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House of Commons Hansard #43 of the 41st Parliament, 2nd Session. (The original version is on Parliament's site.) The word of the day was voting.

Topics

Fair Elections ActPoints of OrderGovernment Orders

6 p.m.

Conservative

The Acting Speaker Conservative Bruce Stanton

It is not a point of order, but rather a debate about the facts presented by the hon. member for London West.

I will let the hon. member for London West know that he will have approximately eighteen and a half minutes remaining in his time when the House next resumes debate, and of course the usual 10 minutes for questions and comments.

It being 6:02 p.m., the House will now proceed to the consideration of private members' business as listed on today's order paper.

The House resumed from November 19, 2013, consideration of the motion that Bill C-523, An Act to amend the Department of Health Act (disclosure of drug shortages), be read the second time and referred to a committee.

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

6 p.m.

Liberal

Wayne Easter Liberal Malpeque, PE

Mr. Speaker, indeed, I am pleased to speak on Bill C-523, presented as a private member's bill from the NDP. The Liberals have actually been calling for the Conservative government to implement mandatory reporting of drug shortages since 2011, and with luck, we will finally see this move forward.

This legislation is quite simple in that it mandates that a supplier, be it a manufacturer, wholesaler, distributor, or importer of drugs, notify the Minister of Health of any planned interruption of the production, distribution, or importation of a drug at least six months in advance. Failure to do this would be punishable via summary conviction and a fine of not more than $1.8 million. Any unexpected interruption would have to be reported to the minister as soon as possible or the supplier would face a summary conviction and fine of not more than $10,000 per day from the day the offence is committed, up to a maximum of $1.8 million.

Moreover, under the terms of this legislation, if a supplier is planning to cease production, distribution, or importation, the minister must be informed at least 12 months in advance or face a summary conviction and fine of not more than $1.8 million.

The minister must develop a plan—and this is important—in conjunction with the provinces and territories to prevent and address drug shortages, inform patients and health care providers, and prepare and implement any emergency response plan to address any shortage of a drug. I said that is important because the record of the government, in terms of doing anything in a co-operative way with the provinces, is that this seems almost foreign to it. This might all sound complicated, but in reality, the bill is simply calling on industry to keep government informed when a specific drug might become scarce, so appropriate planning can be undertaken.

Why was the bill proposed in the first place? Simply put, it was proposed in response to the ongoing shortage of medically necessary drugs across Canada. In the past, the Conservatives have asked drug companies to collect and post information regarding pending shortages on public websites to help health care professionals adjust treatment plans in a timely fashion. However, this is a voluntary reporting system and does not compel drug companies to disclose any information. As the case last year with Sandoz Canada has shown us, this can lead to significant harm to the health of Canadians who depend on necessary medication. We need to address this to prevent problems in the future. Many MPs in their own constituencies have had constituents come in to talk about shortages of drugs, which may have affected their health.

In the fall of 2011, following the Liberal round table on drug shortages, we recommended that Health Canada should establish a team within Health Canada to anticipate, identify, and manage drug shortages, similar to the 11-person team established by U.S. President Obama at the U.S. FDA. The government has not shown any such leadership, however.

Canada's government must institute a mandatory drug shortage reporting system, which would require manufacturers to list unavailable medications and to develop early warning systems that could highlight potential drug shortages, so health ministers, medical professionals, and patients would be notified as soon as possible. It is the responsible and prudent thing to do. Ensuring a safe supply of essential drugs is a key responsibility of the federal government, but it is a responsibility that the Conservative government has not taken seriously.

Shortages of essential drugs needed for common health issues and procedures are not a new problem, nor is the problem limited to Canada. It is a global problem that demands real action. For nearly three years, community hospitals, clinics, and pharmacies across Canada have been experiencing serious shortages in common medications, including those used for cancer care, heart problems, epilepsy, pain control, and surgical procedures. The federal government has had plenty of warning about the situation but has consistently failed to take action.

Members do not have to take my word for it. The Canadian Pharmacists Association sounded the alarm on shortages three years ago. It noted that 90% of pharmacists face drug shortages each week when filling prescriptions and that these shortages have become worse over time. The Canadian Pharmacists Association asked for the health committee to study the issue urgently and to ensure that this issue is on the agenda of the World Health Assembly meeting in May.

For our part, on two separate occasions at the health committee, August 2011 and again in November, the Liberals demanded that an investigation be launched into the shortages. However, all of these warnings yielded nothing but silence from the government. Members know how these committees work. They go in camera, they are basically shut down, government members vote against the motion, and the public does not know what happened.

As I have already mentioned, in the fall of 2011, the Liberals held a round table on drug shortages with drug experts from across the country. The recommendations that emerged from this were clear. Strong federal action was required to address current and future drug shortages.

In the face of these concerns, the Conservatives have done next to nothing. Their wilful disengagement and abandonment of meaningful responsibility for the shortages has worsened the problem. Rather than real action, the Conservatives brought in a toothless, voluntary drug shortage reporting system, which does not force pharmaceutical companies to report drug shortages, as is required in countries like France and the United States. In its first test case with Sandoz Canada, the voluntary system utterly failed to provide provincial health authorities with advanced warning of a shortage. The company's drug production problems were known months before, but provinces were only notified in late February, leaving the provinces no time to create contingency plans. The previous minister of health herself admitted that the voluntary reporting system was a flop.

The Liberals believe that a mandatory national drug shortage reporting system is required, and today we are backing up that belief with our votes. This reporting system should require drug manufacturers to list unavailable medications and to develop early warning systems that could highlight potential drug shortages, so that health ministers, medical professionals, and patients are notified as soon as possible. The provinces are asking for this and health stakeholders are asking for this, yet the Conservatives ignore their calls and continue to support a failed system that is putting Canadian lives at risk.

