Debates of Feb. 15th, 2012

National Strategy for Chronic Cerebrospinal Venous Insufficiency (CCSVI) Act

[Joy Smith, Conservative, Kildonan—St. Paul, MB]

Madam Speaker, I am very pleased to speak to this as I chaired the subcommittee on this particular topic a couple of years ago.

I agree with the hon. member for Etobicoke North, as does the government, that Canadians with MS deserve to know whether the hope of the proposed new Zamboni or CCSVI procedure for MS rests on a solid scientific foundation, that it works and that it is safe. For that reason, I do not support this bill.

A key element of Bill C-280 is the legislative requirement that clinical tests on CCSVI be initiated. Regardless of the best advice being offered by scientists around the world, this House would begin legislating medical research. Supporting this bill could create a precedent as to how we establish our health research priorities. Setting health research priorities through legislation would not be an appropriate policy measure as it would jeopardize the independence of scientific decision making.

This bill would also require that the federal Minister of Health meet with her provincial and territorial counterparts to formulate a national strategy. The minister is already collaborating extensively with provinces, so why legislate that she has to do that? How would provinces react to such use of our legislative authority?

Another element of the bill would require that the Minister of Health ensure that those who have obtained the CCSVI treatment have access to proper health care. This is clearly an intrusion into provincial jurisdiction. Members of the House will know that the delivery of health care services is under provincial jurisdiction.

This bill is unnecessary. It would legislate a scientific and medical issue for which we already have a collaborative system in place. We in this House need to consider the implications of such legislation. Why would we legislate when extensive action is already underway? We need to use our legislative power prudently or risk diluting its value. Legislation should be used only when it is most appropriate and there are no other ways to achieve the desired policy objectives effectively. This is clearly not the case with this bill.

Let us take a moment to look at MS in Canada and the government's response to the proposed Zamboni procedure. An estimated 55,000 to 75,000 Canadians live with MS. We are all familiar with this number. Too many Canadians and their families are struggling with this frustrating disease. We in this House share their frustration. We also share their hope that effective treatments and, ultimately, a cure can be found. That is why the government is determined to support the investigation of CCSVI. However, this must be done carefully to ensure the safety of all Canadians.

As members of this House know, in June 2011 our government committed to supporting a clinical trial. On November 25, 2011, the Minister of Health along with Dr. Alain Beaudet, president of the Canadian Institutes of Health Research, announced that CIHR was ready to accept proposals for a phase I and phase II clinical test on CCSVI. Based on the independent advice of the scientific expert working group, CIHR formally opened the request for proposals in November 2011. Hon. members would be pleased to know that this research is a collaborative initiative between CIHR and the MS Society of Canada. The MS Society has told us that it supports further investigation of CCSVI.

Thorough investigation is the appropriate response with any new medical procedure. While this is difficult for many patients to hear, particularly those with a disease like MS, we need to ensure that procedures are safe before they are made available to Canadians. The principles of disciplined scientific investigation cannot be cast aside, despite the initial hope that has come with the procedure proposed by Dr. Zamboni. That would not be sound medical practice nor would it be fair to MS patients. A clinical trial is the first step. Clinical trials seek evidence on patient outcomes. The main objective of the forthcoming clinical trial will determine whether the angioplasty procedure on veins is safe and effective.

In the coming weeks, CIHR will establish an international peer review committee to review the research proposals it receives. CIHR will announce the successful research team in the coming months. It is critical to move at the appropriate pace on this important matter. An international scientific committee recently reviewed a proposal from Dr. Zamboni himself to conduct a large-scale clinical trial on CCSVI in Italy. The committee concluded that a clinical trial on the safety and efficacy of the proposed procedure should come first.

In other words, they concluded that a smaller scale trial is the way to go at this stage to ensure that the procedures are safe. This is exactly what we are doing right here in Canada.

Bill C-280 also calls for the establishment of an expert panel to advise the minister on the CCSVI treatment, identify criteria for clinical trial research proposals, and advise on the standards for diagnosing and treating CCSVI.

Why legislate this process, when a CIHR scientific expert working group has already been reviewing evidence on CCSVI from around the world for some time now? The working group, made up of scientific experts, reviewed studies of CCSVI published between 2009 and 2011. After doing so they recommended the launch of a request for applications for a clinical trial, and provided terms of reference to guide that research.

Bill C-280 also says that the expert advisory group should advise the government on CCSVI treatment standards. The scientific expert working group is already doing this. For example, in the fall of 2011, a group of experts identified the best procedures for standardizing imaging of veins in the neck and brain. These procedures will be incorporated into the design of the clinical trial. They will ensure consistent assessment of the presence of CCSVI in clinical trial participants.

The CIHR scientific expert working group is already advising the federal government on how best to proceed with regard to CCSVI and MS patients. Bill C-280 would require that the government track individuals who have received the CCSVI procedure. Here again the government has been out front on this issue.

In March 2011, the Minister of Health announced the creation of a Canadian MS monitoring system. This system will gather and share new knowledge on the use of MS treatments across Canada and their long-term outcomes. This information will be useful for Canadians living with MS, for the health care professionals who manage their care and for the researchers who are working toward a better understanding of this disease. The system is currently being developed by the Canadian Institute for Health Information, an independent organization that analyzes information on the health system and the health of Canadians. With information from the monitoring system, CIHI will produce results on the status of MS and its treatment in Canada.

The bill before the House also calls for a conference of provincial and territorial ministers to develop a national strategy. This is unnecessary. The government has been collaborating with the provinces and territories from the outset.

