Djaouida Sellah

[Respect for Communities Act, November 21st, 2013]

Mr. Speaker, I would be pleased to answer my colleague's question. Where does scientific evidence come from? From statistics and conclusive data. That is what the NDP is talking about. On your side of the House, however, you focus on ideology and not scientific evidence.

[Respect for Communities Act, November 21st, 2013]

Mr. Speaker, you have no idea how disappointed I am with this bill. One would think that over the years we would get used to these kinds of laws that do more harm to the public than anything else, but I cannot get used to it. Bill C-2 is a very important reminder of that reality.

There are several elements in this bill that remind us just what the Conservatives represent. They are ideologues, they ignore scientific evidence and they even disregard rulings from the highest court in the country. It is absurd. This bill is first and foremost a way to dismiss the idea of supervised injection sites, just like they tried to do with InSite in Vancouver.

We need to put this bill in context. This bill was introduced because the Supreme Court ruled that the only supervised injection site in Canada—InSite in Vancouver—was necessary and that the Minister of Health should continue to give the facility an exemption. The court based its decision on section 7 of the charter, which states:

Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.

The Supreme Court decision states:

On future applications, the Minister must exercise that discretion within the constraints imposed by the law and the Charter, aiming to strike the appropriate balance between achieving public health and public safety. In accordance with the Charter, the Minister must consider whether denying an exemption would cause deprivations of life and security of the person that are not in accordance with the principles of fundamental justice. Where, as here, a supervised injection site will decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety, the Minister should generally grant an exemption.

I have a lot of questions. The court recognized the positive impact that supervised injection sites have had in east Vancouver, and its ruling was unequivocal:

InSite has saved lives and improved health without increasing the incidence of drug use and crime in the surrounding area.

I repeat, “without increasing the incidence of drug use and crime in the surrounding area”. The court is not the only one to say this. The Canadian Nurses Association agrees:

In Vancouver’s Downtown Eastside, where the Insite safe injection site is located, business owners, service providers and residents in the neighbourhood agree that the clinic has had a positive impact on the health of the people who use it and on the health of the community.

That is a fundamental aspect of this debate. While sites like InSite can improve the situation, the Conservatives want to ban them. The campaign of misinformation the Conservative Party launched just after the bill was introduced is proof enough.

As a health care professional, I find this bill mind-boggling. I want to add my voice to those of people in the field who have criticized this bill. The Canadian Nurses Association is concerned that:

...the conservative “tough on crime” ideology will overshadow evidence that demonstrates positive outcomes for communities with harm reduction programs.

The Canadian Medical Association had this to say:

The CMA fully endorses the existence of these harm-reduction tools, including supervised injection sites, and believes they should be included in a comprehensive national drug strategy. The CMA's position is founded upon clinical evidence. Bill [C-2], it would appear, is founded upon ideology that seeks to hinder initiatives to mitigate the very real challenges and great personal harm caused by drug abuse.

The CMA represents all of the doctors in the country. It added the following, which is even more critical of this government:

The unanimous decision [by the Supreme Court] was grounded in evidence, not ideology. The overwhelming clinical evidence is that centres like Insite save lives when it comes to some of our most vulnerable patient populations. In its ruling, the Supreme Court stated that “…the evidence indicates that a supervised injection site will decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety, the Minister should generally grant an exemption”. What we are seeing today seems to contradict the essence of the ruling.

Harm reduction works. This method has proven to be effective. In Australia, a report on supervised injection sites found that one site had reduced the number of overdoses, reduced the spread of HIV and hepatitis C and alleviated safety concerns related to users shooting up in public places and the availability of clean needles. The report even indicated that the site served as a gateway to addiction treatment.

Mr. Speaker, if that is not improving safety in the community, I do not know what is.

Many countries now have supervised injection sites: Australia, Luxembourg, the Netherlands, Norway, Denmark, Germany, Spain and Switzerland, just to name a few. These sites work.

