Madam Chair, we are holding a take note debate on multiple sclerosis and the results of a clinical study by Dr. Paolo Zamboni, which has turned the MS world on its head. This is especially true in Quebec and Canada, which have one of the highest rates of the illness with approximately 1,000 new cases diagnosed every year.
First, it is my understanding that since 1868, when multiple sclerosis was first diagnosed by Dr. Jean-Martin Charcot, researchers and doctors have considered MS to be a neurological disorder where the immune system targeted myelin, the protective sheathing on the cells of the central nervous system. This is being called into question by an Italian researcher who now considers MS to be a vascular disease that can be treated with angioplasty surgery. This procedure may lead to a reduction of symptoms in those with the disease.
Dr. Zamboni, of the University of Ferrara in Italy, says that the illness is a disturbance of blood circulation characterized by the inability of the venous system to properly drain blood from the central nervous system. It is known as chronic cerebrospinal venous insufficiency, or CCSVI.
In April 2009, he published his first article on the prevalence of venous stenosis in patients with multiple sclerosis. He carried out angioplasties on 65 patients with various forms of multiple sclerosis whose veins were deformed or blocked. The procedure consists of removing blockages from the jugular veins, which are located on either side of the neck.
The news spread so quickly that in May 2009, Dr. Robert Zivadinov of the Jacobs Neurological Institute in Buffalo, New York, began a study of 500 individuals to verify the Italian group's results. His study showed that 56% of individuals with multiple sclerosis had venous stenosis, and 22% of those in the control group without MS had venous stenosis.
In order to understand the hope that such a discovery—even the rumour of it—can arouse, one must understand the reality of life with multiple sclerosis. The clock is ticking for these people. Their health could deteriorate anytime.
In response to pressure from patients, many doctors, neurologists and Dr. Zamboni himself recommended caution because the research involved only clinical trials. The MS Society also expressed doubts about the procedure and called for further research.
The main criticisms are that the technique is new, that the criteria require further confirmation, that the importance of the human element in carrying out the technique must be established and that it is important for these observations to be confirmed by other groups with larger numbers of patients with the disease.
This discovery was the focus of several sessions of the Health Subcommittee on Neurological Disease.
Every year, the Multiple Sclerosis Society of Canada holds meetings on the Hill to let parliamentarians know what the organization wants from the government. They were the committee's first witnesses.
The session dealt with issues that went beyond CCSVI. Then further sessions focused only on that aspect. For the past several weeks, several experts have testified, but people with MS have also delivered very emotional and hopeful testimony.
One critical player was conspicuous by its absence: Health Canada. Not a single Health Canada representative appeared before the committee, despite the fact that many of the witnesses were turning to the department. Members will surely agree that the situation is disturbing. I spoke to members of the subcommittee about this on May 11. I said:
Patients, a doctor and specialists have told us that we should focus on treating CCSVI. Others have said that the current state of science is not advanced enough to do that. Both sides are turning to Health Canada.
However, no Health Canada representatives could join us today to explain why the treatment is not currently offered.
Showing a complete lack of sensitivity, the department finally sent an email last Thursday to the clerk of the committee. I want to read it so that everyone can get a good idea of the challenges with this issue:
Decisions regarding new treatment procedures are medical questions that fall under the jurisdiction of provincial and territorial governments and administrations, health care professionals and health care institutions.
The federal government supports health research, which includes clinical research aimed at discovering and assessing new diagnostic treatment procedures. It does not make decisions or offer opinions on the relevance of new treatments that could be integrated into the provincial and territorial health care systems, and does not suggest any conditions that should be set. Questions regarding accessibility, delivery and funding of clinical services should be addressed to the appropriate health care authorities and professionals at the provincial and territorial levels.
It is of course rather disappointing for many people who are listening to the debate tonight to hear that response from Health Canada. However, that is exactly what it should be saying, given the existing constitutional framework. It is not up to the House of Commons Standing Committee on Health or to the Government of Canada to determine whether this treatment should be made available to patients.
So why are people who want to receive a diagnosis and treatment putting so much hope in an answer—hopefully positive—from this Parliament?
Is it because this Parliament—with the exception of the Bloc Québécois, which has always clearly stated that Quebec and the provinces have exclusive jurisdiction over health—has been inconsistent in its decision-making and is encroaching on this area of jurisdiction, sometimes using its so-called “spending power” and sometimes saying that if the provinces do not like it, they can take the matter to court?
Is it because Health Canada also uses this modus operandi, which, I would remind the House, is inconsistent, while taking its time in stating its intentions regarding this issue?
Is it also because the Subcommittee on Neurological Disease of the Standing Committee on Health scheduled a series of meetings without clearly defining its mandate and without assessing the repercussions of its work? We are not working in isolation. As parliamentarians, we must avoid disappointing people unnecessarily.
And so I am calling on the chair of the Standing Committee on Health to ensure that our work is more clearly defined in the future. I just hope that these brave and determined men and women—at a point where many have undergone or will undergo this surgical procedure overseas—who have come to speak with us will not feel that it was a waste of their time. I figure, and this is but a small consolation if there can be any at all, that these testimonies, including the one Dr. Zamboni will give tomorrow morning, are public and that the health professionals who will be making this decision can refer to them.
Perhaps there is still a solution at the federal level: research. For the Bloc Québécois, research is one of the most promising routes and it must be funded. Because of that, we are asking the federal government to substantially increase the budgets allocated to various research chairs in Quebec universities. That would allow for clinical teams to be established quickly and they could submit their application for the necessary funding.
What is more, in its response, Health Canada recognized the importance of health research, including clinical research, in establishing innovative procedures.
To conclude, in light of the context in which we are evolving, we invite those who have taken a stand during the debate to present their arguments to stakeholders in Quebec and the provinces. It is the provinces and only the provinces that can authorize this treatment. It is not up to us, and it would be disrespectful of people and of institutions to pretend otherwise.