- Member of Parliament
- Minister of Health
- Liberal
- Ajax
- Ontario
- Voting Attendance: 64%
- Expenses Last Quarter: $134,982.00
- Government Page
moved that Bill C-64, An Act respecting pharmacare, be read the second time and referred to a committee.
He said: Mr. Speaker, it is my pleasure to rise.
I want to start by extending gratitude to the member for Vancouver Kingsway for his extraordinary work throughout this process. It was a long, hard discussion to find a place of meeting, but it is an example of what is possible when we, in this chamber, focus on getting things done and focus on working together, rather than focusing on what divides us. I think that sometimes we fundamentally misunderstand the purpose of democracy, which is to build consensus, to find points of commonality and to pull people together to find common ground; it is not to find differences or to sow division.
I also want to thank so many phenomenal colleagues on our side who have dedicated, in some cases, decades to fight for the moment when people are not forced to make a choice between the medication they need to stay healthy or the essential goods and services they need to stay alive, whether that be their rent or their food.
In the 1960s, we launched national medicare, but we forget how challenging that was. It was an incredibly turbulent period to actualize it and to bring it to reality. The dream had long existed, but to bring it to bear was extraordinarily difficult. However, at that moment in time, there were certain things left out, one of which was medicine. That was partially because, at that point in time, the number of medications available were very limited. They were typically prescribed in a hospital setting. They did not have the uses and abilities, and they were not as essential as they are today. Certainly, that dynamic has changed, and this means a new dawn for health.
I am going to talk specifically about pharmacare and the legislation therein, but before I do, I will paint a broader picture of the circumstances it faces.
Like all countries, everywhere in the world, the vast complexity of our health systems is overwhelming. We are driving down a highway at a 100 kilometres an hour, recognizing that we cannot slow down, and we have to change the engine while we are driving. Due to that difficulty, most health systems had not done the hard work of transformation, of really stepping back and looking upstream at how we deal with prevention and deal with reducing the amount of chronic disease and illness that exists within our system.
Then the pandemic hit, and in the pandemic, everywhere in the world, the strains and cracks in our health system were laid bare. Health care workers were asked to carry a burden that was impossibly large, working night and day to try to keep their communities safe, and carrying a load beyond imagining. However, in that moment, here in Canada and in a few places elsewhere in the world, we saw something I think quite remarkable happen, which was that in that chaos, there was one purpose in our system. Doctors, nurses and personal support care workers showed us the possibility of what happens when we move with one purpose, with one direction, and when we focus on people's health and nothing else. We could set aside egos, jurisdiction and turf, and we could make things happen. In an incredibly brief period of time, Canada's pandemic response was indeed one of the best in the world with one of the lowest death rates anywhere in the world. We had unbelievable support for the people working within the system and for one another for that period of time.
Then, challenges resumed. The pandemic began to recede. A war erupted in Europe. Global financial turmoil ensued. We forgot the lessons of the fruits of co-operation and of working together, and many of those divisions returned. Within our health system, we saw a workforce who had carried far too much and was dealing with burnout, yet still had the extraordinary weight of a system that needs to change. We saw, for the population, that health was a bit of a hot plate. People's experience of the pandemic was trauma, really, for everybody. It was especially so for health care workers, but nobody was saved from the traumatic experience of going through the pandemic.
I would say that it is the responsibility of not just this government, but also every government in this country to remember the incredible heroism of those who were working in the health workforce during those dark hours of the pandemic, and with that same spirit of co-operation and determination, to not focus on what divides us or what makes us different, but to focus on what can be done. That is no more important in any area than it is in health. Canadians do not care much about what political party someone is from. They do not care much about whose jurisdiction it is; they want to see results.
That is why the $200 billion that we put forward to invest in health care over the next 10 years was so critical. It required an agreement with every single province and every single territory to develop a plan to deal with the crisis of today, to tackle those issues within our health system around the workforce, the backlogs, the health data and the sharing of patient information, to deal with issues like administrative backlogs, things that are legacies that do not make sense, and to work with every province and territory, regardless of its stripe.