For example, members will have noted that the clinical trial announcement was made by the minister at the federal-provincial-territorial health ministers meeting in Halifax on November 25, 2011. CIHR is committed to working with the provinces and territories as it moves forward with the trial.

The deputy minister of health for Manitoba attends meetings at the scientific expert working group as a provincial-territorial representative.

To conclude, the government has already acted on the key elements of this bill. We have proceeded with prudence and caution to keep Canadians safe. We are relying on the best available scientific evidence. The initiatives implemented by the government have been supported by a wide range of stakeholders, including the MS Society of Canada. The MS Society has applauded the spirit of collaboration between the federal, provincial and territorial governments, and continues to support our work.

It is clear that the research evidence on CCSVI is mixed. In this respect, I would remind the House that well-intentioned medical therapies implemented without adequate research can and have led to unintended negative consequences for patients. That is why medical research has developed rigorous methodologies to test new theories. As legislators, we have a responsibility to allow that research to run its course. It is our duty as parliamentarians to ensure that these procedures are safe for Canadians.

The Government of Canada has put in place the steps to support ethical research, grounded in international standards of excellence. Like all Canadians, we are seeking to better understand the impact this procedure might have on the quality of life of MS patients. We have taken steps and opened dialogue in collaborations with provinces and territories, the medical community and representatives of MS patients.

This is the responsible and prudent approach that balances the need for action and patient safety. The government has a plan of action. Through federal leadership, funding and collaboration, it is moving that plan forward. Our government is acting to give MS patients the answers they need regarding CCSVI.

This bill would neither contribute to those answers nor improve the processes already underway to further our understanding of MS and CCSVI. Quite simply, most of what this bill asks for is already being done. What is more, in my mind, it raises real questions as to whether the bill would be an appropriate use of our legislative authority.

For all these reasons, while I understand and share the goodwill and intentions behind this bill, I cannot support it.

[Christine Moore, NDP, Abitibi—Témiscamingue, QC]

Madam Speaker, I am pleased to rise to speak to Bill C-280. Before I talk about this bill, I would like to give an introduction so that people at home and my colleagues who do not have a medical background can better understand its implications. I will try to summarize it all so that people may have a better understanding of my opinion of this bill.

First of all, we cannot talk about a bill like this without briefly explaining what multiple sclerosis is. I will try to explain it in the simplest terms possible and using analogies, so people will really understand.

Multiple sclerosis is a disease in which the myelin covering the spinal cord, which is the nerve cells that transmit electrical signals in the body, is damaged and lesions, also known as plaques or scleroses, are formed. To give an analogy, it is as if the insulation covering electrical wires were to break down and lesions were to form in some areas. If there is no longer any insulation on an electrical wire, the electricity goes every which way and is lost. If the electricity is not properly conducted and dissipates throughout the body, it causes problems with everything that the nerve cells govern. It causes mobility, vision and various other problems. That is why people with multiple sclerosis experience so many symptoms.

To date, the exact cause of multiple sclerosis is not known. There are hypotheses such as CCSVI or auto-immune activity. We know that genetic susceptibility plays a role. Some think that it could be caused by an unidentified virus but, right now, no one knows the exact cause of multiple sclerosis.

Demyelination, which corresponds to the loss of insulation covering the electrical wires, is caused by inflammation. T lymphocytes, white blood cells that circulate in the blood, are no longer able to leave the brain, re-enter the blood and travel around the body. This causes inflammation that, little by little, attacks the myelin sheath that covers the nerves in the brain.

Chronic cerebrospinal venous insufficiency (CCSVI) occurs when the blood is no longer able to circulate effectively through the veins of the chest, neck and spinal column, which also prevents blood from draining from the brain. We know that blood always flows from the arteries to the veins. It leaves the heart via the arteries, goes to the brain, and returns to the heart via the veins. If the veins are no longer able to effectively drain the blood, it accumulates in the brain. The cells that cause the inflammation remain in the brain.

Knowing that, Dr. Zamboni began his research. He discovered a possible link between CCSVI and multiple sclerosis. He conducted statistical analyses and research, and studied X-rays, MRIs, ultrasounds and angiographies, which are all different X-ray techniques. He found that most MS sufferers—between 85% and 97%, depending on the diagnostic technique—had venous anomalies, so he came up with the idea of treating people with MS for CCSVI.

Early treatments began in several locations around the world. Venous angioplasty involves inserting a small balloon into the veins to prevent them from narrowing, to widen them. This is similar to cardiac procedures in which arteries are unblocked using a small balloon. This is a similar procedure. The treatment, which has been tested and is the subject of this bill, is a surgical procedure commonly used to treat other health problems. However, it is still surgery. As with any surgery, there may be risks that must be taken into account.

I should point out that MS is a very expensive disease. Current treatments are costly. There is no cure for MS, merely treatment of symptoms involving injections and medication, which is expensive.

I should also point out that this is a huge cost to the Canadian economy because MS affects young adults. The disease gets worse over time, but it shows up in early adulthood. If these adults did not have the disease, they could contribute to the Canadian economy by working and participating economically. Because of their disease, they cannot remain in the workforce. We have to understand that this disease is costly both to the economy and to individual MS patients. It is important to support research and treatments that can provide relief for people with MS because it is very costly to the Canadian economy.

