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Standing Committee on Health



Monday, April 16, 2018

[Recorded by Electronic Apparatus]



     Good afternoon to all members of the committee.
    Since the chair and vice-chairs of the committee are not in attendance, I will inform members that I have received an email that Mr. Casey is designating Ms. Sidhu as his replacement, as acting chair for the committee.
    I would simply ask for the consent of the committee to proceed in this manner.
    Some hon. members: Agreed.
    The Clerk: Thank you.
    Welcome to the 99th meeting of the Standing Committee on Health. We have a very busy agenda.
    Before we get to that, I understand that Mr. Oliver has a motion.
    Thank you very much, Madam Chair.
    When we were doing the study on national pharmacare, one of the groups that came and presented was CORD. It's an organization that deals with Canadians who are suffering from rare disorders, rare diseases. They talked about some of the difficulties they had in getting treatment or in gaining access to new pharmaceuticals for rare diseases. That was when we were doing the national pharmacare study. We've heard other testimony at the committee dealing with unique diseases and with the problems Canadians have, particularly when they're in a small subset with a disease or disorder.
    I think, having talked it through, there's an interest in looking at a study. The motion is as follows:
That, pursuant to Standing Order 108(2), the Committee undertake a study on the barriers to access to treatment and drugs for Canadians affected by rare diseases and disorders in order to develop recommendations on actions that the federal government can take, in partnership with the provinces and territories, to remove these barriers; that the Committee report its findings and recommendations to the House no later than December 31, 2018; and that, pursuant to Standing Order 109, the Committee request that the Government table a comprehensive response to the report.
    I'd like to move the adoption of this motion.
    Is there any debate or amendment?
    Mr. Lobb.
    I talked to Mr. Oliver last week and I talked to Mr. Oliver before the meeting. I kindly asked him to reconsider moving his motion today. Actually, I said he was welcome to move his motion today and discuss it if he liked, but to hold off until Wednesday to have the vote on it and potentially look at friendly amendments, etc.
    Given the fact that I would say at least half the committee is not here today, the fact that committee business was not on the schedule today, and the fact that our chair isn't here today, our vice-chair isn't here today, and our second vice-chair isn't here today, I think we should seriously consider, as a committee, holding off talking about committee business. It is well within Mr. Oliver's right to discuss his motion or anybody else's motion as long as they want to put it on the record and discuss it, but the fact of the matter is that I did not see it on the schedule for today—discussion or any committee business. I'm looking at the agenda, and unless I'm starting to develop cataracts, I don't see committee business on here.
    Based on the fact that half the committee is missing here today and that there may be further discussions about Mr. Oliver's particular motion, I think with all due respect we should park it for today. At the beginning of our meeting on Wednesday we can discuss his motion. I promise it will take fewer than five minutes to discuss.
    Committee business is on the notice. I think everybody got that. Committee business is on the agenda today.
    Is it on this agenda that I'm looking at right here?
    That is the agenda for the bill only.
    Fair enough. But regardless of whether or not it's on the agenda, due to the fact that we're missing so many people on the committee today, I think it would be respectful to hold off and discuss it on Wednesday.
    Is there any further debate on Mr. Oliver's motion that's on the table?
    Yes, Mr. Oliver.
     I just want to thank Mr. Lobb for his comments. Our side is here. Are we allowed to talk about who's here and who's not here in committee? I know you can't do that in the House.
    Yes. Mr. Oliver's motion is on the table, and the Liberals are here.
    I think there are two members missing from the Conservative side. Otherwise, everybody is in attendance.
     Mr. Lobb had an alternative motion dealing with the SAP program. I'm wondering if you want right now to consider a friendly amendment to bring a focus to the SAP program in this motion so that we can get this done and to bed today when we have it on the agenda. Half the committee is not missing. We are all here.
    Is there any debate on the motion?
    Mr. Lobb.
    As I said, the permanent representative for the NDP is not here today, and that may or may not matter. It may or may not. The representative here today might be quite prepared to discuss what Mr. Davies wanted to talk about, but she may not. I can't speak for her.
    Ms. Gladu is the vice-chair of this committee. She is the long-serving member of this committee as far as our side goes, and Mr. Webber is also not here today. There are other things we have to discuss today as well.
    Mr. Oliver and I have talked about this. It was his indication that he did not want to make this political. He did not want to make this thing partisan, and I took him at his word on that. If he checks the interviews I did subsequent to their voting my motion down, he'll see that I said that I believe the Liberal Party have now turned around the tin ear they had a couple of weeks ago and are now prepared to deal with these issues in a serious manner. I believe that is a nice peace offering to Mr. Oliver and other members of the Liberal Party. What I am saying to him is that we're prepared to discuss the motion. We're prepared to possibly amend the motion, but we're not prepared to do it today. We would just ask, as a courtesy, that he wait until Wednesday and then we'll be able to do it. I don't think that's that big a request. Given the fact that this motion will not be discussed, will not be reviewed until the fall, there's no pressing reason for it to be discussed by the middle of April or for trying to pretend that it's critical that it be dealt with today when it can be dealt with on Wednesday and still fit within the calendar. I know there are other motions they may want to discuss today, and that's fine. That will make no difference at all as to where this motion gets placed in precedence or priority in the committee calendar. If we plan on doing a certain number of meetings in the fall, that's fine and that's great, but today, in the middle of an ice storm, it certainly does not make a difference.
    The fact that two of my colleagues aren't here today.... Mr. Webber is here now, which is great, but Ms. Gladu and I have not finished our discussions on the motion. We have not finished our discussions on the amendment. It was just the other day that I spoke with Mr. Oliver about his motion and the amendments. I'm just asking him to wait two days so that we can make sure we're satisfied with his motion.
    By the way, I brought forward two motions on this topic prior to the Liberals bringing their motion forward. I think it is quite magnanimous on our part that we're willing to forgo both of our motions and potentially support his motion. If we wanted to really play politics, we could have said to him that he could have amended my motion and supported our motion, and potentially we're not there yet.
    I will make a note that it is almost 3:50 and I am prepared to discuss this until 5:30. If the committee wants to extend the meeting until 10:30, I'm prepared to discuss this, because I believe that it's important for my side that we have it right. I've had discussions with certain people, who are not members of Parliament but who are stakeholders and parents and family members, about potential amendments to motions, and those discussions have not been finalized yet. Until that time, I think it's important.
    I would note that there are Liberal MPs who have received significant numbers of emails from parents and family members about the fact that they voted down the motion a couple of weeks ago. All I'm asking for them to do today is to wait two more days so that we have this correct and they don't receive another hundred or two hundred emails or phone calls to their constituency offices.


