House of Commons Hansard #435 of the 42nd Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was change.

Topics

The House resumed from May 28 consideration of the motion.

Diabetes Awareness MonthPrivate Members' Business

11 a.m.

NDP

Jenny Kwan NDP Vancouver East, BC

Mr. Speaker, I am very happy to engage in this important discussion. In 2014, the Steno Diabetes Center in Copenhagen, along with the University College in London and Novo Nordisk, created the cities changing diabetes program. Its aim is to address the social and cultural factors that increase type 2 diabetes vulnerability among certain people in urban centres. The program now includes partnerships with 20 cities around the world. I am proud to say that Vancouver was Canada's first and only city to become involved, and was one of the first 10 cities globally to join the program.

It is estimated that about 9.4% of Vancouverites are living with diabetes, which is comparable to national incidence rates. However, this overall rate hides who is being most impacted. Vancouver is one of Canada's most socially, ethnically and economically diverse cities, and not all groups are affected by diabetes at the same rates. In Vancouver's more affluent neighbourhoods, diabetes rates are as low as 5%, but in the Downtown Eastside, in my riding of Vancouver East, it is 8%. We also know that indigenous people and people of Chinese and South Asian descent are at a disproportionate risk of developing diabetes.

In December 2017, I wrote to the Minister of National Revenue to express my serious concerns over the Liberal government's mishandling of the disability tax credit. Constituents were dismayed that the Canada Revenue Agency was denying the tax credits to those with insulin-dependent type 1 diabetes. Type 1 diabetes requires ongoing, expensive treatments. It is not uncommon for an individual to be forced to spend upwards of $10,000 a year on various medical devices and insulin. Often, private insurance plans have gaps that lead to it not being covered, or restrictive caps that leave individuals paying large amounts out of pocket.

It is no wonder that the Canadian Diabetes Association found that 57% of Canadians with diabetes say they do not comply with their therapy because they cannot afford the costs of the supplies, devices and medications. The impacts of this are far reaching. Unable to comply with their therapy, it puts people at increased risk of serious health complications. In addition to the human impact, this adds strain to our health care system, as it must deal with completely avoidable emergency interventions. It does not need to be this way.

New Democrats, since the time we won the fight for medicare in this country under Tommy Douglas, believe that our work will not be done until we also have a universal public pharmacare plan. The health and financial impacts of not having a universal public pharmacare plan are as clear as day when we look at the impacts of diabetes in this country. We must also keep in mind that prevention is cheaper than intervention. We know that there are other social policies we can engage in to reduce the risk of people developing diabetes in the first place. These policies will keep Canadians healthier and save our health care system's valuable resources.

Due to the cost of diabetes therapies, it is without question that those unable to comply due to costs are less financially secure. In Vancouver, much of this has to do with the lack of affordable housing. Whether it is kicking the can down the road on funding the national affordable housing plan instead of breaking ground on projects, or avoiding any action on money-laundering schemes that inflate real estate prices, the Liberal government is failing to address the national housing crisis that is acutely severe in Vancouver and in my riding of Vancouver East. Too often, my constituents are forced to choose between paying rent and paying for insulin. This is wrong.

My colleagues, the member for North Island—Powell River and the member for Hochelaga, have tabled bills in this House to take real action to affirm housing as a human right. It is shameful that the Liberal government does not agree. We also know that diet has a significant impact on increasing the risk of developing diabetes and worsening the condition if one is already living with it. Once again, Canadians struggling to make ends meet find themselves less able to have a healthy, well-balanced diet. Food insecurity in low-income areas leave lower-income Canadians struggling to eat well. This creates a third difficult choice for too many residents of Vancouver East, having to choose rent, medicine or food. Again, it does not need to be this way.

My colleague, the member for Berthier—Maskinongé, tabled a bill here to address food waste. Again, both the Liberals and Conservatives opposed our efforts. Another colleague, the member for Kootenay—Columbia, tabled a bill to recognize the importance of local food.

The NDP understands the vital role that food security plays in ensuring that Canadians are healthy and able to contribute to their fullest. We need to do more to both recognize and address the roles that housing and food security play in diabetes prevention and maintenance.

The Vancouver Second Mile Society provides health clinics each year which include diabetes testing. They also do great work with their health programs and preventing seniors from living in isolation and poverty. The Vancouver Native Health Society works to provide knowledge and support for food sustenance development and reducing barriers of access to the natural environment and nutritious traditional foods. They also run a medical clinic which offers a diabetes self-management program, a free learning program to help people with type 2 diabetes better manage their symptoms.

Then there is the Vancouver Chinese Diabetes Education Centre, which exists through partnerships with Vancouver Coastal Health and the Chinese Canadian Medical Society BC and is run out of S.U.C.C.E.S.S. The centre is a great resource for individuals with diabetes and their families to learn about diabetes management, its nature and causes, nutrition and meal planning, the role of exercise and medication and self-monitoring. There is also the kitchen program at the Downtown Eastside Women's Centre, and the Chinese Elders Community Kitchen with the Downtown Eastside Neighbourhood House.

REACH Community Health Centre uses a collaborative model that supports elder health and addresses social factors like loneliness and isolation, as these can be detrimental to overall health and wellness.

I would be remiss if I did not also acknowledge the incredible work that the neighbourhood houses play, whether it is food programs, cooking clubs or community lunches at the Mount Pleasant Neighbourhood House, or the Saige Food Bank and Community Kitchen at Kiwassa Neighbourhood House, to just name a few. Vancouver's neighbourhood houses are vital in efforts to improve the health and well-being of my constituents living with diabetes, and all of my constituents for that matter.

I am proud to stand in the House and support Motion No. 173. I also believe we need to act. We know many avenues where action can be taken; we just need the political will.

Diabetes impacts over three million Canadians every day. Its impacts are far ranging, because of the far range of factors that impact the disease itself. That is why I believe we need to be looking at diabetes through a holistic, intersectional lens. It is exercise, diet and food security, and it is housing security and affordability. It is access to health care, and it is access to affordable prescription drugs. So much of this ultimately comes back to income security and equality.

