Bill C-64

Pharmacare Act

An Act respecting pharmacare

This enactment sets out the principles that the Minister of Health is to consider when working towards the implementation of national universal pharmacare and obliges the Minister to make payments, in certain circumstances, in relation to the coverage of certain prescription drugs and related products. It also sets out certain powers and obligations of the Minister — including in relation to the preparation of a list to inform the development of a national formulary and in relation to the development of a national bulk purchasing strategy — and requires the Minister to publish a pan-Canadian strategy regarding the appropriate use of prescription drugs and related products. Finally, it provides for the establishment of a committee of experts to make certain recommendations.

Department of Health—Main Estimates, 2024-25

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Chair, to the Minister of Health, would Bill C-64 provide for government-funded heart medications?

[Chris Bittle, Liberal, Parliamentary Secretary to the Minister of Housing]

Mr. Speaker, I will be speaking for a bit before I direct some questions to the ministers.

No Canadian should have to choose between paying for prescription drugs or putting food on the table. Unfortunately, many are still forced to make this impossible decision. It is why our government continues to work with provinces, territories and stakeholders to ensure that Canadians have better access to the drugs they need. Today, I will be providing an overview of some of the work by first highlighting our latest announcement, which presents a significant step forward towards national pharmacare.

On February 29, the Minister of Health introduced Bill C-64, an act respecting pharmacare, which proposes the foundational principles of the first phase of a national universal pharmacare plan in Canada. Bill C-64 describes our government's work with provinces and territories to provide universal single-payer coverage for a number of contraception and diabetes medications. In parallel to this, our government announced its plans to establish a fund to support Canada's access to supplies that people living with diabetes require to manage and monitor their condition and administer their medication, such as syringes and glucose test strips. These are impactful initiatives that can positively change the lives of millions of Canadians.

For example, coverage for contraceptives will mean that Canadians of reproductive age, which is nearly one-quarter of Canada's population, will have better access to contraception and reproductive autonomy. This access will improve equality, help reduce the risks of unintended pregnancies and improve a woman's ability to plan for the future.

Cost has been identified by Canadian contraceptive care providers as the single most important barrier to access these medications. Bill C-64 would ensure that Canadians will have access to a suite of contraceptive drugs and devices.

Similarly, one in four Canadians with diabetes have reported not following their treatment plan due to cost. Improving access to diabetes medication will help improve the health of almost four million Canadians living with diabetes and reduce the risk of serious life-changing health complications. These complications include permanent effects to the health and well-being of a person with diabetes, such as heart attack, stroke, kidney failure, blindness and amputation.

This bill also demonstrates our government's commitment to consulting widely on the way forward, including the need to work with provinces and territories, indigenous peoples and other partners and stakeholders. It includes four principles that the Minister of Health is to consider when collaborating with partners towards the implementation of national pharmacare. They are accessibility, affordability, appropriate use and universal coverage.

Bill C-64 would also provide that the new Canadian drug agency would work towards the development of a national formulary developing a national bulk purchasing strategy and supporting the publication of a pan-Canadian strategy regarding the appropriate use of prescription medications. It would also require the Minister of Health to establish a committee of experts to help make recommendations on the operation and financing of national, universal single-payer pharmacare in Canada. Together, these elements would inform the next key steps towards a national, universal pharmacare in Canada, building on the work already under way.

The work under way already includes the previously mentioned Canadian drug agency. The creation of the CDA was announced in December 2023 with an investment of over $89 million over five years. Built from the existing Canadian Agency for Drugs and Technologies in Health, and in partnership with provinces and territories, the CDA will provide the dedicated leadership and coordination needed to make Canada's drug system more sustainable and better prepared for the future in helping Canadians achieve better health outcomes. Engagement with provinces, territories, partners and stakeholders will continue to be an important part of the agency's path forward.

