Debates of Nov. 27th, 2014

Opposition Motion—Survivors of thalidomide

[José Nunez-Melo, NDP, Laval, QC]

In fact, Mr. Speaker, we know that the government is trying to cut $36 billion from the budget for the health system all over Canada.

I think the Conservatives should review and really take care of improving and controlling the research in a proper manner. That is what the government should be aware of and be taking care of for all the citizens of this magnificent country.

I do not have any particular comment on how the Conservatives are now working on it, but it is a matter of the budget, because we know that the research and funds for it have lately been in very bad standing in the government.

After 2015 we will repair all those malfeasances and problems that the Conservatives have been carrying out year after year.

[Colin Carrie, Conservative, Parliamentary Secretary to the Minister of the Environment]

Mr. Speaker, I will be splitting my time with the member for Barrie. I am pleased to have the opportunity today to take part in this very important discussion about thalidomide and to pay tribute to the 12,000 babies in 46 countries who were born with malformations.

Like all Canadians, I am saddened to know that only some 8,000 of these babies made it past their first birthday. Let me assure the House, as has already been expressed by other members on this side of the House, that we will be supporting the motion today.

Many of my colleagues are contributing to this debate by bringing forward varying perspectives, sometimes their own personal stories or experiences, to this very important issue. However, if the best predictor of future behaviour is indeed past behaviour, it is important to consider the historical perspective of the regulatory framework in our country.

It is important to consider what was in place in the late 1950s and the early 1960s, and how this framework has evolved since then. The thalidomide experience caused the government to overhaul the Canadian drug regulatory framework. As a result, Canada has one of the safest and most rigorous drug approval systems in the entire world. The system is continuously evolving and improving as we find new ways to better protect the health of all Canadians.

These changes include the very recent improvements brought forward through Bill C-17, known as Vanessa's law. This bill, brought forward by the Minister of Health received royal assent earlier this month.

Canadians can rest assured that I am fully conscious of the fact that whatever improvements have been made since the thalidomide tragedy, they are of no relief whatsoever to the victims, their families, and friends. Nothing can ever undo the pain and suffering inflicted.

That being said, I feel it is very important to look back at the history of our regulatory framework. The history of federal oversight of foods and drugs in Canada started some 150 years ago and predates Confederation. Oversight was initially confined to ensuring that food and drugs were not adulterated.

The Proprietary or Patent Medicine Act of 1909 was the first legislation to register medicines. Although limited in scope, that act was the beginning of this country's legislative protection of the public against drugs administered without medical supervision. This regime prevailed until 1920, at which time the Food and Drugs Act was introduced. This followed the establishment of a federal Department of Health the previous year.

By the late 1920s, regulations developed under the Food and Drugs Act established specific requirements for the licensing of drugs. At that time, the Minister of Health had the authority to cancel or suspend a licence if these requirements were violated.

A significant reworking of the food and drugs regulations did not begin until 1947, but it laid the foundation for the regulations that are in place today. By 1951, and as is still the case today, manufacturers were required to file new drug submissions prior to marketing their drugs. As I said, that has not changed. However, the required content of these submissions has since changed significantly.

It is under that regulatory regime that thalidomide was first approved for sale in Canada to treat sleeplessness and morning sickness. More specifically, it was approved in November 1960 under the brand name, Kevadon, and again in October 1961 as Talimol.

In 1962, the drug was withdrawn from the Canadian market when it was discovered that it caused birth defects when taken during pregnancy. However, by then a lot of damage had already been done.

As I said previously, approximately 12,000 babies in 46 countries were born with malformations. In Canada, it is estimated that more than 100 Canadian families were impacted. The tragic circumstances surrounding thalidomide's removal from the market in the 1960s prompted a complete revision of the Food and Drugs Act and the food and drug regulations. These revisions were made to strengthen Health Canada's regulatory oversight and data requirements for new drug submissions.

The government asked the Royal College of Physicians and Surgeons to appoint a special committee to review new drug procedures under the Food and Drugs Act. The intent was to critically review the act and associated regulatory powers in order for Health Canada to more effectively carry out its purpose and to protect the public.

In December 1962, new legislation was introduced that substantially broadened Health Canada's powers. For the first time, Health Canada was given the authority to enact regulations respecting the distribution or conditions of distribution of drug samples; the prohibition of sale of certain drugs; the methods of preparation, manufacture, preservation, packing, labelling, storing, and testing of new drugs; and the sale or conditions of sale of any new drug. In January 1963, a complete revision of the Food and Drug Regulations concerning the sale and distribution of new drugs was finalized, and new regulations were arrived at in October 1963. These revisions imposed strict safety requirements. For the first time, manufacturers were required to produce “substantial evidence of the clinical effectiveness of the new drug”, including clinical case reports and in vitro studies, in addition to the previous safety requirements.

At the time that thalidomide was initially authorized, the package of information related to the drug was limited, contained in only a small binder of data. Now the volume of data received by Health Canada for the review of a new drug can fill several hundred binders, with safety, efficacy, and quality-related data.

Given the observations noted by the special committee in the 1960s, drug distribution was also an important issue to be addressed in revising the Food and Drug Regulations. The situation was brought into focus when it was disclosed that the greatest distribution of thalidomide was to the medical profession, as free samples to give to patients. Reports also surfaced that individuals were taking delivery of these unsolicited samples and selling them to wholesalers, pharmacists, and others. The Food and Drug Regulations were therefore amended to discourage excessive and unsolicited sampling, through maintenance of complete distribution records by manufacturers.

