HESA Committee Meeting
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Minutes of Proceedings
The witnesses answered questions.
The committee commenced its clause-by-clause study of the Bill.
Pursuant to Standing Order 75(1), consideration of Clause 1 (short title) and of the Preamble was postponed.
The Chair called Clause 2.
By unanimous consent, Clause 2 was allowed to stand.
On Clause 3,
Stephen Ellis moved, — That Bill C-64, in Clause 3, be amended by replacing lines 1 to 3 on page 3 with the following:“3 The purpose of this Act is to create a funding framework for certain prescription drugs and related products intended for contraception or the treatment of diabetes, and to support”
After debate, the question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
“provinces, territories, Indigenous peoples, Indigenous governing bodies and other part‐”
By unanimous consent, the amendment was withdrawn.
“drugs and related products intended for contraception or the treatment of diabetes, and to provide for the continuation of the national bulk purchasing strategy.”
After debate, the question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
At 6:45 p.m., the sitting was suspended.
At 6:45 p.m., the sitting resumed.
Clause 3 carried on division.
On Clause 4,
Laila Goodridge moved, — That Bill C-64, in Clause 4, be amended by replacing line 20 on page 3 with the following:“that is more consistent across Canada, in order to avoid a patchwork of care;”
After debate, the question was put on the amendment of Laila Goodridge and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
“ans while respecting the autonomy of Canada's highly trained health care practitioners; and”
After debate, the question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
“(d) make progress on providing universal coverage of pharmaceutical”
At 8:30 p.m., pursuant to the order of reference of Wednesday, May 22, 2024, the Chair interrupted the debate; all remaining amendments submitted to the committee were deemed moved and the Chair put the question, forthwith and successively without further debate on all remaining clauses, amendments submitted to the committee as well as each and every question necessary to dispose of the clause-by-clause consideration of the bill.
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
“products across Canada, without limiting Canadians' ability to choose private health care insurance.”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Maxime Blanchette-Joncas, Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 5;
NAYS: Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 6.
Clause 4 carried on division.
On Clause 5,
Stephen Ellis moved, — That Bill C-64, in Clause 5, be amended by replacing lines 35 and 36 on page 3 with the following:“ability of pharmaceutical products. The funding for provinces and territo‐”
The question was put on the amendment of Stephen Ellis and it was negatived, by a show of hands: YEAS: 0; NAYS: 6.
“ries must be provided through agreements with”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
Clause 5 carried on division.
On New Clause 5.1,
Stephen Ellis moved, — That Bill C-64 be amended by adding after line 38 on page 3 the following new clause:
“5.1 (1) The Minister must, within 15 days from the day on which this Act receives royal assent, initiate consultations with each province and territory regarding pharmacare funding agreements.
(2) Any funding agreement must include a provision that annually adjusts the funding provided at a rate equal to the average annual growth of nominal gross domestic product during the most recent three calendar years but no less than 3%.”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
On Clause 6,
Stephen Ellis moved, — That Bill C-64, in Clause 6, be amended by replacing line 1 on page 4 with the following:“6 (1) The Minister must, if the Minister has entered into”
“payments to the province or territory in order to provide, to Canadians without access to any other prescription drug coverage plan, public pharmacare coverage for or to increase any existing public pharmacare coverage for and to provide universal, single-payer, first-dollar coverage for”
The Chair ruled the proposed amendment inadmissible because it infringed on the financial initiative of the Crown, as provided on page 772 of House of Commons Procedure and Practice, Third Edition.
(a) by replacing lines 8 to 10 on page 4 with the following:
“(2) The Minister must, if a province or territory chooses not to enter into an agreement with the Minister, undertake to negotiate with that province or territory whether or not it is entitled to compensation from the Government of Canada for its existing public pharmacare.
(2.1) The following factors are to be considered in the negotiations:
(a) the scope of prescription drugs and related products covered by the provincial or territorial pharmacare;
(b) the cost-effectiveness of the provincial or territorial pharmacare; and
(c) any other reasonable criteria that are recommended by the Canadian Drug Agency.”
(b) by replacing line 11 on page 4 with the following:
“(3) Any amount payable under subsection (1) or (2) may be”
The Chair ruled the proposed amendment inadmissible because it infringed on the financial initiative of the Crown, as provided on page 772 of House of Commons Procedure and Practice, Third Edition.
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Maxime Blanchette-Joncas, Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 5;
NAYS: Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 6.
“(4) Despite subsections (1) and (2), a province or territory may elect not to participate in national universal pharmacare, in which case that province or territory remains unconditionally entitled to receive payments in order to maintain the accessibility and affordability of the prescription drugs and related products already covered by its public pharmacare.”
The Chair ruled the proposed amendment inadmissible because it infringed on the financial initiative of the Crown, as provided on page 772 of House of Commons Procedure and Practice, Third Edition.
Whereupon, Maxime Blanchette-Joncas appealed the decision of the Chair.