I think this provides a real launching point to examining big-picture changes to social policy and programming. The prevalence and impact of diabetes in our society is far reaching and requires far-reaching actions. One such action that I think we need to discuss is the National Inquiry into Missing and Murdered Indigenous Women's call to justice 4.5, which states, “We call upon all governments to establish a guaranteed annual livable income..”.

Let us take the opportunity that Motion No. 173 provides us to recognize the interconnectedness of all of this, and let us think big about solutions.

Diabetes Awareness MonthPrivate Members' Business

11:10 a.m.

Liberal

Nick Whalen Liberal St. John's East, NL

Mr. Speaker, I am proud to have this opportunity today to rise and speak in favour of Motion No. 173 to create November as diabetes awareness month. People at home might be wondering why I have an opportunity to speak to this motion, given that it is close to the hearts of so many members of Parliament. I am sure they would be interested to know that my own private member's bill was preempted by work that was already being done by the House of Commons Standing Committee on Canadian Heritage.

I have had the opportunity to share my private member's bill with a number of members in the House. The member for Surrey—Newton and I were able to work together to make sure that his Sikh Heritage Month bill made it to the Senate and was passed by both Houses in time for declaration prior to the rising of the House.

I was able to work with the member for Cumberland—Colchester, on a couple of occasions, to make sure that his private member's bill for the repatriation of indigenous artifacts was also able to get through the House and be called into law.

People might be aware that in the last few weeks, the member for Saanich—Gulf Islands was able to get Bill S-203, on preventing the captivity of whales and dolphins, through the House by my offering my slot to her on one occasion, and with one of the members from the New Democratic Party.

Therefore, when the member for Brampton South asked if I could help with providing an opportunity to get to second reading on her private member's bill, I was more than happy to help.

One of the reasons is that I have a close connection to diabetes in my family. Just over three years ago, my cousin Jimmy Grouchey passed away from complications of type 1 diabetes, alone in his home in Arizona. Both of my parents come from large post-World War II families. My mom had nine siblings growing up, and my dad had four siblings and two half siblings. The family we were closest to were the Groucheys, because we shared a summer home together. We would vacation together in the summertime, where Jimmy, Christina, David, Jennifer, Jon, Dan and I would have a really great time.

People with diabetes have to manage their disease, and certainly when they are living on their own, complications can result. Jimmy was always a go-getter, fun-loving and free-spirited. With the moratorium on the cod fishery, like many Newfoundlanders, he moved abroad to pursue his career. He had different careers, in sociology, as a patent agent, and in 2009, he became a nurse. He worked in North Carolina and then finally in Arizona.

Lack of awareness about this disease and the complications associated with it can be devastating for families. Jimmy passed away from that. He would have turned 50 on Monday of next week. I wanted an opportunity to tell Jimmy's story and share with the House that families can be affected by this. It is not just statistics; they are individuals and families like mine.

Our government recognizes the impact that diabetes has on roughly three million Canadians who live with it and the 200,000 new cases that are diagnosed each year. I would like to thank the member for Brampton South for her work in bringing this forward to the House. It is important to recognize and raise awareness about it.

By having awareness of diabetes front and centre, fewer people will succumb to the complications. Fewer people will allow themselves to get to the point where they develop type 2 diabetes. More people can have access to prevention methods. More people will have access to care. While friends may not be aware that they have type 1or type 2 diabetes, the month itself will provide an opportunity to have that discussion, to let people know some of the symptoms of someone who might be in an insulin crisis and how to provide them with the help they need.

Our government has been supporting various measures. In 2016-17 alone, we invested $47 million in diabetes research. We recently announced a $30-million partnership with the Juvenile Diabetes Research Foundation. There are various members in the House who have helped to coordinate the multi-party caucus that led to this. It is not just those on this side of the House who are in favour of diabetes research.

When the Juvenile Diabetes Research Foundation comes to the Hill, members from all parties are present to listen to the stories of the ambassadors selected for their work in their cause across the country. It is great to meet those 10-year-olds, eight-year-olds, children of all ages who come from our ridings across the country to Parliament Hill to advocate for their cause. I am happy to participate with members on this side of the House, and I am sure that members from all sides of the House are happy to do so as well.

Also, in partnership with organizations in the private and non-profit sectors, as well as other levels of government, we are testing and scaling up interventions in communities across the country to prevent chronic disease, including diabetes. These interventions focus on common risk factors such as unhealthy eating and on physical activity.

Our government will continue to strongly support healthy living and diabetes prevention, including healthy eating, physical activity and smoking cessation. In thinking about my own health, I remember when the member for Brampton South had an opportunity to encourage some special medical testing on the Hill last year for members of Parliament, through the Juvenile Diabetes Research Foundation.

I had the opportunity to go to this mobile trailer, which provided heart rate monitoring, blood glucose level monitoring and a survey questionnaire, and members of Parliament who had a chance to participate had a deep dive into their health. The results of that were very interesting, and I learned a lot about what I could do to make myself healthier, but also how I could help my kids lead healthier lives as well. They are both far fitter than I am, and when we go jogging they are often about a minute a kilometre ahead of me, but they get me out. We also try to make sure we maintain an appropriate balance of carbohydrates, fats and proteins in our diet. I would like to thank the member for Brampton South for the opportunity to have that extra teaching here on the Hill.

According to the Canadian Chronic Disease Surveillance System, supported by the Public Health Agency of Canada, over three million Canadians, or 8.6% of the population, have diagnosed diabetes. Diabetes is a chronic disease that occurs when the body loses its ability to produce or to properly use insulin, a hormone that controls blood glucose levels.

Canada is famous for its role in the early work on determining that lack of insulin is the cause of diabetes, as well as treatments to provide insulin to people who are suffering with diabetes so they can have that cure. Canada is the perfect place to recognize November as diabetes awareness month. It is probably long overdue; it probably should have happened at the same time when the cure was found.

