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Congratulations on being gasified, Chair. That's good to hear, and I know we'll be talking more about this in the coming days.
I'll be tabling my notice of motion formally on Tuesday, but I wanted to give the committee notice that we'll be seeking to begin study on Bill , which was initially designed as the post-Kyoto long-term targets, the bill by Mr. Layton, and trust the committee will study it and return it to the House post-haste.
The motion will be extremely simple and straightforward for committee members to read, and we look forward to the study of the bill, knowing that the committee has some things to study but not an overwhelming schedule, obviously, this spring.
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So I believe we'll begin.
I think we've discussed this. We'll begin by updating from Tuesday to today, and where we are in terms of the negotiations, if you want, and let everybody know more or less what has happened.
Mr. Warawa, perhaps I could begin with you, please.
I appreciate the willingness of committee members to meet. I've met with representatives of the different parties and I think we have consensus on close to 90% of the issues. For some of the more benign issues, such as what do we call DEHP--should it be di(2-ethylhexyl)phthalate or bis(2-ethylhexyl)phthalate--I don't think that's contentious. But regarding Mr. Cullen's recommendations on defining phthalates, of having less than 0.1%, there are a lot of minor things that I think we've now got consensus on. Which statute should be managing it? Who's accountable? I think we're very close.
To get an overview, perhaps I could ask the department to explain, because what I've passed on to the department is what I believe is the consensus position, by talking to Mr. Godfrey and Mr. Cullen, and they've tried then to draft it into a form that I think properly represents a consensus position. If they could give us an overview, we might have a big picture of where we're going.
What I'd like to do is give you a bit of the architecture of what the government's amendments are. We've really tried to be very responsive to all the suggestions we've heard, so I'll give an overview of what is proposed here.
First of all, we are introducing a new clause 2 to deal with the definition of what would or would not be a phthalate, which is sort of a definitional-type issue.
Then we move on to the regulations section and we compare that with the old bill. The regulation section proposed--
I'm going to speak from the paper that I believe everyone has, which is the consolidated amendments, and that will be the architecture I will speak to. Then we'll have to map that into the individual motions as we move through.
First of all, we have introduced a new clause 2.1, which is essentially a definition to determine what would or would not be determined to be a phthalate, for the purpose of taking any action in this bill. I believe that came from a suggestion of one of the members. We like that idea and we incorporated that.
The next thing deals with the clause related to regulations, and the regulations in the previous version of the bill dealt with regulating a variety of areas for all three of the substances being captured in this bill, the DEHP, the BBP, and the DBP.
We are faced with the issue of already doing risk assessments on DBP and BBP and finding them non-toxic, so it would be very difficult for the department to convince the Governor in Council to add them to schedule 1 and then take action under CEPA, adding to schedule 1 under CEPA. We proposed and we've introduced a clause at the end of this package, clause 7, which would commit the ministers of health and the environment to reassess those two substances within 24 months. We're very much taking into consideration some of the commentary we heard from witnesses and members about doing cumulative assessments and also looking at exposure from cosmetics and other consumer products.
So we've moved DBP and DEHP. We cannot move to do anything with them until we have a risk assessment that says there is a risk to human health. We put that clause at the end of the revised bill.
Then moving on with what we can do with DEHP, the new clause 3 would deal with cosmetics. We would be prohibiting the use of DEHP in cosmetics, using the Food and Drugs Act. So that's what clause 3 is all about.
Moving on to clause 4, we would be looking at toys and other child care products like soothers and teethers, things that could go into the mouths of children under three. We would be using the Hazardous Products Act to prohibit those products from containing DEHP, and that is a step forward. We do that on a voluntary basis right now, and this will expand the age range and the types of products we'd be dealing with and we would put them into a regulation.
These clauses 3, 4, and 5 will all be introduced as one motion.
The fifth picks up on the desire of some commentary we heard to put in the idea of precaution, so we've made reference to the use of the precautionary principle in clauses 3 and 4. We've added a new clause 5 that uses the definition of the precautionary principle in CEPA and linked it to the actions that would be taken under the Food And Drugs Act and under the Hazardous Products Act.
So that is the package that deals with cosmetics and toys and other child care products that could be put in the mouths of children.
