

But the devil is in the details. When we carefully read through this bill, as our health critic the member for Winnipeg North has done and other members of the NDP caucus, we find the intent is quite different than the actual wording of the bill itself.

I would like to touch on two of the most egregious aspects of what is contained within Bill C-51, which essentially, in a very bizarre way, is an attempt to push a very strict regime around natural health products and at the same time, there appears to be an attempt to lessen any sort of regulatory oversight around pharmaceutical drugs.

On natural health products, we have seen over the past few years a growing waiting list for approval of natural health products in Canada. A little bit like the immigration system and a little bit like our health care system, that is the result of both successive Liberal and Conservative governments essentially giving away the public management and the public trust that Canadians have entrusted to Parliament.

What we have seen over the past 20 years is very much a right wing agenda that puts the emphasis on corporate tax cuts above all other things. The result of that is underfunding of our health care system. The result of that is underfunding of our immigration system and the result of that as well is underfunding of the approval process to actually ensure that natural health products are not subject to these long wait lists.

The solution the Conservatives offer up is to simply lump in pharmaceutical drugs with natural health products. I have received far more letters and emails from my constituents in Burnaby—New Westminster on this issue than I have on practically any other. I am going to read into the record a few of the comments that my constituents in Burnaby--New Westminster have written to me on this particular issue.

Mr. Thuot writes: “We all recognize that the pharmaceutical industry has been waging a relentless war internationally on vitamin and alternative natural health supplements for quite some time”.

We have Dr. Chan from Burnaby who writes: “I definitely do not support legislation that treats natural health products in the same manner as pharmaceutical products. Now would be an excellent time for the government to implement a third category for natural health products as was recommended by the Standing Committee on Health in 1998”.

We have Mr. Johrden in New Westminster who writes: “I am opposed to Bill C-51 which has been set in motion to amend the Food and Drugs Act, a bill with worrisome implications for the natural health products industry and consumers”.

We have Ms. Balabanov who writes: “Vitamins and minerals are very important for health and prevention. They cause no deaths as opposed to pharmaceutical drugs that do cause many deaths”.

We have Ms. Lum from Burnaby who writes: “I dare say the only industry being helped will be the pharmaceutical industry who can rake in even more profits once all health foods have been banned or made into prescription drugs”.

We have Mr. Hollenstein from New Westminster who says: “I do not wish this manipulation of the term therapeutic drugs to be an umbrella for all pharmaceutical drugs, to include vitamins and herbal remedies and food in general”.

We have Mr. Robertson who writes, referring to me as his member of Parliament. He said: “I ask you to take a strong stand on this and I for one would like to state that I am vehemently opposed to the passing of such a bill”.

Ms. Bredburn from Burnaby writes: “I am a woman who has greatly benefited by natural health products after years and years of unsuccessful mainstream doctor prescribed drugs”.

The constituents in Burnaby and New Westminster have written time and time again about this foolhardy notion that the solution to the waiting list, that has been caused by government underfunding, will actually ensure that the system works effectively and that new natural food products that are brought on the market will be subject to the appropriate scrutiny and then brought on to the market.

Instead of providing the adequate funding, in a bizarre world that only Picasso could have imagined, we have the Conservatives making the situation worse. However, there is another element to Bill C-51 that I would like to address.

As the government seems to be putting the thumbs to the natural food products industry and most Canadians who rely on herbal remedies and natural food products to maintain their health and well-being, we are seeing, at the same time, an American style approach to the approval of pharmaceutical drugs. What sense is that when in the United States we have seen huge problems with its fast tracking of approval of pharmaceutical drugs?

Progressive licensing simply ensures that drugs are brought onto the market without appropriate scrutiny. We have seen this from other Conservative initiatives in transportation, where it wants to hand over safety management to the airlines themselves. It did not work for railways, as we saw an escalating accident rate, but the government wants to try it for airlines. This type of approach simply does not make sense.

We have seen in the United States drug after drug after drug that has provoked deaths because it was fast tracked. We know that the Conservatives, like the Liberals before them, in these behind closed doors negotiations, the so-called security and prosperity partnership, are trying to harmonize all of our regulations, standards and safety protections that we put into place to lower American standards.

We saw that with transportation safety. We have seen it with the attempt by the Conservative government to raise the pesticide residue permitted in Canadian food. We see this through the SPP process that essentially copying what has not worked in the United States is not in the interests of Canadians.

I would like to read a couple of excerpts from news articles that came out last year around this issue of progressive licensing and how it worked in the United States. I will read a couple of paragraphs from the Washington Post:

Three drugs--Vioxx, Ketek and Avandia--are casting long shadows over the congressional debate on how to update and revise the 15-year-old system that has dramatically sped up the process of bringing prescription medicines to American consumers. All three ran into problems after the Food and Drug Administration approved them for use. The problems ranged from thousands of heart attacks partly attributable to the painkiller Vioxx to a few cases of liver failure caused by the antibiotic Ketek. And the hazards of the diabetes drug Avandia are only now emerging.

The New England Journal of Medicine did a study around cases of these fast tracked drugs, such as the Conservatives are proposing, and these are the comments that came out of that study:

It is incredible that the Agency charged with protecting the public health has such a poor record when it comes to post market drug safety. Regrettably it is incidents like this that demand legislative changes in the way FDA deals with drug safety.

