Debates of May 29th, 2024

Department of Health—Main Estimates, 2024-25

[The Speaker, Liberal, Greg Fergus]

This brings the round of questioning to an end.

We will move to resuming debate and questions for the hon. Parliamentary Secretary to the Minister of Housing, Infrastructure and Communities.

[Chris Bittle, Liberal, Parliamentary Secretary to the Minister of Housing]

Mr. Speaker, I will be speaking for a bit before I direct some questions to the ministers.

No Canadian should have to choose between paying for prescription drugs or putting food on the table. Unfortunately, many are still forced to make this impossible decision. It is why our government continues to work with provinces, territories and stakeholders to ensure that Canadians have better access to the drugs they need. Today, I will be providing an overview of some of the work by first highlighting our latest announcement, which presents a significant step forward towards national pharmacare.

On February 29, the Minister of Health introduced Bill C-64, an act respecting pharmacare, which proposes the foundational principles of the first phase of a national universal pharmacare plan in Canada. Bill C-64 describes our government's work with provinces and territories to provide universal single-payer coverage for a number of contraception and diabetes medications. In parallel to this, our government announced its plans to establish a fund to support Canada's access to supplies that people living with diabetes require to manage and monitor their condition and administer their medication, such as syringes and glucose test strips. These are impactful initiatives that can positively change the lives of millions of Canadians.

For example, coverage for contraceptives will mean that Canadians of reproductive age, which is nearly one-quarter of Canada's population, will have better access to contraception and reproductive autonomy. This access will improve equality, help reduce the risks of unintended pregnancies and improve a woman's ability to plan for the future.

Cost has been identified by Canadian contraceptive care providers as the single most important barrier to access these medications. Bill C-64 would ensure that Canadians will have access to a suite of contraceptive drugs and devices.

Similarly, one in four Canadians with diabetes have reported not following their treatment plan due to cost. Improving access to diabetes medication will help improve the health of almost four million Canadians living with diabetes and reduce the risk of serious life-changing health complications. These complications include permanent effects to the health and well-being of a person with diabetes, such as heart attack, stroke, kidney failure, blindness and amputation.

This bill also demonstrates our government's commitment to consulting widely on the way forward, including the need to work with provinces and territories, indigenous peoples and other partners and stakeholders. It includes four principles that the Minister of Health is to consider when collaborating with partners towards the implementation of national pharmacare. They are accessibility, affordability, appropriate use and universal coverage.

Bill C-64 would also provide that the new Canadian drug agency would work towards the development of a national formulary developing a national bulk purchasing strategy and supporting the publication of a pan-Canadian strategy regarding the appropriate use of prescription medications. It would also require the Minister of Health to establish a committee of experts to help make recommendations on the operation and financing of national, universal single-payer pharmacare in Canada. Together, these elements would inform the next key steps towards a national, universal pharmacare in Canada, building on the work already under way.

The work under way already includes the previously mentioned Canadian drug agency. The creation of the CDA was announced in December 2023 with an investment of over $89 million over five years. Built from the existing Canadian Agency for Drugs and Technologies in Health, and in partnership with provinces and territories, the CDA will provide the dedicated leadership and coordination needed to make Canada's drug system more sustainable and better prepared for the future in helping Canadians achieve better health outcomes. Engagement with provinces, territories, partners and stakeholders will continue to be an important part of the agency's path forward.

In addition, our government launched the first-ever national strategy for drugs for rare diseases, as announced in March 2023. This investment of up to $1.5 billion over three years will help increase access to and the affordability of drugs for rare diseases, with the aim of improving the health and quality of life of people living with rare diseases across the country. As part of this strategy, our government will create bilateral agreements with our provincial and territorial partners to make up $1.4 billion over three years, with a focus on improving access to new emerging drugs that treat rare diseases. We will also support better access to existing drugs and activities directed at improving screening and early diagnosis for rare diseases. The aim of these efforts is to help people living with rare diseases across Canada obtain earlier access to treatments and a chance at a better quality of life.

Our government is now working with provinces and territories on these bilateral agreements, starting with jointly determining a small set of new and emerging drugs that would be cost-shared and covered in a consistent way across the country for the benefit of Canadians living with rare diseases. I am also excited to share with members an update on the excellent progress we are making with the Government of Prince Edward Island to improve access to medication for island residents.

Similar to the work under way for the drugs for rare diseases strategy, our work with P.E.I. will also inform the advancement of national pharmacare. Under the improving affordable access to prescriptions drugs program with P.E.I., those who experience the most vulnerability, including uninsured island residents, seniors, and families with a high burden of medication costs, have seen immediate benefits, including improved access to medication and reduced copays.

Through this partnership, which includes a federal investment of $35 million, P.E.I. has expanded access to over 100 medications to treat a variety of conditions, including heart disease, cancer, and MS. Last June, P.E.I. also reduced copays to $5 for almost 60% of medications regularly used by island residents. Under their seniors' drug program, the family health benefit drug program, the generic drug program and the diabetes drug program, this program has led to island residents saving $2.5 million in out-of-pocket costs so far.