I am thankful for the work of the member for Brampton South. I encourage all members of this House to support this private member's motion. It would provide Canada an opportunity to yet again raise public awareness, encourage additional research and funding for diabetes, and remember family members like Jimmy Grouchey, a family member of mine who passed away just over three years ago and who would be turning 50 next week.

Diabetes Awareness MonthPrivate Members' Business

11:20 a.m.

Conservative

Peter Kent Conservative Thornhill, ON

Mr. Speaker, I rise today to speak to Motion No. 173, which seeks to declare November as diabetes awareness month.

Conservatives support the recommendation of the Standing Committee on Health that Canada implement a national strategy, like the diabetes 360° plan. The Liberals, on the other hand, have rejected the diabetes 360° plan put forward by Diabetes Canada. This is simply shameful. The Liberal government leaves the member's motion as nothing but another empty gesture. In just 10 years, this plan would have helped prevent more than one million cases of type 2 diabetes and saved Canada's health care system and economy billions of dollars.

Eleven million Canadians are currently living with or are at risk of diabetes and pre-diabetes. There are three types of diabetes: type 1, type 2 and gestational diabetes.

Type 1 diabetes is caused by an autoimmune reaction that causes the body to kill its insulin-producing cells. This variation of the disease is still not fully understood. People with type 1 diabetes produce very little or no insulin, causing an abnormal amount of glucose to accumulate in the blood. To keep glucose levels under control, people with type 1 diabetes must administer insulin daily and carefully monitor their lifestyle habits. If those with type 1 diabetes do not have access to insulin, they will die. Between 5% and 10% of people with diabetes possess the type 1 variation.

About 90% of people with diabetes have type 2 diabetes. It is most prevalent in adults, but alarmingly the incidence in children has been on the rise in recent years. Although individuals who develop type 2 diabetes are also genetically susceptible to this condition, it is largely the result of poor nutrition and a lack of physical activity, driven by environmental and socio-economic factors. Type 2 diabetes occurs when blood glucose levels increase because the body does not make enough insulin or cannot properly use the insulin that is produced. Type 2 diabetes can often be prevented by a high-quality diet and by regular physical activity. It can be treated with lifestyle measures with or without medications, including insulin.

Gestational diabetes is a temporary condition that occurs during pregnancy. It affects approximately 2% to 4% of all pregnancies in the non-indigenous population. It involves an increased risk of developing diabetes for both mother and child. Poorly managed gestational diabetes can mean serious health consequences, again for both mother and child.

Many patients take between three and 12 prescription medications and find the cost of equipment and supplies to be in excess of $15,000 a year. For those who require insulin pumps or continuous glucose monitoring, that cost runs to $15,000, in addition to the cost of medicine. Every day, more than 20 Canadians die of complications from diabetes, and 14 have lower limb amputations.

The World Health Organization has called for all countries to implement a national diabetes strategy. Despite having one of the highest diabetes rates in the world, Canada is still without a national strategy.

This motion being brought forward by the member is undercut by Liberal hypocrisy on this issue. Diabetes Canada came up with the diabetes 360° plan to achieve what the World Health Organization was calling for. That plan would have called for 90% of Canadians living in an environment that prevents diabetes; 90% would have been aware of their diabetes status; 90% would have been engaged in preventing complications from their diabetes; and 90% would have had a very strong possibility of achieving improved health outcomes.

Despite committing to support Diabetes Canada, the Liberals again came up short, and they come up short again today, showing just how out of touch they are on issues affecting the health and well-being of Canadians. Not only did the Liberals not support the diabetes 360° plan, but Diabetes Canada asked for $150 million and was left with zero dollars from the current government in budget 2019. We send billions of dollars abroad, yet we refuse to help our own people.

Another failure of the Liberal government on the diabetes file was the rejection of 80% of people living with type 2 diabetes from collecting the disability tax credit to help pay for these costs. When this first came to light, in May 2017, the government maintained that it had not changed the criteria or the process of approval. For months, it denied that anything had changed. However, evidence was finally produced that it had misrepresented the facts. The process had indeed been changed to discount the time spent preparing food. The 80% of individuals who were receiving the credit became the 80% denied.

After repeated Conservative challenges in question period, 58% were subsequently reapproved. However, 42% of them were later denied again, and without notice. The reason the Liberals were so keen to refuse people with diabetes from getting the disability tax credit was that one needs to qualify for the tax credit before one can access the disability pension. Of the folks with type 2 diabetes who were denied the DTC, many had $150,000 accumulated in their pension plan that the Liberals were attempting to claw back. This is unacceptable. The Liberals' out-of-control spending caused them to attempt to victimize the disabled. It is important to support people living with diabetes by making their lives more affordable.

While Conservatives support the proposal to make November diabetes awareness month, we know that Canadians need more than the Liberals' proposed lip service that “a month of recognition” would provide. Canadians living with diabetes need tangible solutions and plans for themselves, their families and loved ones who are suffering from the various variations of this disease. Canadians expect us to be a leader in diabetes awareness, but this will not happen through photo ops and self-congratulation; it will happen only when real solutions, like the diabetes 360° plan, are implemented.

The $150 million requested by Diabetes Canada will save $20 billion in prevention alone, with 770,000 fewer cases of type 2 diabetes, 245,000 fewer hospitalizations for diabetes and an estimated 34,000 fewer lower limb amputations because of this terrible disease. That is a real-world solution that makes common sense.

In conclusion, I believe it is time that the government step up and do what is right and fully implement the plan, as the health committee recommended. Canadians expect the current government to do better. While we will support the motion before us today, we call on the Liberal government to stand up and do the right thing for the hundreds of thousands of Canadians suffering from diabetes.

Diabetes Awareness MonthPrivate Members' Business

11:25 a.m.