     Mr. Oliver.
    I am a bit perplexed by all of the comments over there. I do think this is an important topic. We all have people in our ridings who suffer from rare diseases and disorders. We are all dealing with families. It's an important study. It's one that I've been conscious of. I think we've been aware of it for almost two years now, ever since CORD came and spoke at the national pharmacare presentation. That was our first introduction to the difficulties and challenges that people in their groupings are having in getting access to drugs and treatment.
    The “tin ear” comments and the letters that have been organized I think are not helpful comments as we look for a collaborative all-party approach to this. I have been in dialogue with the president of CORD to make sure this motion was okay with them, but I'm also willing to let Mr. Lobb.... I did tell him in our phone call that this was coming today. It's on the committee business. All the members are present except for one. If he's not prepared for the motion yet and wants to take some more time, then I think, if I have the commitment of the chair that this will be the first item on Wednesday—I'm hearing a five-minute discussion and then we move forward on the motion—in the interest of having the parties in agreement with the motion, I'll defer this until Wednesday to allow that additional time for him to do what he needs to do to think about an amendment to the motion.
    I know that his interest was around SAP, around that program. I've told him that I'd be quite willing to look at adding a friendly amendment to this that would incorporate SAP as a special mention that needs to be addressed. I think we can get there quite easily, but I guess he's not prepared to do it today so I will wait until Wednesday.
    Do I table the motion? How do I do that?


