- MPlibFeb 26, 2015 12:00 pm | British Columbia, Vancouver Centre
Mr. Speaker, measles and pertussis are fatal. A generation ago, diphtheria and polio caused death and disabilities. Vaccinations eradicated these diseases, but now in parts of Canada 40% of children are not vaccinated, putting themselves and others at risk.
The Prime Minister silences scientists who disagree with his ideology, so telling parents to listen to scientists and vaccinate is not credible. He must act.
Will he use some of the millions he spends on self-promotional ads towards a public education campaign on the scientific benefits of vaccination?
- MPlibFeb 26, 2015 7:45 am | British Columbia, Vancouver Centre
Mr. Speaker, I think this is a farce. We have spent, what, 100 hours over the course of the government's tenure here since 2011 talking about time allocation. That is 100 wasted hours of the time in this House.
We had an all-party committee, where the Province of British Columbia, the municipalities around Vancouver, and the Vancouver Police Department brought in amendments that were consistent with the Supreme Court ruling, and they warned the government that it was intruding in those jurisdictions. This is a government that always says that it cannot do anything for anyone because it is not the jurisdiction of the federal government. Suddenly, it is intruding in jurisdictions, and yet not a change was made.
We need to discuss why the government does not listen at committee stage to anything anyone says. It does not accept any amendments from anyone at all, and then it complains that the opposition refuses to allow public consultation. Everyone has accepted that public consultation should occur. Public consultations went on before InSite was set up in Vancouver, so the minister is not really being honest with everyone in this House when she says that the opposition is opposed to public consultation. We are absolutely not opposed, but we think we should listen to experts and to people who tell the minister what the government should be doing with the bill, but nobody listens in this government.
- MPlibFeb 26, 2015 7:30 am | British Columbia, Vancouver Centre
Mr. Speaker, the sudden rush is interesting, and this is what I want to speak about. Why the sudden rush, and why is the Minister of Health here when this was actually under a different committee, not health, where it should have been?
The Supreme Court ruled on this in 2011. We need to discuss the bill in the House and re-debate it, because when the bill went to committee, despite recommendations from many people, as well as provinces, municipalities, and the Vancouver Police Department, not a comma in the bill was changed.
This is part of the issue. The government listens to no one. Everyone is in agreement with the idea of public consultations. There were huge public consultations when InSite was brought in. No one is disagreeing with that. What we want to know is why the government has waited. The ruling was in 2011, and now, all of a sudden, it wants to ram everything through and not allow for debate on why the process at committee, which is important, was actually not listened to. Not a comma in the bill was changed. We need to discuss that in the House.
- MPlibFeb 26, 2015 7:20 am | British Columbia, Vancouver Centre
Mr. Speaker, there are a couple of questions I would like to ask.
Obviously I agree with my colleague in the New Democratic Party that this bill was delayed for a very long time and that all of a sudden the government wants to rush it through. At report stage, members heard from many people who challenged these proposed measures by pointing out that they did not in fact meet the Supreme Court rulings but overstepped them and are going to be open to a charter challenge.
As well, when the bill was tabled by the Minister of Health, it did not go to the health committee. It actually went to an enforcement committee, the Standing Committee on Public Safety, which is a very strange and puzzling thing to happen. This tells us where the government is coming from. For the government, this is about enforcement and not at all about health. However, it is in fact about health.
The question I want to ask is this. Why is it that members do not have the time to discuss what they heard at report stage, when there were two dissenting opinions by the opposition party saying that what was heard from witnesses was not reflected?
This bill oversteps the Supreme Court ruling in many ways. The Supreme Court had five criteria. This bill, coming from a government that says health is a provincial jurisdiction, actually intrudes completely and in great detail into provincial governments, municipal governments, and local police rulings. In fact, those three groups—the provincial governments, the municipal governments, and the police—all put forward amendments that said this bill was intruding into their jurisdictions.
- MPlibFeb 24, 2015 9:20 am | British Columbia, Vancouver Centre
Mr. Speaker, I listened with great interest to my colleague across the way. I know that she is a nurse and understands this issue very well.
The member talked about structure and said that the structure of the suggested committee is not right. She said that she learned from the special committee on missing and murdered aboriginal women that there could have been more people at the table. However, when our leader brought forward the motion today, he said that he was very open to amendments. In that case, did I hear the hon. member suggest that we can add the Canadian Medical Association to the structure of that table? I think the leader said he was open to anything that would make it a better process, so I am asking the member if this is what she is suggesting.
Also, the member talked about a timeframe. The Supreme Court gave 12 months; the current government has done absolutely nothing to deal with the Supreme Court's ruling, and we are now moving into the third month of the year.
The bottom line is that there was time, and I think we can do it in that time. As well, I am glad to hear the hon. member suggesting an amendment to the motion. Does that mean she is supporting it?
- MPlibFeb 24, 2015 8:55 am | British Columbia, Vancouver Centre
Mr. Speaker, obviously if the Supreme Court of Canada does not grant an extension, provincial jurisdictions will craft different pieces of legislation across the country and we will have a situation similar to the one we had in regard to abortion, where some provinces did and some did not. We will see a lot of issues. Regardless of where they live, Canadians will not be able to access what the Supreme Court ruled is a constitutional right under section 7 of the charter.
This ruling came in December. The House has been meeting for quite a while. There needs to be a sense of compassion. We talk about dying with dignity and a lot of people are waiting. They have been waiting a year and we would be asking them to wait longer than a year in pain and suffering.
There are two downsides to asking the Supreme Court to grant an extension: it may not, and we have to think of the compassionate nature of this work.
- MPlibFeb 24, 2015 8:40 am | British Columbia, Vancouver Centre
Mr. Speaker, I will be sharing my time with the member for St. Paul's.
This motion is fairly simple. It is asking for a special committee to be set up to seek input from experts and to have a broad consultation with the public and with physicians because we are talking about physician-assisted death. The Supreme Court has actually talked about the very complex and controversial nature of the whole issue of the idea of assisted death. We know that some people are anxious and concerned that vulnerable people would be coerced. The Supreme Court spoke clearly to the idea that people could be coerced and abused and pushed into making decisions to end their life when it is not necessary. The court has balanced that with the idea that some people do feel they need to end their life for various reasons. Because of the very complex nature of this ruling and because of the very controversial nature of how Canadians see this, many groups should be consulted. It is important for us to deal with this controversy within the public realm, and also to speak to physicians who would be the people dealing with the issue of physician-assisted death.
The Supreme Court was very clear that this legislation has to be balanced. It must balance protection of the vulnerable from coercion, et cetera, and allow for that right to life, liberty, and security of the person, for people who are:
...a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.
That is particularly clear. What the Supreme Court said is that any law must have “...properly designed and administered safeguards...capable of protecting vulnerable people from abuse and error”. The Court was very clear that we need to balance this. It is something about which we need to talk to the public. We need to hear from all the various groups and experts and from physicians.
The courts also said something very important. In the context of medical decision making and informed consent, physicians are fully competent and capable of assessing all of the criteria that the court spoke about earlier, which is about the adult person who is competent, et cetera. Physicians are the ones who diagnose a patient's condition, who know the prognosis of a patient, who understand all of the available choices that a patient has in order to relieve suffering and in order to look at the choices in terms of his or her life. Ending his or her life has to be one of those choices. Assessing competency is core when a physician is dealing with a patient.
Every day as a physician, I spent a lot of time with my patients, giving them the options for treatments and interventions, telling them exactly what their illness is about, what the prognosis is, and what the treatments may or may not be; and giving them every single option, so that at the end of the time patients are the ones who actually choose. It is called informed consent. They are given the information about what to do, where to go, and what decisions to make. This is just one more part of that informed consent, and physicians are the only persons capable of doing that, because they know how to assess competency. Physicians know when a patient is being coerced or abused. They know when a patient is able to understand the nature of his or her illness. Physicians are able to diagnose whether a situation is irremediable. They are able to assess whether the patient is in intolerable pain and whether there is no hope for the patient. In fact, in the context of life and death decisions, physicians are very capable of assessing these criteria.
In some jurisdictions, such as Oregon and Belgium, in Europe, we see that, in the decisions where there is physician-assisted death, there is always a second opinion. Many physicians, in the course of their discussions with their patient, will suggest getting a second opinion, so that patient hears from another qualified physician whether those options are indeed the only ones, and the patient is able to make the choices.
I think it is really important that physicians be able to do this, and I think the courts have said that they believe that physicians are capable of doing it.
One of the things we would have to look at, which is not widely accessible to anyone across the country right now, is an option for many patients who are finding themselves in intolerable pain or who are totally unable to have their condition remedied. That is the idea of palliative care. There is no palliative care accessible. I know that a physician would like to be able to tell a patient that there is a choice, that there is a place to go to for good palliative care, to relieve the pain a person may be experiencing and to do the kinds of things to help them die with dignity. Patients could then have a choice, but this is not a choice that is currently available across the country.
I want to stress that the Canadian Medical Association and I as a physician believe that palliative care is a key component to create as some kind of parallel program that would assist us when the legislation is being written, thereby offering these kinds of informed consent and real options to patients.