NDP

Richard Cannings NDP South Okanagan—West Kootenay, BC

Mr. Speaker, I am happy to speak today to Motion No. 173 that calls on the government to declare November of each year diabetes awareness month. I will say off the top that I will be supporting this motion.

Most Canadians are unaware of the diabetes crisis facing our country. Raising awareness of this disease is not only important for the health of Canadians, it is important for the fiscal health of our medical system.

I would also like, off the top, to thank my friend Brian Symonds, who, in his retirement, has become a passionate advocate for diabetes issues and has provided me with much of the material I will speak about today.

I want to speak first about the diabetes crisis facing Canada, how we need to reduce the number of Canadians with diabetes and how we can help Canadians suffering from diabetes deal with their medical issues. In particular, I want to mention how a public pharmacare system would not only save Canadians money but save the lives of hundreds of Canadians with diabetes and other diseases who die needlessly every year because they do not have full access to the treatments for this very treatable, but deadly, disease.

As has been mentioned by others, Canada has a strong history in the world of diabetes. It is very much a good news/bad news story. We all know the story of Frederick Banting and Charles Best, who, with their colleagues James Collip and James Macleod, discovered insulin in a University of Toronto lab in 1921. That discovery revolutionized the treatment of diabetes worldwide and remains among the most celebrated medical discoveries in Canadian, or even world, history. Diabetes was formerly a death sentence for young people who developed the disease, but with insulin treatments, now they can look forward to long, normal and productive lives.

We are on the eve of the centenary of that discovery, and you would think that we would be able to celebrate that centenary with pride. Unfortunately, the scourge of diabetes is in many ways far worse than it was 100 years ago. The number of Canadians with diabetes has doubled in the last 20 years. Right now, one in three Canadians either has diabetes or has a high risk of developing it. It is an epidemic. If someone is 20 years old in Canada, the chance of developing diabetes in one's lifetime is 50%. For first nations people, that risk is 80%.

The health care costs for diabetes will top $40 billion by 2029. That is in 10 years. Thirty percent of strokes in Canada are the direct result of diabetes. It is the leading cause of blindness in Canada. Forty percent of heart attacks in Canada are a direct result of diabetes. Fifty percent of kidney failures, resulting in a lifetime of dialysis, are directly related to diabetes complications, as are 70% of foot and leg amputations.

Diabetes reduces the lifespan of people by five to 15 years. About 7,000 Canadians die each year as a direct result of diabetes. They die needlessly. We know how to cure this. We invented it. It is a highly treatable disease. A friend of mine, a young indigenous man, died in his twenties because of the complications of diabetes. This does not need to happen, so what do we have to do?

I think, first of all, as the member for Thornhill just stated, we have to listen to Diabetes Canada, the organization that promotes awareness and research on diabetes in this country. They have a well-researched, detailed plan called diabetes 360° that could dramatically reduce our rates of diabetes and reduce the significant impacts it has on the health of Canadians. It will cost money, but that investment will repay itself a hundred times over in savings to our health care system.

The goals of diabetes 360° are that 90% of Canadians live in an environment that preserves wellness and prevents the development of diabetes, 90% of Canadians are aware of their diabetes status, 90% of Canadians living with diabetes are engaged in appropriate intervention, and 90% of Canadians engaged in interventions are achieving improved health outcomes.

I want to pause here for a moment and talk about the medical nature of diabetes.

There are two main types of diabetes. Type 1 diabetes usually presents early in life. The pancreas stops producing insulin, and patients are unable to automatically manage the sugars in their system. With access to insulin and proper monitoring of blood sugar levels, patients can live normal, long, productive lives.

Type 2 diabetes usually presents later in life. It results from prolonged high blood sugar levels affecting the pancreas and suppressing the production of insulin. An individual who is overweight and has high blood pressure has an increased risk of developing type 2 diabetes. It can often be treated effectively with better diet and more exercise, but it also requires careful monitoring of blood sugar levels and access to insulin.

Let me get back to what we can do. The obvious place to attack diabetes is to prevent people from getting type 2 diabetes. We need more community programs to coach Canadians to live healthier lives, to have healthy diets and to exercise regularly.

We also need to ensure that Canadians know their diabetes status. Many Canadians have diabetes today but do not know it. They are at a high risk of developing diabetes and do not know it. Early treatment, combined with a change in lifestyle, can prevent the medical complications of diabetes and allow many patients to control the condition without relying on insulin.

For those who need medication, we need to ensure that they have free access to insulin. As the member for Thornhill said, it costs thousands of dollars a year to access insulin.

Canadians need free access to the medical monitoring devices that help them manage their condition. That could prevent 35,000 hospitalizations each year in Canada. The truth is, many people simply cannot afford the ongoing monitoring costs faced by diabetics. Their doctors ask them to monitor their blood sugar levels twice a day, but their medical plan only covers one check a day, so they do only one check a day. That results in complications, medical problems and hospitalizations. That risk could see them falling unconscious due to low blood sugar. It could result in the loss of nerve function in their feet, or even amputation. They could lose their jobs. A friend of mine was an airline pilot, one of the most prestigious jobs in this country, and he lost that job for life when he developed type 2 diabetes.

Many other countries in the world have developed programs that tackle diabetes from all angles. They have been proven to be both medically effective and cost-effective. We could save lives and money at the same time.

That brings me to the issue of pharmacare: comprehensive, universal and public pharmacare.

The Canadian Federation of Nurses Unions produced a report that found that 57% of diabetics reported failing to adhere to their prescribed therapies due to the fact that they just could not afford them.

According to the Juvenile Diabetes Research Foundation, 830 young and middle-aged diabetics in Ontario die each year because of poor access to insulin. That could dramatically change if all Canadians had access to the medicines they need, but they do not. Canada is the only country with a universal health care plan that does not include free access to prescribed medications. Ten to 20% of Canadians report not filling their prescriptions because they simply cannot afford the cost.

Canada should be proud of its history in the treatment of diabetes, with the discovery of insulin, but right now, we are at the bottom of the pack when it comes to prevention and treatment and are at the bottom when it comes to hospitalizations and needless deaths. We need to turn this trend around.