That particular study indicated that 56,000 Americans died as a result of drugs being fast tracked onto the market. This is the danger with this kind of foolhardy Conservative initiative that may mesh with its right wing ideology that government and safety is bad, let us do away with all of that, and let the company CEOs decide what degree of safety or risk Canadians should have.

Very clearly, all the emails and letters that have come from my constituents say the contrary. Canadians believe the government should ensure a higher standard of safety, a more secure process of approving pharmaceutical drugs.

Bill C-51, the thin edge of the wedge, does exactly the opposite, moving toward a kind of progressive licensing, the fast tracking of drugs that did not work in the United States. That is why in this corner of the House we are saying no to Bill C-51.

[The Acting Speaker, Conservative, Royal Galipeau]

Order. 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 Kenora, Aboriginal Affairs; the hon. member for Labrador, National Defence; the hon. member for Windsor West, Infrastructure.

Questions and comments. The hon. Parliamentary Secretary for Health.

[Steven Fletcher, Conservative, Parliamentary Secretary for Health]

Mr. Speaker, I have heard stories about the loony left and what we have seen and heard here is an example of seeing shadows where there are not any. The fact is the government is looking to bring forward regulations to protect Canadians. I thought NDP members would be in favour of that but they are not. They feel that there is some sort of conspiracy with big pharmaceutical companies and that somehow this legislation will fast track pharmaceuticals, which is absolutely false.

This legislation deals with the life cycle approach of products. I wonder if the member understands what he is talking about. Can he explain his understanding of the life cycle approach to Parliament?

[Peter Julian, NDP, Burnaby—New Westminster, BC]

Mr. Speaker, I think the member is betraying the Conservative approach on health care. Rather than addressing any of the concerns that have been raised by the thousands of Canadians who have written to his office, as they have to every other member of Parliament here, he denigrates them. He attacks them, he insults them and he calls them names. That is exactly the Conservative approach. It is a kind of thuggish approach on health care.

To put it quite simply, the Conservatives have not made the case for Bill C-51. Quite simply, when we look at the American style of approach that they are attempting to use through Bill C-51, the evidence is there in the United States from The New England Journal of Medicine, which he is calling loony leftist. The New England Journal of Medicine has a lot more credibility than the hon. member does when it comes to health care issues.

When The New England Journal of Medicine says that 56,000 person-years were “lost to the harmful effects of drugs approved but later withdrawn for safety reasons” because of fast-tracking of pharmaceutical drugs in the United States, one would expect that the Conservatives, in the public interest, would actually say, “Hold on, let us take a step back on this. We have put together this legislation. Obviously there are some negative impacts on this legislation so we are going to have to--

[The Acting Speaker, Conservative, Royal Galipeau]

It is with regret that I must interrupt the hon. member. Questions and comments, the hon. member for Yukon.

[Larry Bagnell, Liberal, Yukon, YT]

Mr. Speaker, I commend the member for putting input from his constituents on the record. I want to do the same.

I want to ensure that the supplements for people with bipolar syndrome are still available for them. I have some constituents who need them.

Also, in this process, there has to be consultation with first nations, especially those who have in their land claims and self-governance agreements the right to distribute these products.

Finally, this last comment is from a retailer, who says:

Many Canadians rely on natural health products for their health. These products are endangered and consumers need to act now to save them.

Since 2004 when the Natural Health Product Regulations were introduced, natural health products have been increasingly threatened. The new Regulations were Health Canada's response to consumer demands for the government to protect their access to natural health products. The Regulations have had the opposite effect. To “legally” sell a health product the new Regulations impose a licensing requirement. The problem is that 60% of the licence applications have failed. These have been the “easy” applications. Expectations are that 70-75% of applications will fail. For the [Natural Health Products] Community this means that 75% of [natural health products] we rely upon for our health will become illegal.

[Peter Julian, NDP, Burnaby—New Westminster, BC]

Mr. Speaker, I am going to finish my answer to the parliamentary secretary. The government itself is acknowledging the fact that it screwed up on this bill because it is now bringing in amendments to its own bill.

As for what the parliamentary secretary said in a very denigrating way about Canadians generally who have concerns about this bill and about leftist publications like The New England Journal of Medicine, my goodness, if that is a leftist publication, then I think we are dealing with a completely different planet that the Conservatives live on.

These concerns are legitimate. The government has acknowledged that by bringing in amendments in a desperate attempt to try to correct the mistakes it has made in this bill.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

Mr. Speaker, it is with pleasure that I rise today to speak on Bill C-51, An Act to amend the Food and Drugs Act and to make consequential amendments to other Acts.

First and foremost, as vice-chair of the health committee, I would like to say that we have looked at some of these issues and it is a pleasure to see the parliamentary secretary here to support this bill and to debate it.

First, the bill looks at modernizing the regulatory system. What does that mean? It means that because the act was introduced in 1953 and is a little bit older than I am, we can see that it needs some improvement, just as I do on a regular basis.

Second, it looks to improve the surveillance of benefits and risks of therapeutic products throughout their life cycles. At the committee, we have been looking at licensing or surveillance of medication.