As I explained, there is no treatment to cure the disease; we can only treat the symptoms. When we talk about a promising treatment, it obviously gives renewed hope to those who suffer from this disease, because it represents a chance for them to perhaps go back to work and lead a normal life. It is certainly very appealing to those people, because this is something they really wish for. The problem with clinical studies and such things is that we must take the time to do them properly. Such treatments can often seem promising at the beginning, but we do not know if, in the long run, they will actually produce the anticipated results. And when we are dealing with a debilitating disease such as this one, we must be careful not to give people false hope.

I will support this bill. However, we must take the time to conduct proper clinical studies, out of respect for those who suffer from the disease. As a government and as a country, we cannot afford to circumvent the proper procedure for a new treatment—which involves its assessment and validation—and administer that treatment without being convinced that it is truly effective and helpful compared to existing treatments. If we allow ourselves to speed up the process, we lose our credibility. It is really important to take the time to do things properly.

Incidentally, when we talk about a medical treatment, it must be understood that pressure is always exerted by lobbyists. In this context, it is critical to maintain our independence, to ensure that the treatment is good, to avoid yielding to the pressure of lobbyists, and to rely on verified scientific evidence.

Therefore, it is really essential that the clinical trials be done quickly, and that standard practices be followed, so that at last we can determine whether or not CCSVI treatments are effective and can be beneficial to MS patients.

I am asking hon. members to support this bill, but it is important to take the time to do the clinical trials properly, so as not to approve a treatment which may not be as effective as it seems.

[Pierre Jacob, NDP, Brome—Missisquoi, QC]

Madam Speaker, it is with gravity that I am taking part in the second reading debate of Bill C-280, introduced by the hon. member for Etobicoke North.

MS patients must face many obstacles in their daily lives. These include physical obstacles that affect their mobility and financial obstacles that force them to make choices that can be difficult.

Multiple sclerosis is a disease whose causes are still not well understood. It attacks the central nervous system, particularly the brain, the optic nerves and the spinal cord. The symptoms of the disease vary and they affect between 55,000 and 75,000 Canadians. Incidentally, Canada is one of the countries most affected by this disease.

The wording of the bill stresses the fact that every year 400 Canadians die from MS. Moreover, the suicide rate among MS patients is seven times higher than in the general population. Therefore, we have a responsibility to help these people.

Multiple sclerosis, which has been considered an autoimmune disease, became the subject of a new medical theory put forth in 2009 by Italian doctor Paolo Zamboni. According to him, poor blood circulation in the neck veins has an impact on neurons, which triggers MS symptoms. In other words, multiple sclerosis was no longer treated as a disease but, rather as a symptom of a condition that this doctor called chronic cerebrospinal venous insufficiency, or CCSVI.

This study has generated hope among many people living with MS, as well as comments from health care professionals. Many additional studies were conducted to establish a link between blood circulation in the neck veins and multiple sclerosis, through a medical procedure called angioplasty.

However, the results remain inconclusive. Some patients saw their condition improve to the point where their MS symptoms diminished by 50% to 80%. However, in the case of other patients, that procedure did not change anything. Some private clinics all over the world, including in Bulgaria, Poland and the United States, now offer that medical service. In fact, a number of Canadians and Quebeckers affected by MS have travelled to these countries to have the operation, in the hope of improving their health.

Despite the merits of this bill, I want to share some reservations with the House. Scientific studies accepted by the entire international medical community—in order to examine the effectiveness of this treatment and corroborate Dr. Zamboni's theory—might be the first step before the treatment is generalized.

This bill to establish a national strategy for CCSVI does make provisions for further research.

Nevertheless, I want to draw the attention of my colleagues to other measures that could accompany this strategy, namely: integration of the Canadian Institute for Health Information's Canadian multiple sclerosis monitoring system into this strategy, since the purpose of this system is to provide medical follow-up to people with this disease; consideration of the reduced mobility of people with MS in order to facilitate their daily lives and, therefore, the renovation of public buildings to make them wheelchair accessible; implementation of financial assistance for these people in order to help them adapt their homes to their needs as they change with the disease; revision of the employment insurance sickness benefits program, both for people with the disease and for caregivers; implementation of refundable tax credits for those same people; and, finally, implementation of an awareness campaign on the importance of sports for people with multiple sclerosis.

On that last point, the Université de Sherbrooke offers a program for persons with MS. This program began in 1992 and has changed and been incorporated into another program: the adapted physical education and sports program for persons with physical disabilities. The sports component adopted by the university to help improve the physical condition of people with MS is unique and serves as a model for professionals and students from European countries.

As the hon. member for Beauharnois—Salaberry said, society as a whole has to fight against multiple sclerosis. Our Canadian researchers have to advance the science and find a cure for this terrible disease. Our governments have to commit to supporting research and also to supporting people with MS in their quest for a healthy life. In closing, I support this bill, which represents progress in the fight against multiple sclerosis.

[Malcolm Allen, NDP, Welland, ON]

Madam Speaker, I am pleased to join the debate.

I know I am not supposed to say these sorts of things, but let me turn and acknowledge my good friend from Etobicoke North for introducing the bill. I greatly appreciate it. I thank the hon. member in my father's name.

May father died from MS. If he were still alive, he might not have been able to have this treatment because of the type of MS he had. He had what is colloquially known as rampaging MS, which means he never plateaued. He continually got worse along a continuum that looks like a curve going straight up to the sky. After being diagnosed, his last 10 years of his life was a misery. Along with that misery came acceptance. As he once told me, “Someone dealt me some cards and this is the hand I have to play, but no one dealt the hand for your mother. She has to play the same hand I have because she is my life partner”.