    The motion has already been moved.
    The motion has been moved already so I...?
    Is there any further debate?
    I appreciate Mr. Oliver's waiting until Wednesday. Whether or not you need a motion to now move on, that's up to the chair, but if that's what she requires, I can move that.
    I'll move that motion.
    If we can just move on to the next topic, I'll promise Mr. Oliver that at the next meeting it will be five minutes or less and we'll get on and have a great study, and that'll be the way it is.
    I'll move that we postpone the debate until Wednesday.
    Some hon. members: Agreed.
    Mr. McKinnon.
    Pursuant to notices of motion given before the constituency break, I move:
That, pursuant to Standing Order 108(2), the Committee undertake a study on LGBTQ2 health in Canada in order to develop recommendations on actions that the federal government can take, in partnership with the provinces and territories, and that the Committee report its findings and recommendations to the House, and that, pursuant to Standing Order 109, the Committee request that the Government table a comprehensive response to the report.
    Is there any debate on this motion?
    The genesis of this motion is that in Canada the population of LGBTQ2 people is likely under-reported due to stigma. Reliable studies indicate that this community makes up 13% or more of the population, which is roughly 4.7 million Canadians. LGBTQ2 people have continually poorer health than the average Canadian, presenting health outcomes that are only slightly better than indigenous Canadians, a group which is, as we sadly know, poorly served by our health services. This presents significant costs to the Canadian health care system.
    The average LGBTQ2 person is vastly more likely to have contracted HIV, is more likely to suffer from anxiety and mood disorders, to have elevated rates of substance use and abuse, and is more likely to attempt suicide than the rest of the Canadian population. Access to gender confirmation surgeries and appropriate endocrinologists varies across the country.
    The Government of Canada has not commissioned an investigation into the root causes of these health disparities. This motion is an opportunity for the Standing Committee on Health to conduct a study—I suggest no fewer than five to seven meetings—using two primary questions. What determinants and causes are responsible for continually poor LGBTQ2 health in Canada? What are the barriers to LGBTQ2 people accessing better health care, including structural, institutional, financial, physician-side, and/or other barriers?
    With this study, there is an opportunity to identify the root causes of continuing health disparities nationally, to understand best practices, and to address the gaps in the health care system, which is not meeting the needs of the Canadian LGBTQ2 population.
    Is there any further debate on this motion?
    I have a question, Madam Chair.
    Thank you, Mr. McKinnon, for your motion. It is certainly an important issue. You are requesting seven or so meetings on this particular issue. When are you hoping to have this happen?


    That's a $64,000 question because, of course, we have a very tight schedule on into the fall.
    I know there's no time before the fall, but I'm hopeful that we can find time in the fall for it. Whether there are five meetings or seven meetings, that's not part of the motion, but I think we need to discuss amongst ourselves what length of time we need to take for this study.
    Madam Chair, a number of us have been here right from day one on this health committee. In the past, when we set our agenda, we all put down our parties' priorities that we thought would be important issues to bring forward to this table. We even had a subcommittee that met to determine our schedule here as well.
    I see the trend changing with respect to motions now being brought to the table here. They're all important issues, and I wish we could study them all. What I would like to see is perhaps another subcommittee meeting where we can meet—with your priorities, with the Conservatives' priorities, with the New Democrats' priorities—to hash out the schedule that way, to bring forward these motions and to pass these motions.
    This one in particular is great. I support the study of it, but it's just a matter of when. If we can bring our priorities forward as a committee and determine where we rank these specific studies, I think that would be a better way with co-operation from all the parties on this health committee.
    Mr. Eyolfson.
    What I would counter to Mr. Webber's position is that there are things that come to our attention throughout the committee. We've had a number of motions that were put up for studies that were not in our original work plan. As Mr. McKinnon said, in no way does this refer to when it is scheduled, other than saying it's going to be no earlier than the fall. That's what we have the subcommittee for, to hash out the schedule. I think there's nothing inappropriate about putting forward this motion today.
    Is there any further debate?
    Don't get me wrong. I don't find it inappropriate, but I would like to see a change for future motions, if that were possible. It seems to me that it is the trend now that a member just throws down a motion on the study of a certain issue. That's great, if that's the way you want to work, and we can pass these motions or not, but I think it would be more co-operative to get all parties involved and agreeing to this. That was my point.
    Mr. McKinnon.
    I take Mr. Webber's point. I think it's a good point.
    I'm relatively new to the committee. I haven't been privy to its culture over its full time. This is my first motion of this kind before the committee.
     It's important for me to get this in front of the committee. I'm perfectly willing for the subcommittee to meet and discuss this priority as well as other priorities and appropriately schedule them as time permits.
     I thank Mr. Webber for his intervention.
    Is there any further debate on this motion?
    All those in favour—
    Could I have a recorded vote, please?
    On your motion proper...?
    (Motion agreed to: yeas 7; nays 0)
     Next, I believe, is Dr. Eyolfson.