At this time, what happens with medication is that some pre-market tests are done, but we all understand that pre-market tests cannot be done on young children or on elderly people, pregnant women and so on. At the same time, when products are introduced into the market, they are taken by those people as well, so we have been doing a study on post-market surveillance to see what can be done and how to improve the system of post-market surveillance.

The post-market surveillance assessment will be done soon and I believe the report should be hitting the House either this week or next week, hopefully before we rise. The report will have some recommendations about which I am not at liberty to speak at this time.

The other issue this bill looks at is improved compliance in reporting adverse reactions. As for adverse reactions when someone takes a medication, the medication is either reported back to their doctor or not reported at all. So far, our information tells us that only 10% of adverse reactions are reported.

We have been wondering about that. We have been consulting with stakeholders from across the country, the people who really do this work, such as the Canadian Medical Association, the Canadian pharmaceutical associations, the Canadian Nurses Association and so on. We will be coming up with some recommendations on those issues before the House rises, but what is important is that the issue of human resources for health professionals is not being dealt with.

When the Minister of Health appeared in front of the committee, we asked if he was aware of how many Canadians did not have a doctor, a health professional. At that time, which was about three months ago, he was not aware. Further, when we asked if he was aware of what the doctor shortages were in Canada, he was unaware. The third question was the clincher and that was about whether he had a plan. He obviously had a plan, but having a plan for improving the situation of health care professionals in Canada and not being aware of the first two questions begs the question of how he could be fixing a problem without being aware that it exists.

The minister came up very short in front of the committee. I was very surprised when he did not know that three million to five million Canadians do not have a doctor and that in Canada there is a doctor shortage of about 26,000 physicians. They were needed yesterday, not tomorrow, not next year, not 10 years from now, but yesterday.

Because the minister said he had a plan, we asked him what his plans were in the health department to fix the human resources situation. He told us that residency spots in Ontario were available. When we asked how many, he said they had been increased by roughly 100.

I was born in a very small village and my math may not be so good, but when three to five million Canadians do not have a physician and we are told that 24,000 to 26,000 physicians are needed to make sure that Canadians are looked after, it does not take a genius to figure out that we need an aggressive plan for human resources in the health care system. The minister's aggressive plan was to increase the number of residency spots in Ontario by 100.

Twenty-six thousand doctors are needed, yet we are increasing that number by only 100. It will take a zillion years, let me note for the parliamentary secretary, to solve this huge problem. It is a problem in the beautiful riding of Oak Ridges--Markham, the largest riding in Canada when it comes to eligible voters. We need more health care professionals in our riding.

I would like to go back to Bill C-51 and put on the record a number of emails that I have received from people in my riding.

Linda wrote to me and said:

If I prepare apple cider vinegar steeped with a few herbs like sage and lemon balm in my garden for a general winter tonic to ward off flu or colds, or to give in case of sore throat, I could find myself in jail if I give this to my children or husband or give a jar to my neighbour or a friend. Or if I make some skin cream for my son's eczyma from beeswax from some herbs growing in my garden I could be thrown in jail....

She went on to say:

I don't trust Health Canada to keep my family safe. I don't trust the health minister to keep my family safe...

If this bill does pass, and I pray it does not, I will be contacting you and your colleagues....

Another email is from Angela, who says:

I wanted to write to you to see if there is anything you can do to help out with Bill C-51, which the government is trying to pass as law. If passed, Bill C-51 will ban our access to all vitamins, herbs and alternative therapies.

I would like to read a couple more, with the House's indulgence. The next email is from Rosie, who says:

You might remember chatting with Jeff and myself...a few weeks ago...I am writing to protest the passing of Bill C-51 in its current version.

She says that we should take it out of here, pass it on to the committee and have a look at it at committee. That is a great idea. That is what our party is suggesting.

With your permission, Mr. Speaker, I will finish with an email from Marjorie, one of the many that we have received. She says:

By now, many people in the Natural Health Product (NHP) community are pulling their hair out over Bill C-51, an act to amend the Food and Drugs Act.

I end my speech with that.

[Steven Fletcher, Conservative, Parliamentary Secretary for Health]

Mr. Speaker, the member is very able in his capacity as vice-chair of the committee. I look forward to working with him in committee on Bill C-51.

With respect to the issue of the physicians, I would like to remind the member that it was under the previous government that positions were cut and $25 billion was removed from the transfers to the provinces. We are dealing with it now and we are dealing with it well. The minister has done a remarkable job in attracting new professionals through working with colleges.

As well, just last night we passed an immigration bill that will fast track health care professionals such as doctors, nurses, physiotherapists and the like. We are making substantial progress.

On the issue of Bill C-51, we have heard from the NDP accusations that are not correct. I wonder if the member, as vice-chair of the committee, could explain how the committee process works. The fact is that once we go through second reading the committee will have the opportunity to amend the legislation, listen to witnesses and so on. It also gives the government the opportunity to incorporate into the bill suggestions that it has heard from across the country, because of course the government is listening to Canadians. Can the member explain the process a little?

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

Mr. Speaker, I will comment on the process, but I will mention a couple of things with regard to the doctor shortages.

The immigration bill has passed, without our support. If the parliamentary secretary is thinking the bill will solve the problems he has as the parliamentary secretary, and Canadians endure, he is dreaming in Technicolor.

