Debates of May 10th, 2024

Government Business No. 39—Proceedings on Bill C-64

[Mark Holland, Liberal, Minister of Health]

moved:

That, notwithstanding any standing order, special order, or usual practice of the House, Bill C-64, An Act respecting pharmacare, shall be disposed of as follows:

(a) during the consideration of the bill by the Standing Committee on Health,

(i) the committee shall have the first priority for the use of House resources for the committee meetings,

(ii) the committee shall meet between 3:30 p.m. and 8:30 p.m. on the two further sitting days following the adoption of this order to gather evidence from witnesses, provided that any meeting on a Friday may start at 12:00 p.m. for a duration of not more than five hours,

(iii) all amendments be submitted to the clerk of the committee by 4:00 p.m. on the second sitting day following the adoption of this order,

(iv) amendments filed by independent members shall be deemed to have been proposed during the clause-by-clause consideration of the bill,

(v) the committee shall meet at 3:30 p.m., on the third sitting day following the adoption of this order to consider the bill at clause-by-clause, or 12:00 p.m. if on a Friday, and if the committee has not completed the clause-by-clause consideration of the bill by 8:30 p.m., or 5:00 p.m. if on a Friday, all remaining amendments submitted to the committee shall be deemed moved, the Chair shall put the question, forthwith and successively without further debate on all remaining clauses, amendments submitted to the committee as well as each and every question necessary to dispose of the clause-by-clause consideration of the bill, and the committee shall not adjourn the meeting until it has disposed of the bill,

(vi) a member of the committee may report the bill to the House by depositing it with the Clerk of the House, who shall notify the House leaders of the recognized parties and independent members, and if the House stands adjourned, the report shall be deemed to have been duly presented to the House during the previous sitting for the purpose of Standing Order 76.1(1);

(b) not more than five hours shall be allotted to the consideration of the bill at report stage, and at the expiry of the time provided for the consideration of the said stage of the bill, or when no member rises to speak, whichever is earlier, any proceedings before the House shall be interrupted, 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, and, if a recorded division is requested, the vote shall not be deferred; and

(c) not more than one sitting day shall be allotted to the consideration of the bill at the third reading stage, and 15 minutes before the expiry of the time provided for Government Orders that day, or when no member rises to speak, whichever is earlier, any proceedings before the House shall be interrupted, 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, and, if a recorded division is requested, the vote shall not be deferred. (Government Business No. 39)

Madam Speaker, it is my pleasure to rise to talk about Bill C-64, which is an opportunity for us to move forward with pharmacare in this country. In the first order, the bill represents the best of what Canadians should expect from the House, which is different parties working together to find common ground and solutions.

I will start by thanking the member for Vancouver Kingsway for his work in what were often challenging conversations and negotiations, but which led to an exceptionally important bill that is going to do incredible good across the country. As well, I want to thank the member for New Westminster—Burnaby, the House leader for the New Democratic Party, for his work as House leader and now as health critic. In all orders, when we are facing something as challenging as the protection of our public health system and making sure Canadians get the care they require, working in a non-partisan way to drive results is exceptionally important.

I will speak to what is at stake, say a bit about what we have been doing in health and then talk specifically to the legislation that is in front of us today.

It was a stark day for me yesterday because I had two very different kinds of conversations. One conversation was with somebody who was saying, in a roundabout way, that maybe it would not be so bad if our public health care system became private. It is important to focus on what that would mean for this country and why it is something that we should all be adamantly opposed to.

If we allow our system to become a private health care system, there would be a migration of dollars toward a private system and expertise, in which the private sector would take that which was easy and lucrative and leave that which was difficult or involved folks who did not have the means to be able to pay for those services. This would leave less money in a public system that would be dealing with the most expensive problems and the most intractable issues. Over time, we would then see more and more migration of that which was easier into the private system, which would mean that people who do not have the means could not afford the same kind of care.

In a very practical sense, that ends up in the following type of situation: I had an opportunity to be in the United States with my partner for a weekend, and we witnessed a man collapse. It was clearly a person with not a lot of means. He fell unconscious to the ground. We went to his side and called 911. When he became conscious, his first thought was not about his health or worrying about what had just happened to his physical body; his concern was how he was going to be able to afford what just happened to him. I thought about the phone call I made to 911 and whether this was what this man even wanted, because now he has to think of exorbitant health costs to get the care he needs.

Even those who do not fundamentally care about whether their fellow citizens, regardless of their financial circumstances, get the same level of care as everybody else in the country, even if we cannot compel people's morality to care about the circumstance of whether somebody in their own community gets the same level of medical care that they do, the reality is that when somebody does not go to a hospital to get checked for something that is minor, because they do not have money, then it becomes something major. We are then left with the existential question, when that person becomes so sick that they are on death's door, of whether we just let them die or whether we pay the exorbitant costs that we have allowed to accumulate through not having a system that took care of those problems in the first place.

For the prognosticators of doom about our health system, for those who push the idea that we should just allow it to deteriorate and not make the investments or say that it is too difficult, they have to be honest about the future they are painting for Canadians in this country and the type of health care system that they would be left with. It is one where only the affluent have the opportunity to get the care they need. We can imagine a world where nurses cannot afford the care and services they require, but the affluent they are serving do. I do not think that is a society we want to be in.

That is why the investments we are making in health care are so critically important. The federal government has come to the table with nearly $200 billion to invest in partnership with provincial and territorial governments over the next 10 years. In the same spirit as the legislation, the question was not asked about one's partisanship or one's jurisdiction, because I do not think Canadians are interested. They want to see answers and forward progress.