Suicide prevention programs need to be maintained, because we know that many patients who face a chronic, debilitating disease or an intractable illness become extremely depressed. It is one of the first things that happens to a patient when they are diagnosed with something that is intractable or life threatening. Therefore, they are not really making competent decisions because of depression. Good mental health care for patients who have been diagnosed with these illnesses is another option that is not currently available to patients. If we look at dealing with this issue, we have to give patients real options, so we need to expand these programs where necessary.
The second piece we need to discuss is to talk with physicians about legislation. The CMA has said clearly that it believes that the medical profession should be given adequate opportunity to comment or to have input into any kind of legislation, because we see clearly that physicians will be playing a great role.
We also know that physicians themselves are quite split down the middle on this issue. We know that physicians are torn between the two primary ethics. One is to consider first the well-being of the patient, which may very well be to assist that patient in dying with dignity. Second is to do no harm, which many physicians feel is an ethic that conflicts with that.
Therefore, there need to be clear protections, as currently exist in all jurisdictions globally that have legal physician-assisted suicide. They say that physicians who do not wish to assist a patient dying, for moral, religious, or other reasons, have an ethical and moral duty to refer that patient to a physician who will assist that patient.
These are some of the reasons that physicians have to be protected if they make a decision, as is currently the case in regard to abortion. If a physician for moral or other reasons will not perform an abortion, that physician has an ethical duty to refer the patient, if the patient wishes that to be done, to a physician who will do so.
These are very important issues on which we need to hear from physicians as we are crafting legislation. We need to look at best practices in other jurisdictions. That is an important piece.
However, the procedural component of this is very clear. The House will only sit for another 12 weeks. If we in fact get a committee to go now, to travel, to listen to Canadians and meet with experts and listen to physicians, we would be able, after an election with a new government of whatever political stripe, to meet the Supreme Court's deadline with a committee report.
Using a special committee is not without precedent. In fact, other special committees, such as the committee on solicitation, the special committee on the non-medical use of drugs, and the special committee on missing and murdered aboriginal women, have been precedents for this. It is because parliamentary committees have other roles to play in the course of their duties in looking at legislation and would not be able to carry out this job as completely and fully as a special committee could, whose only job would be to do that.
- MPlibFeb 05, 2015 11:55 am | British Columbia, Vancouver Centre
Mr. Speaker, currently small craft are not allowed to dump sewage less than three miles from Vancouver's coastal waters. Transport Canada is thinking of reducing this to one mile, which will cause a serious public health hazard, increasing E. coli contamination on the busy beaches of Vancouver where kids and locals swim.
Public health officers, health authorities, and municipalities have raised concerns with the minister. Will she assure Canadians that she will prevent this public health catastrophe and abandon this reckless idea?
- MPlibJan 29, 2015 10:50 am | British Columbia, Vancouver Centre
Mr. Speaker, I love the word “trust” and how people bandy it about so easily and readily. In fact, between the two governments of Pierre Elliott Trudeau and Brian Mulroney, there were 37 meetings between the prime minister and premiers. We are talking about a Liberal prime minister who met almost every year. Prime Minister Chrétien met with premiers five times and Paul Martin met three times in his very short tenure.
How else does the member think the Kelowna accord came about? How else does he think a national child care and day care early learning strategy was negotiated? How else does he think that the 10-year Canada health accord was negotiated? It was by sitting down with premiers and talking about the problems they and all of us face and finding common ground.
I would ask the hon. member to go back and review his history and get the facts right next time.
- MPlibJan 29, 2015 10:45 am | British Columbia, Vancouver Centre
Mr. Speaker, I want to thank my colleague for his kind words, but also for what is an extremely important question.
As baby boomers age, we are going to be facing, as the Canadian Medical Association calls it, a tsunami of seniors, many of whom are not prepared for retirement. As the member pointed out, they may not have pensions. For some of them, income security will be a huge issue if all they have is the OAS and GIS.
Here we go with the regions. In my province of British Columbia, seniors cannot afford to rent anything, because it is so expensive, but in some provinces they can. When we have unequal access to a basic thing like housing across this country, how are people able to manage? That is where the federal government comes in to sit down to talk about it, to try to find a common solution and common ground to help seniors.
We know that poor seniors suffer worse health outcomes. They become sicker and they need the health care system, which has now degenerated. As the Health Council of Canada said to us in March in its last report, we have now been seeing, for the last three years, inequitable access to health services and services for seniors across this country.
- MPlibJan 29, 2015 10:35 am | British Columbia, Vancouver Centre
Mr. Speaker, I will be sharing my time with my colleague, the member for Vancouver Quadra.
Mr. Speaker, I have been listening to this debate in the House and think that the government side misses the point here.
We are a nation. We are the Canadian government. Canada is the second-largest country in the world. We are a huge land mass. We span very many different regions. We have very many different realities in these regions, realities that may create different challenges and problems in the regions.
I want to point out that it was Robert Borden, a Conservative prime minister, who started these yearly and very consistent and continual meetings, inviting the premiers to the table to talk about things. I think that even then a Conservative prime minister had a concept of what nation-building was about, what it meant to want to form one great nation from sea to sea to sea, all rowing in one direction. That is the only way we can foster this kind of nation-building, this of sense of unity, and the feeling that Canada is competing in a very competitive global economy right now. If we do not all pull together and do not have some common action plan in various areas, whether on economic development, jobs, care, or an energy strategy, we will not be able to have a vision for this nation.
We all know, because of the Constitution, that the provinces have to deliver on some of these issues. However, finding that common ground is what this is about, finding the ability to pull together to say that this is where we want to go as a nation called “Canada”, this is where we can compete economically in this global stage, this is where we can take our best practices and share them and be able to build some solid solutions to difficult problems.
There is something else that happens when people sit around the table—and I know the hon. members have been talking about photo ops. It is not about photo ops. I think the Prime Minister is concerned that if he sits at the table and all the provinces gang up on the feds, as they have been known to do, he will not be able to control the agenda and outcome.
However, this is not about the federal government controlling anything. This is about the federal government listening. This is about the federal government beginning to understand the nature of this country. This is about premiers in other provinces realizing that it is not all about themselves and their own province. It is about how they can understand the challenges that face their neighbours. I do not want to have grievances that I cannot air in front of my neighbours. I do not want to have problems that I cannot discuss and cannot find a resolution to with others. I want to be able to say that we are working together. We cannot work together if we do not meet. No team functions well, for instance on the ice, if its members do not practise together. We have to get together. We have to take our greatest strengths and learn how to develop them.
The current Prime Minister has been the first prime minister in 95 or 97 years not to have met with premiers for such a long time, since approximately 2006 in his case.
I think my hon. colleague talked about the great things that came about from meeting and talking, things like the Canada pension plan, things like a national housing strategy of the day, things like a student loan program that works with the provinces, and things like medicare. Those are the things that define us as a nation. Those are the things that reflect who we were and how we got to where are today and to our having been be known, at one point in time, as one of the greatest countries in the world to live. It was because of some of these social programs that were built by people sitting around the table, arguing, debating, fighting. Yes, it is not always pleasant, but it has also brought about the very strong reputation that Canada has had over the years. We have been known as the world's negotiators, because as we sit around this table and fight and argue, we actually find common ground. We build a sense of purpose in which we will all go in this direction, with this vision.
Therefore, in sitting down, arguing, debating, and fighting with each other to find that common ground, we inadvertently and fortunately learn some very important skills. Our bureaucrats and politicians are known around the world, in every multilateral forum. When we were in government and I was a minister, everywhere I went if there was a problem that countries could not resolve, invariably, 9 times out of 10, they called in the Canadians to chair a group to cut through the differences and find commonality.
That is what we became good at. It is no coincidence that our own general, John de Chastelain, was sent off to northern Ireland. It is no coincidence that when North Korea began to flex its muscles, people asked for Maurice Strong to go, or that the United Nations continues to call on Canadians to come to build that negotiating skill to find common ground.
The Council of the Federation, in which the premiers are meeting and talking among themselves, has absolutely no power to do anything or make the kinds of changes premiers would like to make to ensure very important programs.
We should be talking about energy, as one of my other colleagues said. We should be sitting down and devising a plan. There is a richness of energy resources across this country, including oil or fossil fuels on the east coast. There could be tidal energy. We could have solar energy. We can build wind energy. We have hydroelectricity. In my province of B.C., we see natural gas. There are so many ways that we could tap into all the various and diverse forms of energy. We could create an energy strategy. We could create a strong nation that could compete in providing energy for the rest of the world as things go to hell in a handbasket.
We need to talk about the fact that we once were at the top of the heap in health systems. In 2004, we ranked fourth in health system performance, outcomes, et cetera. I hear people talking about outcomes and performance. I do not see any outcomes and I do not see any performance. All I see is a fragmented country that is beginning to bicker internally, just 13 little nation states developing and trying to find a way to move forward.