In addition, our government launched the first-ever national strategy for drugs for rare diseases, as announced in March 2023. This investment of up to $1.5 billion over three years will help increase access to and the affordability of drugs for rare diseases, with the aim of improving the health and quality of life of people living with rare diseases across the country. As part of this strategy, our government will create bilateral agreements with our provincial and territorial partners to make up $1.4 billion over three years, with a focus on improving access to new emerging drugs that treat rare diseases. We will also support better access to existing drugs and activities directed at improving screening and early diagnosis for rare diseases. The aim of these efforts is to help people living with rare diseases across Canada obtain earlier access to treatments and a chance at a better quality of life.

Our government is now working with provinces and territories on these bilateral agreements, starting with jointly determining a small set of new and emerging drugs that would be cost-shared and covered in a consistent way across the country for the benefit of Canadians living with rare diseases. I am also excited to share with members an update on the excellent progress we are making with the Government of Prince Edward Island to improve access to medication for island residents.

Similar to the work under way for the drugs for rare diseases strategy, our work with P.E.I. will also inform the advancement of national pharmacare. Under the improving affordable access to prescriptions drugs program with P.E.I., those who experience the most vulnerability, including uninsured island residents, seniors, and families with a high burden of medication costs, have seen immediate benefits, including improved access to medication and reduced copays.

Through this partnership, which includes a federal investment of $35 million, P.E.I. has expanded access to over 100 medications to treat a variety of conditions, including heart disease, cancer, and MS. Last June, P.E.I. also reduced copays to $5 for almost 60% of medications regularly used by island residents. Under their seniors' drug program, the family health benefit drug program, the generic drug program and the diabetes drug program, this program has led to island residents saving $2.5 million in out-of-pocket costs so far.

Speaking to our efforts more broadly, we continue to work on regulatory innovation, including agile licensing for drugs to better support drug oversight, both before and after the sale, due to the evolving market. These updated regulations will improve safety, support economic growth, and benefit both Canadians and industry.

In closing, no one should struggle with paying for the prescription drugs they need. Our government will continue to work with provinces, territories and stakeholders on the pharmacare initiatives I have outlined and continue to work with parliamentarians in passing Bill C-64. By working together, we can realize our goal of achieving national pharmacare, which will benefit all Canadians.

My first question is directed to the Minister of Health. Before I was elected to this place, I was the chair of the board of an incredible organization, Quest Community Health Centre. I know, as the Minister of Health knows, that community health centres look to what is missing in communities to fill a void. One of those things in St. Catharines and, of course, across the world, although we can only help in our little corner, was the lack of access to dental care. The staff at Quest, led by Coletta McGrath and Jenny Stranges, was incredible. They were able to build a team of volunteer dentists and hygienists who came in to provide care for those who had not had treatment in decades, who use the emergency room as their dental care. Some would say that they would be a burden on the system, but they were just trying to get pain relief.

I was able to get messages, as the chair, from people who were grateful for having received this service, who could smile again, who could go to job interviews, who could smile with their grandchildren. It is shocking that the Conservatives would deny this to Canadians

I was wondering if the Minister of Health could outline what the government is doing and what the progress of our dental care plan is. I do not need him to respond in the time allotted. I was hoping he could provide an update on the dental care plan.

Request for Office of Speaker to be Vacated—Motion That Debate Be Not Further Adjourned

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Madam Speaker, my comments are definitely relevant because today's debate is derailing all the discussions on Bill C-64, which has just been tabled in the House at report stage.

Does my colleague think that there is a connection between the Conservative Party's and the Bloc Québécois's determination to block this bill and the fact that these two parties always want to debate the topic that we are debating today?

Health

[Sean Casey, Liberal, Charlottetown, PE]

Mr. Speaker, I have the honour to present, in both official languages, the 19th report of the Standing Committee on Health, which is in relation to Bill C-64.

The committee has studied the bill and decided to report the bill back to the House with amendments.

Because of the importance of this legislation and because of the programming motion that referred it to our committee, the level of effort given by the support team from the House of Commons and the Library of Parliament was absolutely commendable. I wish to sincerely thank them for our being able to present the report in such a timely fashion today.