Whether it was Adriana LaGrange in Alberta, Adrian Dix in B.C, Michelle Thompson in Nova Scotia or Bruce Fitch in New Brunswick, and so forth, in every instance, that spirit of co-operation pervaded our negotiations. There was a profound understanding in those conversations that we have to be bigger than our partisanship and have to find commonality. As a result, we have had extraordinary agreements signed with all the provinces and territories, in a short period of time, to lay out the next number of years and to see what that health transformation will look like.
That spirit of co-operation was also seen in Charlottetown, where we were able to have an agreement on some things that are really essential: health data; looking toward interoperability and how our systems work together with a digital charter; reducing wait times for recognition of foreign credentials, taking it down to a 90-day service standard. We were also able to work later with the College of Physicians and Surgeons to take a process of credential recognition that is normally a couple of years and were able to get it down to a couple of months.
The other thing these agreements and conversations did, which I think is critically important for the future of our health system, was to establish common indicators, meaning that every province will have the same indicators for their health system, so that whether someone is a Quebecker in Quebec or a Manitoban in Manitoba, one can see how their health system is faring, not by anecdote but in data, and that can be compared against other provinces. Making sure those indicators are there is essential. It is so important that people feel that positive change, that they experience it in outcomes and that it is also measurable in data.
In our federation, as we are making changes and interventions, that ability to have data and to see how we are moving the needle is essential. What one measures, one achieves. For the first time in these health agreements, we have set these essential tools of measurement to be a key component of our health system.
We can then turn to dental care. There are some who say that this is just a boutique intervention, something that is a one-off, but it is actually part of a broader vision of health. Imagine that in this country there are nine million people today who do not have access to dental care. I want to thank my predecessor, the former minister of health, now the minister of procurement, the hon. member for Québec, for his extraordinary work to get us to this point in dental care. I want to thank the NDP and the member for Vancouver Kingsway for their work with our caucus in a common purpose to make sure that we pull together over health.
Mr. Peter Julian: Hear, hear! Thanks to the NDP.
Hon. Mark Holland: Yes, I want to thank parliamentary co-operation.
Madam Speaker, I would say to this place that this is what we were intended to do. When we were elected as members of Parliament, we are not here to shout things at each other, to belittle each other or to put each other down. We are here to listen to each other. The purpose of debate is to ensure that we take each other's ideas and that we find common ground. In this bill, Bill C-64, in pharmacare and in dental care, we are embodying exactly what I believe our constituents elected us to do.
Right now, we have 1.8 million seniors who, in many cases, have never had access to oral health care in their lives. I talked to a denturist who knew a senior who has not had new dentures for 50 years. They lost their dentures and had no money to replace them. The denturist talked about the dignity and the way that senior felt, knowing that they were going to get new teeth and that they could go out in the world, feeling that somebody cared about them. Let us think of the extraordinary nature of that.
When going to seniors homes and when talking to people who work with seniors, they ask if this is really going to happen. They talk about the dignity that comes from it. It is not only about that healthy smile or that they are not going to wind up in an emergency room for an avoidable procedure, but also about the dignity of saying that we care about them, that we see them and that their health matters.
We have one of the most extraordinary health care systems in the world, but it cannot be the best health care system in the world unless oral health is part of the equation. When we do not take care of oral health, when we are not there for oral health, then the costs, not just in terms of social justice but also in terms of health outcomes, are entirely unacceptable. I would submit that is not the country we want to live in.
I am also extraordinarily proud that, about two weeks ago, the Minister of Families, with many of us there, launched the national food program. When I was at the Heart and Stroke Foundation, I advocated for fiercely for that, knowing when a child goes to school hungry, it is impossible to learn, and when a child is denied nutrition, it has devastating effects on their health. It is so sad to say that the research shows just one healthy meal a day has a dramatic change on health outcomes for children. The other thing it does is to give kids a taste for what nutritious food is. They develop their palates, and for their whole lives, their nutrition and nutritional profile is changed.