Today, the post-thalidomide 1960s revisions of the Food and Drugs Act and the Food and Drug Regulations regarding Health Canada's regulatory responsibilities, the new drug submission requirements, as well as the distribution and sampling of prescription medicines, remain substantially the same. As science has evolved, the revised framework has allowed Health Canada to require appropriate and fulsome studies to support drug approvals. Through the Food and Drugs Act and its regulations, Health Canada regulates the safety, efficacy, and quality of pharmaceutical drugs. The pharmaceutical drugs program involves pre-market review, post-market surveillance and compliance, and, of course, enforcement.

As I mentioned earlier in my remarks, the most recent substantive revision to the Food and Drugs Act, completed earlier this month, is the recently adopted Bill C-17, Vanessa's law. This legislation enables Health Canada to better respond to drug safety issues and improve patient safety related to prescription and over-the-counter drugs, vaccines, gene therapies, cell tissues and organs, and medical devices. It includes new measures to strengthen safety oversight of therapeutic products over their life cycle. These measures are intended to improve Health Canada's ability to collect post-market safety information, take appropriate action when a serious health risk is identified, and help ensure that drug safety information is available to Canadians. As well, these measures serve to promote greater confidence in the oversight of therapeutic products by increasing transparency and improving safety of their use.

In Canada, manufacturers must now file a submission with Health Canada and receive authorization before a new drug can be marketed. These submissions contain substantial information and data about a drug's safety, effectiveness, and quality, as well as side effects, warnings, precautions, and contraindications. Health Canada also continues to enhance its post-marketing surveillance and assessment of programs for health products. Comprehensive evaluations include information from post-marketing surveillance, on a global scale, to determine whether the benefits of a marketed drug continue to outweigh its risks.

The 1960s thalidomide tragedy highlighted the need to reform Canada's drug approval process, and prompted a modernization of the Food and Drugs Act and underlying regulations, which has shaped today's drug regulation standards in Canada. The drug review process continues to evolve and improve, but five decades after the thalidomide tragedy, the initial legislative reforms brought about by the result of this sad chapter in our history continues to underpin Health Canada's legislation and practices.

I look forward to hearing about the minister's constructive meeting with the Thalidomide Victims Association of Canada and what support we can offer these victims.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

Mr. Speaker, I listened closely to the speech by the member opposite. He gave us the quite the background on Health Canada's regulations from the 1960s to today. I would like to provide some clarification on that background.

Thalidomide is a German sedative that was marketed in Canada in 1959 by the U.S. company William S. Merrell, which had the rights to distribute the drug. In the United States, the Food and Drug Administration, the FDA, rejected this drug because they deemed that evidence supporting the safety of this drug was inadequate. Nevertheless, this product was marketed here in Canada.

Does my colleague think that drug safety is the federal government's responsibility?

[Colin Carrie, Conservative, Oshawa, ON]

Mr. Speaker, I believe everyone in this House can state that these tragic events in the 1960s reminds us that we all need to take drug safety seriously. As I said in my speech, nothing can ever undo the pain and suffering that was inflicted on these patients and their families.

We did address this issue in a settlement in the 1990s, but I think Canadians need to know that Canada now has one of the safest drug systems in the world. It was recently strengthened further by the passage of Bill C-17, Vanessa's law, which my colleague from Oakville did so much work on. We now have mandatory recall powers so that we will not to have to negotiate with big pharma. We have mandatory reporting of serious adverse drug reactions. We have tough new fines and jail time for companies who put Canadians at risk. Very importantly, we have transparency for drug approvals and clinical trials.

As I said, nothing can undo the pain and suffering that was inflicted by this medication in the 1960s. It reminds us that we all have to take an important role in managing drug safety.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Mr. Speaker, I want to thank the member for his interesting history of the evolution of our current drug policy system. As he so rightly said, in 50 years, science has allowed us to evolve in order to understand drugs, their adverse effects and how they impact people, and to therefore create better clinical trials, and those other things that have brought us to today. The tragedy of thalidomide had one good thing about it, in that it brought everyone to a point of wanting to have drug safety and to use science to evolve to this point.

However, the motion today on the floor, which the government supports, speaks to compensation for the victims and to some ongoing support on an annual basis. I ask the member whether his government will commit to providing exactly what the thalidomide survivors task force has asked for.

It speaks very clearly to $250,000 in a lump sum, and then $100,000 per year after that. Will the government commit to this?

[Colin Carrie, Conservative, Oshawa, ON]

Mr. Speaker, first I want to thank my colleague for her question. I had the pleasure of working with her on the health committee for a number of years. As a physician, she has likely had the personal experience of dealing with patients who have had serious reactions and consequences from taking different drugs.

It is important that everyone in the House understands that these victims have health issues and that we are reviewing the proposal put forth by the Thalidomide Victims Association of Canada. As the minister has stated, she will be meeting with them shortly to discuss their proposals.

[Patrick Brown, Conservative, Barrie, ON]

Mr. Speaker, I first want to congratulate the member for Oshawa on his very thoughtful remarks. We are certainly fortunate to have a parliamentary secretary who is so engaged on the topic.

It is impossible to stand today to speak about the thalidomide tragedy and not be moved. It is a story of an unspeakable tragedy of distraught parents, and children born with challenges that most of us cannot begin to comprehend. This is a tragic event from the 1960s that reminds us of why we need to take drug safety so seriously.

Nothing could ever undo the pain and suffering that was inflicted. It is a story that changed the way we regulate drugs in Canada. It opened our eyes to the fact that while drugs can bring many benefits, by curing diseases, reducing symptoms, and prolonging lives, they can also carry tremendous risks. It also serves as a constant reminder that we as parliamentarians must do all that we can to strengthen patient safety in Canada. That is why I am very pleased to hear that the Minister of Health will be meeting with thalidomide victims and working co-operatively with them to determine what government can do to support them.