I call on members opposite. The backbench members opposite are not members of the executive council. They can act independently, on their own. They do not need to take direction from the departments and from cabinet. They can stand up for citizens on their own. I hold those backbench members responsible for the fact that some of my constituents are seeing drug shortages. It is because the government failed to act and the backbenchers failed to stand up in their own right for their constituents.

In conclusion, the government's approach has clearly been reckless and shortsighted. However, hope is not lost. If members would stand up and do the right thing and support Bill C-523, we would at least have somewhat of a start in dealing with this problem.

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

6:10 p.m.

NDP

Christine Moore NDP Abitibi—Témiscamingue, QC

Mr. Speaker, I am very pleased to speak to Bill C-523, which was moved by my colleague, the hon. member for Saint-Bruno—Saint-Hubert. This bill would reform the Department of Health Act to deal more effectively with drug shortages.

I would like to mention that I am a nurse by training and that in order to maintain my credentials, I work approximately twice a month in an emergency room and intensive care ward. Critical specialized drugs are used in those places to keep people alive, and that is why I feel it is crucial that we deal more effectively with the issue of drug shortages. Shortages do a lot to complicate matters in a hospital.

Hospitals are already grappling with many issues, such as the fact that there are not enough beds or staff. They are dealing with many problems. Combine those problems with drug shortages and it becomes much more complicated to administer care. This can even lead to operations being cancelled.

Recently, there was a shortage of injection drugs. As a result, non-urgent surgeries were cancelled so as not to deplete supplies of drugs used for those operations in case there were truly urgent cases in which lives depended on those drugs.

The federal government's failure to take action on this issue is having a direct impact on people. People are not getting their surgeries, they are having problems, and their treatment can be out of whack if they change drugs while waiting for a shortage to end.

For example, treating people with psychiatric and mental health conditions is a delicate balancing act, and there is an art to finding the right combination of different classes of drugs to help them and prevent their psychiatric symptoms from recurring. If one of those drugs is taken out of the equation or a substitute is introduced, that can throw off the balance. It can even trigger a psychotic episode. The government needs to understand the critical impact that drug shortages can have on the overall health of patients.

The federal government's failure to act on this matter has forced the provinces to manage it in the end. It becomes very complicated.

This reform is based on two main features: the mandatory disclosure by suppliers of a planned or foreseeable drug shortage and the implementation of an emergency response plan to address shortages.

Drug shortages are a public health issue. Furthermore, this problem is not limited to Canada. It is a global problem. When a company experiences a shortage, its impact will be felt around the world.

In practical terms, the United States has adopted mandatory reporting of drug shortages. That is what this bill calls for. This legislative framework has produced clear results: 195 shortages were avoided in 2011 and 2012 alone. The Food and Drug Administration, or FDA, centralizes the information going around about drug shortages and develops an action plan accordingly. It is ready to take action. Ever since the FDA imposed that requirement, the number of shortages that have been avoided rose constantly between 2005 and 2010. Every year, the number of shortages that have been avoided has gone up. Over those five years, approximately 100 drug shortages were avoided. As I just said, in 2011-12, 195 were avoided.

It is incredible how what is basically simple legislation can actually solve or avoid problems that could be critical for people's health.

Many countries have plans and have tackled the problem of dealing with drug shortages. Health Canada should make changes to its regulations based on U.S. and European practices in order to take effective action to deal with the causes and consequences of drug shortages.

By examining the current Department of Health Act, we see that it is the cause of two failures. First of all, it is a public health problem in that patients do not have access to the drugs they need for their treatment. That manifests itself in different ways, as I noted earlier with the psychiatry example.

A more expensive alternative drug can be purchased. It may have a financial impact on patients. It can worsen their health if their symptoms can no longer be managed. In some cases and with certain drugs, it can unfortunately result in the patient's death.

Accordingly, the minister's inaction on preventing drug shortages and the consequences that entails, can cause death. That is something quite tangible and we cannot stand idly by. We cannot ignore this problem.

What is more, this creates budgetary problems. A drug shortage creates extra costs for our health care system. The supplier network has to be changed and the patients have to be contacted again to be given new treatments, for instance. Switching a person to a new drug sometimes requires extra monitoring or blood samples to be taken in order to adjust the treatment. If a patient is denied an antihypertensive and a substitute has to be found because of the shortage, then his blood pressure needs to be taken. He will need to be monitored by a nurse for a certain period of time to ensure that the substitute drugs truly suit him and are treating the symptoms.

We go from having a patient whose condition was under control because he was taking drugs, to having patients who need to be monitored to ensure that their conditions are still under control. This creates rather significant extra costs to the health care system. Most of the cost created by the shortage is borne by the provinces.

Bill C-523 recognizes this doubly dysfunctional system and aims to provide a solution to the problem of drug shortages. It would legally require suppliers to disclose any planned or foreseeable drug shortages, as I mentioned earlier. That is not too complicated for a company to do. It knows when it could end up with a drug shortage because demand has increased or because there are problems with its production line. Therefore, it is not too complicated for companies to inform the government. It would not be a heavy administrative burden. It is rather simple. Health Canada would then quickly pass along the information to hospitals and the provinces, so that they can take appropriate action.

The bill also calls for an action plan. We know how serious the consequences can be for patients. Having an action plan is a priority. We cannot remain silent.

Lastly, we had an emergency debate about the last drug shortage because the government did not have an action plan. It is not prepared for these situations. It is unacceptable that it is not prepared to take action for our health care system or to combat drug shortages. It shows a lack of concern for the health of all Canadians.

That is why it is very important for us to address this issue and pass this bill, so that we can take action for the sake of patients and Canadians.

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

6:20 p.m.

NDP

François Pilon NDP Laval—Les Îles, QC

Mr. Speaker, I want to thank you for allowing me to speak to Bill C-523, An Act to amend the Department of Health Act (disclosure of drug shortages). Before I begin, I want to thank and congratulate my colleague from Saint-Bruno—Saint-Hubert for her hard work and her excellent bill.