Then we move on to a very long clause 6, which is an approach we see as a compromise approach to deal with the issues of DEHP in medical products while at the same time ensuring we have access to life-saving medical devices that are very much needed and for which there may not be safe substitutes available.
There is a whole range of initiatives to deal with that, and we've introduced three new ideas based on the ideas that have come forward in the last couple of days. We can go into them when we get to that clause.
Then finally, the last one I've spoken to already, and that's the requirement to reassess DBP and BBP.
Thank you, Mr. Chair.
First of all, thank you to the department officials for arranging some of this and putting it into language that the committee can understand and consider.
As Mr. Warawa said earlier, through the conversations, there's in the range of a 90% agreement on the way to cast this bill forward. The 10% that's off for us remains around the clauses 3 and 4 that were listed. I think this is more just seen as a difference of opinion based upon what we heard from witnesses. Clauses 3 and 4 only deal with one of the three phthalates. As you will see--I believe it's here, and I'm not sure which one it refers to in your package--we have an amendment that would change clauses 3 and 4 a bit, that would include all three of the products.
There are two reasons primarily. One reason is that we still see significant health concerns with BBP and DBP. We also see other jurisdictions having gone that route, and manufacturers have, in effect, taken some of these chemicals out of the products already. I explained this to the parliamentary secretary earlier. One of our main concerns is our inability right now in this country to know for certain, if we walk down to the dollar store in the mall, that products coming from China, particularly, and from some of the other countries.... We have a limited ability to actually understand whether these chemicals are in there without going the route of eliminating them, particularly with children's toys, and ones that we know will be placed in their mouths.
I don't want to overfocus on that piece. What I've said to the government and to other committee members is that we're comfortable with the package. The point of difference we're comfortable with committee members considering and having a vote on, and that difference of opinion will be expressed by the various parties and members of Parliament sitting at the committee. So overall we're glad of the conversations that have been had.
In terms of the medical devices in clause 6, this was in direct response to Mr. Bigras' comment. The only slight difference and change we would make is that when you get all the way down to paragraph 6(e), we want to strengthen the language a bit so that there's specific instruction to government to have a label on medical devices that contain DEHP. This was a concession we intended to make to Mr. Bigras, rather than the outright ban, because they raise concerns, particularly from Quebec. Although other hospitals and provinces are starting to go DEHP-free in their devices, and products are being made, we'll make that concession in order to accommodate Mr. Bigras' concern. We want that language strengthened a bit so we're very clear that the government is seeking, I believe within 24 months or 18 months, that there will be a labelling process going on. We thought that was reasonable.
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Correct. I misspoke myself a bit. In paragraph 6(e), if committee members will read along:
within 18 months after the coming into force of this Act, prepare a list of medical devices that do not contain bis(2-ethylhexyl)phthalate that are sold in or imported into Canada
The addition we were making--thank you for that, Mr. Warawa--reads:
and list the DEHP-containing medical devices these devices can replace;
One of the things we're looking for is a replacement and an acknowledgement of what's coming in and what's replaceable. I suppose the intention of a lot of this is that we're looking for an eventual phase-out of this product, because we heard from industry that they're making the products right now. We heard from hospital groups that they are essentially moving in that direction. While we're not requiring or certainly forcing hospitals to do that, in a sense this is an encouragement towards that. So when devices are coming into the country, or if there are alternatives...that those be noted as well.
Certainly I congratulate all members for working together and coming up with something that seems much easier to deal with, and congratulations for listening to my advice, I guess, or the advice of all of us.
Mr. Bigras, do you have a comment you'd like to make at this point?
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Mr. Chair, this will be an initial reaction because I am not involved in the agreement that has been made between the two parties, and perhaps even with the third party -- I do not know because its representative has not yet spoken. The interesting aspect of what has been presented to us is first of all clause 3 that specifies the precautionary principle. I think that this is an interesting step forward that could even be written into other acts. I think that it is a very interesting and very important point.