It is no wonder Montreal's director of public health recommended, in December 2011, that the city establish such a site in the greater Montreal area. He gave a number of reasons similar to the ones I just quoted concerning Australia's experience. Do you know why, Mr. Speaker? Because they are based on conclusive data that the Conservatives and the Minister of Health have patently decided to ignore. I will quote Montreal's director of public health:

The reasons that justify implementing SIS in Montréal are very succinct: the epidemic of infections caused by HIV and HCV, and the excess mortality among IDU [injection drug users]. Cocaine use, the drug most often injected in Montréal, is a major determinant of HIV transmission, as is sharing used needles. HCV infection is also having devastating effects: 7 in 10 IDU have been exposed to the virus and its transmission does not appear to be slowing. As for excess mortality among IDU, the data on hand indicate that the problem in Montréal is alarming.

I urge the government for once to do its job in the health field. Since the Conservatives took power, we have seen the federal government disengage from files where Canadians expect it to play a role. I am referring to the government's refusal to negotiate a new health accord with the provinces, the shortage of prescription drugs, and diluted chemotherapy treatments.

It is unbelievable and completely unacceptable for a bill such as this, which flies in the face of the Supreme Court ruling, to be introduced.

[Mandatory Disclosure of Drug Shortages Act, November 19th, 2013]

Mr. Speaker, I do not intend to amend the bill, but I am asking that the mandatory reporting of drug shortages be included. I want to see it in the bill.

I know that my colleagues opposite might not agree, but, as I said and I repeat, I am totally open to amendments being made in committee. What matters to me is that we are already starting to see the mandatory approach.

[Mandatory Disclosure of Drug Shortages Act, November 19th, 2013]

Mr. Speaker, I thank my colleague, the NDP health critic. I know that she is working very hard on the health portfolio.

In the United States, as in New Zealand and Europe, everyone chose the mandatory system over the voluntary system. Here, we deplore the fact that the government gives companies the option to report drug shortages or not. In fact, the poll indicated the effects quite well. Human lives have even been lost.

The United States may have withdrawn the fines, but they were there initially. The approach is mandatory, not voluntary.

[Mandatory Disclosure of Drug Shortages Act, November 19th, 2013]

Mr. Speaker, I thank my colleague opposite for asking the question. I feel it is a relevant question.

In fact, the bill will not have a financial or administrative impact. When the reporting is not mandatory, the consequences are more costly. We know that human lives have been lost.

In terms of the penalties in the United States, I will say that the penalty was still in force when I introduced the bill. However, it has subsequently been withdrawn.

[Mandatory Disclosure of Drug Shortages Act, November 19th, 2013]

moved that Bill C-523, An Act to amend the Department of Health Act (disclosure of drug shortages) be read the second time and referred to a committee.

Mr. Speaker, I am pleased to present Bill C-523, Mandatory Disclosure of Drug Shortages Act.

Drug shortages are a public health issue. Shortages have a significant impact on the health of Canadians, the practices of health care professionals and system costs.

The most important issue is that of patient health. Drug shortages are a danger to their health because they delay access to drugs and patients are given a less-effective drug with a greater risk of adverse effects. Drug shortages do not allow for a transition period, which is very important for patients on certain drugs.

Drug shortages are not a new problem, let alone a problem unique to Quebec or Canada. This is a global problem that has existed since the 1970s. However, the problem has become more pronounced in recent years. The number of shortages has exploded. Between 2005 and 2010, the number of shortages of FDA-approved drugs increased from 92 to 310.

The Régie de l'assurance maladie du Québec recorded 33 shortages in 2006, but 207 in 2010, before the major Sandoz episode in 2012. This crisis attracted a little more interest for this important public health issue.

Following this crisis, the NDP called for and got an emergency debate, but most importantly, we had a motion pass unanimously in March 2012. The motion read as follows:

That, in the opinion of this House, the government should: (a) in cooperation with provinces, territories and industry, develop a nationwide strategy to anticipate, identify, and manage shortages of essential medications; (b) require drug manufacturers to report promptly to Health Canada any planned disruption or discontinuation in production; and (c) expedite the review of regulatory submissions in order to make safe and effective medications available to the Canadian public.