In terms of the process, it is such that we will now move the bill to the committee and the committee will do an intensive study. We will hear from the brightest minds and most of the shareholders who are involved with the bill. We have looked at our agenda and we will bring Bill C-51 to the committee's agenda upon our return in the fall. At that time, we will discuss and hear witnesses from across the country. If people are watching and would like to be witnesses, they should get in touch with our clerk and she will ensure they are added to the list of witnesses. We like to hear from everyone.

This morning my assistant opened over 100 envelopes with the same message inside. The names of different people were added on to the letter of request or comments that people had made. Therefore, I believe there is a movement, in terms of Bill C-51, looking to stop the bill dead in its tracks right now.

However, we will send it committee, work on it and come up, hopefully, with an improved plan than the one with which the parliamentary secretary gave us to work, which is not enough.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Mr. Speaker, I am pleased to rise to speak to Bill C-51. We know the overhaul of the Food and Drugs Act in Canada has been years in the making and successive governments have attempted and failed. Canadians rely on their government to ensure safety standards are in place to protect their food, drugs and the natural health products they might want to take.

Over many years, we have seen far too many scares. There have been some serious consequences. Drugs and other products have ended up on the market and the health of Canadians has suffered. We certainly can point to Thalidomide as one of those drugs, as is Vioxx. Silicone gel breast implants had consequences that people did not anticipate.

It is very important that a legislative and regulatory process be in place to protect the health and welfare of Canadians. However, we do not see Bill C-51 as being that legislation. Although some aspects of the bill have merit, other aspects of the bill warrant additional attention. Because I only have 10 minutes to talk about this, I will talk only about a couple of aspects of it.

Before I get into this, governments in the past have made the lives of scientists very difficult. We only have to turn to the BSE crisis. Scientists were fired under the previous Liberal government for highlighting the problems with BSE. The case went on for years for those scientists who dared stand up and talk about the fact that some of the products in Canada simply were not safe. We also want to ensure there is adequate protection for employees who dare to blow the whistle on current government practice that affect the health and welfare of Canadians.

The couple of pieces I want to touch on are progressive licensing and direct-to-consumer advertising in the natural health products. I also want to highlight the fact that first nations traditional healers are not protected under the bill. Many of the first nations traditional healers have sacred medicines, which they have used for centuries. However, because they are sacred, they also are not in the public domain in the way that other products are. There needs to be a way to ensure first nations traditional healers are not impacted by the bill as well.

Under the progressive licensing aspect of it, one of the things the bill talks about is setting up an ongoing life cycle approach to drug safety. However, it does not have the needed improvements for pre-market testing and there will be heavy reliance on industry-led post-market follow-up. One of the things we want to see is improved pre-market safety. Any post-market oversight must be done independently. If we turn it strictly over to industry, it is like the fox in the henhouse. Any oversight must be done at arm's length so industry is held accountable both for its pre-market and post-market testing.

In the past we have called for a system to record adverse reactions. I know there has been some movement on recording adverse reactions, but more work needs to be done in this area as well. Largely one of the ways post-market problems show up is in adverse reaction. There needs to be much more work done on ensuring there is a national system in place to look at adverse reaction.

I want to touch on direct-to-consumer advertising. This is a very small piece in the bill, but it opens the doors to look at banning the current act's straightforward ban on direct-to-consumer advertising for health conditions, as outlined in a schedule in the act. The way the new legislation is written this prohibition could be exempted through regulation. This would allow pharmaceutical companies, with an order in cabinet, to bypass the regulations that are in place.

I want to turn to an article that was written by Barbara Mintzes called “Disease Mongering in Drug Promotion: Do Governments Have a Regulatory Role?”. It is an extensive article, so I will not have time to read the whole thing, but I want to touch on two pieces. She starts the article by saying:

Ray Moynihan and colleagues describe disease mongering as, “widening the boundaries of treatable illness in order to expand markets for those who sell and deliver treatments”. In this article, I examine one aspect of disease mongering: activities financed by drug companies to promote sales by expanding the pool of patients potentially treated by their products, when no benefit in terms of reduced morbidity is likely.

Then she goes on and talks about the fact that often these are very emotional responses and cites a couple of ads from pharmaceutical companies that say if people do not take their produce, they will end up dead. That is kind of the short form on it. That kind of fearmongering to encourage patients to use a particular pharmaceutical company's product is not the most reasonable way to make decisions on particular treatments.

In her conclusion, she says “Is a More Robust Regulatory Response Needed?”

She says:

The rationale for regulation of drug promotion is health protection, encouragement of appropriate medicine use, and prevention of deceptive advertising.

She goes on to say:

Canada's Food and Drugs Act prohibits advertising a drug that is “false, misleading or deceptive or is likely to create an erroneous impression regarding its character, value, quantity, merit or safety”.

I think many Canadians would be very uncomfortable with anything that would allow pharmaceutical companies to do more direct-to-consumer advertising than they already do. There is a way they can circumvent the regulations currently, and many Canadians are very uncomfortable with that. We are strongly opposed to anything that would open up the door to allow that to happen. We are opposed to that one aspect of the bill.

I know other members in the House have talked about the hundreds of letters they have received from their constituents, and certainly Nanaimo—Cowichan is no different, around the concerns about how this may impact on their ability to use natural health products. People in Nanaimo—Cowichan like the option of being able to access natural health products without facing some of the same costs involved with pharmaceuticals. They like to have that access through their local health food store. Many are raising concerns around whether this will impact on their access.