The question: "Shall the decision of the Chair be sustained?" was put and the decision was sustained on the following recorded division:
YEAS: Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 6;
NAYS: Maxime Blanchette-Joncas, Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 5.
Clause 6, as amended, carried on division.
On Clause 7,
Peter Julian moved, — That Bill C-64, in Clause 7, be amended by replacing line 15 on page 4 with the following:“7 The Minister must seek advice from the Canadian Drug”
The question was put on the amendment of Peter Julian and it was agreed to.
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Maxime Blanchette-Joncas, Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 5;
NAYS: Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 6.
Clause 7, as amended, carried on division.
On Clause 8,
Stephen Ellis moved, — That Bill C-64, in Clause 8, be amended by replacing line 5 on page 5 with the following:“sential prescription drugs and related products intended for contraception or the treatment of diabetes to inform”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
“tion (1) has been prepared, initiate meaningful consultations based on the list with the pan-Canadian Pharmaceutical Alliance, provinces, territories, Indigenous peoples, Indigenous governing bodies and other partners and stakeholders with the aim of refining the list of essential prescription drugs and related products to inform the development of a national formulary.”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
“the list with provinces, territories, Indigenous peoples, Indigenous governing bodies”
By unanimous consent, the amendment was withdrawn.
“(3) The Minister must request that the Canadian Drug Agency prepare, no later than the second anniversary of the day on which this Act receives royal assent and no later than every year following that anniversary, a revised list of essential prescription drugs and related products to inform the update of the national formulary in order to ensure that it includes all the prescription drugs and related products to which Canadians should have access under national universal pharmacare to meet their medical needs.”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
Clause 8 carried on division.
On Clause 9,
Stephen Ellis moved, — That Bill C-64, in Clause 9, be amended by replacing line 18 on page 5 with the following:“Agency develop, in collaboration with the pan-Canadian Pharmaceutical Alliance, the representatives of the provincial and territorial governments responsible for health and other”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Maxime Blanchette-Joncas, Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 5;
NAYS: Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 6.
“(2) The Minister must request that the Canadian Drug Agency prepare, no later than the first anniversary of the day on which the national bulk purchasing strategy is developed and no later than every year following that anniversary, a report containing a list of the prescription drugs and related products, and their prices, that were the subject of negotiations based on the national bulk purchasing strategy.
(3) The Minister must publish the report referred to in subsection (2) on the website of the Department of Health.”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Maxime Blanchette-Joncas, Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 5;
NAYS: Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 6.
Clause 9 carried on division.
On Clause 10,
Stephen Ellis moved, — That Bill C-64, in Clause 10, be amended by replacing line 29 on page 5 with the following:“(2) The Minister must, after discussions with the”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
Clause 10 carried on division.
On New Clause 10.1,
Stephen Ellis moved, — That Bill C-64 be amended by adding after line 34 on page 5 the following new clause:
“10.1 (1) The Minister must engage in meaningful consultations with Indigenous peoples and Indigenous governing bodies regarding the implementation and management of national universal pharmacare and any modification to it.
(2) The Minister must, no later than the first anniversary of the day on which this Act receives royal assent and no later than every two years following that anniversary, prepare a report that includes the number of consultations that were held, the Indigenous peoples and Indigenous governing bodies that were consulted and a list of the requests and suggestions that those Indigenous peoples and Indigenous governing bodies made to the Minister.
(3) The Minister must cause the report to be tabled in each House of Parliament on any of the first 15 days on which that House is sitting after the report is completed and publish it on the website of the Department of Health within 10 days after the day on which it is tabled in a House of Parliament.”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Maxime Blanchette-Joncas, Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 5;
NAYS: Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 6.
On Clause 11,
Stephen Ellis moved, — That Bill C-64, in Clause 11, be amended by replacing lines 1 to 3 on page 6 with the following:“11 (1) The Minister must, no later than 60 days after the day on which this Act receives royal assent, establish a committee of experts of up to 20 people, among whom must be one representative responsible for health from each provincial and territorial government, and provide for its membership, to”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
“(3) The Minister must cause a copy of the report to be tabled in each House of Parliament on any of the first 20 days on which that House is sitting after the day on which the Minister receives the report.”
The question was put on the amendment of Peter Julian and it was agreed to.
Clause 11, as amended, carried on division.
On New Clause 12,
Stephen Ellis moved, — That Bill C-64 be amended by adding after line 10 on page 6 the following new clause:
“12 (1) The Minister must, no later than the second anniversary of the day on which this Act receives royal assent and no later than every two years following that anniversary, undertake a review of the provisions and operation of this Act for the purposes of assessing the effectiveness of the Act, the costs of national universal pharmacare and the overall benefits to Canadians.
(2) Within 180 days after the review is undertaken, the Minister must cause a report on the review to be tabled in each House of Parliament.”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
On Clause 2,
Stephen Ellis moved, — That Bill C-64, in Clause 2, be amended by adding after line 23 on page 2 the following:“first-dollar, in respect of pharmacare coverage, describes coverage that begins with the first dollar charged and does not require an individual to pay a deductible or any out-of-pocket expenses. (au premier dollar)”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Maxime Blanchette-Joncas, Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 5;
NAYS: Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 6.
