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37th PARLIAMENT, 2nd SESSION

Standing Committee on Health

EVIDENCE

CONTENTS

Tuesday, October 7, 2003

0905

The Chair (Ms. Bonnie Brown (Oakville, Lib.))

Mr. Denis Choinière (Director, Office of Regulations and Compliance, Tobacco Control Program, Healthy Environments and Consumer Safety Branch, Department of Health)

0910

The Chair

Mr. Rob Merrifield (Yellowhead, Canadian Alliance)

Mr. Denis Choinière

Mr. Rob Merrifield

Mr. Denis Choinière

Mr. Rob Merrifield

Mr. Denis Choinière

Mr. Rob Merrifield

Mr. Denis Choinière

Mr. Rob Merrifield

Mr. Denis Choinière

The Chair

Mrs. Betty Hinton (Kamloops, Thompson and Highland Valleys, Canadian Alliance)

Mr. Denis Choinière

0915

Mrs. Betty Hinton

Mr. Denis Choinière

Mrs. Betty Hinton

Mr. Denis Choinière

Mrs. Betty Hinton

The Chair

Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ)

Mr. Denis Choinière

Mr. Réal Ménard

Mr. Denis Choinière

Mr. Réal Ménard

Mr. Denis Choinière

Mr. Réal Ménard

0920

Mr. Denis Choinière

Mr. Réal Ménard

Mr. Denis Choinière

Mr. Réal Ménard

Mr. Denis Choinière

Mr. Réal Ménard

Mr. Denis Choinière

Mr. Réal Ménard

The Chair

Mr. John McKay (Scarborough East, Lib.)

0925

Mr. Denis Choinière

Mr. John McKay

Mr. Denis Choinière

Mr. John McKay

Mr. Denis Choinière

Mr. John McKay

Mr. Denis Choinière

Mr. John McKay

Mr. Denis Choinière

Mr. John McKay

0930

Mr. Denis Choinière

Mr. John McKay

Mr. Denis Choinière

Mr. John McKay

Mr. Denis Choinière

Mr. John McKay

Mr. Réal Ménard

Mr. John McKay

The Chair

Mrs. Brenda Chamberlain (Guelph—Wellington, Lib.)

Mr. Réal Ménard

Mr. John McKay

Mr. Réal Ménard

The Chair

Mr. Rob Merrifield

Mr. John McKay

The Chair

Mr. Denis Choinière

The Chair

Mr. John McKay

0935

The Chair

Mr. Réal Ménard

Mr. Denis Choinière

Mr. Réal Ménard

Mr. Denis Choinière

Mr. Réal Ménard

Mr. Denis Choinière

Mr. Réal Ménard

Mr. Denis Choinière

Mr. Réal Ménard

Mr. Denis Choinière

Mr. Réal Ménard

The Chair

Mr. Réal Ménard

The Chair

Mr. John McKay

0940

The Chair

Mr. John McKay

Mr. Réal Ménard

The Chair

Mrs. Brenda Chamberlain

The Chair

Mr. Rob Merrifield

The Chair

Mrs. Brenda Chamberlain

The Chair

Mrs. Brenda Chamberlain

The Chair

Mrs. Brenda Chamberlain

The Chair

Mr. Réal Ménard

0945

The Chair

Mr. Réal Ménard

The Chair

Mr. John McKay

Mr. Réal Ménard

Mr. John McKay

Mr. Réal Ménard

The Chair

Mr. Rob Merrifield

0950

Mr. Réal Ménard

The Chair

Mr. John McKay

Mr. Réal Ménard

The Chair

0955

The Chair

Mr. Donald McCarty (Vice-President, Law, Imperial Tobacco Canada Limited)

The Chair

Mr. Donald McCarty

The Chair

Mr. François Damphousse (Director, Quebec Office, and Representative, Physicians for a Smoke-Free Canada, Non-Smokers' Rights Association)

Ms. Cynthia Callard (Executive Director, Physicians for a Smoke-Free Canada)

1000

The Chair

Mr. François Damphousse

The Chair

Mr. François Damphousse

The Chair

Mrs. Brenda Chamberlain

1005

Mr. Donald McCarty

Mrs. Brenda Chamberlain

The Chair

Mr. Rob Merrifield

Mr. Donald McCarty

Mr. Rob Merrifield

Mr. Donald McCarty

Mr. Rob Merrifield

The Chair

Mr. Réal Ménard

1010

Ms. Cynthia Callard

Mr. François Damphousse

Mr. Réal Ménard

Mr. François Damphousse

Mr. Réal Ménard

Mr. François Damphousse

Mr. Donald McCarty

Mr. Réal Ménard

Mr. Donald McCarty

Mr. Réal Ménard

Mr. Donald McCarty

1015

Mr. Réal Ménard

Mr. Donald McCarty

The Chair

Mr. John McKay

The Chair

Mr. John McKay

Mr. Donald McCarty

Mr. John McKay

Mr. Donald McCarty

Mr. John McKay

Mr. François Damphousse

Mr. Donald McCarty

1020

The Chair

Mr. Stan Dromisky (Thunder Bay—Atikokan, Lib.)

Mr. John McKay

The Chair

Mr. Stan Dromisky

The Chair

Mr. Jeannot Castonguay (Madawaska—Restigouche, Lib.)

The Chair

1025

The Chair

Mr. Jeannot Castonguay

The Chair

Mr. Réal Ménard

Mr. John McKay

The Chair

Mr. John McKay

The Chair

Mr. Denis Morrice (Co-Chair, Best Medicines Coalition)

1030

1035

The Chair

Mr. Rob Merrifield

Mr. Denis Morrice

Mr. Rob Merrifield

Mr. Denis Morrice

1040

Mr. Rob Merrifield

Mr. Denis Morrice

Mr. Rob Merrifield

Mr. Denis Morrice

Mr. Rob Merrifield

The Chair

Mr. Grant Hill (Macleod, Canadian Alliance)

Mr. Denis Morrice

1045

Mr. Grant Hill

Mr. Denis Morrice

Mr. Grant Hill

Mr. Denis Morrice

The Chair

Ms. Carolyn Bennett (St. Paul's, Lib.)

Mr. Denis Morrice

Ms. Carolyn Bennett

1050

Mr. Denis Morrice

The Chair

Mr. Stan Dromisky

Mr. Denis Morrice

1055

The Chair

CANADA

Standing Committee on Health

NUMBER 057

2nd SESSION

37th PARLIAMENT

EVIDENCE

Tuesday, October 7, 2003

[Recorded by Electronic Apparatus]

¿ (0905)

[English]

The Chair (Ms. Bonnie Brown (Oakville, Lib.)): Good morning, ladies and gentlemen. We're picking up our review of Bill C-260, and we're going to begin with a report from the officials in Health Canada, to tell us what has happened since we began with this bill.

I don't know if it's Ms. Tunstall or Mr. Choinière. One of you is going to begin, I believe.

Mr. Denis Choinière (Director, Office of Regulations and Compliance, Tobacco Control Program, Healthy Environments and Consumer Safety Branch, Department of Health): Good morning. My name is Denis Choinière, and I'm the director of the office of regulations and compliance, tobacco control program in Health Canada. With me today is Victoria Tunstall, who is a policy analyst in the program.

I would like to thank you for giving us the opportunity to appear before you this morning to give you an update on the development of regulations to reduce the ignition propensity of cigarettes. I have prepared, in tab 1 of your information package, speaking notes, but in the interest of time I will give you just a summary of those speaking notes.

Quite a bit of work has taken place since we last appeared before the committee in February. Our main task these last few months has consisted of going over the comments received, further to the consultation document of last December. Through a variety of meetings with experts and representatives of the industry, we have ascertained that some of the concerns raised require that we pursue more in-depth research, but none of them appears substantial enough at this point to preclude the development of regulations.

After review of the comments and our own analysis, we have concluded that the ASTM standard E2187-02b is still an appropriate standard to serve as the basis of the regulations we are working on. This is the same method we proposed last December, and it's the same method that is still proposed by New York State.

If you're trying to follow my speaking notes it won't work, because I'm just going from one part to another here to save some time.

To establish an accurate picture of the Canadian cigarette market, we have been testing brands against the standards. We have a total of 62 brands that we have tested, and only one so far has passed the test. It's an American-made brand, More Menthol.

We've also been busy looking for ways to answer some of the questions raised by the proposal. For example, Health Canada does feel that it's important to be able to accurately measure the effectiveness of future regulations. So to this end, we've been working with fire officials to improve consistency of data collection for cigarette fires across the country.

On the subject of toxicity, which is one of the main concerns raised by interested parties, we have been able to locate some more relevant information. You may remember that the concern here was that reducing the ignition propensity of cigarettes might increase the toxicity of cigarette smoke because of the changes in materials and design.

After reviewing the results of toxicological studies conducted by both Philip Morris and Brown & Williamson in the U.S., we concluded that although there were changes in the smoke chemistry, namely a significant increase in carbon monoxide levels, they did not translate into any overall meaningful changes in toxicity. However, caution must be exercised, as these tests performed were quite limited. Health Canada feels that this is still an important concern, and is considering requiring that manufacturers perform adequate toxicity testing before and after modifications are made to the cigarettes.

Another issue we paid attention to was consumer behaviour. A concern expressed by the tobacco industry here was that consumers, believing their cigarettes to be fire safe, would thus become more careless. To examine this we've undertaken two major steps. First, we're conducting a survey right now to establish a baseline of consumer behaviour. Second, we're looking in detail at a database on fires that have occurred in Ontario, which is maintained by the Ontario fire marshal. So we're examining and taking out relevant data, to get a good picture of the fires that have occurred in Ontario so far.

[Translation]

All the work carried out recently has helped us, in our opinion, to strengthen the regulatory proposal.

Under tab 3 in your briefing package, you will find an outline of the proposed regulations, as we foresee them at this time. The main points of the proposed regulations would be as follows. The proposed standard would require that when tested on ten layers of filter paper using ASTM method E2187-02B, there be a maximum of 25% full length burns. That's the same standard we proposed last December.

For toxicity testing, manufacturers would have to test their cigarettes before and after modification. Unfortunately, the proposed in vitro tests only cover a limited range of toxic end points caused by smoking, but these are the best available methods at the current time.

As for the implementation date, the standard would apply one year after the regulations are registered. This should allow the manufacturers sufficient time to convert their product lines to reduce ignition propensity technology.

