44th Parl. 1st Sess.
May 31, 2023 02:00PM
Madam Speaker, I am pleased to rise to speak to Bill C‑284. As members know, this enactment provides for the development of a national strategy to support the prevention and treatment of eye disease to ensure better health outcomes for Canadians. It also designates the month of February as age-related macular degeneration month.
The preamble of Bill C‑284 reads as follows, and I quote:
Whereas vision loss in Canada is associated with a number of causes, including macular degeneration, cataracts, glaucoma and diabetic retinopathy;
Whereas millions of [Quebeckers and] Canadians live with eye disease that could lead to vision loss or blindness if not treated;
Whereas it is estimated that vision loss costs [Quebeckers and] Canadians billions of dollars every year, both in financial costs and in loss of well-being;
Whereas the loss of central vision can severely impact a person's independence and quality of life;
Whereas coordination and information sharing between the federal and provincial governments is needed to ensure new treatments are made available, to prevent and treat eye disease and to prevent health inequities among people with vision loss;
It also states, and I quote:
And whereas Parliament considers that it is desirable to be proactive in the fight against vision loss and to implement a national strategy on eye care
In the same vein as many bills introduced over the past few Parliaments calling for autism, cancer or diabetes strategies, this bill calls for a strategy in the form of a report on eye health. Not surprisingly, the bill has the support of the Canadian Ophthalmological Society and the Canadian Association of Optometrists. In the wake of the introduction of the bill and World Sight Day on October 13, these groups published a survey that highlights the lack of understanding among Canadians about this important aspect of our health.
As we know, the strategy proposed in Bill C‑284 is built on four pillars:
identify the training, education and guidance needs of health care practitioners and other professionals related to the prevention and treatment of eye disease, including clinical practice guidelines;
promote research and improve data collection on eye disease prevention and treatment;
promote information and knowledge sharing between the federal and provincial governments in relation to eye disease prevention and treatment; and
ensure that Health Canada is able to rapidly consider new applications for treatments and devices used for macular degeneration, cataracts, glaucoma and diabetic retinopathy.
The Bloc Québécois will vote in favour of the principle of the bill, because eye health is important for people's quality of life.
All in all, the bill itself does nothing. It only forces the government to produce a report that will establish a national strategy for eye care. Furthermore, designating the month of February as age-related macular degeneration month is a symbolic measure.
Although health services, including eye care services, are the jurisdiction of Quebec and the provinces, this bill gives the federal government a role by funding research and approving medications or devices.
The bill overall respects Quebec's and the provinces' jurisdictions. That is why the Bloc Québécois supports it. However, the Bloc will take the time to study the bill to ensure that the federal strategy is complete and complements the actions of the Quebec government.
In Quebec, optometry services are available to people under 18 or over 65, and emergency services are covered for everyone. There is also a visual aid program, which allows any individual with a permanent visual impairment who is covered under Quebec's health insurance plan to obtain visual aids such as magnifiers, an optical system, a calculator, a Braille typewriter, a white cane, an electronic obstacle detector, night vision goggles, and the list goes on.
The program also offers financial help to get a guide dog, as well as resources for students. Speaking of guide dogs, I am going to talk about a fantastic Quebec organization that does remarkable and indispensable work. I am talking about Mira.
In his childhood, founder Éric St-Pierre developed a passion for raising dogs. He trained dogs on the family farm, following his father's advice. His ease and natural talent with the animals led him to undergo professional training in order to have a career training guard dogs and sniffer dogs.
In 1975, Mr. St‑Pierre built a kennel in Sainte‑Madeleine. He spent most of his time training dogs. One day, a friend who worked as an orientation and mobility teacher at the Nazareth and Louis Braille Institute asked Mr. St‑Pierre for advice about the behaviour of a guide dog from the United States. Back then, there were no francophone guide dog schools in Canada. Éric St-Pierre quickly realized that these dogs were not raised or trained in conditions that worked in Quebec. He realized that there was also a language barrier limiting many people's access to the services of these dogs. He therefore promised the institute that he would train dogs for them, and that is how Mira came to be. It was the first francophone centre for guide dogs in Canada.
Mira was founded in 1981. It is a non-profit organization that provides free guide dogs and service dogs to people with visual or mobility impairments, as well as to young people with autism spectrum disorder.
