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Liberals to create national drug agency as building block of pharmacare plan

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OTTAWA — The federal Liberal government is promising a new agency to negotiate prescription drug prices for Canadians to try and drive down costs — a move billed as an “important step” on the path to an eventual national pharmacare plan.

In a sign of just how expensive pharmacare could be, the federal budget tabled Tuesday is also promising to spend $500 million a year, starting in 2022, to subsidize drugs that treat rare diseases.

The Liberal government said it intends to work with provinces, territories and other partners to develop the mandate for the national drug agency, with Health Canada to receive $35 million over four years starting in 2019-2020 to create an office to support the plan.

The budget, the government’s last before this fall’s federal election, also includes plans to create a national formulary — a list of drugs that have been evaluated for both efficacy and cost-effectiveness.

The measures in the budget alone will not close the gap for Canadians that require prescription drugs they can’t afford, Morneau warned in his House of Commons speech.

“A publicly funded, universal health care system is a source of pride for Canadians and a source of strength for our country. It is a legacy that we are building on with this budget.”

A central question remains: how the government plans to pay for it.

A universal pharmacare plan does not appear affordable for Canada right now, said Rebekah Young, the director of fiscal and provincial economics for Scotiabank. Adding such a plan to the government’s books without major tax hikes would require stronger growth than Canada sees even in the best of times, she warned.

Provinces do not have a lot of capacity to take on substantial new costs, Young said, noting the parliamentary budget office has estimated the cost of a pharmacare plan at about $20 billion a year.

“The big question then becomes who is going to pay and how much?” she said. “That will definitely be a key feature of the summer debate when we head into the election.”

The federal New Democrats have promised that if elected, they would follow through on a universal pharmacare plan to respond to dramatic increases in prescription drug costs. Indeed, Tuesday’s budget lacks a sense of urgency on the matter, said NDP Leader Jagmeet Singh.

“Canadians were counting on this Liberal government to meet their basic needs, and sadly, they were let down,” he said in a statement. “We will have the courage to make different choices.”

Canadians spent $33.7 billion on medication in 2018, a staggering increase over 1985, when they spent just $2.6 billion on prescription drugs. People take more drugs to manage more conditions than they used to — living longer, and better, but at considerable expense.

Canada’s current patchwork of drug coverage, which comprises more than 100 public programs and 100,000 private insurance plans, is not well equipped to handle the increasingly expensive drugs now coming to market, the government said in its budget document.

“Absorbing these rising costs is difficult for individual Canadians and their families — and poses challenges to the long-term sustainability of government- and employer-sponsored drug plans.”

The plan in Tuesday’s budget follows interim findings issued by a federal expert panel led by former Ontario health minister Eric Hoskins on the “building blocks”of pharmacare, including an agency to oversee a national drug plan.

Drug spending in Canada is expected to surpass $50 billion by 2028, the report found.

Dr. Gigi Osler, president of the Canadian Medical Association, said Tuesday she was glad to see some details on the government’s pharmacare vision.

“I think it is the first step towards making it (pharmacare) a reality,” she said. “Our position is that all Canadians should have access to medically necessary drugs regardless of their ability to pay.

Hoskins’ advisory council is set to issue a final report on the issue of access to drug coverage this spring, with the findings to be tabled in the House of Commons.

“We look forward to receiving the advisory council’s final report later this spring as we move toward national pharmacare for Canada,” Morneau said.

—Follow @kkirkup on Twitter

Kristy Kirkup, The Canadian Press

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RCMP seeks names of potential victims of coerced sterilization, Lucki says

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OTTAWA — The RCMP is seeking the names of potential victims of coerced sterilization procedures and wants lawyers to help in the process, RCMP Commissioner Brenda Lucki said Tuesday.

In testimony before the House of Commons health committee, Lucki said the RCMP is willing to meet with victims, adding it would be helpful if lawyers could talk to complainants about coming forward.

“The lawyers … if they were to speak with those victims and provide them the options of coming to the police, we would absolutely sit down with each and every victim that they had to look at it from a criminal point of view,” she said.

“Obviously they are not going to release their names without their consent as well. But … if we were to have those conversations, and possibly we could convince victims to come forward through the lawyers, that would be one avenue that we could explore.”

MPs asked Lucki to testify as part of a study about ongoing concerns from predominantly Indigenous women who allege they were coerced or forced into tubal ligation procedures during childbirth.

Her testimony also followed a letter sent this spring by NDP health critic Don Davies who asked the RCMP to conduct an investigation of serious and credible allegations that have been brought forward.

Lucki told Davies in a March letter that the force would work with commanding officers in each province and territory as well as other police agencies to see if any complaints have been reported.

“To date, we have no allegations that are on file for forced or coerced sterilization that were found to be reported to the RCMP directly,” Lucki said Tuesday. She said the RCMP takes all criminal allegations very seriously and that the force has reached out to the Canadian Association of Chiefs of Police to raise awareness.

The issue has been the subject of much public scrutiny, particularly in the past two years.

In 2017, the Saskatchewan Health Region issued a public apology after complaints from Indigenous women, and a proposed class-action lawsuit was launched naming as defendants the Saskatoon Health Authority, the provincial and federal governments, and a handful of medical professionals.