Finally, we have worked, and continue to work, on another critical part of the regulatory process, that is, the cost-benefit analysis. For the cost assessment part, we have just requested input from tobacco manufacturers. Under tab 4, you will find a copy of the letter we sent to Canadian cigarette manufacturers on October 3, including a copy of the survey questionnaire. We have asked for responses by mid-November. A similar questionnaire will also be sent this week to other potentially affected parties. Based on the work done so far, we expect that proposed regulations would be ready in early 2004.

Before concluding my presentation, I would just like to give you a brief update on New York State's proposal, which I know is of interest to some. Following a review of the over 7,000 pages of comments they received, New York State officials released a revised proposed rule for their fire-safety standards for cigarettes in late August this year. The revised rules still propose a standard of 25% maximum full-length burns, the same standard proposed by Health Canada. The only significant difference is the addition of technical requirements for companies that choose to use banded-paper technology. The deadline for receipt of this round of comments, for New York State, is November 3, 2003. So their process has been delayed, and our guess would be that we will see the rule adopted in early 2004.

Thank you very much for your attention. Ms. Tunstall and I would now be pleased to answer your questions.

¿ (0910)

[English]

The Chair: Thank you very much.

Do you have questions, Mr. Merrifield, or do you want to defer to the mover of the bill? If you have questions, go ahead.

Mr. Rob Merrifield (Yellowhead, Canadian Alliance): I just have one quick question. You say that of the 62 brands that were tested, one met the standard.

Mr. Denis Choinière: Yes.

Mr. Rob Merrifield: Is that a Canadian brand, or a brand sold in Canada now?

Mr. Denis Choinière: It's a brand sold in Canada and made in the U.S.

Mr. Rob Merrifield: This is the same one that's in New York City.

Mr. Denis Choinière: I'm not sure where that brand is manufactured. I can't tell you at this time, but I could find out.

Mr. Rob Merrifield: You're saying that the cost is yet to be determined. Are you in the process of that right now?

Mr. Denis Choinière: Yes, we're in the process of doing a cost-benefit analysis. Work started in April, and we just sent a letter. Part of the assessment requires input from manufacturers so we know whether or not we're close to the mark, in terms of cost assessment.

Mr. Rob Merrifield: What's your timeline on that?

Mr. Denis Choinière: We've asked to get responses back by mid-November, so that's 45 days.

The Chair: Thank you.

Ms. Hinton, do you have any questions?

Mrs. Betty Hinton (Kamloops, Thompson and Highland Valleys, Canadian Alliance): I do have a question, but since I just joined the committee a few short months ago it may have already been answered many months back.

I have to ask why we are looking at putting another additive in--although I realize it's for safety--that may cause more problems health-wise. Why wouldn't we be addressing the cigarette issue by suggesting that there be no additives in cigarettes, therefore making them less lethal?

Mr. Denis Choinière: Most of the Canadian cigarettes do not contain additives in the tobacco. The additives that are used are in the paper or in the filter. That's quite contrary to what they have in the U.S. market, where up to 200 additives are used. So Canadian cigarettes are quite different.

In order to meet the standard we're proposing, there may not be any need to add additives. So far, the technology that seems to work is what they call banded technology, banded paper. At one place on the paper you build something similar to a speed bump. If you don't draw on the cigarette, that slows down the burning and may extinguish the cigarette--it prevents it from burning further. So there may not be a need, from what we've seen, to add any additives.

¿ (0915)

Mrs. Betty Hinton: May I ask one more question?

On what they refer to as light cigarettes, which we all know are not light, I understand there are holes punched around the bands, which is supposed to make them less harmful.

Mr. Denis Choinière: They dilute the smoke.

Mrs. Betty Hinton: Right. But in fact that makes people smoke twice as many. So will this band you're talking about that's supposed to be a safety feature have the same effect? Will it change the taste or the flavour, so people are prone to smoke more of them to get what they got originally?

Mr. Denis Choinière: We have no data on how it affects the taste of those cigarettes. We just know that a couple of brands--one is the Merit brand in the U.S., manufactured by Philip Morris--have those speed bumps, those bands on the paper along the tobacco rod. They're being sold. I assume some consumers find them not objectionable in taste, so they purchase them.

For Canadian cigarettes, we haven't really looked at the issue of flavour or taste impact. All we are concerned with, in this case, is making sure that whatever technological feature is added, it will reduce the ignition propensity of the cigarettes.

Mrs. Betty Hinton: The last is not a question, it's a request to the chair. I would like to have some backup from this gentleman that there aren't any additives in Canadian tobacco. I find that very hard to believe.

The Chair: We can request that.

Mr. Ménard.

[Translation]

Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ): Madam Chair, I'd like to take a bit of a different tack here with Health Canada.

You have developed a regulatory framework and consulted with the various partners, like, I assume, industry representatives, anti-smoking groups and consumer associations. What you would like us to take from this is that you have agreed on a standard.

Would your proposal, the regulatory framework, be binding on the industry if the published regulations were adopted? What would that mean? Would it mean that the New York State standard would apply?

When you say that there is a 25% success rate... In other words—I'm rephrasing a simple question so that we can take another look at it—if the regulations that you are proposing were adopted and implemented, what would that mean for manufacturers and what would it mean in terms of availability of the product to the consumer?

Mr. Denis Choinière: The ASTM standard sets out how to measure cigarette ignition propensity. The standard provides for, for example, 5, 10 or 15 layers. We have chosen to use 10 layers in this case. So when 100 cigarettes are measured, for example, the standard would require that no more than 25 be full-length burns. That's where the 25% comes from.

Mr. Réal Ménard: But does that mean that with these regulations, it could be said that Canada has cigarettes that won't start fires, as our colleague is proposing to do with his bill?

Mr. Denis Choinière: We don't think that this will cut the risk to zero. We do think that it will help to reduce the number of fires that are started, but in terms of giving you an exact number, that will only be possible later, once the exact numbers are known. We don't think it would be reasonable to aim for 100% at this point. I think that once we have some experience with the 75% standard, we can take another look at it and see whether it should be brought up to 100%.

Mr. Réal Ménard: So what you're saying in your regulations is that out of 100 cigarettes tested by the industry, 25 must not be full-length burns.

Mr. Denis Choinière: No more than 25 can be full-length burns. So the standard, if you will, is referred to as 75%. Seventy-five per cent of cigarettes should meet the standard; 25% would fail. In other words, a maximum of 25% of cigarettes could fail.

Mr. Réal Ménard: But how is that an improvement over the way things are now?

¿ (0920)

Mr. Denis Choinière: Currently, out of approximately 60 brands, all but one fail the test.

Mr. Réal Ménard: And that's an American brand.

Mr. Denis Choinière: It's an American brand that is sold in Canada.

Mr. Réal Ménard: So what you're saying is that our cigarette makers will now have to meet the 25-75 test. It doesn't eliminate the risk of fire, but it decreases the likelihood of fire.

Mr. Denis Choinière: That's why the bill is about reducing cigarette ignition propensity. We are not talking about eliminating ignition propensity at this point.

Mr. Réal Ménard: Do you think that Mr. McKay is a happy man?

Mr. Denis Choinière: You would have to ask him.

Mr. Réal Ménard: That's all, Madam Chair.

[English]

The Chair: Before we go to Mr. McKay, I should say to those people who are new to the committee that we have been focusing on prescription drugs for the past few weeks. All of a sudden, we have to stop that set of thoughts and get back to cigarettes that will be less inclined to start fires.

Just for Mrs. Hinton, this is a private member's bill brought forward by Mr. McKay. He was very concerned by fires started by cigarettes, and felt that there was technology newly available that cigarette manufacturers should have to apply to cigarettes in order to prevent fires.

Since the bill was introduced in the House and referred to us, Health Canada has been working to try to come up with their own answer. I guess we want to find out from Mr. McKay whether he is satisfied with the plan outlined in the binder, whether he wants to pull back his bill if he's totally satisfied, or whether he still wants to push it forward.

Could you alert us to that at the outset of your remarks? Then we'll kind of know where we're at with this bill.

Mr. John McKay (Scarborough East, Lib.): First of all, I want to compliment the department on the work they've done since we last met. It's just remarkable, absolutely remarkable. When I first came here, I thought there was a bit of light between the minister's position and the department's position. That gap has been narrowed quite substantially, and I can't say how pleased I am with the progress they've made and the tests they've done over the course of the period of time we gave them to do it. They've been very responsive, Madam Chair, to your and the committee's initiatives, so I think we are a million miles ahead of where we were before. We're not fighting with each other.

As to the responses themselves, in some respects they follow type and it's kind of interesting. There were essentially three questions raised, the one on toxicity, the one on changing of behaviour, and.... It looks like we've eliminated the toxicity question as far as we can do so at this point, which was really the only substantive question. As to the behaviour modification, it seemed like a bit of a bogus argument in the first place, where people would somehow or another intentionally fall asleep while they were smoking. That didn't seem to make a lot of sense to those of us who were concerned about the issue.

As to other tobacco products, well, I really have no objection in principle to coming back to the committee at some future date and including other tobacco products, but let's stay focused on manufactured cigarettes.

On Ms. Hinton's concern as to whether it actually increases or decreases smoking behaviour, I had an interesting e-mail. The officials can't say this, but I can. It was from a constituent who's also an employee--either an employee or a former employee--of a tobacco manufacturer, and the real worry is that it will change smoking behaviour. For most smokers--and I'm not a smoker, but I'm told this is true--the first hit is the best hit; the first puff is the best puff. Now, a lot of people just put the cigarette down, then it burns down, and that's all that happens. With a fire-safe cigarette it will burn down to say the first speed bump and will self-extinguish more quickly. Then the behaviour may well be modified by the smoker making the decision: will I go and get a new cigarette and do it all over again, or will I relight the extinguished cigarette?

Any manufacturer is of course concerned about the reduction in the consumption of cigarettes. It may well change behaviour. There may be fewer cigarettes actually smoked as a result of this, but it is frankly a sidebar issue as far as the efficacy of this bill is concerned. Nevertheless, that is one of the issues the industry is concerned about.

About the concerns that are on record, I think you've dealt with them brilliantly. You've done a survey across all groups: the industry groups, the fire groups, the Physicians for a Smoke-Free Canada, all those groups. The answers follow type, and I encourage members to read the tabs that contain that information.