All of Mira's services and activities are based on the principle of body equality, meaning that what is accessible to everyone must also be accessible to people with disabilities. Within this framework, the organization's mission has the following objectives: increase the autonomy and promote the social integration of people with disabilities through the use of guide dogs and service dogs; provide services freely to all beneficiaries, regardless of their income; improve the mobility and orientation of people with disabilities so that they can move about freely in their daily lives; create an individual intervention plan adapted for each beneficiary that takes into account the beneficiary's level of autonomy, social and professional context, and mobility needs; and promote the benefits of service dogs in public places, in schools and on public transport.
Mira is known for its innovative programs, dog training techniques and fundraising activities. Since it was created, Mira has provided more than 3,700 dogs free of charge to people living with one or more disabilities. Much of this success is due to public support and concern. Without this help, Mira would not be what it is today.
I am now going to talk about two people I knew well and who lost their sight because of macular degeneration and diabetes. When I was finishing high school, a friend of mine found out that in a few years she would lose her sight to a genetic disease, early-onset macular degeneration. Diane Lamarche had a bright future ahead of her. She was a serious student who got good grades in high school. She enjoyed walking, basketball and tennis. She was also an avid reader.
We got to know each other better when we worked together as playground monitors in Lebel‑sur‑Quévillon. In our senior year of high school, she told us that she was losing her sight and that she was already learning Braille. The news left us gutted. She was so young, and had such a promising life ahead of her as an adult.
Our eyes and vision are indispensable for acquiring information from our external environment. They make it possible to coordinate all our movements, in particular those of our hands. Vision has three roles: perceptual, sensory and cognitive.
Another person who was even closer to me, my uncle Germain Boyer, lost his vision in his 70th year because of his diabetes. I remember that he enjoyed Yule logs so much that he would stock up every year. He has since passed away, but I will always remember his kindness and cheerfulness. I want to send my love to my aunt Denise and my cousins Sylvain and Mélanie in memory of him.
Ultimately, prevention remains an effective way to avoid vision loss, unless it is caused by macular degeneration, poor health or genetics.
If passed, this bill will help ensure better eye health and better vision for Quebeckers and Canadians.
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Madam Speaker, I am happy to rise today to speak in support of Bill C-284, an act to establish a national strategy for eye care, presented by my friend and colleague, the hon. member for Humber River—Black Creek. I know this is something the member has been working on for quite some time and I would like to recognize her extensive work on this issue.
This piece of legislation would not only ensure better health outcomes for Canadians, but also recognize the month of February as Age-Related Macular Degeneration Awareness Month, bringing awareness to the leading cause of vision loss in people 50 years or older.
More than eight million Canadians are presently living with one of the four common eye diseases and more than one in 10 older adults have some degree of vision loss, which places them at serious risk of losing their vision. Vision loss can be harmful to many elements of daily life, impacting the way a person works, participates in activities and interacts with the world around them. That is why it is our duty to take proactive measures to prevent and treat these diseases effectively.
Routine vision care can help to reduce the risks of blindness and vision loss later in life and improve the outcomes associated with eye diseases like cataracts and glaucoma. Unfortunately, the COVID-19 pandemic worsened the issue of vision loss in Canada as eye surgeries were cancelled or delayed and wait times to see vision care providers also increased over the course of the pandemic. That is why a national strategy—
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Madam Speaker, I will be careful of that.
Unfortunately, the COVID-19 pandemic worsened the issue of vision loss in Canada, as eye surgeries were cancelled or delayed. Wait times to see vision care providers also increased over the course of the pandemic. That is why a national strategy for eye care is essential. It would provide a comprehensive road map, laying out a common direction and shared leadership. It would build collaboration among researchers, medical professionals and community organizations to develop innovative approaches to combat eye diseases and preserve sight.
In 2021, the CNIB opened a new centre in Brampton South, providing access to innovative technology and training for Bramptonians with sight loss. It is doing incredible work, and I am confident that Bill C-284 would bring us one step closer to empowering Canadians impacted by blindness with an integrated approach.
As members in this House know, Bill C-237, the National Framework for Diabetes Act, passed unanimously in 2021. I want to touch on how blindness can be a serious complication because of diabetes retinopathy, and I also want to recognize Diabetes Canada's work on this issue as well.
Earlier this year, I met an advocate named Ryan and his dog named Joe. Ryan lives with diabetic retinopathy. He told me about the challenges Canadians with vision impairments face using their insulin pumps. He and many other Canadians are experiencing these hardships, so we need to work together to remove those barriers.
Living with blindness, especially as a result of chronic disease, is an experience that is difficult for people without visual impairment to truly understand. This further underscores the need to have a coordinated strategy so that we can work together with provinces and territories, indigenous peoples and other partners to improve health outcomes. Through this approach, we can proactively identify and intervene in cases of diabetic retinopathy, mitigating the risk of vision loss.