The Canadian Health Food Association has written a letter to the Minister of Health, on June 9, outlining many of its concerns around the natural health products aspects of the bill. I will touch on a few of them, but the association has quite accurately outlines.

The association talks about the fact that in the preamble to the bill there is no identification of the importance of health promotion or disease prevention. We know health promotion and disease prevention are very important aspects. If we want to talk about impact on our health care dollars being spent, we know health promotion and disease prevention need far more emphasis than they current get.

The association talks about categories, that the proposed amendments to the act include a new term called “therapeutic product” under which NHPs, as a subset of drugs, fall. It says, “The term “NHPs” does not appear anywhere in C-51 until page 40 when transition provisions are discussed.

It talks about authorization and licensing, that the applicant is required to establish that the risks of the product are outweighed by the benefits. Its comment on that is:

There is nothing in the Bill that indicates in what manner the applicant is to satisfy the risk-benefit ratio. No parameters or definitions have been included, that recognize the inherent differences between NHPs and pharmaceuticals, in particular new drugs.

It goes on, as well, to talk about the fact that, in many cases, the minister would have far more powers through the regulatory process and that it would not be an open and transparent process.

The association's brief to the minister talks about the fact that there needs to be accountability, openness and transparency around how decisions are made, that we do not need a regulatory process. In fact, we know that most regulations do not need to come to the House of Commons for approval.

We have heard the Conservatives say, “trust us”, that the regulatory will be in place to ensure that everything will lineup the way the bill says it will, but that is not true. The regulatory process happens outside the House of Commons, outside the legislation, so there is not that openness and transparency.

I encourage members of the House to take a look at the very concerns that have been raised by constituents in our ridings and across the country and ensure that natural health products and the safety of consumers is protected by the bill.

[Steven Fletcher, Conservative, Parliamentary Secretary for Health]

Mr. Speaker, I had the pleasure of working with the member on the health committee in the past and I always appreciate her comments.

My question deals with the beginning of the member's speech where there was a demand for increased free market surveillance. This bill, in the case of natural health products, looks at the risk profile of a natural health product. A product that has been used for thousands of years or is of low risk would be approved very quickly. This is very important to those who have natural health products because everyone in this industry is aware that there is a huge backlog in natural health products.

If we actually do what the member is insisting on doing, that will make it more difficult for natural health products to enter the market and therefore will deny people the opportunity to have the maximum choice of natural health products.

I wonder if the member would reconsider that position and accept the life cycle approach where products are viewed on a risk profile and low risk products are approved quickly and high risk products receive lots of scrutiny and are monitored for the entire time the product is in the market after being released into the market.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Mr. Speaker, in fact I was talking about pre-market work around pharmaceuticals, not natural health products.

When I was talking about natural health products, again I want to point to the concerns that were raised by the Canadian Health Food Association when it talked about the fact that the bill does not indicate any parameters and definitions, particularly around natural health products.

Part of what we have talked about in other contexts, aboriginal for example, is that if there is sufficient consultation done prior to a bill coming before the House, the passage of the bill is much smoother. In the area of natural health products, it would be very important to do appropriate consultation with not only people who manufacture the product but the users and many of our constituents who have a lot of knowledge about these products.

I would suggest that before we take a look at the risk benefit analysis for natural health products, we need to talk to the people involved in the industry in a much more thorough way.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Mr. Speaker, I appreciate the comments made by my colleague from Nanaimo—Cowichan and certainly some of the concerns that she has raised.

Through the course of this debate, I too have received a significant number of interventions, emails, letters and phone calls on the topic as have, I am sure, all members of the House. There is a certain consistency that runs through them. I want to share one and then pose a question. The Van Zutphens from Port Hood are great citizens and are very good at sharing their opinions on particular issues. Mrs. Van Zutphen wrote, “We support the need for regulation that ensures that the products recommended by our naturopathic doctors are safe and effective but we do not support legislation that treats natural health products in the same manner as pharmaceutical products. We encourage the government to implement a third category for natural health products as was recommended by the Standing Committee on Health in 1998”.

I apologize for not knowing the position of the NDP on this particular issue, so I will ask the member where they do stand on the creation of that third category of products.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Mr. Speaker, the NDP has supported the creation of that third category.

I know that in a previous Parliament there was a private member's bill before the health committee and I was pleased to sit on the health committee where there was extensive discussion and witnesses from across the country.

Generally what we have heard, and it is fairly conclusive, is that people do not want to see natural health products treated as a drug nor as a food, and that third category seems to be the most reasonable way to go.

[Alan Tonks, Liberal, York South—Weston, ON]

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

There are many Canadians who have an intense interest in issues related to prescription drugs and natural health products. Their use has skyrocketed over the last number of years. I think Canadians can rest assured that when the bill is sent to committee, the committee is going to give due diligence in a very professional and consultative way. I am convinced of that.

My colleague from Oak Ridges—Markham is the vice-chair of the committee. On behalf of the committee and the chair he invites those who have a wide interest to make their concerns known to the committee. To use a clinical analogy, after the kind of analysis that will go into this legislation the prognosis for action is going to come to grips with some of the more modern issues that have evolved over the last three or four decades.