There are two points of substance, and they have to do with your proposal for “no later than two years following registration”. So the bill as potentially amended says that the Governor General does not make a regulation on or before June 30, 2004. Is our clock ticking from June 2004, or is our clock ticking as of the coming into force on December 20, 2004? What's our two-year window here?

¿ (0925)

Mr. Denis Choinière: Because we don't know exactly when the regulations would come into force, I mean the date of registration, it's difficult for us to use a calendar date as a reference point. We're starting from the date of registration, which is when the regulations become law, if you will, and that's when the clock starts ticking.

Mr. John McKay: It's from the registration date.

Mr. Denis Choinière: Yes. The tobacco regulations must go to the Canada Gazette part one, and then they have to be tabled before the committee. Once the committee has dealt with them in the House, then they go for final publication in the Canada Gazette part two. But before they're published in the Canada Gazette part two, the Special Committee of Council needs to approve them. When the Special Committee of Council, which is a committee of cabinet, has dealt with regulations, they're usually registered the day after, and that's when they become law.

Mr. John McKay: Can you outline for the committee a projected series of dates for those regulations?

Mr. Denis Choinière: It's difficult, and take this with a big grain of salt, if you will. If we pre-publish the regulations in early 2004, there is a possibility the proposed regulations will be tabled before the committee in April. I'm not sure, though, and you're in a better position than I to know if the House or the committee will be sitting in April. Once it's tabled, the committee has 30 sitting days to deal with the proposed regulations. If it deals with the proposed regulations within two or three sitting days, then it can go back and have final publication. At best it could be June, but more realistically we're probably looking at the fall of 2004.

Mr. John McKay: The critical point would be, if in fact we anticipate an election in the spring, this committee should deal with the draft regulations prior to that date so the legislative clock can tick independently of Parliament sitting.

Mr. Denis Choinière: It would be something along those lines.

Mr. John McKay: If we could include that in a separate report, Madam Chair, I think we should, because it's rather important. I don't want to lose the whole parliamentary session over something.

Why is it two years from that proclamation date? Why is there that length of time?

Mr. Denis Choinière: After the registration the standard would come into force in one year. The two years are to revisit the issue of toxicity testing. There are two tracks that follow each other. One is the standard, so one year after registration the standard is implemented. However, before that standard is implemented, we want baseline data on the toxicity of the tobacco products before modification. Once they have modified it after one year, we want them to test and to report no later than two years after registration.

Mr. John McKay: Then, just to follow the bouncing ball, we would have a final gazetting as of June 2004, for instance.

¿ (0930)

Mr. Denis Choinière: It's something like that.

Mr. John McKay: You would have one year for the manufacturers to modify their processes, and then you want a report back within two years of June 2004, at which time that would automatically trigger a review on toxicity.

Mr. Denis Choinière: Yes. That's why we would want to have the data on toxicity.

Mr. John McKay: That's basically on the advocacy of the whole design as well, I should think.

Mr. Denis Choinière: We have other tracks that are not in regulations because they don't need to be--for example, the survey I was talking about earlier. The data collected by the fire marshals and all that will be done at the same time. They are not in the regulations because they don't require the tobacco industry to do anything; it is us collecting the data. At the end we assume that within a year after the coming into force or the implementation of the standard, we will have sufficient data to review internally the effectiveness and the impacts on behaviour, toxicology, and so on.

Mr. John McKay: Those timelines seem reasonable.

Just to speak to Mr. Ménard's point, I might point out that 75% effectiveness is all that's achievable under the current standards. The other issue is that you have to assume that the industry will not like the proclamation of these standards, that it will affect how they manufacture cigarettes. Since they are a litigious industry, I would expect that there will be some litigation fallout from any proclamation. I think the department is wise in adhering to standards that are already accepted across the industry.

Mr. Réal Ménard: One of my questions was, are you a happy man?

Mr. John McKay: Am I unhappy?

The Chair: That's what I'm trying to find out too, Mr. Ménard.

Mrs. Brenda Chamberlain (Guelph—Wellington, Lib.): We never know. We've never seen him happy.

Mr. Réal Ménard: That was my impression.

Mr. John McKay: My wife says I'm very even-tempered; I'm just mad all the time.

Some hon. members: Oh, oh!

Mr. Réal Ménard: You know we reviewed the Divorce Act, eh?

The Chair: I think Mr. Merrifield has another question, and then we'll come back for some conclusion from you about this.

Mr. Rob Merrifield: Initially you brought this forward to change the Hazardous Products Act in a private member's bill. The department was here and, if I remember rightly, their recommendation was not to do it under this but to do it under the Tobacco Act as a regulation. I'm just wondering where we're at with that. With the intent and where we're going with it, it's worthy of consideration. The problem I have is the vehicle. Why has there been a change of position, and what's your recommendation on it?

Getting back to what John was just talking about, would not going through the regulations under the Tobacco Act be a better vehicle to get outside of Parliament than this?

Mr. John McKay: Madam Chair, do you want me to respond to that?

The Chair: I think we should let Mr. Choinière give his opinion on that question, whether it should be the Tobacco Act regulations or the Hazardous Products Act amended, and then we'll let Mr. McKay come back in, because these are the two experts who have been working on this bill.

So, Mr. Choinière, what do you think of that question?

Mr. Denis Choinière: As a public servant first, I think I should not interfere with the legislative process, so I will let you decide which piece of legislation you want to adopt or not.

But I'll say right now that because we have the Tobacco Act as a tool, we've used it so far to develop the regulations. And because we see the Tobacco Act as being a comprehensive act allowing us to tackle the problem of tobacco use from different angles, we see these regulations as fitting under that act. So we propose pursuing regulations under the Tobacco Act.

The Chair: Mr. McKay, would you like to comment on that?

Mr. John McKay: Just on that point, one of the rules of law is not to hire a lawyer and then do all the talking. When I went over this with legislative counsel, we considered this issue. The legislative counsel's view was that the Hazardous Products Act was the appropriate vehicle. I'm not disputing Mr. Choinière's view that possibly the other vehicle might be more appropriate.

What I would like to see as an end result is the regulation proclaimed. I'm not fussing overly as to whether it's under the Hazardous Products Act or whether it's under the Tobacco Act; it's neither one nor the other, to me.

My suggestion to the committee will be that we pass this as is, because I don't think they have any capacity to change the legislation under which the bill is presented. But that will act as a legislative prod, as we say, to the proclamation of these regulations, because they're essentially going to be regulations, whether they're under one act or under the other act. We keep the legislative prod in place, and we say in a separate report that in the event the minister chooses to proclaim the regulations under the Tobacco Act, then that would satisfy the intention of the bill.

¿ (0935)

The Chair: Mr. Ménard.

[Translation]

Mr. Réal Ménard: What's going to happen in terms of...? We understand your goal and the vehicle you've chosen. Publication will take its course and if this is implemented, what will happen if manufacturers in Canada don't meet the test or the criteria established under the regulations?

Mr. Denis Choinière: Pursuant to a current a provision in the Tobacco Act, when a standard is set, manufacturers must abide by it, and any departure from that standard could result in a fine. But I can't tell you right now what the amount of the fine is; I could find out.

Mr. Réal Ménard: In the course of your consultations, to get an idea of how stakeholders feel about these regulations, can I assume that the anti-smoking lobby is especially pleased, that consumers will potentially be pleased and that manufacturers are particularly annoyed? Would that be an accurate assumption on my part?

Mr. Denis Choinière: Let me explain a few nuances here. Up until now, the anti-tobacco NGOs have been highly in favour of the proposal, except that we were criticized for being too slow in moving forward. So that's one minor nuance.

Mr. Réal Ménard: They will always have the impression that you are quashing the process.

Mr. Denis Choinière: With regard to the manufacturers, they said they were in favour of the objective, but they have some problems with the proposed standard and its date of implementation.

Mr. Réal Ménard: But do you think they believe it's possible to achieve this standard?

Mr. Denis Choinière: Up until now, we've had at least two meetings with the technical committee of the three main tobacco manufacturers in this country, and I think they are working hard to attain the standard and get a product on the market that complies with it.

Mr. Réal Ménard: In any event, they would have until 2005 from the date of publication.

Madam Chair, will these regulations come back before the committee?

Mr. Denis Choinière: Yes.

Mr. Réal Ménard: Yes, that's right. Therefore, we could also carry out consultations. You can see that without the members of Parliament, there is no democracy.

[English]

The Chair: Thank you, Mr. Ménard.

So the committee has to decide whether the report they've heard from the department about the new regulations and the timeline for them is going to be sufficient to achieve Mr. McKay's goal, which was about these self-extinguishing cigarettes—or whether they want to go ahead with this amendment to the Hazardous Products Act.

Do I have any opinions on that from members of the committee, because that's the essential question?

Mr. McKay is suggesting that we pass the bill to keep the “legislative prod”, as he puts it, in place. The health officials seem to be saying that the course they're on is essentially following his lead on what he wanted done, and that it can be done within the Tobacco Act and the change in the regulations they're proposing.

So the question before you today is do you want to pass the private member's bill, or are you satisfied that Health Canada is far enough along in a process that we don't need this bill, and that maybe we just need them to carry on with what they're doing?

Mr. Ménard has a comment.

[Translation]

Mr. Réal Ménard: Madam Chair, I don't know whether or not it's feasible, but given the information we have, would it be possible to hold another meeting with industry representatives and tobacco group representatives, just to hear their views on the situation?

I know we have a lot on our plate, but it would only be one meeting. If we make a decision this morning, it seems to me that since we should always have as much information as possible to work with... Couldn't we consider just one meeting with industry representatives, the main spokespersons and tobacco group representatives to review the department's initiatives and to give these individuals an opportunity to us what direction they hope we will take? Otherwise, I think we'd be rushing things a bit. As you know, nothing good comes of hasty decisions.

[English]

The Chair: Mr. McKay, then Mrs. Chamberlain.

Mr. John McKay: The industry has also already appeared before the committee, but it also responded to Health Canada's inquiries on the three questions that were asked—increased toxicity, false sense of security, extension to other products—and they basically follow type.

¿ (0940)

The Chair: What does that mean? You've said that three times.

Mr. John McKay: Follow type?

The group A is the tobacco industry, and there are seven respondents. To nobody's great surprise, four of them think there's increased toxicity risk, but three of them, interestingly, said they had no opinion. So half of the group thinks there's an increased toxicity risk, and the other half has no opinion at all.