I really want to commend the health ministers across the country because, over the last 10 months, as I had an opportunity to work with them to negotiate the agreements we signed, it was a spirit of co-operation and putting the health of Canadians first. It does not matter whether it was Adriana LaGrange in Alberta, Tom Osborne in Newfoundland and Labrador, a Conservative and a Liberal, or Adrian Dix, a New Democratic health minister in B.C.; they understand we have an important job to do and that we need to focus on what unites us and how we make things better.

The results were incredibly detailed health agreements that not only put money into the system but also showed exactly how that federal money is going to be spent. Thus, Canadians can view where those dollars are going to go to improve their health system and issues such as the health workforce, where we make sure that we have the doctors and nurses Canadians need and that everybody has a relationship with a doctor in this country. In addition, this enables us to put common indicators across the country so people can see the progress their province is making.

We know what is measured is achieved, and for the first time in our health system, these agreements put common indicators across the country so we can see the progress occurring in our health system and see what those investments are doing on key indicators identified by CIHI, which is an independent agency dealing with health data.

However, in dealing with the urgency of the now, let us recognize that our health system has been enormously strained. Throughout one of the darkest periods in public health that, certainly, we have known in our lifetime, health care workers were asked to do Herculean amounts of work. They were asked to rise to an occasion and do more than I think any reasonable person could be expected to do, but they met that hour and did it. As in health systems all over the world, instead of being met with a break, they were met with even more work, with burnout, with all kinds of mental fatigue and mental health issues as a result of the pandemic, with a backlog of procedures and with a health system that was even more overwhelmed.

What was remarkable about that period of time, going back to the spirit of co-operation, is that we made extraordinary progress. This was when the health system was fully aligned in the darkest moments of the pandemic, everybody was given more agency to practise at top of scope, jurisdiction was of distant consideration and people's immediate urgent health needs were first. We are dealing with that, with these workforce agreements and the work we are doing bilaterally with provinces and territories, but it is not enough to deal with the crisis of now. We have already made such huge progress. On where we were a year ago versus where we are now, that progress is evident through our whole system, but we recognize we also have to be upstream.

That brings me to another conversation that I had yesterday. I had the opportunity to be with the member for Ottawa—Vanier at a denture clinic in Vanier. Here is another example of parliamentary co-operation, where two parties came together and recognized an essential need in this country, which is that some nine million Canadians do not have access to oral health care.

We have now seen more than 30,000 seniors, just in the first few days of this dental program, receive care for the first time. I have been able to see what that means, in many instances by going into clinics. I will talk about what I saw in that denture clinic in Vanier. A denturist was talking about a senior who had not had their dentures replaced in 40 years; they did not have the money. This senior had no teeth and used a black apparatus to crush food in their mouth. One can imagine the dignity and the spiritual change in that person when they came in and realized that, after 40 years, they were finally going to get teeth in their mouth. The denturist being able to describe that moment, the pride they had in being able to deliver that service and give that senior that dignity, was absolutely extraordinary.

I had an opportunity in my own riding, just a few days before that, in Ajax, to meet with a senior. I never had a chance to meet him before. His name is Wayne. He sometimes goes by “Moose”. He was talking about himself and his wife. He had a need for partial dentures, and he had other oral health problems, as did his wife, which they had been putting off. In terms of what it meant to him to feel seen and to be able to get those issues taken care of, the truth is that we know it is not just a matter of dignity. It is not just a question of what kind of country we want to live in. What about the cost?

I think of Wayne and his inability to pay for the medical care that he needed for oral health care. Left untreated, Wayne could very well end up in a hospital room with an unnecessary surgical procedure, placing his life at risk. Imagine the staggering cost of that.

Dental care is not about some kind of boutique political intervention. It is fundamentally about making sure that people get the preventative care they need. It is part of the overall action that we are taking as a government, not only dealing with the crisis of the now, but also casting our eyes into the future and asking how we can work together.

Clearly the Bloc Québécois members have concerns about the jurisdiction issue, which I completely understand. It is a concern for me too. However, in my opinion, this is not a question of jurisdiction. It is actually a question of co-operation. There was one question that dominated my conversations with Quebec's health minister, Christian Dubé: How can the Government of Canada and the Province of Quebec work together to improve our health care system?

There are plenty of opportunities for us to work together in a spirit of co-operation to improve our health care system. It is easy to pick quarrels, point out differences and raise the issue of jurisdiction. However, I believe that for Quebeckers, what really matters is their health and government action.

Dental care is a great example of that. In Quebec, the Minister of Heritage has done extraordinary work in her riding. Almost all the providers in her riding have signed up, meeting a lot of that misinformation that was coming from the Conservatives with true facts. The experiences of those providers have been extraordinary. That is an example of us working together.

I said to Minister Dubé in Quebec that if they want to administer the program, it is no problem. Our care is about the patients, not about the jurisdiction. Our only requirements, if a one wants to take it over, is that one has to have at least the same level of care, number one, and number two, we are not going to give more to administer the program than it costs us to administer it. If it costs one more, that is something one has to bear on one's shoulders or look internally at how one is operating one's system.

That is an example of making sure that we get the care now and that we fix the question of jurisdiction later. For somebody who has a dental emergency, for a senior who does not have teeth in their mouth, they do not care about jurisdiction. They care about care and about getting it done. That is what we are focused on.

Before I come to pharmacare, one of the other things we are doing is about school food. When I was at Heart and Stroke, I had the opportunity to lead the Ontario mission and to be the national director of children and youth. One thing that was shocking to me was that when a child has one healthy meal, it can totally change their health outcomes. It does it for a couple of reasons. First, just the act of eating fruits and vegetables and healthy food has a transformative effect on health and prevents chronic disease and illness. Second, how does one learn if one is hungry? Third, one actually gets to develop a taste for healthy food that lasts one's entire life. Therefore, this is an extraordinary investment that is going to make a massive difference.