This is where the leadership of federal government comes in. We have always been the glue that holds this country together. We have always been the government that is responsible for ensuring that every resident of this great nation, no matter where they live, no matter what province they live in, no matter what region they live in, territory, or wherever, has equitable access to whatever, whether it is justice, health, energy resources, or jobs.
These are the things, especially at a time like this when we are facing so many challenges in being competitive in a global economy, that we need to pull together on. This is when a visionary leader in the federal government would bring premiers together to talk about how we can help each other face challenges.
When I was a practising physician, and also as minister visiting and listening to communities, I found that when people sit at a table they come together and start talking about their own specific grievances. I heard someone say today that individuals are only worried about their own provinces, as they should be. I do not think that is nation-building. Of course, people want their provinces to prosper, but they also want their nation to prosper. If it does, then everyone prospers as a result.
When people sit around a table, I have always found that a great outcome is that they suddenly get the other person's problem. People begin to understand the challenges that the other people and groups face, and in this case the challenges that other provinces face. Then they begin to start getting it. As they get it, they begin to form common ground in developing a strong economy, in making sure that all of their people get jobs across the country. We want to talk about mobility, the ability to go from province to province. We want to talk about pan-Canadian strategies that would move us forward.
We have seen how this country has moved with that kind of leadership at the helm. That is the federal government's ultimate task, to build a nation, to be the glue that holds this country together. In health care we see that the premiers are begging. It is not the premiers who should call these meetings, but it is for the Prime Minister to go to the Council of the Federation, whose next meeting will be here on January 30. They are hoping that the Prime Minister will attend and talk about how we can build these things together.
Health care is losing. People in every province are not achieving the same access to health care. These things are happening.
There is one important thing the Prime Minister can do that would bring back trust, and that is to sit down, face the premiers, and talk about where we go as a nation on four or five specifics, including growth, the economy, social programs, the health of our people, et cetera.
- MPlibJan 28, 2015 11:15 am | British Columbia, Vancouver Centre
Mr. Speaker, one in five Canadians will experience a mental illness in his or her lifetime. Currently, three million Canadians suffer from depression. Suicides account for 24% of deaths in 15 to 24 year olds, and the suicide rate is climbing among men who are 85 and over.
In 2011, all parties in the House voted to support a Liberal motion for a national suicide prevention strategy. In 2013, the Mental Health Commission of Canada made recommendations for mental health policies in the workplace. The government has failed to implement any of those policies.
Last week, the Mental Health Commission gave Canada a failing grade on 12 out of 13 indicators for mental health outcomes. Suicide rates are still above the G8 average, self-harm among students is growing, and workplace stress and anxiety is rising. Stigma still prevents many from seeking help.
I encourage all members to support the Bell Let's Talk campaign today. Each tweet will get a 5¢ donation from Bell.
- MPlibJan 26, 2015 12:15 pm | British Columbia, Vancouver Centre
With respect to the creation of the position of President of the Public Health Agency of Canada in Bill C-43, the Budget Implementation Act: (a) what are the names, positions, organizations or affiliations of all the stakeholders consulted leading up to the creation of this position; (b) what submissions, proposals or recommendations were made by stakeholders during the consultation process before the creation of this position; and (c) what are the dates, times, and locations of the meetings with those individuals or organizations consulted before the creation of this position?
- MPlibDec 08, 2014 12:20 pm | British Columbia, Vancouver Centre
With regard to government advertising related to the Canada 150 celebrations: (a) what has been, or what is anticipated to be, the total spending on advertising related to these celebrations, for each fiscal year from 2010-2011 to 2019-2020 inclusive; (b) what are the details of consultations or focus groups with respect to this advertising, providing details as to (i) the dates, (ii) the participants in any such consultations or focus groups; (c) what organizations or firms participated in the design and production of any advertising which has already been broadcast or published, giving (i) the name of the vendor, (ii) the reference number of any related contract, (iii) the date of the contract, (iv) the description of the goods or services provided, (v) the delivery date, (vi) the original contract value, (vii) the final contract value if different from the original value; (d) what is the title, content, and reference or ADV number of each advertisement which has already been produced; (e) what are the details of each advertisement placement to date, giving the title or other identifying detail of each television station, radio station, or print publication in which the advertisement was broadcast or published; (f) what is the total number and percentage share of advertisements which have been (i) produced, (ii) broadcast or published, broken down by official language of Canada, or by non-official language, specifying that language; (g) what has been the total cost of advertisements which have been broadcast or published to date, broken down by language of broadcast or publication; and (h) what is the anticipated cost and number of placements of advertisements which have been authorized to be broadcast or published in the future, broken down by language of broadcast or publication?
- MPlibDec 08, 2014 12:00 pm | British Columbia, Vancouver Centre
Mr. Speaker, the government ratchets up its war on science by forcing scientists to find matching funds to do basic research.
Scientists at CIHR say that research on aboriginal children, seniors' health, and nutrition is now at risk, since it is nearly impossible to find matching private funds unless the research leads to commercialization. Institutes are now pitted against each other for limited funds.
Canada used to be a leader in biomedical research. Now it is a race to the bottom. Will the minister stop her attack on scientists, do her job, and fund essential basic health research?
- MPlibDec 04, 2014 7:15 am | British Columbia, Vancouver Centre
With regard to the Canada Revenue Agency, for each year since 2004 inclusively: (a) how many Reminder Letters has the Charities Directorate issued to charities; (b) how many formal complaints have been received concerning the political activities of charities; (c) how many political-activity audits have been commenced, (i) of those audits, how many have been concluded, (ii) how long did each audit last; and (d) what has been (i) the total expenditure on the political-activity audit program in each fiscal year since the program was established, (ii) the total expenditure on each completed audit?
- MPlibDec 01, 2014 1:40 pm | British Columbia, Vancouver Centre
Mr. Speaker, I find it very interesting that my colleague spoke a lot about public health. If this is meant to look at public health, why did the bill go to the public safety committee when it was introduced by the Minister of Health and should have gone to the health committee? However, that is not the question I want to ask.
Illicit drugs impact on a person's health. The member said so. Harm reduction is very important because it tries to minimize that impact on a person's health. When we see rates of HIV drop from 2,100 to 30 and deaths go down from over 240 a year to zero, does the member not think that is a positive impact on health? The Canadian Medical Association, the Canadian Nurses Association and the Canadian Public Health Association all believe this is an important bill.
When InSite was started, the Liberal government ensured that local people, the province, the city, the police, everyone, did their due diligence, and we accepted that. There were huge public consultations that went on for over a year before this was agreed on. Why can this bill not do exactly that? Why does it intrude as much as it does?
- MPlibDec 01, 2014 1:25 pm | British Columbia, Vancouver Centre
Mr. Speaker, the important thing about any kind of public policy is evidence, which has shown, not only in Europe, but also in Australia, and in Vancouver East, that these safe injection sites save lives. We know that all of the people who have lived may not be important to the government, perhaps because they are intravenous drug users or suffer from HIV or hepatitis C. The government does not seem to care about certain people in this country. That is evident from all of the decisions it makes. The point is that the injection sites saves lives. Every HIV case costs the government $500,000 a year per patient. Therefore, it not only saves lives; it saves money.
- MPlibDec 01, 2014 1:10 pm | British Columbia, Vancouver Centre
Mr. Speaker, one of the things my colleague, the member for Vancouver East, was just saying is that this particular piece of legislation far oversteps what the Supreme Court of Canada ruled.
The Supreme Court of Canada gave five very clear factors that the government must look at if it is ever to approve another safe consumption site in any particular place that applies for one. It is not imposing it on anyone. It is any place that applies for a safe consumption site. That is the first thing.
What we feel, and what many witnesses have said, is that this so oversteps that directive that it intrudes into provincial jurisdiction, into municipal jurisdiction, into the jurisdiction of the local police forces, into the work of that region's public health officer, and into whatever the public health officer is doing based on criteria set by the College of Physicians and Surgeons.
What we see is that when the government is asked a question about health, it continues to say that we should not talk about it because delivery of services is a provincial jurisdiction. Then all of a sudden the government posts 26 very specific pieces on its legislation, factors that are going to intrude so much on the jurisdictions of other levels of government and on other police forces and on physicians that it is unbelievable.
The Supreme Court of Canada ruled that the right to life, liberty, and security of the person under section 7 of the charter overshadows any decision based on the Food and Drugs Act. That was noted.
I was there. I was in fact the designated minister to look after this issue when we were in government. What we found was that when the Downtown Eastside, during the Vancouver agreement, asked for the safe consumption site to be put in place, it was put forward by the province and by the mayor of the city. The police agreed to have a bubble zone whereby people could use an illicit substance only in that particular area. Everything was taken into consideration.
Let me give some facts.
Prior to the safe injection site being put up in Vancouver, there were about 234 overdose deaths per year in the prior two years. There were 234. After the safe injection site was set up in 2010, there were 2,395 overdoses, and not a single one of them resulted in death. That is why the Supreme Court of Canada said that this safe injection site actually saves lives.
When I listen to what is said around here, I realize that this particular government seems to think that somebody who is using substances and who is going to die is probably disposable, but obviously these people are human beings. They are Canadians. Their lives are worthwhile.
