Ramez Ayoub

[Health, February 27th, 2018]

Mr. Speaker, innovation and research are key to improving the lives of people suffering from brain-related illnesses and disorders. Foundations such as Brain Canada, whose offices are in Montreal, are actively working on changing the lives of some 3.6 million Canadians suffering from all kinds of neurological infections.

Can the Minister of Health inform the House of her efforts to support neuroscience research across Canada?

[Sainte-Thérèse Lions Club, February 8th, 2018]

Mr. Speaker, the Sainte-Thérèse Lions Club is celebrating its 50th anniversary this year.

The philanthropic organization has been improving the lives of people in Thérèse-De Blainville and elsewhere since it was founded by Roméo Légaré in 1968. The Lions Club is dynamic and engaged and plays an important role in the community. It has injected over $2.5 million into the community to support people with disabilities, the less fortunate, and youth, and has also been active in health care and education. The Lions Club is a wonderful example of solidarity and generosity and a great inspiration to all.

I would like to take this opportunity to highlight the work of club president, Lion Danielle Corbeil, who has been involved with the Lions for 19 years. I would like to congratulate all members of the Sainte-Thérèse Lions Club and thank them for their solidarity and devotion to our community.

Bravo! Happy 50th!

[Firearms Act, November 7th, 2017]

Mr. Speaker, I am pleased to rise today to speak to Bill C-346, An Act to amend the Firearms Act (licences).

As my colleagues know, we campaigned on a promise to implement reasonable, effective measures with respect to firearms that promote public safety while ensuring that law-abiding firearm owners are treated in a fair and reasonable manner.

I believe it is fair and reasonable to require firearm owners to obtain a permit to own firearms. It is also fair and reasonable that people applying for a permit be required to provide information proving that they do not pose a threat, including information about any new mental health conditions as well as the attestation of current or former conjugal partners. It is also fair and reasonable that that information should be updated regularly, since circumstances can change in life.

That is why firearms permits currently have expiry dates. Every five years, firearms owners must apply to have their permits renewed and they must submit updated information on their eligibility. That is fair and reasonable.

Licences for many other things, such as cars, work the same way. However, the bill before us would eliminate the very idea of an expiration date for the firearms licensing system. In other words, this bill would allow people to go 10 years without having to update their licence information. That is not right or reasonable. This bill would not be in the interest of public safety. That is why I cannot support it.

Let us take a closer look at what Bill C-346 is proposing. Under the bill, a firearms licence would essentially be valid for life for any licence holder over 18. The idea behind the licensing provisions of the Firearms Act is to protect public safety by ensuring that applicants are appropriately screened.

The provision of the bill regarding lifetime licences will weaken the regime and undermine the very purpose of the act. What is more, it is dangerous to let people go for 10 years without updating the eligibility information on their permit. The information that is collected every five years under the current regime is critical to protecting the public. It is an invaluable tool for the chief firearms officers who review this information.

Chief firearms officers use this information to determine whether there are safety risks associated with allowing an individual continued access to a firearm. This is done based on the understanding that people's personal circumstances change over time. The chief firearms officers feel it is very important that this information be kept up to date, as do most Canadians.

Neither communities nor law enforcement officers would want a firearm owner who is not eligible to be able to go for 10 years without undergoing any kind of assessment, while maintaining continued access to firearms.

As I mentioned earlier, applicants have to provide a statement from their current or former partner confirming that they are not a threat. This statement is essential for several reasons.

For one thing, studies have shown that battered women are five times more likely to be killed by their aggressor if he owns a firearm. A study by the Violence Policy Center in the United States showed that nearly two-thirds of the women murdered with a firearm were killed by their intimate partner.

If that is not proof enough, we are seeing more and more evidence of the link between domestic violence and mass shootings. A recent American study that looked at mass shootings between 2009 and 2014 showed that 57% of them involved the murder of a family member or a current or former intimate partner.

If we were to pass this bill, a person could have serious concerns about a former partner owning a firearm, but Canadian authorities would be unaware of those concerns for 10 years.