We are also taking action on marketing to kids with front-of-pack labelling and taking action with the $500-million fund to develop capacity for mental health services on the ground in communities across the country. I could go on and on, but I only have a short period of time to talk about the thing that we are here to talk about. I see the member for Vancouver Kingsway, and I want to thank him for this.

When we talk about contraceptives, it is incredibly frustrating to me that, over the last number of days, we have seen a march and a protest here to try to take away women's rights and take away their right to choose. We have seen over 80 Conservative members, I believe is the number, who have been endorsed because of their belief that they should take away a woman's right to choose, and that is fine. I am pro-choice, and there are members who are not.

However, what I do not understand is if someone is against a woman's right to make a choice about her own body, how can they also be against giving her contraception? What choice is she left with? Let us look at that very specifically. If a woman today is in need of contraception and does not have the money for it, what are they supposed to do? Maybe they can find the money for oral contraception, but it has a failure rate of 9%. An IUD has a failure rate of 0.2%, but it costs $500 up front. For the women who do not have the money to pay for it up front, they are left with a less effective tool to be able to have control over their sexual and reproductive health.

How, in the one order, can we say to a woman that they are not allowed to choose or make a choice for their body, but in the other order, say that we are not going to help them get contraception to be able to make a choice about their body that way either? In other words, they get no choice. What conversation is being had about sexual health? If someone is against giving contraception to women and against them having a choice over their body, then they would at least talk about sexual health.

For women, it is extremely important to know that their body is something that they should always have autonomy over. Sex is something that should feel empowering and should make them feel like themselves. It is something they should never be coerced or pressured into. It is something that they should never feel ashamed of. It is something that should feel pleasurable.

[Some hon. members]

Oh, oh!

[Mark Holland, Liberal, Ajax, ON]

There are members laughing.

Madam Speaker, imagine that? As health minister, I cannot talk about whether or not sex is pleasurable. Do members? Do members know how much sex people have in this country?

[Some hon. members]

Oh, oh!

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, they are laughing again, and that is so juvenile.

Guess what: In this country, or in any country, people have sex. How often does that result in a baby? Less than 0.1% of the time. Most of the sex people are going to have in their lives is for pleasure. Why is it important to be able to say that sex is pleasurable? The reason is when someone thinks that their body is there to serve somebody else, rather than to serve themselves and their pleasure, then they are going to be more likely to accept abuse, more likely to accept manipulation and more likely to be hurt.

I will say this lesson hit home for me very hard in my life when I was young. In my life, I was faced with deep sexual violence that happened when I was a kid. My family did not talk about sex. The result of that was me being afraid of my sexuality and of sex, and linking sexual violence to somehow being part of sex. I did not understand what sex was, and I was deeply confused. That is something that caused me an enormous amount of damage.

We know that sexual identity issues are a leading cause for teen suicide. Many young people struggle with many questions: What do I do? Do I please this person? Do I please myself? Is it okay to please myself? What do I want? It is okay to be ourselves, and we need to be able to say that in this country. It is okay to have autonomy over one's body.

Again, I will ask the question: If someone is against contraception and against choice, in terms of abortion, then how come one cannot talk about female sexuality? Is it because they do not want women to have any choice at all? That is an important question.

Therefore, making sure that women have access to the contraceptive medicine they need is absolutely essential to women having autonomy and control over their own bodies. It is, frankly, about making sure that they are not used, manipulated or have a negative experience with that.

Lastly, I will talk briefly, because I know I am pretty much out of time, about diabetes. Diabetes medication is so essential because if diabetes patients do not have access to the medication they need, and far too many Canadians do not have the dollars for their medicine, it means they are going to be much more likely to experience heart disease, kidney failure, blindness or limb amputation. It is yet another example, like contraception, where the money we would to spend to make sure that people get medication would actually save the health system more than it costs by avoiding all kinds of disastrous health outcomes. It is not just a matter of social justice or preventative health, but in this instance, it would bring huge savings to our health system.

Why are Conservatives against it? They say that it is fantasy. Then, let me try to negotiate it. When I talk to the provincial health ministers across the country, they are ready to act. If Conservatives are against it because they think the system is too expensive, then what is their alternative? How would people get their medication? They do not say that. If it is just that they are against the idea that people should get the medicine they need, then they should have the honesty to say that is their reason. Then, we can have a debate about the merits of the type of country we live in and whether or not those medications are available for the people who need them.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, I listened attentively to the health minister's speech. He talked about, at one point, finding common ground and finding solutions. He recited every single anecdote in this speech that he did in his second reading speech on the bill.

This bill, Bill C-64, only got three days of debate in the House, and it was then sent to committee. Now, we have a programming motion, so it is a guillotine or gag order attempting to be imposed on the House of Commons to order a committee of the House to dispense with the bill after something like 10 hours of consideration at committee. If we are talking about finding common ground and finding solutions, then we should allow the House and its committees to do their work instead of ramming things through.

I wonder if the minister could explain why, in the programming motion, he is not obliged to testify before the committee.

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, in the first order, it is hard to take the call for more debate seriously when you are 100% against the bill and have no interest in negotiating it, adding to it or subtracting from it, so having a debate that is binary, where—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

I am not against anything.