As a physician, I can say that every single life is worthwhile when we look after our patients. People stand here in this House and talk about the fact that this is not wanted in their particular region, but as the member for Vancouver East has said, nobody is inflicting or imposing anything on anybody's town or village or city.
There was a situation in which 234 people were dying from overdose deaths. The rates of HIV and hepatitis C in that little place called Vancouver East were up to extraordinary levels. There were 2,100 new cases of HIV prior to the setting up of this safe injection site in Vancouver. Today there are 30. That change from 2,100 to 30 means this form of harm reduction works.
However, the idea of the 26 pieces in the legislation that the government brought forward is so intrusive that it is going to make it absolutely impossible for any city to ask for a safe injection site, for any police to okay it, for any public health officer to give the details and the data for why it is needed, and for any province that wishes one to be able to say so.
We brought in amendments. Between the New Democratic Party and the Liberal Party, there were 60 amendments brought to this particular bill, Bill C-2, but not one comma was changed. Not one. This is what happens in most parliamentary committees right now under that particular government: no one listens.
We pay extraordinary amounts of money for people to come as witnesses, and they are expert witnesses. They come to present to Parliament, but so much for consultation. We listen to what they suggest, and when the majority suggest particular amendments, the government just says no.
The government runs a parliamentary committee, which is made up of parliamentarians from all parties. It is not an arm of the government but an institution of Parliament, and therefore should be completely non-partisan in what it delivers. It should listen to experts and factor in what they say. That is what consultation is about. It is not about listening to a whole bunch of people and then telling them, “Thank you very much, but I do not think I care about what you said. I do not like it and I am not going to do it.”
The government's ideology opposes harm reduction. Harm reduction is a term that has been expunged from every single piece of language the government brings about. It does not like the idea of harm reduction.
As a physician, I will tell the House what harm reduction means. When someone is suffering from a disease that can threaten their lives, harm reduction is an intervention that brings down the harm so that the person does not die as a result of that particular illness and is able to continue on until a cure or some other way to help them live properly is found. We have seen exactly that in the safe consumption site in Vancouver.
In Australia, Spain, and Portugal there are safe consumption sites. It is as a result of what was done in Europe that we decided to do this particular pilot project in Vancouver. “Evidence-based” is a term that is thrown around by the government. “Evidence-based” means that when one does something, one looks at the outcomes to see what the evidence shows. What is the rate of mortality? What is the rate of morbidity? What is the harm done? How is that harm alleviated? That is the meaning of “evidence-based”, and it is very clear that the safe injection site in Vancouver showed that evidence of success.
The fact that the government has put up all these barriers means there is never going to be another safe injection site in this country. The one in Vancouver has been extended for a year; I see that as a really obvious ploy to wait until this bill passes so that the government can stop the safe injection site in Vancouver from even existing.
These are people's lives. For me as a physician, it is untenable that a government would stand in the way of saving lives. It is also untenable that within an hour of the time this bill was tabled in the House by the Minister of Health, a letter went from the Conservative Party of Canada to all its members and donors that said the Conservatives had just put forward a bill that was going to stop junkies from shooting up in their neighbourhoods.
When that comes from a government, it is extraordinary. As far as I am concerned, it is absolutely disgusting that people's lives should be so meaningless to the government that it would send out such an absolutely callous letter asking for money.
All I have to say is simply this: the word “consultation” is a joke. Parliamentary committees are a joke, currently, under this government. People can come to say whatever they like; the government never listens.
When we hear people say that this bill has been brought back exactly as it went to committee, with not even a comma changed, I think that tells us the state of Parliament at the moment in this country: it is no longer a democracy.
- MPlibDec 01, 2014 12:25 pm | British Columbia, Vancouver Centre
With regard to the formulation of policies concerning firearms regulation: (a) what are the details of the “bureaucratic initiatives” concerning firearms regulation which were referred to by the Prime Minister in public remarks made in Sault Ste. Marie, Ontario, on October 17, 2014, including (i) when was each such initiative commenced, (ii) in which departments or agencies, and which divisions, offices, or organizations within those departments or agencies, do the bureaucrats who commenced each such initiative work, (iii) what has been the total expenditure associated with each such initiative, (iv) what are the titles and file numbers of any reports, dossiers, or other documents associated with, or generated in relation to, each such initiative?
- MPlibDec 01, 2014 11:00 am | British Columbia, Vancouver Centre
Mr. Speaker, today is World AIDS Day. AIDS is the world's leading infectious disease killer. The WHO reports 39 million deaths since 1981.
Today, 35 million people live with HIV, mostly in low and middle-income countries. Of those, 24.7 million live in sub-Saharan Africa alone. Some 3.2 million with AIDS are children under 15.
Despite advances in science and significant efforts by the global health community, most people with or at risk for HIV have no access to prevention, care or treatment. While progress has been made in preventing mother-to-child transmission, there is still no cure.
British Columbia plays an important role in the prevention and treatment of HIV-AIDS. The HAART program, available to every positive resident in B.C., has seen a drastic drop in the number of new infections annually. The world calls B.C.'s program “treatment as prevention”, since after the second dose, the virus is absent from the blood stream and cannot be passed on.
China, Brazil, the U.K. and Austria have adopted B.C.'s program, yet Canada's federal government has yet to acknowledge its existence.
- MPlibNov 28, 2014 8:35 am | British Columbia, Vancouver Centre
Mr. Speaker, the Auditor General slammed the current government for failing to address the high cost of food in Canada's north.
There is evidence that to survive people have to scrounge for food in the dump; yet, the minister for the north continues to deny this. What is worse, elected officials say she has been bullying them to endorse her failed program and apologize to the Conservative Party. This is shameful. This is not the first time the minister for the north has failed the north.
Will she listen to the Attorney General and act now to ensure that the people of the north have access to nutritious and affordable food?
- MPlibNov 27, 2014 9:00 am | British Columbia, Vancouver Centre
Mr. Speaker, I want to thank the member for his interesting history of the evolution of our current drug policy system. As he so rightly said, in 50 years, science has allowed us to evolve in order to understand drugs, their adverse effects and how they impact people, and to therefore create better clinical trials, and those other things that have brought us to today. The tragedy of thalidomide had one good thing about it, in that it brought everyone to a point of wanting to have drug safety and to use science to evolve to this point.
However, the motion today on the floor, which the government supports, speaks to compensation for the victims and to some ongoing support on an annual basis. I ask the member whether his government will commit to providing exactly what the thalidomide survivors task force has asked for.
It speaks very clearly to $250,000 in a lump sum, and then $100,000 per year after that. Will the government commit to this?
- MPlibNov 27, 2014 8:20 am | British Columbia, Vancouver Centre
Mr. Speaker, if the minister meets with the thalidomide survivors, as she said she would, she should be prepared to grant them exactly what they ask for. She should also keep an ongoing watch to ensure that if new symptoms or new problems arise under the compensation on an annual basis and the lump sum compensation does not work, the annual compensation could be increased to meet the specific needs that may or may not arise.
It is clear what the survivors are asking for. They want a $250,000 lump sum payment and $100,000 per year to provide them with the technical and the living assistance that they will need on a day-to-day basis. That is pretty clear. There was no obfuscation on the minister's part, I hope, when she said she would listen to them and do what they ask.
- MPlibNov 27, 2014 8:15 am | British Columbia, Vancouver Centre
Mr. Speaker, my colleague made a very good point when he said that at the time the lump sum was given—and this is why hindsight is 20/20—no one expected that thalidomide survivors would live to become 50 years of age. Nobody understood how medicine worked to help people like that. New technologies and all sorts of things have helped thalidomide victims to survive to this time. Now that they are in their 50s, all of the problems of aging have occurred earlier in this group than they would for many of us. Hopefully, we can wait until we are well into our 80s before we get some of these problems, but the thalidomide victims have the problems now.
The lump sum the thalidomide victims are asking for may give them the ability to renovate their homes and have an appropriate environment in which to live. It is the yearly stipend that they are asking for that would bring forward the question of what they need on a yearly basis to get assisted living if they need it and to get the technical assistance and the equipment they need to help them live in their homes, work, and have meaningful and normal lives in the community.
If other illnesses happen to come with chronic aging, for most of us there is a health care system that will pick that up, and the thalidomide victims will get the health care they need if it is an acute problem. However, this is about being able, every day and every month, to address their needs on an ongoing basis until they no longer survive and no longer need that money. That is why I want the government to ensure that it will continue this yearly stipend and not just give another one-time lump sum payment.
- MPlibNov 27, 2014 8:10 am | British Columbia, Vancouver Centre
Mr. Speaker, that is an important question. My colleague is also a physician. She knows that one can look back. It was in the 1950s and 1960s when this occurred. We can ask why, but that is something I cannot answer. I was not around. I was not in government at the time. I was not privy to the discussions around the table.
I know the then minister of health under the Conservative government decided he would not provide compensation. The excuse he gave was that the government would then have to provide compensation for the many people who had been infected by tainted blood.