An essential part of being upstream and avoiding illness and sickness is dental care, a national food program and, yes, action on pharmacare. This is a big task. We know that some 21% of Canadians are struggling to meet the financial burden of being able to afford their medicines. We took essential action on bulk purchasing, reducing the cost of medicine in this country by hundreds of millions of dollars, by working with provinces and territories to do bulk purchasing.
We are taking critical action in P.E.I., with a plan for Islanders, on a pilot basis, to improve affordable access to prescription drugs. Since June 1, 2023, we have been able to reduce copays to five dollars for almost 60% of medications regularly used by Islanders. P.E.I. residents have saved more than $2 million in out-of-pocket costs. This was a precursor to show us what could happen. Whether one goes to P.E.I. or other provinces, and I know that the member for Malpeque talks a lot about this, they will hear about the difference it is making in the lives of people, having medication taken off the table as a concern. It is absolutely huge.
We also launched, in March 2023, a national strategy for drugs for rare diseases, with an investment of $1.5 billion over three years because we know that drugs for rare diseases can be cripplingly expensive, yet they are absolutely vital to keep people alive.
I will give one quick story before I talk about the bill in front of us and about the action we are taking. I had an opportunity a few weekends ago to be in the United States with my partner. We watched someone in front of us collapse. That person was obviously not a person of means. As they came to and I called 911, the thing that person was worried about was not their health, but it was how much money they were going to have to spend. How much money did my call to 911 burden that person with?
We do not want to be in a place, with any element of health care, where somebody of limited financial means, through no fault of their own, is in a circumstance that they cannot afford care, or where nurses on the front lines, taking care of patients and investing their entire lives in trying to make things better, are not given the opportunity to get proper health care for themselves.
Why these drugs? Why did we start with diabetes medication and with universal contraceptives? Let me start with diabetes medication. I want to thank the member for Brampton South for her fantastic advocacy on diabetes specifically. There are 3.7 million Canadians, and it is a growing number, who have diabetes. When I had a conversation in Ottawa with 12-year-old Raina, she summed it up better than anybody else. She said that as a 12-year-old it is really hard in this world, and that no 12-year-old should have to worry about all the problems of the world and also how they are going to afford their medication. If 12-year-old Raina can get it, then this House can get it.
When a person does not have access to their diabetes medication, it means they risk heart attack, stroke, kidney failure, blindness and amputation. I was talking to Sarah in a diabetes clinic, who told me about patients who were reusing syringes because they could not afford them. The risk of blood-borne disease is terrible. That is not the country we should live in, so we all need to rise to this moment to say that for people with a precursor disease like diabetes, which is so indicative of whether they will have future chronic disease and illness, it is essential that we are there with medication for people.
On contraceptives, let me just give one example that illustrates the case. Oral contraceptives cost $25 a month and have a 9% failure rate. The IUD costs about $500, lasts five years and has a failure rate of 0.2%. What it means is that a person who does not have money ends up choosing the birth control option that is cheaper, which has a 9% fail rate and means they are more likely to wind up with an unwanted pregnancy or a sexually transmitted disease if they are not able to make the choices that give them autonomy over their own body and their reproductive health and future.
Therefore, it is absolutely essential, and not only for health. For example, in British Columbia, it has been demonstrated by UBC that it is saving more money with this initiative than it costs to roll it out. That is similar to what we are going to see in diabetes. This has such a powerful effect in prevention that it actually reduces costs overall.
The message it sends to women about their bodies and about their sexual and reproductive rights and autonomy is essential, which is that in this country, no matter where she is, a women will get what she needs to have control over her future and her body. That is a powerful statement, and it goes beyond just contraceptives as a drug.