This bill amends the Department of Health Act to oblige drug suppliers to advise the minister of any interruption or cessation of the production, distribution or importation of drugs. It also obliges the minister to prepare and implement an emergency response plan to address shortages of drugs.

Drug shortages in Canada are a major public health problem and the federal government has a role to play in this. The drug shortage phenomenon is nothing new. This has been a recurring problem since the 1970s and there have been successive shortages under Liberal and Conservative governments without either taking action to solve this problem. Nonetheless, it is important to note that these shortages have increased in number and duration over the past few years.

The crisis in 2012, caused by the temporary shutdown of the Sandoz plant, one of the largest manufacturers of injectable drugs for hospitals, clearly showed the scale of this issue. The NDP actually used an opposition day at the time, March 14, 2012, and secured unanimous passage of a motion to resolve the issue. However, as on so many occasions before and since with this government, we have seen a lack of leadership and of will.

Just as with rail safety, air safety, the oil industry and the environment, this government has once again asked industry to regulate itself. We need only mention the many oil pipeline spills, the many railway accidents and the tainted meat scandal to demonstrate the ineffectiveness of industry self-regulation.

In fact, the only effective aspect of industry self-regulation is the effectiveness with which former Conservative members of Parliament have obtained jobs in sectors for which the Conservative government is promoting self-regulation. That could be the topic of another debate all by itself.

Let us return to the subject of the bill, drug shortages. Another reason why it is absolutely necessary to have legislation in this area, possibly the most important reason of all, is the safety of patients.

Drug shortages put patients at risk; they also require doctors, pharmacists and nurses to do extra work and ultimately lead to additional costs for all of us.

According to a survey by the Canadian Pharmacists Association, 91% of pharmacists stated that patients have been affected by drug shortages, either because of delays in treatment or because treatment was stopped, or because of the extra cost to purchase medication, extended hospital stays, procedures being delayed or cancelled, or because the original condition worsened.

In some cases, the impact may be minimal overall. However, in a number of cases, shortages can be catastrophic because the cost associated with medication can skyrocket and become too expensive for individuals who need to be on the drug.

Take a concrete case like epilepsy, where stopping medication sometimes has disastrous consequences. When someone stops taking antiepileptics or the medication is or must be changed suddenly, recurrent seizures can become more serious and longer than before. Prolonged attacks that last more than five minutes require emergency medical care and can even be fatal.

How does that tie in to the debate? Between 2009 and 2012, we experienced shortages of at least five different antiepileptic drugs. Some of them were made by a single pharmaceutical company.

These shortages have forced some people to use a different preparation, if available, or to switch medications without any transition, thus putting at risk the lives of all these people.

A government must protect its citizens. What did the government do? Once again, it shirked its responsibilities and blamed the provinces, its second favourite target after the official opposition. Indeed, the government said that, in its opinion, the provinces were responsible for changing their procurement policies.

However, that is not the opinion of the Quebec Minister of Health, Dr. Réjean Hébert, who unequivocally said the following, in the May 10, 2013, edition of L'actualité:

It is also Health Canada's responsibility to manage drug shortages. If the federal government was doing a better job, there would be fewer drug shortages.

It is high time that the federal government take responsibility. It can do so by voting for the bill we are debating today.

First and foremost, we are asking the government to adopt a system for the mandatory disclosure of drug shortages, as called for by the vast majority of patient and health professional groups. Canadians and their health professionals are entitled to have access to information that is crucial for public health.

That system is used in the United States, the European Union and New Zealand. France also adopted a system in the early 1990s and saw a significant drop in the number of shortages.

We are also urging the government to stop being so confrontational with the provinces and territories. We are asking it to work with them and with stakeholders to find a solution that will decrease the number of shortages and reduce their impact on patients and on our health care system.

According to statistics from the Régie de l'assurance maladie du Québec, the number of drug shortages rose from 33 in 2006 to 207 in 2010. That is unacceptable, dangerous and outrageous. It must be fixed right away. That is why we are asking everyone in the House to support the bill that was introduced by the hon. member for Saint-Bruno—Saint-Hubert.

I would like to conclude with a message for Canadians. The NDP believes that the health of Canadians is more important than profits for pharmaceutical companies. With this bill, we are taking the appropriate steps to ensure that Canadians will have access to the drugs they need, when they need them.

When it comes time to vote on this bill, we hope that the Conservative government, for once, will also put the interests of Canadians ahead of those of pharmaceutical companies.

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

6:30 p.m.

NDP

Élaine Michaud NDP Portneuf—Jacques-Cartier, QC

Mr. Speaker, I am very proud to rise in the House today to support my colleague's bill, Bill C-523, An Act to amend the Department of Health Act (disclosure of drug shortages).

Before I begin, I would like to commend the initiative shown by the hon. member for Saint-Bruno—Saint-Hubert in tackling a public health problem that is very troubling and unfortunately has very serious consequences, namely, drug shortages. I also wish to congratulate her on her thoughtful work and consultations, and on everything she has done to prepare this bill. Given that she is a doctor, she is very familiar with and knowledgeable of the subject matter. She has introduced a bill that really tackles something that should be a priority for all governments, including the federal government and provincial governments.

My colleague's bill aims to amend the Department of Health Act in order to oblige drug suppliers to advise the minister of any interruption or cessation of the production, distribution or importation of drugs. If it passes, Bill C-523 will also oblige the minister to prepare and implement an emergency response plan to address shortages.

Drug shortages have been a problem in Canada for a long time. For over 40 years, drug shortages have been a growing and recurrent problem. In January 2012, the Sandoz plant closed temporarily, and the company had supply problems again in November of last year. That is a striking example of the disastrous consequences that a drug shortage can have for Canadian citizens.