Secondly, in clause 6, I feel that a balance has been achieved in the spirit of the amendment, in the sense that it also allows us to recognize that there can be risks. As I understand it, everything must be spelled out in the labelling, but it does not prevent people's access to medical treatment. So, with the transparency, the information given to medical technicians, and the desire to make sure that the public is informed, I think that an appropriate balance has been written into the amendments that are before us. But we can perhaps talk about that when we move to clause-by-clause study of the bill.
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Let's begin. I've briefly talked with the clerks. They're trying to get caught up here, in terms of advice.
Can we start with new clause 2.1?
We were under discussion of amendment. In order to go back and start with new clause 2.1, which seems the logical approach, I would need consent of all members here to let us do that, so that we could go back, start with new clause 2.1, and then move on to clause 3, and so on.
Do I have consensus?
Some hon. members: Agreed.
Some hon. members: Oh, oh!
The Chair: I've been advised that amendment G-5.1 on page 5.1 would be the one we need to look at first.
This is very similar to amendment NDP-0.2 on page 4.1, and NDP-2 on page 11.
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Thank you, Mr. Chairman.
Of course, clause 3 of the bill deals with regulations. Under G-7.1, clause 5 being proposed by the government would apply to this question of the creation of regulations.
Mr. Cullen's motion would apply. It says “In the administration of this act”. I see that as a broader and more all-encompassing opening of that phrase. It applies to the whole bill. There may be lawyers who could tell me differently, but it seems to me it would apply to the regulations as well. I think it's fairly obvious.
But my point would be this. If we accept Mr. Cullen's amendment, I would prefer the last two lines to say “to prevent adverse health impacts or environmental degradation”. I'm looking for his response to that suggestion. I think you'd have it apply to the whole bill and you'd cover both elements.
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So now we're on amendment G-7.1.
Could you just wait half a second, Mr. Warawa, please.
Just for everybody's information here, the clerk is advising us.... There could be some scope issues with this, but above all, we would need to.... I assume we're eliminating proposed clause 5. I think we agreed to that. He just doesn't move part three.
What the clerk is suggesting, Mr. Warawa, is that we deal with this as two separate motions. In other words, clause 3 would be one motion and proposed clause 4 would be a different motion, and of course, you just don't move proposed clause 5, so that would be gone.
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This is the 10% disagreement in terms of a difference of opinion as to what was heard from witnesses.
For committee members, for ease of understanding, there are three phthalates in play here--DEHP, BBP and DBP. If you follow beyond this--and I'm not going to refer to it any deeper than this--we have two NDP amendments that are similar to this one presented by the government, but they include all three phthalates instead of just the one.
So for ease of principle so that we can have the debate, essentially, or the difference of opinion between committee members, if we don't amend, do we--not friendly--subamend?
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Yes. I think as we've gone through the learning process of how to most effectively do this, we took advice from departmental officials and others that, for efficacy, this was the most direct and cleanest way to do it. I know there's some concern about how much you change a bill in terms of its intention, but the intention remains. It's the vehicle being applied to get it done, based upon the advice of those who are actually going to do the work.
The second point on this in terms of our subamendment is that we've seen other cases.... I know there are concerns about doing a reassessment, which I think comes later in the bill. We'll be seeking a reassessment of these because we think the original assessment was flawed, and also looking to remove the products at the same time. This follows directly out of our notions around the precautionary principle, which states that in the absence of 100% proof, if there's cause for concern, you can still act. That is why we've moved the subamendment to the government's 7.1.
So clause 3 is dealing with cosmetics. What Mr. Cullen is proposing is that we add to this, with a subamendment, DBP and BBP. What's being proposed in the total picture is that those be reassessed, and if they are assessed as being dangerous at that time, then they would be regulated. That is what's being proposed. At this point, they will be assessed.So to add them to this before they're assessed is somewhat putting the cart before the horse.
The precautionary principle is part of that. That's what was recommended by Mr. Cullen, so it's part of that, but it is dealing specifically with cosmetics. Proposed clause 4 will be dealing with items that could be put in the mouth of a child. But specifically, clause 3 is dealing with cosmetics, and I think it sends an unhealthy message if we're making regulations before we've had scientific reassessments for DBP and BBP.
So I would not support that and would recommend that the committee not support it.
