OFFICIAL REPORT (HANSARD)

House of Commons Debates VOLUME 147 NUMBER 090 2nd SESSION 41st PARLIAMENT Tuesday, May 27, 2014 Speaker: The Honourable Andrew Scheer HOUSE OF COMMONS CANADA (Table of Contents appears at back of this issue.) COMMONS DEBATES May 27, 2014 DEBATES Edited Hansard * Table of Contents * Number 090 (Official Version) Official Report * Table of Contents * Number 090 (Official Version) Compte rendu officiel * Table des matières * Numéro 090 (Version officielle) 147 090 27 05 2014 2014/05/27 10:05:00 House of Commons Débats de la Chambre des communes House of Commons Debates 41 2

The House met at 10 a.m. Prayers

ROUTINE PROCEEDINGS Routine Proceedings (1005) [ English ] Public Sector Integrity Commissioner The Speaker : I have the honour, pursuant to

section 38 of the Public Servants Disclosure Protection Act, to lay upon the table the case report of the Public Sector Integrity Commissioner concerning an investigation into allegations of wrongdoing. [ Translation ] This report is deemed permanently referred to the Standing Committee on Government Operations and Estimates.

[ English ] Government Awareness Day Act Mr. Don Davies (Vancouver Kingsway, NDP) Bill C-601. Introduction and first reading moved for leave to introduce Bill C-601,

an act respecting a Government Awareness Day . He said: Mr. Speaker, I am honoured to rise to introduce two private members' bills today, with thanks to my seconder, the hon. member for Burnaby—New Westminster . These bills are particularly special, because they owe their existence to the imaginations and hard work of three young people in my riding of Vancouver Kingsway: Matthew Ching, Liam Kynaston, and Alan Zhou. They are present in the House today.

All three students are winners of my Create Your Canada contest, which invites high school students to develop and submit their ideas on how we can make Canada and the world a better place. Matthew's idea is captured by this bill proposing to establish July 8 as government awareness day. July 8 is the day of Canada's first Parliament, which began in 1867. This would be a day for all Canadians to recognize our democracy, reflect on its importance, and think about ways we can improve it.

It would encourage Canadians to take an active role in our democratic process, perhaps by writing letters on topics of interest to their local government MLA, MPP, or MP. In a time of low voter turnout and democratic challenges around the world, this is a positive and creative idea that would strengthen Canadian democracy and citizenship.

I would like to congratulate Matthew and these fine young students on their contributions to Parliament and our country and thank their teachers and all who entered my contest from Gladstone Secondary School, Eric Hamber Secondary School, Windermere Secondary School, and Sir Charles Tupper Secondary School in Vancouver. (Motions deemed adopted, bill read the first time and printed)

Food and Drugs Act Mr. Don Davies (Vancouver Kingsway, NDP) Bill C-602. Introduction and first reading moved for leave to introduce Bill C-602,

An Act to amend the Food and Drugs Act (sugar content labelling) . He said: Mr. Speaker, once again, I am honoured to rise to introduce the second of my private members' bills today, which again is a product of the Create Your Canada contest in my riding. Again, it owes its genesis to the imagination and hard work of young students in my riding, Matthew Ching, Liam Kynaston, and Alan Zhou, who are present in the House today. Alan and Liam's idea is enshrined in this bill called

an act to amend the Food and Drugs Act, sugar content labelling. This legislation would require all prepackaged foods to prominently display the sugar content on the front of the product. This reflects their research revealing the harmful effects of sugar and its presence in high concentrations in many prepackaged foods, of which many consumers are unaware. This bill would improve the health of Canadians, especially young Canadians, and would provide increased information to Canadian consumers.

Once again, I would like to congratulate Alan and Liam and these fine young students on their contributions to Parliament and our country, and I thank their teachers and all who entered this contest from Gladstone, Eric Hamber, Windermere, and Sir Charles Tupper secondary schools in Vancouver. (Motions deemed adopted, bill read the first time and printed)

Petitions Impaired Driving Mr. Harold Albrecht (Kitchener—Conestoga, CPC) : Mr. Speaker, I have the honour to present four different petitions this morning signed by citizens from across Canada. In the interest of public safety, they want tougher laws and the implementation of new mandatory minimum sentencing for those persons convicted of impaired driving causing death. They also ask that the Criminal Code of Canada be changed to redefine the offence of impaired driving causing death as vehicular manslaughter.

Rail Transportation Mrs. Carol Hughes (Algoma—Manitoulin—Kapuskasing, NDP) : Mr. Speaker, I am pleased to stand in the House to table four petitions. The petitions are with respect to the Algoma Central Railway passenger train. This petition came into place when the government withdrew its subsidy to Algoma Central Railway passenger service. The government has actually reinstated the funding for one more year, which has given some relief to the stakeholders, but they are continually concerned about the future. The petitioners are calling for consultation.

They are concerned about the economy of their communities, their health and safety, accessibility to the area, and the impact this has on businesses. The petitioners are calling on the government to look at maintaining passenger rail across Canada. The petitioners are from Richards Landing, Sault Ste. Marie, Hawk Junction, Windsor, Tiny, Wawa, Thornhill, Hornepayne, Blind River, Batchawana Bay, Echo Bay, and Elliot Lake.

(1010) Agriculture Mr. Ted Hsu (Kingston and the Islands, Lib.) : Mr. Speaker, I have two petitions to table today. The first petition is from my constituents in Kingston and the Islands regarding Bill C-18 . The petitioners are worried about the right to save, reuse, select, exchange, and sell seeds. They are calling on Parliament to enshrine those rights in legislation.

Democratic Reform Mr. Ted Hsu (Kingston and the Islands, Lib.) : Mr. Speaker, my second petition comes to me not from my constituents but from people in rural eastern Ontario and the outskirts of Toronto. Perhaps they wish their voices to be heard in the House of Commons. The petition is with regard to the so-called fair elections act. The petitioners are calling on the government to amend or withdraw the act, because it has not been amended sufficiently. They feel that there has not been proper consultation with elections experts.

[ Translation ] Victims of Violence Mr. Mathieu Ravignat (Pontiac, NDP) : Mr. Speaker, I have the privilege of presenting a petition that condemns the lack of justice for children and women who are victims of violence. The petitioners are calling on the government to do more to protect them. I would like to congratulate Aline Lafond from Maniwaki, who campaigned to get this petition signed. It is an important cause, and I am pleased to present this petition.

[ English ] Criminal Code Mr. David Tilson (Dufferin—Caledon, CPC) : Mr. Speaker, I am presenting a petition from a number of residents of my riding who are concerned about child prostitution and violence towards women having increased in countries where prostitution has been legalized. The petitioners are asking Parliament to amend the Criminal Code to decriminalize the selling of sexual services, to criminalize the purchasing of sexual services, and to provide support for those who desire to leave prostitution.

[ Translation ] Canada Post Ms. Charmaine Borg (Terrebonne—Blainville, NDP) : Mr. Speaker, I have the honour of presenting two petitions that have been signed by people from my riding of Terrebonne—Blainville. The first petition is about cuts to services at Canada Post. Those who signed the petition are particularly worried about the fact that home delivery is being cancelled. They are urging the government to reject Canada Post's plans to reduce services and to look at other options for modernizing the crown corporation's business model.

Consumer Protection Ms. Charmaine Borg (Terrebonne—Blainville, NDP) : The second petition I am presenting is calling for an end to unfair, excessive fees. This petition was also signed by people from my riding. They are calling on the government to put an end to unfair fees, such as ATM fees, exorbitant rates charged by payday lenders and price-fixing at the pump. I am pleased to present these two petitions today.

[ English ] Dementia Mr. Malcolm Allen (Welland, NDP) : Mr. Speaker, I have two petitions to present today. The first petition is with regard to the need for a national strategy on dementia. As we know, across this country, a great many folks, specifically seniors, suffer from dementia. The petitioners are calling on the government, saying that a strategy is indeed needed on a national scale, not just at a provincial level. Although some provinces are tackling the issue, we need a national strategy.

Canada Post Mr. Malcolm Allen (Welland, NDP) : Mr. Speaker, the second petition is signed by literally hundreds and hundreds of members of my riding and from across the Niagara Peninsula. The petitioners are calling on the government to keep home mail delivery. Canada Post is an essential service for many across this country, specifically folks in my riding who either have mobility issues, may be seniors, or may simply be folks who need to get that mail and are not able to get to those so-called community mailboxes that are going to be who knows where across this country, especially in downtown areas.

The petitioners are calling on the government to make sure that Canada Post continues home mail delivery into the future and actually enhances that service.

Pensions Mr. Kevin Lamoureux (Winnipeg North, Lib.) : Mr. Speaker, today I rise to table yet another petition in regard to Canada's old age programs for pensions: OAS, GIS, and CPP. In particular, the petitioners ask the Prime Minister to recognize the importance of allowing Canadians to continue to be able to retire at age 65 and to collect their pensions. They are in great opposition to the increase in the retirement from age 65 to 67. Yet again, this is likely the most popular petition I receive from my constituents, and I provide it today for the Prime Minister and the government.

(1015) Citizenship and Immigration Ms. Irene Mathyssen (London—Fanshawe, NDP) : Mr. Speaker, as you may recall, a terrible tragedy happened in London, Ontario last fall. Very clearly, the number of petitions I have received indicate how very deeply this cut into the community. It has to do with the loss of a family of three who were waiting for landed immigrant status. The community is concerned that public service jobs have reduced staffing levels to the point that people wait inordinate amounts of time for citizenship and landed status.

The petitioners call on the government to ensure that the Department of Citizenship and Immigration is properly staffed and resourced in order to reach decisions on applications in a fair and timely manner and that all immigration officers consider factors with regard to humanitarian and compassionate grounds.

International Trade Ms. Elizabeth May (Saanich—Gulf Islands, GP) : Mr. Speaker, I rise this morning to present two petitions. The first is from residents within Saanich—Gulf Islands from Pender Island, Brentwood Bay, North Saanich, Sydney, and throughout the riding. They call on this administration to cease its pursuit of the Canada-China investment treaty and to refuse to ratify it at the cabinet table. This is a treaty that, as the petitioners point out, presents significant threats to Canadian sovereignty because of the inability to leave the Canada-China investment treaty in less than 36 years should it ever be ratified.

Lyme Disease Ms. Elizabeth May (Saanich—Gulf Islands, GP) : Mr. Speaker, the second petition comes from residents of Brampton, Kingston, and Caledon. I am grateful for their support for the private member's bill that will be going to the health committee this week, Bill C-442 , my private member's bill on a national Lyme disease strategy. I am very grateful to all members of the House for their support and for this petition.

Agriculture Mr. Matthew Kellway (Beaches—East York, NDP) : Mr. Speaker, I am pleased to present two petitions in the House today signed by residents in and around my riding of Beaches—East York. The first calls upon Parliament to refrain from making any changes to the Seeds Act or to the Plant Breeders' Rights Act through Bill C-18 and further to enshrine in legislation the inalienable rights of farmers and other Canadians to save, reuse, select, exchange, and sell seeds.