Canada now has one of the safest drug systems in the world, and our government recently strengthened that even further, giving royal assent to Bill C-17, Vanessa's law. Protecting patients is a shared responsibility, one that also rests with fellow legislators in the provinces and with provincial health departments, individual health care professionals and administrators, the colleges that regulate medical practice and other professional organizations, key partners like the Canadian Patient Safety Institute, and the Drug Safety and Effectiveness Network, and last, of course, the manufacturers of drugs.

The thalidomide tragedy of the 1960s, like no other event before or since, has impressed upon us what a truly enormous responsibility that is. While the quest for new cures is vital, it is equally important that we do everything in our power to ensure that drugs that reach the market do not cause harms that outweigh their benefits. That is why all parties in the House and in the other place united to unanimously support Vanessa's law, and why so many stakeholders and individuals endorsed that legislation.

Although many steps have been taken previously to strengthen Canada's drug safety system, we all recognize that the Minister of Health and Health Canada did not have adequate powers to protect patients from drugs that were found to be unsafe once they were on the market We, as legislators, acted decisively to provide the new tools to address this gap.

I would like to take some time today to focus on how Vanessa's law will enhance patient safety, how it will reduce the risk of tragic events like those associated with thalidomide, and how it will help Canadians to make informed decisions about the drugs they are taking.

Vanessa's law will ensure that knowledge about approved drugs and medical devices continues to be gathered and shared with the public once products enter the market. This is important because clinical trials can only tell us about how a drug will affect a particular population, the population it was tested on. They do not tell us how the drug will affect everyone who might take it once it is on the market.

When a company submits an application for market authorization to Health Canada, reviewers analyze the results of all tests and studies that are submitted. If the product is safe, effective, and of high quality, the department will give the company a licence to market a drug in Canada for a particular use. However, once products reach the market, Health Canada's ability to gather knowledge about them has traditionally been limited, and its ability to take action when problems arise has also been limited. That is why there are new provisions in Vanessa's law that represent a game changer.

Let me take a moment to describe some of them and why Vanessa's law is so crucial. One important new provision is that Vanessa's law will give the Minister of Health the ability to set the terms and conditions on an authorization and to make those terms and conditions publicly available. What this means is that, as part of the authorization, Health Canada will be able to ask a pharmaceutical company to continue to gather information in the real world, after the product reaches the market, and to make the results of the information gathering public so that Canadians and their health care providers have easy access to them.

For example, Health Canada may require the company to gather information about the impacts of a drug on patients with multiple medical conditions. Health Canada could require a company to monitor and assess the effects of drugs on patients with impaired kidney function. This may or may not have been studied in the initial clinical trial, and the approved label would indicate that.

However, this information may prove to be important as we gather real-world experience and see some patients with impaired kidney function and how the drug affects them. It may become apparent that there is no difference in the benefits and harms experienced by patients with impaired kidney function.

However, should it become clear that there may be a cause for concern, Health Canada will be able to compel the manufacturer to conduct active safety surveillance or conduct a new study specifically to address the issue. The information about what activities the manufacturers are being compelled to undertake will be made public. It will be a transparent system so that prescribers and patients will know what actions are being taken. Vanessa's law also provides the Minister of Health with the power to compel a label change for a drug and to make that information publicly available to Canadians. In the past, most companies have agreed on a voluntary basis to undertake a label change. Sometimes, however, protracted negotiations have been required, and sometimes, those negotiations were not successful. The new powers provided by Vanessa's law have changed that, so if adults or children are taking a drug, they will be able to access this new information. This will allow us, as Canadians, to make informed decisions in consultation with our health care providers.

However, not all new information comes from tests, studies, or the ongoing proactive monitoring of a drug. Sometimes, adverse events are completely unexpected and only identified through a rigorous adverse drug reaction reporting system. This reflects the reality I mentioned before, that patient safety is a shared responsibility. That is why Vanessa's law included mandatory reporting of serious adverse drug reactions and medical device incidents by health care institutions. Simply put, serious adverse drug reaction reports from manufacturers, health care institutions, health care professionals, and the public often provide the first clue about an emerging drug safety issue.

To date, adverse drug reactions have been under-reported in Canada. It has only been mandatory for companies to report adverse drug reactions related to their products. It was recognized that it is critical that we increase the reporting of adverse drug reactions so that Health Canada could take quick action when a problem is detected and share the knowledge rapidly with health care professionals and, most importantly, the public, in order to prevent further harm.

Sometimes, it may be necessary to remove a drug or particular batch of the drug from the market. Other times, it may be appropriate to change the label of a drug so that health care practitioners are aware of the new information when they make their prescribing decisions. In other situations, it may be most appropriate to require the company to conduct some active monitoring to gather further information.

I mentioned earlier the important work done by the Canadian Patient Safety Institute and the Drug Safety and Effectiveness Network. The Canadian Patient Safety Institute works with governments, health organizations, leaders, and health care providers to inspire improvements in patient safety and quality care. It acts as an advocate and catalyst for improvements in patient safety, and it invests in and brokers policy and system changes to protect the health of Canadian patients. As Health Canada works to roll out the new authorities provided in Vanessa's law, either immediately or through developing regulations, these organizations will be able to provide advice.

Nothing can undo the pain and suffering endured by the thalidomide survivors and their families, and it is truly tragic. However, with the passing of Vanessa's law, federal regulators have important new tools to enhance on-market drug safety. The legislation is a very real step to reducing the risk that similar tragedies will occur in the future, and it represents a very important federal contribution to the shared goal of patient safety in Canada.

[Carol Hughes, NDP, Algoma—Manitoulin—Kapuskasing, ON]

Mr. Speaker, we certainly appreciate the fact that the Conservative government has indicated it will be supporting this motion. The thalidomide victims have been waiting for this for a long time.

Looking at the information that is before us, we have to also consider not only the impact this has had on the victims because of their deformities but the impact it has had on their whole lives and that it will continue to have as they are aging.