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Mr. Bigras, I did consult on some of these issues. Basically I was told that if no member from this committee stands up and objects to what we tabled in the House, there's not likely going to be any changes to it.
So I would be looking for consensus here that we vote on the proposed change, and then we vote on this and proceed.
I think that's what I'm hearing in people's comments. It's okay.
Mr. Regan, please carry on.
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Again, I've listened to the Speaker a lot over the years, and usually he will say that he supports the ruling from the chair.
So obviously my decision would be to rule whether it's admissible or not. I have advice from the clerk. If there are no objections within this committee, and the mover of the bill said he understands that to make this bill more functional, he's taking the advice of the department, that's good enough for me, because we want a functional bill.
Obviously if someone here is violently opposed to that, they can raise it in the House, open the question, and there would be a question about that portion of the bill.
We have to hear Mr. Bigras in order to make sure he knows and understands what I'm proposing.
Mr. Bigras.
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I understand completely what you are proposing. By way of corroboration, I am going to tell you about a precedent. Precedents can guide our decisions.
Bill was approved in committee. Amendments had been made, and there was consensus among committee members that the amendments were in order, despite the view of the chair. A vote was taken and the ruling of the chair was overturned. When the bill went back to the House, the Speaker felt that the changes went beyond the scope of the original bill. The amendments were not accepted, and we went back to the original bill that had been tabled in the House to begin with.
So I would like to know if, based on the precedent of Bill C-257, the same thing could happen to the bill we are considering today.
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Thank you, Mr. Chair, for recognizing me. That is not the reason this has happened. First, it was not a question of money, nor of royal assent, but rather a question of including the notion of essential services in the bill, and the Speaker of the House felt that that went beyond the scope of the bill.
We cannot say anything we like, such as that it is a Bloc Québécois bill on replacement workers. I do not want to be a party-pooper. But there are 308 MPs in the House, and any one of them can get up and say that the bill goes beyond its original scope...I do not want to be a party-pooper, I want to make sure that the work we are doing here can come to an appropriate conclusion and follow a normal procedure. We must not keep working just to end up in a situation like the one I was talking about, especially when there are precedents, and when they have been brought to our attention.
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Right, then to find a way to remove Mr. Bigras' concerns, is there language that can be proposed that would allow the authority to stay within this bill, then, for this particular part?
It's a little frustrating, to be honest. We're being given that this is the best vehicle, and now we're essentially having to try to find a substandard vehicle in order to appease a technicality in the House. That's unfortunate if it's the route that we go, but we don't want a situation where there may be a difference of opinion on this in the House and someone can object on a technical reading and have the bill dismissed. That would be even more unfortunate.
Are we prepared to find another vehicle to do it?
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I do have a salient point, which is that if the bill were permitted to continue on in its present form and, as the clerk identified, it would be a stand-alone, is that constitutional? Is it a legal bill? I would suggest that it may not be successful if it were stand-alone. Maybe the department could advise us.
I think there is consensus that we want this to go ahead, but the way it is now, it may not be successful either. There may be problems either way. It would have a greater chance if it is improved to be a good bill and if there is unanimous support for it to continue on, I suspect the Speaker would support the ruling and advice of the committee.
I have a question. Is there a risk of it moving forward? Is there a constitutional problem or a legal problem with the bill, as it was originally written?
You do not believe me, Mr. Chair. You have that right, except that precedents support me. I probably believe you, but the reality is that precedents exist, that it is possible. If it is possible, and if it has already happened, it could very well happen with this bill too.
At the end of the day, Mr. Chair, this is not my bill, it is Mr. Cullen's. If Mr. Cullen wants to risk the bill going back to its original form when it gets back to the House of Commons, that is his choice.
I want to point out the risk. You have made your decision. I respect your view entirely. Now, if Mr. Cullen wants to take the risk, that is up to him.
Mr. Bigras raises good points about procedure, as do you, Chair, about changes being necessary.
Here's what we don't want to see happen. If we have changed the scope and the admissibility of the bill, yet there is agreement around the table, then if there comes a time when this bill comes back to the House of Commons with a disagreement about some of the contents in it because there is then a debate over one of three phthalates, any member in the House can stand up under the guise of admissibility and say, “I don't like this bill”--but really what they mean is that they just disagree on the chemical component--and wipe out the bill entirely. That would be a greater tragedy.