Genetically Modified Alfalfa Mr. Matthew Kellway (Beaches—East York, NDP) : Mr. Speaker, the second petition calls upon Parliament to impose a moratorium on the release of genetically modified alfalfa to allow proper review of the impact on farmers in Canada.

Blood and Organ Donation Hon. Wayne Easter (Malpeque, Lib.) : Mr. Speaker, I present a petition under Standing Order 36. Petitioners request that sexual preferences of people not be an instant refusal of the right to donate. They request that the Government of Canada return the right of any healthy Canadian to give the gift of blood, bone marrow, and organs to those in need, no matter the race, religion, or sexual preference of a person. The right to give blood or donate organs is universal to any healthy man or woman.

Dementia Ms. Rathika Sitsabaiesan (Scarborough—Rouge River, NDP) : Mr. Speaker, this morning I have the honour to present petitions on behalf of people from all over the greater Toronto area who draw the attention of the Minister of Health and the House of Commons to the fact that the federal government needs a national strategy for dementia and the health care of persons afflicted with Alzheimer's disease or other dementia-related diseases. The petitioners call for the passage of Bill C-356 ,

an act respecting a national strategy for dementia. They outline multiple points, and I would like to read a few of them, if I may, Mr. Speaker. They call for the initiation of discussions, within 30 days of the act coming into force, with the provincial and territorial ministers to develop a comprehensive national plan to address all aspects of Alzheimer's disease and related dementia, ADRD. Furthermore, they ask for the encouragement of greater investment in ADRD research, discovery, and the development of treatment that would prevent, halt, or reverse ADRD.

[ Translation ] Oil Industry Mr. Pierre Jacob (Brome—Missisquoi, NDP) : Mr. Speaker, I have here a petition that was signed by about 30 of my constituents. They want the government to stop giving $1.3 billion in subsidies to the oil industry every year. They want the Prime Minister to follow through on the commitment he made at the G20 in 2009 to phase out the subsidies. The petitioners point out that the subsidies are incentives for energy sources that produce high levels of greenhouse gas emissions and discourage investments in green and renewable solutions. They are asking the Prime Minister to stop giving billions of dollars to oil companies and start investing in a sustainable economy.

(1020) [ English ] Human Rights in Egypt Ms. Lysane Blanchette-Lamothe (Pierrefonds—Dollard, NDP) : Mr. Speaker, I present today an important petition about human rights relations in Egypt. People who signed this petition draw to the attention of the House the fact that the basic human rights, democratic freedoms, and the rule of law continue to be abused and repressed in Egypt.

Therefore, the petitioners call upon the Canadian government to condemn abuses of human rights in Egypt, urge Egyptian authorities to ensure that the basic human rights of all Egyptians are protected, regardless of partisan affiliation or personal beliefs, and demand that the rule of law and freedom of the press be observed and respected in all cases.

Canada Post Hon. Judy Sgro (York West, Lib.) : Mr. Speaker, this petition is regarding the changes to Canada Post. The petitioners call upon the Government of Canada to take the necessary legislative and regulatory steps to immediately reverse the implementation of the recently announced service rollbacks and cost increases proposed by Canada Post Corporation. The petitioners further call upon the government to formally oppose any future steps to privatize Canada Post Corporation, its operation, or its services.

Questions on the Order Paper Mr. Tom Lukiwski (Parliamentary Secretary to the Leader of the Government in the House of Commons, CPC) : Mr. Speaker, I ask that all questions be allowed to stand. The Deputy Speaker: Is that agreed? Some hon. members: Agreed.

GOVERNMENT ORDERS Government Orders [ English ] Protecting Canadians from Unsafe Drugs Act (Vanessa's Law) The House resumed from March 28 consideration of the motion that Bill C-17,

An Act to amend the Food and Drugs Act , be read the second time and referred to a committee. Bill C-17. Second reading Hon. Hedy Fry (Vancouver Centre, Lib.) : Mr. Speaker, I rise to support this bill, but to support sending it to committee. While this bill is a substantial improvement on the status quo, it has still taken the current government eight years, even though as Liberals we have pushed the government to change the way it regulates, the way it develops, and the way it looks at drug safety for Canadians.

However, the Conservatives have put the bill forward and there are some pieces of the bill that we like, but we think it falls short. There are other things we would like to see in this bill, and the minister herself has said in the House when she introduced the bill that she is open to amendments, so we are taking the minister at her word, and we are going to say we would like it to go to committee. We hope the minister will be true to her word and will look at our amendments then. Here are some things we like about the bill.

We think that the minister getting the power to recall drugs is a very important piece that has been a long time coming. The minister has to be able to do so without first getting the manufacturer's approval. Before this, the minister had to get the manufacturer's approval to recall a drug or to say that a drug has severe side effects. The new language says that “If the Minister believes that a therapeutic product may present a serious risk of injury to human health...”. That is good language, and we support the minister getting those powers.

The minister used to have to overcome the reluctance of the companies to want to give that information. Now the minister would have the ability to compel industry to provide the information about the drugs that the minister wishes to either seek a notice of compliance on or that are actually out there in the public, and be able to recall them. This is all common sense, but it is crucial because nobody but the company itself knows the background of the clinical trials, of how the company formulated the drug and how that innovation occurred.

Therefore it is important that the company is made to be forthcoming with some of that information. What we also like about this bill is that the minister would compel health care providers and pharmacists to mandatorially report at-risk drug reactions. As a physician, I can say that was a difficult thing to do because it meant that physicians, after a whole busy day of seeing patients, at the end of the day then had to report all these things. It can take sometimes two hours out of their day.

Now that the minister would provide an electronic means by which this could be easily done, it would make it much easier for physicians to comply with this. The minister's ability to enforce conditions on market authorization and to compel changes to product labels is also very important, and the ability to move that forward would ensure patient safety. We think that is important, but we also want the minister not to do so in a hurry so that it would stop due diligence in terms of the ability to get the kind of information we need.

The fines of up to $5 million a day for the failure to remove a drug or the failure to obey the enforcement measures by the minister is also a very positive area. Members will notice that we are saying that there are some very positive things about this bill. However, before this bill came about, I was writing a bill on this very same thing because we got a little tired of waiting for the government to do this after eight years; so I had some round-table meetings with experts on the issue.

Here are some of the major elements that these experts feel are missing from the bill, which would make the bill stronger: better implementation of the ability to ensure patient safety, to ensure that there are appropriate regulations, and to ensure pre- and post-market surveillance of drugs.

This is about the precautionary principle, which should give the minister the power to ensure that the first and foremost thing she or he is concerned about, wherever possible, is being sure that on reasonable grounds, to prevent potential injury to a person or a citizen, the minister has that power to recall or remove a drug or not allow for notice of compliance. “Reasonable grounds” is sufficient. The minister should be protected for her ability to do this, using the term “reasonable grounds”.

The minister's power should not just be limited to those who sell the drugs, because we know that in some areas the people who manufacture the drugs are not the people who sell the drugs.

(1025) They have different production arms and different distribution arms that distribute their drugs under different names. Therefore, it is important for the minister to look at the whole chain of distribution not merely at the manufacturer when recalling a drug. Right now I think that the definitive issue of injury or harm is up for

interpretation. For instance, let us look at the birth control drugs that did not work recently. No one felt that this was an important reason not to allow the drug a notice of compliance or to recall it, because they felt that if women became pregnant when using a contraceptive that did not work, it was not an adverse reaction and it did not cause severe injury or harm, because pregnancy is a lifestyle choice. I think that was a bending of the

interpretation of what harm is. If women are taking a contraceptive, it is because they do not want to get pregnant. If they get pregnant, that is an adverse reaction. I think the ability to define what is injury or harm should be more clearly spelled out for two reasons: one, to protect the patient; and, two, to protect the minister from any kind of reaction from the company because it is clear what she means and what the legislation means by injury or harm. That should be clearly spelled out.

It should be based not on subjective but on objective criteria that are in keeping with what we know about risks and harms pertaining to drugs. That would provide the minister protection and give her broader powers. As well, we know that we cannot tell the adverse effects of a drug purely from the clinical trials. When a drug is undergoing clinical trials, it is done with a cohort of people who have been chosen, and out of that cohort it can be decided what the negative and adverse reactions are to the drug.

However, when the drug goes out into the main community, into the citizenry at large and the general public, individual reactions to drugs can differ. While people may not have had reactions during the clinical trial, others in the main community may show adverse reactions.

Therefore, the minister must have the ability to say that, although the government gave the drug a notice of compliance, due to the new reporting requirements for physicians and pharmacists it has noticed that after a year or six months there are adverse reactions that were not intended and did not show up in the clinical trials and that the drug will be recalled temporarily while we check on these. Then, ensuring that the precautionary principle is in place, the government can look at the drug and either put it back on the market if changes have been made or permanently recall it before it does any further harm.

To clearly define what we are doing is in the best interests of the minister. It would protect her from any kind of legal suit and so forth. That is an important piece we would like to see included. The Auditor General has spoken on many an occasion about the lack of transparency in Health Canada's decision-making process. For instance, Health Canada publishes only very limited information on drugs and high-risk medical devices for which a notice of compliance is applied for. However, it does not tell us why it did not allow a drug a notice of compliance.

It does not tell us what its opinions are about the drug, even though it may give it a notice of compliance and say that it is generally safe. There may be other clinicians who have said there are some concerns about the drug. Health Canada should put that out there to the public, so that pharmacists, prescribers, and patients would know that there could be some conditions under which the drug was allowed to go out there. There may be some potential negative effects with which the minister and the department are concerned, but they are releasing the drug anyway.

That was in the bill when it was put forward as Bill C-51 . I noticed it has been removed. I wonder why, because it was a very good piece in that legislation that we agreed on and that the Auditor General wanted to happen. That enhances the transparency of Health Canada in terms of its regulations and looking at drug safety. We cannot afford to use the fact that the manufacturer does not want us to give out trade secrets. We do not have to give out trade secrets when we are saying that we think there may or may not be a problem that we have in the back of our mind even though we have put the drug out there.

It is an important thing to do. Europe is doing it. The European drug agency is putting out what the negative opinions are on a particular drug, even though it felt that the benefits outweighed the risks and that is why it put it forward.

(1030) There should be a legal requirement to register clinical trial data. This should be open to physicians, patients, and pharmacists so that they are able to know what clinical trial data shows. Now, I know that the government thinks that would let out trade secrets. However, the European drug agency is doing this. The clinical data that is put out in terms of the clinical trial does not have to disclose proprietary issues regarding the drug itself or its trade secrets. It is about the ability to ensure patient safety, which is foremost in the mind of Health Canada, as it should be.

Therefore, to release the full report of pre- and post-clinical trials and surveillance on an ongoing basis is an absolute necessity, but it is not in the bill. Not only is the European drug agency doing this, it is thinking of expanding it to bring in anonymous or non-nominal general patient responses to the drugs so that, again, there is full knowledge and full disclosure. Also, the FDA has just tabled its intention of doing the same thing.

Canada is way behind both Europe and the United States in terms of looking at patient safety, in terms of full disclosure, and in terms of acquiring full disclosure by the manufacturers, who do not seem to be worried about the proprietary issues of trade secrets because they know what to put in and what not to. Clinical information is not a proprietary trade secret. The formula of the drug and how the innovation occurred are proprietary trade secrets, but not clinical trials or data about them.