The issue is not what happened and why, it is where do we go from here. How do we right those wrongs? How do we move forward now? We have to learn from this so it never happens again, so the people who are harmed as a result of decisions made by governments will know that the government will do the right thing and come up solutions.
I cannot account for what happened then, but we need to move on and learn so that in the future this does not recur.
- MPlibNov 27, 2014 8:00 am | British Columbia, Vancouver Centre
Mr. Speaker, I rise in support of the motion before us. I wholeheartedly support the survivors of thalidomide and the work they have been doing to bring this issue to the public's attention.
I also want to thank my colleague, the member of Parliament for Vancouver East, for bringing this issue forward and for her support.
The government has agreed to support the survivors' request. I congratulate the Minister of Health and thank her for taking this position.
We all know the story of what happened with thalidomide in the 1950s. In 1954, the drug was created by a German company and was sent out to other countries. With the exception of the United States, most clinical trials showed that this was a safe drug at the time. However, in 1961, issues of deformities and very drastic side-effects from the drug began to show up in women who were pregnant. Therefore, in 1961, most countries removed the drug from the market.
However, the drug continued to remain in Canada for a few extra months. As a result of pregnant women taking that drug, 2,000 children died. As we know, if a child or fetus is unsustainable because of severe malformation, it does not necessarily exist. There were miscarriages very early in pregnancies or mid-pregnancies due to these kinds of deformities. There were 10,000 children born with serious defects, and that does not include the thousands of fetuses that never came to fruition as a result of severe malformations.
It is important that we look back at this story. As a result of this, Canada began to develop, and has developed, a very strong and vigorous drug reporting system. We always need to learn from our mistakes. Hindsight is 20/20, and we tend to think that we could have done different things at the time. However, at that time, I do not think people understood or knew that drugs could cause many of these issues, such as the defects from the use of this drug.
However, we need to bear responsibility for what happened in those days. One of the things we feel is important to remember is that, and it does not matter what party is in government, the federal government made decisions that caused this problem. Therefore, the federal government has a responsibility and a duty to right that wrong. There are also ethical and moral aspects, and we need to ensure we have compassion, that justice is served and that we care for Canadians who are harmed or suffer, as this group has, from any kind of side effect.
I wanted to speak to the motion, because the Parliamentary Secretary to the Minister of Health brought up this issue, and it is worth discussing. It is extremely relevant for us to talk about the drug approval system in Canada.
We do have a strong drug approval system and, indeed, it was because of thalidomide. Vanessa's law is a good law, but we believe it could have gone further. We have heard recently that in the last seven years, the number of faulty drugs that have gone on the market have tripled.
One of the things that could have been strengthened in Vanessa's law is not merely that the minister can pull a drug off the shelf if he or she finds it is either faulty or there are adverse effects being reported from the use of the drug, but ensure that it is truly open and that the public is aware of that.
The Food and Drug Administration in the United States has public reporting of clinical trials and public reporting immediately when there are adverse effects of faulty drugs. We have seen that over and over. However, we have a tendency not to let the public know, and we need to do that. It is important that the health care professionals who prescribe drugs and the pharmacists who dispense them, in many instances off the counter, are aware, as soon as possible, when there is some adverse effect or when there is a faulty drug.
This is something we need to talk about, and I am not being partisan. I think we all feel it is important to speak to the issue of drug safety.
I also am pleased the minister has decided to support the motion, but I would like to ensure that the details, and the devil is always in the details, of what the thalidomide survivors have asked for will be taken into consideration.
We know that in 1991 a simple one-time-only payout was made to many of the thalidomide survivors of about $52,000 to $82,000, depending on the severity of their disabilities. However, to be cynical, I do not think most people at that time felt that anyone with such severe disabilities would survive into their fifties. That it is a tribute to the resilience and the powerful will of the survivors of thalidomide. They have spent a lot of time learning how to live with these disabilities, how to work with them and find meaningful jobs, how to move on and live some sort of meaningful life.
However, because they have reached their fifties and many of their family members have passed on, or maybe their parents are no longer able to support them, they are suffering probably sooner than most of us from chronic disabilities, such as arthritis and diseases. We well know that many of them only have one lung, sometimes one kidney or have severe limb deformities because of the effect of this drug. It is really important now for these survivors to get the help they need.
I hope that when the government says it will support the motion and it will support the survivors, that we do not go back to the old, “let's give them a lump sum”. We have seen what Germany and the United Kingdom have done. They have given yearly stipends and financial living assistance to many of their survivors, which totals somewhere around $88,000 to $110,000 per year.
I hope the government will give the survivors what they have asked for. We know they will need to have an annual living stipend, as they have asked for, which will allow them to get the adaptations they need for their cars, their homes and their workplaces. They will need the technical assistance to help them to do the things that we take for granted, such as washing their hair, brushing their teeth, basic daily living needs. They will need help such as home care or someone living with them full time or part time to assist them. That requires an annual stipend and financial living assistance for as long as these survivors live.
We know clearly what they have asked for. They have said that they want a $250,000 lump sum payment immediately and $100,000 a year for as long as they live. This will allow them to live meaningful, pain-free lives, have basic living care, and continue to work, if they work.
I repeat that I hope the minister will give these survivors exactly what they have asked for and not water it down.
We can all learn from this lesson. I want to thank the War Amps. In 1991, it pushed for that stipend when it was told very clearly by the government of the day, in late 1989, early 1990, that there would be no money because that would create a precedent for those who were infected by tainted blood.
As members know, the Liberals, when they formed government, spent a great deal of money on recompense and on living expenses for people who had been infected by tainted blood, following a major inquiry into the tainted blood issue.
The bottom line is that government has a responsibility, regardless of its strip, to look at these mistakes, redress them, and learn from them. That is very important. Thalidomide has taught us a very important lesson. As I said, we have a strong regulatory system, one of the best in world, and that has come about as a result of this problem.
I hope we are really open about the public's need to know. As we saw with birth control pills about a year ago, the government knew about the faulty pills. Women were taking these pills and health professionals were dispensing them, without knowing about the faultiness of those prescription drugs. Of course, we know what the result of taking a faulty birth control pill is. That could be a huge problem for many women who did not wish to become pregnant.
Over and over, we have seen the need for openness to the public. The Food and Drug Administration in the United States has done this very well. We can take a page from its book and learn that the more people know and understand, the better the caveat emptor, the better they can understand what they take so they can make rational decisions on over-the-counter drugs and on the health care professionals who prescribe them.
This piece needs to be put into Vanessa's law. I know many of us, the official opposition and our party, brought this up during the hearings on that bill. We felt this still was missing. This is not, as the parliamentary secretary said, being partisan. If we all care and we are all in agreement, we can talk about the things we need to do to improve our system.
I wish to thank my colleague from Vancouver East for bringing this forward. I hope the government will in fact listen to the victims, and be very generous and open with that compensation.
- MPlibNov 27, 2014 7:50 am | British Columbia, Vancouver Centre
Mr. Speaker, I am pleased to hear the parliamentary secretary support this motion, because it is worthwhile. I echo my colleague from the NDP's position that it should be timely and as soon as possible.
I noticed in her speech that the parliamentary secretary discussed Vanessa's law and the openness, transparency, and evidence based decision-making of the Conservative government. That is an appropriate thing to talk about, because it was as a result of thalidomide that we moved to a very strong drug regulation system.
However, I am hoping that the parliamentary secretary's speech means that things will change and that evidence based decisions will be made. As she well knows, at public hearings in committee, the government has tended not to listen to evidence by specialists and experts but continued along without any making changes to any of its legislation.
Can I ask the parliamentary secretary if this signals a new era?
- MPlibNov 24, 2014 11:35 am | British Columbia, Vancouver Centre
Mr. Speaker, 95 people are living today with severe disability due to thalidomide. They need government support now. Our drug approval system failed these Canadians once. The Minister of Health has a responsibility to do what is just and compassionate so they are able to live their lives with dignity, optimum functioning, and free from pain.
Will the minister do the right thing?
- MPlibNov 18, 2014 4:10 pm | British Columbia, Vancouver Centre
Mr. Speaker, Bill C-608 designates May 5 each year as a national day of the midwife. I rise to support this bill.
However, I want to make a side comment. We seem to be debating more and more bills that recognize a particular day for a profession or a cause. While these are all very useful in bringing awareness and importance to the cause, I hope we are not in danger of watering down the effect by having a day for everything. Sooner or later we will not pay attention to the days anymore.
This is an important issue, though. I believe this bill is important in recognizing the role of the midwife as part of a health care team in low-risk deliveries. In fact, we now know that most low-risk deliveries should be delivered by a primary care provider. In some areas that could include a midwife and in other areas it could include a nurse practitioner trained in midwifery. In others it could be a family physician who is trained in midwifery.
Midwifery is a way of providing quality, timely, cost-effective, patient-centred care, and I want to stress more than anything else the use of these primary care providers in terms of low-risk deliveries.