We know that with early intervention and coordinated care, vision loss can be preserved. Of vision loss cases, 75% can be prevented if patients are diagnosed early and have access to treatment. We know that providing hope and better health outcomes for individuals affected by eye diseases is transformational. Already, the Government of Canada is leading and supporting a range of activities related to eye disease prevention and treatment.
I would like to talk about the investments announced in budget 2023 to strengthen our public health care system.
Budget 2023 commits $196 billion in funding to support our health work force; reduce backlogs; expand access to family health, mental health and substance use services; and modernize our health system. This is to ensure provinces and territories can provide the high quality and timely health care Canadians expect and deserve.
We see the surgical backlogs and the impacts on our systems, and we are addressing that need. Surgical backlogs, including vision-related surgeries, are a key part of this plan and are a health system priority of this government. Budget 2023 includes a $2-billion one-time top-up to provinces and territories to address urgent pressures in emergency rooms, operating rooms and pediatric hospitals. In addition, Indigenous Services Canada’s non-insured health benefits program also provides vision care to eligible first nations and Inuit beneficiaries where they are not otherwise covered by other plans or programs.
The government has also made significant investments in vision loss prevention and research. Over the last five years, the Canadian Institutes of Health Research has invested approximately $61 million in vision-related research. This research spans the spectrum of prevention, diagnosis, treatment and management of various vision-related conditions.
These investments contribute to the evidence base needed to improve health systems and health outcomes for Canadians experiencing vision loss.
Finally, I wish to highlight that medically necessary vision care services are covered by provincial and territorial health insurance plans. Any vision care service that must be performed in a hospital is covered and supported under Canada’s public health care system. The federal government is committed to continue working with provinces and territories on our shared health priorities, including those related to vision care.
In conclusion, Bill C-284 would allow the Minister of Health to develop a national strategy to support the prevention and treatment of eye disease. It would facilitate engagement with provinces, territories, key stakeholders and partners to ensure that we are all pursuing common objectives in the vision care space, along with sharing best practices. This bill would complement existing work and research efforts, supported by provincial and territorial governments, and the Canadian Institutes for Health Research.
Once again, I wish to thank the hon. member for Humber River—Black Creek for putting forward this important bill. I know that my residents in Brampton South and, indeed, all Canadians are counting on us to act quickly to prevent and treat eye diseases. I encourage members to vote in favour, as we continue to strengthen our efforts on vision care in Canada.
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Madam Speaker, it is an honour to rise today and speak to Bill C-284, put forward by my colleague from Humber River—Black Creek. The question before us today is fundamentally about ensuring that Canadians receive a coordinated response regarding their health care needs, particularly eye care.
The proposed national eye care framework intends to promote information sharing and knowledge sharing between the federal and provincial governments in relation to eye care disease prevention and treatment, all the while ensuring that both levels of government respect their roles within our national health care system. To quote the bill directly, a key component intends to “promote research and improve data collection on eye disease prevention and treatment”. Doing so would enable eye care health providers a centralized resource to access the status of their own patient base and make sure that they share their expertise across the country, all the while ensuring that only the best and newest technologies are used going forward.
According to the Canadian Council of the Blind, due to an increase in surgery wait times caused by the lockdowns during the pandemic, there has been a $1.3-billion increase in the cost of vision health over the past two years. All of this is compounded by the fact that 75% of vision loss cases in Canada can be prevented if patients are diagnosed early and have access to treatment. Furthermore, 70% of existing vision impairment in Canada is estimated to be correctable with prescription glasses.
This proposal from my colleague is not only very commendable, but is being put forward at a very timely moment. A national framework would allow all provinces and the federal government, as well as health care practitioners and researchers, to sit down at one table and jointly develop and implement the measures necessary to make sure that all Canadians from coast to coast have access to eye care and the best practices available in a timely manner.
Developing an effective framework is now more critical for the future of our children due to the prevalence of electronic devices. They release blue light, which can reach the retina, the inner lining of our eyes. Studies have shown that this light can damage cells in the retina, leading in some cases to early age-related macular degeneration, a unique concern of the modern age that is far more likely to impact our children. Children may not even know that their phones could be permanently damaging their eyes due to a lack of educational awareness.
Some might resist getting an eye care exam due to the belief that glasses are not “cool”. I will admit that it was hard for me, some 10-plus years ago, to admit that I needed glasses. This is a pressing challenge, as a long list of diseases and health care problems can only be discovered through a regular eye examination. Many eye diseases do not have any preceding symptoms and cannot be treated without a professional assessment.