I asked this question before, but I did not get an answer to it from the member's colleague, so I hope that the member can enlighten us, given that he sits on the health committee. Can he tell us, now that they have finally agreed to support this, how quickly they will be acting? Can he elaborate on the steps that will be taken so that these victims can be comforted and know what is coming before them?

[Patrick Brown, Conservative, Barrie, ON]

Mr. Speaker, I did sit on the health committee for several years but have not been on the committee for the last two years. I do have a keen interest in health care, and obviously this tragedy shocked all of us. It is an issue about which we all have endless concern.

The member mentioned that she is pleased that we are supporting this motion and I am glad to hear that. There is no partisanship when it comes to standing united in the face of this tragedy.

I am so pleased that the Minister of Health has announced she will be meeting with the Thalidomide Victims Association of Canada. It is important to state that it is going to happen. The government will be here to provide whatever support it can in the wake of this tragedy.

Health Canada has learned from this tragedy and has made improvements that have reduced the risk of this kind of terrible event from occurring again, including an overhaul of Canada's drug and regulatory framework. That is important. We recognize the pain and suffering of the victims and we are here to support them. At the same time, we want to make sure that we learn from what happened and that Health Canada has the framework and the regulatory ability to ensure we can prevent something like this from ever happening again.

[Rick Norlock, Conservative, Northumberland—Quinte West, ON]

Mr. Speaker, I listened to the submission made by my friend from Barrie with regard to the government's support of the victims of thalidomide and the terrible tragedy that occurred some 50 years ago. It does not seem so long ago that we were viewing on our televisions and reading in our newspapers about the terrible effects of this drug.

My friend also made note of Vanessa's law. This legislation was introduced in the House by our caucus mate from Oakville and was passed in the House. It builds on this government's record of ensuring drug safety across Canada. Canada has one of the strictest and strongest regimes of drug oversight in the world.

I wonder if my friend might continue to inform the House that this is a non-partisan issue. All of us in the House have agreed to work together to make sure that these things, to the best extent possible, do not happen again.

Perhaps he could refresh our memory with regard to Vanessa's law and some of the steps that our government has taken to ensure, as best it can, that we have the strongest regime possible concerning drugs. I wonder if he would comment on these issues.

[Patrick Brown, Conservative, Barrie, ON]

Mr. Speaker, the member for Northumberland—Quinte West has made his life in public safety, and this falls into that category. This is all about public safety.

I want to touch on Bill C-17, Vanessa's law, which was raised by my colleague. It is important to recognize what this legislation will do. It is a step forward for patient safety and for public safety. Bill C-17 will bring in mandatory recall powers, so that we will not have to negotiate with big pharma companies; mandatory reporting of serious adverse drug reactions; tough new fines and jail time for companies that put Canadians at risk; and transparency for drug approvals and clinical trials. These are all critically important steps forward.

Obviously the tragic events in the 1960s remind us of why we need to take drug safety seriously. Let us be clear. Nothing can ever undo the pain and suffering inflicted on these individuals. That is why it is so important that we get it right, so this never happens again. That is why it is important that we use every power and tool within government's regulatory powers to make sure we have the proper framework in place to protect patients.

[Carol Hughes, NDP, Algoma—Manitoulin—Kapuskasing, ON]

Mr. Speaker, I am pleased to stand in the House and speak to this important issue.

I will be sharing my time with the hon. member for Scarborough—Rouge River.

Allow me to give you an overview. In 1961, the Government of Canada approved the sale of thalidomide as a safe drug for alleviating nausea among pregnant women. However, it was observed that this drug caused miscarriages and serious birth defects, such as missing limbs and organs, deafness and blindness.

This drug had adverse effects and disastrous consequences for many families. For the past 50 years, the survivors have been living with their limitations. Many survivors are now suffering from nerve damage and painful wear and tear on their bodies. It has caused enormous challenges for them, including the loss of the ability to use their limbs to care for themselves and damage to their spines and joints, which severely limits their mobility. It has limited their ability to gain employment and it means they have often had to depend on others for very basic tasks, such as using the toilet, dressing and preparing meals.

As we see, there has been a wide range of impacts, and those are not limited to what I have mentioned, actually. There certainly are a lot of things happening to these victims—the survivors, actually, because as I have indicated I believe, and as many have indicated before, approximately 10,000 thalidomide victims were born worldwide and there are about only 100 of them who are actually still alive here in Canada. We can see that their lives are being affected very deeply, at this point.

I am going to quote a few articles from the newspapers because I think it is important to hear these victims' personal stories.

This is a report from the CBC news, entitled “Thalidomide victim calls on Canadian government for compensation”.

The story is from Marie Olney, whose arms are only about 15 centimetres long and each has only three fingers. We can see how challenging it has been for her. She states that, “The disabilities we have were caused as a direct result of a decision by Health Canada to approve the drug without further testing”.

She goes on to say that it is very difficult for her to prepare meals. To even shovel her walk is actually quite impossible for her to do,

She stated that “On a daily basis there are many things I have to do using my legs, my feet, my mouth, my chin” .

Then, “What I'm garnering from my work is a lot less because of all the money I'm having to pay out for these services”.

We see a person who has been so severely affected trying to make ends meet and is unable to do that because the services have either been cut back or are just not there, and we have to understand that, certainly, the federal government's cuts to health care do not help. At the end of the day, the money that she does make does not go far enough.

She certainly is needing more and more services as she ages and, unfortunately, the money is just not going far enough.

Also, Mercedes Benegbi, who is from Montreal, states, “Many of us still rely on our parents, our friends. We can't live like that anymore,” and of course a lot of them have aging parents and we know that they are not able to care for them the way they would like to care for them.

She goes on to say, “Without funding from the federal government, we are living in a state of never-ending crisis—one that is not only physical, but also financial and emotional”.

Other countries have already provided yearly support to thalidomide victims. We are pleased to see that the government will support the NDP motion on this.