That is what this is about. It is about saying to families like mine that there may be hope and that we should find out if there is. We are not sure; this is not an absolute. In life we hear the old adage about absolutes: death and taxes.

My father was happy to pay his taxes from the time he turned 14 and went to work in Ireland, and he was happy to pay them in this country when he showed up in 1962. However, he died too young because of a disease for which we had no cure. Along that continuum, the quality of his life depreciated because there were no other treatments.

If he were alive today, he would say to me, “This treatment will probably not help me, but it ought to be available to someone else who may be helped by it”. He would say that because of what he and we knew his life was: a living hell.

This was a man who worked all his life from the time he was a boy. He went to the shipyards as a boy. He was 14 years old. He came to this country because he ran out of work in place where there was no longer any, and so he brought his family here, including me. When it came time for him to enjoy the last part of his life with my mother, his life partner, in retirement, he was robbed of that and so was she because of this disease.

There are colleagues, both in this Parliament and the last Parliament, whose family members are afflicted in the same way, maybe not to the same degree as my father was, but who indeed suffer from MS.

My friend from York South—Weston told me earlier about his brother, and I know there are other members on the other side who also have family members with MS. They should do this for them. They deserve that. They deserve no less than that.

We have an opportunity, not to wave a magic elixir, because there is none, but there is a clinical trial that has been requested and we should do it.

We literally have thousands of folks, Canadians who have left this country to have the procedure in other countries around the world. Now that they have come home, we can study them. We can see how they are doing. We can see where they were before, because they were being given the usual treatment regime: drugs. Drugs, between morphine and all the others he had to take to try to numb his pain, basically numbed my father into a semi-comatose state half the time. Do not let other have to suffer this. Do not let them have to go through what he did.

I do not wish anyone else the life I had in watching the one my father had to lead. It was agony for us to watch, let alone the agony my father endured as an individual, as stoic as he was. He had bruises from one end of his shin to the other because he kicked the coffee table so much to make that pain worse than the pain of MS.

Here we have an opportunity to say to people, “We want to give you a chance”. That is all it is, a chance, no more than that. It is a glimmer of hope, no more than that.

The one thing my dad and all other MS sufferers over the decades never had was hope. They knew when they were diagnosed, that was it. The best the MS Society, and all the other folks who do the good work they do, could give them was drug therapy.

I watched my mother become an advocate like I have never seen before. Members should see what happens to a little Scottish woman when she decides that her life partner is going to get the best care she can possibly find. They would not want to get between her and it, if she thought her man should have it. There is no way in the world anyone could get between them. If anyone tried, that person would get run over. All four feet, eleven inches of her would knock a dozen people down and the next dozen as well.

My mom would tell my dad's physician that she wanted my dad to have the treatment that she had found on the Internet, treatment that was being done in Europe and South America, even though the physician said it would not work for my dad. She would tell the physician that he had not idea, because he was shooting in the dark.

That is what physicians do with MS patients. They will tell patients to try this or that because it might work, but they do not know for sure because they cannot measure it. The next time a patient has an attack, the physician does not know if the patient is any better off or if the attack is less serious than the previous one. They do not know because doctors cannot measure it.

MS is a symptomatic disease. There certainly are things that happen. People end up in wheelchairs and constantly have pneumonia. They eventually end up with congestive heart failure. If they are lucky like my dad they will manage to survive the first attack, even if they have no resuscitation order in place. My dad managed to get through that attack. How many others did not? How many others have died because we did not give them some hope? How many others are giving up?

Some of those with MS are young people. My dad used to say that he was lucky because he got MS late in life. He would see others, vibrant young folks in their twenties and thirties with it, whereas he was diagnosed when he was nearly 60 years old. He said he was the lucky one. I do not know how he ever had the courage to say he was the lucky one to have MS late in his life. I do not have the faintest idea how, but he did. I do not think anyone can be lucky, regardless of the age they get it at. It is not a lucky life to have.

However, what we can do for those folks who are suffering is to give them some hope. We should not let them give up, because that is what happens with this disease. It saps the energy out of them. It eventually saps the life out of them. It dulls any sense someone has about going forward. People with MS have no sense that they can go forward, because they know what the end will be. The journey along the road to the end is literally a living hell.

We must give them some hope; that is all we are asking for. The bill asks no more than for us to say, let us do the proper science. It is not about voodoo. It is not about snake oil. It is about doing the proper science. It is about ensuring that the treatment is adequate and correct for those who need it, because not every sufferer will fall into the protocol. They know that. There are lots of them out there who think this treatment will not work for them and that they should not get it. Not all of them are saying they want it, just that they hope this is something that will help. There is no question about that. All one has to do is to talk to them.

I was in the grocery store the other day with my wife, and a couple came by whom I thought I recognized. Sure enough it was the couple I thought I knew. The wife had been to South America to have the treatment. The last time I had seen her she was using a walker. This time she was walking. Her husband was pushing the buggy with the groceries in it and she was walking beside him without any assistance.

That is why we should give these people hope. That is why we need to support the bill.

[Mike Sullivan, NDP, York South—Weston, ON]

Madam Speaker, I am very pleased to join this chorus of caring Canadians who believe that Canada is a place where medicine should be the best in the world, and that we should not be holding back.

I want to applaud all of the speakers so far today, as well as my friend from the riding just north of me for introducing this bill and being such a strong and passionate advocate.

All I really want to do is to talk about some of the true life stories that go unsaid.