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, through you to the Conservatives, they are against this bill and against providing contraceptive and diabetes medications. That is fair. They can be against it, but the House has an elected will. What we saw on the very first day that we attempted to put this bill before the House was obstruction and what we have seen with other bills is obstruction, not obstruction to continue a conversation, but obstruction because they do not want it.

I do not know how long we could have a debate about whether or not we should do it. What is the value of that debate to public discourse? We could talk about it until the cows come home, but Conservatives are against it. There is going to be an opportunity obviously at committee, at third reading and at report stage to have a lot more debate on the bill, Bill C-64, and to hear their single position, which is in opposition.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Speaker, I thank the hon. minister for his speech. I want him to know that I was deeply moved and shocked by the story of what he experienced when he was younger. It reminds us of the importance of fighting against all forms of violence, all forms of sexual violence, especially against children. I was very moved and I hope that this type of trauma will never happen to anyone ever again.

Now, with respect to the bill, I commend the minister's openness to collaborating with Quebec and the provinces. He is saying all the right things. In reality, however, based on the way the bill is drafted, it is paternalistic Ottawa that is dictating what its priorities are and disregarding the model that Quebec has in place for pharmacare, which is meeting the most urgent needs. There is no coordination. There was no advance planning. We saw the same thing with dental insurance. Ottawa is giving $2 billion to Sun Life for management fees alone, while we have a public system in Quebec. The minister could have sat down and discussed how to coordinate this. He also talked about the importance of keeping the public health care system, yet he chronically underfunds the health care systems by covering 20% of the cost, when it should be 35%.

Why is there such a huge gap between the benevolent rhetoric and the actions that undermine the system in Quebec and the provinces?

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, I certainly appreciate my colleague's question, because it is important.

Regarding the first example, I can talk a bit about the bilateral health agreements. This is a good example of collaboration where we were able to establish common indicators across the country without imposing any directives. It is not about telling Quebec what to do. No, that is not the case at all. Rather, it is about being able to measure progress in our health care system across the country based on data. Yes, this applies in Quebec, but it also applies across the country. That is important. I hope such a system could be possible one day on a global scale.

The agreement specified that this really was a Quebec jurisdiction. I respect that enormously. That is why it is Quebec's plan. We are here to support the plan and to provide funding. It is important to communicate how federal money will be used, but it is really up to Quebec.

As far as oral health care is concerned, there is tremendous need right now. That is why it is essential to act today to ensure that Quebeckers can receive this care now. Then we can find a common solution.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, I would first like to congratulate the minister, the member for Ajax. I had the privilege of leading the team that negotiated with him, who led his team, which resulted in this historic agreement on pharmacare. The New Democrats, and, I believe, the minister, believe that every Canadian should have access to the medicine they need regardless of their ability to pay through our public health care system. This would be a historic first step toward that.

I want to ask the minister a question about diabetes, because that is a very important part of the class of drugs that would be covered. He and I both heard stories about parents who have to wake their children up, their five-year-old daughter or their seven-year-old son, every hour and a half at night to test their blood sugar levels because they do not have access to continuous glucose monitors or insulin pumps.

A very important part of the deal that we have negotiated would cover that, making sure that everybody has access to the test strips, monitors, pumps and syringes they need to keep themselves healthy. Could the minister tell us what impact the Conservatives' delaying access to that medication is having on the families across this country that are worried about their family members who require these instruments to stay alive?

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, it was a tough conversation. Virtually every day we were talking about different elements of it.

The member for Vancouver Kingsway was very clear that his heart and his intention were on fixing the very issues he is talking about. I know that he carries heavy in his heart, as I carry heavy in mine, the types of circumstances that he is talking about, where families desperately need these medicines in order to keep their kids safe and healthy.

I remember Sarah from a clinic in Ottawa, and I talk about this often just because of how much it rattled me. She said that people are reusing syringes, increasing the danger of blood-borne disease, and that there are people who wind up having a limb amputated or going blind unnecessarily because they did not have the medication they needed.

We cannot afford to delay; we have to get this done. There is too much need and there are too many people who are suffering.

Again, I get that the Conservative Party is against the plan. Conservatives made that very clear. They do not want it. They do not believe that this is an area in which we should be taking action. However, the collective will of the House is that we do serve and help these people. I would say that blocking the bill under the pretense of wanting more debate is nonsense. The Conservatives are against it and are never going to be for it. There is no amount of debate that will ever get them to a different position. Their sole purpose is obstruction, which would block these essential medicines from getting to the people who need them.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Madam Speaker, I have sat here and listened to the member, but honestly, so many of the things he is talking about are provincial issues. The member has talked about contraception. In the 1980s, I could walk into any clinic and, for $2.00, get contraceptives. However, he is providing the idea that Canadians cannot get access. I will let him know that when the provinces are providing these programs, they do work. In 1989, for $2.00, one could get a package. That is what we were doing then.

The member talks about all of the great work that the Liberals are doing, but I really think what we see is a lack of consultation. They speak greatly about the dental care program. As a former dental health person, I can tell him that if we do not have antibiotics, a person is not able to have their tooth pulled.

I am just wondering whether the member ever actually studied to find out these things. I am wondering why we are getting into the provinces' territory when they were actually providing many of these services.

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, I will be frank: Canadians across the country are just not interested in that argument. They have critical needs that need to be met, and we have to work collaboratively to do it.

Canada has a responsibility to maintain and protect the Canada Health Act. The Canada Health Act is a matter of absolute federal jurisdiction, and the idea that we would abdicate the field and let our health system deteriorate and fall apart makes me wonder what the real argument is.