As a very young person, when I was very, very young, I was exposed to sexual violence. That experience, in a family that did not talk about sex and did not have a conversation about what healthy sexual relationships were, had a devastating effect on my life, my self-esteem and my ability to stand up for myself at different moments in my life. It is difficult for somebody who does not have the information about their sexual health, who is not told that sex would never have anything to do with violence, that violence is about control and sex is about connection, that sex should always be consensual, should never be exploitive, should never involve violence and should always involve what a person wants for their body, that it should be pleasurable and it should make them feel like themselves.
As a health minister, it should not be in any way controversial for me to say those things to people. Whether a person is in a marriage or intersecting for the first time with somebody else sexually, they need to understand it is okay to be themselves and that as long as it conforms to those things, such as that sex should be pleasurable and that one should be empowered in one's body and have access to the reproductive medicines one needs to make choices about one's life, it is going to save lives, because the second-leading cause of death for young people is suicide. We lose about 500 kids every single year, and way too often it has to do with them not feeling comfortable in their own bodies. We have to end that.
In totality, looking at all of these actions, this is a new dawn for health, dealing with the crisis of now and also looking at prevention, so that we can build on what we started in the 1960s and ensure that all Canadians have access to the greatest health care system in the world.
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- Feb/29/24 2:35:46 p.m.
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Mr. Speaker, when China, Russia or any other country threatens Canada, it is an attack on our democracy, on the House of Commons and on every member here. That worries me a great deal.
That is why we have put in place policies to further strengthen public safety and to ensure that national security is not compromised.
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- Feb/29/24 2:20:28 p.m.
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Mr. Speaker, I want to say that an attack on our national security by a foreign nation, be it China or Russia, represents an attack on democracy. It represents a direct attack on every member of the House. I share the member's outrage that China or any other country would attempt to interfere in our process.
The Public Health Agency, which is one of the most respected agencies in the world, hired two Canadian citizens who were eminent and well-known scientists in Canada, but who lied. It is the Public Health Agency that discovered that. It is the Public Health Agency that fired them. That is why there is now an RCMP investigation about their actions.
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- Jun/15/23 4:40:44 p.m.
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Madam Speaker, speaking of honesty, what I find dishonest is members using all the options available with the hybrid system and then saying it is a terrible system that they hate. They use the system every day.
We debated this for three years. We are free to use the hybrid Parliament every day. I love democracy here in Canada. I am so proud to say that, each day, I make sure that our democracy is as open as possible. When we have a system that provides a bit of flexibility, it helps more people become MPs. The hybrid system allows people to have a personal life while also fulfilling their responsibilities here in the House.
The member opposite knows full well that being a member of Parliament is very hard work and that the hybrid Parliament gives us a little room for a personal life.
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- May/12/23 11:31:25 a.m.
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Mr. Speaker, when one of the greatest darknesses ever known to man began to cast its shadow over Europe, Canada responded in an unprecedented way, sending tens upon tens of thousands of men into harm's way. Every single one of us viscerally and deeply understands the sacrifices that they made at that point and that those in our Armed Forces make now on behalf of democracy. There is not a person in this House who is not seized by that. How we honour it and the ways in which we recognize it may differ, but let us never question our commitment to that cause.
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- May/9/23 3:14:56 p.m.
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- Re: Bill S-5
Mr. Speaker, as I was saying, we live in an extraordinarily challenging time. I would say it is also a privileged time. We get an opportunity to defend democracy here and to join in camaraderie with other democratic nations in ensuring that democracies thrive in pressure as the shadow of autocracy attempts to do great damage to our democracies. When we go back in time, the issue of foreign interference is not new. It is something that has existed for a long time.
As I referenced today in question period, when I was the critic for public safety, after Justice Iacobucci issued his report building on Justice O'Connor's report, there were essential recommendations, and both justices spoke at that time of the imperative nature of action and specifically the imperative nature of establishing a committee of parliamentarians that would have the opportunity to look into every aspect of security and intelligence.