What has been done since then to implement this motion? The Conservative government's database for voluntary reporting of drug shortages failed to ensure a transition period that is crucial to the health of Canadians. The government is leaving the health of Canadians in the hands of pharmaceutical companies, which are the only parties that decide when to report drug shortages.

More recently, the Minister of Health also announced the introduction of the multi-stakeholder toolkit and the protocol for the notification and communication of drug shortages, which:

...sets out clear expectations, principles and processes for how and when stakeholders across the supply chain share information in anticipation of or response to a drug shortage.

These are interesting and necessary tools, but they are far from sufficient. Neither the protocol nor the toolkit require manufacturers to provide accurate and timely information, and most importantly, no one is ultimately responsible for ensuring compliance with the protocol. This is not up to par—Canadians deserve better, and that is why I introduced this bill.

Moreover, in January 2013, Diane Lamarre, president of the Quebec order of pharmacists, stated that what the federal government had done so far was not enough.

Quebec's Minister of Health, Dr. Hébert, shared a similar sentiment when he said, “If the federal government was doing its job properly, shortages would be better prevented”.

The bill on mandatory disclosure of drug shortages addresses the need to introduce a transition period to ensure that the health of Canadians is protected.

The bill stipulates that the pharmaceutical company shall notify the minister of any planned or foreseeable interruption of the production, distribution or importation of a drug at least six months in advance. If a pharmaceutical company decides to cease producing, distributing or importing a drug, it must notify the minister at least 12 months in advance. The bill also stipulates that any companies found in violation of the act are liable to a fine.

Although we are talking about the regulatory framework for disclosing drug shortages, I am not suggesting that we reinvent the wheel.

Mandatory disclosure of drug shortages exists in the United States, New Zealand and in the European Union. Why not here in Canada? It has been called for by various groups, including the College of Family Physicians of Canada in a letter to the Prime Minister in 2011, and the Ordre des pharmaciens du Québec. Even officials at Health Canada have recommended to the minister that it be required.

Mandatory disclosure of drug shortages will have a direct positive impact on the practices of health professionals.

This bill has had many supporters. Some of the groups that support my initiative include: the National Association of Pharmacy Regulatory Authorities; the College of Family Physicians of Canada; the Ordre des pharmaciens du Québec, which adopted a resolution to support my bill; the Association des anesthésiologistes du Québec; the Newfoundland & Labrador Pharmacy Board; the Prince Edward Island Pharmacy Board; the Association des pharmaciens des établissements de santé du Québec; the Canadian Federation of Nurses Unions; and the College of Physicians and Surgeons of Alberta.

Drug shortages have a direct impact on the health of patients, first and foremost. These shortages undermine the health of Canadians and make it harder for our health system to run smoothly. The facts are overwhelming. Drug shortages have a significant impact on patient health and the work of health care professionals and put enormous pressure on health care costs.

The survey confirms that shortages are becoming increasingly common, as 78% of pharmacists said that they had difficulty sourcing a drug in their last shift at work. The survey also confirms the effects this has on the health care system, since 91% of hospital pharmacists agreed or strongly agreed that drug shortages are increasing costs to the health care system, and 76% of hospital pharmacists reported a significant impact on their workload.

The impact that drug shortages have on the patients is even more worrisome. According to a survey, 64% of doctors indicated that shortages of drugs had consequences for patients, and 78% of hospital pharmacists agreed or strongly agreed that the shortages adversely affect patients.

Furthermore, 91% of pharmacists said that their patients had been inconvenienced as a result of drug shortages. The impacts are greater in certain cases. For some, the consequences are limited to having to take—and pay for—a sometimes more expensive alternative drug.

For people with epilepsy, for example, the situation is more severe. When people suddenly stop taking anticonvulsants, seizures can become longer and more serious, and may require urgent care. They can sometimes even be fatal. Between 2009 and 2012 there were shortages for five different anticonvulsants, some of which were made by the same pharmaceutical company. These shortages forced some people to use a different preparation or, if available, another drug without the benefit of a transition period. That is unacceptable and it needs to change.

