Tuesday, August 26, 2008

Transcript of questions from Clement at Canadian Medical Association meeting.

This is the transcript from the floor of the Canadian Medical Association meeting where Clement gave his uneducated & misinformed views of harm reduction, smoking cessation, palliative care and strangely, pot luck dinners.

My thanks to my source, here's his: Excerpts from the official transcripts that HC prepares... thanks, mystery person!

Question: Thank you, Minister. Albert Schumacher from Windsor. Just to correct your example in smoking reduction, Minister, we do ask our patients to smoke less on the road to quitting. We ask them not to smoke in their home, around their family. We ask them not to smoke in their cars with their children. This is sometimes a very long process in getting them smoke-free. Any legislation that the government puts forward as far as smoke-free public places obviously assists us so in smoking, harm reduction is indeed a long cycle and it does take many efforts to get there. So I would hate for you to use that example again. (Applause.)

Hon. Tony Clement: Well, thank you. Thank you, Dr. Schumacher. I think my point though was we don’t -- we don’t try to convince people to stay on cigarettes but have less -- fewer cigarettes. Ultimately the goal is the same: to be smoke-free. And that should be our goal when it comes to injection drug use as well. That’s my point.---Question: Grant Friesen from Alberta. Mr. Minister, I’m a public health physician. I am disappointed by your comments related to harm reduction. I would want to emphasize that harm reduction is a continuum and there are certainly elements of harm reduction that are very important in terms of to clinical practice, not only in public health but across all areas of medicine.

Question: Thank you very much. I’m Bonnie Cham. I’m a physician from Winnipeg and I’m chair of the CMA Ethics Committee. I rise not to ask a question but to respond to your emphasis on ethics in your discussion on harm reduction.I found the use of medical ethics to justify a political decision which will affect social policy to be troubling at best and misleading at worst. Ethics consists of a balancing of rights and harms as do all medical decisions that physicians in this room help their patients reach every day.

IV drug users, as the rest of us, have the right to compassion and to access and care which is proven to be beneficial and those physicians who are affiliated with this type of care need to balance the harm of ongoing IV drug use versus ongoing exposure to non-supervised injection.By all means, consider all the issues and facts but please don’t use medical ethics. Supporting harm reduction programs is not a breach of the CMA’s Code of Ethics and medical ethics should not be misused in this way to support and justify a political decision. (Applause.)

Hon. Tony Clement: There’s no question there. I don’t believe there was a question there so the debate continues.

Question: Chris Mackie, new physician working in public health in southern Ontario. And my question is around the way government works. And I’ve been fascinated with the federal government and how decisions are made and I’m wondering

Hon. Tony Clement: You’ve got to get a new hobby, but anyway. (Laughter.)

Question continues : in terms of policy like around Insite, it seems to me that the evidence is clear that Insite has medical benefits for the patients as well as benefits for the community. And I’m thinking both of the primary articles published, reviews done by your government and I’m wondering what would it take for your government to change its position on Insite? If the Kirby Commission, for example, concluded that Insite was of benefit, would your position change?

Hon. Tony Clement: Well, certainly I’m always open to new research and to new insights into Insite, if I can use that term. I did -- I would be happy to send you a copy of my remarks where I go over the Expert Advisory Panel’s review of the research and some other comments that have been perhaps marginalised by some but I think are valid comments about methodology. So I’ll leave it at that because I’ve already mentioned that in my remarks but we’d be happy to share those with you.

Question: Thank you, Madam Chair. Minister, I’m Lloyd Opal. I’m a physician in Vancouver. I’d like to ask you a question about enforcing standards of truth in advertising for health products. As you know, Bill C-51 is now before us and contains important elements that protect consumers against false or misleading health claims and I hope you know, Minister, that when you’re standing up for reducing misleading advertising, you’re certainly among friends here at the CMA. This bill contains an element that does protect against advertising, selling, producing products that are less than forthcoming and honest about their benefits. This I know has provoked a furious reaction directed towards your department

Hon. Tony Clement: And me.

Question continues: --- from the natural health products industry. Oh, not you.

Hon. Tony Clement: No, a few.

Question continues: And, frankly, you know I think you’ve been very courageous in holding the line. I hope that you can assure us, Minister, that there will be no compromise on the consumer protections afforded in this bill and that you will act to continue to enforce and strengthen consumer protection against health fraud and false health claims.

Hon. Tony Clement: Thank you for your comments. It’s been a tough file because of the false and misleading attacks on the bill and me personally and so on so it has been a difficult file. But Bill C-51 had as its genesis the fact that Canadians need modern legislation to protect them on a whole range of issues and when I started to look at that legislation, to my horror, I found that the legislation really hadn’t changed very much in 50 years and that we really were driving a jalopy while other countries, our major trading partners — USA, countries in Europe — are, you know, in the latest version of the BMW but we’re still in our jalopy. And so that had to change to protect Canadians properly. Imported products, domestically treated products, you name it, all across the range, vaccines, pharmaceutical drugs, for the first time I’m proposing a mandatory adverse drug reaction registry so that we all know simultaneously across the country if a prescription drug that had hitherto been approved by Health Canada actually is having an impact that we should be aware of. These are all important things that -- we’re going to be tracking food from the farm to the fork, as I say. And these are all important things in terms of the public safety.

On natural health products, you’re absolutely right, there isn’t a week that goes by that I do not issue warnings about a certain natural health product, this is or that that is either mislabeled or has deleterious harmful health impacts and all I can do is warn. I have no power to recall right now — none, zero. I cannot recall a single -- I cannot recall a single drug and I cannot recall a single natural health product. That’s got to change. And certainly we are looking at some amendments because some people are taking advantage of the fact that you have to read that bill in conjunction with several other bills, several other acts in order to get the whole framework and we want to try to fix that to alleviate some of the more outlandish claims that I’m going to be banning vitamin C tomorrow, that Tony Clement is going to be banning potluck dinners. I mean you know for a guy from Muskoka to ban potluck dinners, that would be a death knell. (Laughter.) But I can tell you that we’ll do those kinds of things that will make crystal clear the intention and make sure that the administration of the bill is correct. But the purpose of the bill is to protect the health and safety of Canadians and that will not change.

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