Unfortunately, for years, those recommendations were not acted upon, and not only those recommendations, but many others. I am not going to enumerate them all, but it is fair to say that upon getting the privilege of becoming Canada's government, we immediately acted to create that committee of parliamentarians to make sure that every member of Parliament, regardless of what party they are from, has the opportunity to look into every aspect of security and intelligence so that they can know that there is no aspect of our security and intelligence that is under any shield.
On the important matter we are debating now, we respect the Speaker's ruling, and we are taking important action to deal with the foreign interference we are seeing. We saw the Minister of Foreign Affairs declare the diplomat in question a persona non grata. The Minister of Public Safety has made it clear on numerous occasions that we will not accept any form of foreign interference in our country and that any foreign interference would be met with strict action that is taken proportionately and deliberately. One of the things that are so important is that as events unfold, it is important for us to validate facts, to have conversations, to fully think out the consequences of actions, and then to act, as we have in this case.
We have been debating this important motion already for 12 hours, and I do not need to remind members that the purpose is not to have a debate in this chamber, but to move it to the procedure and House affairs committee, which can do its important work and make recommendations. The longer we debate this matter, the more we simply do not have the opportunity to get what the members of the opposition in the Conservative Party are saying they want, which is recommendations, answers and actions. That is what we continue to focus on. The longer we are here and the more speeches we have, and we are already at 12 hours, not only do we not have an opportunity to act at PROC on that matter, but it stops this House from dealing with extremely important issues.
One of the things that were displaced was Bill S-5 and the debate we are having on the amendments to CEPA, which are putting forward incredibly important improvements to our Environmental Protection Act to make sure we are there and taking action on the environment. This is also stopping us from being able to take action on firearms and ghost guns, which we are hearing, from across the country—
Some hon. members: Oh, oh!
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- May/4/23 2:45:55 p.m.
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Mr. Speaker, what we can agree on unequivocally is that a target of a member of Parliament's family is an act beyond anything we can imagine. Every single one of us have dedicated our lives to democracy. We have seen ourselves—
Some hon. members: Oh, oh!
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- May/4/23 2:44:16 p.m.
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Mr. Speaker, I have to rise in my place because I think it is important for us to take a step back to recognize that, as Russia and China target this House and all democratic places everywhere, there is absolutely no question that the government, and any government in the history of Canada, would see a threat against any parliamentarian as anything other than a threat against every single person in the House. The assertion that anything else is the case is ridiculous.
All of us stand firm and resolute against the threat to democracy. It is absolutely a threat against us all, and we will rise to the hour every time.
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- May/1/23 2:54:12 p.m.
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Mr. Speaker, I ask the member opposite, whether it is Russia or China, our collective response to that threat on our democracy, the democracy that the member opposite has tried to defend and protect her whole life, the democracy that I have worked to try to defend and protect my whole life, how do we work together to counter that.
Instead of trying to score partisan political points, or find ways to extract partisan advantage or imply somehow that anybody is advantaged by autocrats who attempt to destroy democracy, we need to stand shoulder to shoulder, side by side against it.
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- May/1/23 2:52:46 p.m.
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Mr. Speaker, we are in an inflection point in history where Liberal democracies are under direct attack. We are seeing it in Europe. We are seeing it all over the world. The objective of those dictatorships is not to elect a political party; it is to destroy democracy.
History will look back to this hour when we were called to stand up against tyranny and we were called to stand shoulder to shoulder against interference. They will ask who did the hard work of standing up against foreign interference and who played games with it. They will ask who sowed fear and division, and who worked to make sure that we protected our democracy.
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- May/1/23 2:38:41 p.m.
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Mr. Speaker, as the Leader of the Opposition knows, because he was here, the Prime Minister stood in his place and answered those questions five times. Ministers of the House also answered questions.
I will say, without equivocation, that the attacks that are taking place on democracy, be they by Russia, China or any authoritarian regime, are something that we must stand in unison against. The attack on one member of this democratic House is an attack on every single one of us. We cannot direct our security and intelligence, but we can sure stand up for democracy.
