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A seat at the table

Naturopathic doctors engage government on Bill C51
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Political Pills? As the federal government attempts to regulate the natural health product industry, opposition members cry political foul, warning that Health Canada might bury tough restrictions in Bill C51

In a country where health care has only recently lost political ground to the environment, any changes to the Hippocratic apparatus are bound to draw attention, both fearful and hopeful.

Such is the case with Bill C51, a federal proposal that would update and amend the dusty pages of the Food and Drug Act. The bill, which has gone through second reading, will regulate natural health products, a prospect that has doomsayers branding Canada as a police state operating at the behest of lobbyists and supporters looking forward to a renewed framework for managing those products.

Dr. Jennifer Moss found herself teetering towards a more measured version of the former when she first found out about the bill. She has a natural health practice just off the highway in Garibaldi Highlands. “I think in the beginning, people got freaked out and scared,” she said. “As more time has gone by, more information has come from my association.”

She’s referring to the Canadian Association of Naturopathic Doctors (CAND), and they’ve been seated at the government table during consultations. The industry’s primary worries revolve around terminology and access. To boot, there are differences between provincial and federal definitions that CAND would like clarified. One term drawing concern is “therapeutic product,” which industry professionals say is vague enough to slot natural health products in with pharmaceuticals. That term could alter completely the way natural health products are manufactured and sold.

Another problem term is “practitioner,” which, at the moment, doesn’t include natural health doctors and so clamps their prescribing powers.

“Our concerns with Bill C51 are that natural health doctors may have difficulty in continuing to access all the natural substances they utilize and have utilized with their patients for years,” said CAND’s executive director, Shawn O’Reilly. “Under the bill, some of those natural health products may be designated as prescription therapeutic products, which would take them out of the hands of naturopathic doctors, as currently they don’t have prescribing rights in any products.”

That has Moss worried. Take St. John’s wart, something Moss recommends often to combat light depression because it raises serotonin levels. “Under the bill, it could be designated a prescription.”

David K. Lee has been working with Health Canada on C51 as director in the office of patented medicines and liaison. In an interview with Pique Newsmagazine , Lee acknowledged apprehension surrounding the “prescription therapeutics” handle.

“What was in the original proposal was an inclusion of the therapeutic products definition,” he said. “As we were trying to modernize the framework, we realized that, when you’re making proposals at the bill level, they cover a lot of the products underneath. ‘Drug’ had always included a number of products under it. It included pharmaceuticals, both over the counter and prescription, and natural health products. When they were written in five years ago, they were under the Food and Drug Act as a drug. We subsequently heard that it was inappropriate, in their view, to lump the natural health products in with drugs because it implies we’re taking a pharmaceutical approach to natural health products.”

According to Lee, it’s estimated that 71 per cent of Canadians take natural health products to some degree. They might be taking them, for example, in combination with AIDS drugs. Rather than ban products outright from the market, the bill may call for additional labeling requirements so that the effects of using them in combination with prescription drugs are easier to predict. Further, what’s on the label must be in the bottle, said Lee, as some products use a different strain of plant than what is advertised, and the effects can be harmful. This is something CAND wholly supports, said O’Reilly.

In the early days of the bill, around the time that Moss found out about it, there was considerable hysteria about state powers that bill promised to bestow. Search and seizures, said activists, could be performed without the benefit of a warrant. That’s fiction, said Lee, and it’s not something CAND is worried about, either.

“Some of the fears that people were raising may not have been well-founded,” says NDP health critic Judy Wasylycia-Leis. “But the fact of the matter is we don’t know for sure what the bill will do when it comes to natural health products. Therefore, knowing how the Conservatives have flipped things into law before — for example C50, which was a budget bill that brought in immigration changes — we can’t be sure this wont have a bad effect.”

Currently, the bill is with the Standing Committee on Health, where a handful of amendments are being debated. Those amendments include a separate category for natural health products, clear rules for investigative strategies and the creation of an advisory committee, which would be built of consumers, patients, health professionals and industry representatives.

“What you’re looking for in a committee of that nature is to make sure your proposals will work to the objective you’re proposing them for,” said Lee. “If you’re proposing something about changing a label, then you want a multiplicity of views. You want maybe some practitioners, so a homeopathic representative. You need industry because they’re going to have to follow these rules, and knowing how they can follow them and whether they can follow them is necessary.”

According to Wasylycia-Leis, the amendments are a sign that government rushed through the initial drafting of the bill.

“We’ve got a series of very detailed amendments that the government is prepared to make in committee that have been raised over the past few months,” she said. “That’s testimony in itself that the government did not put enough effort into this bill in the first place. One gets even more suspicious and concerned about where the government is coming from when it’s mishandled this far. We’re at the point of saying we need to see major amendments to the bill in committee, which is preceded by very thorough consultation and a list of witnesses who can testify to potential impacts, or suggest that one should create a separate piece of legislation.”

Meanwhile, political sabres have been rattling throughout Parliament’s summer break. The Liberals, who did not respond to multiple interview requests, are framing their Green Shift plan as a central plank in their electoral platform. And the Conservatives, who spent last weekend at a caucus meeting in Quebec, took to microphones to call the Liberal bluff. In the event the writ is dropped, the bill will die.

Just the same, the Food and Drug Act is old, and, regardless of the reigning government, it will need to be updated sooner or later. To be sure, this isn’t just a Conservative initiative; the Liberals got the ball rolling years ago.

“And you want to be at that table,” added Moss. “It’s easy to be reactionary initially. But you need to sit down, gather the information and understand what you’re reading.”