“Indigenous governing body means a council, government or other entity that is authorized to act on behalf of an Indigenous group, community or people that holds rights recognized and affirmed by section 35 of the Constitution Act, 1982. (corps dirigeant autochtone)”
By unanimous consent, the amendment was withdrawn.
“national bulk purchasing strategy means a system of procurement implemented by the Minister and the pan-Canadian Pharmaceutical Alliance whose objective is to obtain a uniform price schedule from Canadian pharmaceutical companies for the purchase of prescription drugs and related products in the national formulary. (stratégie nationale d'achat en gros)”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
“national bulk purchasing strategy means a strategy developed by the Canadian Drug Agency to inform the Government of Canada's procurement of prescription drugs and related products in large quantities at a lower price per unit. (stratégie nationale d'achat en gros)”
By unanimous consent, the amendment was withdrawn.
“single-payer, in respect of pharmacare, means funded solely by the Government of Canada. (à payeur unique)”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
“universal, in respect of pharmacare, means providing uniform coverage to all residents of all provinces and territories, including Indigenous peoples. (universel)”
The question was put on the amendment of Stephen Ellis and it was negatived on the following recorded division:
YEAS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4;
NAYS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7.
Clause 2 carried on division.
On Preamble,
Stephen Ellis moved, — That Bill C-64, in the preamble, be amended by replacing lines 15 and 16 on page 1 with the following:“role of the provinces, territories, Indigenous peoples and Indigenous governing bodies in the provision of health care, including cover‐”
By unanimous consent, the amendment was withdrawn.
“ries, Indigenous peoples, Indigenous governing bodies and other partners and”
By unanimous consent, the amendment was withdrawn.
“by the Canada Health Act;”
The Chair ruled the proposed amendment inadmissible because it sought to amend the preamble of the Bill that, as provided on page 774 of House of Commons Procedure and Practice, Third Edition, may only be amended if necessitated by other amendments made to the Bill.
The Chair ruled the proposed amendment inadmissible because it sought to amend the preamble of the Bill that, as provided on page 774 of House of Commons Procedure and Practice, Third Edition, may only be amended if necessitated by other amendments made to the Bill.
The Chair ruled the proposed amendment inadmissible because it sought to amend the preamble of the Bill that, as provided on page 774 of House of Commons Procedure and Practice, Third Edition, may only be amended if necessitated by other amendments made to the Bill.
“And whereas the Government of Canada is committed to addressing the issue of transparency of drug prices and drug price negotiations;”
The Chair ruled the proposed amendment inadmissible because it sought to amend the preamble of the Bill that, as provided on page 774 of House of Commons Procedure and Practice, Third Edition, may only be amended if necessitated by other amendments made to the Bill.
The Preamble carried on division.
On Clause 1, Short Title,
Stephen Ellis moved, — That Bill C-64, in the short title, be amended by replacing line 22 on page 2 with the following:“1 This Act may be cited as the Funding Framework for Contraceptives and Diabetes Medication Act.”
The Chair ruled the proposed amendment inadmissible because it sought to amend the short title of the Bill that, as provided on page 775 of House of Commons Procedure and Practice, Third Edition, may only be amended if necessitated by other amendments made to the Bill.
“The Minister may, if the Minister has entered into an agreement with a province or territory to do so, make payments to the province or territory in order — to enhance any existing pharmacare coverage. This may include a combination of public and private payer systems to ensure broader access to specific prescription drugs and related products intended for contraception or the treatment of diabetes.”
The Chair ruled the proposed amendment inadmissible because it was moved at the wrong place in the Bill, as provided on page 772 of House of Commons Procedure and Practice, Third Edition.
Clause 1, Short Title, carried on division.
On Title,
Stephen Ellis moved, — That Bill C-64 be amended by replacing the long title on page 1 with the following:“An Act respecting a funding framework for contraceptives and diabetes medication”
The Chair ruled the proposed amendment inadmissible because it sought to amend the title of the Bill that, as provided on page 775 of House of Commons Procedure and Practice, Third Edition, may only be amended if necessitated by other amendments made to the Bill.
Whereupon, Stephen Ellis appealed the decision of the Chair.
The question: "Shall the decision of the Chair be sustained?" was put and the decision was sustained on the following recorded division:
YEAS: Maxime Blanchette-Joncas, Brendan Hanley, Peter Julian, Arielle Kayabaga, Yasir Naqvi, Marcus Powlowski, Sonia Sidhu — 7;
NAYS: Todd Doherty, Stephen Ellis, Laila Goodridge, Robert Kitchen — 4.
The Title carried on division.
The Bill, as amended, was adopted on division.
ORDERED, — That the Chair report the Bill, as amended, to the House on division.
ORDERED, — That Bill C-64, as amended, be reprinted for the use of the House of Commons at report stage, on division.
At 9:13 p.m., the committee adjourned to the call of the Chair.