It is amazing to me that the Food and Drugs Act has not been updated since 1953. When we think of it, traditionally the debate centred around generic and brand name pharmaceutical companies. At one time the brand name pharmaceutical companies did most of the research and the generic companies picked up some of their patents after they had expired and brought cheap drugs to Canadians. The debate was always about achieving the right balance between the pharmaceutical companies in terms of serving the best and higher interests of Canadians. The debate has evolved far past that now, not that that debate is not still going on.

Natural health products are being used now by a large spectrum of Canadians. These products are supported by research and development by many companies that are Canadian and that are part of the health care system.

I would like to add one element that has not been touched on by any of the members that I am aware of to this point. Not too long ago in Maclean's magazine it was indicated that in fact megadoses of vitamins and nutrients taken in combination with certain prescribed drugs could have a deleterious effect with respect to the very objectives of the regime that had been entered into either on the advice of a physician or in a haphazard way by the consumer. Sometimes people will take megadoses because they have concluded they could not be harmful. Taken on their own the publication indicates that they probably are not, but taken in combination without appropriate advice, they can have a very disastrous effect.

I do not intend to pass any judgment on those conclusions because I am not qualified to do so, but those particular conclusions were picked up by several research based publications in the medical field. They in turn have said that this is a very important health risk, that the legislative regime should start to come to grips with.

For example, selenium taken on its own has certain advantages, but taken with warfarin, which is a blood thinner, the medical research documents and Maclean's magazine indicate it could have a very bad effect. I just use that as an illustration.

What is our responsibility with respect to the legislation that would take all of that into consideration?

The government has said that there should be elements of what is called a life cycle risk management system. In other words, the onus is not on the companies that all of a sudden see something in terms of research to say to Mr. and Mrs. Consumer that they had better not take that product in combination with the prescription they are taking, and the company will withdraw that from the market.

The onus is voluntary on the producer of the particular vitamin or whatever it may be, and it could be a prescription drug. We have had examples of that before. The life cycle risk management places the onus on the sector, be it pharmaceutical or natural health products. When they have, on the basis of the best available research, even an inclination that there is a problem, they have the responsibility to come forward. That is as it should be. I do not think anyone on this side or the government side should be arguing about those components to give the minister more authority, either through an injunctive mechanism or whatever it may be, to react in keeping with the seriousness of the medical implications of pharmaceutical drugs or naturopathic or natural health products. That is something we do in terms of serving the higher interest of consumers. As representatives of Canadians, we have a responsibility to make sure that the regime that is in place will do that.

It is interesting to note from the documentation I have read that for the first time the generic and non-generic pharmaceutical companies are in agreement with respect to consumer advertising. There are some consumer groups that take exception, but the generics and non-generics have said that they think there is a higher interest to be served by allowing consumers to see the full picture of a pharmaceutical product before them.

I have seen those truncated ads on television that do not give any background. They give a name but they say that people should go to their doctor. That is fine, but people should go to their doctor anyway. If it is on the basis of a little more information to talk to a doctor, why should we be saying to consumers that they should not have that information?

The generics and the non-generics in fact are agreeing with those provisions of the proposed legislation that really attempt to give more information.

I am not going to come down on either side of that issue, other than to say to my colleagues that I have been impressed with their understanding of these issues. When the bill comes to the committee those issues will be well debated. The committee will be hearing from a broad spectrum of interests and I am convinced that the public interest will be considered.

I have concentrated mainly on the implications with respect to the therapeutic category. I do believe that the natural products portion of the bill needs to receive more intense consideration. The reason is that Canadians generally see that as an opportunity for them to participate in their health care. The more we can help them to do that, the more we will be invigorating our health care system and bringing Canadians into the health care equation as active and informed participants.

If this legislation does those things, it will serve Canadians well. I am convinced, having listened to this debate, that in submitting this bill to committee, the broad spectrum of interests will be considered in a balanced and fair-minded way.

[Steven Fletcher, Conservative, Parliamentary Secretary for Health]

Mr. Speaker, I would like to thank the member for his thoughtful comments and note his grasp of the issue. He has demonstrated that he has given this issue some consideration.

The hon. member struck on one of the key elements of the bill, and that is the life cycle approach. I would like to give the member an opportunity to explain why the life cycle approach is beneficial for the consumer.

[Alan Tonks, Liberal, York South—Weston, ON]

Mr. Speaker, the largest criticism, both for research based pharmaceuticals and in fact for natural nutrients and products, has been that in the existing regime there is the capacity to back up in terms of applied research and getting the product onto the market.

I think this is in fact reverses that. A life cycle risk management is in fact a more dynamic process that places the onus on the full spectrum of medical jurisdictions, so to speak, and in fact will get those products out more quickly and in a safer manner. Surely that is the end result we all want to achieve. I think the legislation, properly worded and implemented, would do that.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Mr. Speaker, this has been an excellent debate today. Some very strong points have been brought up throughout its course.

One of the common themes from the members on this side has been the concern around whether this legislation will handcuff naturopathic doctors. We are being asked by the Minister of Health to place some blind faith in him. He had said at first that it would in no way have an impact on natural health products, but now he is saying that he is going to bring forward some amendments when this legislation reaches committee. He is asking us to support moving it through committee.

