Hon. Leona Aglukkaq
Minister of Health
House of Commons
August 8, 2011
I am writing about the proposed changes to the Health Canada’s Marijuana Medical Access Program (the Program).
Since its inception in 2001, I have written the Health Minister on a number of occasions with various concerns about the execution of the Program. The Program has been found unconstitutional by several courts, and been criticized by medical professionals, law enforcement agencies, advocacy groups, and patients.
Considerable evidence points to the fact that the Program is ineffective in many ways, particularly in Canadians’ ability to access the Program.
The following illustrates the issues that I have repeatedly written the Health Minister about in the past:
•The Program does not provide timely access to necessary medical treatment. The most frequent complaint I hear from Canadians is their inability to access the Program in a timely matter. I have written the Health Minister four times between 2010 and 2011, urging the government to resolve the lengthy wait times endured by patients waiting for their Program application to be approved. Such a delay in access to health care treatment is unacceptable, as thousands of Canadians rely on medical marijuana to treat life-threatening illnesses and chronic pain. It further compounds the onerous and prohibitive nature of the Program. In addition, the Ontario Court of Appeal found in both the November 2003 Hitzig and the April 2011 Mernagh cases that the Program is unconstitutional because of a lack of access for those in need.
•There is a lack of public education about the Program. Patients frequently experience issues in finding a doctor who will sign off on their application, as doctors have not been properly educated about the program and use of medical marijuana as a treatment for patients. This point was highlighted in the Ontario Court of Appeal’s April 2011 ruling.
•Health Canada’s foray into the production of medical marijuana has been widely criticized. The quality and safety of Health Canada’s cannabis supply has repeatedly been called into question. The production of a domestic supply of research-grade cannabis via Prairie Plant Systems has been criticized because of the cannabis’ low levels of THC, lack of strain selection, and alternatives to smoke ingestion.
•Despite recommendations from the Senate Special Committee on Illegal Drugs, the Ontario Court of Appeals, and the Canadian AIDS Society, Health Canada does not yet recognize the work of community-based dispensaries (eg. compassion clubs). The department needs to find constructive ways to support their important work and research. Without compassion clubs, which exist in communities across the country, many patients would be forced to obtain medical marijuana in illegal and dangerous situations.
•There has been a consistent lack of consultation with key stakeholders, even though individuals are very knowledgeable about the program and its limitations have requested the opportunity to be involved in consultation and policy development. I hope Health Canada will use this consultation to establish an immediate dialogue with key stakeholders to better meet the needs of patients.
•Federal and provincial governments are profiting from patients who can afford to participate in the Program. In January 2011 it was revealed that patients participating in the Program are charged HST on medical marijuana purchases in applicable provinces. This creates a jurisdictional conflict, whereby select Canadians pay more for medical marijuana. Prescription medications, requiring a similar approval by one’s physician, are zero-rated on Schedule VI of the Excise Tax Act. This causes many vulnerable Canadians further financial and emotional hardship.
In order to better meet the needs of patients, Health Canada must acknowledge and respond to these ongoing issues. After reviewing the new regulations, several questions must be addressed before proceeding with any proposed changes.
1.Health Canada has not demonstrated its plan for providing documentation of lawful possession of medical cannabis within the new Program. Many patients have already experienced anxiety over their lawfulness while waiting for delayed renewal licenses to arrive. How will Health Canada support medical marijuana patients to demonstrate their legal possession of this medication and avoid the precarious legal situations that have arisen with the current application system?
2.How will Health Canada ensure that the granting of licenses will be done in a timely manner? Access to the current Program has been impeded by the bureaucratic nature of the application process, delaying or preventing access for many of the most seriously ill patients. Any revisions to the Program must increase access to this medical treatment and Health Canada must adopt a system to enforce timely distribution goals for licensed suppliers.
3.The new regulations place greater responsibility on doctors to utilize and prescribe medical marijuana as a treatment and their approval of applications will become more critical than ever. With this additional change to the licensing system, how will Health Canada work to better educate doctors about their responsibilities under the new Program? The proposed Program changes are very vague.
4.Finally, my greatest concern lies in the “commercial” production of medical marijuana proposed within the new Program. Why has Health Canada selected out commercial producers in its new Program proposal? Health Canada’s previous contracts with commercial producers have been highly problematic. If Health Canada plans to license commercial producers within the new Program, how will it work to avoid these same problems previously experienced by patients regarding the quality and variety of government commercially produced cannabis? I have a few key concerns regarding commercial producers:
a)Given the currently limited number of producers in Canada who would meet the security and organic farming standard necessary to produce medical marijuana, how will Health Canada deal with the increased production demand under the new Program, if individual growers are no longer able to grow their own supply?
b)How will Health Canada ensure commercial producers are selling medical marijuana at a fair market price? Currently, many medical marijuana patients grow their own supply or buy medical marijuana from their local compassion club because commercially produced options are too expensive. Yet Health Canada appears to be moving towards a commercial distribution system, rather than not-for-profit community-based producers.
c)How does a commercial distribution system keep costs reasonable for patients, and also provide the benefits offered by community producers? Compassion clubs offer specialized education, care and support around the provision of medical cannabis, yet this viable option appears not to be under consideration. Why is this?
An increasing number of advocates and concerned citizens are suggesting that the Program be a provincial responsibility. Has Health Canada considered the feasibility of transferring the Program to provincial authorities? This system might allow medical marijuana to be produced and distributed via a regional system that meets the needs of patients in the community, by utilizing the current system maintained by compassion clubs. As noted, these dispensaries already serve the needs of more medical marijuana patients than Health Canada’s current Program, and therefore make a logical next step for provinces to utilize them as licensed growers and distributors in their region. A provincial approach would also allow provinces to offer community programs around patient, physician, and distributor education and support.
However, before transferring the responsibility to the provincial level, the federal government would need to ensure that all provinces were willing to offer an equilateral system of distribution and support. If provinces created their own programs with varying levels of support, medical marijuana patients might suffer gaps in their care and feel forced to seek care in jurisdictions with the most accessible programs.
In conclusion, the Program must be functional and fulfill its original purpose: ensuring that medical marijuana patients get timely access to the high quality medical marijuana. I urge you to act in good faith and respond to the many recommendations submitted about the Program and work with your officials to improve the Program.
Libby Davies, MP
NDP Health Critic
NDP Spokesperson for Drug Policy