Speaking to our efforts more broadly, we continue to work on regulatory innovation, including agile licensing for drugs to better support drug oversight, both before and after the sale, due to the evolving market. These updated regulations will improve safety, support economic growth, and benefit both Canadians and industry.

In closing, no one should struggle with paying for the prescription drugs they need. Our government will continue to work with provinces, territories and stakeholders on the pharmacare initiatives I have outlined and continue to work with parliamentarians in passing Bill C-64. By working together, we can realize our goal of achieving national pharmacare, which will benefit all Canadians.

My first question is directed to the Minister of Health. Before I was elected to this place, I was the chair of the board of an incredible organization, Quest Community Health Centre. I know, as the Minister of Health knows, that community health centres look to what is missing in communities to fill a void. One of those things in St. Catharines and, of course, across the world, although we can only help in our little corner, was the lack of access to dental care. The staff at Quest, led by Coletta McGrath and Jenny Stranges, was incredible. They were able to build a team of volunteer dentists and hygienists who came in to provide care for those who had not had treatment in decades, who use the emergency room as their dental care. Some would say that they would be a burden on the system, but they were just trying to get pain relief.

I was able to get messages, as the chair, from people who were grateful for having received this service, who could smile again, who could go to job interviews, who could smile with their grandchildren. It is shocking that the Conservatives would deny this to Canadians

I was wondering if the Minister of Health could outline what the government is doing and what the progress of our dental care plan is. I do not need him to respond in the time allotted. I was hoping he could provide an update on the dental care plan.

[Mark Holland, Liberal, Minister of Health]

Madam Chair, I want to thank the member for St. Catharines for his work and for his advocacy, in and out of public life. It is tragic when we see folks, who have not received the dental care that they need, wind up in an emergency room or wind up with an urgent health care situation that could have been avoided.

Two weeks ago, I was in rural New Brunswick talking to a dentist who said, “I know exactly who does not have coverage in my community. I know that, on some given Saturday, that person is going to wind up in an emergency room, and I am going to get a call to go in and give care urgently, pro bono, away from my family, to try to fix that situation, hoping that it is not grievous for that individual.” I think that the member is talking about a situation very similar in St. Catharines.

Not allowing people to have dental care is not just a matter of dignity, of somebody having a proud smile that makes them feel good about who they are and gives them confidence to be out in the world. It is fundamentally an issue of prevention. People who do not get good oral health care wind up with bad health outcomes. They cost our health system an inordinate amount of money. That is why I am so encouraged.

The member asked for an update, and I gave it to the House earlier. We have seen more than 120,000 claims and over 100,000 seniors in just over three weeks. We are seeing, as of July 8, a new portal. We already have 10,500-plus oral health professionals who have signed up to this plan. I think we are going to see a real growth in that number. We have seen two million seniors signed up. Next month, we are going to be opening it up to persons under 18 and folks with disability who are currently on a disability tax credit. It would mean that, by next year, everybody, all nine million Canadians who do not have oral health care, will have coverage.

One may ask why this was not done at the start of our health care system. Well, at the beginning, when we were starting so many decades ago with a national health care system in this country, it was thought that oral health was just a matter of cosmetics and that it was not essential health. Of course, science and data have evolved. We know that a myriad of diseases, illness and conditions is caused by lack of oral health. Oral health is health, and that is why it is so essential that we continue to make progress to make sure that every Canadian is covered.

[Chris Bittle, Liberal, St. Catharines, ON]

Madam Chair, I have been hearing a question to the Minister of Health again. I have been listening with interest throughout this debate, and I take the Conservatives at their word that they are concerned about the opioid crisis. They are seeing it in their communities, as we are seeing it in all of our communities, affecting people across the community.

I went on a ride-along with my local fire department, and we got a call: vital signs absent. We raced down to Montebello Park. The image that burns into my brain is the legs of a resident of St. Catharines sticking out of the stall in the washroom in Montebello Park. Paramedics brought that person back, as paramedics, firefighters and first responders are heroically doing across the country.

However, I was wondering if the minister could comment on what we are hearing in response to what I believe is health care: addiction and mental health. I know the Conservatives say that it is health care, but what I am hearing is just a repackaged version of what we tried in the seventies, eighties and nineties, which was “Just say no”. The Minister of Health talked about Newt Gingrich and the common-sense revolution, the harsh law-and-order penalties. We have tried to solve this as a society, through—

[The Deputy Chair, NDP, Carol Hughes]

I will ask the minister to respond.

[Ya'ara Saks, Liberal, Minister of Mental Health and Addictions and Associate Minister of Health]

Madam Chair, I want to thank the member for sharing what he is seeing in his own community. We are seeing this in communities across the country, and it is so important we meet the moment. A war on drugs is what the Conservatives are purporting to be the answer, with forced treatment and saying they care for their loved ones, but they want to criminalize people.