I want to go back to Ms. Olney, who basically said that she is disheartened that the government has taken so long to step up but is happy that it has. She went on to say:

They promised in 1963 and, but for a very small compassionate amount in 1991, they've not delivered on that promise at all. It's money that we need to survive in dignity and to stay as independent for as long as we can.

It is incumbent upon us as legislators and policy-makers to ensure that when we have legislation or situations in Canada that affect people, especially when it impacts their health, the proper resources and supports are there for them to live in dignity. I have a sister with Alzheimer's and I know how important it is for her to get the services and to ensure that she has the support she needs to continue to live a dignified life.

We need to tip our hats to Dr. Kelsey, a Canadian-born doctor who held the position of medical officer at the U.S. Food and Drug Administration in Washington in the early 1960s. She almost single-handedly averted a public disaster in the U.S. with respect to this specific medication, because she would not allow the department to approve it. Although the drug companies kept pushing her, they were not providing the proper information needed to ensure that she would be confident that it would be a good decision to make with respect to the protection and health of U.S. citizens.

Unfortunately, at the same time those applications were put in, the federal government of the day in Canada rushed it through and passed it. Although it felt like an eternity, it was not long afterward that babies were born with flipper-like arms or limbs. There were some who were born abroad to Canadian families because women had been prescribed thalidomide. There were at least 15 wives of Canadian soldiers who were posted in Germany who had given birth to children with severe limb deformities between 1959 and 1961. That had to be swept under the carpet because at that time the women were not supposed to be with the men overseas, and some of those children were left behind because of their disabilities. As members well know, in the older days a lot of these children were put in asylums or perished. Therefore, we must look at the impact this is having on not only the survivors but also the families who had children affected by thalidomide who may not be alive today and who still live with that.

As my time is coming to an end, I think it is extremely important to raise a couple of issues with respect to what needs to happen here. Not only should the survivors be compensated, but it is also imperative that a thalidomide survivors' fund, consisting of two components, be put in place. They are asking for the following: a one-time payment for survivors to help them address their immediate and urgent needs; a monthly payment to the survivors based on the level of disability to assist with ongoing care and medical needs; the creation of an independent board to oversee the implementation and administration of the fund; the appointment of a program administrator responsible for assessing the degree of disability of each survivor based on a simplified three-point scale, and for issuing monthly payments; and the creation of a monitoring and reporting program for the outcomes of grants to be executed by an independent body. It is an opportunity for us not only to do the right thing but also to ensure that we get it right and learn from these lessons.

On that note, I await questions and answers.

[Stella Ambler, Conservative, Mississauga South, ON]

Mr. Speaker, I wonder if the member for Algoma—Manitoulin—Kapuskasing could give us her thoughts on the Minister of Health's comments yesterday about co-operation and meeting with the thalidomide victims association. Does the member think this is a positive step in the right direction? What are the kinds of items that she would like to see discussed in those very co-operative meetings?

[Carol Hughes, NDP, Algoma—Manitoulin—Kapuskasing, ON]

Mr. Speaker, I am not sure if the member was listening to my speech, but I do appreciate her question.

I did say that the survivors have indicated that they have been waiting for a long time. There had been some asks for quite some time for the government to meet, so of course we are very happy that the minister made that statement yesterday, that there were finally some meetings and some headway on this, and that we are going to see approval of this.

I have mentioned what needs to happen, so I do not think that I need to reiterate the five points. Obviously, there are other countries that have already moved on that. that. This is certainly a step in the right direction and, as I have mentioned, the survivors are very happy that this is going to move forward.

[Guy Caron, NDP, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Mr. Speaker, today we are debating the issue of thalidomide.

There are lessons to be learned from the tragic story of this drug's approval and the suffering it caused to so many families. It teaches us a lot about the need to broadly apply the precautionary principle. We often disregard this principle because, in our society, we always want to do things quickly.

The precautionary principle seeks to ensure that any new product, whether it be a food or drug, will not cause any harm, before putting it on the market. Today, the precautionary principle is often replaced with risk management. The profitability of certain foods or drugs could lead us to take greater risks and repeat the tragic mistakes that were made with thalidomide.

I would like to hear my colleague's thoughts on the importance of the precautionary principle in the pharmaceutical industry, particularly in this case.

[Carol Hughes, NDP, Algoma—Manitoulin—Kapuskasing, ON]

Mr. Speaker, I would like to thank my colleague for his question because I think it is very important to take precautions, conduct research and wait to obtain positive results before approving such drugs.

The thalidomide survivors are aging. Their families are unable to continue giving them the help they need. It is therefore important to find a solution, as the survivors' association is calling for. We really appreciate the government's support. We are moving in the right direction.

[Pierre Nantel, NDP, Longueuil—Pierre-Boucher, QC]

Mr. Speaker, it is clear that most parliamentarians are happy that we are discussing an injustice that has gone on for decades.

Strangely enough, I knew two people affected by thalidomide rather well. They were full of spirit and optimism in their quest for autonomy, despite the situation they were in as a result of this medical and pharmaceutical error.

We are happy to hear that the government will support this motion, but could my colleague identify the key reasons why we have been able to agree so quickly on this? There is obviously no shortage of injustices in the world. I am thinking of her own constituents.

[Carol Hughes, NDP, Algoma—Manitoulin—Kapuskasing, ON]

Mr. Speaker, I thank my colleague for his great question.

We have seen the adverse effects and the health problems caused by this medication. As I mentioned earlier, survivors are asking for the services they need to live with dignity. That is what is bringing us together and allowing us to work together and fix this situation.

The government is now prepared to repair the damage and commit to supporting thalidomide survivors. We are very happy about that.