During the election campaign, I talked to a constituent who probably was not going to vote, but I spent a good hour talking to him. He was desperate to get Botox injections in his legs so he could go back outdoors. His muscles were so frozen that he was like a stiff board lying on a bed, unable to move any part of his body but his index finger and his eyes. He was able to play video games on a computer a friend had set up for him, but that was all he could do: move a mouse very slightly with his finger and watch with his eyes. He could still speak and think, but he was trapped in his body. He wanted desperately to have another set of Botox injections, which the Ontario government was not going to pay for, so he could get in a wheelchair and be pushed outside to breathe fresh air again. That was not going to happen and it was absolutely tragic. I do not know if this treatment would help him, but he did not have that opportunity.

A friend of mine was diagnosed just a few months ago. She went through a series of very odd, unexplained dizzy spells and various strange events that were ultimately diagnosed as multiple sclerosis. She is in her late thirties or early forties and is absolutely terrified by what this prognosis means, by what is coming. When I talk to her, that is one of the things that I realize most about this disease, that everyone who gets it knows what is coming. Everyone who gets it is absolutely terrified by being that frozen figure trapped on a bed, able to move only a finger and an eye. That is what they all know will happen.

This treatment has provided, for the first time in centuries, some kind of measurable hope. The government members sit there and suggest that this should be held back from Canadians, from people who want this little bit of hope. These people are going to get it anyway. As a result, all that we are doing is creating an industry in the United States and other countries around the world that should be here.

I want to talk about my brother who was misdiagnosed about 10 or 12 years ago when he had eye trouble and went for an MRI. The doctors then did not tell him anything because his eye troubles kind of went away.

Two years later he went for another MRI because he was having trouble with his hands. The MRI technician asked him why he was back. He asked what the technician meant by that. The technician asked if the doctor had told him what he had. The MRI technician knew, but the previous doctor had not said anything to him. He had MS and the MRI technician knew he had MS.

I watched my fit, capable, active brother, Chris, deteriorate badly, mostly over the past four years. He has two young children, John and Delphine, and a wife, Sue. I then watched him have hope because he went for the treatment in Albany, New York a year and a half ago. Before the treatment, he was in a wheelchair full time, could no longer walk and was deteriorating. Since he has had the Zamboni treatment, he is now moving around in his home, albeit with a walker sometimes. He still gets tired. It is not getting better than that, but it is so much better than it was. He prays every day and thanks God for someone having discovered this treatment. His family do the same.

He is not what he used to be, but there are legions of stories of people who have had improvement from this treatment. The members opposite sit there and oppose it and suggest that somehow we need a few years of more study. In those few years, thousands of people will die of this disease and thousands more will succumb to further degradation of their limbs and their bodies. If that could be prevented, stopped or arrested we would be doing those people a service. To refuse that treatment to Canadians whose lives might be affected is despicable. I do not have another word for it. It is not what Canada's medical system is supposed to be. It is not what Canada's medical system should provide. We should be doing everything we can to provide what is clearly a safe and effective treatment.

I again thank the sponsor of the bill, who will now get to wrap this up.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Madam Speaker, the government claims it has a moral and ethical obligation to work with the scientific and medical community and proceed only on the basis of the best medical and scientific evidence. The government has not pursued the best science or the leading experts and it has failed in its moral responsibility. The government has lagged every step of the way, despite the fact that 400 people die each year of MS in Canada and patients worsen, on average, by one disability score each year.

Twenty-one months have passed since our initial request for clinical trials. Since 2009, when treatment for CCSVI was first announced, 800 Canadians will have died from MS-related complications or suicide, while the government has ignored the science. Thirty-three months will have passed by the time the government implements a registry.

Sadly, I hear speeches loaded with highly questionable material from the government. Comments are scripted because no member of Parliament or government official ever attended one of nine CCSVI international conferences, never heard the data, never reviewed MRIs, never witnessed the procedure. As a scientist and health professor, I will have attended seven of the conferences by this weekend, presented at three, and spent close to 100 hours reviewing MRIs and watching the procedure. Those living with MS and their families understand that this debate was never based on science, as it should have been, but rather wilful blindness, politics and the government's self-preservation. I chased the science. Why did the government not?

The government makes the ridiculous claim that Canada is leading internationally, but this is absolutely not the case. The government has been lagging both the provinces and internationally. Sixty other countries are testing and treating CCSVI. The United States is currently conducting three FDA-approved phase II clinical trials, while the government just put out a request for a phase I/II trial.

The government made claims about the scientific evidence to support CCSVI, yet failed to acknowledge or present any of the international data regarding MS patients' improvements and quality of life following CCSVI treatment, nor the efficacy and safety of the procedure. For example, Dr. Petrov reports that 63% of his 461 patients show a functional improvement.

It has becoming increasingly apparent, from multiple countries around the world, that every patient is different, with different venous anatomy, a different course of MS, a different length of illness and some patients do experience improvement in symptoms. Dr. Mehta studied 150 consecutive patients who showed more than a 25% increase in quality of life scores a year after the procedure was measured by a doctor who did not know that the procedure had taken place.

The government claims that most of what I am asking for in Bill C-280 is already under way. This is absolutely not the case.

First, follow-up care remains a problem today and has not been adequately addressed. Patients are still being denied appointments and tests are being cancelled. Driver's licences are even being threatened if patients dare ask to pull out of drug trials.

Second, phase I/II trials will not put Canada at the forefront of international research.

Third, funding for trials has not been provided.