Mr. Réal Ménard: That's not what I'm talking about.

[Translation]

Based on the regulations and the work done by Health Canada, the groups have not appeared before us, because we were not even aware of what had been done. So I'm saying there is new data. We may have a good intuitive grasp of what the tobacco industry and consumer groups will tell us, but before going ahead on the basis of new information, it seems to me that you as a lawyer should know that the principles of natural justice dictate that we give everyone an opportunity to express their views.

So I would be more comfortable, even though we have a lot of work to do—and you know how passionate I am about drug prices—and despite the fact that we're going to Eastern Canada soon, I'd like us to have at least one meeting, just one, regarding the new regulatory framework and the steps that you're proposing, with industry and consumer group representatives.

[English]

The Chair: Mrs. Chamberlain.

Mrs. Brenda Chamberlain: I would support Mr. Ménard's point of view. Obviously, I have Imperial Tobacco in my riding, and I think it is important to know what they feel on a bill such as this.

You know, smoking is not illegal in Canada. We have smokers around the table here, and we have smokers in all walks of life. The reality is that we know it's not a good thing. However, I think they are an important stakeholder and they should at least be heard in the process of democracy. So I do support that suggestion.

The Chair: Mr. Merrifield.

Mr. Rob Merrifield: I just have one comment.

I would agree with that. I think they should be here and be heard, especially in light of the questions on costs, and so on, and how it will impact them as a company that is producing a legal product in Canada, which you can't answer right now. So I think from that avenue alone, we should give them the respect of being here and being heard.

The Chair: We've had three people speak to the idea of having a meeting with witnesses from major stakeholders in this bill, before we proceed to clause-by-clause.

Can I see a show of hands: how many people would favour that particular strategy? Seven do. I think that's the majority. If the majority of people present would like to hear stakeholders before they do clause-by-clause on this bill, then I would ask for a motion to refer this to a future meeting. We can't do clause-by-clause this morning.

Unfortunately, we have to report back to the House on this bill by October 29, so we don't have a lot of time. So I think any kind of a referral motion would have to fit in before October 29, which would be kind of a cute trick, provided the clerk can secure the witnesses you want to hear from--that is, the tobacco companies and maybe some consumers.

Mrs. Chamberlain.

Mrs. Brenda Chamberlain: I know this might be a little unorthodox, but maybe we could go wild. I don't know why we couldn't do clause-by-clause “conditional on”, and after we hear the witnesses we could go back and review it. Then it would be in place and ready for October 29, because we are under a tight timeline.

Is that not possible?

The Chair: I don't think so.

Clause-by-clause is a formal process of the committee. It means we are ready to move ahead with whatever our decision is on the clause-by-clause. It's like saying let's pass a bill in the House conditional upon something else happening.

Mrs. Brenda Chamberlain: No, but I mean do all the big work and have it ready.

The Chair: Well, in actual fact, the passage, clause-by-clause, could be done in about five minutes.

Mrs. Brenda Chamberlain: Oh, all right. Fine.

The Chair: Mr. Ménard.

[Translation]

Mr. Réal Ménard: Thank you, Madam Chair.

I don't think we need to hear 30 witnesses. If we want to act quickly... This is Tuesday morning. Couldn't we do this Thursday afternoon? Couldn't we ask the clerk to convene industry representatives? We know who the representatives of the anti-tobacco groups are. We could call in two or three witnesses Thursday afternoon and then that would be done. We don't need to hear 40 witnesses.

¿ (0945)

[English]

The Chair: That's dreaming in technicolour, Mr. Ménard, because you can't get witnesses like that in two days. But we could ask the clerk to try to work in a meeting when we're in town. Don't forget, we're going out of town at some point, toward the end of the month. And next week is break week, which means the week after is the only week.

[Translation]

Mr. Réal Ménard: Madam Chair, we have representatives of the industry in the room, as well as spokespersons for consumer groups. I'm sure that if they agree to be available, we could dispose of this issue quickly on Thursday afternoon. It's not as if people weren't prepared for this. Let's make an effort and see whether they can come on Thursday afternoon.

[English]

The Chair: Let's put it this way. The committee has voted, with a show of hands only, that they would like to have this extra meeting. Let us put it in the hands of the clerk and let us suggest that if there are representatives of the major stakeholders here, after this meeting they can speak to the clerk. Because as you point out, they may be able to resolve a time, place, and date fairly quickly. Of course, then the clerk has to get a room. So you may get a notice from the clerk about some unorthodox time for this committee to meet to hear these witnesses.

Is that agreeable to everyone?

Mr. John McKay: Let me speak to Mr. Ménard's half-democratic initiatives. He seems concerned that he hears from the tobacco industry. That's fine.

In Health Canada's initiative, there were seven of them. There are also fire, public health, and public safety officials, and there are 30 of those. Then there was another group of non-governmental organizations that showed some interest. There are eight of those. So if we think we need to be fair and give the tobacco industry their response, then you had better go and open it up again, because you can't be half pregnant. You are either going to open it up or you're going to deal with it as is.

My view is that you heard from the stakeholders in February. They submitted their written briefs. They responded to Health Canada's initiatives over the course of the summer. You know darned well there are all kinds of negotiations that go on behind the scenes here as to what is acceptable and what is not. There is not a great amount to be learned by a further meeting.

I'm in the hands of the committee, but I think you're going to have a bit of a recycled meeting.

[Translation]

Mr. Réal Ménard: Mr. McKay, I'm sure you agree with one thing. We can't be democratic only when it suits us. If I had to vote this morning, I'm not sure... We do agree with the principle, but here we have a new regulatory framework that will bring about a number of new factors both for the industry and for consumers. I understand that there are consultations, but you are asking us to pass a bill as parliamentarians. We agree with the principle, but given the information we have to date, I don't think it's exaggerating to ask the main individuals concerned to appear before the committee. I'm not talking about trying to delay the process by holding 40 meetings; I'm asking you for one more meeting on the specific regulatory framework that we as parliamentarians have learned about for the first time today. In my view, that's not an unreasonable request.

[English]

Mr. John McKay: Well, do you think that, say, fire safety or Physicians for a Smoke-Free Canada are not stakeholders in this matter? All you seem to want to invite are the tobacco manufacturers. If you're going to invite the tobacco manufacturers, then you have to invite everybody else, too.

[Translation]

Mr. Réal Ménard: Yes, all right. We can invite them.

[English]

The Chair: The problem we have.... It seems the logical way to get around this would be to have the spokesperson from the tobacco industry association, and maybe the consumers association and the national fire safety association--just have three witnesses, the three main interest groups.

The clerk tells me the tobacco industry association has fallen apart, so it will be hard to get one person to speak on their behalf.

I still think we could have a quick review from the various viewpoints in one meeting. It seems the committee would be more comfortable with that. There is no intention to open it up, rather, to have one meeting to review what the stakeholders think about this. I think consumers, the fire people, and the tobacco people would be the three groups we'd have.

Mr. Rob Merrifield: I don't necessarily have a problem with that, but I don't think that was the intent, to open it up. We know what the consumers feel about it, and we know what the fire people feel about it. But when we asked the question about how it would impact the industry, the answers weren't forthcoming. In fact, the study is still in process. That is my concern.

It's not about advocacy, it's about information. I think it's appropriate to have that information from the industry if we are going to go clause by clause on this and put forward a recommendation.

¿ (0950)

[Translation]

Mr. Réal Ménard: There has to be representatives from consumer groups too, Mr. Merrifield. There can't only be representatives from the tobacco industry, no more that there can be only representatives from consumer groups. We still have to hear a wide range of views. I agree with Mr. McKay that we should have representatives from fire departments. I have no problem with that.

[English]

The Chair: Sarkis is pointing out that we have representatives from the tobacco industry in the room right now, and from the Non-Smokers' Rights Association. I'm wondering if they would feel comfortable answering questions right now. Maybe we could get this all over with.

Mr. John McKay: There are three people along the wall there. It would be very useful.

[Translation]

Mr. Réal Ménard: Would you agree with that?

[English]

The Chair: Is that agreeable to everyone? Okay, then we won't need an extra meeting on Thursday afternoon.

I'll ask the representatives from Health Canada to step back for a few minutes, and I'll invite these other people to come to the table.

¿ (0955)

The Chair: Gentlemen, perhaps the new witnesses at the end of the table would introduce themselves and give us their opinion on this situation we're facing.

Mr. McCarty, who do you represent?

Mr. Donald McCarty (Vice-President, Law, Imperial Tobacco Canada Limited): Given the short notice, I really only represent my own employer, Imperial Tobacco Canada Limited. I am the vice-president of law of that company. I am the chairman of the legal committee of the Canadian Tobacco Manufacturers' Association. I don't have a mandate from them or from the other manufacturers to speak on their behalf today. I'm sure some of my views are shared, but I can't guarantee that.

The Chair: Would you like to begin?

Mr. Donald McCarty: We received the draft Friday afternoon and we studied it a bit yesterday, so it's premature to say what our opinion is. However, I'll tell you what a couple of our opinions are.

First, we think that toxicity testing as recommended by the regulation is probably a good idea and is long overdue.

Toxicity testing, in our view, should be expanded not only to include the issue of low ignition propensity cigarettes but the development of cigarettes that are potentially less harmful to health. We've had the opportunity to invite a number of Health Canada representatives to our own laboratories, as well as to the laboratories of our parent company, British American Tobacco in England, and have presented to them the progress we've made on reducing such products. Having standards in place by which the toxicity of cigarettes can be tested is an important part of developing that, so we're all in favour of it.

I hope I've surprised somebody by saying I'm at least in favour of some of it.

In terms of the standard itself, we're willing to work with Health Canada in developing a standard. I have concerns. I'm not sure it's going to be possible to make the standard.

One of our biggest concerns is as follows: There has been a precipitous decline in smoking, the newspapers reported recently. Certainly there is a precipitous decline in the number of cigarettes we sell, and that decline is far beyond what we thought the legitimate reduction in demand to smoking would have forecast. That caused us to lay off 300 workers in your riding, or close to your riding. We had to lay off people in Montreal. We had to close a plant.