When a major pharmaceutical manufacturer like Sandoz is having a hard time producing 36 drugs, 16 of which are completely out of stock, that obviously has a direct impact on people's quality of life and health. In fact, 91% of pharmacists report that their patients have been affected at some time by drug shortages. In light of these overwhelming statistics, the NDP believes that this is a very serious problem.

Drug shortages may require pharmacists to resort to alternative treatments or to delay providing a treatment to a patient because there is no pharmaceutical substitute. Sometimes, patients have adverse reactions to ingredients in what was supposed to be a similar drug. This is about chemicals that have a direct impact on how the body works. You cannot just substitute one drug for another and not expect any consequences. Consider drugs used to treat depression, anxiety and psychological conditions. It can take months or even years to find the right dosage or the right drug to treat various illnesses. If there is a shortage and one antidepressant has to be substituted for another, that can have a disastrous effect on people's health and their quality of life.

The NDP thinks these situations are totally unacceptable. Before being elected to the House of Commons, I used to work at the Régie de l'assurance maladie du Québec as an information officer. One of my main duties was to answer calls when people had questions about the public health insurance plan or even the public drug insurance plan that we are lucky to have in Quebec. The questions were on the cost of the drugs, their billing, or their insurance. Almost every day, I received calls from patients, often seniors unfortunately, who were dealing with a drug shortage. They had to try to find a substitute. Quite often, they had to pay extra money to find a drug that could give them temporary relief, with the risk of suffering side effects. Sometimes, there simply were no drugs available. People had to wait, sometimes at great risk to their lives.

In Quebec, we are quite lucky. The public drug insurance plan covers most of the prescription costs for people who do not have access to private insurance. When a person has to take a brand name drug instead of a generic drug, the extra cost is not covered by the public drug insurance plan. These extra charges come directly out of the pockets of people who have no other choice but to take the brand name drug. They have to rework their budget.

We are talking about seniors on the guaranteed income supplement who are barely making ends meet. They have to deal with drug shortages and maybe pay $50 or $60 more every month. This can easily total up to $100 for some medications.

I cannot imagine people in this same situation outside of Quebec. Some people have no drug coverage and have to pay the entire cost. It is a huge expense and the result of poor planning. No matter the reasons for drug shortages, the fact remains that people do not have any information or only have the information that the pharmaceutical company wants to give them. They are not able to predict them. Pharmacists, doctors and everyone working in the health system are directly affected by the shortages.

I will give another example. I spoke earlier about people with psychological or psychiatric problems. My colleague from Laval—Les Îles talked about people with epilepsy. That is another illness that is difficult to manage. It takes several attempts to find the right medication and the right dosage. If the patient has to skip a dose or change medications, the effects can be terrible. Someone who suffers from grand mal seizures has difficulty coping with the convulsions. If they change medications, the seizures can be more severe, more frequent and more violent. A seizure that lasts more than five minutes requires immediate hospitalization and can even result in death.

We really are talking about the tragic consequences of a lack of medication, even for a day. People who, like me, do not suffer from chronic conditions of that kind, cannot imagine the consequences. But my brother has epilepsy. I have seen the effect of the seizures, even with his medication. He has not had to deal with a drug shortage. I cannot imagine the impact on his daily life, and on my parents, if my family no longer had access to the medications he needs. That is so difficult to live with.

A government has a responsibility to act. We cannot just sweep this into the provinces' backyards, as the Conservative government is doing constantly. We have to take action. We have to do more than simply trust the pharmaceutical industry.

Have I heard anything more ridiculous than that? Not often, but it does not matter. They say that they have established a voluntary disclosure protocol. Wonderful. What additional information have we had since the protocol was established? Not a lot.

It makes absolutely no sense to entrust the lives of millions of Canadians to the good will of the pharmaceutical industry. This is the time for action.

My colleague is proposing to put a stop to the industry's dilly-dallying in disclosing drug shortages. The minister has to stop blaming the provinces for her own inaction and to shoulder her responsibilities for once. The voluntary disclosure protocol that the Conservatives have put in place does not require manufacturers to provide accurate information in a timely manner. They can provide information whenever they choose. No one has been identified to guarantee compliance with the protocol. Therefore we have to wonder what is the use of the protocol, other than providing more paperwork. For a government that does not like red tape, there seems to be a lot of it in their various initiatives, but unfortunately with no concrete results.

The first step in managing a problem like drug shortages would be to show some transparency, so that everyone concerned has a true picture of the situation. That is what my colleague's bill proposes and I congratulate her for her initiative.

Canadians need to have all the necessary information on drug shortages. We strongly believe that the public needs and has a right to all this information. Health care experts also have a right to that information. Pharmacists have a right to have the information as well, because they have to advise their customers. Some patients would like to have generic drugs and some would prefer something else. Pharmacists need to have up-to-date information to be able to advise the people who come to them with a real need.

We could look at what is being done elsewhere. In the United States, New Zealand and the European Union, they have all developed a mandatory disclosure system and have proven that system regulation can be a good thing. France did the same thing in the 1990s, and they have experienced fewer shortages than other western countries since that protocol took effect.

The Association des pharmaciens des établissements de santé du Québec, the Canadian Medical Association and the Cancer Society are all important health care agencies that have expressed their support for my colleague's Bill C-523.

I hope that all members of the House, regardless of their party, will support it as well.

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

6:40 p.m.

NDP

Sadia Groguhé NDP Saint-Lambert, QC

Thank you, Mr. Speaker.

I am pleased to speak to this issue and defend the proposal put forward by the member for Saint-Bruno—Saint-Hubert in Bill C-523, which addresses preventive disclosure of drug shortages by pharmaceutical companies.

This is an important public health issue that affects Canadians from all regions and all walks of life. This is also an opportunity to assert that the health of Canadians is not a free commodity and that public interest takes precedence over free enterprise in the drug industry.

We need to legislate this because, true to form, the Conservative government is watching the problem worsen, is saying it is acting in the interests of Canadians and is making a lot of noise. It gets riled up and then nothing happens. However, the statistics on drug shortages in Canada are stunning.