Fourth, there is no expert advisory panel in place with people who have actually done diagnosis or treatment. Importantly, as all members of Parliament and Canadians know, the dates can and will have to be amended at committee.

We have a duty to speak for those who cannot. This means listening to those who are awaiting CCSVI treatment, those who have had treatment and learning as much as we can about the science. Thirteen Canadian CCSVI patient groups, representing over 14,000 people living with MS, have written to the Prime Minister, the Minister of Health and all MPs asking that they support Bill C-280.

Finally, I ask my colleagues to be a true, honest voice for suffering MS patients and their families and to vote for Bill C-280. Patients say, “You know what the right thing is. Do the right thing”.

[The Deputy Speaker, NDP, Denise Savoie]

The time provided for debate has expired. Accordingly, the question is on the motion. Is it the pleasure of the House to adopt the motion?

[Some hon. members]

Agreed.

No.

[The Deputy Speaker, NDP, Denise Savoie]

All those in favour will please say yea.

[Some hon. members]

Yea.

[The Deputy Speaker, NDP, Denise Savoie]

All those opposed will please say nay.

[Some hon. members]

Nay.

[The Deputy Speaker, NDP, Denise Savoie]

In my opinion the nays have it.

And five or more members having risen:

A recorded division on the motion stands deferred until Wednesday, February 29, 2012, immediately before the time provided for private members' business.

A motion to adjourn the House under Standing Order 38 deemed to have been moved.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Madam Speaker, I rise in continuation of a question raised in question period. I would like to canvas a number of the investments that have been made, particularly pertaining to the Prime Minister's recent trip to China. We have been told there have been substantial pieces of progress for the Canadian economy. I think a lot of Canadians have questions on their minds now that we see quite a substantial increase in the direct investment, and that is the ownership of Canadian resources by enterprises owned by the government of China, in fact with boards of directors controlled by the Communist Party of China.

I want to make it clear that I certainly support the idea that we have better ties with China. This is not a statement about our relationship with China and the importance of raising human rights in Tibet and the situation for dissidents in Chinese jails. Our opportunities for raising these issues are enhanced with having a respectful, strong relationship. This is about how Canadians should respond to ensure that foreign investment reviews are clear, that the information is transparent and available and that there are national security reviews that go along with this, particularly where strategic Canadian resources, such as oil sands and uranium, are being traded with the People's Republic of China's enterprises.

I would like to put this into context. The hon. Minister of Natural Resources has said there is not very much investment from China directly in the oil sands. Of the $73.6 billion invested in the oil sands between 2007 and 2011, oil sands investment from China was approximately $12 billion, or 16%. This is not a small percentage.

The involvement of Chinese companies, particularly PetroChina, the China National Offshore Oil Corporation and largely Sinopec have been strategic. In the case of Sinopec it has managed to buy a 9% share in Syncrude for a cost of just about $5 billion. It managed to have a seat on the board of Syncrude and be in a position to veto any decision that Syncrude might otherwise make to process the bitumen crude in Canada, thus creating Canadian jobs in Canadian refineries. That strategic advantage for Sinopec does not seem to have been studied in the way that I think Canadians would have expected.

When I asked this question in relation to the oil sands last week, the Minister of Industry claimed that back in 2009 “we improved the transparency”. This was in relation to my question about the national security aspects of this kind of investment. In fact, when we go back to the decisions in 2009, we find that the cabinet rejected the advice of the expert panel that had been put together in 2007. It was a competition policy review panel that had been mandated to review these arrangements.

According to the Canada Gazette of September 30, 2009:

The term national security should be explicitly defined and national security reviews should take place according to concrete, objective, and transparent criteria. This recommendation was not accepted...

In addition to the oil sands investment, we now have the Prime Minister coming back with a deal for uranium. This deal for uranium has much more lax accounting procedures than was offered in previous deals with China, which is why in the past Canada has not continued to trade uranium in China. The strategic concern is not just for what China would do with the uranium, but for China's relationship with the civilian nuclear industry program in Pakistan and the potential for nuclear proliferation. These are strategic concerns.

I would like the government to tell Canadians exactly what national security review—

[The Deputy Speaker, NDP, Denise Savoie]

Order, please.

The hon. Parliamentary Secretary to the Minister of Industry.

[Mike Lake, Conservative, Parliamentary Secretary to the Minister of Industry]

Madam Speaker, I took note of the member's questions, both last week and again this week. Both questions are important in light of tonight's debates.

Last week, she asked the minister about foreign security provisions in the Investment Canada Act. The minister responded that the national security aspect was included in the law in 2009. Unsatisfied with the answer, the member for Saanich—Gulf Islands stood up in the House yesterday and asked the following. She said:

Mr. Speaker, last week I put a question to the Minister of Industry relating to the Chinese takeover of Canadian resources.

He said I was unfamiliar with the Investment Canada Act changes of 2009.

She went on to say:

In fact, the Canada Gazette of September 30, 2009 said:

Then the member quoted from the Canada Gazette, just as she did now:

The term national security should be explicitly defined and national security reviews should take place according to concrete, objective, and transparent criteria. This recommendation was not accepted— Then the member said today, “close quote”.

The trouble is, if you read the Canada Gazette it is not a closed quote. It actually goes on to say something else. The member for Saanich—Gulf Islands was wrong for two reasons. First, she was quoting from a summary of comments and responses to the gazetting of national security provisions in the summer of 2009. She was not quoting from the regulations themselves. Further, she cut the quote in half, as I just mentioned.