So we're asking ourselves, why did this happen? Certainly there is a significant reduction in smoking that's occurring, and that's a good thing. But while we speak there are factories in China presently making counterfeit cigarettes that are identical replicas of what we see now in Canada. They're producing them by the container load. They're coming over here by the hundreds of thousands. The RCMP has seized several containers so far, but we know there's a huge volume of counterfeit cigarettes that are coming onto the market. There is also a huge volume of cigarettes that are smuggled from foreign manufacturers. There is also a huge number of cigarettes that are being made illegally in Canada in various ways and sold in Ziploc bags.

One of our concerns is that a standard such as this will probably increase that phenomenon. Maybe that's unavoidable, but it will happen. And it will have consequences that are serious and maybe even chaotic for the legitimate industry that remains. We're working with law enforcement authorities to try to help them control that, but I'm not sure they can be entirely successful. They're certainly trying.

In terms of the standard itself, we're willing to work with Health Canada in developing that standard. It will be put into place, I think, regardless of what we say, and we'll work with it. We'll try to develop it.

I'm also not convinced that passing a test that involves putting a piece of cigarette on ten pieces of laboratory filter paper--and the reason they chose this filter paper, I remind you, is because there is a lot of it available in laboratories--is not necessarily representative of real-world conditions, but it's a start.

So we'll work with Health Canada. I think the timing may be difficult to meet. I think the cigarette that will eventually be produced might indeed be more toxic in certain respects. It's a little early to tell, perhaps, but I certainly think it will be. But we'll try to work with it.

[Translation]

The Chair: Mr. Damphousse.

Mr. François Damphousse (Director, Quebec Office, and Representative, Physicians for a Smoke-Free Canada, Non-Smokers' Rights Association): If you don't mind, I will let Ms. Callard speak before I do.

[English]

Ms. Cynthia Callard (Executive Director, Physicians for a Smoke-Free Canada): Hello. I'm Cynthia Callard, with Physicians for a Smoke-Free Canada. I want to thank the committee for having this hearing on this bill. I think it's really important and it shows the power of parliamentary scrutiny.

Before Bill C-260 was on the books, progress toward fire-safe cigarettes in Canada was very slow. This bill has triggered one of the fastest regulatory developments in Health Canada I've seen.

Our biggest challenge to health, I think, is the slow process of developing regulations in Health Canada. For example, the Tobacco Act, which was passed in 1997, has a handful of regulations passed, important ones--for example, health warnings on cigarette packages. But there are many other regulations that are waiting to be made, ones on overall toxicity levels, for example, or even just basic ones like having health warning labels on promotions, and they have been stalled. Without Bill C-260, I don't think this progress would have been made.

Unless the committee passes Bill C-260 and sends it back to the House, so it's maintained alive, I'm very worried that the regulatory process will stall, because resources are deployed to somewhere else in Health Canada, which happens quite frequently, or because of an oversight caprice, where people get stuck on a point, or because the tobacco companies threaten to go to court and everyone gets nervous, the lawyers get involved, and things drag out even longer.

So one of the greatest contributions I think this committee could make would be to pass Bill C-260 so it's coherent, send it back to the House and keep it alive, keep watching the development of regulations for the Tobacco Act and the actions of the tobacco companies, and encourage Health Canada to do what it can to respond more quickly to the unhealthy actions that are taken or actions that are taken that encourage use.

The one quick point I would make is that whenever you regulate, the standard reply that policy-makers get from tobacco companies is that they want to talk, they know the way that's best, and it's best it be kept in some sort of consultation, which can spin on for years and years.

The second thing you often hear is that it's going to lead to smuggling. I don't really understand why fire-safe cigarettes in Canada marketed in brand packages of companies will create more smuggled cigarettes from China marketed in the brand names of companies. The consumer is not going to know which one is fire safe and which is not. It's not clear to me. If someone has figured it out, maybe they could explain that one to me later.

What is clear to me is that we always hear the refrain that whatever the government does, it's going to lead to smuggling, and therefore they shouldn't do it.

Thank you.

À (1000)

The Chair: Thank you.

Mr. Damphousse, would you just briefly give your remarks, because we now have the bells ringing for a vote.

[Translation]

Mr. François Damphousse: Thank you very much, Madam Chair.

[English]

The Chair: I'm sorry, I misinformed you. We come to this meeting alert to the bell to vote. I assumed this was it, but of course, it's not. It's just calling people to the House.

[Translation]

Mr. François Damphousse: That's fine.

I share Ms. Callard's comments and I just want to remind the committee of what I said last time I testified before you on this issue. In my opinion, any delay means that other people, both smokers and non-smokers, will die senselessly because of fires caused by cigarettes. So whether it's Bill C-260 or the Health Canada regulations, what I want is to see progress as quickly as possible.

On the issue of toxicity, last time I had given the committee confidential industry documents that clearly showed that there would be no increase in toxicity if cigarettes were made nonflammable or much safer. In addition, a great deal of research has been conducted by the U.S. government on this issue. Several tests have been developed to verify the toxicity of cigarettes and all the data collected to date shows that nonflammable cigarettes are no more toxic than regular cigarettes. So there should be no problem as far as that's concerned.

In terms of acceptance by consumers, I had also given you industry documentation to the effect that for some companies, certain nonflammable cigarettes were even more acceptable to smokers. I also gave you the research findings last time I testified on that issue. Normally, nothing should delay the implementation of such a measure. The more the process is delayed, the more people will be injured or die because of these fires.

That's all I have to say. Thank you.

[English]

The Chair: Mrs. Chamberlain.

Mrs. Brenda Chamberlain: Thank you.

I appreciate the witnesses coming forth in such a manner, because I know that's hard and the pressure is on you. But it's very helpful to us.

To the last speaker, who wants this done as quickly as possible, while I understand the urgency, it has to be done right. You can't just throw something in because you want it. It has to be done right. It is important to examine it, and not just say we just have to do this.

To Mr. McCarty, you say that they are more toxic. Why do you say that?

À (1005)

Mr. Donald McCarty: We think they will be more toxic, but it depends on the method you eventually use. One of the reasons why the paper works better as a low-emission cigarette is apparently because it's less porous. The less porous a cigarette is, the more the smoker will inhale tobacco smoke, as opposed to tobacco smoke diluted with air, for example.

We also understand there might be an increase in carbon monoxide, but testing is recommended by Health Canada on that issue, and I'm happy to see that. I don't know that the types of testing they pursue, that they will make us do, will be totally indicative of whether the product is or is not less harmful. What it will tell us is how much more of a particular by-product of smoke can be found in these cigarettes as opposed to a regular cigarette.

Mrs. Brenda Chamberlain: Thank you.

I really appreciate hearing your point of view. I think it's very important that we did hear it, and I thank the chair for being open to this kind of a forum.

Thank you, Bonnie.

The Chair: Mr. Merrifield has a question.

Mr. Rob Merrifield: You're saying that timing would be tight, and I don't understand that. If everybody was going to change to this and you're going to put the bands on the cigarette, what is the limiting factor there?

Mr. Donald McCarty: The limiting factor might be the fact that it's one of our competitors who has a patent on that product and we'd have to make sure that they'd actually give it to us, or sell it to us. That's one thing we have to consider. It's patented by Philip Morris, one of our competitors.

We're looking at other possibilities. One of the other theories is rather than having concentric bands down the paper, one of our sister companies has been looking at the possibility of having a narrow strip of more porous paper, or a speed bump, down the entire length, which makes it burn more slowly. In other words, rather than having concentric bands every couple of millimetres down, it would happen for the whole length. That's another thing we're looking at. We're looking at different types of paper. We're conducting research on other potential methods of doing it. Nothing is affirmed or promising yet.

Mr. Rob Merrifield: One of the other comments made by John, and maybe it's purely speculative, but I want your comment on it, is he was suggesting that bands put on the cigarette would allow you to puff, have it extinguish, relight, puff, extinguish, and consume significantly less cigarette product as a result. Is that something you would agree with?

Mr. Donald McCarty: I don't necessarily agree with the analysis. If it makes people smoke fewer cigarettes, so be it. We really don't care about that. Maybe people don't believe us, but if people smoke less that's fine with us; we're not going to try to get them to smoke more. That's fine. I'm not sure about that particular analysis.

The analysis we have will say that if a cigarette goes out, as generally those of you who are smokers will know, if you relight an extinguished cigarette it tastes foul on the relight. That makes a cigarette less desirable to smoke. That might be a reason why people would go seek a cigarette that is not fire-safe, which they may have found through an illegal channel. There are companies set up in Canada right now that make perfectly fine cigarettes that are perfectly illegal, but they're there.

Mr. Rob Merrifield: The chair just reminded me it depends how desperate you are to light up. I am not a smoker, so she'd know.

Thank you.

The Chair: Are there any further questions for these witnesses?

Mr. Ménard.

[Translation]

Mr. Réal Ménard: I think, in the end, if the industry agrees on the principle of the bill, then we will have covered quite a broad spectrum, because parliamentarians and the population will support the goal, which is to reduce the risk of fires.

My question is this : do you think that the standard that Health Canada is proposing, based on the State of New York's standard, is feasible, and do you think we will have done our work, as parliamentarians, if we use that standard?

That is my only concern, and I put the question obviously to the three witnesses. I think I know what their answer will be, but I would nevertheless like a clear response from them, within the context of this formal process.

À (1010)

[English]

Ms. Cynthia Callard: I think it is very helpful to have a standard that applies beyond Canada. There is usefulness in having some universal, global standards. The New York standard is the one that's had the most testing. Most people seem to be supporting it. I think it would be very useful for Canada to adapt it, and I think once Canada has, it will be adapted in other parts of the world. So the adoption of this bill will actualy have ancillary and beneficial impact on people elsewhere if New York State, Canada, Australia, New Zealand, and other jurisdictions follow suit.

[Translation]

Mr. François Damphousse: This will also set a precedent, in that these will be the first-ever regulations on the manufacturing of cigarettes. That will be a first.

Mr. Réal Ménard: A positive first.

Mr. François Damphousse: A positive first in our case, obviously. And this could pave the way for other initiatives, because we have always established measures aimed at controlling, for example, the industry's marketing activities or at increasing taxes. All those measures have contributed to reducing tobacco consumption.

In Canada, the Tobacco Act allows us to regulate the product, which is something that no other country can do right now. Obviously we think this is an opportunity to... As Mr. Choinière stated, the structure exists within the Tobacco Act to establish a standard for cigarette manufacturing. If we have less flammable cigarettes, that's a good starting point. Then that will open the door to future standards that could perhaps even make cigarettes less harmful.