Simple awareness of the depth of the diabetes crisis is a start. I support this motion wholeheartedly, but we need real government leadership and investment in community health programs and public pharmacare to make a real difference in the health of Canadians. We need the government to listen to Diabetes Canada and to implement diabetes 360°. We can do this. We must do this.

Diabetes Awareness MonthPrivate Members' Business

11:35 a.m.

Oakville North—Burlington Ontario

Liberal

Pam Damoff LiberalParliamentary Secretary to the Minister of Health

Mr. Speaker, I am pleased to speak today to offer the government's support for Motion No. 173, brought forward by my colleague, the member for Brampton South. I would also like to commend the member for her dedicated work on this important public health issue. She has been a tireless advocate and has ensured that diabetes and the work that needs to be done remains top of mind for all of us. She introduced a motion at the Standing Committee on Health to study this issue, which resulted in a very substantial report from that committee, and now she has brought forward this motion.

Motion No. 173 would declare November of each year diabetes awareness month. This would be another example of Canada showing leadership in helping those with diabetes. This is leadership that dates back to the discovery of insulin almost 100 years ago by Dr. Frederick Banting, from my home town of London, Ontario, and Dr. Charles Best.

Support for Motion No. 173 would also complement the recognition of November 14 as World Diabetes Awareness Day, which already takes place in Canada. A diabetes awareness month would create more awareness and understanding among all Canadians about this disease, what it is, how is can be prevented and how it can be managed.

Diabetes is a serious chronic disease that can hamper a person's ability to fully participate in the economic and social life of Canada. If left uncontrolled, all three forms of diabetes can lead to serious complications, and for some, premature death.

There are three types of diabetes. Type 1 is not preventable. Gestational diabetes, which occurs in pregnant women, usually disappears after delivery, although it does lead to an increased risk of developing diabetes later in life.

Close to 90% of diabetes cases in Canada are type 2, which is preventable. It is why a diabetes awareness month could have a great impact from an awareness and education perspective. Through greater awareness, we could help stop type 2 in its tracks. This would include drawing greater attention to how Canadians can address the risk factors for diabetes, including physical activity, unhealthy eating, tobacco use and harmful use of alcohol.

It is important to recognize that it can be challenging for some to address these risk factors for diabetes. They are often tied to issues such as income, education and the social and physical environments in which a person lives. These issues can result in a person having more difficulty accessing and affording healthy foods or undertaking regular physical activity.

The government support for Motion No. 173 aligns with recommendations from Diabetes Canada's diabetes 360° plan to promote healthier environments. It also complements this recommendation put forth by my colleagues on the Standing Committee on Health:

explore options to improve public awareness and education on diabetes, particularly through community programming, including public awareness of the relationship between nutrition and diabetes

Over three million Canadians, or 8.6% of the population, have diagnosed diabetes. Some population groups have higher rates of diabetes than others, including men, first nations and Métis people, people of African and South Asian descent and people with lower income and education levels.

Healthy eating has a significant impact on the health of Canadians and on the health care system. It contributes to obesity and to the onset of chronic diseases like diabetes.

Also challenging is that Canada's food environment can make it difficult for some Canadians to make healthy eating the easy choice. Less than half our teenagers report eating enough fruits and vegetables. First nations children living off reserve and Inuit and Métis children experience higher levels of food insecurity than non-indigenous children. Preliminary studies are also starting to show that the risk of Inuit developing type 2 diabetes has increased significantly in recent years.

The Government of Canada has been taking action through our healthy eating strategy. Led by Health Canada, the government has strengthened nutrition labelling on food products and has eliminated industrial-produced trans fats in foods.

The launch of the new Canada food guide, which is based on scientific evidence and facts, not only proposes a wide range of nutritious foods for Canadians but emphasises that healthy eating is more than just the foods one eats. It promotes lifelong healthy eating habits by encouraging people to prepare healthy foods at home and to eat together and it offers creative resources to help Canadians do so.

The government is also investing in promising community-based partnerships through the Public Health Agency of Canada's program called promoting healthy living and preventing chronic disease through the multi-sectoral partnerships. Funding delivered through this program has leveraged additional investment from non-taxpayer resources, which has enabled the government to increase the reach and impact of its funding. Funded projects, such as farm to school: Canada digs in; kid food nation; and APPLE schools are helping Canadian youth and children to eat better by building their food literacy skills and to have fun while learning.

The government is also investing in FoodFit, which provides low-income adults with hands-on food skills, tips for preparing affordable and nutritious meals, group physical activity and goal-setting to help participants eat well and lead healthier lifestyles.

Finally, our food policy for Canada sets out a vision that will help Canadians and the communities in which they live access food that is healthy, affordable, culturally appropriate and locally produced. This includes support for food security in northern and indigenous communities and support to reduce food waste.

Diabetes awareness month would also be an excellent opportunity to promote and reinforce efforts to get Canadians to move more and sit less. While Canadian adults report being more active now than in the previous decade, we know Canadians still are not getting enough physical activity. Only 18% of Canadian adults are meeting the 150 minutes of moderate to vigorous physical activity guideline per week, or the equivalent to biking for a little over 20 minutes a day. As well, only 40% of children and youth are meeting their recommended 60 minutes of moderate to vigorous physical activity per day. Of them, girls are less active than boys.

The government recognizes that we cannot solve the issue of getting Canadians more physically active alone. In June 2018, the government joined the provinces and territories in releasing a report entitled “A Common Vision for Increasing Physical Activity and Reducing Sedentary Living in Canada: Let's Get Moving”. Federal, provincial and territorial governments and a wide range of organizations and partners worked together to develop this policy framework. The common vision is catalyzing efforts across Canada at national, provincial, territorial and local levels to put in place actions to help Canadians get more physically active.