We need compassion. We need health care. We need a firm commitment to a comprehensive suite of tools that, yes, includes harm reduction. It is shameful to see there is such a lack of compassion on the other side of what it truly takes to invest in Canadians, to invest in families and to invest in communities to save lives in this overdose crisis.

We have put a billion dollars on this side of the House toward saving lives, and we will not stop. We are meeting this moment with our provincial jurisdictions. We are meeting the moment with our communities, with harm reduction, with treatment, with prevention and with care. On this side of the House, we care about Canadians.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Chair, I am splitting three ways, and my questions will be for the Minister of Mental Health and Addictions.

My colleagues have asked about a company called Fair Price Pharma, which is run by former B.C. public health officer Perry Kendall and a partner. Its business is selling heroin. The results of an Order Paper question show that in a two-year period leading up to December 13 of last year, the minister met with Fair Price Pharma on September 15, her predecessor met personally with Fair Price Pharma four times and that health officials met with it an additional seven times. That is a dozen meetings in two years, which is a lot of meetings for a minister and officials with one company in the heroin business.

What is being discussed in these 12 meetings between Liberals and this heroin company?

[Ya'ara Saks, Liberal, Minister of Mental Health and Addictions and Associate Minister of Health]

Madam Chair, to be clear, I, as Minister of Mental Health and Addictions, have not met with Fair Price Pharma. The September 15 meeting the member is referencing was actually a meeting of ISED, with another office and not my department. There were members of my staff who were present at that meeting, who were invited to listen in. To be clear, we meet with experts in this field. Dr. Kendall was joined by Dr. Schechter and other experts at those meetings, and we need to talk to experts, even if we do not agree with them.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Chair, this is not a dispassionate expert. This is someone who went from the public health world into selling heroin. Twelve meetings in two years is not normal even for an expert. Again I will ask, what is being discussed in these meetings? What is Fair Price Pharma asking the Liberal government for?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, the Dr. Kendall the member is referencing was part of the B.C. government, not the federal government, just to be clear. As I mentioned before, those meetings were held at ISED, I did not attend those meetings and was not privy to the discussions around the table.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Chair, 12 meetings in two years. Four in-person meetings with this heroin company and the former minister. This new incoming minister must have been briefed on the nature of this close relationship and what was being discussed.

For a final time, why is the government meeting 12 times in two years with this heroin company? What is being discussed? What is Fair Price Pharma asking for?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, the member across the way knows perfectly well the meetings were held at ISED. The member also knows I have not met with Fair Price Pharma. The member also knows my predecessor did meet with Fair Price Pharma.

That being said, what I do know is across the way they do not listen to many of the experts we need to listen to, including Moms Stop the Harm. I would love to know why the Leader of the Opposition refuses to meet with families who know what they need in their communities. We will meet with everyone. Why do the Conservatives not do that?

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Chair, a lot of people want to hide their meetings with drug dealers, but I would have expected better from this minister.

What is the purpose of these 12 meetings with this corporate drug dealer?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, I have answered this question already. He can keep asking it, but we will speak to all experts on what matters, and most importantly, to save lives; all tools and resources.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Chair, is the Government of Canada party to any contracts or agreements involving Fair Price Pharma?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, no.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Chair, will the minister demonstrate her point either way by releasing all contracts involved in safe supply?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, pharmaceutical contracts are the purview of the provinces in terms of prescribed alternatives.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Chair, we put forward a motion at the government operations committee asking for any contracts to which the federal government is a party. The Liberals have been filibustering to block the release of those contracts. If no contracts existed, I suspect Liberals would not be motivated to filibuster to block their release.

Will the minister agree to release any contracts to which the federal government is a party, involving these drug programs?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, federal funding toward prescribed alternative programs goes to the operations of the programs themselves.

As I have said, contracts with pharmaceutical companies for prescribed medications are between the province and those pharmaceutical companies. We support the implementation of programs.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Chair, there have been 12 meetings with a heroin-selling company. The government is refusing to release contracts involving the Government of Canada and corporate drug dealers.

Why will the minister not tell us what was discussed in those meetings, and why is the minister sitting on these contracts?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, as I have stated, but I will repeat for the benefit of the committee, contracts such as these are between provinces and these companies.

[Tracy Gray, Conservative, Kelowna—Lake Country, BC]

Madam Chair, my questions are for the Minister of Mental Health and Addictions.

The minister's department approved an open drug use policy in public places, including parks and playgrounds in British Columbia, in 2023.

Does the minister believe children seeing drug usage normalizes drug usage for children?

[Ya'ara Saks, Liberal, Minister of Mental Health and Addictions and Associate Minister of Health]

Madam Chair, we are committed to a compassionate approach to this public health crisis that is clearly anchored in public safety as well, but we need to understand that those who use drugs need to be directed to health care. Families and communities have a right to be safe wherever they are, parks—

[The Deputy Chair, NDP, Carol Hughes]

The hon. member for Kelowna—Lake Country.