[The Chair, Liberal, Sean Casey]

We'll have a recorded division on CPC-22, please.

(Amendment negatived: nays 6; yeas 5 [See Minutes of Proceedings])

CPC-22 is defeated.

The next amendment is BQ-1.

Bill C-64, An Act respecting pharmacare, authorizes the Minister of Health to make payments to a province or territory if an agreement has been entered into with that province or territory. The amendment provides for payments from the minister to the province or territory, even if no agreement has been entered into. House of Commons Procedure and Practice, third edition, page 772, states, “Since an amendment may not infringe upon the financial initiative of the Crown, it is inadmissible if it imposes a charge on the public treasury, or if it extends the objects or purposes or relaxes the conditions and qualifications specified in the royal recommendation.”

In the opinion of the chair, the amendment seeks to alter the terms and conditions of the royal recommendation and could impose a new charge on the public treasury. Therefore, I rule this amendment inadmissible.

[The Chair, Liberal, Sean Casey]

That brings us to CPC-20.

Bill C-64, an act respecting pharmacare, authorizes the Minister of Health to make payments to a province or territory, if an agreement has been entered into with that province or territory, in order to increase any existing public pharmacare coverage. The amendment seeks to broaden those payments to provide Canadians with public pharmacare coverage, which would have the effect of extending payments to a new group of Canadians not already covered by the royal recommendation.

As House of Commons Procedure and Practice, third edition, states on page 772:

Since an amendment may not infringe upon the financial initiative of the Crown, it is inadmissible if it imposes a charge on the public treasury, or if it extends the objects or purposes or relaxes the conditions and qualifications specified in the royal recommendation.

In the opinion of the chair, the amendment proposes a new scheme, which would impose a charge on the public treasury. I therefore rule this amendment inadmissible.

That brings us to CPC-21. This is going to sound familiar to you.

Bill C-64, an act respecting pharmacare, authorizes the Minister of Health to make payments to a province or territory if an agreement has been entered into with that province or territory. The amendment provides for payments from the minister to the province or territory, even if no agreement has been entered into.

As House of Commons Procedure and Practice, third edition, states on page 772:

Since an amendment may not infringe upon the financial initiative of the Crown, it is inadmissible if it imposes a charge on the public treasury, or if it extends the objects or purposes or relaxes the conditions and qualifications specified in the royal recommendation.

In the opinion of the chair, the amendment seeks to alter the terms and conditions of the royal recommendation and could impose a new charge on the public treasury. Therefore, I rule the amendment inadmissible.

That brings us to CPC-22. Shall CPC-22 carry?

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Thank you, Mr. Chair.

For over five hours we have had to listen to the multiple interventions of filibustering by our NDP colleague there. If you believe our colleague, he has the medication to make everything better. The NDP are the saving grace for our country, apparently. That's what Mr. Julian is saying, which I have to disagree with vehemently.

It's interesting. We're debating CPC-13, and the line is “make progress on providing universal coverage of pharmaceutical”. I believe we're probably the only party that's talking about providing universal coverage of pharmaceuticals, because Bill C-64, as we have talked about tonight, is truly only about providing access to contraception, as well as providing medication for those struggling with or living with diabetes.

It is a common-sense amendment. It's one of 43. Sadly, we only got to CPC-13 because of the interventions and the filibustering of our NDP colleague who, every chance he got, made sure.... He could not put any amendments forth to try to make this bill any better, which is deeply disappointing. I know him to be a decent man, but he sure likes to hear himself talk. I hope Canadians were paying attention to that.

There's no doubt that he will probably try to get a little bit of extra time in after I cede the floor, Mr. Chair. I'm imploring you to please.... We've had enough of his interventions. For over five hours we have had to listen to him. It's deeply disappointing, because we could have got to more of the CPC amendments. There are over 43.

I want it on the record that Conservatives rolled up their sleeves and got to work on this, while our NDP and Liberal colleagues said that they were not going to do it. All we have heard is rhetoric from our colleague down the way, who has tried to block any of the common-sense amendments that the CPC put forth in good faith.

