Helena Konanz

Mr. Speaker, Thanks · 22 wordsbefore I begin, I want to give a quick shout-out and congratulations to the kids at Penticton Secondary School, who recently raised, ThanksClaims · 32 wordsif members can believe it, $80,000 for the Canadian Cancer Society’s Relay for Life with the help of Princess Margaret Secondary, Summerland Secondary and many other local organizations, businesses and community members.¹ Thanks · 5 wordsI congratulate these great kids, ThanksClaims · 12 wordsand the best news is that people can still donate, at cancer.ca. Procedure · 8 wordsI want to start with a simple question.Procedure Positioning · 30 wordsWhy does a physician in this country have to fill out the same paperwork for the same drug, for the same condition, over and over again, while their patients wait?Positioning Claims · 335 wordsThat is the problem the bill is trying to solve, and it is a real problem. According to Health Canada’s own records, obtained through Order Paper Question No. 1104, the special access program has received over 148,000 requests since 2015.² Last year alone, nearly 12,000 requests came through.³ Many of these are repeat applications for drugs that Canadian clinicians have been successfully requesting for years. These are therapies that are well established and approved by regulators, with real-world track records behind them, yet the system treats every single one as if it is the first time anyone has ever asked. A physician who has prescribed the same therapy for the same rare condition 10 times must submit a fresh application for patient number 11. They fill out the forms, they wait, they answer Health Canada’s follow-up questions, and they wait some more. According to the government’s own written response to questions tabled in this House, the average processing time for a special access program request is 4.65 days.⁴ That might not sound like that much, but the longest processing time on record was 1,641 days.⁵ For patients with serious and emergency needs, even a few days of unnecessary delay can mean permanent, irreversible harm. The Canadian Organization for Rare Disorders has put numbers to what this costs. Only 60% of rare disease treatments reach Canada at all.⁶ Most arrive up to six years after patients in the United States and Europe have access to them.⁷ This is the broken system that Bill C-265 is trying to address. The bill would direct the Minister of Health to establish a standing pre-approved list of non-marketed therapeutic products for serious or life-threatening conditions.⁸ Physicians could prescribe directly from that list without starting from scratch every time. Products would be eligible based on prior special access program authorization, a clean safety record or current approval by a recognized foreign regulator.⁹ An expert advisory committee would be consulted on the list.¹⁰ However, who those experts would be is not defined. Thanks · 24 wordsI want to acknowledge the member for Thunder Bay—Rainy River for his work on this. He has approached it collaboratively and with genuine intent.Thanks Claims · 21 wordsHis background as a physician gives him first-hand understanding of just how much time Canadian doctors waste on repetitive administrative processes.¹¹ Promise · 16 wordsConservatives will support sending this bill to committee, where we will work to address our concerns.Vague promise Claims · 9 wordsMy colleague from Riding Mountain raised these concerns before, Procedure · 6 wordsbut I will raise them again.Procedure Claims · 72 wordsOur first concern is the presumption of approval when two specialist clinicians submit a joint treatment plan. The problem is that the bill places no requirements on these two clinicians to be independent of each other or independent of the treating practitioner. There is nothing in the legislation to prevent the second opinion from coming from a colleague in the same clinic, a supervisor, a business partner or even a family member. Reasoning · 11 wordsA second opinion is only meaningful if it is genuinely independent. Claims · 96 wordsOur second concern is the absence of any exclusion of controlled substances from the pre-approved list. In 2013, Conservative health minister Rona Ambrose took special action to restrict the special access program after it was used to approve access to pharmaceutical heroin for patients with chronic addiction.¹² Those restrictions were deliberate and warranted. The Trudeau government later dismantled them.¹³ As currently drafted, Bill C-265 would give the Minister of Health the authority to place substances like dangerous hard drugs directly onto a pre-approved list, from which any qualifying practitioner could order them without individual case-by-case review. Positioning · 25 wordsWe have watched the government use every lever available to it to normalize and expand access to hard drugs under the banner of harm reduction.Positioning Promise · 15 wordsConservatives are not going to support legislation that would create another pathway for that agenda. Claims · 20 wordsThe bill’s own sponsor has said that diversion of these substances must be prevented. We take him at his word, Promise · 24 wordsand we will hold him to it at committee with an explicit amendment to exclude hard drugs from the scope of the pre-approved list. Claims · 95 wordsOur third concern involves who gets to nominate products for the pre-approved list. As written, the bill would allow not just licensed practitioners but also pharmacists, hospitals and medical non-profit organizations to submit products for inclusion.¹⁴ The term “medical non-profit organization” is nowhere defined in the legislation.¹⁵ When my colleague from Riding Mountain asked the government in an Order Paper question to tell us how many special access program requests were made, broken down by requester category, whether practitioners, pharmacists, hospitals or non-profit organizations, Health Canada told us that this information is not centrally tracked.¹⁶ Positioning · 4 wordsThat is not good.Positioning Claims · 34 wordsThe government cannot even tell the House who is submitting these applications, and now we are being asked to expand the nomination criteria to include an undefined class of organizations with no meaningful guardrails. Positioning · 10 wordsThat appears like an open door that can be abused.Positioning Promise · 22 wordsConservatives will propose amendments to restrict nomination rights to licensed practitioners who use the special access program in their day-to-day clinical work. Procedure · 8 wordsThere is a broader point worth making also.Procedure Claims · 107 wordsThe health minister has had every opportunity to reform how this program operates currently and has not done so. Bill C-265 would offer some relief but would not fix the underlying problem. What it would do, if strengthened at committee, is reduce the repetitive administrative burden on physicians, provide a clear and faster pathway to proven therapies for patients who have no other options and do so without opening new doors to hard drugs or creating a regulatory bypass for pharmaceutical manufacturers. If amendments are accepted, the legislation would make a meaningful difference for Canadians who are waiting for treatments that already exist and are already proven. Positioning · 5 wordsThey have waited long enough.Positioning