I'll keep this very short. Regarding the constitutionality of the bill, one of the things that all members of Parliament do when drafting bills is check for constitutionality using the advice of the House of Commons. We didn't pull this out of thin air. We've gone through that check. So there is a difference of opinion, I would suggest, between the government officials present here today and the advice that we get from the House of Commons, upon which we all rely.
I'm not into having duelling banjos between lawyers as to what is constitutional and what is not, but we've gone through the check already. It's not as if we didn't consider constitutionality in this.
To summarize, I'm not sure if we can establish a gentlemen's agreement to have a difference of opinion here about the different elements that are listed, but to allow it to go ahead through the House even though there may be a moment at which we've clearly expanded the scope of the bill to include a better mechanism. We didn't expand the scope of the bill to change its nature or to try to do something radically different. We're just using a better tool, on which we have advice from department officials, and which, there is some agreement around the table, is a better tool to use.
I'll call the vote, then, on what is proposed clause 3 in amendment G-7.1.
Again, we won't worry about numbering here; we'll just deal with it as it appears in front of us.
(Amendment agreed to [See Minutes of Proceedings])
This again includes the precautionary principle, as requested by Mr. Cullen. The last clause dealt with cosmetics. This deals with products being brought into contact with the mouth of a child who's less than three years of age.
It deals with DEHP. Again, the issue is whether it should also include DBP and BBP. The position of the government is that it very well could, but at this point we need to reassess DBP and BBP. That will be a high priority of the government. After the reassessment, they could very well be prohibited, but at this point it would be just DEHP for products being in contact with the mouth of a child.
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Amendment NDP-3 on page 12 and the government's motion on page 15.2 are dealing with the same issue of medical devices. Mr. McGuinty brought up the issue of unintended consequences. We agree, and I'm hoping we can find some middle ground here. I thought we had some. The proposal would ultimately result in the ban of safe and effective medical devices, even if there were no safe and effective alternatives in Canada, which is Mr. McGuinty's point.
Under Mr. Cullen's proposal, regulatory decisions made by another regulatory agency about the safety and effectiveness of DEHP-free alternatives would determine whether or not DEHP-containing medical devices would be available in Canada. The current medical device regulations prohibit the sale or importation into Canada of unlicensed medical devices, even if they've been approved for sale in another regulatory jurisdiction. Health Canada's safety requirements for medical devices are generally more stringent than those in many countries, and generally you'll find more evidence for safety and effectiveness.
Unfortunately, we cannot accept this amendment as it may introduce new potential safety risks posed by using DEHP devices not approved for use in Canada. We believe our recommendation on page 15.2 strikes that balance, and we would hope that Mr. Cullen would withdraw his motion and support the one on page 15.2.
Thank you.
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We're prepared to go to the government's suggestion, but let it be known within the committee that I have deep concerns with the approach taken by government officials on this one, particularly to raise the spectre of people not being able to gain access to needed surgeries.
There are two reasons. One built right into this regulation would allow the government to extend the use of devices that contain DEHP. That was one of the things we said. The second is that we have list after list of hospitals in Canada and North America that are going DEHP-free, clearly not jeopardizing their patients.
So while I will withdraw this amendment because it was some part of the negotiation, it's absolutely ridiculous to keep suggesting this notion that someone's going to be lying on a hospital table somewhere in Canada not being able to receive medical assistance because of this bill's proposal. Government, at some point or another, will find its way to where the medical consensus is coming from, that DEHP-free medical devices are becoming a standard. They are becoming a norm because the companies are making them, the hospitals are accepting them, and they're advertising the fact they are DEHP-free. So we'll move to the labelling as a first step, but this effort is certainly not done today.
So I'll withdraw this motion.
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As to the crux of the matter in terms of doing this reassessment, our understanding is that this is what we'd call a paper assessment, that there is much out there in the scientific literature about these chemicals and what's happening. It's not as if we have to go into the field and start doing....
That's why we're comfortable with the 12-month reassessment, because it's gathering evidence and work that has already been done in the field.