They told Canadians in the House during debate just to trust them and they would get this bill: “Let's let Conservatives and the House pass this bill to get it to committee and we will do good work.”

Well, there was one party that came to work tonight—

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

With pleasure, Mr. Chair.

Here, once again, what we see is the original clause stating, “provide universal coverage of pharmaceutical products across Canada”. It's an aspirational goal; it's just not the truth. I think we've heard this resounding over and over and over again, and the reasoned argument that we have presented is that in Bill C-64, clause 4 will be amended by replacing line 30 on page 3 with the following “(d) make progress on providing universal coverage of pharmaceutical” products across Canada.

You know, Chair, I think it important again that this is about having Canadians understand that transparency and sunny ways are something that, at the current time, very sadly for Canadians, do not exist with this NDP-Liberal coalition government. What we are seeing is a lack of transparency.

They are spending money at the risk of insulting drunken sailors. To say that they are spending money “on behalf of Canadians” is in line with the problems that they have already created. We've heard the number of people who are living in food insecurity because of the spending of this NDP-Liberal costly coalition. Then what do they say? The statistic is that 26% of Canadians are going without food. Those are mostly parents who are going without food so that their children can eat. They're skipping meals, going to food banks, etc. They have food insecurity so that their children can eat.

What do we see now? We see that the government that created this problem is going to swoop in and save Canadian children by creating a national school food program. Well, let's be honest. If they hadn't created the problem in the first place, such that Canadians couldn't afford to feed themselves, they wouldn't have to create a national school food program.

This is like if I have a prosthetic business and I remove one of Mr. Doherty's legs, and then I sell him a prosthesis. It's not a funny analogy. It's something that's shared between Mr. Doherty and me. I apologize for being rather graphic, but it just makes no sense. It's like I rammed into his car when I have a car business, and I sell him a new one. I mean, I am creating a problem for him and then selling him the solution. Canadians who are no longer ready to be fleeced by the costly coalition know what lies at the heart of the spending addiction that this government has.

The cost of mortgages has doubled. The cost of rent has doubled. The number of homeless encampments is beyond imagination.

You know, it's always interesting to be in the House of Commons and listen to question period without answer. Folks ask, “Well, back when Pierre Poilievre was the minister of housing, how many houses did he build?” He didn't have to build houses, because there wasn't a housing crisis. The federal government didn't have to step in or didn't have to try to step in, as they have tried to do now, and they have failed miserably by building fewer houses and spending more money. The economy of the country worked in the way that it was imagined to work, such that people who are house builders were building houses. Permits were granted by municipal governments, and Canadians had money in their pockets that allowed them to afford to pay their mortgage. Interest rates were not out of control, while now they are rising the most rapidly that they have in the last 40 years.

In the economic situation that has been created by this costly coalition, they have the audacity to say that they will step in and solve your problem, even though it's a problem that they have created.

You can't afford your medications. What we heard some of the testimony talking about was that Canadians are choosing between eating and paying for their medications. Well, if the cost of food wasn't so high, then they could pay for their medications. If the leader of the NDP's brother were not a lobbyist for Metro, then maybe the cost of food would be less.

If we didn't have a carbon tax, the dreaded tax on everything.... I know that Canadians have heard this before, but it bears repeating. If you tax the farmer who grows the food and the trucker who ships the food, then the people, like all of us who buy the food, are going to have to pay more.

As we see that cascading effect, then we know that is where the problem lies. It's the spending addiction. It's the $10-a-day day care program, again, that can't be delivered. We know there are not spots out there for Canadian working families in which both people have to work because of the costly coalition and the cost of everything. They are unable to find a day care spot for $10 a day.

Again, they have the.... I can't even explain it. They have the anti-Midas touch. It's not that things turn to gold; it's that things turn to something else in a very different colour when they touch them, which again doesn't allow people to have appropriate access to the things they need in this country.

Allowing the costly coalition to create another costly program for two medications, two conditions, in this country would be a significant jeopardy. To go on and again suggest that this is more than what it is, which is what line 30 is suggesting with “providing universal coverage of pharmaceutical” products.... This is not doing any such thing.