If the member was not listening when I was talking about the difference between oral contraceptives' having a 9% failure rate versus an IUD at 0.2%, how could she talk to a woman who does not have the dollars about why she would—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

Resuming debate, the hon. member for Calgary Shepard.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, I listened attentively to what the health minister was saying, so I am glad to be the first person to rise on my side to maybe provide a rebuttal and also to reset the debate, because the debate is not directly about Bill C-64; it is about a programming motion.

When I listened to the minister's speech, I also had the time to compare it to his speech that he gave at second reading. The same three anecdotes he raised today were raised then. Two of the three are completely misleading, and one was a very personal experience of his that he raised, which is his right as a member and a minister.

However, this is about a programming motion that would guillotine debate in the House. It would order a committee of the House to basically consider a bill within 10 hours, a bill that would have profound impact on the structure of Canada's health care systems, plural because they are systems. Quebec has a different system than Alberta, than British Columbia, than Saskatchewan and than other provinces in Canada.

We know from much research that has already been done by CIHI, The Conference Board of Canada, Statistics Canada, and CLHIA, which is the life insurance trade association, that 97.2% of Canadians already have access or are eligible for access to an insurance benefit plan of some sort. I know that in my home province, we have Blue Cross, which is usually the insurer of last resort that provides a lot of the services that the minister talked about.

The worst part of all is that we would be programming a committee of the House to study what essentially amounts to a pamphlet of legislation. The minister talked about finding common ground and solutions. I have also heard other members of Parliament talk about how important committee work is to them. Now we would basically be guillotining and gag ordering a specific committee of the House, the Standing Committee on Health, to do its work in 10 hours.

That is why I asked a question for the health minister on why he felt the need to exclude himself from having to come to testify before the health committee. One would think that he would put himself before the members at committee and answer all of their questions on the reasoning behind C-64 and the wisdom of it, because it is not a national pharmacare plan. That is not what it would do. It would cover two very small areas of medicine.

I will note that in the minister's second reading speech about Bill C-64, he had all of one sentence devoted to rare disease drugs and rare disease patients, typically the source of the most expensive therapies, the most expensive drugs, on an individual basis, not on a broad basis. Typically most drug plans in the provinces, whether private or public, spend the most on things like the very basic medication for infections. Medications like amoxicillin or penicillin and variations thereof are the ones that are quite expensive because people get a lot of infections, so it it just a question of volume in those situations.

There is a lot of medication out there that is expensive because it is brand new; it is coming onto the market for the first time. Recently I learned about a new oncology drug that is going to be made available in the United States, but it is cutting-edge, specialized medicine made for the individual patient. The drug comes with a few tens of thousands of dollars of cost associated with its delivery. There will be some cancer centres in Canada that will not be able to have it available for patients, but it will be available to other patients in other parts of Canada. Oncology drugs would not be covered under the plan.

There would actually be nothing covered in the plan except for those two areas of medications, which are very specific ones as well. Like I said, there would be nothing for rare disease patients. The minister talked, in his original speech at second reading, though not today, about the $1.5 billion being devoted to rare disease drugs. That announcement was made in 2019, yet only now has some of the spending gone out, not to cover drug costs but to cover things like the creation of rare disease registries to get foundations, universities and private organizations to start up a rare disease registry specific to one individual drug.

There is often a problem in how the Liberals propose things. They say something, make claims, and then it takes years before anything actually happens. As an example, in 2019 there was an announcement. In 2024, still not a single rare disease drug has been covered by the $1.5 billion. It took five years of waiting. Rare disease patients cannot wait. In fact it was the Liberal government that cancelled the original rare disease strategy in 2016. At that time, the president of the Canadian Organizations for Rare Disorders, Durhane Wong-Rieger, said that it was the kiss of death for patients with rare diseases.

She is a literal ball of energy and an amazing woman, an amazing advocate for patients with rare diseases. This was in 2016. It took the government three years just to announce funding and five years after that to roll out a single dollar. Now the government wants to convince us that it needs to expedite Bill C-64 by programming and ordering the Standing Committee on Health to consider certain things but not others.

I will go through the programming motion, since the minister did not feel the need to even explain why this was necessary. He repeated, essentially, his second reading speech on why we need to expedite this so quickly. There were three days of debate in the House before there was a vote at the Senate and in the Standing Committee on Health. I looked at the work the Standing Committee on Health had done. It did not even have the chance to consider the bill. That is how quickly the government is now programming what is going on.

The first line of this programming motion is very simple: “the committee shall have the first priority for the use of House resources for the committee meetings”. It seems quite reasonable that it would be given first right to interpretation, rooms and catering services if the committee is expected to sit for hours and hours on end. I guess a programming motion would have to have that in it.

The second part is, “the committee shall meet between 3:30 p.m. and 8:30 p.m. on the two further sitting days following the adoption of this order to gather evidence from witnesses, provided that any meeting on a Friday may start at 12:00 p.m. for a duration of not more than five hours”. Essentially, that is saying there will be two more meetings of the Standing Committee on Health and 10 hours of testimony. There are countless members in the House who will say that, during consideration of a bill, witnesses will testify, explain an idea or perhaps a missing amendment or particular line in a bill between the French and the English, which happens on a fairly regular basis. They either do not match, do not make sense or there could be more added to a bill to clarify or constrain a bill. Ten hours is simply not enough for a bill that would have such a substantive impact.

According to the health minister, the Liberals are going to celebrate a bill with such a substantive and profound impact as some great achievement. I do not believe that. I believe this is a pamphlet. This is not national pharmacare. There is no spending associated with this bill. Every one of my constituents back home knows there is no spending associated with this bill. If the Liberals keep ramming the bill through at this pace and it passes through the Senate at some point in the future, not one single drug will be paid for through this legislation because there are no dollars associated with it. There is no, what we call, ministerial warrant from the Minister of Finance connected to this bill. There will be no medication paid for through this particular bill. That is why I do not understand why this programming motion is of such necessity when the committee has not even had a chance to consider it.