Mr. Réal Ménard: Mr. McKay doesn't look to the Tobacco Act, he looks to...

Mr. François Damphousse: I said earlier that the two options available to us are feasible and both of them, as Ms. Callard mentioned earlier, should be...

Bill C-260 spearheaded the work that was undertaken by Health Canada, and we are very pleased about that. We want the bill to continue moving forward, because if ever something happened within Health Canada with the proposed regulations, at least we would also have that option. It's very good for us to have both of those engines working at the same time.

Therefore, we believe this initiative could eventually lead to other regulations for this product. As Ms. Callard mentioned, this country of ours has set many precedents in terms of controlling and reducing smoking. Consider, for example, the health warnings to which the tobacco industry was so strongly opposed. Industry officials argued that they wouldn't even be able to print the warnings on their packages. However, six months after those regulations were adopted, the industry complied and included the health warnings on cigarette packages. Strangely enough, they had said that this was impossible.

The same applies to nonflammable cigarettes. We've been told that it will be very difficult to adopt the standard that has been proposed in the State of New York. But if we adopt that standard, I am certain that the tobacco companies will be able to comply. Some brands of cigarettes currently on the market do in fact meet the standard, for example, Merit or, as Mr. Choinière said, the More brand.

Mr. Donald McCarty: My friends to my right have raised several points. First, when you ask if the test can be done, the answer is yes. The reason for this test's popularity is that it is relatively easy and inexpensive and can be duplicated quite quickly in any laboratory. So yes, it can be done.

Is this test truly indicative of what will happen in the real world? Personally, I have my doubts. For now this may be the only test out there.

Mr. Réal Ménard: What do you mean?

Mr. Donald McCarty: If a cigarette goes out when it is burning in a closed container on 10 sheets of laboratory filter paper, does that necessarily mean it will go out if it is squashed between some sofa cushions?

I don't know, but that is the only test we have. We have done tests with furniture, I think those test results could be shared with Health Canada, if that hasn't already happened. This is another way of doing the test, but it is more complicated and more difficult to standardize.

Mr. Réal Ménard: You're doing more than Health Canada is asking you to do. As in any process of collective bargaining, you want more but you end up accepting less. So, at this point in time, you would encounter many problems.

Mr. Donald McCarty: No, that's not what I'm saying.

The beauty of this test is that, because it is standardized, anyone can use the same kind of paper in laboratories anywhere in the world to duplicate that test. Obviously, a chair that is used for testing in Montreal might be different from a chair that is used somewhere in Vancouver or in another country. These are not standardized tests.

À (1015)

Mr. Réal Ménard: I just want to understand you. In terms of what Health Canada is currently proposing, the test poses no problems from an operational perspective. You're saying that you don't think the test can tell us what will happen in real life and that it can't truly protect us from fires.

Mr. Donald McCarty: I'm merely saying that I have some reservations.

I would like to comment on an important point that Mr. Damphouse raised. He said that this is the first time that we will be regulating the content of a cigarette. He is right.

What we have wanted for a long time—and this is a very, very important point—is to see products developed that are less harmful to our health. Over the past few years, the progress made has been very positive. We have to move forward. In our view, in order to make sure that this type of cigarette will see the light of day here in Canada, we must work with Health Canada to ensure that a standard will be adopted and that this standard will apply throughout the country. If we can then find a less harmful cigarette, and Health Canada likes it and it's a beginning, by all means, they can regulate it.

[English]

The Chair: Thank you, Mr. Ménard.

Are there any further questioners?

I'm sorry, Mr. Ménard's time is up. Mr. McKay.

Mr. John McKay: I just--

The Chair: I think we could probably move to clause-by-clause after this. I'm not seeing a lot of questions coming up.

Mr. John McKay: I have two questions, one with respect to toxicity and one with respect to the market chaos. Mr. McCarty indicated that there are a lot of cigarettes being produced in China that are counterfeit cigarettes and that it may lead to increased smuggling and there would be some chaos in the marketplace as a result. I wonder whether in fact we're not indirectly doing you a favour by proclaiming fire-safe cigarettes and proclaiming those regulations. I wonder if in fact the result of this would be that it would be more difficult to sell anything other than those kinds of cigarettes in the country.

I'm interested in the comments of both of you.

Mr. Donald McCarty: Now who buys a pack of cigarettes sees what's inside when they do. The counterfeit cigarettes that are being sold now are perfect copies of a regular pack of Canadian cigarettes, so when the person buys it, he pays either the full price if he's been truly duped or he pays a much lower price if he knows he's buying something illegal and he opens his cigarettes later, but he can't tell what's inside when he buys it.

Mr. John McKay: But in some respects it also gives the regulatory authorities another reason to just seize those cigarettes.

Mr. Donald McCarty: They have enough reasons to seize them, sir. The cigarettes that are coming in are illegal. They don't pay the duties on them. They don't pay any taxes on them. The government is being deprived of gazillions of dollars of tax revenue on this, and when they find them, they seize them. It's not because they're fire-safe or not fire-safe that they're seized or not seized.

Mr. John McKay: Is there any other comment on that question?

Mr. François Damphousse: I think the smuggling issue is a non-issue in this case, for fire-safe cigarettes. You are very well aware that the smuggling crisis that hit us in the beginning of the 1990s was caused by none other than the tobacco industry. Actually you are legally suing the tobacco industry in civil court and also criminal court. Obviously there hasn't been any ruling as of yet, but the evidence points quite clearly to their behaviour.

I think if there is a problem coming from counterfeit cigarettes, there are other mechanisms that could be put in place, such as more effective tax markings that would help the authorities to control what is legal on the market and what is illegal, if it's not possible to determine from the counterfeit packaging because that packaging very well imitates tobacco pack markings. This would be much more effective for the authorities to prevent smuggling coming in. And let's not forget that the Canadian market for Asian counterfeiters is not a very big market, because brands here in Canada are not sold elsewhere except for Florida. The counterfeiters are much more interested in counterfeiting brands like Marlboro, which is sold across the world, or Winston, or other brands that will make them a much bigger profit than just the Canadian market could.

So I don't believe this is an issue that should be considered when we're talking about fire-safe cigarettes.

Mr. Donald McCarty: Madam Chairman, I have a point of order. I feel it is important to make this point. I don't like being tarred with the brush that my colleague to my right has just tarred me with. My company is not charged, and we're not sued. I'd like to make that clear. I'm not willing to be tarred with that brush.

À (1020)

The Chair: Thank you for that clarification.

Mr. Dromisky.

Mr. Stan Dromisky (Thunder Bay—Atikokan, Lib.): Thank you, Madam--

Mr. John McKay: Sorry, I think the--

The Chair: No, I think we've had the two sides of this story, Mr. McKay. I think we'll let Mr. Dromisky into this question.

Mr. Stan Dromisky: Madam Chairperson, my chief concern is the safety factor. First of all, many of the cigarettes that are on the market today are so poorly made that the red-hot embers fall out of the cigarette while you're smoking it. In other words, they're not packed the way they should be packed, or for some reason or other that red-hot ember could end up in your lap. If you have inflammable clothes, a skirt or whatever you have, pants, you're in danger of something happening to you or to your clothing, or to the chesterfield you talked about.

The other point is the cigarette.... I'm a smoker all right, and you're listening to a smoker. I will be writing and I'll light a cigarette, take a puff, put it down, and I continue my writing and then say to myself that it's time for another puff, and I look and the cigarette is gone. It burns right to the cork practically. In other words, it keeps on burning.

To me, that is a very serious safety factor. It could have fallen out of the ashtray. It could have rolled off the desk. It could have gone in among papers on my desk and it could have done damage to the furniture or whatever. The point I think is a valid one. I would like to see something done regarding the continually burning cigarettes, continuously till they get to the very end. If we pass this, I think that one problem will be solved.

As far as the packing of the cigarettes is concerned, the way the companies pack them, that's another problem that possibly could be dealt with in the future.

The Chair: Thank you, Mr. Dromisky.

Seeing no further hands, on your behalf I will thank the witnesses who bravely stepped forward and answered your questions so well.

We will now move on to clause-by-clause. I will ask you to pick up a package in which you will see there are three amendments submitted by Mr. Castonguay, simply to make the dates relevant to the time period we are now in. The bill itself talks about 2001 in a couple of places; therefore it has to be updated for our timeline.

You will see there is a package of three amendments. The first one is called L-1. It amends clause 1, replacing line 16, on page 1, with the following: “on or before June 30, 2004.”

It is moved by Mr. Castonguay. Thank you.

Are there any questions about this amendment? Are there any speakers? Seeing none, I will call the question.

(Amendment agreed to)

The Chair: Please turn to amendment L-2.

This is again an updating to put the year 2004 in. It is moved by Mr. Castonguay. Are there any comments? Seeing none, I will call the question.

(Amendment agreed to [See Minutes of Proceedings])

(Clause 1 as amended agreed to)

(Clauses 2 and 3 agreed to)

The Chair: Now we have amendment L-3, which amends clause 4, again updating it.

Mr. Castonguay.

Mr. Jeannot Castonguay (Madawaska—Restigouche, Lib.): I so move.

(Amendment agreed to [See Minutes of Proceedings])

(Clause 4 as amended agreed to)

The Chair: Shall the title carry?

Some hon. members: Agreed.

À (1025)

The Chair: Shall Bill C-260, as amended, carry?

Some hon. members: Agreed.

The Chair: Shall the chair report Bill C-260, as amended, to the House?

Some hon. members: Agreed.

The Chair: Shall the committee order a reprint of the bill, as amended, for the use of the House at report stage?

Some hon. members: Agreed.

The Chair: Thank you very much, ladies and gentlemen.

[Translation]

Mr. Jeannot Castonguay: Madam Chair, we've been told that regulations are coming and this seems to be the case. Could we produce a very short report when this is tabled, a report that will call on the government to table regulations in the House within six months? We need to ensure that things will keep moving, that the Canada Health Act is not simply a sham. There has to be some movement! That way, we won't get caught off guard and we won't have wasted our time.

[English]

The Chair: You would like a report tabled in the House asking for that?

Is that agreeable to everyone?

Some hon. members: Agreed.

The Chair: It is agreed. Thank you, Mr. Castonguay.

I think we should congratulate Mr. McKay.

Mr. Réal Ménard: And because we support your bill, you will support gay marriage? It's a deal. Thank you.