I know that every other time we have brought this up, pointing out that all of the testimony was directed exactly towards contraceptive pills and devices and diabetic medications and devices, this costly coalition today has voted it down, because they do not want Canadians to know that what they are attempting to create here is very limited in scope and does not fulfill the needs of all Canadians.

Further to that—I'll say it again—this does not mean that Conservatives are against medications or against contraceptives or against the good health of Canadians. That is not what this means. What it means is that the way they are going about it, without transparency, without accountability and with the background of spending money foolishly on things like consultants.... We're seeing hundreds of millions of dollars being spent there that could be spent elsewhere. I clearly outlined previously the money that was wasted on the Medicago fiasco—half a billion dollars—and now we have the Novavax fiasco at another $130 million, with a recurring cost of $17 million to Canadians without anything at all to show for it—nothing.

It's not their money they're spending. It's our money. This is our money. What we're asking for is accountability and transparency, and we're telling the truth and pointing out that what is happening is not the way they're portraying it. This is about contraceptives and diabetes medications. That's what this is about. This is not a universal pharmacare program in which it doesn't matter where you go. You probably won't even have to show a card, if everything's free. You just have to have your prescription—boom, everything is free.

Nothing is free. There's no such thing as a free lunch. This is coming out of the pockets of every Canadian. With the amount of debt and the debt servicing costs that are happening now in this country, the debt servicing costs are more than $1 billion, with a “b”, every single week—every week—which, sadly, we know is more than the Canada health transfer. It is more than that because this Prime Minister of the costly coalition believed that interest rates would never go up. Of course, there's the infamous quote that budgets balance themselves.

We know that this costly coalition continues to have an ongoing deficit spending position, which was never the expectation of any government in the history of the free world. That's not their expectation.

Folks out there listening, think of it from your own perspective: If you're making $500 per week and you're spending $600 per week every single week, then it becomes very difficult—

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Thank you, Mr. Chair.

It's nice to have the floor after having to sit for almost four hours, listening to our NDP colleague filibuster every one of the CPC amendments. He likes to point fingers, and say the CPC are filibustering, but in reality we're the only party that put forth any amendments to this bill.

I will challenge Canadians that whenever a bill comes forward, it is the opposition's job to review pieces of legislation. As the government always says, “Let's not let perfection get in the way of progress.” It says, “Just trust us. Let's get it to committee, and we will work with all parties to make this bill better.”

The Conservatives rolled up their sleeves. If Canadians have been listening in for the last four hours, they will see that we have put forth some common-sense amendments, non-partisan amendments, that would make this bill clearer and more concise and would tell Canadians all about Bill C-64.

Unfortunately, after every discussion regarding the CPC amendments, our colleague from the NDP wants to filibuster. He goes on and on and on, and blames filibustering for four hours on Conservatives. I would assume... Well, pardon me; I won't say “assume”. You never want to assume anything. However, I would bet, Mr. Chair, that our colleague from the NDP will probably raise his hand and want to filibuster my intervention for the remaining minutes of this committee meeting.

What's sad is that the NDP had an opportunity, with its coalition, to really make something that would be beneficial for so many Canadians. Instead, it bowed down to its Liberal colleagues in the coalition. It's desperate to try and keep the Prime Minister in power, instead of fighting for Canadians and a true pharmacare program.

Mr. Julian spoke about his constituent who had cardiac issues. I spoke about my former constituents who succumbed to a terrible disease, ALS. There are millions of Canadians struggling because of the lack of access to a pharmacare program or affordable drugs. The NDP did not fight for a true pharmacare program; it settled on contraception and diabetes. Ultimately, we are left with a two-bill drug that really doesn't include any other Canadians who—

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Let's be very clear: The reason our colleague from the NDP is voting no is because he's been told by his coalition that this is the way they want it. This is the way that he is to vote with respect to any CPC amendment. It's the same old, same old that we hear time and again when it comes to legislation that we've been told time and again in the House...