One of the things we found through the CEPA review was that the pace of things, in terms of assessment and getting the assessment back out, is often a concern for Canadians. That's why we feel confident with the 12 months and the possibility of getting it done.
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It is a paper assessment. There might be some situations, but we will not likely go out and do a new research project that could take two or three years. We will be looking at the information that's out there.
That said, to collect all that information, to understand it, to talk to any other experts, to do a report, to do the peer review that would be necessary to do that, and to get our heads around this cumulative impact assessment and look at examples used in other places is a complex challenge for a risk assessor. So I feel that it would be very tight and that we would probably shortchange the risk assessment if we were to require all of that to happen in a 12-month window.
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There are things between amendments that we have to do.
While we're waiting here a minute, let me tell you that we have this room booked a little later. I would ask members, if at all possible, to carry this on a little past one o'clock. I'd need consensus to do that. Wouldn't it be nice to finish this while we're here and have the experts here?
That's coming up; I'm not asking you now.
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Maybe we could order more cookies for Mr. Godfrey. It's on the record, Mr. McGuinty.
I'm advised that I don't need consensus to carry on, so we'll just keep going. There go your cookies, Mr. Godfrey.
Next is amendment NDP-3.2 on page 13.2. It will become new clause 3.2, not 3.1, as listed. It's very similar to part (a) of amendment G-15.2.
It's something that we very often do. It's just something that is not a legally binding kind of thing. So you ask people to come to the table and you hope that they get there, but you might have to encourage them along. So it's the issue of giving some time to do something where we don't have a regulation or something else behind us to force people to come to the table with us, to be able to work with them to bring them to the table.
So it's not a legally binding event, but yes, it is very much the kind of thing that Health Canada does on a regular basis.
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My name is Supriya Sharma. I'm the director general of the therapeutic products directorate in Health Canada.
Maybe I'll just address the issue of clinical practice guidelines and what we do and don't do.
As a regulator, it is a bit unusual that we would be stepping into the area of facilitating clinical practice guidelines. Ms. Milburn-Hopwood is correct in that as Health Canada, especially around the public health area, we do often step into those, but very rarely do we really move to clinical practice guidelines for specific products. However, in unusual situations, where there's a leadership role—in this case, around a specific category of product—we do take a leadership role in terms of bringing people to the table.
When we do that, it would depend on the individual issue. So if there are implications for provincial heath authorities or for individual hospitals or for individual practitioners, we would basically look at the issue and then bring the appropriate people to the table.
For some of the medical device issues, absolutely, we've had people from the various ministries of health at the table, along with certain health professional organizations and certain individuals as well.
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I have two things, and we're getting prepared to withdraw our amendment.
In proposed clause 6 here, on page 15.2, there are just two places, maybe three, where I think some words can be taken out to strengthen the language.
I guess what I'm looking for is some sort of consideration from government before we withdraw: in paragraph (c) where it says “that within 24 months after the coming into force of this Act”, to say “the government requires the labelling of medical devices”, rather than “takes steps”; and then in paragraph (d), “take steps to facilitate”.... It may seem like a small thing, but I've noticed in the drafting of laws that if you're not very specific and tight with the instruction in the law, then there's lots of room for open interpretation. Three years down the road, you can say, “Well, why haven't you done this thing?” and the government can claim, “Well, we took steps to”, but still haven't done it. And we saw that very much through the CEPA review.
The only other piece that I would look for is in paragraph (e). This one is talking about preparing a list of medical devices that don't have DEHP in them. All we would ask is that there is a corresponding list of what they're able to replace. So if there's a specific tube that's come on line that we know is DEHP-free, it is meant to replace this apparatus, and vice versa, just to make it easier for hospital administrators to have a list so that they know what's being replaced and by when.
That's all.
So if we can get that feeling from government that we're willing to just tighten up the language, be more directive, talk about a replacement list, then I'll withdraw NDP-3.3, or whatever it is now.
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I think there are probably two separate issues there. One is the interest of tightening up the language, talking about taking steps, and I don't think we have a problem with that. That seems fairly straightforward.