It is important for the minister to strengthen the bill by doing this and to do everything under the rubric of good independent research, and not just the companies' research. There should be an independent body that looks at those clinical trials, and not just Health Canada. Again, Europe is doing that, and the FDA has tabled its intention to do that. It has to be done in the name of public safety and good evidence-based information. We would like to see more transparency from Health Canada on why it gives a drug a notice of compliance and why it does not. What are the reasons?

Again, we need to know that about certain drugs. People read about drugs, and when they find out that other countries use certain drugs, they wonder why Canadians cannot get it. They want to know why they are not allowed access to drugs that could save their lives, et cetera. Good information helps people understand why certain decisions are made. However, right now we do not know anything about why Health Canada approves a particular drug or not, why certain drugs are suspended, and why some drugs remain on the market in spite of adverse reactions in other countries.

These are some things that we feel would strengthen the bill. Disclosure in the name of public safety is always very good. We need to ensure that the first thing in the mind of Health Canada when it approves a drug, or not, is that people can trust Health Canada to make good decisions in their best interest, and be able to do so in an objective and clinical evidence-based response. I think that right now Health Canada faces a great deal of mistrust from the public and drug prescribers because it is not transparent in some of these things.

Why would the bill allow government and cabinet to impose stringent rules favouring data protection of manufacturers under the Food and Drugs Act? We do not think that should be able to stand alone. We have seen issues where people have asked for drugs, but the government has said that the Food and Drugs Act is the reason it is not doing certain things. However, the Supreme Court of Canada has ruled very clearly that the issues of right to life, liberty, and the security of the person trump any piece of legislation, which is under

section 7 of the charter. Patient safety should be foremost in anything that the bill would bring forward. We oppose the amendment to the Food and Drugs Act in the bill to protect manufacturers' data. It should only be for proprietary data protection and not for anything else. The government should be protecting the patient, and Canadians. The Liberal Party thinks that the bill is long overdue. There are some good points in Bill C-17 that move forward, with some steps we approve of, to enhance patient safety and knowledge of drugs for therapeutic prescribers.

(1035) The minister said that the bill should be open to amendments. We have, as I said just now, about five amendments we would like to see that would strengthen the bill. We approve of big chunks of the bill, and we would like to see the bill go to committee. We hope that the minister will be true to her word and allow for amendments to come forward so that the bill can go to the House and be accepted by all of us unanimously, because it is in the best interest of patient safety. Mrs. Carol Hughes (Algoma—Manitoulin—Kapuskasing, NDP) : Mr.

Speaker, I agree with my colleague that this legislation is actually a good first step towards a comprehensive plan. There have been many calls from health professionals and advocates. The bill will finally grant the Minister of Health the necessary power to pull unsafe drugs from the market and ensure better labelling and possible adverse effects of drugs. We have to remember that in 2011 the Auditor General warned that consumers are not receiving safety warnings about pharmaceutical drugs fast enough because Health Canada is slow to act on potential issues that it identifies.

New Democrats feel we need optimal prescribing practices. We want to make sure that Canadians are prescribed the most appropriate medication, that they know the medication they are taking is safe, that it is necessary, that it is prescribed the right way for the problem, and that negative side effects and drug interactions are avoided where possible. Every Canadians wants to make sure of that, but there have been situations where that has not been the case. The Liberals had 13 years to do something on this when they were in power, and they failed to act.

Does my colleague believe that Health Canada should increase the resources of the Common Drug Review, so that it can expand its work in evaluating the cost and effectiveness of prescription drugs? I think that would be a move in the right direction. Can she let me know whether or not she agrees with that?

(1040) Hon. Hedy Fry : Mr. Speaker, the member's question is a good one. One of the reasons we see such a delay, as the Auditor General pointed out, in telling adverse effects is because there are insufficient resources, but also because there was not any mandatory adverse drug reporting by physicians and pharmacists. The bill will go a long way to do that.

However, as the member heard, it is really important that the government be able to implement the elements of the bill when it is put forward and it has the resources to do so, and that it has some sort of independent advisory group that can look with a very clinical and objective eye at the drugs coming out, look at the clinical trials and say whether that drug is appropriate, whether it is needed, and whether its benefits outweigh the risks. There is no drug without a risk, not a single drug I know of that does not have a risk.

It has to be benefit versus risk, but resources would go a long way to ensuring that all of this is done. If we do not have resources, we see the same delays the Auditor General talked about. It is almost a year sometimes in getting some of that information out to the patient and the prescriber. Mr. Kevin Lamoureux (Winnipeg North, Lib.) : Mr. Speaker, my colleague is very knowledgeable about health care in general and recognizes the importance of pharmaceuticals that are affordable and safe.

We try to ensure that patients receive the type of pharmaceuticals, prescription medications they need, but cost is becoming more and more of an issue. Could the member comment on the ever-increasing cost of prescription drugs in Canada? Hon. Hedy Fry : Mr. Speaker, having a drug is one thing but the ability for people to access the drug is another. Recent studies have shown that one in five patients with a chronic illness is not able to afford prescriptions so the medication is taken sporadically, which means that the medication is not doing the good it should do. People are getting sicker.

When they go into a hospital this increases hospital costs and acute care for the patient. The ability to afford prescriptions is an important factor. Canada is the only country in the industrialized world with a universal health care system that does not have a universal pharmaceutical strategy. One of the core objectives in the 2004 accord was to look at a national pharmaceutical strategy. The government, in its wisdom or lack thereof, completely ignored that in 2006. What we now have is one of the most costly and non-accessible pharmaceutical systems in the world.

We should be looking at what other countries are doing. New Zealand, for example, has a system whereby when the government buys a drug for a formulary, the cost is so much lower than the cost in Canada. We are paying the second-highest cost for drugs in the world. This is really ridiculous. We need to look at a good pharmaceutical strategy. If we had the United Kingdom's national pharmaceutical strategy, we could save $14 billion a year. If we had the New Zealand pharmaceutical strategy, we could save more than that.

That money could be put into the health care system in terms of health promotion and disease prevention, palliative care, mental health, all of the pieces that are missing right now. It is like being penny-wise and pound foolish. I do not understand why the government has not let that happen and has let it lag. [ Translation ] Ms. Lysane Blanchette-Lamothe (Pierrefonds—Dollard, NDP) : Mr. Speaker, I thank my colleague for her speech. I am sure she is very knowledgeable about many health-related issues.

As she probably knows, in his 2011 report, the Auditor General pointed to problems with Health Canada's timelines for informing people about problems with drugs. Up to two years can go by before Health Canada even finds out about problems. The report was released in 2011, but it was not until December 2013 that the government introduced this bill, which is a step in the right direction. As my colleague said, Bill C-17 was a long time coming. However, I wonder why previous Liberal governments did not tackle this problem when they had the chance. Were they not aware of the problem?

Can my colleague enlighten me? (1045) [ English ] Hon. Hedy Fry : Yes, Mr. Speaker. The system was not as bogged down when the Liberals were in power as it is currently. The system now takes a long time to move. It takes a long time to get notice of compliance to approve drugs. It takes a long time to get out adverse reporting and that is because the government has severely cut back on the resources needed to move it forward.

It has been shown that by voluntarily asking manufacturers to okay whether a drug can be recalled or whether various restrictions can be put on a drug, industry has to agree and that takes a long time. We have learned certain things over the years. One can go back as far as the 1920s and ask why certain things were not done then. Body of knowledge information, what other countries are doing, best practices, allow us now to see where we should be going. We should be making the strong changes that are in this legislation and we should be adding the ones that would make it stronger.

We need to ensure resources are available to do so. Mr. Charlie Angus (Timmins—James Bay, NDP) : Mr. Speaker, I remember when OxyContin was first prescribed in Ontario. At the time it was supposed to be a miracle drug because it was not supposed to be addictive. We found that it was heavily over-prescribed, leading to all manner of problems in the general community. In my region, people who would never become addicted to opiates or that were given OxyContin without explanation of the effects.

It raises the question of optimal prescribing practices and the need to work with the medical community to ensure that when doctors are given new medicines on the market that the issue of side effects and the implications of those drugs are properly explained. The Canadian Agency for Drugs and Technologies in Health currently operates the optimal use program. It produces clinical guidelines and disseminates them to physicians, but it seems that there is an insufficient relationship between the impact of drugs and how this is being explained to physicians.

Given my hon. colleague's experience in the medical community, what does she think we need to do to ensure that when drugs are brought onto the market the issue of side effects and implications of those drugs are properly given to physicians on the front line? Hon. Hedy Fry : Mr. Speaker, that is a very good question. It shows why this bill is important and why some of the measures have talked about to strengthen the bill would make this bill different.

For starters, when a drug goes through clinical trials before it gets to Health Canada and gets a notice of compliance, all of that information is kept absolutely secret. No one knows about it. Physicians are not warned. Pharmacists are not warned. Nobody knows how the clinical trials went, what the reasons were for accepting the drug, or what the problems were with the drug. That is what we are asking for. They are doing it in Europe, and the FDA has now tabled its desire to do that and has put it forward. At the same time, clinical trials are limited, in that they only go to a certain cohort of people.

When the drug hits the general public, adverse reactions and risk factors, as in the case of OxyContin, do not come forward until it has been in the marketplace for some time. It is then that we suddenly find that people are finding very specific uses for it out there. Every single opiate is addictive, and so was OxyContin. Everyone knew that, but the fact that people could take OxyContin and syringe it and add various things to it and inject it was not known in the clinical trials because they were not doing it in the clinical trials. That is another reason we want complete surveillance of drugs.

It is to provide a warning, over the course of time, as to what the new adverse effects are. It therefore blows my mind, knowing all of this, that the government would approve the generic production of OxyContin to six different generic companies within the last year, knowing what it now knows about OxyContin and having been asked not to do it.

(1050) Mr. Dan Albas (Parliamentary Secretary to the President of the Treasury Board, CPC) : Mr. Speaker, I will be splitting my time with the member for Lambton—Kent—Middlesex . I am pleased to speak today on Bill C-17 , which proposes to amend the Food and Drugs Act to better protect Canadians from potentially dangerous and unsafe drugs. Over the past three years I have served on the Standing Joint Committee for the Scrutiny of Regulations and have come to appreciate first-hand the importance of regularly reviewing and carefully scrutinizing regulations in our legislation.

Often the results can be quite surprising when reviewing regulations, and that is certainly apparent in the Food and Drugs Act. In my view, that is why the amendments proposed in Bill C-17 are extremely important to Canadians. I would like to highlight this with an example. Under the current act, if a drug or medical device poses an unacceptable risk to patient health, only the drug and medical device manufacturers can initiate a recall, and that is only after they become aware that a risk exists.

In other words, under our existing laws, it is up to the manufacturers to determine whether or not there is a health risk serious enough to warrant a recall. Health Canada plays a secondary role. The current law only requires a manufacturer to notify Health Canada of the manufacturer's decision to issue a recall after the fact. However, it does not end there. Under our current laws, government cannot step in and order a manufacturer to recall a drug or medical device that is unsafe.