Let us look at what would happen after 10 years if new information about eligibility were not supplied. First, the licence would not expire because it would have no expiration date. Essentially, the bill introduces the concept of a suspended licence for those who do not renew their licence, and it enables people to voluntarily relinquish their licence.

However, this proposed legislation does not adequately explain what a suspended licence means. The concept of a suspended firearms licence does not exist in the Firearms Act, nor is it defined in the Criminal Code.

There is nothing in the bill before us that defines this concept. It would introduce a vague system that would create uncertainty and jeopardize public safety. For example, if a person's licence is suspended, can that person buy, sell, or exchange a non-restricted firearm? The bill does not say.

Since the bill does not explain how it would amend the Firearms Act with regard to the transfer of non-restricted firearms, a person could buy a non-restricted firearm with a suspended licence, because their laminated card would still look valid.

By all accounts, this is not the only point on which this bill is too vague. It also fails to state whether people who continue to possess firearms after their licence is suspended could continue to hold a suspended licence, even though this would violate our firearms laws. We still do not know whether this means that those who have access to restricted or prohibited firearms could simply choose to allow their licence to be suspended indefinitely while still possessing a non-restricted firearm.

This type of omission is unacceptable in a bill dealing with such an important issue as firearms and community safety. The bill's inconsistencies go against the government's sensible and effective approach to firearms. In the past two years, the government has implemented reasonable basic measures to ensure Canadians' safety, while continuing to treat responsible firearm owners in a fair and respectful manner.

The government allowed decisions on technical classifications to be made by the law enforcement community rather than allowing politics, instead of public safety, to determine how a gun is classified. These decisions are made by the RCMP, in accordance with criteria established by Parliament in the Criminal Code and other regulatory regimes.

The Minister of Public Safety and Emergency Preparedness overturned a ministerial directive from the previous government that would have allowed firearms manufacturers to determine the classification of their own products, and a new and more representative Canadian firearms advisory committee was established. It includes representatives of women's groups and public health organizations, as well as police and the firearms community. That makes sense, because decisions about firearms concern all of us.

In summary, we are putting public safety first while remaining respectful of responsible gun owners. Since Bill C-346 does not make public safety a priority, I invite all honourable members to join me in opposing it.

[Paul Larocque, October 18th, 2017]

Mr. Speaker, I rise today to honour an influential man, a visionary in our community. Paul Larocque is retiring from politics after 24 years of exemplary public service as mayor of the town of Bois-des-Filion.

Mr. Larocque has decided to spend more time with his family and more time taking on new professional challenges after being elected six times, which shows how highly regarded he is in Bois-des-Filion. Knowing Paul personally, I share that admiration and consider myself lucky to have had the opportunity to work with him over the past 18 years on many files, including Highway 19, for example, as well as to call him a friend.

Well known for his integrity, his social and political involvement, his economic vision, and his courage in the face of adversity, Paul Larocque helped modernize his town's administration, while also tackling some of the critical issues facing our region.

Paul, you are, and will always be, an inspiration.

[Business of Supply, October 5th, 2017]

Mr. Speaker, I really appreciate my colleague's question.

The more we study this issue and the more we look at the facts, the more it becomes clear that we need national pharmacare. I agree with that in principle, but we have to achieve that end as quickly as possible and provide the best possible care. We also have to make sure drugs are prescribed to the right people at the lowest cost possible. That is what we are going to do.

[Business of Supply, October 5th, 2017]

Mr. Speaker, that is a very good question.

Our government has done a number of things to help the provinces set up a bulk purchasing program so they can reduce costs. Initiatives like that come from the federal government and the House as a whole.

The Standing Committee on Health is talking about these issues and is not waiting for all the results to come in before taking action. The important thing is to keep going, not necessarily to make predictions. We have to act now, and that is what we are doing.

[Business of Supply, October 5th, 2017]

Mr. Speaker, I am a member of the Standing Committee on Health, which is studying the possibility of creating a pan-Canadian pharmacare plan. We are in the process of gathering information.