Women with high-risk pregnancies obviously should be handled in a hospital setting by an obstetrician, but in Canada more and more people with low-risk pregnancies are going directly to obstetricians. This increases the cost of care, and it does not give the quality of care and the continuity of care that a primary care provider such as a nurse practitioner, a family physician, or a midwife can provide to a patient.
Midwives play an essential role in promoting health and reducing maternal and infant mortality globally. Members have heard from my colleague from the Conservatives speak to that point just now. In fact, midwives are expert primary care providers in low-risk pregnancies and births and can optimize the childbirth experience for women at all risk levels.
It may be useful, however, to look at home birth statistics in Canada.
A lot of midwives I know prefer home birth and promote home birth. In some hospitals in some parts of Canada, they are an essential part of a team within the hospital setting.
Midwives performed 2,360 home births in 2008, which is an increase in home births of 25% in only five years. There are no national home birth statistics, but the percentage of non-hospital births in Canada more than tripled between 1991 and 2007. This increase coincides with the sudden rise in use of midwives within a low-risk birth experience.
Healthy women who are pregnant, however—and this is just me speaking as a physician—should always know that there is a 40% chance during actual birthing of having some kind of high-risk intervention necessary. In very large busy cities, it is often difficult at that point to get a person who has a complication from home to a hospital setting to deliver safely.
According to the chief of maternal-fetal medicine at Toronto's Sunnybrook Health Sciences Centre, women must therefore look carefully at home births as an option.
However, in countries with very high infant and maternal mortality rates where there is no basic health system in place, a midwife, and in some cases not even a fully qualified midwife, is an option in some faraway villages to have somebody with some training, no matter how small, available to provide a birthing at home. In the rainy season in many developing countries, a passable road cannot be found to get to a birthing centre that has all of the equipment.
Midwives have had a huge role in bringing down infant and maternal mortality, globally and especially in the developing world. Here in Canada, home births account for approximately 2% of all births in Canada, the U.S., and most western European countries, with the exception of the Netherlands, where home births account for one-third of all births.
I think it is appropriate to say that in Canada we only have midwives registered in B.C., Alberta, Manitoba, Ontario, Quebec, and the Northwest Territories. It might be interesting for other provinces to look at the role of the midwife as part of a primary care team in low-risk pregnancy and delivery.
There are currently seven midwifery education programs available in Canada. The program is a four-year baccalaureate program.
Midwives are and should become a larger part of health-care systems not only here in Canada but around the world.
Between 2000 and 2010, the number of births attended by midwives in the United States rose by 41%. Bangladesh, one of the few countries that have actually met millennium goals four and five on infant and maternal mortality and morbidity, actually committed to training an additional 3,000 midwives to reach the millennium goals, which is an extraordinary thing to happen.
Afghanistan has committed to increasing the number of midwives from 2,400 to 4,500 in a short period of time. Ethiopia has committed to increasing the number of midwives from 2,000 to 8,000. Rwanda has committed to training five times more midwives, which increases the ratio, sadly, from one to 100,000 to one to 20,000. It would be really nice to have a better ratio. In some of these countries, the ability of midwives to train to deliver babies is a core and essential part of looking at mortality and morbidity during pregnancy and childhood.
In 2010, the global strategy for women and children's health noted that an additional 3.5 million health workers, and that includes midwives, are required to improve the health of women and children substantially in the 49 lowest-income countries. The World Health Organization recommends one skilled birth attendant for every 175 pregnant women. I refer back to the fact that Rwanda is moving from one for 100,000 women to one for 20,000, when we know that the ideal ratio is one for 175.
There is much work to be done in looking at the role of midwives, not only in the developing world and not only globally but here in Canada and in some of our isolated areas.
I want to thank the member for bringing this issue forward. The more Canadians understand midwives and what they do and we look at better community care models of care, we will see midwives playing an essential role in that compendium of care and in that comprehensive list of caregivers.
- MPlibNov 07, 2014 9:25 am | British Columbia, Vancouver Centre
With regard to government funding, for each fiscal year since 2007-2008 inclusive: (a) what are the details of all grants, contributions, and loans to any organization, body, or group in the electoral district of Vancouver Centre, providing for each (i) the name of the recipient, (ii) the location of the recipient, indicating the municipality, (iii) the date, (iv) the amount, (v) the department or agency providing it, (vi) the program under which the grant, contribution, or loan was made, (vii) the nature or purpose; and (b) for each grant, contribution and loan identified in (a), was a press release issued to announce it and, if so, what is the (i) date, (ii) headline, (iii) file number of the press release?
- MPlibNov 06, 2014 11:50 am | British Columbia, Vancouver Centre
Mr. Speaker, last week, Health Canada found that 24 drug production facilities had so seriously violated safety regulations that they were non-compliant with the law. Now, the Conservatives knew this in 2013 and did not notify the public until now, a year after the U.S. Food and Drug Agency flagged the problem.
In 2011, the Auditor General warned the government that it took too long to notify Canadians of drug safety risks. Why did they put Canadians at risk, and should we divest their role to the FDA?
- MPlibNov 03, 2014 11:05 am | British Columbia, Vancouver Centre
Mr. Speaker, I rise to pay tribute to the latest inductee into the Canadian Medical Hall of Fame, Dr. Julio Montaner of the B.C. Centre for Excellence in HIV/AIDS. Julio has devoted his life to HIV/AIDS research, founding the B.C. Centre for Excellence with Dr. Martin Schechter in 1992, and was president of the International AIDS Society from 2008 to 2010. Julio's work led to the development of the highly active anti-retroviral therapy, HAART, which reduces the viral load, preventing HIV transmission.
In 2000, the World Health Organization and the UNAIDS program adopted HAART as the global standard of therapy. Brazil, Australia, the United States, China and France have implemented the therapy, yet the Canadian government has still not done so. Dr. Montaner has received many international awards, especially the Grand Decoration of Honour for Services to Austria. However, a prophet is not without honour, but in his own country and in his own house.
The induction into the Canadian Medical Hall of Fame finally recognizes Dr. Montaner's work in his own country. I hope the Canadian government will do the same.
- MPlibOct 28, 2014 12:00 pm | British Columbia, Vancouver Centre
Mr. Speaker, last week we tabled a motion asking the government to work collaboratively with Parliament to contain Ebola at source. In that spirit of co-operation, we even amended our original motion to accommodate the government's concerns.
Since then, there have been 400 new Ebola deaths and spread to another African country. Effective action in Africa is even more critical now and so is a national Ebola plan for Canada. It is time to put aside political partisanship and end these deaths.
Will the minister vote for our motion?
- MPlibOct 27, 2014 11:50 am | British Columbia, Vancouver Centre
Mr. Speaker, I have a question for the Minister of Health. It is a non-partisan question.
Last week, we tabled a motion asking the government to work openly and collaboratively with Parliament to end the Ebola epidemic at source, in West Africa, and to have a clear national plan in case of an infection in Canada.
Will the minister accept our offer to be open and co-operative, and support this motion?
- MPlibOct 21, 2014 2:30 pm | British Columbia, Vancouver Centre
Mr. Speaker, Liberals will be supporting Bill S-211 because it aims to designate the first Saturday in June of each year as national health and fitness day.
We are pleased to support this bill from my colleague from West Vancouver—Sunshine Coast—Sea to Sky Country. It is a laudable initiative indeed, even though symbolic. However, I think we need more than just a day and we certainly need to do more as governments to promote healthy, active living at all ages.
I remember my years as a physician when I was very involved with the British Columbia Medical Association and the Canadian Medical Association. One of the things we had been trying to do for years, and I am talking about 30 years, was promote one hour of daily quality physical activity in schools, but we could not get that done. Not all provinces have that at the moment.
I heard my colleague say that if one begins as a young person learning to be physically active every single day of one's life, it becomes a lifestyle habit. It becomes like brushing one's teeth, having a snack in the middle of the afternoon, getting homework done, watching TV, all of those other things. It becomes a part of one's routine and one's life. It is easier then to carry that on as one grows and goes through life cycles, so that by the time one becomes a senior, one would continue to have that active physical living.
We know that active living is not only a good thing to incorporate into one's lifestyle, but it is an important part of health promotion and disease prevention. Exercise and active living helps people who have Alzheimer's postpone the disease. If we can start getting people active throughout their lifetime, we may be able to postpone Alzheimer's. If we postpone Alzheimer's for five years, we will literally be seen to have eradicated the disease, mainly because we do not live five years longer every year, and people would not have their ability to remember and function neurologically fail.
We also know that there is a rise in children who will never be as healthy as their parents were, mainly because of type 2 diabetes and obesity. It does not help to have computers, as we all sit here everyday and watch ourselves become slightly addicted to social media and everything else we do with computers. Again, it tends to bring down the level of physical activity in young people.
We also find that eating fast foods, processed foods and a large amount of food that is high in fat and sugar have a tendency to create obesity. We know that increases the risk of stroke, heart disease, and with type 2 diabetes, vision problems, as well as neurological problems later on in life.
Active living will assist people throughout their lives to either prevent or postpone chronic disease and illness, which, to be crass, costs the health care system a great deal of money. Active living will create savings so that we can put money into other things that are necessary to keep us healthy and give us quality of life, such as mental health care or other areas of health promotion and disease prevention.