Mr. John McKay: We'll go for a smoke on it.

The Chair: Now, we used a little more time, ladies and gentlemen, for this than we planned, but I think we eliminated the need for a meeting on Thursday afternoon, as had been suggested. So that's very good.

Now, you'll recall we had two sets of witnesses on prescription drugs, and in my mind's eye I was thinking we would invite them to come tomorrow afternoon. So we wouldn't have a meeting Thursday afternoon on the tobacco issue; we would have a meeting on Wednesday afternoon on prescription drugs.

I understand from the clerk, who has done some inquiring, that the first set of witnesses, the Best Medicines Coalition, cannot come tomorrow, so they are here currently. Do I have your approval to listen to them in the next half-hour?

And the Council of Canadians can come another time, perhaps tomorrow afternoon, so we could get at least half of the set of witnesses over with in the next half-hour.

Is that agreeable, people?

Some hon. members: Agreed.

The Chair: Thank you very much.

Could I ask Mr. Morrice to come forward, from the Best Medicines Coalition, and to make his presentation to us?

And while he's coming to the table, Mr. McKay would like to speak.

Mr. John McKay: I want to thank the committee for their efforts in this bill. It's seldom that a legislator gets to do something where you can save lives, reduce injuries, and save millions of dollars' worth of property damage, and do it all by a simple regulation. So I think we've actually accomplished something here.

I'd like to think the committee worked in a non-partisan and collaborative fashion. Utimately, we did something good for the people of Canada. It doesn't get any better for legislators. I want to thank you all for your help on this important file.

The Chair: Thank you, Mr. McKay.

Let's get our minds around prescription drugs again while we have a witness here.

Perhaps I can call you back to order, ladies and gentlemen. Mr. Morrice is ready to go.

Mr. Morrice, you have the floor.

Mr. Denis Morrice (Co-Chair, Best Medicines Coalition): Thank you.

I'm very sorry, but Dr. Kathy Kovacs Burns, who co-chairs the Best Medicines Coalition with myself, hurt her back and couldn't get on the plane last night.

Thank you very much for hearing me today, as opposed to putting it off another day. I'm really booked solidly.

The Best Medicines Coalition is a coalition of groups who are saying they want access to the best medications. When we looked at your news release on it, we looked at all the topics, and it's almost like one of those things where we could comment on all of them. So we've selected one, which is: “Consumer and health professional access to drugs including, but not limited to access to new drugs for new diseases and old drugs for old diseases (excluding commentary on provincial formularies).” So that's the one we selected from your committee list.

In light of the time, and I know that you're all very, very busy, I'd be more than pleased to deal during the question period with Internet pharmacy; costs; direct-to-consumer advertising; CCOHTA; the CDR, the new common drug review; and any of those questions, but I'll keep my comments really directed to the one I just identified.

Access to best medicines by patients and Canadians generally must be easier, timely, universal, and comprehensive. Access to best medicines for Canadians is a function of two sequential processes. The first one is into Canada, with the federal government looking at the safety and efficacy of a drug, and looking at the withdrawal of old drugs. Then there's the provincial process, which really is will it be on the provincial formulary and will people really have access to it?

I'll only talk about the one, which is the federal one that you asked us to talk about—but you really can't separate them, in a way, if you're talking about access. To think that a drug is on a formulary and fully listed in one province, but in the very next province it's on a restricted listing, and in the next province it's not even listed at all, it really doesn't make sense in our health care system.

The Best Medicines Coalition is calling for the federal government to provide consumers and health professionals, and in fact all Canadians, timely and consistent access to the best medicines, by dramatically improving the drug review system for new drugs and the process for ensuring that the effective old drugs remain accessible on the market.

I'll jump to the rationale here. Access to medicines is a critical quality-of-life issue for Canadians living with chronic disease or illness, and fundamental to the health care system. In 2002 Dr. Niegel Rawson compared the performance of regulatory agencies, and he concluded that “the median approval time in Canada continues to be significantly longer than the times achieved in Sweden, the U.K. and the U.S., and it remains considerably longer than Canada's own target”. Today we're talking in the area of 700 days, compared to Canada's own target of over 300 days. So that's a huge difference, and we think there is a solution to that.

Canadians should not experience undue delays in accessing new drugs that can better treat diseases by decreasing symptoms, reducing hospitalization and surgical cost, and improving quality of life. Access to best medicines will keep people out of the emergency rooms and hospital beds, and let them get back to living their lives. It is important that patients have access to newer drugs within a class, or for a given diagnosis, since new drugs are often found to be of higher quality than older drugs. This may have a number of impacts, including reduced mortality, reduced morbidity, and reduced spending on other medical services, such as in-patient stays and emergency room visits. On the other hand, Canadians should not be jeopardized when old drugs are pulled off the market for whatever reason.

I'll jump right to the recommendations.

Number one, the federal mechanism or body should set public performance targets that will ensure that the total process for drug approval and release into the market is timely, and that effective old drugs or best medicines are maintained on the market.

Number two, actual results should be compared against targets every six months, commencing with the first six months after implementation. As part of the review, the federal mechanism or body should identify, as objectively and as quickly as possible, the barriers to meeting these targets.

À (1030)

Let's just comment on that alone, because very often we're looking at resources, but it really gets confused sometimes as to when did the pharmaceutical company actually apply? They applied in another country on a certain date, and you hear about it. So a parent is wondering, why does that person, that parent in England, have access to that medication and my child doesn't? So we want the transparency around that issue alone.

Number three, priority status should be placed on drugs for life-threatening illnesses and for breakthrough drugs for chronic, debilitating illnesses. These should have a special approval policy and process. In the drugs for chronic diseases now, we're seeing in terms of the biologics that they are making an unbelievable difference and really changing the lives of people.

Number four, more qualified staff should be hired to not only expedite all new drug reviews but also drug approvals for release onto the market.

Number five, the federal mechanism should develop an electronic tracking system, accessible to the public and the applicant, to track the drug review and approval processes through the release onto the market, and to track older drugs destined to be removed from the market.

When a company submits their drug for review, we as patient groups don't know about it. Then there's all this confidentiality that comes in. Health Canada can't tell us and the pharmaceuticals supposedly can't tell us, so we're left, yet somehow we know something is happening there, and we don't know where it is sitting in the queue. So we'd like some transparency around that.

That is the last one. For transparency, the federal mechanism or body should establish a stakeholder advisory committee, including patients. We truly believe that by patients being at the table we'll be able to sort through a lot of this.

The other one that is very important right now, and it is the debate that comes, is the patient surveillance, to find out. When drugs are tested, they're in clinical trials, which are on a selected group. Once it's given to the doctors and doctors have access to it out in that market, it's a different scene. We're looking at very serious drugs now, and surveillance is critical.

I'm not talking about adverse drug reactions now. There is a system for that, good, bad, or sad, however you want to define that, but the patient and patient-centred surveillance program is critical. That would clean up a lot of the bad things we're hearing about the wrong drugs, and so on. What we're really talking about is the right drug to the right person at the right time and at the right price.

I'll end there.

À (1035)

The Chair: Thank you, Mr. Morrice.

Mr. Merrifield.

Mr. Rob Merrifield: Thank you for coming in.

We actually just went on a series of meetings throughout western Canada, and we're looking forward to the ones in eastern Canada on this subject.

You focused in on actually hoping that you can get better drugs approved more quickly, and easier access to consumers. One of the things we are hearing that concerns us in relation to the amount of drugs that are getting to patients is more the problems we have with the drugs that are existing.

Some of the numbers are absolutely astounding. Some of the witnesses came forward saying that 50% of all people who are hospitalized have adverse reactions to drugs, and within our facilities, 10,000 deaths per year. So these numbers, if they're accurate, are astounding, and we've heard this from more than one witness.

So before we open up easier access to drugs, we really have to examine what kind of a situation we have on controlling the drugs that we have right now and how many deaths are because of inappropriate use.

I know you didn't comment on that part of it. You're just looking at better drugs coming to the market quicker--fair enough. But in relationship to that, we also got into the whole idea of direct-to-consumer advertising, and you're making a recommendation here that we should have the public monitor some of the approval processes to make it more accountable. How do you square that with direct-to-consumer advertising that is pushing our borders, a spillover from the United States, and how does that fit with the coalition?

Mr. Denis Morrice: The Best Medicines Coalition is against direct-to-consumer advertising, and it's that simple. What we're really for, and I think we have it all wrong in medication, is--

Mr. Rob Merrifield: What's the difference between that and opening it up to the access? When you have new drugs coming down, you're saying open it up to the consumers so that they can put pressure on.

Mr. Denis Morrice: Well, that's the approval; that's not the review. We're talking about the review process, where patients would be at the table knowing exactly what drugs are coming, how they're being reviewed, where they sit in the queue, what comes next, that end. The direct-to-consumer advertising is much more from the pharmaceutical industry advertising, as you see in the United States and a number of other countries.

What we're really talking about is DTCA. It shouldn't be DTCA, it should be DTCE, and it's education. It's not many years ago that when we got sick, we went to a doctor and our doctor gave us care, the best drug, we assumed. If we needed an operation, we got it. That's not true any more. We're waiting up to two years for a hip or knee replacement right now. We don't get access to the medication we should have.

And people don't even know.... if you walked out on the street and asked anyone what a provincial formulary is, they wouldn't know what it is. So we're saying that people need that information. If we have every minister of health in this country saying people have to take more responsibility for their own health, how can they do that if they don't have the information, and if they don't have the education?

In my position, certainly with the Best Medicine Coalition and certainly with the Arthritis Society of Canada, we're saying if there's going to be any kind of advertising whatsoever, then an equal amount of money has to come to our organizations so we can educate the people. And that's not what has been happening. It ends up with little organizations like ours trying to educate people with our limited dollars. So the issue really is not advertising, it's education. But no one is really dealing with it except for organizations like ours.

À (1040)

Mr. Rob Merrifield: That's always the goal, to balance, isn't it? Some people come forward and say advertising can be educational, but is it educational or is it exploitation? That's what we have to weigh, and we're always weighing that, I think, with everything we do.

You mentioned something earlier, at the very beginning, that you wanted to comment on the Internet pharmacy. You may have some questions on that and how that relates to what's actually happening. It's our understanding it's a growing business, doing very well in this country and south of the border. What's your comment on what you see happening?