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- Apr/20/23 2:26:54 p.m.
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Mr. Speaker, it is clear that no one in the House of Commons shares China's objective. Foreign interference is a major concern for all members.
Every member of the House of Commons is loyal to our country and responsible for protecting our democracy. That is clear. Calling that into question is unacceptable.
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- Apr/18/23 2:47:57 p.m.
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Mr. Speaker, at the foundation of the question being asked is whether this government would ever allow a foreign government to dictate or influence our decision. The answer to that is a categorical no.
Secondly, embedded within that is a question, I would say, of the loyalty of members of Parliament to their country. They can call it sanctimony. I call it my entire life, and I know that other members on the other side do as well. They have fought for our democracy every day of their lives. They fought to get here to be members of Parliament. To have their patriotism questioned is unacceptable.
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- Apr/18/23 2:41:15 p.m.
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Mr. Speaker, there is no question that every member of the House, on this side and certainly in opposition, is loyal to our country, Canada. There is absolutely no question that interference from China or other countries is designed to destroy our democracy. That is a serious concern for us and that is why we are using every avenue we can to protect our country.
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- Mar/23/23 3:00:39 p.m.
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Mr. Speaker, when we are dealing with something as serious and as fundamental as foreign interference in our democracy, how we engage in those conversations, how we talk to one another, is exceptionally important.
What we have said from the onset is that we have NSICOP, which allows members from all parties to look into every aspect and every corner of government on all of these issues. We have appointed an eminent expert, who was appointed, in fact, by the Conservative government to be Governor General, to look at these issues and whose commitment to our democracy is impeccable. He will make recommendations on the next step.
We have to be careful about throwing around allegations as though they are fact. Instead, we need to be judicious in how we deal with these matters.
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- Mar/23/23 2:59:29 p.m.
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Mr. Speaker, we had an inquiry with Justice Iacobucci and Justice O'Connor, with Canadians who were wrongfully detained in other circumstances, and a set of recommendations was asked to be acted upon. Unfortunately, they were not acted upon by the prior government. They were acted upon by this government.
Let me be clear. When we are talking about what is at the very core of our democracy, I think we can all be united. There are autocratic regimes right now that are looking to destabilize western democracies. They seek to undermine democracy by engaging in partisan games on things like national security. It is inappropriate. It is important that we deal with these matters in a judicious, fact-based way.
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- Mar/9/23 2:37:11 p.m.
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Mr. Speaker, the supposition that a foreign government's objective is to elect a political party is a ridiculous notion. The reality is that the objective of foreign interference is to destroy our democracy. It is a threat to every single member in the House. The idea that every single member in the House is not united in repelling that threat is preposterous.
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- Mar/7/23 2:52:47 p.m.
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Mr. Speaker, I have every reason to believe that the member opposite, for the entirety of his life, has fought for Canadian democracy. I would believe that he knows that I have done the same. I believe that he would know every member in this House has done the same.
I believe the member opposite would also know that foreign interference is a threat to our democracy, and that the objective of any nation to interfere in our democracy is not a threat against a party or a government, but a threat against our democracy.
We are united in making sure that foreign interference is repelled. National security cannot be played with. We need to deal carefully and delicately—
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- Mar/7/23 2:30:14 p.m.
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Mr. Speaker, it is the height of irresponsibility, when talking about national security, to talk about the fact that national security should just be set aside and we should just open this up as if it could be done. It is not something that I think is being responsible.
Responsible leadership is saying that every single member of the House is totally and utterly committed to protecting Canadian democracy. The assertion that anything else is true is offensive and untrue. Playing games with national security is not appropriate.
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- Feb/14/23 3:07:16 p.m.
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Mr. Speaker, this is completely unacceptable. There is no one in the House who is not loyal to our country.
It is clear that not only the minister, but every member of the House is entirely loyal to Canada and to our democracy. It is unacceptable to say otherwise.
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