[Rathika Sitsabaiesan, NDP, Scarborough—Rouge River, ON]

Mr. Speaker, today we stand as a Parliament to call for support for the survivors of thalidomide and to work with people on the ground and the Thalidomide Survivors Task Force.

For people who might be watching at home or on YouTube later, I will give a quick background on what it is and what happened.

Thalidomide is a drug that was marketed as a safe treatment for nausea during pregnancy in the early 1960s. While it was a sedative, the drug, instead of being helpful, caused miscarriages and severe birth defects, including missing limbs, organs, and deafness and blindness. Approximately 10,000 thalidomide survivors were born worldwide. We cannot really be sure how many people were affected in Canada, but we know that approximately 100 survivors are still living in Canada.

According to the Thalidomide Victims Association, 62% of the survivors are women and 38% are men. They live across our country: 19% in western Canada, 20% in Ontario, 58% in Quebec, and 3% in eastern Canada. Therefore, Canadians from coast to coast to coast have been affected by this drug, which was thought safe in Canada in the early 1960s.

I will spend most of my speech on the current situation of the survivors.

After about 50 years of attempting to work around their limitations, it has really taken a toll on many of the survivors, who are now suffering from nerve damage and painful wear and tear to their bodies. This has caused enormous challenges for them, including the loss of the ability to use their limbs and to care for themselves, and damage to their spines and joints, which severely limits their ability. They have a limited ability to maintain employment and are dependent upon others for basic tasks, such as using the toilet, and dressing and preparing themselves.

This deterioration of the survivors' health has placed them in a very precarious situation, whether financial or emotional, and quite a few of them suffer from mental health issues as well. I will provide some examples from people who have been courageous in sharing their experiences with the Thalidomide Victims Association of Canada, and I will read excerpts from a report from the association.

In 1992, there was a lump-sum payment. A deal was negotiated and compensation was given to the survivors who were affected by thalidomide in the 1960s. Lump sum payments were made in order to deal with the urgent needs of the survivors, but speaking with people I know, as well as reading reports by the Thalidomide Victims Association of Canada, we know that the lump-sum payments did not help with long-term investments for these families. Many suffered socioeconomically because of the fact that they could not afford to pursue post-secondary education, and they continue to be affected in the workplace today because of that.

I will speak about the education aspect, including about primary school and undergraduate-level education. Fewer than 5% of thalidomide victims were able to achieve their primary level of education, compared to more than 15% of the Canadian population at the time. At the undergraduate level, significantly fewer thalidomide survivors pursue a post-secondary education. Only 25% were able to complete their post-secondary education at the undergraduate level, compared to 35% of the Canadian population on average.

Another angle to look at is financial security and employment. Today, 31% of thalidomide survivors are afraid to quit or lose their jobs because of the pain and treatment they have to deal with.

As well, 17% cannot work anymore and are now dependent on their pensions, if they have been able to accrue pensions, or are dependent on disability benefits or on family members to take care of them, and 58% are actually afraid to lose their jobs, which would lead to a further deterioration of their situation.

Looking at just these three statistics, we see that a lot of the survivors of thalidomide are living in fear. They fear losing their job and they fear quitting their job if they are in a precarious situation at their workplace. They are afraid to move to other employment because they know they may not be able to find other employment or will be further victimized because of the pain they have to deal with.

Looking at the lump sum compensation that was made to the victims, we see that 20% do not receive any more compensation today, 50% make less than $10,000 a year in the annuities that continue to be paid from the compensation, and 75% receive only $20,000 a year as compensation. We know that $20,000 a year and $10,000 a year are definitely far below the poverty line in this country.

The victims and survivors of thalidomide are living below the poverty line, or that is the compensation they are receiving. That is just not right.

I want to talk about two people in my life who are thalidomide survivors. An example of those in the statistic of 20% who receive no more compensation is Charles. Charles is a friend of the family. He did receive some compensation for his urgent needs at the time. Now he does not receive much compensation anymore. He was able to get a special steering wheel for his vehicle.

Charles is an amazing guy who, though a thalidomide survivor whose arms were affected by the drug, overcame his adversity by getting his 5th degree black belt. Charles is an amazing guy. It goes to show that anything is possible as long as people believe in themselves, and Charles is an amazing example of that.

He has been able to make accommodations. For example, he is able to drive by using a special steering wheel in his vehicle. However, he has sadness. He says that it is really sad that he cannot spread his arms around his kids. It is true. Even though he lives with such optimism and persistence to continue and do well, that is the reality for him. I spoke of fear earlier, but there is also the sadness. This is their reality.

Another example is Daniel, who is a greeter at the Powerade Centre in Brampton, one of the sports arenas in the GTA. His arms and his legs were affected. He cannot drive and is completely reliant on public transit, but Daniel is absolutely another example of beauty and optimism. He has a smile as big as the world. He is always the life of the party. However, privately, he will also share that he lives with a lot of pain. He tries to be optimistic and positive about everything and positive about life, because that is what he has to do to move on with life.

Let us look at some more statistics on daily life: 26% require partial or full assistance of another person in preparing their meals, and 14% require full assistance for showering.

I want to share some more quotes about some of the participants in the report. Here is a quote:

I find it more difficult to manipulate the tools and material necessary to my work; I need help more often.

We are talking about job security.

In talking about mental health, here is another quote:

If I go back approximately 5 years ago, I had suicidal thoughts and had no stable and fulfilling work. The fear of not having enough money and losing my autonomy can make me very anxious.

We are talking about people who continue to live with fear and anxiety.

Here is another one, about future stability and pension:

Can only work part-time hours as a result of my disability. Part-time employees are not allowed to contribute to pension and therefore, despite working for 21 years, I have no pension. I find this very scary for the future.

There is fear and anxiety about the future.

Here is another quote: “I will need to retire earlier than 65”.