Mr. Denis Morrice: It's not right. Going back to medications and the talk about adverse drug reactions and so on, you can't get these drugs without a prescription. That's why we're saying that the doctor needs the support and the background information in order to provide the appropriate medication. We all talk about pharmacists. Without question, the pharmacists' profession is the most educated, well-trained, underutilized profession in this country, when you think about what they do and all the training they have. But that's the end of it.

But to go into the Internet pharmacy, when we're saying that patients should be able to go to the drugstore and see their pharmacist and get good counselling, what kind of counselling will you get from the Internet pharmacy? Of course, the doctors could be questioned who are signing those slips also. But more importantly, the Internet pharmacy, which is probably a $70 million or $100 million business right now, I truly believe is undermining our health care system in terms of how we should be providing health care.

Mr. Rob Merrifield: If they used Internet pharmacy for pharmaceuticals in remote areas of the Arctic, or in northern Canada, would you see that as a problem and not acceptable?

Mr. Denis Morrice: I would look for a kind of mail order system where the delivery is made after you make sure a physician is in place, or visiting physicians who go to the north make sure it's done that way. Then you have a key contact person. The way we're looking at changing health care, we're now talking about nurse practitioners, we're talking physiotherapist practitioners, and I do believe that is the right way to go, because we don't have enough doctors. Therefore, we have to find another mechanism of supplying the service.

Mr. Rob Merrifield: Thank you.

The Chair: Dr. Hill, do you want to question?

Mr. Grant Hill (Macleod, Canadian Alliance): Let's speculate for a moment. Suppose a brand-new arthritic preparation is approved in Britain, and you've accurately identified that it can be very slow to approve that very same product here in Canada. Do you think we would lose sovereignty if we accepted the British trials, the British experience and the British checkmark and approved that product without doing those same tests here in Canada?

Mr. Denis Morrice: I hear what you're saying, and that's where the flags start to go up. I think we're talking about harmonization, to harmonize it to some degree. We're talking about various types of decisions that from Canada's and from Health Canada's end we could say that's an okay decision, that part is okay. Let them look at the manufacturer to make sure that part is being done and so on. But this part over here, I would like to think that our federal government, Health Canada, would make sure that the drug that's coming on is okay for citizens. Therefore, it should not be a kind of holus-bolus acceptance, where we accept it because it's been accepted in the U.K. or in the United States.

I'd say we have to maintain our system. However, let's be more efficient about it. Why run a lot of the same trials again? There would be certain trials we do have to run again, and there would be certain mechanisms we do have to do again. I would like to suggest that there are many mechanisms we don't need to repeat. There's a lot of duplication, and millions of dollars are wasted that way.

À (1045)

Mr. Grant Hill: Help me to understand which trials you think would be redundant, would not need to be done again on say a new arthritic preparation.

Mr. Denis Morrice: We'd have to have the doctors here. I'm not a doctor, but I can give you an example. I don't know the trials--exactly how they're done in terms of blind studies and whether they're open trials--but in terms of Embril, a new biologic that just received approval for juvenile arthritis, for children, that was over two years ago in England and the United States, yet children here didn't have access to it. That's what I'm really talking about, to say how can that be happening over there.... And when I talk to the rheumatologists who are arthritis specialists, they say they have a child now without the nausea, without the pain; they're back at school; they're back playing sports; they're out with their friends when they weren't before. So when you see that, you say, “Whoa. When we stand back, what is it we can do?”

And I know the people in TPD and the biologics and genetics therapies directorates in Health Canada are looking at the harmonization and that kind of decision-making. I don't know what they are, and I trust that they will make them. Clearly, they have to have the resources to do that; otherwise.... How can a drug sit in the queue for a year and a half or two years before it's even picked up for review? It's just not fair.

Mr. Grant Hill: So if I understand you, you wouldn't remove some of the trials, but you would have the process speeded up so that a product such as the one you're talking about doesn't wait a long time before it kicks off?

Mr. Denis Morrice: Yes. When the application comes in, it sits in a queue. It's like a truckload of stuff that comes in, and it just sits there until it gets picked up. That's where the big delay is. Apparently our reviewers in Health Canada are superb; they do excellent reviews. But it's a matter of the pile sitting here and just waiting to be picked up. So it's a matter of asking where are the resources to make sure those things are picked up.

The other part of that is the efficiency aspect, saying okay, what is it we can do--or not do--that would not be a duplication, and I would leave that to the researchers, the doctors and the Health Canada experts, to decide. But I'm very confident that there are many ways that millions can be saved.

The Chair: Thank you, Mr. Hill.

Ms. Bennett, and then Mr. Dromisky. And I think that will probably be it for today.

Ms. Carolyn Bennett (St. Paul's, Lib.): Thanks very much.

Maybe I'll just follow up on Dr. Hill's comment. I understand the FDA has a process in which citizens are involved by which certain products, based on international evidence, can be more green-lighted, fast-tracked, based on the availability of lots of international evidence, and then other things go through the regular channels.

You represent one of the most engaged stakeholder groups, in terms of the arthritis patients. Do you think that's something that could work, or is it at a later stage that you want the patients involved, in terms of post-market surveillance?

Mr. Denis Morrice: We see them being involved right from the very beginning. And that's where the education comes in. As people become more educated, and the feedback.... We're not just talking about adverse drug reactions. We don't want patient surveillance to be people just being negative about something. We're asking, what's working; what really works, and how is it making a difference; and also to be at the policy table when they're sitting around asking, what is the priority?

Ms. Carolyn Bennett: And what's the value.

As you know, the Romanow commission suggested a drug agency that would maybe coordinate with the provinces some of the common drug review, some of the stuff around post-market surveillance, and maybe some of the evaluation you're describing, in terms of value for money, quality of life, and all of those things.

Does the Best Medicines Coalition support that idea? How would you see it work? And what are your views in terms of what the health ministers have done, in sort of kicking the tires and eventually going toward a common formulary?

À (1050)

Mr. Denis Morrice: With the common drug review, it's one of those things that sounds good and looks good; now it's a matter of trying to really get at it. But if some provinces buy out, never mind buying in, then it won't work.

What Mr. Romanow was talking about in terms of a national pharmacare program is really what it should be. How can we justify that a child in one province has access to a medication and in another province they don't? Never mind another country, we're talking about Canada. That just does not make sense. The only way of doing that is to create that national operation.

So we would agree with Mr. Romanow in terms of setting up the national agency, but the provinces then have to agree. And quite frankly, it means the provinces really have to set that turf aside and look at what is for the greater good. Because right now they control their drugs and so on.

How do we create a system where we're doing the right thing for everyone?

The Chair: Thank you.

Mr. Dromisky.

Mr. Stan Dromisky: Thank you very much.

I'm really interested in your perception of how people can be educated regarding their prescribed drugs. Let's be realistic about it. I'm going to talk about the province of Ontario, where a doctor might have to see fifty, sixty, or seventy patients in one day. He prescribes one drug. He doesn't say to the patient, here's a list; here are six or seven drugs; make a choice; I'll tell you about each one of them, then you make a decision. He doesn't have time to do that, so the person doesn't learn a damn thing about that drug. All he knows is the doctor has prescribed something for me and I'm going to get some kind of relief from whatever my ailment might be.

So I go to the drugstore. Now, what you said about the druggist is absolutely true. My family druggist will put out a slip of paper, sometimes very lengthy, and give all kinds of information about the drug that is being prescribed, about what adverse effects might happen, and about other kinds of drugs made by other companies that will do the same kind of job. That is a technique, a strategy, an instrument for educating the public, and that's the only place I can see it so far. There's nothing from the Department of Health, nothing from any provincial ministry, nothing from clinics, and nothing from hospitals--only the druggist.

Would you think for a moment that maybe the druggist should play a far more important role in prescribing certain basic drugs, in light of the information they might give when they counsel? Most druggists, such as those in my drugstore, counsel and talk to the patients who come there with their prescriptions. They talk about what's good about it; they talk about what Mrs. So-and-So is doing. It is a wonderful place to go if you want to learn. Now, should druggists, especially those in northern Canada, be practitioners as well to a certain degree?

Mr. Denis Morrice: It's like a little bit of thin ice there. Again, that's the role of doctors and pharmacists, and I think that's where the collaborative effort has to come in. How do you divide up those protocols or whatever you want to call them? How do you do what you can do, at the same time making exceptions for geographical areas? But for me, it would be that in concert with the Pharmacists Association and the Medical Association we would say here's what we're going to do.

With respect to information and the education aspect, the Arthritis Society is very involved with the Cochrane Collaboration. There was a Dr. Cochrane--people should be aware--in England who was so upset when he retired because he saw what was happening to children. Antibiotics were being given to children who shouldn't have been getting them. He got so frustrated he set up the Cochrane Collaboration, and what he said was, we're going to do reviews.

Canada took on the area of musculoskeletal; that's right in the area of arthritis. We partnered with the Cochrane Collaboration, and we said okay, we'll partner with you as long as you do those reviews using international experts, epidemiologists from around the world, as long as patients are at the table, and as long as the information is in lay language.

One-pagers were done and we're at our first meeting. Here are the patients around the table with the doctors, and I watched one of the patients take this. It's in draft form only; it has the name of the drug with the epidemiologist's name across the bottom. And she took it off the table, folded it up, and put it in her purse.

Three months later we went back and I said to her, “I'm not challenging you; I want to know what you did with that.” She said, “Well, I took it to my doctor, I handed it to my doctor, and I asked, why am I not on this? Here it is in lay language from world experts.” And the doctor said, “Why not?” She said, “We then sat for twenty minutes and talked about my disease, and I'd never had twenty minutes with that doctor before in my life.”

That was the difference with her now being educated. And it's the same at the pharmacy. You have a good pharmacist, but you can look at many pharmacists as retail businesses. You don't get the time with them. So the whole pharmacy thing is another issue that has to be dealt with, but I do believe there's a huge role for pharmacists to play.

À (1055)

The Chair: Thank you.

Seeing no further questioners, I will on your behalf thank Mr. Morrice for coming and thank all of you for your hard work this morning getting a bill through and getting one more witness heard in our study of prescription drugs.

It does not look like we will need a meeting tomorrow afternoon. The Council of Canadians could come on Thursday morning and fit into that panel. I would ask you to be on time on Thursday morning, because we now have five witnesses as opposed to four.

Thank you very much.

This meeting is adjourned.