I agree that my speech today further supports the fact that there is a real need for such a plan. However, before negotiating a pan-Canadian program with the provinces and the other Canadian regions, we must finish our study, which we have not done yet. I am in the midst of collecting information and we will ultimately table a report.

We just received the PBO report, which provides all kinds of extremely important information. However, we have to digest the information and then have intelligent discussions based on the evidence. That is what we will do.

[Business of Supply, October 5th, 2017]

Mr. Speaker, I am pleased to have a chance to contribute to today's debate on prescription drugs, which are an important part of our health care system. In order for us to commit to a national pharmacare program, the necessary groundwork must be laid to support efficient management of pharmaceuticals in this country.

That is why I am pleased to be here today to talk about appropriate prescribing and use of drugs. Appropriate prescribing is an important component of our government's commitment to improving the affordability, accessibility and appropriate use of prescription drugs.

Significant increases in the use of prescription drugs to treat health problems have led to an increase in inappropriate use and unnecessary spending on these drugs.

Inappropriate prescribing for seniors comes with a specific set of concerns. More than 80% of Canadians over the age of 65 take at least one prescription drug regularly. In fact, one in three Canadians takes five or more medications a day. It is estimated that 37% of these prescription drugs are potentially harmful or ineffective, costing the health care system more than $400 million a year.

The World Health Organization estimated that in 2012, half of the world's drugs were either prescribed, dispensed, or sold inappropriately, and that half of all patients failed to take them correctly. A proper prescription aims to improve prescription drug use by ensuring that the right drug is prescribed to the right patient at the right time. Our government acknowledges that it is an important part of our health care system that we have to improve if we want to reduce waste, protect patients from unnecessary harm, and make progress in health care.

Patients seek prescription drugs when they are sick, and prescribers use their expertise to choose drug treatments for their patients. When prescribed and used appropriately, prescription drugs can prevent sickness, improve productivity and quality of life, reduce absenteeism, support mental health management, and even cure illnesses.

In fact, when appropriately prescribed and used, drugs are an essential part of clinical care. However, 50% of Canadians do not take their drugs exactly as prescribed. Furthermore, questionable prescribing practices lead to both inefficiency and waste. If they are not used appropriately, prescription drugs can cause serious harm and put additional pressure on other parts of the health care system.

According to the Canadian Society of Hospital Pharmacists, every year, drug non-compliance is the cause of 10% of all hospital admissions and 25% of hospital admissions for the elderly. Every year, 200 drugs are approved, and it is very difficult for prescribers to keep their knowledge up to date.

Many of the new drugs that are authorized for use in Canada each year come with higher price tags but very few additional clinical benefits compared to other less expensive drugs that are already on the market. The appeal of these new drugs may lure patients and prescribers into using them instead of existing drugs or other treatments that are more effective.

Unfortunately, our health care system does not always give prescribers the support they need in choosing the best drugs for their patients. In Canada, colleges of physicians and medical associations develop clinical guidelines to help with prescribing drugs. However, many of these guidelines are developed with the help of industry funding and are not subject to quality checks.

In budget 2017, we allocated additional funding to the Canadian Agency for Drugs and Technologies in Health, or CADTH, to help support existing intergovernmental efforts to ensure that drugs are prescribed and used properly. That includes identifying best practices and promoting new implementation strategies for appropriate use.

CADTH is responding to the need for more guidance on prescribing practices by adapting its products and services. In the future, CADTH's appropriate use programs will include evidence-based prescribing guidelines and examine the comparative efficacy of non-pharmacological treatment options. For example, CADTH's review of first- and second-line pharmacological diabetes treatments meets the need for more sound evidence about categories of drugs, not one drug in particular. This will help prescribers select the right drug and optimize its therapeutic use.