Through budget 2018, $25 million over five years is being invested to support Participaction to increase participation in daily physical activity among Canadians through the Let's Get Moving initiative. Participaction is working with governments, communities and organizations from other sectors to change social norms through long-term and coordinated public education and engagement to increase physical activity. I recently participated in the community better challenge, run by Participaction, to identify Canada's most physically active community.

Another project funded through this program, which will help get Canadian girls moving more, is FitSpirit Healthy Lifestyles for Teen Girls. This eight to-10-week training program for girls empowers them to adopt healthy lifestyle habits and to celebrate the completion of the program by collectively completing a five-kilometre running challenge.

In her 2017 report, entitled “Designing Healthy Living”, the chief public health officer of Canada highlighted that how we design and build where we live, work, study and play is key to improving physical and mental health for all.

With this objective in mind, the Public Health Agency of Canada has invested in projects such as Housing for Health. Housing for Health will combine improvements to neighbourhoods in cities with health promotion programming and encourage community engagement to increase physical activity, healthy eating and social interaction among residents in their communities. This project is an excellent example of how partners from diverse sectors can work together to encourage active and healthy living.

In closing, the government believes that recognizing diabetes awareness month would benefit all Canadians. It would help to increase awareness about this chronic disease, which can help reduce the stigma attached to those living with it.

I would like to again thank the member for Brampton South for sponsoring the motion in the House, and I am thankful for the opportunity to show the government's support for it today.

Diabetes Awareness MonthPrivate Members' Business

11:45 a.m.

Liberal

Eva Nassif Liberal Vimy, QC

Mr. Speaker, I am pleased to rise today for the last time in the 42nd Parliament of Canada to speak to Motion No. 173, which was moved by my hon. colleague from Brampton South. The motion says that November should be diabetes awareness month. I would like to congratulate my colleague on her work.

Although Canada has always promoted health care and health care developments and worked hard to improve Canadians' health—which we are all proud of—there is still a lot of work to do. Diabetes is a chronic disease resulting from an individual's inability to produce enough insulin or use it properly. There is no known cure.

The two most common types of diabetes are type 1, which requires daily insulin injections, and type 2, which can be managed with proper diet, exercise and medication.

According to the International Diabetes Federation, 425 milion people around the world have diabetes. It is a veritable pandemic, as the incidence of the disease is increasing considerably. The World Health Organization estimates that 622 million people will have diabetes by 2040. In 2015, diabetes caused five million deaths worldwide. Furthermore, diabetes kills one person every six seconds globally, which is more than AIDS, tuberculosis and malaria.

The Public Health Agency of Canada has put out the following statistics: every eight minutes, someone in Canada is diagnosed with diabetes; one in four Canadians lives with diabetes or prediabetes; and 200,000 new cases are diagnosed every year. What is even more frightening about these statistics is the fact that diabetes can lead to other health-related complications including cardiovascular disease, kidney failure, nerve damage, vision loss and depression. These are all conditions that present challenges for those living with diabetes as well as their families, their communities and our health care system. On top of that, most Canadians who have diabetes have no idea they have it.

It is also important to note that Canada has the highest prevalence of diabetes in the world for reasons that are yet unknown. If current trends hold, one in three Canadians will have diabetes by 2020. Given the growing concern about health in Canada and my many years of experience working as a nurse, I share the hon. member's vision and understand the importance of having a diabetes awareness month. This month will have a significant impact. It will help in detecting the first signs of diabetes, preventing its onset for millions of Canadians and, most importantly, it will reaffirm Canada's commitment to fighting the prevalence of this increasingly common disease.

Canada has always been a leader in the fight against diabetes. However, despite our efforts, strategies and policies, the quality of data on diabetes monitoring in Canada clearly show that more effective approaches are essential and needed, now more than ever. The prevalence of diabetes has increased considerably over the past decade, which further increases the threat of this chronic disease.

At a time when rapid strides are being made in science, medicine and health care, Canada has the financial, scientific and technological resources to fund and develop new strategies and carry out research that will lead to groundbreaking discoveries. We have the means to make more of those discoveries.

I strongly believe that one of the key strategies for fighting this disease is prevention through education. In other words, we need to invest more in raising awareness of how serious this disease is and how it is linked to unhealthy lifestyles, reflecting strong support for government measures. This would stop diabetes from spreading further in Canada.

The president of the International Diabetes Federation, Professor Nam Cho, says that the most economical, effective and efficient way to solve diabetes-related problems, from prevention to intervention, morbidity and mortality, is through education.

That is exactly what creating a diabetes awareness month would do. It would be a great way to continue the discussion and would provide a tool for educating Canadians, promoting awareness, helping diabetics manage their own condition effectively and highlighting the message that every person with diabetes deserves the best information and the best care.

As a former nurse, I know how powerful health education can be, and I strongly believe that raising awareness of diabetes, enhancing education and improving knowledge on how to control and treat it will minimize the risk of complications. That will reduce morbidity and mortality among diabetics.

Secondly, establishing a diabetes awareness month would not just help Canadians; it would help us as well. It would enable the federal government to give more thought to the areas where increased efforts are required and to identify sectors for which we could provide more effective programs and policies.

Establishing a diabetes awareness month would encourage all levels of government to work together to ensure that Canadians get the care they need and can enjoy a better quality of life because of what we have done. That is why the following message regarding Motion No. 173 is so important: in partnership with private sector organizations, non-profits and other levels of government, we are testing and broadening the scope of the measures being taken in communities across the country to prevent chronic illnesses, including diabetes.

Listening to communities and working with other levels of government, partners and stakeholders will result in improved information and data quality as well as relevant and accessible programs. This will ultimately improve the health of all Canadians.

Diabetes is a disease that can affect anyone, and I am very concerned that some 44% of Canadians with diabetes do not even realize they have it. This chronic disease can cause alarming symptoms, which vary from person to person and should never be ignored. Symptoms include anxiety, confusion, concentration problems and visual field anomalies.