The government tells you, “Just let it get to committee, and we'll work in good faith. Amendments will be taken in, and we'll work with great collaboration with all parties to get this bill right.” Look where we are today with a piece of legislation that really isn't... It's being called pharmacare. It really isn't pharmacare.

This is the line that we're talking about, so that Canadians are fully aware of what we're talking about here. It is page 3, subclause 4(a), and the last sentence reads “in a manner that is more consistent across Canada.” What is being proposed is “that is more consistent across Canada, in order to avoid a patchwork of care”.

The whole argument that we hear from our colleagues down the way is that there are millions of Canadians who do not have... There are some who do have care. They have programs and access to medications. There are some Canadians who don't. For me, that would be a patchwork of care that we're experiencing and that Canadians are experiencing. If you want to believe what our colleagues are saying, the government is trying... Bill C-64 is all about making sure we're eliminating the patchwork of care. Why not put that in the bill? It's no different from what we said earlier on.

We talk about the heart medication. We have cardiac patients and constituents who have cardiac issues. Our colleague from the NDP has brought up a number of times that his constituent faces $1,000 per month because of the patchwork of care that we have in our country, yet he still didn't negotiate, when he was sitting at the table with his coalition partners, to have cardiac medication in here.

There is another rare disease that was not mentioned here. I don't believe it was mentioned in any of the testimony either. It's ALS, and thousands of Canadians are afflicted with this horrible disease. I remember one of my constituents who was struck down at the age of 28. He was a soldier with our Canadian Armed Forces. “The best of the best”, his commanding officer said. At the age of 28, with his future right in his hands, Deane Gorsline was struck down with ALS. He lived the remainder of his life much like my former employee, Brett Wilson, who passed away last August, nine months after his dad Rick passed away from ALS as well.

After their diagnosis, both Rick Wilson and Deane Gorsline lived the remainder of their days fighting for Canadians who were struck with ALS. They were better people than I am. They turned their attention to ensuring that the next Canadians who would be diagnosed with ALS had access to those drugs that could prolong their lives, in the hope that they could walk back the impacts of that terrible disease.

We don't have a rare disease strategy in this country. When we talk about this national pharmacare plan, that's what our colleagues suggest Bill C-64is, and it does none of this. It doesn't provide greater access for those Canadians who are struggling with rare diseases such as ALS.

I think about that when we're talking about this bill. Due to the size of our country, and in some cases the comparatively small population of Canadians who are afflicted with certain diseases, Canadians struggle to have access. Pharmaceutical companies will not look at Canada in a favourable way to provide access for the small groups of Canadians who are afflicted with such illnesses as ALS. They are forced to lobby and forced to do whatever they can, even though their days are limited before this terrible disease takes over.

It is absolutely horrific to see and watch. I think about cancer patients within our country for whom this bill does nothing in terms of access to more medications and treatments. If it was a true pharmacare bill, we should have noted that. Maybe it would have been brought up. It's disappointing. This CPC-11 is a non-partisan amendment that simply clarifies, or adds to the line, and again, I'll read it out. After “in a manner that is more consistent across Canada”, it simply adds, “in order to avoid a patchwork of care”, which is exactly what we're talking about.

Mr. Julian's got his hand up, so he'll continue his NDP filibuster in the next little bit here, and he'll go on and on about how Conservatives are ragging the puck and filibustering this bill, but at every chance, he's on that speakers list, Mr. Chair, speaking as much as Conservatives members.

With that, Mr. Chair, I will cede the floor so that we can get to the vote on CPC-11, unless Mr. Julian wants to continue his filibuster.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Thank you, Mr. Chair.

I'll note that the Conservatives have allowed one amendment to be voted on in three hours. Thousands and thousands of dollars of committee time have been devoted to this study, and the Conservatives' filibuster blocking this legislation, as they have been blocking it since February 29, has meant that Canadian taxpayers, folks who are working hard trying to make ends meet, have seen thousands of their tax dollars going into a filibuster to block legislation that is going to help people.