Where our existing law becomes more bizarre is that if something like a candy bar is deemed unsafe to the public, the Minister of Health can issue a recall. To summarize, the Minister of Health can issue recalls for dangerous and unsafe foods, but not for dangerous and unsafe drugs. In my view, this situation is completely unacceptable. Bill C-17 proposes to remedy this situation by ensuring that the Minister of Health has mandatory recall power to compel a manufacturer to recall a drug or medical device if it is determined that it presents a serious or imminent risk of injury to health.

This authority provides government with the power to initiate a recall instead of leaving the decision to the manufacturer or requiring Health Canada to negotiate with industry when the health and safety of Canadians is at stake. I should also add that under this recall provision, once a recall is ordered, anyone who sells a drug or medical device and is aware that the product has been subject to recall may be convicted of an offence.

There is also a provision for an exemption to this penalty, an exemption that allows for Health Canada to have the flexibility to authorize the sale of a recalled product with our without condition. Why does that make sense? It is because it is conceivable that in some circumstances a patient may have unique medical needs for which no alternative to a recalled drug is available. I should also point out that under the new recall measures there would be no changes that would limit a manufacturer's ability to issue a voluntary recall.

However, if a manufacturer fails to act quickly and decisively, the Minister of Health would have new powers to better protect the health and safety of Canadians. Recently I met with a constituent who shared with me the importance of quality control in diabetes testing strips. How much insulin to take is determined by these strips, and serious failure in these test strips could result in death. The need for increased protection for Canadians in this area, and many others, is important, and that is why I will be supporting the bill.

The health and safety of Canadian families must absolutely come first, and serious risks at the manufacturing level have to be treated seriously. While researching the bill late last evening, I was struck deeply when I came across the number of Canadian families that have suffered the loss of a loved one as a result of a dangerous drug. Indeed, a colleague of ours in this place knows all too well the serious need for Bill C-17. In fact, the more I researched this area, the more apparent it became of the need for Bill C-17 to become law.

(1055) In my view, this bill is long overdue. It is simply not acceptable that drugs that could pose a risk to patients remain on the market at the arbitrary discretion of the manufacturer. To give some further perspective on how out of date these current regulations are, fines under the act are $5,000, while under Bill C-17 these fines can be increased to up to $5 million a day. Even jail time can be imposed under very serious circumstances. These are protections, I would argue, that Canadians need.

Before I close, here is some brief history I also believe is relevant and that I am sure many members of this House would appreciate hearing. Canada's Food and Drugs Act was first passed in 1920. Significant changes were made in 1947. Further changes were made in the 1960s, after a dangerous drug that was legal at the time resulted in the death and deformation of thousands of infant children. I believe that Bill C-17 , which amends the Food and Drugs Act, is long overdue.

Protecting Canadians from unsafe therapeutic products without delay or administrative red tape is a priority that I believe all members of this place should share. I would also note that the Minister of Health has stated that she would be open to amendments to Bill C-17 if ideas are brought forward that would better protect Canadian patients. From a regulatory perspective, the mandatory recall measures proposed in this bill are consistent with mandatory recall measures for therapeutic products in other countries, including the United States and the European Union.

I submit that it is time that Canada joined the list of countries with mandatory recall legislation, and I ask that all members of this House join me in supporting Bill C-17 . I thank all members for taking the time to hear my thoughts on this piece of legislation. [ Translation ] Mr. Alain Giguère (Marc-Aurèle-Fortin, NDP) : Mr. Speaker, the text of this proposed legislation is important, but so is enforcement. Unfortunately, Canada has one great weakness: it passes bills but does nothing to enforce them. Just yesterday, we talked about rail safety issues with the distinguished member.

In theory, there is a law that protects Canadians, but the Auditor General discovered that the law is not enforced. There is no real oversight, just a smokescreen. The member indicated that the minister is open to amendments to improve what is a necessary and useful bill. My question for my distinguished colleague is this: will measures also be taken to enforce this law on the ground? Passing a bill without doing anything to enforce compliance is pointless. What guarantees can my distinguished colleague offer about the idea behind this excellent bill? [ English ] Mr. Dan Albas : Mr.

Speaker, I worked with the member opposite on the public accounts committee and always enjoy his joining in the debate. First of all, this is at second reading. I believe we should swiftly send this piece of legislation to the committee so that we can have a thorough examination. Then if members have ideas about how to increase the efficiency and effectiveness of this legislation, I am sure the committee would be happy to hear them.

Specific to the member's concern about not being able to get the job done, as I said in my speech, it is important that Health Canada, through the Minister of Health , have the ability to compel recalls in a safe and effective manner. This legislation will do that.

I would hope that the member would recognize that and not only support the bill's referral to committee so that we can have it studied but also support it at third reading so that we can have this measure in place and give the tools to Health Canada to protect the health and safety of Canadians, as I am sure this member, and every single member of this place, wants to see happen.

(1100) Mr. Kevin Lamoureux (Winnipeg North, Lib.) : Mr. Speaker, I am sure the member listened to what the Liberal Party's critic had to say on the legislation. We see the benefits of having the bill go to committee. The Liberal Party has suggested, in a very tangible way, a number of amendments that need to be made to the legislation to improve it. To what degree does the member believe the government will listen to opposition members, in particular individuals like the Liberal Party's health critic, who is exceptionally knowledgeable about the issue and wants to improve the legislation?

We recognize there is benefit, and we want to see the legislation go to committee. Does the member equally recognize the benefit of improving the legislation through amendments, even if they come through the opposition? Mr. Dan Albas : Mr. Speaker, first, I served on the justice committee, one of the committees I quite enjoyed working on, when it considered the not criminally responsible legislation. We actually took amendments from both the New Democrats and the Liberals where they made sense.

If we can all agree that this is good legislation, a good first step, as one member said, is to take it to committee and put forward common sense amendments that would improve the bill. I am sure they would be looked at and, hopefully, supported. We all want the health and safety of Canadians to be first and foremost. On his other point about whether we will listen to the health critic, I am sure the health committee will say that it listens to the health critic all the time. However, by the same token, many of the provisions she mentioned in her speech, I believe, exceed the actual bill's scope.

Some of those ideas may be perfectly appropriate and some of them may be ruled out of order. We will let the committee process go forward and find out which amendments can be tabled and are in order. Then the committee can examine and articulate which suggestions should go forward and which ones should remain on the table. Mr. Bev Shipley (Lambton—Kent—Middlesex, CPC) : Mr. Speaker, it is an honour and a pleasure for me today to stand to support and talk to the House about Vanessa's law.

As my colleague from Okanagan—Coquihalla mentioned, this bill requires the reporting of serious adverse drug reactions to ensure that doctors and patients are aware of new risks, and introduces new tough fines for companies that put Canadians at risk. I encourage all members to support the bill's referral to committee so some progress can made on the important issue of drug safety and work toward better protections for Canadian patients.

I will focus my remarks on the importance of mandatory reporting of serious adverse drug reactions and also medical device incidents by health care institutions and how this would improve our ability to respond to safety issues that would help keep Canadians safe. As members of the House can appreciate, drugs can not only have beneficial effects for patients, but can sometimes have unintended and unwanted side effects. These side effects, better known as adverse drug reactions, can sometimes represent very serious medical risks.

What are termed serious adverse drug reactions in the bill are ones that require hospitalization and are often life threatening or result in permanent disability. Adverse reactions to medications are estimated to amount up to 25% of emergency room visits and hospital admissions, an amazing number that would likely shock most of us. That is why I find it so appropriate that the bill has been entitled Vanessa's law, in memory of the member for Oakville 's late daughter, who tragically died of a heart attack while on prescription drugs that were later deemed not safe and then removed from the market.

The bill would make it a requirement for certain health care institutions to provide Health Canada with serious adverse drug reactions or medical device incidents. This information would allow Health Canada to take steps to prevent further harm related to these products. As I mentioned, although a significant number of Canadians are admitted to hospitals each year for serious drug reactions, again 25%, this important information about drugs and medical devices does not always reach Health Canada. This is a serious concern and one that legislators can actually help address.

Our country has one of the most rigorous drug approval systems in the world. Before a drug reaches the marketplace, the department reviews it for safety, quality and effectiveness. This review is generally based on scientific data that is attained through previous studies and observed in clinical testing. Clinical testing is an important

part in the development of drugs and medical devices, and we have every reason to have the confidence in the science. However, studying drugs before they are put on the market cannot tell us everything about these products. When a drug or medical device is introduced to the real world, it may produce different results from those that were observed in a controlled clinical trial setting. In fact, some serious issues may only become known after a medical device or drug is actually on the market.

It is therefore critical that we continue to monitor the use of drugs and medical devices in the marketplace and that information on serious adverse reactions are reported to Health Canada in a timely manner. Under current law, and this is interesting, only manufacturers and sponsors of clinical trials must report serious adverse reactions. However, they do not receive reports on some of the serious adverse reactions and cannot report incidents to the department if they do not know about them.

(1105) I will give credit where credit is due. Adverse drug reactions reported to Health Canada have been on the rise over the past five years. Unfortunately, despite these improvements, it is estimated that less than 10% of adverse drug reactions are actually reported. This underreporting of important safety information is a serious concern as it limits Health Canada's ability to identify at an early stage the potential safety issues with a product and to take timely action to prevent additional patient harm.

Some positive steps have already been taken to address underreporting by educating health care professionals on the value of reporting and how to properly report to Health Canada. Pre-emptive steps have also been taken to introduce new simplified forms and electronic forms to report. Devoting health care resources needlessly to an overly complex system creates a problem in itself and nipping this in the bud is simply good policy. In addition, Health Canada has worked with standard-setting bodies such as Accreditation Canada to assist health care institutions to standardize their process for reporting.

Although this has helped, it is still not enough. We need to do better. With Vanessa's Law, we will strengthen serious adverse drug reaction and medical device incident reporting, as well as provide the tools needed to respond to unsafe drugs. Let me give a few examples to illustrate how this safety information can benefit patients and how the bill would support these measures. When Health Canada receives important information about a certain medical device or drug, it will take the necessary steps to prevent future harm.

Health Canada could alert health care professionals to any new harms and how they could be mitigated, or require the manufacturer to change the labelling to add a warning. We know that many serious adverse drug reactions are preventable. Taking action to prevent these harms will free up valuable hospital resources, through addressing threats to health and safety before hospitalization is required. As alluded to earlier, we are well aware of how busy health care institutions have become and we do not intend to impose any unnecessary burden on an already strained health care system.

That is why we are strongly committed to further consultations with health care institutions, as well as with provincial and territorial governments. There is a clear commitment in the bill to developing regulations that will set out what information is required, how it is reported and which health care institutions will be required to report. Only those health care institutions that are best positioned to improve the quantity and quality of reporting would be required to report.

Only useful safety information about a drug or medical device will be gathered in ways that are efficient and within time frames that are meaningful. Again, all with a view to ensure the least burdensome way to get the safety information that is needed. Further, it is an expressed commitment in the bill that reported requirements will take into account existing information management systems with the view to not imposing any unnecessary administrative burden.

