Mr. Speaker, I will sharing my time tonight with the member for Saint-Bruno—Saint-Hubert. I am delighted to be able to participate in tonight's emergency debate on the critical shortage of drugs currently facing our hospitals and their patients.
I particularly want to commend my NDP colleague, the member for Vancouver East, who requested this debate and without whose leadership this issue would never have come to the floor of this House. For sure, the government would not have taken this kind of positive initiative. On the contrary, while patients, hospitals, and provincial and territorial governments are all looking to the federal Minister of Health for leadership, the minister is ducking, weaving and passing the buck. It is patients who are paying the price.
Let us be clear: It is the federal government that can and must take responsibility for anticipating, identifying and managing shortages of medically essential medications. The government knows it, but thus far has simply abdicated all responsibility.
Let us take a look at how we got here, who is being impacted and what needs to be done to ensure that we never end up here again. The issue, of course, is that Canada is currently experiencing a shortage of medically essential drugs, projected to last 12 to 18 months.
Across the country, many regions have had to change prescription strategies, use replacements, often without experience of how they work, or cancel elective surgeries altogether. It is patients who are paying the price.
The medications in question are painkillers, anesthetics, anticoagulants, antibiotics and cancer drugs. One set is injectable opioids, the main method of pain control throughout surgery and in the post-operative setting, and with most hospital admissions.
Thus, with many hospitals running low on these drugs, the shortage is having the most serious impact on patients in intensive care units and those who are dying and need pain management. Nurses working in palliative care have told us that many of those in palliative care are dependent on injectable opioids since they cannot take medications by mouth. It is imperative that we have supplies for these patients or they will go through withdrawal, adding further pain and suffering to their last few days or months.
The Canadian Pain Society has reported a spike in suicidal callers concerned that they will not be able to manage their chronic pain without the necessary pain medication. Indeed, the impact of the shortages is being felt right across our country.
Here is what we are being told. Two hospitals in Quebec are cancelling elective surgeries, and hospitals in Ottawa are saying that they will have to do the same if their drug supplies are further depleted. In my hometown of Hamilton, Hamilton Health Sciences expects to run out of at least 10 types of mostly intravenous medications within the next 90 days, and has identified roughly 50 drugs that are affected. As a result HHS is warning of cancellations to surgeries and procedures as early as this week.
Alberta, Manitoba and British Columbia are suggesting that they, too, may have to cancel some surgeries. Patients in Alberta are being asked to buy their own anti-nausea drugs because hospitals can no longer provide extra supplies to patients.
Clearly this drug shortage is creating a crisis from coast to coast to coast. I am so pleased that you, Mr. Speaker, allowed us to have this emergency debate here in the House tonight. However, I must also point out that it did not need to be this way.
The crisis we are facing today could and should have been prevented. The problems with drug shortages, sadly, are recurrent and systemic. In fact it has been a few years now since Canadian doctors and hospitals have become increasingly aware of the risk of a substantial drug shortage. They have spoken out and have advocated. In the process, they have made it clear that the crisis we are facing today could have been prevented.
Similarly, the Canadian Pharmacists Association took the absence of any reliable national data or reporting into its own hands. It decided in September 2010 to conduct a survey to better understand the extent of the problem. The report indicated that out of 427 pharmacists from across Canada, 93.7% of those pharmacists indicated they had trouble locating medications to fill a prescription in a week, and 89% of them indicated that drug shortages had greatly increased since the previous year.
On December 15, 2010, using the information from the Canadian Pharmacists Association's report, The Globe and Mail wrote that the shortage of common drugs was becoming more and more widespread across the country, pointing to the shortage of key ingredients as one of the causes of the increased shortages.
Just a month later on January 27, 2011, anesthesiologists warned in an article in The Globe and Mail that the discontinuation of the production of sodium thiopental in the U.S. combined with the potential shortage of propofol could make it impossible for anesthesiologists to do their work and could postpone surgeries.
On May 13, 2011, both The Globe and Mail and CTV reported that the cancer drug carboplatin was in short supply and that hospitals were worried that patients receiving chemotherapy could face delays. Staff at Princess Margaret Hospital in Toronto were forced to scramble and get stock from an Australian hospital just to meet patient demand.
On August 18, 2011, the National Post reported that Health Canada had added 16 more medications to its list of drugs in short supply across the country. Health Canada blamed the situation on a manufacturer in the United States.
I am not suggesting that this list is exhaustive, but it does serve to point out that both drug shortages and calls for federal government action well pre-date the current crisis.
In fact, in August 2011, the health minister herself raised this issue with the pharmaceutical industry, but she stopped short of taking meaningful action. Instead, she set up a voluntary reporting system that clearly has not worked. Rather than mandating pharmaceutical companies to inform the government whenever there is a slowdown in production, the Conservatives made it voluntary. That is where the current drug shortage at Sandoz, the pharmaceutical drug company based in Quebec, becomes illustrative in showing why voluntary measures do not work.
Sandoz knew last November that it was going to be slowing down production because it had received a warning letter from the United States Food and Drug Administration regarding “significant violations” at its manufacturing sites which could cause the drug products to be “adulterated”. Sandoz stopped or reduced production of 110 different drugs while it was making quality control improvements to its physical plant in Boucherville, Quebec. The company did not give prior warning of this production halt, despite the fact that it knew months before that such action would be necessary. That is the problem with voluntary reporting. If it is going to affect the bottom line, why would a company voluntarily report on itself?
If mandatory reporting were in place, the federal government could have acted to protect Canadians and the provincial partners could have developed a complementary response.
As it stands now, federal-provincial co-operation has been virtually non-existent. In fact, the federal health minister's preferred modus operandi is to point the finger and assign blame rather than accept responsibility. Here is what she said in this House on March 7 in response to a question on drug shortages posed by my friend and colleague, the NDP health critic and member for Vancouver East:
I want to be very clear that the shortage has been created largely by the decision of the provinces and territories to pick a sole source supplier, and that supplier cannot provide the drugs now.
Really? Is it the fault of the provinces and territories? I do not think so. Instead of blaming health providers and the provinces, the minister should protect and defend their interests. That is what real leadership is about. That is the kind of leadership that would give Canadians confidence that the minister is on top of her file.
Instead, patients and health care providers are witnessing a mad scramble by Health Canada to speed up the approval of offshore medications, rushing them through testing for quality and effectiveness. That is probably of small comfort to the many patients who fear that quality control will be compromised in the name of sheer expediency.
We have the opportunity to do the right thing. I would urge the minister to start collaborating with drug producers and health care professionals, as well as her colleagues in the provinces and territories, to find lasting solutions, solutions to both the current crisis and to maintaining the integrity of the supply chain so that future issues can be prevented or, at the very least, mitigated. It is about showing leadership. Canadian patients deserve nothing less.