The concern of vision loss in Canada requires a coordinated response, in both education and organization, between the provinces and the federal government, especially since there is a high percentage of seniors and school-aged children who have undiagnosed eye care issues. Very few children had their eyes tested during the pandemic, and as previously mentioned, many spend a great deal of time in front of a computer screen.
Referring to Canada as a whole and for a better understanding of the gravity of the situation, here are some of the numbers. Over eight million Canadians, or one in five, have some form of eye disease. Some 1.2 million Canadians live with vision loss or blindness. It is estimated by the Canadian Council of the Blind that vision loss and blindness were likely associated with 1,292 deaths in Canada in 2019. These deaths would have occurred due to factors such as increased risk of falls for the elderly and isolation experienced by those with vision loss.
Vision loss has a profound impact on our society and economy, costing an estimated $32.9 billion a year, $4.2 billion of which is attributed to reduced productivity in the workplace. Over half of the cost, $17.4 billion, is attributed to reduced quality of life, which is primarily due to a loss of independence, especially among seniors.
Many of us have a personal connection to someone experiencing vision loss. My own mother struggles with age-related macular degeneration, or AMD, which is one of the top five causes of blindness. The other four are cataracts, diabetic retinopathy, glaucoma and uncorrected refractive errors. Of these, all but two, AMD and glaucoma, can be prevented through proper care if caught at an early stage, or treated with modern tools such as laser eye surgery and/or prescription glasses.
While glaucoma has no present cure, there are treatment options that, if begun early enough, can prevent an individual’s loss of vision. Even in the case of AMD, a healthy lifestyle and regular eye exams can help delay the loss of vision as one grows older. Also, new recent accredited medical devices provide the hope to even reverse AMD, at least temporarily. In the case of cataracts, we have been able to treat this condition, I am told, as far back as the time of ancient Egypt.
There should be no excuse in the modern world to fail to provide Canadians with the knowledge about what treatments they can access in our provincial health care systems. Losing one's vision increases mental, financial and social hardships on an individual. It can lead to a loss of mobility and an inability to live independently, to drive, to read or to participate in physical activity. It can result in a loss of social interaction or even lead to social isolation, which can often lead to depression and other mental illnesses.
Through being proactive and taking preventative measures now, we can not only save individuals and families from a great deal of grief, but also help maintain the solvency of our health care system by helping provinces avoid spending even greater resources down the road in both treatment time and costs. Through proper education and awareness campaigns, Canadians can potentially save themselves from great heartache and financial costs by reducing smoking, having a healthy diet, getting regular eye exams and being informed of family genetics.
It must be stressed, however, that a health care strategy and delivery remain in provincial jurisdiction. The intent behind this national framework is for the federal government to serve as a centralized communication hub between eye health care providers in different provinces and federal regulators, allowing them to share their expertise and knowledge with each other. The requirement of regular reporting should also spur faster responses from Health Canada in reviewing and approving new technologies for the benefit of all.
This program must be a team effort led by professionals, in conjunction with the provinces, with the federal government keeping its involvement in proper scope, namely participating in this national framework. As long as these concerns are respected and decisions on strategies and spending priorities remain within provincial jurisdiction, as stipulated in the Canada Health Act, I can support this bill and look forward to doing so.
By passing Bill C-284, not only can we help millions of Canadians struggling with vision loss, but we can also be proactive and reduce the number of children who could face vision loss in the future. Eye care is but one part of our comprehensive health care strategy in Canada.
In my remaining time, I wish to speak more personally. At some point, I believe we will need a larger discussion on how health care is funded and how accountability in that funding is measured. Both levels of government provide dollars to health care, and it is clear that, while partially federally funded, health care is delivered provincially. The topic of health care funding and delivery comes up often when I hold round tables and town halls in Chatham-Kent—Leamington, where constituents often blame one or the other or both levels of government for the inadequacies in the system they experience.
I am reminded of Saturday mornings two decades ago in my own household. During the week, we had four daughters, but on Saturday mornings, when it came time to take out the garbage, we had five: Alyssa, Carina, Brenna, Kiana and “Not Me”. It was always Not Me's turn to take out the garbage. Health care accountability often reminds me of those Saturday morning discussions when people point at two levels of government and both levels of government point at each other.
Former provincial treasurer Darcy McKeough, who is in his nineties and still lives in my riding, mused in a biography that the level of government that does the spending should do the taxing so as to be held accountable. That will be an interesting discussion one day, but it is not for today.
Today, I encourage all members of this House to support this legislation put before us by my hon. colleague.
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