This will lead to the development of a meaningful reporting system that is not only focused on increasing the quantity of data, but also in gathering quality data. It is important for Health Canada to continue to monitor drugs and medical devices once they are on the market. The information that health care institutions will provide on serious adverse drug reactions will allow Health Canada to assess the balance between the benefits and the risks of a drug while it is on the market. More important, it will support timely identification of safety issues and early action to prevent future harm.

Our government's priority is the health and safety of Canadians families. Strengthening the reporting requirements for drugs and medical devices will better protect Canadians and their families from preventable harm. These important measures need to be taken, and I hope Vanessa's Law will receive support from all parties so that all of us as a country can take action for better protection of Canadians. I am thankful for the time allotted for me to speak to such an important bill and I look forward to questions.

(1110) [ Translation ] Mr. Matthew Dubé (Chambly—Borduas, NDP) : Mr. Speaker, I thank my colleague for his speech. Although we support the bill, we are nevertheless disappointed that it was introduced such a long time after the problems were flagged. I believe my colleague is aware of the 2011 Auditor General's report. After all, we were both members of the Standing Committee on Public Accounts, and he knows as well as I do that the Auditor General had deplored the time lag in disclosing information about the safety of drugs. Does my colleague know what caused this time lag?

In his opinion, why has it taken the government so long to take action in this important matter? [ English ] Mr. Bev Shipley : Mr. Speaker, I would like to thank my colleague from the other side for his question. We have spent time together on public accounts. When we receive the Auditor General's reports, we as a government and as a Parliament make our best efforts to improve what we may think is best for Canadians when we are going through a process or legislation. In this particular case, we have now got an incredible bill in front of us, put forward by the member for Oakville .

It is not only about his family. We all heard the speech he gave in support of this bill. What this bill would do is relate back to our communities and our families about the significance of making, in this case, some very significant changes for the protection of Canadians. It would provide the monitoring and the ability to take products that may be harmful to us and get the labelling changed. It would introduce monitoring, so we could actually provide assurance that the medications we are taking are safe. It is not only for adults.

We know, in this particular case, that although the product may have been good for an adult, it had some very serious adverse effects for a young person. To answer my colleague's question, we are moving ahead and we are moving ahead quickly. We want to get this bill into committee, so that if there are changes and, as the Minister of Health has said, if there are good amendments that make sense in moving this forward for the protection of Canadians, we will make them. I look forward to the support of this bill as we move forward.

(1115) Mr. Kevin Lamoureux (Winnipeg North, Lib.) : Mr. Speaker, I want to pick up on one of the comments that the member made when he talked about medications and drugs and the benefits versus the risks. It is critically important that we recognize that, when we have these prescription drugs, quite often there is this mindset that they are good for us and that, at the end of the day, no one is going to die from them or have negative side effects to the degree in which they prevail in society today. That is why education is a very important aspect when it comes to medications.

Along with that education, we have to have the information. We have to know the impact that these medications have, as a general rule. This is where there has been a great shortfall. I wonder if the member would like to pick up on that particular point, which is the need not only that we have the information, but that the information be passed on through education in order to prevent people in the future from dying or falling quite ill as a result of getting prescription drugs that they should not have been taking. Mr. Bev Shipley : Mr. Speaker, I thank my colleague, because what he talked about is real life.

One of the key issues of that question is that the education process is needed. The other part of it is reporting when there are adverse effects. Right now, basically, the manufacturer and the sponsor are the only ones that are required to do the reporting. When we have medical professionals who acknowledge and see adverse effects that are happening to a patient, they would now have to do that reporting. That is going to be part of the education, at least at the professional level. The labelling is going to help.

We need to make sure that the labelling is also in an educational format, so that families can understand it. [ Translation ] Mr. Matthew Dubé (Chambly—Borduas, NDP) : Mr. Speaker, first of all, I would like to mention that I will be sharing my time with my colleague from Churchill . I would also like to take the time to acknowledge the courage of my colleague from Oakville, with whom I had the opportunity to work in committee. To my mind, the fact that he took the time to share his experience is not only very moving, but also very important.

Personal experience plays an important role in our efforts to make progress on such a file. It goes beyond politics. As my colleagues said, the NDP will support the bill at second reading. We recognize that it is a step in the right direction. In fact, a number of my colleagues said so this morning. We also recognize that it is important to send this bill to committee in order to hear from certain witnesses who may not have been adequately consulted.

I am thinking of the Canadian Nurses Association, among others, which says that the front-line workers who face medical challenges in communities were not sufficiently consulted. It will be a good opportunity for us to hear what these people have to say and perhaps to propose amendments. It must be said, unfortunately, that we have been waiting for this for a very long time. The introduction of this bill has been delayed a bit. As I was saying earlier, when I asked my colleague a question in 2011, I was on the Standing Committee on Public Accounts.

We were studying the Auditor General's report, which raised the problem of drug safety and the fact that the time between Health Canada receiving the information and sharing it with the public takes too long. In some cases it took two years, which is far too long. I remember some of the testimony we heard. There did not seem to be a very clear commitment from the government at that time. Nonetheless, we have to look on the bright side. It is better late than never. The bill has been introduced and we believe it is a step in the right direction. We have to acknowledge that.

In this matter, we have to address a number of aspects having to do with drug safety. We will talk about it further. This is an extremely important issue. In the case of food safety, there were some explosive issues, such as the XL Foods recall, for example. This issue has a direct impact on the daily safety of thousands of people in Canada. When it comes to food and drugs, we want to make sure that people can look after their health safely. People take drugs to feel better, not to end up with more problems. It is very important to ensure that companies can be required to recall their ineffective drugs.

We must also ensure that information is shared. That is very important. What we noticed, and continue to notice, is that there is an issue with transparency and the sharing of information. For example, one suggestion that the NDP made with regard to this issue and this bill relates to the public disclosure of the results of clinical trials. We know that information is not always being made public or shared with Canadians. I think that is a major problem, given that people often do not know anything about the drugs they are taking. They just go to the doctor and get a prescription.

They rely on the doctor's expertise and the often very basic information they may have.

(1120) This is even more important today because, with all the information that is available on the Internet, many people may try to find the information themselves. If the government gave them information from reliable sources such as the department, it could be very reassuring for them. Canadians would know that the information provided by the government was reliable, accurate and complete. There is still a lot of work to be done in this regard. Speaking of information and transparency, this also relates to food safety.

I do not really like to make this comparison, since we are talking about two different issues, but they are similar in that the government and the minister need to take some responsibility. For example, with respect to the XL Foods recall, the Americans were the ones who discovered the problem. This bill contains an extremely important element in this regard: it ensures that the minister can issue a recall even when the negative effects of the drug are discovered outside Canada. The information sent to the United States or Europe, for example, shows that many drugs are used throughout the world.

We must not limit ourselves to our own experience. We must benefit from the knowledge of others. Once again, this bill is a step in the right direction. It is becoming a recurring theme for the government to use information that was discovered, seen and recognized in other places to make important decisions regarding the safety of drugs in Canada. The work of my colleague from Saint-Bruno—Saint-Hubert also ties into this since she introduced Bill C-523 , which deals with drug shortages. At first glance, drug shortages do not seem to have a direct impact on drug safety, but I would venture to say that they do.

It has to do with transparency and the dissemination of information. It is problematic when the public—and not just patients, but doctors as well—does not have full information about drug shortages, a problem that my colleague's bill aimed to fix, because other drugs are used, including some lesser-known ones that could pose certain risks. These drugs are used in emergencies but the individuals involved do not necessarily understand all of the side effects that can sometimes be negative. We need to understand why it is important to make this improvement.

I know that a government member could tell me that the Minister of Health showed some openness on this issue last week when she claimed she was prepared to look into drug shortages. However, our team and one of our NDP colleagues made a meaningful suggestion, and this suggestion could significantly improve Canada's entire pharmaceutical system. The provincial governments are obviously responsible for ensuring that the health care system runs smoothly. People have a lot of concerns about drugs.

They need to have good information and we need to ensure that our prescription system helps take care of Canadians and does not cause harmful side effects. The public is very concerned about this, and we must take measures such as the ones in this bill to protect the public. Although we have some concerns and this bill has some flaws, all parties can agree that it is still a step in the right direction to improve our health care system. After all, our public health care system is one of the cornerstones of our society. Any step in the right direction to improve this system must be supported.

(1125) [ English ] Mr. Terence Young (Oakville, CPC) : Mr. Speaker, I want to thank the members opposite for supporting Vanessa's law, Bill C-17 , the protecting Canadians from unsafe drugs act. I want to give my sincere thanks to all the members who are supporting it. I am pleased to tell the House that we have had really tremendous cross-party support. This is a non-partisan issue, of course. This legislation has received that support since it was introduced.

In fact, the NDP health critic, the member for Vancouver East , issued a press release the day it was tabled and called it a step in the right direction, as the member opposite just did. I was also happy to hear that the Minister of Health has heard support from the Liberal member for Malpeque , who urged the minister to secure passage of Bill C-17, Vanessa's law, which will strengthen the federal government's ability to provide oversight and to take action to assure the safety of drugs after they have been approved. I want to thank that member for that support as well.

The cross-party support this bill has received is very encouraging, and I look forward to working with these members and others in securing its swift passage. To that point, I want to request that we please get this bill out of the House today. I am hoping it will be approved to go forward to the Standing Committee on Health, of which I am member. If we do that quickly, we can get it to committee next week. It is my wish and my hope that this bill will be passed before the end of June in the House of Commons and sent to the Senate. This is important, because Canadians are suffering adverse drug reactions daily.

If we hold up Vanessa's law, that will continue and will be more likely to continue throughout the summer. The publicity from this bill is making Canadians more aware of the risks of adverse drug reactions when taking prescription drugs. I ask members to help get this bill out of here by noon today, get it to the Standing Committee on Health, and get it approved and sent to the Senate, for the safety of Canadians. (1130) [ Translation ] Mr. Matthew Dubé : Mr. Speaker, we do indeed recognize the work of this member, but we also recognize the work of all the members and critics involved in this matter.

Clearly, we recognize the urgency of the situation. We also recognize the importance of raising certain issues and making the necessary improvements in committee. My colleague talked about the positive aspect of this bill receiving support from all parties. However, it is important to point out another positive aspect in that the government seems to be prepared to hear some amendments at committee stage. Once again, let me congratulate the member for his courage to participate in this debate and to use his personal story.

I agree with him that our health care system is one of the cornerstones of our identity and our society. We must ensure that the system works properly, especially when it comes to drugs. At the end of the day, those drugs intended to treat people must be safe. [ English ] Mr. Kevin Lamoureux (Winnipeg North, Lib.) : Mr. Speaker, I am encouraged by the intervention by the Conservative member in regard to the bill. In essence, he has requested that we try to get this bill passed here this morning.

Given the assurances provided by government members, and particularly by this Conservative member, there is merit in concluding this bill before lunchtime. I would ask the member from the New Democratic Party if his party is prepared to allow it to pass before lunchtime. I suspect that we could get consensus to do that. [ Translation ] Mr. Matthew Dubé : Mr. Speaker, I will not speak for my colleagues. Since I am sharing my time with my colleague from Churchill , perhaps others will want to comment on the issue and add their two cents' worth to the debate. It is not for me to stand in their way.