The Canadian Anesthesiologists' Society published the results of a survey of its members last June in the Canadian Journal of Anesthesia. The statistics are alarming. The sample included 60% of the society's members in all Canadian jurisdictions.

The survey revealed that 66% of respondents had experienced at least one shortage, forcing 49% of respondents to administer an inferior anesthetic. In addition, 8% of respondents witnessed drug errors caused by a shortage, 14% regarded drug shortages as having prolonged patients' recovery from anesthesia, and over 10% viewed shortages as resulting in an increased number of postoperative complications. That, however, is not the worst of it. The worst part is that, according to the survey, four respondents indicated that a shortage of anesthesia drugs and other essential drugs led to postoperative deaths. The drug shortage has become a human tragedy. We have to act now to put an end to that tragedy.

It is also clear that these shortages have had a significant impact on the work of health professionals. In the fall of 2012, the Canadian Medical Association, the Canadian Pharmacists Association and the Canadian Society of Hospital Pharmacists surveyed their members. That survey revealed alarming findings.

The survey confirmed that shortages are becoming increasingly frequent, with 78% of pharmacists stating that they had difficulty sourcing a drug in their last shift at work. The survey also confirmed that this situation is affecting the health system because 91% of hospital pharmacists agreed or strongly agreed that drug shortages are increasing costs to the health care system, and 76% of hospitals reported a significant impact on their workload.

We have wasted enough time. According to the Canadian Press, Health Canada did not choose mandatory reporting, in spite of the recommendations of the department's officials, because of the time required.

I will quote a Canadian Press article from December 27, 2012. Steve Outhouse, spokesperson for the former minister of health explained:

...a voluntary system was chosen because it would take too long for Health Canada to bring forward regulations mandating companies disclose production gaps.

More than a year later, nothing has been done to move in that direction. Because of this government's failure to take action, people are paying a high price.

I realize that mandatory reporting will not solve the problem of drug shortages. However, it is an indispensable tool that can help better manage the situation and provide patients and their health care providers with pertinent and complete information in order to better manage the consequences.

The United States, the European Union and New Zealand have all opted for mandatory reporting.

There is nothing revolutionary about this bill. It is based on what is happening around the world.

The financial penalities included in the bill are modelled on a proposal contained in a bill passed by the U.S. Congress. The principle is as follows: if the act is not enforced, there must be consequences.

It is important that we move towards mandatory disclosure. This is not a witch hunt against the pharmaceutical companies because I know they did a lot during the 2012 crisis. Sandoz, in particular, notified its clients of upcoming shortages. However, it is important to ensure that patients are safe and have access to the treatment they need in a timely manner.

I am asking all my colleagues and the government to support the bill because it is in the best interests of all Canadians.

[Health, November 19th, 2013]

Mr. Speaker, drug shortages are a public health issue.

In recent years, those shortages have had a significant impact on the health of Canadians, the practices of health care professionals and system costs.

The NDP wants pharmaceutical companies to be required to report any disruption in the drug supply.

Will the government support our bill, which is designed to protect the health and safety of Canadians?

[Safeguarding Canada's Seas and Skies Act, November 4th, 2013]

Mr. Speaker, I thank my young colleague for her timely question. I will answer it by saying that unfortunately, this Conservative government is not concerned about the environment or the costs that could result from its inaction or its approach.

The Conservatives act only after the fact. Prevention is not part of their thinking. After the event, it is necessary to legislate and think about compensating people, instead of working within a preventive framework, step by step.

Unfortunately, however, we cannot blame this Conservative government, because as far as it is concerned, science does not exist. The Conservatives govern exclusively on the basis of their ideology.

[Safeguarding Canada's Seas and Skies Act, November 4th, 2013]

Mr. Speaker, I would like to thank my colleague for her timely question. She is well aware that I represent a constituency on the South Shore of our beautiful and mighty St. Lawrence.

Since my election to this House, I have noticed that the Conservative government is unfortunately not concerned about the environment or climate change.

We must protect our ecosystem, and our fauna and flora. We have a duty to preserve the environment for future generations. I would like my children and grandchildren to have access to drinking water that is not contaminated. God knows what that is going to cost them, because future generations will inherit a heavy burden through the inaction of this Conservative government.