The full quote from those comments and replies is as follows. The Canada Gazette states:

4) The term national security should be explicitly defined and national security reviews should take place according to concrete, objective, and transparent criteria. This recommendation was not accepted since national security threats are dynamic in nature and, therefore, constantly evolve. Neither Part IV.1 of the ICA nor the Regulations define the term “national security” since future threats to national security cannot be predetermined and any such definition may limit the government’s flexibility to respond to future threats.

That is the complete quote.

However, that does not mean that national security provisions do not exist. How do I know that? Because they are not hard to find. We just have to grab a BlackBerry or an iPad and go to www.ic.gc.ca. If the hon. member wants, after we are done here she can come over and I can show it to her on my iPad. They have been there for more than two years. I would ask the member to go and read that section of the website and the associated regulations before getting up to ask her next incorrect question.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Madam Speaker, obviously the hon. member would understand that when one says “close quote”, I am closing the quote around the part of the Canada Gazette that I was able to read. In the 30 seconds that I had to pose a question in question period, I did not read the remainder of that quote. He is quite right, that is what it says.

The point is that these were expert recommendations following a substantial review involving experts in the Investment Canada Act, both how we would respond to competition and how we should respond to national security. The reality is, contrary to what the minister said, when he said that they improved transparency, there is no transparency.

Yes, I have reviewed the entire Investment Canada Act. I do not need to look at the member's BlackBerry but I appreciate his offer. The reality is that we have let down our defences. We are, in the words of former defence experts, sitting ducks.

The question remains. If they cannot define “national security”, do not have concrete objectives and do not subject sales of oil sands and uranium to a national security review, how on earth can they claim that they are protecting the national interests?

[Mike Lake, Conservative, Edmonton—Mill Woods—Beaumont, AB]

Madam Speaker, the member knows that our government supports foreign investment that benefits Canada. We will continue to support an Investment Canada Act that encourages foreign investment into our country. Foreign investment contributes a significant amount to our economy, connects our firms to the world and creates high-paying jobs right here at home in almost every important economic sector.

Members also know that when the government believes that undertakings are not being respected, we will act to protect Canadian interests. We have done it in the past and we will continue to protect our interests in that fashion.

Moreover, while we continue to take steps to encourage foreign investment, we also took steps in 2009 to put national security provisions in the Investment Canada Act regulations. As I mentioned earlier, those regulations have been in place since 2009 and the member can read those regulations in full at www.ic.gc.ca.

[Irwin Cotler, Liberal, Mount Royal, QC]

Madam Speaker, when I posed my question last November, regarding the evidence to support mandatory minimum penalties, including whether the mandatory minimums were compatible with the charter, the parliamentary secretary replied also in an irrelevant fashion on the issue of costs. He concluded in a kind of customary, demagogic disclaimer that, “We support the victims, while they support the criminals”.

I trust that the answer this evening will address the question I raised and avoid demagoguery. I trust, also, that it will take into account what has changed since I put the question in November. Namely, that evidence-based testimony in different jurisdictions exists to the effect that mandatory minimums are excessive, unfair, ineffective, injurious constantly and do not have a deterrent effect. As well, I trust that it will take into account the Ontario Superior Court of Justice decision earlier this week that struck down a mandatory minimum sentence for violating the charter. I assume that the member opposite is well aware of the case.

I look forward to hearing how the government continues to justify insisting on such penalties in Bill C-10 in light of this ruling and in light of the preponderance of Canadian and international evidence on this matter.

I might add that yesterday evening, former Supreme Court Justice John Major himself supported the judgment. He lamented the prejudicial impact on judicial discretion by these mandatory minimums.

The Conservatives have advanced the notion that if one opposes mandatory minimum sentences, one is soft on crime. Admittedly, on its face, opposing mandatory minimums may appear counterintuitive.

However, this is not about being soft on crime. It is about being smart and effective on crime. In particular, the evidence demonstrates that mandatory minimums are a failed policy. Stacking our Criminal Code with such mandatory minimums would do nothing to reduce crime or improve public safety. Indeed, it would lead only to an increase in crime and may violate the charter, as we saw earlier this week.

Moreover, mandatory minimums do not in fact advance the goal that they purport to reap; namely, that of crime prevention and of deterrence.

As I noted in this House in debate on this topic in 2006 and since:

Indeed, the vast preponderance of studies in every jurisdiction have concluded that mandatory minimums are neither a deterrent nor are they effective.

However, we need not look beyond our own borders for proof that mandatory minimums do not work. Indeed, our own Department of Justice published a study in December 1990 which states:

The evidence shows that long periods served in prison increase the chance that the offender will offend again. In the end, public safety is diminished rather than increased if we “throw away the key”.

Indeed, the U.S. Sentencing Commission released a comprehensive 645 page report in November concluding that federal mandatory minimum sentences are often “excessively severe”, are “not narrowly tailored” to apply only to those offenders who warrant such punishment, and are “not applied consistently”.

The truth is, as the Canadian Bar Association and others have shown, mandatory minimum sentences have a disproportionate impact on those minority groups that already suffer from poverty, deprivation and disadvantage.

We have a situation where, for example, 34% of aboriginal women are in prison. That is a shocking fact. Mandatory minimums would not alleviate or address this problem; rather, they would exacerbate them. They would unduly limit judicial and prosecutorial discretion, and if more offenders plead not guilty, given such mandatory minimums, we would be likely to further strain our scarce judicial resources, something from which no one would benefit.