I understand perhaps it would be easier to tell Conservatives, members of the Bloc and independent members that they are slowing down the committee's work, that they are not allowing the committee to proceed with witness testimony or consider the contents of the bill, but that has not even happened yet. We have not even had a chance to invite witnesses to explain to us their views on the contents of the bill.

When the minister talks about finding common ground and solutions, he accuses the Conservatives of being against it. Of course we are against it. We voted against the bill, but that doesn't mean we cannot improve an F product and make it maybe an F+ product. I know that is not a grade in universities or colleges in Canada, but we can always make something terrible a little less terrible. This is essentially, like I said, a pamphlet. For me, it was easier to vote against it because I saw nothing for patients with rare diseases. That is not a surprise to anyone in this place.

I remember the original debate on an NDP private member's bill, which I believe was Bill C-340, if memory serves. It was on national pharmacare. At least the title was on national pharmacare, not the contents. It was put forward by the member for Vancouver Kingsway. He and I debated it for most of the day. I was all about access for patients with rare diseases, and I said that was why I could not vote for that bill at the time.

It is not a big surprise to many members of the House and members of the other place that I would be against a bill that has has a title of national pharmacare, but would not do anything for patients with rare diseases. Members know of a personal anecdote I have mentioned many times in the House. I have three living kids with a rare disease called Alport syndrome. One daughter passed away very young, at 39 days old, with a different rare disease. I always joke with my friends in the rare disease community that I am due. I should probably play the lottery as I would I have a decent chance of winning because both of those conditions are rare.

In the case of my living kids, it is a rare disease of the kidneys, CKD, a chronic kidney condition. In the case of my youngest daughter who passed away, she had Patau syndrome, which is a chromosomal condition and very, very rare.

If one knows a child with Down syndrome, one should hug them. They are very special little kids. My daughter had a condition that is considered much worse than Down's. Down's is survivable. There are a lot of very sweet kids who live with Down syndrome, and their families are made incredibly happy by them because they are sweet into the teen years, into their twenties, thirties and forties. One never has to go through those teenage years, as I am going through right now with one of my kids, where suddenly, as the dad, I know nothing and they know everything, which is okay. I will go through this three times in my life.

I will move on to the next part of the programming motion, which reads, “all amendments be submitted to the clerk of the committee by 4:00 p.m. on the second sitting day following the adoption of this order”.

We are quite fortunate there was unlimited time provided, I believe, for the first two speakers on a programming motion. Perhaps members are surprised I would rise on this, but I intend to use this time to explain why I do not like the programming motion and the defects with Bill C-64, and to remind the minister about what the summary of his own legislation says that it does, because it is the complete opposite of what the minister just explained to the House. It is the complete opposite from his second reading speech as well, so members can stay tuned for that part.

On these amendments, we are fortunate because we have a constituency week coming up. I can guarantee many of us will be sitting down and working with patient advocacy groups. We will be going to our stakeholder groups and meeting with our constituents. I have a few who have emailed me on this subject. I will be finding useful amendments to this bill that would improve it in my eyes and in the eyes of my constituents. We have the time.

Had we had a sitting week coming up, had there not been unlimited time for the first speaker on the official opposition side, we could have been rushed to provide amendments by 4 p.m. after the first day. That is an incredibly low amount of time considering this first came to the House February 29 and then the last vote was on April 16 before it was sent to the committee.

Doing a programming motion like this, or a gag order to the committee, is wrong. I do not agree with programming motions. I believe I voted against nearly all of them that ever came through the House. I believe the health minister was also the House leader at one point when Motion No. 16 was being moved through the House. There was also a previous one, and I believe it was a member for Waterloo who moved Motion No. 6, which would have programmed how committees work in the Standing Orders forevermore for the Houses.

I cannot base our opposition or our support for any particular motions and programming motions on good faith coming from that side because I simply do not believe the cabinet, the front-benchers. I do not believe them. There are many good-hearted backbenchers in the Liberal benches. They are easier to work with, I find, than those on the front bench. The front bench I just do not trust. I do not trust the front-benchers to do the right thing for Canadians. In fact, Canadians do not trust them. If we look at the polls, there is about a 20-point disparity, depending on which poll we consider, between what the government is polling at and what the official opposition is polling at.

I will move on to the next point, which reads, “amendments filed by independent members shall be deemed to have been proposed during the clause-by clause consideration of the bill”. I actually do not have a problem with that. Independent members should be treated like every other member of the House, especially during considerations of bills.

Now comes the next one, which gets gets quite technical:

the committee shall meet at 3:30 p.m., on the third sitting day following the adoption of this order to consider the bill at clause-by-clause, or 12:00 p.m. if on a Friday, and if the committee has not completed the clause-by-clause consideration of the bill by 8:30 p.m., or 5:00 p.m. if on a Friday, all remaining amendments submitted to the committee shall be deemed moved, the Chair shall put the question, forthwith and successively without further debate on all remaining clauses, amendments submitted to the committee as well as each and every question necessary to dispose of the clause-by-clause consideration of the bill, and the committee shall not adjourn the meeting until it has disposed of the bill...

This means that, once the 10 hours of testimony are done, once that particular portion of the committee's work is done, every single amendment has to be voted on immediately, with no debate for amendments. In those 10 hours, if witness testimony takes five or six or seven hours, we then have a few hours left over to consider and debate amendments. We could not even persuade the other side of the wisdom of the amendment. This is so profoundly wrong. I see this programming motion all the time when it comes to omnibus budget bills.