I want to address the national bulk purchasing strategy, because it is true that Canadians pay more, and they pay more because of Conservative government decisions to extend patent protection. It was a beautiful sweetheart deal by a former Conservative government that extended patent protection so that Canadians pay unbelievably high drug prices. It was Conservatives who caused that, and instead of saying, “Gee, we're sorry, Canada. We apologize for everything we've done to wreck your access to medication”, we have Conservatives filibustering the next step, which is having a national bulk purchasing strategy that, through universal single-payer pharmacare, would allow us to bring the cost of those drugs down.

When New Zealand did the same thing, Mr. Chair—and I know you're aware of that—the cost of some drugs went down by 90%. Not only does this bill, Bill C-64, enhance Canadians' ability to access medication—diabetes medication and contraceptive medication and devices—but by putting in place a national bulk purchasing strategy, it also allows us to start what other countries have already found, which is, rather than paying massive prices and extending patent protection to the pharmaceutical industry with the huge costs that has entailed—it's made huge profits, and lobbyists are happy—having a national drug purchasing policy that will allow us to follow the lead of countries like New Zealand that have reduced the cost by 90%.

What this Conservative amendment, CPC-9, proposes to do is stop that, freeze it in place and not allow the bill to move further so that we can have in place a national drug purchasing strategy that goes beyond diabetes and contraceptives. I oppose this.

It's been three hours. Conservatives have allowed one amendment to come to a vote. I wish they would stop doing this, as it's not in the interest of their constituents or of any Canadians for them to continue as they have since February 29 in blocking this legislation.

[Daniel MacDonald]

The pan-Canadian Pharmaceutical Alliance acts on behalf of all of its members, all provinces and territories in Canada, and, in doing, so coordinates the purchase for their public drug plans, and, indeed, some federal drug plans are a part of that as well. It has the ability to conduct those price negotiations.

Bill C-64 authorizes the minister to seek advice from Canada's drug agency in its position as having expertise in the field to guide the development of advice to support that future conversation among decision-makers about how there might be improvements that could be realized. It doesn't commit that they would be adopted. It merely supports the development of advice to support a conversation.

[Daniel MacDonald]

There are two parts there. First, this does not create a new role for Canada's drug agency in the realm of price negotiations. I want to be very clear about that.

The bill sets up a future conversation about the future of pharmacare. Now, as part of that, the bill sets out that the minister may request advice from Canada's drug agency on two elements to develop expert advice to support that conversation.

One of those two pieces is to guide the development of advice on where Canada might go in terms of realizing improvements in its price negotiation strategy today. The reason for that is that previous advice by expert panels—I'm referring specifically to Hoskins—on how pharmacare might work have always pointed to the savings that would be realized from coordinated, negotiated drug acquisition. That's the element that Bill C-64 refers to: the development of the advice or further understanding about how and where that might work. It is not intended to be a reference to the existing activities of the pan-Canadian Pharmaceutical Alliance at all.

[Daniel MacDonald]

Not at all. What the national bulk purchasing section of Bill C-64 refers to is—I'm just seeking a term here—more improvements in the existing price negotiation steps that are taken in the pharmaceutical management system in Canada today: Where might improvements be sought? How might that be affected?

It's intended to be an expert-guided conversation, and Canada's drug agency is suited to guide that conversation, but it is not intended to be in any way a replacement for the pCPA. I just want to be clear about that.

[Daniel MacDonald]

That sounds better.

No, that is not at all what I was suggesting. I was simply stating two parts of the response to the question.

The first is the existing coordination of price negotiation that provinces and territories have set up through the existing pan-Canadian Pharmaceutical Alliance, and I was simply distinguishing that from the advice the minister, under Bill C-64, would be seeking from Canada's drug agency to suggest a future development or a move forward. My remark was not intended in any way to suggest there would be a replacement of existing activities; it was just about supporting the discussion among provinces, territories, indigenous peoples and other partners and stakeholders about where to go next and what improvements might be made.