    Thank you, Madam Chair.
    I'd also like to move a motion:
That, pursuant to Standing Order 108(2), the Committee undertake a study on the impacts of Methamphetamine abuse in Canada in order to develop recommendations on actions that the federal government can take, in partnership with the provinces and territories, to mitigate these impacts; that the Committee report its findings and recommendations to the House no later than December 2018; and that, pursuant to Standing Order 109, the Committee request that the Government table a comprehensive response to the report.
    Is there any debate on this motion?
    Mr. Webber.
    Thanks, Madam Chair.
    I won't reiterate what I said earlier. If we want to put motions all day long, then I guess that's the direction we're going in. We can do that as well. We can have the whole meeting be putting motions on what we should study next and what we feel is important to us. If that's what we want to do, then so be it.
    Is there any other debate?
    All those in favour?
    Could I have a recorded vote?
    (Motion agreed to: yeas 6; nays 0)
    The Acting Chair (Ms. Sonia Sidhu): We will proceed to the consideration of Bill C-326.
     I'm pleased to welcome our two guests from the Department of Health. David Morin is the director general for safe environments, and Greg Carreau is the director of the water and air quality bureau. They're available should members have any questions about the bill or amendments. Thanks for being here today.
    Pursuant to Standing Order 75(1), consideration of the preamble is postponed. The chair calls clause 1.
    (On clause 1)
     I am proposing that clause 1 be amended by replacing line 20 on page 1 to line 17 on page 2 with the following:
5.1(1) The Minister shall identify any foreign government or international agency that, in the Minister's opinion, has standards or guidelines respecting the quality of drinking water that should be compared to the guidelines respecting the quality of drinking water that are being developed in Canada.
(2) The Minister shall review the standards or guidelines respecting the quality of drinking water established by any foreign government or international agency identified under subsection (1) to determine which aspects of those standards or guidelines shall be compared to the guidelines respecting the quality of drinking water that are being developed in Canada. The Minister shall then perform the appropriate comparison.
(3) The Minister shall, during each fiscal year after the fiscal year in which this section comes into force, publish the results of the comparison.
    With regard to the reason for those changes, I've spoken to the author of the bill, and we've received feedback from the department. There is a sense that incorporating international agencies would open up other comparative bodies that the minister could look at. Identifying other foreign governments would also be an effective change rather than limiting it to the OECD countries that were in the original bill. I think this makes the bill stronger.
     It's important. I mean, Canadian efforts to safeguard drinking water quality has to take into consideration the leading science being done internationally, both by different countries and by organizations that reach beyond individual countries. I think the amendment provides the flexibility needed to maintain the focus of Canadians on the most credible international agencies in making sure we apply the best water quality standards that we can to our standards development.
    Thank you.


    First, is there any discussion on the amendment? If not, we can have a vote on the amendment.
    (Amendment agreed to)
    The Acting Chair (Ms. Sonia Sidhu): Shall clause 1 carry as amended?
    We just voted on that, didn't we?
    It was on the amendment.
    (Clause 1 as amended agreed to)
    The Acting Chair (Ms. Sonia Sidhu): We'll move on to Liberal amendment 2.
    This is for an order in council. The bill will be amended by adding after line 17 on page 2, the following:
2 This act comes into force on a day to be fixed by order of the Governor in Council.
    That is simply just a tidying-up point. It establishes a date for the coming into force of the bill as a decision of the council.
    If there is no debate, we will vote.
    (Amendment agreed to)
    The Chair: New clause 2 has carried.
     On Liberal amendment 3, we have Mr. Oliver
    I don't have a Liberal amendment 3. Are we ready to deal with the preamble?
    There was a concern in the preamble that reference is made to the “Federal-Provincial-Territorial Committee on Drinking Water”, which is not something that is under federal jurisdiction or ministerial control. It is a question of whether that appropriately belongs in the preamble. However, I understand there are restrictions on what committees can do with preamble content.
    Chair, I'm wondering if we could have an opinion on the committee's capacity to change that.
     The amendment seeks to make a substantive modification by removing elements from the preamble. As House of Commons Procedure and Practice, third edition, states on page 774:
    In the case of a bill that has been referred to a committee after second reading, a substantive amendment to the preamble is admissible only if it is rendered necessary by amendments made to the bill.
    In the opinion of the chair, the proposed amendment is substantive and is therefore inadmissible.
    Shall the preamble carry?
    Some hon. members: Agreed.
    The Chair: Shall the title carry?
    Some hon. members: Agreed.
    The Chair: Shall the bill carry as amended?
    Some hon. members: Agreed.
    The Chair: Shall the chair report the bill as amended to the House?
    Some hon. members: Agreed.
    The Chair: Shall the committee order a reprint of this bill as amended for the use of the House at report stage?
    Some hon. members: Agreed.
    The Chair: Thank you, Mr. Morin and Mr. Carreau, for being here and joining us today.
    [Proceedings continue in camera]
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