The working group on drug shortages found that the number of registered drug shortages rose from 92 in 2005 to 310 in 2010. That is an increase of over 300%. It is equivalent to six registered drug shortages per week.

In 2011, 250 drugs were on back order, representing a 40% increase over the previous year. It is clear that supply disruptions are on the rise and that more drugs are being affected.

Here is an analogy. This kind of problem in another industry would have no real impact on the lives of Canadians. If a person wants to buy a new car, but the dealer cannot deliver it on time, that person just goes and buys another make of car. That does not work for the drug industry.

According to the report of the working group on drug shortages that I quoted, drugs that are subject to shortages are essential, which means that they are used to treat or prevent serious health conditions and there are no substitutes. In other words, unlike dissatisfied customers, sick people cannot simply find substitutes for the drugs they need. That happens often, too often.

From January 2010 to August 2011, 93% of the 127 unforeseen shortages involved essential drugs and 41% were both essential and produced by a single manufacturer. This kind of breakdown in the supply chain has a significant impact on the health of all Canadians.

In 2012, the injection drug shortage caused at least 65 surgeries to be delayed. Doctors surveyed by the Canadian Medical Association, the Canadian Pharmacists Association and the hospital pharmacists association confirmed that drug shortages affected their patients' health.

It is important to understand that illnesses do not wait for the drugs that treat them to become available. When there is a shortage, illnesses continue to flourish, worsen and spread. No one is immune: rich or poor, young or old, Canadian or not. Illnesses spread if they are not treated, and that is that.

These interruptions in the supply chain also have an economic impact, first of all, because they drive up the cost of the health care system. A delay in treatment or surgical intervention causes the patient's condition to deteriorate. The longer we wait to treat that person, the harder and more costly it is. Some 91% of hospital physicians agree. These delays also cause an increase in the workload of health care providers.

All of these disruptions wind up being more costly for our health care system, and therefore our economy. Let us not forget that healthy employees are essential to keeping our businesses running smoothly.

A 2011 labour force survey conducted by Statistics Canada ranks health problems as the number one cause of absenteeism at work, apart from vacation. In 2011, every full-time employee lost on average eight working days because of sickness. That is a total of 105 million work days lost annually.

Canada is experiencing a labour shortage in certain sectors, which is threatening our competitiveness and our growth. Our businesses even have to call upon temporary foreign workers at times in order to meet their labour needs. Thus, it is important to tackle this public health problem immediately in order to improve the health of our workers and reduce absenteeism.

Has the government taken any sensible action to address the shortcomings in the drug supply chain? Absolutely not. It is hiding behind its usual ideology: the free market. Let it go; leave it alone; the market will take care of itself.

With that approach, it is putting the health of Canadians in the hands of pharmaceutical industries. It is forgetting that it alone has the possibility of anticipating the needs, and knowing the state of the supply and the capacity of the pharmaceutical industries to meet demand. The government refuses to ask them whether they will have the capacity to meet demand in the short, medium and long terms so that it can adjust. It prefers to rely on the goodwill of the industry. The Conservatives keep extolling the virtues of business, but here, they are not acting as good managers.

The NDP is a responsible party that understands the realities and challenges of public health. That is why we have developed a constructive approach. It is based on the need to inform and to anticipate the need for drugs in the country.

It is simple. We must introduce a mandatory reporting system that requires pharmaceutical companies to inform Health Canada of any potential shortage, as the College of Family Physicians of Canada is calling for.

The NDP wants to ensure that the health care professionals have access to the necessary information to take care of their patients and to make their work more efficient. For that, we must oblige the pharmaceutical industries to report any drug shortages. We must not rely on their goodwill.

Other developed countries do it and it works very well. In the United States, for example, Barack Obama's administration issued an executive order last October requiring all manufacturers to report shortages to the Food and Drug Administration.

It is time for the federal government to do its job and look after public health. Canadians' health is more important than the profits of the pharmaceutical industry. We must take appropriate action to guarantee that everyone has access to health care and medication. That is why I support the bill before us today.

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

6:50 p.m.

Conservative

The Acting Speaker Conservative Bruce Stanton

Before I recognize the hon. member for Honoré-Mercier, I must inform her that I will have to interrupt her at 6:57 p.m. to allow time for the right of reply. The normal time for a speech is 10 minutes, but in this case, she will have about 7 minutes.

The hon. member for Honoré-Mercier.

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

6:50 p.m.

NDP

Paulina Ayala NDP Honoré-Mercier, QC

Mr. Speaker, everyone knows that the serious drug shortages Canada is facing are jeopardizing our health care. Health Canada issues notices and warnings about medications.

Obviously, when health care is affected, our economy is as well. We can all agree that sick people and people who are not working cost a lot of money. A mom or dad who has to stay home when their child needs treatment because they could not get the right medication also costs a lot of money. Hospital costs are also affected. It is not good for anyone.

Who has to find the solution? Since health care is a provincial jurisdiction, some say that it should be up to them. That is not how it works. It is not that easy. It is true that provincial governments share part of the responsibility, especially with respect to supplies. When pharmaceutical companies are getting virtually exclusive contracts, competitors have less interest in manufacturing drugs, which therefore limits the choice of drugs.

However, the federal government must shoulder some responsibility too. Drug shortage problems have been growing since the mid-2000s. They affect both generic drugs and innovative drugs, which are more expensive and are not necessarily Canadian drugs. Those are drugs imported form pharmaceutical companies abroad. They are more expensive, of course.

That is why a number of countries, such as France and the United States, have introduced policies to reduce and control the magnitude of those shortages. There are many reasons for the shortages. It is not just because not enough drugs were produced. For instance, there have been cases where the raw materials went bad because the facilities of a pharmaceutical company were in bad shape. The drugs that were subsequently produced were not of good quality; they were actually dangerous. Therefore there can be many causes and quality control is very important.