It is nevertheless important to recognize that although diabetes is incurable, it is treatable. We will save lives by educating Canadians about diabetes, disease prevention and healthy lifestyle choices and by providing further education on the symptoms and long-term complications of diabetes.

In closing, I want to express my strong support for this motion, because I know that promoting a diabetes awareness month will have a significant impact and will help us improve the lives and health of many Canadians.

Diabetes Awareness MonthPrivate Members' Business

11:55 a.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

Resuming debate. Accordingly, I invite the hon. member for Brampton South for her right of reply. The hon. member has up to five minutes.

Diabetes Awareness MonthPrivate Members' Business

11:55 a.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

Mr. Speaker, I would first like to thank the member from St. John's East for the support he has provided for this important motion, Motion No. 173. He is also a great advocate for this issue.

When I introduced Motion No. 173 to make November of every year diabetes awareness month, my goal was to raise national awareness of this disease and its complications as an important first step leading to its prevention and elimination.

I want to thank my hon. colleagues in the House for their support on this issue which affects so many Canadians. The numbers are staggering and I am saddened every time I repeat them, but it is important to summarize them.

Over 11 million Canadians live with diabetes or prediabetes, a new case is diagnosed every three minutes and 90% of these cases are type 2, which means it can be prevented through better awareness, education and lifestyle changes.

I know this first-hand from my many years as a health care professional before I got into politics in my hometown of Brampton, Ontario; from the many experts I have heard from in Parliament, serving on the Standing Committee on Health; and as a chair of the all-party diabetes caucus.

Diabetes is the cause of 30% of strokes, 40% of heart attacks, 50% of kidney failure requiring dialysis and 70% of non-traumatic lower-limb amputations. This is the harsh reality. In the Peel region alone, the rate of diabetes more than doubled between 1996 and 2015.

The general public remains unaware that elevated levels of blood glucose are associated with long-term damage to the body and the failure of various organs and tissues. Diabetes can result in short-term and long-term complications, many of which, if not prevented and left untreated, can be fatal. All have the potential to reduce the quality of life of people with diabetes and their families. This condition has a number of long-term complications that have serious consequences.

It is very possible to control certain risk factors for type 2 diabetes, including making healthy lifestyle choices like eating well, exercising and reaching and maintaining a healthy weight. For individuals with prediabetes, medication can also help prevent the development of type 2 diabetes and avoid long-term complications.

Maintaining a healthy lifestyle and a healthy weight, together with medication to control blood sugar levels and vascular risk factors, are common cornerstones of diabetes management. It is possible to reduce human suffering from this disease, such as amputation through prevention, aggressive management of existing diabetes and the provision of the right education for people with diabetes and health care professionals.

Diabetes awareness month in November would serve as an important reminder of the increasing national incidence of diabetes and the significant human, social and economic costs of billions of dollars that it brings. It would be a time to alert Canadians to the fact that diabetes is a serious condition that is presently underestimated with respect to its frequency, cost and impact on quality of life. That is why I am proposing Motion No. 173 to make November of every year diabetes awareness month.

In recent years, the OECD has ranked Canada 15th out of 17 peer countries on diabetes mortality. We can and must do better.

I have had the chance to visit Banting House, the former home of the great Canadian physician and researcher Sir Frederick Banting, whose discovery of insulin was a game-changer in the treatment of diabetes for patients in Canada and around the world. Outside of Banting House, there is a flame that burns in recognition of the ongoing challenges that face each one of us. Until this disease is defeated, the flame will not be extinguished.

I know this is possible only if we work together in a non-partisan manner. I respectfully ask each and every one of my hon. colleagues from all parties to support Motion No. 173 to help defeat diabetes through awareness.

Diabetes Awareness MonthPrivate Members' Business

Noon

Conservative

The Deputy Speaker Conservative Bruce Stanton

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

Diabetes Awareness MonthPrivate Members' Business

Noon

Some hon. members

Agreed.

No.

Diabetes Awareness MonthPrivate Members' Business

Noon

Conservative

The Deputy Speaker Conservative Bruce Stanton

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

Diabetes Awareness MonthPrivate Members' Business

Noon

Some hon. members

Yea.

Diabetes Awareness MonthPrivate Members' Business

Noon

Conservative

The Deputy Speaker Conservative Bruce Stanton

All those opposed will please say nay.

Diabetes Awareness MonthPrivate Members' Business

Noon

Some hon. members

Nay.

Diabetes Awareness MonthPrivate Members' Business

Noon

Conservative

The Deputy Speaker Conservative Bruce Stanton

In my opinion the yeas have it.

And five or more members having risen:

Pursuant to an order made on Tuesday, May 28 the recorded division stands deferred until Wednesday, June 19, at the expiry of the time provided for oral questions.

Bill C-83—Time Allocation MotionCorrections and Conditional Release ActGovernment Orders

Noon

Waterloo Ontario

Liberal

Bardish Chagger LiberalLeader of the Government in the House of Commons

moved:

That, in relation to Bill C-83, An Act to amend the Corrections and Conditional Release Act and another Act, not more than five further hours shall be allotted to the consideration of the Senate amendments stage of the said bill; and

That, at the expiry of the five hours provided for the consideration of the Senate amendments to the said bill, any proceedings before the House shall be interrupted, if required for the purpose of this Order, and in turn, every question necessary for the disposal of the said stage of the bill shall be put forthwith and successively, without further debate or amendment.

Bill C-83—Time Allocation MotionCorrections and Conditional Release ActGovernment Orders

12:05 p.m.

Conservative

The Deputy Speaker Conservative Bruce Stanton

Pursuant to Standing Order 67.1, there will be a 30-minute question period. I ask hon. members who wish to participate in the 30 minutes to rise to get an indication of how many want to speak.

As is the usual case, I ask hon. members to keep their interventions to approximately one minute. That will allow all members who wish to speak the opportunity to do so. Members can be recognized more than once. I remind hon. members that most of the question time in the 30 minutes is reserved for opposition members. However, members from the government side are certainly welcome to participate as well.