Moreover, as we have seen, inequitable, inconsistent and excessive mandatory minimums invite a spectrum of constitutional challenges that would further clog the courts and further take us down from principles of justice and fairness, while fostering disrespect of and lack of confidence in the criminal justice system.

I close by saying that, at the end of the day--

[The Deputy Speaker, NDP, Denise Savoie]

Order, please.

The Parliamentary Secretary to the Minister of Justice.

[Kerry-Lynne Findlay, Conservative, Parliamentary Secretary to the Minister of Justice]

Madam Speaker, I am proud to speak today about minimum sentences.

As mentioned last November, in response to a question from my hon. colleague from Mount Royal, this issue has been discussed on several occasions, not only in this House, but also before the Standing Committee on Justice and Human Rights.

As a former minister of justice, he knows I cannot comment on a case still before the courts.

In May 2011, Canadians gave us a clear mandate. They want to live in healthy and safe communities. In our opinion, the government's main focus must be on victims of crime who, from a financial perspective, pay most of the price of crime.

The strong mandate this government received from Canadians in May 2011 included support for our commitment to table comprehensive legislation that would reintroduce several law and order bills, including those that proposed mandatory minimum penalties for child sexual offences and for serious drug crimes.

Bill C-10, the safe streets and communities act, includes reforms from nine previous bills. Bill C-10's proposed amendments would make communities safer by extending greater protection to the most vulnerable members of our society, enhancing the ability of our justice system to hold criminals accountable for their actions, and helping improve the safety and security of all Canadians.

The government's approach is balanced. It addresses prevention, enforcement and rehabilitation, and respects the rights of the accused while also respecting victims' interests, as well as community safety. This approach reflects the reality that Canadians lose faith in the criminal justice system when they feel the punishment does not fit the crime.

It appears to me that the member opposite contradicts the position of his own party when he criticizes the proposed mandatory minimum penalties that this government proposes to better denounce serious crimes, a policy supported by premiers and attorneys general across Canada.

For instance, former Bill C-54, which has been reintroduced as part of Bill C-10, the safe streets and communities act, and which proposes mandatory minimum penalties for sexual offences committed against children, received the support of all parties at third reading.

I often hear the opposition referring to studies that unequivocally demonstrate the ineffectiveness and excessiveness of mandatory minimum penalties. With all due respect, this is hardly conclusive. There is research that suggests mandatory minimum penalties are not effective. However, other research indicates there is evidence that mandatory minimum penalties have had positive effects on serious offences, such as impaired driving.

Another argument the opposition continually relies on to criticize either the use of mandatory minimum penalties or the restrictions on the availability of conditional sentences is the impact such proposals would have on prison populations and the related cost implications.

The government has always been clear that the cost of protecting victims far outweighs the cost implications of such reforms. Although there is a cost to having proportionate sentences, there is also a significant cost to victims and Canadian society as a whole.

In 2008, crime in Canada cost an estimated $99 billion, the majority of which, $82.5 billion or 83%, was borne by the victims. Victim costs include the value of damaged or stolen property, pain and suffering, loss of income, and health services.

This government has a clear and strong mandate to ensure that Canadians are better protected from dangerous criminals by ensuring that they are not permitted to serve their sentence in the comfort of their homes.

Mandatory minimum penalties will ensure clarity and consistency in sentencing, while at the same time ensuring that perpetrators of serious crimes do not reoffend during the period of incarceration.

It is time for all members to recognize the significant impact that serious and violent crimes have on Canadian communities and victims.

[Irwin Cotler, Liberal, Mount Royal, QC]

Madam Speaker, my question was prompted by the fact that all of the available evidence, including that from the Department of Justice itself, shows that mandatory minimums are excessive, disproportionate, ineffective, costly and do nothing but increase prison populations. The question still stands. This week an Ontario Superior Court judge confirmed that mandatory minimums are a failed policy. Indeed the judge said in this case that they would be “fundamentally unfair, outrageous, abhorrent and intolerable”.

Moreover, the Minister of Justice has an obligation under the Department of Justice Act to ensure that legislation comports with the charter. I have heard nothing from the parliamentary secretary this evening that rebuts any of the preponderance of evidence, that says anything about the unconstitutionality of the legislation, or that addresses the question of costs, in that mandatory minimums will exceed the costs.

At the end of the day the question remains unanswered, and I can understand why. The preponderance of evidence is simply against the position of the government.

[Kerry-Lynne Findlay, Conservative, Delta—Richmond East, BC]

Madam Speaker, I would like to respond to some of the opposition's criticism to the government's efforts to ensure that serious crimes are adequately punished.

Our government intends to ensure that serious crimes, including violent crimes, result in sentences that appropriately reflect the seriousness of the offence and the degree of responsibility of the offender.

To that end, our Bill C-10 would reform the Criminal Code in order to achieve the following: provide new mandatory minimum penalties for seven existing offences related to child exploitation; impose mandatory minimum sentences for serious drug offences that are related to organized crime or that target youth.

Generally speaking, minimum sentences would apply when there are aggravating factors, especially when the production of the drug in question presents a danger to public health or safety.

Bill C-10 proposes mandatory minimum sentences for sexual offences against children and serious drug offences.

[The Deputy Speaker, NDP, Denise Savoie]

The motion to adjourn the House is now deemed to have been adopted. Accordingly, this House stands adjourned until tomorrow at 10 a.m., pursuant to Standing Order 24(1).

(The House adjourned at 8:05 p.m.)