This person is living with fear. Knowing that the age of retirement has now been increased to age 67 by our current government, this person, who is living in extreme pain, will now need to wait. This person is already saying they cannot continue working until age 65, yet they will have to work until age 67.

I am thankful for the leadership we are seeing and the cross-party support we are seeing for the motion. I would have loved to speak more about Dr. Frances Kelsey and her bravery, but I am also saying that we need to work together with the thalidomide survivors task force. We are asking for a negotiation that would allow the creation of a program that would provide a one-time payment for urgent needs and ongoing monthly support as well, based on people's levels of disability and their ongoing needs.

Thank you, Mr. Speaker, and I look forward to further questions.

[Pierre Nantel, NDP, Longueuil—Pierre-Boucher, QC]

Mr. Speaker, I would like to thank my colleague for her wonderful speech, which gave us a glimpse into the lives of two thalidomide victims. Once again, she was extremely dynamic.

I am wondering what she thinks about this serious problem, which occurred at the very moment these people came into the world. Today they are all about the same age. As my colleague said so well, it is only natural for people to begin to feel worried about their retirement at the age of 50 or 51. Could my colleague elaborate on that issue?

We heard testimony from thalidomide victims, and perhaps that was key in getting everyone here to stand behind these victims. We can easily understand the issue, do the math and say that it does not make sense and that they should be given some sort of income supplement.

[Rathika Sitsabaiesan, NDP, Scarborough—Rouge River, ON]

Mr. Speaker, I thank my hon. colleague, the member for Longueuil—Pierre-Boucher, for his question. He shared earlier that he had friends as well who have been affected by thalidomide.

He is right that we all like to live with certainty. Uncertainty creates anxiety, and living with uncertainty all one's life about one's future and future prospects increases anxiety.

I will share one more quote that I had prepared for my speech. It is about job security. It says:

I have had to change jobs at work because of this change [shoulder surgery]. At the rate I am going I will not be able to work within a short amount of time.

This person is trying to work, doing the best they can to contribute to our economy and contribute to the betterment of their lives as well as the lives of the people around them, but because of the impediment the disability has created and because thalidomide was in their systems as a fetus, they are now having to deal with the possibility of employment loss, which means they may not have been able to contribute much to their Canada pension plan and that they also may not have an employer pension program.

We need to make sure that we as a society are looking out for our mistake. I was not even born when this mistake happened, but I take ownership for it because we as a society need to be that way.

We are blessed that Dr. Frances Kelsey is a Canadian, but the Americans are far more blessed than we were, because as a scientist working for the FDA, she prevented that drug from being approved in the U.S. The Americans are far more blessed than we are, because they do not have to deal with it.

However, we as a society have a responsibility to the innocent victims of this drug. We need to make sure that their future security is looked after. There are not a lot of victims. There are fewer than 100 people.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Mr. Speaker, I thank the member opposite for her speech. I listened to it very carefully, and a good part of the speech was dedicated to the victims of that tragedy.

The hon. member mentioned she was not even born when it happened. I was already born when it happened. I do not remember it. I was a few years old when they started clinical studies in Germany.

Of course, help for the victims is very important. It was a huge tragedy that happened. We cannot turn the clock back, but I would like to ask the member for a comment on the commitment by the Minister of Health to meet with the Thalidomide Victims Association of Canada and the co-operative discussions that will follow.

[Rathika Sitsabaiesan, NDP, Scarborough—Rouge River, ON]

Mr. Speaker, I thank my hon. colleague for those two points that he mentioned, one about the manufacturer in Germany and the second about the Minister of Health now agreeing to meet with the Thalidomide Victims Association of Canada.

I will start with the second question, which had to do with my comments about the minister now agreeing to meet with the victims association. The minister is showing a great response today. However, it is important to note that victims have been requesting to meet with the Minister of Health for a long period of time, and now that we have been able to get some media coverage about it, I am glad the minister is now willing to meet with the victims association.

The first question was about the manufacturer in Germany. The member mentioned that he was around when the clinical trials were just starting; I was not even a concept at that time.

I want to point out that the manufacturer, though it is 50 years later, has now finally apologized. It took the manufacturer 50 years to apologize for this drug and the effects it had.

Canada made a mistake, and I hope that we as a country can take the brave step of apologizing to the victims and survivors of thalidomide and do the right thing by meeting with the victims association to ensure that survivors continue to get support for their urgent needs and continue to have some security for the rest of their lives.

[Stella Ambler, Conservative, Mississauga South, ON]

Mr. Speaker, I will be splitting my time with the member for Mississauga East—Cooksville.

This tragic event from the 1960s reminds us all, as parliamentarians, why we need to take drug safety so seriously. Nothing can ever undo the pain and suffering inflicted upon the victims of the thalidomide tragedy. However, we can work both to ensure these mistakes never happen again and to support those who are most in need.

That is why I am pleased to stand in support of this motion before the House today. I also look forward to hearing about the constructive discussions that the Minister of Health and the Thalidomide Victims Association of Canada will be having in a meeting to be held shortly. I understand the minister is currently reviewing the proposal put forward by the association and will be working with the victims to determine how best they can be supported going forward.

I will be focusing my remarks today on the supports that Canada today places on maternal health to support mothers in bearing healthy children.

The health and well-being of women and children are issues that this government cares very deeply about, as do I as a mother. A healthy start to life is fundamental in promoting and protecting the health of Canadians. The thalidomide tragedy not only demonstrates what can happen when governments do not place a strong enough emphasis on drug safety, but also why mothers need all of our support to have healthy children.

The prenatal period is a critical one for all women, and this government continues to work with our partners to support healthy and safe pregnancies and healthy babies. Our government's efforts are wide reaching, and include national guidelines for maternity and newborn care, prenatal and infant nutrition guidelines, safe-sleep awareness and low-risk drinking guidelines in pregnancy.