In the past, our ability to address inappropriate prescribing was impeded by limited access to reliable national data on prescribing practices and the use of prescription drugs. Without that kind of data, our understanding of the problem and our ability to address it are limited. Without sound, objective evidence, programs to promote appropriate prescribing and repair the damage done by inappropriate use cannot be designed to focus on the areas of greatest need.

We responded to this challenge with federal investments in budget 2016 and budget 2017, so that Canada Health Infoway could work with the provinces and territories to develop a national electronic prescription program to allow health professionals who issue prescriptions and pharmacists to share information electronically.

This system, called PrescribeIT, will help reduce prescription errors, inform pharmacists of potentially dangerous drug interactions, and help patients take their medication as prescribed. Since it will be integrated into existing drug information systems in the provinces and territories, it will provide decision-makers with a more accurate overall picture of pharmaceuticals in Canada.

PrescribeIT is already in use in Ontario, where the first electronic prescription was sent to Huntsville on August 30. A number of organizations in the country are already working on appropriate use, and Canada has shown its capacity for developing tools and resources in order to create effective programs. What is missing is an active strategy to capitalize on the objectives and progress of existing organizations and programs. Such a strategy could help eliminate duplication of efforts in this domain, address important gaps, and ensure more effective intervention.

In order to help determine how international best practices could be adopted for developing such a strategy, Health Canada is now asking the Drug Safety and Effectiveness Network to conduct an in-depth analysis of international organizations responsible for the appropriate use of drugs.

At this stage, I would like to talk about two leading organizations recognized by the Drug Safety and Effectiveness Network, that were created over the past few years to address the issue of appropriate use in Canada, the Choosing Wisely campaign and the Canada Deprescribing Network.

Choosing Wisely is a campaign to help clinicians and patients engage in conversations about unnecessary tests and treatments, and make smart and effective care choices. To date, more than 40 medical specialists have made recommendations on inappropriate care, including the use of prescription drugs.

Recently, with the help of federal funding, these leading organizations were able to broaden the scope of their message across the country.

The Canada Deprescribing Network was established out of concern for the risk related to the use of medication by seniors. This group of clinicians, researchers, and patients work together to promote the deprescribing of medication that may no longer be of benefit or that may be causing harm. To date, the network has produced a number of resources, including guidelines on deprescribing the four drugs most commonly prescribed to seniors. These two leading organizations are working together with the Canadian Agency for Drugs and Technologies in Health in key areas for improving the care that Canadians receive by coordinating their work on the inappropriate prescription of drugs used to treat insomnia.

I am sure my colleagues will agree that improving the prescription and appropriate use of drugs is key to improving the effectiveness and sustainability of our health care system. On that, I am prepared to answer questions.

[National Defence, September 29th, 2017]

Madam Speaker, in the new national defence policy, the government recognizes that when it comes to the military, our service members are our number one resource. Last year, however, the Auditor General indicated that our armed forces were massively understaffed, and that the problem was going to get worse, not better.

Would the Parliamentary Secretary to the Minister of National Defence tell the House about the efforts being made to reverse this trend and ensure that we can increase the regular force and the reserves, not only in Quebec but across the country?

[50th Anniversary of Collège Lionel-Groulx, September 22nd, 2017]

Mr. Speaker, today I rise to acknowledge the 50th anniversary of Collège Lionel-Groulx, a public institution dedicated to college-level and adult education in Sainte-Thérèse. Collège Lionel-Groulx stands out in the Lower Laurentian region for its special relationship with its partners and for its contribution to the economy. It is known throughout Quebec for the quality of its education programs, for instance in theatre. Some famous people graduated from there, including Sophie Desmarais, Simon Boulerice, and Julie Le Breton.

I am also pleased to acknowledge the excellent work of the leadership of the college and its director general, Michel Louis Beauchamp, and its chairman of the board, Samuel Bergeron, as well as the work done by the Fondation du Collège, led by Jocelyne Roch and backed by Paul Paré, chairman of the board.

This passionate team is working for the benefit of our young people and our future.

Happy 50th anniversary, Collège Lionel-Groulx.