In the past, we knew where the drugs came from. They often came from certain European countries. Now they can also come from emerging economies, where quality control is less rigorous than in North America or Europe. We must be careful. That is the federal government's responsibility. Emerging economies have supply problems. As a result, there is a significant increase in demand. Our population is aging and therefore needs more and more drugs. For some diseases, we can now find drugs that we did not have before, so demand has gone up. However, the main reason is that the population is increasingly aging. We must look after our seniors who have worked for us to be where we are today.

While demand has gone up, production has remained the same. Clearly, private companies want to make a profit. We all agree that they are not there as a charity.

Finally, since major patents have expired, pharmaceutical companies are focusing on producing new drugs that are more expensive instead of producing existing drugs that are just as effective and cheaper. That is also something to keep an eye on.

In 2011, the United States tried to find a solution to this problem. They required that all companies disclose all shortages. They also encouraged them to report any slowdown in production because these situations can be prevented.

It is up to the provincial governments and especially to us, federally elected members, to find a solution. I would like to address my colleagues now. It is up to us, as legislators, to pass the right laws. The health of Canadians is also our responsibility.

Clearly, I will be supporting my colleague's bill, Bill C-523, An Act to amend the Department of Health Act concerning the disclosure of drug shortages, which would oblige drug suppliers to advise the minister of any interruption or cessation of the production, distribution, or importation of drugs and oblige the minister to prepare and implement an emergency response plan to address drug shortages.

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

6:55 p.m.

NDP

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

Mr. Speaker, I would like to remind members that drug shortages are a major public health problem in which the federal government has a role to play.

This bill would give Canadians access to the same information that Europeans and Americans already have in terms of care. Drug shortages put patients at risk. They create more work for doctors, pharmacists and nurses in our healthcare system, and result in additional costs.

We need to switch to solution mode. In a letter to the industry, the Minister of Health has asked the industry to regulate itself. A new website is also available for voluntary reporting. These initiatives do not really help with planning, however, since the information is not always updated during a shortage.

Professor Jean-François Bussières looked at the drug shortages reported on the vendredipm.ca website—these are shortages from the Sigma purchasing group, which makes mandatory reporting of shortages part of its supply contracts. His study showed that 20% of all drug shortages reported on vendredipm.ca are not reported on the government's drug shortages website. This is ironic.

Having the industry require its suppliers to disclose any supply shortage to protect its production capacity seems normal to the Conservative government. It does not seem so keen to apply the same logic to pharmaceutical companies by requiring them to disclose drug shortages.

The minister spoke during the first part of the debate on my bill and said that it did not amend the right law. I would like to say something. The health of Canadians is more important to me than pharmaceutical companies' profits. It is the Minister of Health's responsibility to guarantee that Canadians have access to drugs at all times. Unless I am mistaken, the Department of Health Act, which I seek to amend, sets out the minister's prerogatives. That is why I am asking the minister to coordinate efforts to prevent any drug shortage, remedy it and develop and implement more emergency measures to address these shortages.

The federal government, which is content to deregulate a number of public safety measures, claims that the voluntary approach in this area is working. However, the facts tell another story. Drug shortages are not reported within a reasonable amount of time to allow for a transition period. The Conservatives pushed with all their might for a voluntary approach that has not worked in a number of sectors. The penuriesdemedicament.ca website and the protocol for the notification and communication of drug shortages include many aspects of my bill, including the disclosure of drug shortages, but not the legal obligation to do so.

There is a reason why a number of groups of health professionals, including the Ordre des pharmaciens du Québec, the College of Family Physicians of Canada and the Canadian Federation of Nurses Unions, are calling for this mandatory approach. We are behind here in Canada, because the United States and Europe, our largest economic partners, have already passed similar bills.

In closing, I call on the Conservative government to accept its responsibility to protect public health and to pass my bill concerning the disclosure of drug shortages.

I urge my Conservative colleagues not to vote against common sense.

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

7 p.m.

Conservative

The Acting Speaker Conservative Bruce Stanton

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

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

7 p.m.

Some hon. members

Agreed.

No.

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

7 p.m.

Conservative

The Acting Speaker Conservative Bruce Stanton

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

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

7 p.m.

Some hon. members

Yea.

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

7 p.m.

Conservative

The Acting Speaker Conservative Bruce Stanton

All those opposed will please say nay.

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

7 p.m.

Some hon. members

Nay.

Mandatory Disclosure of Drug Shortages ActPrivate Members' Business

7 p.m.

Conservative

The Acting Speaker Conservative Bruce Stanton

In my opinion, the nays have it.

And five or more members having risen:

Pursuant to Standing Order 93, a recorded division stands deferred until Wednesday, February 12, 2014, immediately before the time provided for private members' business.

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

Employment InsuranceAdjournment Proceedings

February 6th, 2014 / 7 p.m.

Liberal

Wayne Easter Liberal Malpeque, PE

Mr. Speaker, I raised a question on the consequences of the government's attack on EI, which, when it was raised on November 27, had already seen some 1,100 islanders leave the province. I asked the minister why she, as the regional minister and Minister for Fisheries and Oceans, thought it was okay for P.E.I. to lose its youth and split families asunder, and why she has minister has championed policies that have forced islanders to leave.

The Minister of Employment and Social Development responded, but clearly his response shows that he does not understand a seasonal economy in any way, shape, or fashion. He said, “Not one person has to leave P.E.I. in order to search for available work to qualify for EI”. That was not the question. We are not talking about qualifying for EI; the question was about the ability to qualify for EI in the future, not the ability to move. The question then was about the consequences of the EI changes, which are forcing many islanders to leave.

It is not only about those who leave, but also about those who, as a result of the changes in the system, are left poorer as a result. The economy in Prince Edward Island, and indeed the Maritimes, has been suffering as well. The impact has been so profound that the Council of Atlantic Premiers has been holding hearings on the issue of employment insurance. It has come out very strenuously against the federal government and these employment insurance changes.

