SoVote

Context: House Hansard - 320 - May/29/24

May/29/24 11:07:59 p.m.
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Madam Chair, I think the fund is established specifically for that purpose. It is going to vary province to province, but what I want to see for those in need who are in income insecure situations is that we have the ability to do that. Now that I have a chance, I will go back to the other issue. One thing to note about sexual health and contraceptives is that we are having conversations in the pharma space, like the one I am having with Manitoba, because it is really taking leadership there, to see how we can spread and increase the action around sexual health. To me, that certainly includes action on AIDS.

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Mr. Mike Morrice

May/29/24 11:08:41 p.m.
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Madam Chair, I am encouraged to hear that on both fronts. I appreciate that. I would like to tell the minister about another constituent of mine, Noor Ayesha. Noor is battling an incurable rare cancer. For it, she requires an oral drug. The name is Pemazyre. It has been approved by Health Canada but is not recommended by the Canadian drug agency for public coverage. Noor's oncologist recommends that she take this drug to help her live longer, but it costs $800 U.S. per tablet and has to be taken daily. It is a cost of over $15,000 U.S. per month. Here is what Dr. Jennifer Knox, a medical oncologist at the Princess Margaret Cancer Centre and professor of medicine at the University of Toronto, had to say about Pemazyre: “this drug represents real progress, a key scientific and clinical advancement.” Noor's family has had to turn to starting a GoFundMe to help her fight cancer and live longer because the Canadian drug agency has not recommended Pemazyre for coverage. What steps is the government taking to address this gap between Health Canada's approval of rare cancer drugs and the CDA's recommendations for public coverage in order to ensure that patients like Noor can access the treatment they need without prohibitive costs?

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Hon. Mark Holland

May/29/24 11:10:10 p.m.
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Madam Chair, in the first order, I want to say to the member and to Noor and her family how sorry I am that she is going through this, and how dreadfully difficult it would be to get that diagnosis and live with that condition and then have to worry about medication on top of it. We do have action on drugs for rare diseases. We are negotiating now with provinces to try to identify what drugs we can look at to help folks who have a rare condition and need rare drugs so they can get help dealing with these extraordinary costs. One of the reasons it is so important that we take the collective action we are taking with pharmacare and take these steps is that we need to get to a world where everybody gets the medication they need and they are not in the kind of situation that the member described Noor is in.

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Mr. Mike Morrice

May/29/24 11:11:02 p.m.
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Madam Chair, can the minister share more about what can be done in working with provinces and territories to address this seeming gap? The issue, it seems, is that Noor cannot access the drug because it is approved by Health Canada but not listed by the Canadian drug agency as recommended for public coverage. Can he share more, just briefly, about what can be done in working with provinces and territories to address this?

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Territories

Hon. Mark Holland

May/29/24 11:11:30 p.m.
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Madam Chair, given the level of specificity, perhaps the member could send me the details and I can get back to him directly. I want to be precise and I want to dig into the specific circumstances that relate to that exact drug. It is a very fair question. I want to do that for both him and Noor.

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Mr. Mike Morrice

May/29/24 11:11:49 p.m.
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Madam Chair, absolutely, I would be happy to do that. I appreciate the specificity. I would next like to ask about Dylan and Kim. They are two of many parents in my community who have shared with me what it is like to raise a child living with CF. In their case, it is their son Jackson. As we know, kids like Jackson need expensive medication, such as Trikafta, which can significantly improve their quality of life. However, given the high cost of Trikafta and other CF drugs, many families struggle to afford it unless they are covered by private insurance. Those with access only have it because of private insurance through their employer. It often means that the value of this coverage is actually more than the person makes in terms of their salary. Of course, no child should go without essential treatment because of their family's financial constraints. Can the minister share when the government plans to move forward with the pharmacare program that would include drugs such as Trikafta and maybe, at minimum, require private insurers to cover the drugs that public plans do? I understand this is already the case in Quebec and something CF Canada is calling for.

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Hon. Mark Holland

May/29/24 11:13:13 p.m.
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Re: Bill C-64

Madam Chair, first of all, for Dylan and Kim, I appreciate the member's advocacy. I cannot imagine how difficult that circumstance is, and that is exactly what we want to shut down. This is precisely why we are acting on pharmacare. One very important question we have is about which model to use. We have a pilot in P.E.I. that is working very well, which is based on a fill-in-the-gaps model. The model that Bill C-64 is based on is a universal model. We are now looking at those two models in a real-world setting to see which one is best to use as a delivery mechanism for all drugs. We have a committee that will be looking at that over the next year, which will really paint that path forward. These are very active matters of consideration, and this is one of the reasons it is so important that we establish that bedrock, which is the legislative foundation for pharmacare in Bill C-64, and take this action. In this way, we can make sure that we get to help families such as that of Dylan and Kim. That is envisioned in Bill C-64, and very much in my heart and in my mind as we are working on this.

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Mr. Mike Morrice

May/29/24 11:14:20 p.m.
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Madam Chair, as the minister likely knows, because the word “pharmacare” is restricted to contraceptives and diabetes, I hesitate to use it at this point. I know that is the minister's vision for where he wants it to go. However, I am thinking about parents, such as Dylan and Kim, who want to understand more about when this could be expanded to them. Could we at least hear the minister's aspiration for when he would look to see that expansion in place?