We can perhaps look at finding a way to assist people who are physically and mentally unable to work and live reasonable quality lives. There are a lot of things we could do with that money we would save the health care system by reducing hospital costs.
At the same time, people will be healthier, work and live longer. We see that seniors today are living and working longer. They will continue to contribute to the tax base, the economy and the productivity of the nation.
The initiative to designate a national health and fitness day has been gaining widespread support for all those reasons. We now have about 150 municipalities across the country that have adopted some form of health and fitness day.
The bill originated in the other place by Senator Nancy Greene Raine, who is an avid supporter of active living. Increased physical activity not only promotes physical health but also mental and emotional health. Again, we find that people who exercise more are less likely to be depressed and less likely to have problems like Alzheimer's.
Over the last decade, the participation rate in physical activity in Canada has actually declined. The majority of Canadian adults and children do not meet the physical activity level guidelines. According to the Public Health Agency of Canada, in the period between 1981 and 2007-09, measured obesity roughly doubled in most age groups in the adult and youth categories for both sexes. The data also indicated that approximately one in four, which is 24.3%, Canadian adults age 18 years and over is obese. The combined rate of Canadians who are overweight and obese is 62%.
In 2005, the costs of adult obesity in Canada were estimated at $1.8 billion in direct health care costs and $2.5 billion in indirect costs for a total of $4.3 billion.
Obesity and lack of physical activity increases the risk of developing several chronic diseases, including osteoarthritis. We know it is linked to some types of cancer, though we do not quite know how direct the links are.
The 2009 report estimated that on average an inactive person compared to an active person spends 38 more days in hospital and uses 5.5% more family physician visits, 13% more specialist services, and 12% more nurse visits.
The rate of obesity varies across the country. It is a good thing to dedicate a day across Canada to fitness, and for the federal government to be talking about this since the federal government is responsible for the health and well-being of Canadians regardless of where they live.
What we saw from a recent UBC study is that my home province of B.C. has the lowest obesity rate. That is probably in part because British Columbians tend to engage in more healthy and active lifestyles. It just so happens that we also live in lotus land which offers the best things since sliced bread. The mover of the bill can relate to this, coming from British Columbia himself.
In 2005, the previous Liberal government invested $300 million over five years in the Public Health Agency of Canada for an integrated strategy of healthy living and chronic disease to ensure that Canada had an integrated approach in addressing major chronic diseases and their risk factors. One of the key pillars was promoting health by addressing the conditions that lead to unhealthy eating, physical inactivity and unhealthy weights.
There are many factors that play into the physical activity and healthy living of adults all the way through their life cycle. This is important; this is a start. This is only one of many things we can do. It is one way to remind us, at least once a year, that we should get out there and become active.
- MPlibOct 21, 2014 1:40 pm | British Columbia, Vancouver Centre
Mr. Speaker, I would like to thank the member for participating in this debate. As a physician, she would probably be able to shed light on this question. If in the space of one month, after Canada had supposedly sent so much aid, we saw a doubling of the number of deaths, based on the evidence, surely that should say to somebody that it was not working because there should not be double the number of deaths if what we were doing was working and was timely. Through some disclosure in debate in the House today, we have since found out that we cannot account for a lot of the aid that was promised and did not get there, including vaccines.
The World Health Organization has repeatedly asked for more personnel to help on the ground. We know that Cuba sent 365, the United States sent 3,000 of their armed forces out there on the ground immediately and Canada has sent 13 people. The minister has suggested that she would not send anyone unless we have an exit strategy. Surely, if Cuba can do this and the United States can send 3,000 people right off the bat a month ago, I would like to know this.
Could the minister not follow what they were doing? Could she not follow their exit strategies instead of dragging our feet once again? Since April, we have been dragging our feet on this.
- MPlibOct 21, 2014 1:10 pm | British Columbia, Vancouver Centre
Mr. Speaker, I thank my colleague for a very well-researched and moving speech.
We know that the Chief Public Health Officer of Canada actually has to report to Parliament as public health officer of Canada, and reporting to Parliament through the health committee is an appropriate way to do so. I think this is about openness, this is about transparency, and this is about public accountability, because there are many questions that have not been answered in this House. There are many questions that have not been answered in both of the public press conferences held by the minister and the Chief Public Health Officer on Friday and on Monday, which dealt with the vaccines, why it took so long, why only a little over $4 million of $65 million promised has been received, where the rest of the money is, and why it is not there. We know that timeliness is important.
My question for my colleague is simply this. How else—and let us imagine that no one else wanted to accept this motion—can we get accountability, transparency, and openness from the Chief Public Health Officer and from the Minister of Health, whose duty it is to actually coordinate and manage any infection that occurs in Canada and abroad?
- MPlibOct 21, 2014 12:40 pm | British Columbia, Vancouver Centre
No, Mr. Speaker.
- MPlibOct 21, 2014 10:20 am | British Columbia, Vancouver Centre
Mr. Speaker, what we are hearing is what we already know. This is what we heard from the Minister of Health and the Chief Public Health Officer on Friday, with an update on Monday. The gist of this motion is not about that. It is to ensure that we get some questions answered about some really important problems.
The government put in only a little over $1 million in April, and that was well after Ebola had been going on for quite a while. We have to admit that the World Health Organization dropped the ball and did not take it seriously either, but we came on in April.
We have now been told by the government that it has put $65 million in all into helping the regions affected, yet we see that only $4.3 million of that money has actually been spent or has actually been sent or has actually been given or committed. Where is the rest of the money? Timeliness is important.
I would like to get some answers about the foot-dragging.
- MPlibOct 21, 2014 10:05 am | British Columbia, Vancouver Centre
Mr. Speaker, my colleague has laid out the problems very clearly.
This epidemic started in September with outbreaks of Ebola. The World Health Organization did not pay attention, then it worsened in December, and it was not until April that our Canadian government began to pay attention and gave about $1.2 million to start. This situation has come to the place where it is now because people have dragged their feet.
We talk about SARS. We did not learn anything from SARS, obviously. Timeliness of response in a public health crisis in any epidemic is key. There was no timely response here from our government.
Yes, I commend the Minister of Health and the Chief Public Health Officer for standing up on Friday and Monday of this week to inform us, but it is kind of too little, too late. The problem is that we need to contain the situation as soon as it begins to happen.
Does the hon. member think this particular motion, that we brought today, is out of line or is it brought forward because we have seen everyone drop the ball over the last few years and we have begun to realize that we need to have some clarity and transparency around public health?
- MPlibOct 21, 2014 8:10 am | British Columbia, Vancouver Centre
No, Mr. Speaker.
- MPlibOct 21, 2014 8:00 am | British Columbia, Vancouver Centre
Mr. Speaker, I have two questions I would like to ask the hon. parliamentary secretary to the Minister of Health.
In April, the Ebola epidemic began to show that it was the beginning of an epidemic. In June, the honorary consul for Sierra Leone got a letter from Washington asking for protective equipment. However, since he sent that message to the ministry, the minister of the Public Health Agency of Canada auctioned off 1.3 million masks and more than 209,000 gloves for the price of $50.
Can the hon. parliamentary secretary tell me why the government did not send that instead, on request, to West Africa? Why was it just auctioned off?
Secondly, I would like to know what took the generous 800 to 1,000 vaccines so long to get there? It only got there yesterday. Why did it take so long, since April and June, to get these things done?
- MPlibOct 21, 2014 7:45 am | British Columbia, Vancouver Centre
Mr. Speaker, I gather the member must not have been listening when I made my speech.
No, it is not enough. That is why we brought this motion forward. We need to get regular briefings. I would like to point out to the member that these public press conferences that occurred only occurred last Friday and this Monday. It is kind of late in the game to have these happening, but nothing is ever too late, so I thank the minister and the Chief Public Health Officer for doing that.
It is important that as this disease continues to progress or not progress we get regular, updated briefings on what is going on. Of course it is not good enough. We do not want Canadians to be panicking. We do not want parliamentarians not knowing what to tell their constituents when they ask questions.
As soon as they started in Ontario, the Minister of Health and the Chief Medical Officer of Health of Ontario immediately went out and did it. I am just saying that it is not enough. No, it is not.
- MPlibOct 21, 2014 7:40 am | British Columbia, Vancouver Centre
Mr. Speaker, we have seen this happen over and over at committee, but this is something different. There is a huge risk to Canadians if this disease ever gets to Canada. This is about public safety and public security. If we put aside partisanship and let the minister and the Chief Public Health Officer know that all members of the House are prepared to work together to ensure that evidence-based protocols are put in place, that might go a long way, because we will not be as critical. We may ask questions. We may look at creative and positive ways to work together to find the right answers.
- MPlibOct 08, 2014 11:40 am | British Columbia, Vancouver Centre
Mr. Speaker, while we all understand that the nature of contagion of Ebola is low outside of endemic areas, Canadians are understandably anxious about reported cases outside West Africa, such as in Texas and Spain.