Dr. Judith Bartlett, a Metis physician who co-authored the external review, told the committee on Tuesday that Indigenous women interviewed for the report often felt invisible, profiled and powerless.

She also said she does not believe women will come forward to the RCMP because there is “no safety there for them.” Those interviewed for the report were granted anonymity, she said, noting they often felt much better having been able to express the harm done to them.

Much more research is needed to understand the scope of the problem because any time an individual is asked to make a decision when they’re not in the state of mind to weigh pros and cons constitutes coercion, Bartlett said.

Dr. Jennifer Blake, chief executive of the Society of Obstetricians and Gynaecologists of Canada, told MPs that obtaining consent for tubal ligations at the time of delivery should be avoided at all costs. She also noted that when she first learned of allegations a forced sterilizations, she thought it was in reference to a historical issue.

Last Tuesday, lawyer Alisa Lombard, a partner with the firm Semaganis Worme Lombard, told the health committee she represents a client, referred to as D.D.S., was sterilized without proper and informed consent in December 2018 at a Moose Jaw, Sask., hospital

That same month, the United Nations Committee Against Torture urged Canada to act to address the issue of coerced sterilization, setting a one-year deadline to report back on progress.

In response, Health Minister Ginette Petitpas Taylor and Jane Philpott, then Indigenous services minister, sent a letter to provinces and territories proposing a working group of officials to discuss the concerns.

Health Canada said Tuesday the group has had “productive discussions” about the scope and purpose of the federal-provincial-territorial plan to “advance cultural safety and humility in the health system.” As a first step, officials decided Health Canada would take the lead on “an environmental scan of cultural safety initiatives and practices across Canada,” the agency said in a statement.

—Follow @kkirkup on Twitter

Kristy Kirkup, The Canadian Press

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Blair says more gun-control action needed, signals no new steps before election

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OTTAWA — Crime Reduction Minister Bill Blair says more must be done to address gun violence, but he’s also signalling that no new measures will be taken before the fall election.

Steps could — and should — be taken to prevent the theft, illegal diversion and cross-border smuggling of handguns, Blair said Tuesday. 

As he entered a cabinet meeting, Blair emphasized the importance of secure storage of firearms to prevent them from being stolen and ending up in the wrong hands.

The government is also open to working with municipalities to allow them to decide exactly where, or even if, firearms can be stored within their boundaries, he said.

However, the parliamentary sitting is expected to conclude shortly and the government is scrambling to tie up loose ends before the summer recess and an election campaign likely to begin in September.  

“Some of this would require regulatory and legislative change,” Blair said. “And I think it’s important not only to do the right thing, but to take the time to do it right.”

Prime Minister Justin Trudeau asked Blair last August to study the possibility of a ban on handguns and assault-style rifles after a shooting spree in Toronto.

A recently released summary of a federal consultation said Canadians were divided on the idea.

Still, Blair’s office said late last month that no options had been ruled out to clamp down on guns “designed to hunt people” as it weighed new options. Rumours of a federal ban on the popular AR-15 semi-automatic rifle began to circulate.

While Blair reiterated Tuesday there are firearms the government considers “so dangerous that there really is no place in a safe and civil society for them,” he made no firm commitment to ban or buy back such guns from owners.

Blair stressed a need to ensure secure storage, prevent people from buying firearms on behalf of criminals and deter smuggling of weapons into Canada from the United States, which he called “the largest handgun arsenal in the world.”

“There are a number of very effective measures that I believe that we can and must take to create a safer environment.”

Allowing municipalities to enact additional restrictions on handguns would not only be “wholly inadequate,” it would also be inefficient, said Heidi Rathjen, co-ordinator of PolySeSouvient, which wants an overhaul of the gun classification system with the ultimate aim of banning weapons specifically designed to kill people.

“All one has to do is consider the glaring disaster resulting from a patchwork of state and local gun laws south of the border,” she said Tuesday.

“And one has to ask: why would stricter controls on handguns be justified in cities and not in rural areas? It seems more like the Liberals chose not to deal with the highly politicized issue of banning handguns and instead decided to pass the buck to municipalities.”

The law already requires safe storage of firearms, but there has been a “significant increase” in the theft of large numbers of handguns from homes and retailers, with the guns ending up on the street in the wrong hands, Blair said.

He acknowledged there are responsible handgun owners who obey all the rules. “We may ask them to undertake additional measures to secure their weapons to make sure that they’re not vulnerable to being stolen.”

Public Safety Canada says 24 firearms were stolen from a shop in Prince Albert, Sask., by snipping one cable, raising concerns that the after-hours commercial storage regulations could be insufficient.

Some businesses “may not be fully compliant” with existing regulations, say department notes released through the Access to Information Act. However, chief firearms officers “indicate this is infrequent and businesses come into compliance quickly when non-compliance is identified.”

The RCMP says some businesses go beyond minimum requirements through measures including shatterproof glass in display cases, video-monitoring systems and alarms, safes bolted to the floor, deadbolt locks and solid doors instead of hollow ones for storage rooms.

— Follow @JimBronskill on Twitter

Jim Bronskill , The Canadian Press


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