In the hearings, one of the concerns was that too few people were coming forward. Why? They are fearful that if they come out and tell about the situation they are faced with as a result, they will be targeted by the government, audited, and hassled. I know the members opposite are shaking their heads, saying that would not happen. Well, I saw on TV a few minutes ago what happened to the environmental charities. Any of them who have spoken out against the federal government are already being targeted and audited. That is the way the government works; it operates on fear. These people are worried, and they have reason to worry.

Secondly, businesses themselves are not able to obtain workers for part-time work because 50¢ on the dollar is being clawed back. Maybe I can sum it up best with a letter that someone sent to the Minister of Fisheries and Oceans. This person said that he had moved to P.E.I. from Ottawa in 1986 and had run a successful business from 1988 to 2004. Since then he has been working with various seasonal businesses and most recently with one that shows terrific potential. The changes to the EI guidelines, however, have required him to work for 50¢ on the dollar while drawing EI.

Not only that, in so doing he bears the employment related expenses, such as child care, travel, meals and so on. By his estimation, this results in him working for roughly 35¢ on the dollar.

He asks, “Please tell me how this is helping me, the economy, or anybody else? It's certainly hurting my family and offers no hope of a better future unless I move away”, which is not an option for him.

That is his question.

Employment InsuranceAdjournment Proceedings

7:05 p.m.

Essex Ontario

Conservative

Jeff Watson ConservativeParliamentary Secretary to the Minister of Transport

Mr. Speaker, I am happy to speak today to correct the misinformation the member for Malpeque has been speaking about regarding the employment insurance program. In fact, I think if he checks the blues from just a few minutes ago, the member said that it was not about qualifying for EI then turned around and said that it was about qualifying for EI.

As the Minister of Employment and Social Development has pointed out, the accusation that the government is forcing islanders to move is clearly false. Not one individual, no matter what the age or situation, in P.E.I. or anywhere else in Canada, has had to leave the province to look for work in order to qualify for EI. In fact, the overall unemployment rate for workers of all ages in P.E.I. is improving as our economic recovery is continuing.

The reality is that across Canada, far fewer than 1% of people were disqualified because they failed to search for work or refused to accept suitable work. In fact, 80% of the increase in disentitlements in 2013 was because the claimants were out of the country.

Contrary to the claim of the member opposite, our recent changes do not require individuals to take any job that is available to them. Rather, available work is only considered suitable if the recipient would be better off accepting new employment than receiving EI benefits. Most importantly for P.E.I., while those who cannot find work during periods of seasonal unemployment are expected to look for work, they are not forced to move or forced to accept work that pays less than their EI benefits, nor are they forced to take jobs for which they are not suited or that are not suitable because of their own personal circumstances.

Issues such as child care and access to transportation are taken into account when determining the suitability of a particular job for a particular individual. The whole idea behind these changes is to make EI more responsive, fair, and flexible. It also helps address labour shortages, which are happening even in regions of high unemployment. I know that is the case in my constituency.

Further, net migration numbers in P.E.I. fluctuate annually. This has nothing to do with the EI program. For example, for those between 25 and 29 years of age, the ages when many islanders are beginning their careers, unlike the member opposite, there have been some years of in-migration mixed with equal numbers of out-migration. It is unfortunate that opposition politicians, the member for Malpeque, and activists continue to irresponsibly mislead Canadians about the facts and to instill fear where none need exist.

Canadians would benefit from a dialogue on this issue based on accurate facts and not on false examples so they can decide for themselves the merit of the changes.

Employment InsuranceAdjournment Proceedings

7:10 p.m.

Liberal

Wayne Easter Liberal Malpeque, PE

If we want to talk about irresponsibility, Mr. Speaker, it is over on that side of the House. Conservatives do not understand the seasonal economy and how it works.

Let me give another example. A farmer came into my office. He pays an employee $16 an hour. The individual has been with him 18 years. The farmer asked me if he would get in trouble if he paid this person cash. I said that of course he would and asked why he would want to pay him cash. The farmer's response was that he works with the farmer full-time from April 1 to November 30, and the rest of the season he is needed only a day and a half a week. When he works that day and a half a week, the individual is paid $16 an hour, and EI claws $8 off of his employment insurance. If he takes the deductions off, the man is working for about $5.50 an hour.

The consequences are these: the individual is poor, the farmer has trouble getting helpers, and it contributes to an underground economy. Everybody loses, and it is the result of the government's lack of understanding of seasonal industries and how they work. They need skilled workers too, and the government is driving them away from Atlantic Canada.

Employment InsuranceAdjournment Proceedings

7:10 p.m.

Conservative

Jeff Watson Conservative Essex, ON

Mr. Speaker, the member, of course, neglected to say that in that same example, the person still gets his EI benefit as well.

Again, not one single person in Prince Edward Island has had to move out of the province to qualify for employment insurance. Claimants are only expected to look for work within their own communities.

Once again, the rules around applying for and qualifying for EI have not changed. Existing rules were only clarified, such as the responsibility of EI claimants to actively look for work while receiving benefits. Employment insurance continues to be there for Canadians who have paid into the system and have lost their jobs through no fault of their own, including in areas where jobs simply do not exist outside seasonal or specialized industries.

Rail TransportationAdjournment Proceedings

7:10 p.m.

NDP

Yvon Godin NDP Acadie—Bathurst, NB

Mr. Speaker, I asked a brief question in the House. It was about the presence of Via Rail in the Atlantic provinces.

To put this in context, CN announced that it would invest $30 million in the railway between Moncton and Miramichi and from Bathurst to Campbellton. That leaves the section from Miramichi to Bathurst between the two.

The provincial government of one of the poorest provinces in Canada invested $25 million in the railway. It is not pleasant to admit that we are one of the poorest provinces but, as everyone knows, ours is a small province with just 750,000 people.