That is their right as members of Parliament. However, we do recognize the urgency of this matter, just like the members of the other parties. At the same time, I will leave it up to my colleagues who wish to speak to do so. We are also going to make every effort to work effectively in committee and ensure that the bill will be studied, in order to keep improving the situation. [ English ] Ms. Niki Ashton (Churchill, NDP) : Mr. Speaker, I am very pleased to rise in the House to speak on Bill C-17 ,

an act to amend the Food and Drugs Act. As has been stated in the House, we in the NDP are supporting the bill at second reading. We believe that Bill C-17 would bring several key improvements to current drug safety laws. The bill would allow the government to recall drugs or order a distributor to take corrective action to remedy a problem with a drug. The health minister could order a manufacturer or importer to modify the label of a drug to update the side effects or health risks associated with it. The health minister could order a review of a drug and require a copy of the review.

The bill would require manufacturers to update Canadian information on the risks associated with a drug, even if the safety risks were discovered in another country. We believe that this bill is a good first step in protecting Canadians' health and in improving the gaps in current drug safety legislation. Most importantly, it would give the health minister the long-needed power to recall unsafe drugs and to require that drugs undergo further testing if they appear to pose a health risk. However, we believe that this proposed legislation does not go far enough.

We want to see more comprehensive drug safety planning that goes beyond the measures in the bill. As I have acknowledged, Canada needs a comprehensive drug safety plan so that Canadians can be assured that their medications are safe for use. Canadians need to have access to plain-language information about why their medications are safe, including on testing processes and on medication labelling. To give some background, we know that 150,000 Canadians annually experience serious reactions from prescription drugs.

In 2013 alone we saw several major drug safety incidents, such as diluted chemotherapy drugs given to over 1,200 patients in Ontario and New Brunswick. France banned the product Diane-35 in January 2013 after four French deaths were linked to the drug, but Health Canada has remained quiet and has refused any follow-up action to ensure that Canadians are aware of the risks. Off-label use of acne medication Diane-35 is linked to nine adverse reactions causing death in Canada.

Another example is drug-maker Apotex, which was sanctioned by the FDA due to concerns raised about quality control and repeated deficiencies at two of its Toronto area manufacturing facilities. Health Canada was apparently not concerned about the warnings, even though it had not inspected the facilities since 2011. Finally, I and many of my colleagues have raised a drug incident with the minister, and I know that many Canadians have been concerned about this, particularly Canadian women.

For example, there have been voluntary recalls of high-profile drugs used to treat heart problems, high blood pressure, infections, and mental illness. However, I want to point to a particular concern, as I said, for Canadian women, which is the birth control pill Alysena-28 and five other popular birth control pills that were voluntarily recalled or had serious safety warnings issued about them: Diane-35, Yaz, Yazmin, Esme-28, and Freya-28.

Despite warning signs and the fact that many Canadian women were sharing on social media and with the mainstream media information about the deficiencies they were noticing and hearing about, the Conservative government was slow to act in terms of recalls. We know that most risks associated with prescription drugs are identified after they are introduced to consumers. Almost one-fifth of new active substances approved by Health Canada between 1995 and 2010 were later given serious safety warnings. Despite this, Health Canada still does not require post-market drug studies.

We know that seniors are five times more likely to be hospitalized for adverse drug reactions. A recent study showed that one in 200 seniors are hospitalized for an adverse drug reaction versus one in 1,000 for other Canadians. We know that seniors are often on more medications, and this demonstrates the need for a better evaluation and monitoring system to prevent adverse reactions. We also heard from the Auditor General, who in 2011 reported on Health Canada's regulation of pharmaceutical drugs. The Auditor General at that time stated:

(1135) The Department does not take timely action in its regulatory activities, with the exception of its review of two types of drug submissions. In particular, the Department is slow to assess potential safety issues. It can take more than two years to complete an assessment of potential safety issues and to provide Canadians with new safety information. The Auditor General went on to raise various concerns when it comes to our regulation system. When it comes to delays in terms of drugs that are necessary and have been proven to be very beneficial to people, I want to draw attention to the pill RU-486.

Sadly, too many people have not familiarized themselves with the literature. It is an integral method in terms of reproductive choices, including medical abortion, that women have around the world in countries like the U.S. and 56 other countries. We know that Health Canada is taking too long in approving this pill. Despite the fact that it has been shown to be beneficial, we have yet to see an approval that would put Canada in the group of so many like-minded countries in making sure that women have access to medication they actually need.

We acknowledge that this is an important first step and a step in the right direction. However, we need the government to be far more proactive when it comes to drug safety and when it comes to recognizing the importance of making medication available to people. I want to share one particular area where the federal government, sadly, is not showing leadership. It is in the cutbacks to medical coverage, including drug coverage, for first nations people.

In fact, just yesterday, I met with the leaders from a first nation in Manitoba, Fisher River, and spoke with other first nations leaders who are very concerned about the cuts to non-insured health benefits, including drug coverage. It is a situation that is sadly putting more and more first nations people, including elders, in vulnerable situations, given that they are not able to access the kind of medical service and coverage they need to be the healthiest they can be. I am particularly concerned that this is affecting a population that we know lives disproportionately in poverty.

They often have less access to medical services, such as the care of a doctor, or nurses, for that matter. I find it particularly troubling that the government, despite its commitment to moving forward when it comes to safe drug coverage, at the same time is cutting drug coverage for first nations people who would be covered under non-insured health benefits.

While we acknowledge that this is an important step, we also ask for leadership from the government when it comes to drug safety, drug coverage, and understanding that the federal government has a critical role to play in ensuring safety for the citizens of our country. Certainly we in the official opposition, the NDP, stand on the side of so many Canadians who are asking the federal government to finally take action.

(1140) Mr. Charlie Angus (Timmins—James Bay, NDP) : Mr. Speaker, I listened with great interest to my hon. colleague and the points she raised in this important discussion on ensuring that we have the protocols in place to protect health in dealing with drugs that are being put on the market. One of the questions that has been raised is the importance of public disclosure of clinical trial results. Currently the results of many clinical trials are never published or made publicly available in Canada.

There has been a move to have these reports, good or bad, put out there so that patients, physicians, and researchers have all the information they need to deal with new drugs being put on the market. In 2005, the World Health Organization stated its support for the requirement to register clinical trials, to develop worldwide standards for trial registration, and to encourage sponsors to make their data public. I would like to ask my hon. colleague what she thinks about the importance of making the clinical trial information on the drugs being prepared available to the public. Ms. Niki Ashton : Mr.

Speaker, absolutely, it is critical to take leadership on this front and to respond to the call of the global community when it comes to transparency and really supporting safety of clinical trials of drugs that Canadians would use. This is obviously very connected to the drug that I mentioned, RU486, where Health Canada has been notoriously cryptic. In fact, at first, it said it was not in trial and then it remembered it was and yet, there is no way for us to know at which stage it is and what these trials look like.

All we do know is that 57 countries around the world see this drug as safe and beneficial to women in their country, particularly women in remote areas, yet in our country, our own health department is keeping this information from us, not just in connection with this drug but generally. It has not practised the kind of transparency we would need. We hope that Bill C-17 would be just the first step of many that the government will take to ensure that we have a robust safety system when it comes to approving drugs and making it clear to Canadians what that process is, along the way.

(1145) Ms. Elizabeth May (Saanich—Gulf Islands, GP) : Mr. Speaker, I appreciate the member's remarks and the fact that the official opposition will be voting in support of the bill, as will I. I certainly hope it will pass before we rise this summer, as the hon. member for Oakville has indicated he would like to see. Would the hon. member for Churchill agree that perhaps at the close of our second reading debate today, we might be able to move for unanimous consent that the bill go straight to committee? Ms. Niki Ashton : Mr.

Speaker, as we have indicated, we are very much in support of the bill and have been from the beginning. I think it is important for us to be able to share our position and, certainly, our hopes for further steps that need to be taken in this same vein. I think that is an absolutely critical role that we have as parliamentarians. Certainly, I expect that many of us will share our support and share further steps as this debate goes forward. We certainly hope that we can bring this bill into law sooner rather than later. Ms. Elizabeth May (Saanich—Gulf Islands, GP) : Mr.

Speaker, it is a pleasure to rise today to support Bill C-17 ,

an act that would protect patients and indeed all Canadians from drugs that are approved and used as prescribed and yet can result in patient deaths. It is rare in this place to have such unanimity around a bill put forward by the government. This important legislation would amend the Food and Drugs Act. The government has taken a courageous step. The Minister of Health should have the right to recall an unsafe drug. That has been obvious since 1962, when Canada's Parliament discovered that it needed a special act of Parliament to pull thalidomide off the shelves.

For half a century we have continued in the same circumstance. The Minister of Health has no power to recall a drug when that drug is recognized as dangerous. It is quite astonishing. It is not because parliamentarians and various ministers of health have not frequently wondered why they lacked those powers but it is because of one thing and that is the unholy, somewhat criminal power, that pharmaceutical lobbies hold over governments around the world. I will be supporting Bill C-17 but I will be suggesting some areas where it could be strengthened. I would like to pay tribute to two people.

The first is the Canadian Minister of Health . Even though this legislation could be much stronger, it took courage to bring it this far. I have to pay tribute, as everyone has mentioned, to the member of Parliament for Oakville whose own personal story is now well known. This is Vanessa's law. This legislation is named for his daughter. There really are no words to express the depth of my admiration and gratitude to this individual member of Parliament. The member's situation and that of many others brings to light a really significant threat.

I have been looking for the statistics for Canada but I will use those for the United States. In the U.S., roughly 100,000 people a year die from using prescription drugs as prescribed. There are a lot of risks to using prescription drugs. Pain relief drugs can create an addiction problem. People are using prescription drugs in ways that were not prescribed. Canadians use roughly the same drugs. The number of Canadians who die every year from using a drug prescribed by a doctor they trust, without any warning about side effects or possible death, must be in the thousands.

In the case of the hon. member for Oakville , his daughter Vanessa Charlotte Young took the drug Prepulsid as prescribed for a fairly minor health condition. Her parents went with her to every medical appointment. No one said anything about a side effect that might cause death. No parent would ever have allowed their child to take that drug had they known. The hon. member for Oakville wrote a wonderful book called Death By Prescription . In the book he tells of going on Johnson & Johnson's website after his daughter's death to find out information on Prepulsid.

He found other stories online and found that investigations had been done on this drug and that 80 deaths had been associated with it. The doctor did not know that when he prescribed the drug. The parents did not know that. Young Vanessa certainly did not know that. Bill C-17 shines a light on a very large problem but it only begins to deal with the problem. When we think about the drug-pushing criminal element, we do not tend to think of white-collar crime. That is what this is.

When a pharmaceutical executive decides not to warn the health minister that there are problems with a drug, that some people might die, because the company's profit margins are high, then that kind of activity should be criminal. If that executive decides that any studies done on a drug are proprietary, are confidential, and should never be shared, that kind of activity should be criminal. This legislation proposes steps to criminalize it.