We will begin now with questions. The hon. member for Kamloops—Thompson—Cariboo.

Bill C-83—Time Allocation MotionCorrections and Conditional Release ActGovernment Orders

12:05 p.m.

Conservative

Cathy McLeod Conservative Kamloops—Thompson—Cariboo, BC

Mr. Speaker, in 2015, the government said that it would do things differently, that it would respect Parliament and would move away from motions that did not allow appropriate time for debate.

I want to point out something very unique and interesting about this bill. It took you, Mr. Speaker, approximately 11 minutes to read the amendments to the bill. Within four minutes of debate, the government gave notice of a motion of closure. Not many speakers had the opportunity to debate the bill before that.

How is this consistent with the promises the minister made in 2015 to do things differently?

Bill C-83—Time Allocation MotionCorrections and Conditional Release ActGovernment Orders

12:05 p.m.

Regina—Wascana Saskatchewan

Liberal

Ralph Goodale LiberalMinister of Public Safety and Emergency Preparedness

Mr. Speaker, we have arrived at the stage of debate where there is now an opportunity for the House to respond to the work that was done in relation to this legislation by the Senate. In other words, the bill has had a thorough debate in the House. It has passed through all the stages in the House. It has had extensive committee hearings. It has gone to the Senate and has been reviewed there. The Senate has considered the legislation, made a number of amendments and sent the bill back to the House with those amendments.

The point is that this is a very advanced stage of debate. We are not beginning with the bill in its raw form; we are beginning with the bill at a very advanced stage. Therefore, members have had extensive opportunity to debate, consider and in fact make amendments.

The point of contention between the House and the Senate is the independent review process that was crafted by the House. Therefore, we are defending the position that was taken by the House on the very important question of how there could be proper review and oversight of the correctional system.

Bill C-83—Time Allocation MotionCorrections and Conditional Release ActGovernment Orders

12:05 p.m.

NDP

Peter Julian NDP New Westminster—Burnaby, BC

Mr. Speaker, I am so saddened, as I think most Canadians are, that every day the Liberals continue to repudiate all the commitments they made back in 2015 to work with members of the House of Commons, to stop omnibus legislation and to stop the abuse of the use of closure.

As the House knows, the government has gone far beyond the previous government's abuse of closure by bringing in a new “gag” closure that allows only 20 minutes of discussion after it is moved and only one member of the government gets to speak. Members of the opposition do not get to ask questions, make comments or anything of that nature. It shows how toxic the government has become with respect to trying to move legislation through the House and get it improved so the legislation does what it purports to do.

In the case of Bill C-83, the NDP offered dozens of amendments, because the bill has been largely criticized by the Elizabeth Fry Societies and many other intervenors. We brought forward the witness testimony and said it would improve the bill. The government refused all of that.

Is that not the reason why the government is ramming it through today, because it is a controversial bill that has been much criticized and the government refused to listen to all the witnesses and members of the opposition who tried to make improvements?

Bill C-83—Time Allocation MotionCorrections and Conditional Release ActGovernment Orders

12:10 p.m.

Liberal

Ralph Goodale Liberal Regina—Wascana, SK

Mr. Speaker, with the greatest respect, I have to disagree with the hon. gentleman.

First, he was critical of omnibus legislation. This is not omnibus legislation. It is legislation pertaining specifically to the correctional service and is focused upon one piece of legislation, not a number of different bills.

Second, he was concerned about what he called a “gag” order or the closure procedure. This is not a closure procedure. This is time allocation, which is qualitatively different from what he was criticizing.

Third, I would point out that amendments to the legislation have been welcomed and accepted from all parties in the House and indeed by the Senate as well.

Therefore, this is not a peremptory approach. There has been a huge amount of debate and a lot of input. That input has been weighed very carefully and a great deal of it has been accepted.

Bill C-83—Time Allocation MotionCorrections and Conditional Release ActGovernment Orders

12:10 p.m.

Conservative

Arnold Viersen Conservative Peace River—Westlock, AB

Mr. Speaker, this morning proves that the Liberals will do anything and say anything to get elected. In the last election, they promised they were not going to use closure motions as often as we had in the last parliament. They are also saying that they are not going to raise taxes after the next election, even though their spending is way out of control.

There has only been four minutes of debate on this bill prior to this closure motion being moved. Does the minister think that is appropriate?

Bill C-83—Time Allocation MotionCorrections and Conditional Release ActGovernment Orders

12:10 p.m.

Liberal

Ralph Goodale Liberal Regina—Wascana, SK

Mr. Speaker, there have been many hours and days of debate in consideration of the legislation through all the stages in the House of Commons and in the Senate. We are now at the point of responding to the Senate's recommendations. It is not as if the debate was just beginning today or four minutes ago. In fact, the motion that was moved by the House leader provided for five more hours of debate on the specific question of how the House would respond to the recommendations made by the Senate.

This is not a closure motion, it is time allocation and it follows the full length of parliamentary procedure through both the House of Commons and the Senate, where many worthy suggestions have been made, a lot of very well-informed debate has taken place and many amendments have been accepted. We are now into the final stages of that discussion where it is appropriate for the House to take a decision and to vote.

Bill C-83—Time Allocation MotionCorrections and Conditional Release ActGovernment Orders

12:10 p.m.

Winnipeg North Manitoba

Liberal

Kevin Lamoureux LiberalParliamentary Secretary to the Leader of the Government in the House of Commons

Mr. Speaker, there seems to be a great deal of concern in regard to the process of things. We have seen member after member stand up on a wide variety of pieces of legislation. Even when I was in opposition, at times we need to use this tool in order to advance legislation. We could see opposition members debating things indefinitely, unless either the tool of time allocation is used or the opposition is prepared to allow the debate to come to an end.

I wonder if my colleague can provide his thoughts on the matter that time allocation is a tool that is necessary at times, that we have seen New Democrats and Conservatives support time allocation, and that this is not outside the norm.