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Hon. Mark Holland

May/29/24 11:14:48 p.m.
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Madam Chair, I would say that our health care system has always been iterative. We have built it out a piece at a time. However, one of the most frustrating things for me, as health minister, is to go to different parts of the country and hear stories of things that we could do on a preventative basis and are not doing. I mean, we could talk about Iqaluit. I was up talking with Inuit leaders about tuberculosis outbreaks there. There are things that we still have happening—

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The Deputy Chair

May/29/24 11:15:18 p.m.
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The hon. member.

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Mr. Mike Morrice

May/29/24 11:15:19 p.m.
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Madam Chair, I would love to continue that conversation with the minister. As the minister knows, Canada also has one of the highest rates of MS in the world, with more than 90,000 Canadians living with this disease. Of course, while the cause is still unknown, emerging research has highlighted the potential for significant advancements in the prevention of MS. I have heard directly from constituents that they want to see the Government of Canada commit $15 million to fund MS research in partnership with MS Canada, focusing on prevention, repair and regeneration. I understand that the minister also met with MS Canada earlier this month. Can he share what it will take for the government to commit these funds?

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Hon. Mark Holland

May/29/24 11:16:01 p.m.
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Madam Chair, I am extremely happy to see that, in the last budget, we responded to the Bouchard report and will be putting major money into research. I think it is $2.5 billion, generally a very significant portion for health research. Through the Canadian Institute for Health Research, we funded an enormous amount of research into MS. The member is absolutely right: Canada is a leader, unfortunately, when it comes to MS, so we also need to be a leader in research. When I look at these investments, I certainly hope that this independent agency will be taking a look at these requests and deepening our commitments in research. However, those dollars in the budget are absolutely essential to that end.

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Mr. Mike Morrice

May/29/24 11:16:42 p.m.
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Madam Chair, I appreciate the minister for meeting with representatives from MS Canada. It is best that he hear from them directly rather than from me, but it also good to know that there are parliamentarians on all sides who are keen to see the investment made potentially, for example, in the next fall economic statement. I would like to turn to a question for the Minister of Mental Health. There are two local mental health service providers in my community, Thresholds and the CMHA Waterloo Wellington, which have been struggling for months to secure funding for a mental health emergency room to provide appropriate care for people in crisis and to alleviate the strain on overcrowded emergency rooms. There has not been government funding available, so they have had to open this summer using their own budgets, and they have about three months' worth of staffing support available to demonstrate how critical the support is. Of course the provincial government also needs to step up. Given the urgency and the critical need for this kind of facility, I would like to hear what the minister believes are the immediate actions the federal government could take to support these kinds of local initiatives and ensure that people in crisis have access to the care they need without overburdening the emergency rooms.

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Hon. Ya'ara Saks (Minister of Mental Health and Addictions and Associate Minister of Health, Lib.)

May/29/24 11:18:00 p.m.
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Madam Chair, I know that the member is such a staunch advocate for mental health and for helping those who use substances in our communities. I do not think there is a quick fix to getting our health systems to incorporate mental health in the full spectrum of care. That is why we are taking an integrated approach through the bilateral agreements. As I mentioned earlier in the evening, just for example, in Ontario, $700 million of its $3.1 billion bilateral agreement is going toward mental health and substance use. We have to move the needle. We are not there yet. Community service organizations have been the bedrock of providing mental health services in the gap that we see across jurisdictions. That being said, this is exactly why programs like the youth mental health fund are being put into place in budget 2024, but there are no quick fixes. We are moving mental health into the health care systems. We are seeing, for the first time ever, that there are mental health ministers in nearly every jurisdiction across this country, which shows us that there is a prioritization to work collaboratively. I am happy to meet with the member to talk about what is going on in his own community with regard to the CMHA. Local CMHAs do terrific work, and I would be happy to discuss.

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Ms. Melissa Lantsman (Thornhill, CPC)

May/29/24 11:19:32 p.m.
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Madam Chair, today the minister stood by her failed decriminalization project in British Columbia after being forced to walk it back. Last week, she voted against ruling out the expansion of drug decriminalization everywhere else in Canada. Will the minister unequivocally commit today to never expanding her insane decriminalization policy from B.C. to anywhere else?

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Hon. Ya'ara Saks (Minister of Mental Health and Addictions and Associate Minister of Health, Lib.)

May/29/24 11:20:02 p.m.
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Sadly, Madam Chair, I have to say again that the stigmatized language from the other side of the House is highly disturbing. Decriminalization is one tool of many in addressing the overdose crisis. It exists in jurisdictions around the world, such as Switzerland, Portugal and Spain, and we know it is an important tool that we need to use. I really wish the member would look at the evidence and the facts rather than use rhetoric.

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Ms. Melissa Lantsman

May/29/24 11:20:32 p.m.
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Madam Chair, the failed experiment in British Columbia was walked back by the minister herself after she was forced to do it due to a request from B.C. because of so many deaths. Will she rule it out for her own city, in Toronto?

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Hon. Ya'ara Saks

May/29/24 11:20:52 p.m.
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Madam Chair, as the member well knows, we have said no to the Toronto proposal. Again, she seems to ignore the many stakeholders and evidence supporting a full use of tools to address the overdose crisis. People are dying because of street drugs; they are not dying because of decriminalization.

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Ms. Melissa Lantsman

May/29/24 11:21:13 p.m.
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Madam Chair, will the minister say no to Toronto forever?

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Hon. Ya'ara Saks

May/29/24 11:21:19 p.m.
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Madam Chair, we do not deal with hypotheticals on this side of the House; we deal with facts. I wish the member would actually engage in an evidence-based conversation on what a comprehensive strategy to addressing the overdose crisis looks like.

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