We need $10 million to keep Via Rail healthy so that the train continues to run from Halifax to Vancouver via northeastern New Brunswick and eastern Quebec.

That means it leaves Moncton, goes through Miramichi and Bathurst, Campbellton, the Matapédia valley, Amqui and then on to Rivière-du-Loup.

The Conservatives said they had no intention of investing in the railway that connects Bathurst to Miramichi, the one that allows VIA Rail to bring passengers to Acadia.

The Conservatives are in the process of killing VIA Rail service in eastern New Brunswick and eastern Canada.

The Conservative members for Madawaska, Restigouche and Miramichi are keeping mum. This railway goes through the riding of Miramichi and the Restigouche region. Will the Conservative MPs from New Brunswick have the guts to oppose their government's decision?

New Brunswick has eight Conservative MPs. Can you imagine? Eight out of ten MPs are Conservative. The question is whether they will have the guts to fight to keep VIA Rail in the region.

We are talking about a train that goes from coast to coast. If we lose the section between Miramichi and Bathurst, that means we are losing eastern New Brunswick and part of Quebec, an area with a population of roughly 350,000 to 400,000 people.

The government just told us that VIA Rail may have another option. It will go from Moncton to Edmundston, but then we will have a passenger train going through the woods.

VIA Rail has already reduced service from six to three days a week. What do they need? They need to lose 50% of passengers to justify eliminating VIA Rail service from Halifax to Quebec City. They are abandoning passenger service from coast to coast.

I have to wonder what is going on with the eight Conservative members from New Brunswick. What are they doing to try to save the railway? Are they letting the Prime Minister make these decisions all by himself? Are they letting the Prime Minister hurt Atlantic Canada, as we see day in and day out?

The Conservative members from New Brunswick have a duty to tell their Prime Minister, since they are on the government side, that they will not accept the loss of the rail line in eastern New Brunswick or anywhere in eastern or Atlantic Canada.

I want to hear the government's response. They are familiar with the problem, and for $10 million, they are prepared to abandon VIA Rail in eastern Canada.

Rail TransportationAdjournment Proceedings

7:15 p.m.

Essex Ontario

Conservative

Jeff Watson ConservativeParliamentary Secretary to the Minister of Transport

Mr. Speaker, our government makes significant investments in VIA Rail from Atlantic Canada, right across to western Canada, and the member consistently votes against them. The Government of Canada provides VIA Rail, a crown corporation that operates independent of the government, with significant funding to provide passenger rail services to Canadians. In 2012-13, the funding provided to VIA Rail for operating and maintaining its network was $275 million. This significant subsidy from Canadian taxpayers enables VIA Rail to operate its network of services throughout the country.

In addition to providing annual funding, the government has provided nearly $1 billion in capital funding since 2007 for VIA Rail to upgrade track and signalling infrastructure, modernize stations, improve accessibility, and refurbish rail cars.

While the government has made significant investments in VIA Rail's infrastructure, it is not in the business of buying rail lines.

Instead, the federal government's role is to provide a legislative framework under the Canada Transportation Act that encourages stakeholders to seek commercial solutions to issues such as the discontinuance of rail service. As such, the line transfer and discontinuance provisions in the Canada Transportation Act are aimed at encouraging the retention of rail lines where it makes sense to do so, by giving railway operators and other interested parties the opportunity to acquire rail lines for continued operation before they are discontinued. Other interested parties include the provincial and municipal governments and urban transit authorities, in addition to other railway companies.

With regard to the section of CN track in northern New Brunswick, CN has followed the discontinuance process in indicating that it plans to advertise it for sale. This process requires a railway to notify governments and urban transit authorities when a rail line is identified for discontinuance in its three-year plan. The government does not own freight rail infrastructure and has no intention of buying this section of CN track.

In the meantime, CN will continue to be responsible for maintaining the rail line during the discontinuance process to ensure that service is not disrupted. VIA Rail service on its Ocean line between Montreal and Halifax continues as per its planned schedule.

VIA Rail's objectives are to provide safe and efficient passenger rail service. In this regard, VIA regularly assesses its operations to decide how best it can achieve these objectives. As a crown corporation, VIA Rail will ultimately be responsible for making decisions about its passenger rail services in New Brunswick and will assess alternatives to ensure there will be no service interruptions.

I would like to remind my colleague that this was a business decision made by a private company. There is a regulatory process in place, which the company is following, and while the discontinuance process is under way, CN is responsible for maintaining its track infrastructure.

Finally, our government supports a passenger rail network that meets the needs of today's travellers while supporting the efficient use of taxpayer dollars.

Rail TransportationAdjournment Proceedings

7:20 p.m.

NDP

Yvon Godin NDP Acadie—Bathurst, NB

Mr. Speaker, I cannot believe what comes out of this government's mouth. The Conservatives are saying that they have invested in VIA Rail and the railway. Meanwhile, they stopped the train that went to the Gaspé.

Right now, there is about 5,000 km of track from Halifax to Vancouver, and they plan on cutting 70 km between Miramichi and Bathurst. These communities and municipalities will no longer have passenger train service.

What is the alternative? I would like to hear from the government. What is the alternative? They say that they will not abandon VIA Rail. But what then is the alternative? Is it going through Edmundston? If so, since there is no station, they will have to buy land, and it is assessed at about $50 million compared to $10 million.

Perhaps the government wants to have the train go through the town where the aboriginal affairs minister lives. Maybe that is it; I do not know. However, there is only forest between Moncton and Edmundston. There are no communities. That is the ideal recipe for losing VIA Rail in eastern Canada, and the Conservative government is contributing to that. Furthermore VIA Rail does own railway lines. It owns part of the line between Ottawa and Montreal. It also owns part of the line on the way to Toronto. It is not true that VIA Rail does not own railway lines.

We are asking the Conservative government to spend $10 million to save eastern Canada's railway.