I have a question for my colleague and I would like to get my colleague's position on record. If he sees that this bill would in fact be disenabling naturopathic doctors or in some way would handcuff them from conducting their trade or having access to the full range of various products, will he be voting against this when it comes back to the House?

[Alan Tonks, Liberal, York South—Weston, ON]

Mr. Speaker, the end objective is to protect Canadians and ensure their safety. All instruments and regulatory mechanisms are or should be designed to achieve that end, first and foremost. There is not a member in the House who would sacrifice that objective and principle on a wing and a prayer. I think that is why the legislation has been brought forward.

There are some gaps in the Food and Drugs Act, going back to 1953, that need to be updated. At the end of the day when the bill comes out of committee, and I am sure that all members in the House would agree, if Canadians cannot be assured that their safety has been protected and is characterized in the legislation, then we would be placing Canadians at serious risk and would have to oppose that legislation.

As I said and will say to my colleague, I am very optimistic, having heard the quality of this debate, that what comes out of committee will satisfy the broad spectrum of Canadians and the broad spectrum of interests within the natural products area.

[Brian Masse, NDP, Windsor West, ON]

Mr. Speaker, it is a privilege to speak on Bill C-51, An Act to amend the Food and Drugs Act.

When we lay the grounds for legislation, it is important that we have confidence in the regulatory process and the ability to ensure that we are going to have accountability with this change to the act.

There has been a lot of discussion today about Bill C-51 and a good debate about its consequences. There is one thing I want to remind the House about, which creates the insecurity I wrestle with. I certainly am not going to be supporting this bill any further. I believe that the arguments have been well laid out as to why we cannot continue to move this forward. The legislation needs some fundamental changes.

I do not have any confidence that the drug industry is going to be subdued in this process. Let us look, for example, at the direct marketing that is going to happen with this bill. It goes back to an experience that I had here on the Hill in 2004 when we started looking at what I believe was Bill C-9 at that time, the Jean Chrétien Pledge to Africa Act, to provide help for AIDS in Africa. It was the precursor bill of Canada's Access to Medicines Regime.

The bill's purpose was to provide drugs to those developing countries that might be facing issues related to HIV-AIDS, tuberculosis, malaria and other types of diseases that were affecting civil society. The contemplation of the bill came through an international treaty that allowed the generic production of different types of medicines to proceed, medicines that may have already had a patent restriction on them, if the actual pharmaceutical company would not provide them at a low cost to those nations.

We went through a whole series of processes and lobbying at that time. There was a very powerful lobby by big pharma to stop that bill dead in its tracks. There was some political support to try to move it forward. What ended up happening is that big pharma got a provision in the bill that was not even part of the internationally signed agreement with the TRIPS and the Doha.

Where we actually could have provided any available drug to go forward, we created this artificial list of what drugs would be available to be sent overseas and which ones would not be. The danger behind this was that it allowed for lobbying to keep certain drugs off the market.

Many people said not to worry. They said that would not happen, that it would not be ethical and that the companies would not do this. We were told that the companies would behave themselves.

To make sure this would not happen, there was a provision in the legislation to make sure big pharma would not be doing it. Lo and behold, even as we were doing that, big pharma was caught lobbying, including by me. It was exposed. It made headline news that the pharmaceutical companies were already lobbying to keep some of the drugs off the market. This plan fell flat on its face.

This is what I am concerned about with regard to this bill and how we go forward. I am concerned about the active lobbying and also the prescriptive behaviour that can take place with drugs. This could actually affect everything from safety to health care costs. Also, we kind of have a self-prescriptive society. The commercials have hit the Canadian airwaves already. They are very clever. They have been done very well. Probably they should win awards, because everyone knows what is happening but they get around the technicalities.

At the same time, these commercials lead people to go to their doctors. The doctor may prescribe some type of medication or may want to provide some type of generic alternative. Then the patients perhaps insist that they know the actual effects better. It can create longer wait times, make people potentially consider changing doctors, or other types of behaviour.

This concerns us, because I certainly would hate to see the cost of drugs rise, some of which have already skyrocketed, based on marketing and advertising campaigns and influence from the drug companies. That is important to note, because we already know that women generally suffer the consequences from prescription errors. This problem actually could expand. We believe what the experts have said. They have noted this vulnerability in the system that is being proposed.

One of the other things that we have identified as very important with regard to this case is the issue related to the lack of parliamentary oversight. The fact of the matter is that this bill is going to give more provisions for the government to be able to override the parliamentary process and for the minister to have expanded powers.

That is a concern because what we have seen with this administration is very much a centralized ideology. That has been its choice of how it wants to govern and that is fine, but at the same time, it opens up the probabilities for greater control. And it may not even be necessarily this administration that does it in the future.

I am suggesting that in the future we could once again have these types of control elements that really change the nature of how we actually have drugs administered in our society. This is another reason that New Democrats are saying at this point that we do not want to change the law right now.

Another thing I wanted to connect to right now is that we seem to be moving to a less regulatory society in some respects. Some of that is of great concern. I can tell members about it based on my background in the transportation sector. For example, in rail and air when we have been moving to safety management systems and letting the industry police itself, and there is going to be more of that with this type of bill, we have seen what is really very much a falling out of safety in many respects.