Working closely with a wide range of partners, the government strives to protect expectant mothers and new mothers, and provide them with the information they need to help them care for themselves and their newborns. This government recognizes the importance of investing in and supporting new moms early. That is why we invest over $112 million annually to nearly 285,000 vulnerable children and their families each year.

One of our most far-reaching and successful programs focusing on the prenatal period is the Canada prenatal nutrition program. We invest over $27 million annually to support 279 projects across Canada, serving over 59,000 participants each year. The focus of this program is to meet the needs of prenatal and early post-partum women facing conditions of risk, including teenage pregnancy, poverty, geographic or social isolation, tobacco or substance use and family violence. This program provides access to a wide range of services to pregnant and recently post-partum women, and often assists them in accessing other important services such as housing, shelters and counselling supports.

It is worth mentioning that this program has enabled communities to leverage over $16 million annually in additional support to provide greater access to supports for pregnant women and new mothers. This support includes funding, volunteerism and in-kind resources from provincial, territorial, municipal and community partners. We know this program has a positive impact on the health and well-being of mothers and their infants. Participants with high levels of engagement in its services were noted as 40% more likely to give up alcohol, more than twice as likely to increase their use of vitamin supplements, four times more likely to breastfeed longer and less likely to have pre-term or small-for-gestational age babies.

Specifically with respect to aboriginal maternal and child health, our government is also investing over $150 million this year alone to support community-based maternal health and child development programming and services in their communities. This includes Canada prenatal nutrition programming on reserve, the aboriginal head start program, the brighter futures program, the fetal alcohol spectrum disorder program and the children's oral health initiative.

Together, these programs and services are supporting first nations and Inuit children and their families to reach their full developmental and lifetime potential. Improving the health of first nations and Inuit people is a shared undertaking among federal, provincial and territorial governments, and aboriginal partners. Our government remains committed to working with partners to improve the health outcomes of all aboriginal peoples.

The government also plays an important role in ensuring health providers and policy makers have the information they need on the overall health of women and infants. Through the Canadian prenatal surveillance system, the Public Health Agency of Canada monitors and reports on maternal, fetal and infant health in Canada. This work is done in collaboration with leading health professionals from across the country: Canadian researchers, public health practitioners and other stakeholder organizations.

The agency works with these stakeholders to ensure that the information provided meets the needs of our health care community and allows important partners, such as the Society of Obstetricians and Gynaecologists of Canada, to use these data to develop policies, programs and guidelines to improve the health of Canadian women and children.

The Canadian Institutes of Health Research, the government health research arm, also strives to create new scientific knowledge aimed toward improving health and more effective health services and products.

Our government has invested over $840 million since coming to office in 2006 to support research related to reproductive, maternal, child and youth health challenges. For example, we have established the Canadian Neonatal Network to facilitate collaborative research and a project led by Dr. Shoo Lee to reduce infant mortality and the length of stay needed in neonatal intensive care units. This project has developed innovative tools to reduce hospital acquired infection and severe intestinal infection by 30%.

We also have a number of research projects on the horizon that are directly related to newborn and children's health. These projects range from pre-term birth and child and youth mental health, to analyzing the origins of certain childhood diseases.

Another related area where the government has placed a great deal of effort and investment is early childhood development. Two key federal programs focusing on early child development are the community action program for children and aboriginal head start, as I mentioned earlier.

The community action plan for children provides over $53 million in annual funding to community-based groups and coalitions to develop and deliver comprehensive and culturally appropriate prevention and early intervention programs. These programs promote the health and social development of vulnerable children from birth to six years of age, as well as their families, facing conditions of risk, including poverty, geographic and social isolation, teenage parents, tobacco and substance use, and family violence.

The aboriginal head start on reserve program and the aboriginal head start in urban and northern communities program, with funding of $49 million and over $29 million a year, respectively, provide early intervention strategies to address health promotion, nutrition, parental involvement, social support and education. The focus of these programs both on and off reserve is to provide aboriginal children with a good start in life so they are ready to meet the challenges of starting school and coping with life's challenges with confidence.

There is a growing body of evidence that reveals the far-reaching effects of these types of programs beyond early child development. Every dollar spent in supporting a healthy start in these early years will reduce the long-term costs associated with health care, addiction, crime, unemployment and welfare. As well, it will lead Canadian children to become better educated, well adjusted and more productive adults.

Our public health efforts in maternal health are effective, and come as a result of many years of investment in health promotion and prevention activities.

I think this entire chamber and, indeed, all Canadians are today seized with the tragic events that happened in the 1960s with respect to thalidomide and its victims. In addition to supporting the motion before the House today and working with victims to determine what supports can be offered, our government is working to ensure that tragedies like this never happen again, and that new mothers continue to receive the support they need.

[Carol Hughes, NDP, Algoma—Manitoulin—Kapuskasing, ON]

Mr. Speaker, I appreciate the member's speech. She talked a lot about aboriginal health. We need to be very clear that when it comes to aboriginal health, the government in its 2012 budget cut $200 million out of Health Canada and the Public Health Agency of Canada and another $165 million out of aboriginal affairs, which had a direct and significant impact upon several aboriginal organizations that worked with first nations, Metis and Inuit health. We have to be extremely honest about what the government has and has not done.

However, on this specific issue, thalidomide survivors, we are doing the right thing. Moving the motion and having the government act very expeditiously is doing the right thing.

There was frustration on the part of the thalidomide survivors task force when it had attempted to contact the minister in March. It had sent a report to her in September and the minister indicated recently that she had not even read that report. Obviously, things are moving around and we are very pleased about that.

The thalidomide survivor task force is asking for funding that consists of two components, and I know she is aware of those components. One is with respect to a one-time payment. The other is a few breakdowns with respect to their need for continued assistance.

Could the member elaborate on what her government is prepared to do for them?