I will remind the House that the Liberal platforms in 2015 and 2019 promised not to do omnibus budget bills, yet they have done them repeatedly, over and over again. In fact, in Liberal budget 2023, they had section changes to clauses 500 to 504 on natural health products. That has nothing to do with the budget. There are no spending items related to it, but it was a regulatory expansion to apply rules for pharmaceuticals directly onto natural health products.

It caught a lot of people by surprise, including myself, that in a budget bill, which sometimes has hundreds of pages, one would do such a thing. They basically clip what they usually do at the finance committee, and now they have dropped it and ordered the Standing Committee on Health to do it in one particular way, in their way, their preferred way, with no debate on any amendments.

Why should one allow backbenchers from any of our political parties to freely consider the judgment and the argument being made by another member of another political party, individually or on behalf of their political movement, on the wisdom of a particular amendment to a government bill? I know, it would be shocking to even have that consideration.

It would be even more shocking for some members of the government benches to know that I have voted for government amendments at committee. I know. I hear “shame” from my side of the benches, but it happens. Sometimes they have a good idea. I am willing to consider good ideas. I am willing to. I have been on several committees over my time, from foreign affairs to finance to the Standing Joint Committee for the Scrutiny of Regulations. I am on the immigration committee and the Canada-China committee now, the select committee. I will vote for reasonable amendments. I will even talk to my own side to try to convince them if there is a reasonable, logical amendment that makes sense. Sometimes there is an argument made by a member of another party that actually makes sense. This section prevents that. There will be no debate on amendments. One is just supposed to vote on them.

Of course, what will happen is that there will be a question of having a recorded division on every single one of those votes. This means the committee will continue, likely, late into an evening, because it is basically programmed. To demonstrate that this is wrong and should not be done, I am fairly sure that there will be members of the committee who will want a recorded division on every single item so that we can go back to it later with our errors and mistakes and illogical situations that arise because two sections perhaps conflict with each other. This type of amendment process, clause by clause, is incredibly important, and we now will not be allowed to be given this opportunity.

The sixth portion of this guillotine gag order on the Standing Committee on Health says:

a member of the committee may report the bill to the House by depositing it with the Clerk of the House, who shall notify the House leaders of the recognized parties and independent members, and if the House stands adjourned, the report shall be deemed to have been duly presented to the House during the previous sitting for the purpose of Standing Order 76.1(1)

This is a fairly reasonable amendment that is often provided by members in other committees to make sure that, when reporting on a bill, the House leaders are informed, typically to go on the Notice Paper. I do not have a direct issue with this particular portion, apart from the fact that this is a programming motion, a gag order, that is going to guillotine a committee of the House without that committee even having had the chance to consider a bill.

The next section is section (b). It says:

not more than five hours shall be allotted to the consideration of the bill at report stage, and at the expiry of the time provided for the consideration of the said stage of the bill, or when no member rises to speak, whichever is earlier, any proceedings before the House shall be interrupted, 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, and, if a recorded division is requested, the vote shall not be deferred...

It continues. There is another one, but I am going to stop right here. This essentially means that, when amendments come back from committee, they are sometimes ruled out of order. They cannot be considered at committee but they can be considered by the House because the House has control of its committees, and the House can decide whether certain amendments can be voted on. Those are typically then submitted to the Speaker.

This essentially says that this process will also be guillotined after five hours. I know they love gag orders. I know they love to guillotine debate. My hope is, too, that during this debate on the programming motion, they do not gag order the gag order. I would hate to see that. It would be like a double gagging of the orders of the House and really limiting debate.

They have done it before. They have done it on Bill C-7 and Bill C-14, the two medical assistance in dying bills. At different stages of those bill, they both programmed and then shut down debate on them. I have seen, plenty of times, allocation motions being moved by cabinet to force bills through the process on matters of conscience.

It is not as if they are technical bills where perhaps there is timeline the Liberals need to reach and where, for the proper administration of government, they can perhaps make an argument they can stand on, but for matters of conscience, to guillotine debate is wrong. In this particular case, I would say that this is not a matter of conscience. I think this is about administration of government services and what the contents of the bill are actually about versus what they are not about. When the Liberals impose a guillotine with time allocation and force the closure of debate, the major disadvantage to Canadians is that they cannot prepare themselves. They cannot organize themselves when they are opposed to particular ideas and when they want to ask questions like, “Why is my rare disease, my health condition or MS not covered in this bill? Why is diabetes covered?”

I know a lot of diabetics, and I am not picking on them directly. I am just asking a simple question. The most common rare disease is multiple sclerosis, or MS. A lot of people in my family have it, as well as friends, colleagues and co-workers. There are spouses of members on this side who have it. Therefore, why is that particular condition, and its medication, which is expensive medication, not in this particular piece of legislation?

It is a choice the government made, so why can we not debate that choice the government has made for those two particular conditions and the medications associated with them? If they are being covered, why not others? There are so many other types of medications, such as the most common ones: penicillin, amoxicillin and all the variations of the “-cillins”, because there are so many of them. Why are they not covered in this particular piece of legislation?

On this programming motion, should we put forward such an amendment to be considered at committee? If it is deemed non-votable at committee, why can it not be considered at report stage?

I guess I will only get through the programming motions, and I will have to come back later to finish talking about Bill C-64 and some of the things the minister said, as well as my concerns with the PMPRB, CADTH, pCPA and the entire architecture of drug approval in Canada.