(1150) I think a lot of members will have read the book The Constant Gardener or saw the film. It always struck me that the most powerful part of that work of fiction by John le Carré was his comment in the legal disclaimer so that no drug company could sue him. He wrote: ...I can tell you this. As my journey through the pharmaceutical jungle progressed, I came to realize that, by comparison with reality, my story was as tame as a holiday postcard. We are dealing with a seriously corrupt process.

I am not talking about any individuals within it, but when the large pharmaceutical companies around the world have so much power over regulators that they can avoid having automatic recalls for drugs or having the drugs assessed properly before they are registered, we have a real problem. One place we could look for solutions is a wonderful institution that operates out of the University of British Columbia called the Therapeutics Initiative. That institution does something that, unfortunately, is all too uncommon. It refuses to accept any favours, trips, or presents from drug companies.

It operates on a very strict ethical code of conduct and reviews the data packages that it is allowed to see from the health department of British Columbia. It decides and advises the government whether pharmaceutical drugs being proposed for use in the B.C. health care system will do more benefit than harm. It has come to different conclusions than Health Canada on a number of occasions. Where are the clauses of the bill that need to be beefed up? Some of my colleagues have mentioned this already. Briefly, we need to look at transparency.

The Canadian Medical Association Journal , by the way, wrote an excellent review on this bill called, “Regulating prescription drugs for patient safety: Does Bill C-17 go far enough?” It was released May 13 of this year and I commend it to members. It provides some very good areas where the bill could be strengthened. One thing it points to, and others have as well, is that there should be the registration of all drug trials and the results of those drug trials should be made public. A recommendation from the Canadian Medical Association Journal

article is that we should also make sure that when Health Canada decides not to register a drug and concludes it might be unsafe, that information should also be made public. Health regulators should no longer tremble with fear about what the pharmaceutical industry might do to them if they warn the citizens of their country that a drug may have very significant side effects that pose a threat to life and health. Therefore, more transparency is required, and I hope that will be seen at committee. The second area is clause 31.2 of the bill, that would increase the level of fines up to $5 million.

It sounds like a lot until we look at the recent drug company settlements around the world. This is a list just in the last few years, since 2008. GlaxoSmithKline, for fraud and illegal promotion of Paxil, Wellbutrin, and Avandia, was fined $3 billion since 2012. The $5-million penalty in this bill puts it into a bit of perspective. Merck, for kickbacks to health care providers, paid $1.6 billion in settlements and fines since 2008. Eli Lilly, for the illegal promotion of Zyprexa, has paid $1.3 billion since 2009. There is a very long list here of significant fines.

For off-label promotion of Topamax, an epilepsy drug, Johnson & Johnson was fined $81 million. There were $600 million in fines for the off-label promotion of botox to Allergan. Novartis was fined $422.5 million for the off-label promotion of Trileptal in 2010. The list is longer than I have time for in my short speech. I hope it makes it clear to parliamentarians that while $5 million is a big number to us, it is small change to big pharma. We need to boost the penalties.

In my remaining time, I want to suggest that at the end of the question and comment period following my speech, we put to the House that since all members in all parties that have so far spoken to this bill today support its passage and would like to see it go to committee, we ask for unanimous consent to approve this quite excellent bill and work to make it better.

(1155) Mr. Terence Young (Oakville, CPC) : Mr. Speaker, I thank the member for Saanich—Gulf Islands from the bottom of my heart for a heartfelt and highly accurate speech. I certainly agree that the Therapeutics Initiative is one of the best institutes in Canada for identifying safety risks around prescription drugs, and has been for some time. Her call for amendments to be bill, from my viewpoint, are more than welcome, and the Minister of Health has said she is willing to consider amendments. In my view, this is democracy at its best.

It is a non-partisan issue and the minister is taking a non-partisan approach, so I am very pleased about that. The member talked about fines of $5 million a day. The bill also includes the provision that when there is criminal negligence and a court saw that it needed to be addressed with a major fine, there could be unlimited fines. A judge could conceivably fine a big pharma company that committed criminal negligence the full amount of their sales for the period of time the drug was on the market. We need Bill C-17 now, as soon as possible.

We need it approved now at second reading to get it to the health committee, if the House approves. We can talk about those issues and hopefully get the bill passed by the end of June. We need to get it approved now. I am hoping that today, at the end of the hour, the parties will agree to send it to committee so that we can reduce the damage and the adverse drug reactions that patients might otherwise experience if we drag out this process. Ms. Elizabeth May : Mr. Speaker, I am humbled by the very kind words of the member for Oakville .

He knows this file better than anybody, at a personal cost that none of us should have to pay. We are in his debt. I am certainly heartened that it is possible for the fines to be increased if the courts find criminal negligence causing death, but I think the minister should have the ability to raise the fines, rather than just having the ability for a judge down the road, at the judge's discretion, to apply the kinds of fines that will make big pharma recognize that Canada is not a country where they can play fast and loose with our health.

(1200) Mr. Charlie Angus (Timmins—James Bay, NDP) : Mr. Speaker, I listened with great interest to my hon. colleague and I was very interested in the litany of fines that have been paid out by big pharma. There was a real eye-opener for me one night when I was at a restaurant that a friend owned. The friend was putting on a dinner for doctors. It was a private function. Someone showed up at the door of the restaurant with an envelope containing $500 cash. The restaurant owner asked him what he was doing there, and he said he was paying for the booze. It was a salesman from a drug company.

The restaurant owner said, “I am sorry; this is not something I am supporting. You can leave if you are going to pay money to anybody to promote your drugs. If you want to promote your drugs, do it outside my premises”. I was very shocked by that. I had no idea whether this was a common practice or not, but it certainly struck me.

I ask my hon. colleague if she could drill down a bit more for people listening to this debate about the kinds of fines that have been paid by these companies, because these fines really raise questions about basic standards of putting public interest ahead of the very large profit margins that may be at stake. Ms. Elizabeth May : Mr. Speaker, I wish the story of the hon. member for Timmins—James Bay about someone showing up with an envelope full of cash was unusual in this business.

I was shocked to hear from experts in the Therapeutics Initiative, and this is a stunning statistic, that for every doctor in Canada, there are three drug salesmen. There are conferences. A seminar on a new drug happens to be held in Hawaii. In his book, the hon. member for Oakville tells a story that I found at page 253. In referring to his time as a member of the provincial legislature in Ontario, he writes: The Big Pharma lobbyists are nice people. They have a job to do. And in most cases it includes spreading around a lot of money. They do it subtly.

There is no quid pro quo . “Hey, if I buy you dinner...will you speak up to help get our drug approved...?” But before you finish the last bit of your beef tenderloin, you will have heard the marvellous story of how their drug keeps patients out of the hospital and saves the taxpayers hundreds of millions. There is the pressure from the pharmaceutical lobby and the quite inappropriate distribution of gifts. As the hon. member for Timmins—James Bay said, the fact is that there is a litany. I did not mention Abbott, which blocked 23 states from obtaining a cheaper alternative to their cholesterol drug.

They were fined $22.5 million in 2010 for blocking jurisdictions in the U.S. from accessing a cheaper version of the drug that works just as well. Let us pull back the blinds on the pharmaceutical industry, which spends more money to find a cure for baldness than it does to deal with malaria. Let us look at the profit motive, which is insidious, and find more ways to get generics out there.

Let us look very closely at trade agreements like CETA and the trans-Pacific trade partnership and see what that is doing to advance the profits of pharmaceutical companies at the expense of the people they are supposed to be curing. [ Translation ] Mrs. Carol Hughes (Algoma—Manitoulin—Kapuskasing, NDP) : Mr. Speaker, I really appreciate my colleague's comments. The member for Timmins—James Bay also emphasized prevention. Every year, 150,000 Canadians experience serious reactions to prescription drugs. We have been waiting for this bill for a long time.

The Liberals were in power for 13 years, and they did nothing to ensure that drugs in Canada are safe. Given that 19.8% of the new active ingredients approved by Health Canada between 1995 and 2010 later became the subject of serious warnings, does my colleague think that this bill will address all of our concerns? Is there any way this bill can be improved? Ms. Elizabeth May : Mr. Speaker, I would like to thank my colleague from Algoma—Manitoulin—Kapuskasing . I completely agree with her. There is no doubt that Bill C-17 is very important. This is a brave step forward in the interest of everyone's well-being.

However, we have to improve it, and I hope we can do that quickly. I believe everyone here agrees on that. The minister herself even said that she is ready to accept amendments. We have to take decisive action against dangerous drugs. We have a once-in-a-generation chance to make sure this bill is as strong as possible. (1205) [ English ] Mrs. Carol Hughes : Mr. Speaker, this is really an important piece of legislation. As we said, it has been a long time coming. The Liberals certainly did not act on this issue.

Given that we see a government that is going in the right direction but that sometimes thinks that what it has put forward is the be-all and end-all, it is again important to indicate that there needs to be oversight with respect to the amendments that will be put forward. Certainly our party is willing to put amendments forward once it goes to committee, but we should not be rushing legislation in the House just so it can get to committee for discussion and have the government members not even look at those amendments. Those are extremely important.

I know that my colleague is well aware of the Auditor General's report in 2011 on this issue, but I am asking if she thinks the bill is comprehensive enough. I am sure her answer will be “Of course not, because we have talked about amendments”, but maybe she can elaborate a bit on some of the other safety aspects that we should be putting in place. Ms. Elizabeth May : Mr. Speaker, in terms of the comprehensiveness of the bill, it certainly addresses a lot of the right areas, and a lot will remain to be done by regulation. We want to see the transparency that I referred to around all trials.

All drug trials should be registered and their results made public. We want to see transparency around Health Canada's decisions on whether it is going to allow a drug or not, around the area of fines, and around drug recalls. We need to have much better information on the side effects of prescription drugs. As well, the labelling should be as clear as possible so that anyone with a prescription drug is able to see, without having to search out secondary materials, whether there are significant side effect risks with this drug.

Those pieces are coming in subsequent regulations, but when we go to committee, we will study it more closely. We are in somewhat of a hurry, because the sooner we act, the more Canadians can be protected from drugs that they never would have used if they had known of their health risks. Ms. Libby Davies (Vancouver East, NDP) : Mr. Speaker, I am pleased to be in the House today to debate Bill C-17 at second reading, which is an opportunity to talk about the bill in principle before it goes to committee.

Before I begin my remarks, I just want to note that although we give numbers to bills, this bill has been referred to as “Vanessa's law”. I want to pay tribute to our colleague on the other side of the House, the member for Oakville , for the incredible work he has done around drug safety, not only in his own constituency but also nationally, across the country. It is appropriate that the bill be named Vanessa's law and that it be a reminder to us all of what can happen when we do not have adequate legislation around drug safety in this country. I am glad we are debating this bill.

I have been told by some of my colleagues that a number of the government members are quizzing the opposition as to why this bill is not being rushed through. I want to begin with that point, because it is a familiar strain to hear. The government introduced this bill back in December, I believe, but it did not come into the House for debate until March. When it came up for debate, it was a Friday afternoon, so it had maybe an hour of debate. This is the only opportunity that has come forward.

Therefore, any suggestion that we have to rush this bill through or that somehow the opposition is holding this bill up is absurd and not based on reality, because it is the government itself that has dragged its feet on this bill. We have said continually that we believe the bill should go to committee, but I am aware that some of my colleagues want to speak to this bill in principle at second reading, which is as it should be. I hope that it will go to committee soon so that the Standing Committee on Health can get into the bill, call witnesses, and examine it more closely.