For example, there is the transportation sector. We just did a complete study. There was a panel. We talked about a culture of fear and intimidation that prevents the actual workplace from operating the SMS properly. What we have actually seen is a step back in rail safety over the last number of years as we have had increased problems.

We are really worried about having the regulatory body become more involved with regard to policing itself. What we would say is that we need to have a stronger involvement by Health Canada.

We have seen these actual situations in the past in our society. It is not just Canada that has this problem. It is in the United States as well, where active lobbying has put drugs on the market that do not necessarily meet the tests of the day and have to be recalled. That includes everything from a series of drugs related to heart medications to others such as breast implants. There are the tragic circumstances with thalidomide. These have had consequences. I think we are going to witness greater problems there.

There is a legitimate problem that we have in this country with regard to getting some of the drugs and medications to market. The hope for this bill is that it will expand those opportunities, but it is very much based upon a risk management cycle. Once again, that risk management, left in the hands of the industry for the most part, is something that gives us some trouble because of the influence.

I have witnessed it myself, as I mentioned, with Bayer doing the actual lobbying to keep some of its drugs off Canada's Access to Medicines Regime. That was even at a time when there was heightened awareness and there were actual hearings going on in Ottawa. There was discussion about that bill. There were a lot of politics around it and active lobbying on behalf of NGOs, the generics and the pharmaceutical companies. The spotlight of the nation was on this and they broke the rules at that particular time with no hesitation. They were not apologetic about it.

So when we move into this type of system, we have a lot of concerns, because it will not just be the attention that is being provided right now. It will also be later on, as the politics about the bill wind down, where the regulatory regime and the oversight are so necessary, because then what we will probably be faced with, unfortunately, is a clawing back of decisions that caused problems for Canadian consumers and their health.

With regard to health products, I know that the Natural Health Product Protection Association has been very adamant about changing the way the system is being done here. Unfortunately, this is a regressive step. I have seen a lot of emails and letters and have had phone calls come in, not only just to my office but also in the Windsor and Essex County region. They are from people expressing disappointment with the government for not adequately fixing their situation. This bill is going to compound their situation so they certainly are not supporting this.

Therefore, with the way this is right now, what we are calling for is to make sure that we actually have a new bill. I know that the government is intending to table some amendments and it is positive that the government is actually looking at some of the weaknesses of the bill, but we believe the bill is far too weak in many respects. We should be re-entering a debate and forming a bill that is going to work.

[Steven Fletcher, Conservative, Parliamentary Secretary for Health]

Mr. Speaker, I am afraid many aspects of the member's argument are incorrect. For example, the way that pharmaceuticals are dealt with would not change under the bill. What would change is that products like natural health products, which will be dealt with separately from drugs or food, would be evaluated on a risk profile. That means if a natural health product is of low risk, it will be able to enter the market much quicker than at present and this will allow people to have access to that natural health product much faster.

The bill would also allow us to deal with product safety like lead in toys, for example. Many Canadians would be surprised to know that the Government of Canada does not have the power to take products off the shelf. We have to rely on voluntary compliance.

I would like the member to reflect on the impact his party's position will have on people accessing natural health products. How does the member explain that he essentially has a position that will delay natural health products into the marketplace?

[Brian Masse, NDP, Windsor West, ON]

Mr. Speaker, we have a disagreement with regard to natural health products. We would like a separate category and that will be the best for the long term. The process that we have right now does not have adequate resources.

I agree with the parliamentary secretary that there are elements in the bill that are very positive, children's toys, for example. I am willing to bet that pulling products off the shelves could move ahead immediately, even without this type of legislation.

As the transport critic, I can tell the House that there are other ways we can protect Canadians and that is by tracking some of the cargo that comes into this country. Right now Canada checks less than 5% of the actual cargo that comes off transports that come by sea, and that is deplorable. There could be an increase there. The United States has the same problem.

The government has tabled another customs bill that would provide new powers. We have not seen that come forward in the House for debate yet. We are looking forward to working with the government on that measure and hopefully we will have a bill that is successful.

There are many different facets on how to protect Canadian consumers with regard to faulty products, especially children's toys. We actually have private member's legislation put forward by the member for Skeena—Bulkley Valley on some of these measures, so we are very sensitive to that. We have encouraged the government to support our ban on pesticides. That would have been something progressive that the government could have done today.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

Mr. Speaker, I heard the hon. member mention that he would agree with some areas of the bill. I think it is the same on this side of the House. That is why we are moving forward to refer it to committee, so it can have a look at it and have amendments from a variety of stakeholders from across the country and see what we can do to improve the bill. We know it is imperfect and I think the member would agree with me on that. Why not move it to the next step? Why stop it here?

[Brian Masse, NDP, Windsor West, ON]

Mr. Speaker, that is a legitimate question. We believe that the time has come to send this bill back to Canadians, to do it properly. The bill has too many flaws that are going to create problems later on. That is the reason why we have said it is time to back this up. There are some things that could be done in the interim to protect the safety of Canadians, not only through the health department but also through other departments.

If we send the bill to committee, the fear that we have is that there will not be enough of a bill left over to actually have something progressive and supportable at the end of the day. We would prefer to see a re-engagement on this so we can get it right. We have had to go through this many times.

This is the fifth or sixth time we have cycled through the bill. Unfortunately, it has always been flawed by the influence of big pharma. We need to pull that out and do it properly. We would support that process.