[Safeguarding Canada's Seas and Skies Act, November 4th, 2013]

Mr. Speaker, I will be sharing by time with the hon. member for LaSalle—Émard.

I am pleased to rise in the House to speak to Bill C-3, An Act to enact the Aviation Industry Indemnity Act, to amend the Aeronautics Act, the Canada Marine Act, the Marine Liability Act and the Canada Shipping Act, 2001 and to make consequential amendments to other Acts.

As we can see, this bill has a long title. Bill C-3 is an omnibus bill that seeks to enact or amend five pieces of legislation. For the benefit of those watching us, I will try to summarize it. The first part implements the Aviation Industry Indemnity Act that has allowed the Department of Transport to compensate certain airlines for any war-risk losses, damages or liability. As a result, the government can cover the cost of damages related to unlawful actions, such as rebellions, attacks or armed conflicts. The goal is to ensure the continued operation of Canada's major aviation services in the event of seizure, regardless of whether stakeholders are able to obtain insurance at that time.

With respect to Part 2, to provide certain persons with powers to investigate aviation accidents or incidents involving civilians and aircraft or aeronautical installations operated by or on behalf of the Department of National Defence, the Canadian Forces or a visiting force.

Part 3 amends the Canada Marine Act in relation to the effective day of the appointment of a director of a port authority.

Part 4 amends the Marine Liability Act to implement the International Convention on Liability and Compensation for Damage in Connection with the Carriage of Hazardous and Noxious Substances by Sea, 2010.

Part 5 amends the Canada Shipping Act, 2001, by imposing new requirements on operators of oil handling facilities, including the obligation to notify the minister of their operations, and submit their plans to the minister.

Part 5 thus introduces a new requirement whereby the operators of oil handling facilities must submit to the minister a response plan, civil and criminal liability for response organizations engaged in response operations, the application of new measures and monetary sanctions, with new investigative powers for Transport Canada investigators.

After initial review of this omnibus bill, and despite the rejection of our proposal to expand its scope, I offer my qualified support for Bill C-3 at second reading, while drawing attention to the Conservatives’ lack of credibility with respect to marine and aviation safety issues, and their contradictory policies.

As the saying goes, this Conservative government does not put its money where its mouth is. This has become the trademark operating mode of this Conservative government. This bill is an attempt to make up for its lack of credibility in the area of transport safety, particularly with respect to tanker traffic on the West Coast and growing opposition to the northern gateway pipeline, first proposed in 2006.

This bill also implements the International Convention on Liability and Compensation for Damage in Connection with the Carriage of Hazardous and Noxious Substances by Sea, 2010, to which Canada is a signatory.

The government is trying to make up for lost time, which is unfortunately difficult to do. In the fall of 2012, two large ships at sea off the West Coast were wrecked because of the current volume of traffic. The amendments proposed in this bill are not enough to prevent a catastrophic spill. The context of the bill puts the emphasis rather on administrative organization and a real failure to improve the environment. Mr. Ben West of ForestEthics Advocacy has said that we have moved ahead quickly in the wrong direction on this matter.

If the Conservative government was really concerned about safety, why did it not apply what was agreed to under the 2010 convention immediately? If Bill C-3 was really designed to promote greater safety with respect to oil tanker traffic, a Conservative government should have seized the opportunity to cancel the cuts in the most recent budgets and the shutdown of marine safety programs.

The NDP is committed to the polluter pays principle. We also want to strengthen the petroleum boards' capacity, which is currently zero, to deal with oil spills, as recommended by the Commissioner of the Environment and Sustainable Development. In addition we want the Coast Guard to be required to work with its U.S. counterparts and to conduct a parallel study to examine the risks resulting from additional tanker traffic in Canadian waters.

It is appalling that this government is constantly making cuts in structures that have proven effective in the past, or that it is closing them, just as traffic increases and the ships carrying oil and potentially hazardous substances get bigger.

I wonder what is the idea behind the bill before us. I moderately support the bill, but I would like it to go to committee and have experts speak out on parts 4 and 5.