In terms of the list, I would go back to seek some clarification about what a replacement list would entail. In general, we wouldn't be making recommendations on the use of an individual medical device over another individual medical device. That really is the practice of medicine. So an individual practitioner would make that risk assessment based on the patient they had in front of them.
So I just need some clarification on what a replacement list would really entail and what the implications of that would be.
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There are a number of different hospital associations, so there is an umbrella organization that represents all hospitals. Again, it's not a group that we would normally consult with, simply because they're primarily administrative. Each province has its own hospital associations, and they're very different in terms of how they interact with the individual health authorities, etc. So we actually go on a province-by-province basis and we see who their responsible associations are and how they function, and then we try to bring the best people to the table.
If there is a public health aspect of it, we would then either go to the ministries of health or we would go through the community, actually the public health officers. Again, it really is on a case-by-case basis, but we have to match who we bring to the table to the issue that we're there to discuss. It's a very varied stakeholder group, usually on a case-by-case basis.
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Thank you, Mr. Chairman.
I think your point is well taken about the concern that obviously doctors have to make the decision. But I think what Mr. Cullen was looking for is that you're going to have one list of the products that contain phthalate, so why not also have a list of products that don't contain phthalate? You aren't making the decision for the doctors about which one they will use in the end. The point is that they at least would have a list available to them of what alternatives are there, and then it helps them make their judgment, it strikes me.
I think this seems like a reasonable suggestion.
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I think that's why I was seeking clarification, because what I was understanding is that there would be an individual product and then an alternative suggested for that product.
In terms of the numbers, simply to go over it, when we're talking about all classes of medical devices, we're talking about approximately 650,000 devices. When we're talking about the products we're dealing with in the classes of 2s, 3s and 4s, it's in the tens of thousands as well.
When we're talking about a list, then, if we actually talk simply about a list of medical devices that are containing DEHP, we're already talking around a list of about 10,000 products. If the request is that we're making a list of about 10,000 products and then making a comparable list of 30,000 to 40,000 products, we start getting into a question of how useful those lists would be and the ability of an individual to really go through all that and make an assessment.
The last point about the list of products that wouldn't contain DEHP is that this would also include lists of medical devices that would never include DEHP because there would be no reason for them to. So I wonder--and again this is obviously for the committee to debate--whether or not it would be more confusing or helpful.
I think that's the perspective we're coming from.
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I should give a point of clarification. Especially from the regulatory perspective, we wouldn't be drafting the clinical practice guidelines; the term “facilitate the drafting”, or the development of it, is purposeful because of the issue of jurisdiction.
As I mentioned, it really would be going to the people who would be best placed to give advice, and bringing them together to be able to formulate the clinical practice guidelines. We would normally have people at the table who could inform that position, but it would be unusual to go through, for instance, a ministry of health if the issue was really at a hospital level, because you would end up going through another organization, and that organization would speak to somebody else.
The reason it takes 24 months for the drafting of clinical practice guidelines is that it's a very detailed process. You not only draft them, but you have to bring in the expertise. Then you have to do the reality check of what this really means for practice; then you have to figure out a way to implement and communicate that. It really is bringing the appropriate people to the table. Whether we go through another organization or.... If it's a product-related thing and a very specific thing, we would normally go directly to the users of those products.
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Sorry, it didn't answer my question.
As a matter of practice, in the process you would facilitate through Health Canada, would you not engage senior officials from Ontario, New Brunswick, P.E.I., Quebec, and other governments who are involved in running health care systems, along with other hospital associations and experts, this subgroup of the Canadian Medical Association, and so on? Would you not convene them into this process as full participants?
The long title that we proposed originally is to “prohibit” the use of BBP, DBP, and DEHP. We were proposing, instead of “prohibit”, “respecting”, and the bill then guides how to manage those phthalates. So we're “respecting” as opposed to “prohibiting”. We think that's a little bit more accurate wording, so that's what we're proposing.
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Shall the title carry as amended?
Some hon. members: Agreed.
The Chair: Shall bill as amended carry?
Some hon. members: Agreed.
The Chair: Shall I report the bill as amended to the House?
Some hon. members: Agreed.
The Chair: Shall we reprint the bill as amended and use this in the House at report stage, send it back to House?
Some hon. members: Agreed.