Can the Minister of Health tell us exactly what is Canada's level of preparedness for containment of possible cases of Ebola, including access to vaccines and treatment here in Canada?
- MPlibSep 30, 2014 11:05 am | British Columbia, Vancouver Centre
Mr. Speaker, the untimely passing of Jim Deva leaves a large void in Vancouver's LGBTTQ community. Jim was an activist and a fighter. He never gave ground on principles concerning equality and social justice. He was an instrument of change that impacted everyone across the nation.
It was Jim who educated me about the blatant discriminatory treatment by Canadian customs against LGBT bookstores. He was going to take the federal government to court if he had to. He did, and he never backed down. The story of Little Sisters Book and Art Emporium v. Canada has become a legend.
Jim was at every LGBT protest, march, or demonstration, leading, supporting, and bringing his unflagging belief that the goal of equality was worth the fight.
Jim's life was cut short too soon. My condolences go to Bruce, Janine, and all of Jim's family.
Jim will be missed. There are still windmills to tilt at and causes to fight for, like transgender rights, but wherever the fight for justice rages, his spirit will be there, urging us on, and his name will be on our lips.
- MPlibSep 23, 2014 11:10 am | British Columbia, Vancouver Centre
Mr. Speaker, today, the Canadian Medical Association called on the federal government to engage the provinces in creating a pan-Canadian dementia plan. Canada is the only G7 country without a comprehensive national strategy.
The most common form of dementia is Alzheimer's disease. Currently, 500,000 Canadians live with this degenerative disease. That number will double in the next 20 years. While research into cause and treatment is important, the most vital missing element is building the health system's capacity to deliver care to the increasing number of Alzheimer's patients.
While the federal Minister of Health may shrug off this responsibility to the provinces, she is wrong. In every country with a national plan, the national government led the way, integrating dementia care into their health systems, which includes best practices in management, prevention of chronic disease, and ensuring that community and social services, housing and caregiving are integral parts of the system.
While there is currently no cure for Alzheimer's, research shows that by early identification and proper management we can delay its onset to the point of near elimination of the disease.
- MPlibSep 23, 2014 10:05 am | British Columbia, Vancouver Centre
Mr. Speaker, shall I sit down, or shall I answer? Will the hon. member allow me to answer? If I am asked a question, I want to answer it.
What we saw was that we actually got rid of that deficit within three years and started to post 10 years of balanced budgets, with surpluses. We put in the largest amount of money ever put into health care, $41.2 billion. It was by Paul Martin, in 2004, for the 2004 health accord.
Money was being spent, innovation was moving, and jobs were being created. Canada was number one in 2000, according to The Economist. It was number one in the world in economic growth.
- MPlibSep 23, 2014 9:50 am | British Columbia, Vancouver Centre
Mr. Speaker, I am pleased to rise to speak to the Liberal opposition motion.
One of the things I want to stress is that this will be about jobs, jobs, jobs. When we look at what has happened with job creation in this country, we see that in the past year Canada has experienced negative job growth. In fact, as my colleague just said, from August 2013 to August 2014, the entire country created a net 81,000 jobs, but only 15,300, or 19%, of these are full time.
How do we expect families to live, to work, to pay their mortgages, to feed themselves, to send their kids to university, to do all the things that families have to do when they are working part time? It is not a sustainable way for people to live, so creating full-time jobs is what we need to talk about, not part-time jobs.
We can look at the United Kingdom. My colleague spoke about the number of jobs, but I want to put it into perspective. In the same period of this year, the United Kingdom created a 2.6% increase in new jobs, the United States 1.5%, and Canada 0.5% only.
Therefore, Canada is not doing very well. In spite of what we hear from the Conservative government, Canada is not creating new jobs, and when we do not create jobs and people keep losing their jobs and try to live on part-time jobs, there are huge effects that no one is talking about.
The health effects of unemployment were well documented in the 1990s, when many countries in the world were facing recession. We know there is a high incidence of high blood pressure, a high incidence of anxiety and depression, and a high incidence of suicide. A lot of people cannot afford to feed their families and a lot of people cannot afford to buy the prescriptions they need for chronic diseases. That is another impact that we are not even counting when we think about jobs and the ability of people to work, to pay taxes, to produce, and therefore to grow the economy. These things are inextricably linked.
The Liberal Party is not just saying that this is a terrible plan that the Minister of Finance announced; we are also offering a solution. We are offering an opportunity for the Conservatives to change the plan and moderate it so that it can actually start creating the kinds of jobs we are looking for.
The Canadian Federation of Independent Business suggests that this plan the minister tabled could create about 20,000 to 25,000 jobs. However, we also have economists saying that it could create no new jobs and actually cause a loss of jobs. These are things we have to take into consideration.
What we are presenting is evidence-based. I will go on to say why it is evidence-based, but we are talking about a way the government could help to stimulate businesses to create about 175,000 new jobs. We can compare 20,000 jobs, or a possible loss of jobs, to the creation of 175,000 jobs.
If the government is serious about doing the right thing to help stimulate the economy and create jobs, then the government will listen. This is not about politics. This is not about the Liberals saying they know better than the Conservatives and pointing out what they did; it is about finding the best solution when Canadians are having a difficult time.
This is where we in Parliament should work well together. All of the political parties should look for the best evidence-based solution.
The government has heard our solution. We are suggesting that for every new job created by any kind of business, small, medium or large, the business will get a holiday from EI premiums for two years, the same length of time the government is proposing for its plan. That is the first thing we are proposing.
I want to explain why I say it is evidence-based. When we became government in 1993, we had an unemployment rate of about 14%. By the time we left government, that unemployment rate was down to 6.5%, so that measure surely worked. The evidence shows that when we did something, it achieved the objective.
In 1997 we brought in a new hires program for two years. In this program, for every new job that was created, the company, regardless of its size, was given freedom for two years from EI premiums. That was an important thing. Then we topped that up in 1998 with a new hires program for young people, who were facing an 18% unemployment rate. We brought that down to about 12%.
We are talking about stuff that worked. We said that every business, regardless of its size, that hired a young person between the ages of 18 and 24 would actually get a holiday from EI premiums.
As a physician I have talked, and as a party we have talked, about being evidence-based. It means looking at what works. We can say that it worked. The figures are there. Everyone may deny it, but they are there. Members can go and look them up. It is true. We also started bringing down EI premiums overall. Every year, we dropped those so that by the time we left government in 2005, EI premiums across the board were down for all businesses. That is the way to stimulate work, agreeing that, in fact, it is small and medium-sized businesses that create the majority of jobs in this country.
We are offering a very important solution. This is not something that, again, looking at the evidence, we made up. We can see that this plan the Minister of Finance tabled was a very bad one.
Barrie McKenna, of the The Globe and Mail, said, “Put simply: Growing companies, not small ones, drive economic growth”. He said that growing companies, period, drive economic growth.
He continued, “Governments should want more of them. But [these] policies are sending exactly the opposite signal: Stay small. Don’t grow”.
Then we have Mike Moffatt saying, “...it is clear that firms under the $15,000 EI threshold”, which the current government is setting, “have a big incentive to keep wage increases to a minimum so they do not lose their tax credits”.
Those firms can do a couple of things once they get over $15,000 in EI premiums: they can lower the incomes of their employees, or they can cut their hours of work. This is a disincentive, not an incentive to create jobs.
Sometimes I think the government across the way has to put big flashy things in the window. The Conservatives think it is going to work, but they have not done their homework. They have not actually looked at the consequences of what they are going to do. They have not looked at the outcomes. This is where their plans are nearly always flawed and blow up in their faces.
I also talked about the evidence the Liberals had when we brought in an across-the-board payroll decrease in EI premiums, year after year. Here is what Stephen Gordon, who is an economic professor at Laval University, said:
Reducing payroll taxes is usually a clear win-win situation, resulting in increased employment and higher wages. The Conservatives have passed up this opportunity by creating yet another targeted boutique tax credit.
Instead of making things easier for everyone, the current government has actually created a more complex tax system. It has created these little boutique tax credits. It seems to thrive on giving little boutique tax credits to certain groups, and we have seen that this has not worked. It has not actually resulted in what the government wants.
I like to say that this particular plan by the finance minister is right up there with the brilliant plan, with a $13-billion surplus left by a Liberal government, to cut the GST by two percentage points, which cost $13 billion. One does not have to be an economist to know that 13 from 13 is zero, so the current government ended up with a zero balance at the time it needed it most, because a year later, there was a recession. The government was unable to deal with this. We have seen the snowballing consequences of what the government does.
If the Conservatives really mean to do well by Canadians, it is important that they pay attention. We are not asking to take all the credit. We are saying that if they do it, we will back them up. We will support them on this, because in this House, this is not about playing politics. Sometimes, yes, we do play politics. We are in politics, after all. However, it is most important, at a difficult time in our history, for us to come together, all political parties, to do the best thing, based on evidence and based on what the outcomes are going to show us we will achieve. We would work together to do the right thing to create jobs at this particular time, when people are losing jobs and suffering as much as we know they are.
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