44th Parl. 1st Sess.
May 31, 2023 02:00PM
Madam Speaker, it is a great honour to stand in this House today and speak in support of Bill C-284, an act to establish a national strategy for eye care. I am proud to say that New Democrats will be supporting this bill and, in fact, as I will point out in my remarks, this is something we have been championing since the 1960s.
This legislation, in general, would provide for “the development of a national strategy to support the prevention and treatment of eye disease to ensure better health outcomes for Canadians.” The bill states:
The national strategy must describe the various forms of eye disease and include measures to
(a) 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;
(b) promote research and improve data collection on eye disease prevention and treatment;
(c) promote information and knowledge sharing between the federal and provincial governments in relation to eye disease prevention and treatment; and
(d) ensure that Health Canada is able to rapidly consider new applications for treatments and devices used for macular degeneration, cataracts, glaucoma and diabetic retinopathy.
This legislation would also designate the month of February as age-related macular degeneration awareness month.
I want to pause and thank my hon. colleague from Humber River—Black Creek, who has been an energetic, spirited and passionate sponsor of this bill. It would not be right to proceed any further without noting her energy and great work in promoting this overdue policy.
Eye health has been underfunded and deprioritized in Canada for too long. As a result, millions of Canadians are being put at unnecessary risk of vision loss because they lack access to eye care. A national strategy on eye care would ensure better access, better outcomes and quality of life for Canadians. It would also support Canadian leadership in vision research that can be exportable to the world.
Canada's New Democrats believe that our public health care system should cover us from head to toe, and that includes comprehensive eye care. Currently, access to eye care varies widely from province to province, resulting in variable health outcomes and exacerbating inequalities in our health care system. Over eight million Canadians are living with an eye condition that puts them at significant risk of blindness. An estimated 1.2 million Canadians are currently living with vision loss, with many facing a lack of investment in services and supports that impacts their living life to its fullest potential. That number is expected to grow to two million people by 2050. It underscores the need and the appropriateness of acting now so that we can arrest that alarming development.
The leading causes of vision loss in Canada are the following: Cataracts affect some 3.5 million people; age-related macular degeneration, 1.5 million people; glaucoma, about 300,000 people; and diabetic retinopathy, almost a million people or some 800,000.
Routine eye exams play a crucial role in the prevention of vision loss. If certain eye diseases are diagnosed early enough, they can be effectively managed through different invasive measures and before expensive and more invasive procedures are required. According to a recent report by Deloitte, the cost of vision loss to our economy, both directly and indirectly, was some $33 billion in 2019. That is projected to grow to some $56 billion by 2050.
If diagnosed early and if people have access to regular screening and treatment, most vision loss can be prevented: in fact, in about 75% of cases. Seventy per cent of existing vision impairment in Canada is estimated to be correctable with prescription glasses. The sizable proportion of correctable vision impairment is related to the barriers to access to vision care in Canada. Most guidelines recommend having an eye exam once a year for people aged six to 18 or 65 and older, as well as for those with diabetes or with an existing eye disease. For healthy people aged 19 to 64, one visit per two years is considered sufficient. However, this very basic diagnostic health need is not being met.
I will give a few examples. Starting September 1, free annual eye exams paid for through the Ontario health insurance plan will no longer be available to seniors. Manitoba and Nova Scotia currently only insure eye exams every 24 months for every senior, which is twice as long as is recommended. Millions of Canadians without extended health benefits do not have their eyes checked or cared for, due to cost.
As I said, the NDP has been advocating for universal public optical treatment since its founding convention in 1961. I am going to quote from that convention, which reads, “Believing that a country's most precious possession is the health of its citizens, the New Party will introduce a National Health Plan, providing benefits to those who need them without regard to their ability to pay. The plan will cover a full range of services: medical, surgical, dental and optical treatment, as well as prescribed drugs and appliances.”
It is a little over 60 years since that statement was made, and here we are in a G7 country and we are not making sure every citizen can get their eyes checked every year, never mind have the relatively inexpensive correction done that would prevent them, in many cases, from getting vision loss and even blindness. That is a national shame and it is time it was rectified.
More recently, the NPD's 2019 election platform committed to achieving head-to-toe public health care for all Canadians, and we specifically included eye care. In the 2021 platform, we committed to a long-term path to providing public coverage for eye care, along with other health services. In May 2021, the New Democrat member of Parliament for Algoma—Manitoulin—Kapuskasing, who I note is in the chair today, introduced Motion No. 86. That motion called on the federal government to work toward the creation of a national strategy for action on eye health and vision care. One can see not only that our support for this bill is there because of the need and the overdue nature of this, but that New Democrats have been playing a key role in placing this issue on the national agenda for decades.
I have to point out where the Government of Canada has simply failed to meet its commitments in this regard. In 2003, the Government of Canada made a commitment to the World Health Organization to develop a vision health plan for Canada by 2007 and to implement that plan by 2009. To date, no plan has been developed.
As recently as July 2021, the Government of Canada voted in the UN General Assembly for the first agreement to be adopted at the United Nations designed to tackle preventable sight loss and ensure that eye health is part of the United Nations sustainable development goals. In this resolution, the establishment of a national vision health plan was endorsed again by Canada.
As much as I credit the hon. member for taking this overdue measure, one has to wonder why this had to take the form a private member's bill, why the government is not meeting its own obligations and why it is not actually introducing government legislation using the full force of its control of the Order Paper to meet its own commitments, which it has made not only to Canadians but on the world stage.
It is important to note as well that this legislation has the support of stakeholders across this country. Several organizations, including Fighting Blindness Canada, the Canadian Council of the Blind, the Canadian National Institute for the Blind, Vision Loss Rehabilitation Canada, Diabetes Canada, the Canadian Association of Optometrists, the Canadian Ophthalmological Society and the Canadian Association of Retired Persons, have all advocated for a national eye care strategy for many years.
I want to pause for a moment to talk about the particular impacts this has on marginalized groups, including its gender impacts. When gender differences limit access to proper eye care services, women are at greater risk of developing eye diseases that are otherwise treatable and preventable. Recent studies published in The Lancet Global Health in 2020 revealed that women carry the greater burden of visual impairment globally. More women than men have impaired vision due to cataracts, age-related macular degeneration and dry eye disease. One in four women is at risk of vision impairment, compared to just one in eight men.
I will conclude by thanking the hon. member again for introducing this bill and let her know that the NDP will enthusiastically support it at all stages.
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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, 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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