The motion reads, “not more than one sitting day shall be allotted to the consideration of the bill at the third reading stage, and 15 minutes before the expiry of the time provided for Government Orders”, and it goes on like that, which basically means that there will be one day for final speeches, and then it will be done and sent to the other place. It is wrong to ram through a bill in this method, with bad faith being shown by the health minister, claiming that we were opposing it and not willing to consider things, when he has never bothered to listen.

Gaza

[Chandra Arya, Liberal, Nepean, ON]

Madam Speaker, during the last about 200 days, Israel has killed over 34,000 Palestinians, including about 14,000 children. In Gaza, Israel has displaced 90% of the population, destroyed 70% of the infrastructure, destroyed all universities and demolished all hospitals. Not satisfied with this, Israel has now initiated a ground invasion of Rafah.

The reign of Israeli terror must come to an end. Innocent Palestinians, including children, held in Israel must be released, and the terrorist organization Hamas must unconditionally release all the hostages immediately. The United States has admitted that its bombs have been used to kill Palestinians.

I call on Canada to immediately implement an official arms embargo using Canada's Special Economic Measures Act and pressure Israel to end its invasion. This is the issue that defines who we are as Canadians.

Falkland Stampede

[Mel Arnold, Conservative, North Okanagan—Shuswap, BC]

Madam Speaker, we know the Prime Minister is not worth the cost, but here is something that is: the 104th annual Falkland Stampede. North Okanagan—Shuswap is an amazing place with beautiful people and spectacular events.

One of the longest-running events in the area, and one of Canada's longest-running rodeo stampedes, is coming up on the May long weekend. If anyone is looking for affordable family entertainment, this is the place to be. With three days of rodeo fun, food trucks, beer gardens, cowboy church, dances, and pancake breakfasts, there really is something for everyone. There is even a parade, which is free, because even the Prime Minister cannot carbon-tax free.

We will be there on Sunday for the parade and the rodeo, and we hope to see wagonloads of families out enjoying Falkland showing off its best, including one of the largest Canada flags. The louder the crowds cheer, the harder the broncs buck at the Falkland Stampede. Yee-haw.

Calgary Nagar Kirtan

[George Chahal, Liberal, Calgary Skyview, AB]

Madam Speaker, this Saturday, the Dashmesh Culture Centre will host Calgary's annual Nagar Kirtan, commemorating Vaisakhi, the birth of the Khalsa. The Nagar Kirtan embodies a vibrant procession filled with sacred hymns and traditional martial arts, guiding the Sri Guru Granth Sahib Ji through our community streets. I am especially honoured that the parade will travel to Prairie Winds Park, right in front of my constituency office in the heart of northeast Calgary.

This event stands as Calgary's second-largest gathering, following the Calgary Stampede. It serves as a testament to our city's rich cultural tapestry and spirit of unity. All attendees, regardless of religion, caste, gender, economic status or ethnicity, are warmly welcomed to enjoy complimentary vegetarian meals, symbolizing inclusivity and compassion.

I extend my heartfelt gratitude to the Dashmesh Culture Centre, dedicated—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

The hon. member for Nanaimo—Ladysmith.

The Barsby Bulldogs

[Lisa Marie Barron, NDP, Nanaimo—Ladysmith, BC]

Madam Speaker, I would like to take a moment to highlight an incredible team in my riding of Nanaimo—Ladysmith: the John Barsby Secondary School football team, or what locals know as the Barsby Bulldogs.

The Barsby Bulldogs is a team full of dedicated and skilled players, winning multiple provincial titles in British Columbia. The success of this team is the result of the collective strength of all those who continue to lift them up. Generation after generation, the high school football team has been surrounded by many who make the Bulldogs the strong community it is, including coaches, parents, community members, alumni, teachers and administrators.

One particular individual I want to give a special shout-out to is Coach Stevenson. The positive impact Coach Stevenson has made on the lives of many over the years is undeniable, so much so that the team sees time and again previous high school players coming back as adults to take on coaching youth football themselves.

Coach Stevenson may be humble, but he deserves to be acknowledged for his important mentorship and thanked for his dedication to the team. Congratulations to the—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

The hon. member for Glengarry—Prescott—Russell.

Lennox O'Reilly Hinds

[Francis Drouin, Liberal, Glengarry—Prescott—Russell, ON]

Madam Speaker, I am rising to recognize an individual in my riding who passed away earlier this year. He was a friend. Next week, we will be celebrating his life.

Dr. Lennox Hinds was an outstanding public servant who served Canada for 35 years. He believed in political engagement. He was a Liberal. I knew him for over 25 years. I was just a young adolescent when I met Dr. Len Hinds. He always proved to be a friend who provided sound advice. Sometimes I would have to keep his door for last during elections because he would always want to have a drink and chat about politics.

My sincere condolences go to his wife, Marjorie, and his family. He will be missed.

General Sir Arthur Currie Award

[Greg McLean, Conservative, Calgary Centre, AB]

Madam Speaker, on April 22, John Adams, the President of Valour Canada, presented the annual General Sir Arthur Currie Award to one of Calgary's finest, George Brookman, often referred to as Mr. Calgary.

There is much I can say about George and his contributions to Calgary and to Canada, but I would be here for quite a while. His recognition for this award is due to his role in steering events that contribute to our understanding and support of our military. Like the general honoured in the award he received, George Brookman is a true leader. We thank George for all he does for Canada's military heritage and so much more.

Valour Canada is an organization that educates young Canadians about our shared military heritage by developing learning opportunities to foster a deeper understanding of who we are as individuals, as citizens, and as a nation. We thank John Adams and his team at Valour Canada. We are indebted to them for their work.