I wanted to get that out of the way before we talk about the substance of the bill. It irks and irritates me that we so often hear this refrain that something has been slowed down or is not going fast enough when it is the government's own calendar and timetable that have pre-empted a bill being in the House. We have had very minimal debate on this bill. Let us be clear about that. We do need to have debate at second reading. Second reading is here for a purpose.

It is here for all members of Parliament to debate a bill in principle and get an overall understanding of it before it goes to committee and gets wedged into the clause-by-clause process. Therefore, I am happy to be speaking today at second reading on Bill C-17 , which would amend the Food and Drugs Act. For the record, a number of my colleagues who have spoken to the bill and I as the health critic for the NDP, the official opposition, have said that we think this bill is a good first step in protecting the health of Canadians and improving the gaps in the current drug safety legislation.

The bill is long overdue. When I say “long overdue”, I mean decades. I read an

article in the Canadian Medical Association Journal a couple of months ago presented by Matthew Herder, Elaine Gibson, Janice Graham, Joel Lexchin, and Barbara Mintzes, who happens to be a researcher who lives in my community in east Vancouver. It was a good analysis of this bill and it was interesting to read their analysis. It begins by pointing out something that people have probably forgotten, because it is one of those historical stories that happened long ago, but it had a profound effect on the lives of children, families, and Canadians overall.

In their analysis, they begin by pointing out that Canada was the last developed country in the world to remove thalidomide from the market. To do that required

an act of Parliament. That was in 1962. There are those of us here who remember hearing about the devastating consequences and catastrophic effects of that drug and what it did to children and families. Therefore, it is incredible that it required a specific act of Parliament to withdraw that particular drug. In fact, the two manufacturers voluntarily withdrew the drug from the market in March 1962.

(1210) However, that legislation stopped short of granting legal authority to the director at the health branch to unilaterally recall drugs, even though officials recognized that the co-operation of the manufacturer to recall a drug from the market could not be solely relied on. Here we are, more than 50 years later, and we still have this gaping hole in Canada's Food and Drugs Act. We still have a huge issue around drug safety. Certainly, Health Canada is a regulator. It is meant to analyze new drugs that come on the market and approve them.

Astoundingly, however, the federal government has never had the power to actually recall a drug. It has to negotiate around that. There are many examples over the years where we have seen consequences from minor to serious to catastrophic to death because of this lack of oversight and based on the principles of caution and safety of Canadians. We are very glad to see that the bill would allow the minister to recall drugs. It would give fairly extensive powers, which is very important. I want to give some broader oversight. A number of issues related to the bill are also very important. I just quoted from an

article in the Canadian Medical Association Journal . While they support Bill C-17 , they outline the need for at least six critical elements to be looked at and hopefully examined and added to the bill. All these people are experts. They are very involved in the issue of drug safety in Canada, and have done a lot of analysis not only on this bill, but on the reality of drug safety in Canada. I would like to spend a little time going over those elements.

By way of backdrop, we should be aware that even the Auditor General, in 2011, warned consumers, the government and all of us as legislators that consumers were not receiving proper safety warnings about pharmaceutical drugs fast enough because Health Canada was so slow to act on the potential issues that it identified. That was a pretty serious matter, and it took the Auditor General making a public report to flag the issue of drug safety. In that report, the time lag was characterized as very serious.

It noted that it meant people sometimes had to wait more than two years before Health Canada completed a drug safety review of a product already on the market and provided updated information about the risks. As the Interim auditor general noted at the time, “I think two years is too long”, and we certainly agree with that point. That same 2011 audit also found there were gaps in the transparency about drug information. In fact, it is really keeping Canadians in the dark about Health Canada's drug safety work.

There has been an issue about clinical trials and the lack of information that is being provided, which has been a long-standing issue. We should note that in many other countries, information around clinical trials is provided so researchers, medical practitioners and consumers alike can make themselves aware, if they want to, about a product, particularly at the clinical trial level, and this is very important. I know the minister recently made announcements about providing better information.

Again, this is a good step, but it is very important to have this as part of a legislative package to ensure there is transparency in the work of Health Canada. What do we have to hide? We should have nothing to hide. This information is critical to the health and safety of Canadians and to the medical community. It is also critical to health researchers who examine new products that are coming on to the market and the kind of testing and clinical trials that have been done.

(1215) We should always be on the side of transparency, of accountability and of advocating for much greater safety measures. If this means some of the procedures become more complicated for the manufacturers or they have to go through other steps, so be it. What is paramount and what is the first order of the day is patient and drug safety. Certainly the bill will help in this regard, but more needs to be done. Here are some of the other issues that hopefully will be examined at committee.

Although the bill calls for mandatory reporting measures for health care institutions, we really need to look at not so much the issue of adverse reactions, but the failure of Health Canada to follow up on them, which the bill does not do. Again, there is a huge issue in safety, adverse reactions and what kind of process is in place to ensure this is properly followed up on by Health Canada so we have a continuum.

There should be a seamless process that is clear and transparent for Canadians, for people who are interested in this issue to know they do not have to keep digging deeper and deeper to try to figure out a little information here and there, or if an adverse reaction is reported, will it be followed up. These things should be taking place as a matter of course. These things should be fundamentally inherent in the Health Canada process. Unfortunately, we have seen these gaps and so it becomes a bit of a patchwork approach that simply has failed. This system has not been a great model for drug safety for Canadians.

This is one element of the bill that needs to be looked at because it does not deal with the failure of Health Canada to follow up on adverse reactions. Nor does the bill deal with the issue regarding off-label prescriptions for drugs for adults and the risks this may pose. The bill impacts prescribing off-label drugs to children, which is a step in the right direction. As we know, the practice of off-label prescriptions means a prescription is used for another use than originally intended, which is often totally legitimately.

However, the need for oversight on the safety of off-label prescriptions is really important. This question requires some examination. I have spoken about access to public information, about drug trials and the need for additional drug testing as to why medications are considered safe or not. These are some of the questions that need to be examined at committee. We have to go through the system step-by-step and really examine where there are gaps are holes. We will have to question the officials very closely on this.

None of us are particularly expert on this, but we will have to try to navigate that process as best we can. Then we will have to look at the bill and layer it over that process and determine what holes still exist and what gaps, problems and issues have not been identified and dealt with in the bill. I have named a few. Certainly another issue is the question of labelling. We are very concerned that there needs to be a much better communications system set up between doctors, pharmacists and patients for communicating and reporting on risks.

If we have a good system in place, if an adverse report has been made and if we know there is a risk, how can we ensure there is a better communication of those risks, either through labelling or how the medical community addresses this?

(1220) In fact, this has been a big issue at the Standing Committee on Health in recent months. We looked at the whole question of prescription drugs and how they could be either misused, mis-prescribed or abused. These drugs can save lives, help people heal and get better, but they can also kill if they are not used properly. We heard many stories and examples about prescription drugs and the lack of information, or a heavy-duty selling job by a pharmaceutical company or not enough transparency and information about safety concerns or adverse effects of it affecting people.

Unfortunately, there are too many tragedies. There are too many cases of people suffering from adverse effects of prescription drugs because of improper prescribing or, worst case, of a fatal overdose and death. This is a very important. In fact, we need some sort of national database that effectively communicates between the different parts of the health system. We have a complex health system, but there is a federal role, which is to provide leadership and give overall oversight on patient and drug safety. Health care is delivered at a provincial level, and many players involved.

At the end of the day, there has to be some federal responsibility. While I am glad the Minister of Health has understood and been clear that this issue needs to be addressed, we have a long way to go, not only in drug safety but in oversight of our health care system and ensuring there is proper communication between different parts of our health care system. Joel Lexchin of York University, a real expert on drug safety and someone who has been before the Standing Committee on Health since I have been there, said that Bill C-17 was a step forward for Canada's drug safety legislation.

However, he also expressed concern that the legislation did not go far enough and that Canadians still needed to know about the evaluation process that determined whether medications were safe enough to be sold in Canada. I look forward to this going to committee. We support the bill at second reading. It is an important first step, but more needs to be done. I hope that when the bill gets to committee, we can actually look at it in good faith and look at it on its merit to determine the elements of the bill that are in good order, approve them and sent them back to the House for approval.

However, I hope we also look at the bill with a critical eye. Surely that is what we are here to do. Unfortunately, over the last few years I have seen amendments shot down at committee just because they came from the opposition. I really hope that does not happen. I know there are colleagues who care deeply about the bill and I know that at the end of the day we want to see the best bill we can. I appeal to the members that when we get to committee, we look at its merits and at what we can do to make the bill better, to answer some of the concerns.

There is overall broad support, but there are issues and concerns. Let us address those. Let us look into that and work in good faith to ensure the bill is the best it can be. We will then have done a good job.

(1225) Mr. Charlie Angus (Timmins—James Bay, NDP) : Mr. Speaker, I have listened with great interest to my colleague. She has such immense experience in the issues of the need for a national health care strategy in this country and the need for the federal government not to walk away from its long-standing role in the delivery of health care. I would like to ask my colleague about the issue of prescribing practices. I raised the issue earlier of when OxyContin was first put on the market. In Ontario, in particular, I noticed that it was being prescribed for all manner of reasons.

People who would go in with a back problem or people who would go in for surgery were being prescribed sometimes large amounts of OxyContin. The impacts, the very addictive impacts of this drug, were not fully explained to the physicians who were prescribing, and it was certainly not explained to the people who received it. We saw spikes of addictions all across the spectrum of society. People ended up becoming addicted to this very addictive drug because there had not been the proper explanations. In the end, there was certainly a backlash on the whole use of OxyContin.

The Canadian Agency for Drugs and Technologies in Health has an optimal use program around the issue of prescribing and awareness amongst doctors. There is an attempt to raise awareness, but there are concerns that there is not enough work being done to ensure that physicians are fully informed, independent of the drug companies' claims, of the potential impacts before they start to prescribe. I would like to ask what my hon. colleague thinks of this. Ms. Libby Davies : Mr. Speaker, that is a very important question.

In fact, this is specifically one of the issues that the Standing Committee on Health looked at just a couple of months ago. I can tell members that we heard some pretty disturbing testimony. For example, we heard from researchers who told us that they went to so-called “educational sessions” that were paid for by pharmaceutical companies; that they were really about the promotion of a particular drug; and that then they would get, not a diploma, but some sort of certificate to say that they had gone to this educational session and that it was A-okay, green light ahead.

Yet, of course, as the member points out, we have seen some really disturbing situations with OxyContin. It is a very powerful drug. I have to say that pain management is a very important thing. It is a huge issue in this country. There are many people who are living with severe pain. In fact, there is a group called Canadian Pain Coalition that works on this every day. It is very concerned about ensuring that bona fide drugs are available for pain management.

However, there is a critical issue about prescribing practices and ensuring that drugs are being used for the appropriate setting with a patient and that the prescriptions are not just being ripped off the prescription pad; and of course in other circumstances people are actually selling the drug or abusing it themselves. It is a huge issue, and