Proceedings of the Standing Senate Committee on
Social Affairs, Science and Technology

Issue 27 - Evidence - November 29, 2012


OTTAWA, Thursday, November 29, 2012

The Standing Senate Committee on Social Affairs, Science and Technology, to which was referred Bill C-313, An Act to amend the Food and Drugs Act (non-corrective contact lenses), met this day at 10:29 a.m. to give consideration to the bill.

Senator Kelvin Kenneth Ogilvie (Chair) in the chair.

[English]

The Chair: Honourable senators, I declare the meeting in session.

[Translation]

Welcome to the Standing Senate Committee on Social Affairs, Science and Technology.

[English]

I am Kelvin Ogilvie, a senator from Nova Scotia and chair of the committee. I will ask my colleagues to introduce themselves.

Senator Seidman: Judith Seidman from Montreal, Quebec.

Senator Eaton: Nicole Eaton, Toronto.

Senator Enverga: Tobias Enverga, a senator from Ontario.

Senator Cordy: I am Jane Cordy from Nova Scotia.

Senator Munson: I am Jim Munson, senator from Ontario, but I have to say my heart is in New Brunswick.

Senator Merchant: Good morning. I am Pana Merchant from Saskatchewan.

The Chair: Thank you colleagues.

I am calling on you to deal today with the agenda that has Bill C-313, An Act to amend the Food and Drugs Act (non-corrective contact lenses). We have two sessions. The second session will begin to later than 11:30. Is that agreed? Thank you, colleagues.

I will now invite our witnesses to present in the order that I introduce them, beginning with Tushar Mehta, Operations Manager, Camden Passage Inc.

Tushar Mehta, Operations Manager, Camden Passage Inc.: Thank you for giving me the opportunity to appear before the distinguished committee on behalf of Camden Passage in reference to Bill C-313.

As a Canadian distributer of cosmetic eye accessories, we welcome the regulation of non-corrective contact lenses under the Food and Drugs Act to ensure that only the products of the highest level of quality and safety are sold in Canada. We believe that all purely cosmetic contacts sold on the Canadian market should be made of the best quality materials in proper production facilities, appropriately packaged, labelled and in compliance with all sterility requirements. It is for this reason that Camden Passage's products are manufactured under the most stringent conditions in the United Kingdom by a leading manufacturing facility and meet all applicable ISO standards.

It must be noted that Camden Passage Inc. is the distributer in Canada for EDIT, a manufacturer and supplier of high-quality accessories on a multinational basis. EDIT has supplied in excess of 4 million such accessories and over 10 million accessories in total since 1998.

Camden Passage Inc. has sold 180,000 pairs in under two years. It appreciates that the products are relied upon by so many consumers and recognizes the value of maintaining and protecting its good reputation. As I said, EDIT manufactures the accessories to the highest possible standards. To operate any in other way would have serious commercial consequences. We would not distribute inferior or substandard product, which generally comes from Asian sources.

That being said, I would like to address certain concerns and health risks relating to this proposed bill. We believe the proposed legislation does not address the actual health concerns created by the use of cosmetic eye accessories. To be clear, this product is sometimes called ``cosmetic contact lenses,'' although that is a misnomer as these lenses do not refract or bend light. Their sole purpose is cosmetic. They shade the eye colour or serve a theatrical purpose. Indeed, many of our sales are to the theatrics community and movie industry.

It should be noted that these health risks are fundamentally the same as those caused by any product used in or near the eye. Users may injure themselves if they do not take proper care or follow product instructions in the use of this or any product, and classifying this as a medical device does not address these concerns.

As the medical evidence demonstrates, the health risks associated with these products are not increased by the manufacture of the products themselves. In every recorded case, the health risks are related to user error. Examples in the literature of ocular disorders due to purely cosmetic products abound. Reports also exist for eye injury caused by nail extensions commonly used by women who apply false eyelashes or makeup while wearing them. Eyebrow piercings are also problematic and essentially unregulated.

As well, other products used near the eye that are also associated with adverse effects are detailed in many studies, which refer to such products as mascara, eyeshadow and dye for tinting of lashes and brows.

This brings me to my second point. To the extent that the proposed new classification of these products as medical devices would persuade the provinces to impose the requirement that they be sold by prescription by eye care practitioners, it will not address risks to the public. In fact, such a result will ultimately produce a harmful, unintended consequence, which in our opinion will far outweigh any good achieved by Bill C-313.

I submit to you today, honourable senators, that the inevitable consequence is that when a product is made unavailable at an affordable price in Canada, which would be the case as a result of these regulatory changes — going from approximately $25 to $35 a pair to over $100 for the same products, as well as the eye care practitioner's dispensing fee — consumers will no longer purchase in Canada. They will be driven to the Internet where they can obtain coloured contacts at a fraction of the increased cost from Asian sources that are not of the same quality as our ISO product standards. There will be problems with the materials used, manufacturing defects and few or entirely absent instructions, rather than the very finest quality European-based manufacturers such EDIT.

In other words, the unintended consequence of this regulatory action will be the creation of a booming grey market where the consumers in Canada will vote with their mouse, purchase inferior product from the Orient and have it delivered to Canada.

The medical literature is filled with unjustified claims that should the products be sold through a health care professional, the risks to the public would be reduced. However, this is a conclusion based only on assertion. There is no study that demonstrates an increase in public safety results from such a measure. In fact, the evidence provided in the literature tends to demonstrate the opposite: The true cause of concern is the lack of consumer adherence to instructions. The assertion that a consumer will follow instructions better if they are given by an eye care practitioner is just an assertion. There is no proof, and the actual evidence tends to demonstrate the opposite.

The Chair: I will have to ask you to speed up. You are exceeding your time.

Mr. Mehta: I will skip a little bit. Moreover, there are many other products used around the eye that place the public at risk. It would be quite absurd to classify all of these as medical devices or require that they be purchased from eye care practitioners. To do so, we believe, would lead to unintended consequences and open the door to the sales of unregulated, poor-quality lenses through other means. While the federal regulatory authorities have no jurisdiction over whether these products require prescription for purchase — being a provincial matter — it is clear that the move to classify them as medical devices is inspired by the notion that the provinces should require that they be purchased with the intervention of an optometrist or ophthalmologist. That will certainly create an underground market in Canada as result of the restrictive regulatory regime, and that would then create real risks for Canadian consumers.

A reasonable solution may be to permit the sale of these products at cosmetic counters of pharmacies and department stores where the sales staff are trained in the use of the products they sell, and where Camden Passage Inc. can add value with the product training materials for retailers.

Thank you very much for allowing me the opportunity to present, and I look forward to addressing any questions or issues you may raise.

The Chair: I will turn to Dr. Lillian Linton, President, Canadian Association of Optometrists.

Dr. Lillian Linton, President, Canadian Association of Optometrists: We would like to thank the committee for allowing us to appear in support of Bill C-313 to classify non-corrective contact lenses as medical devices. We would like to express our appreciation to Senator Duffy for sponsoring this bill in the Senate and to Patricia Davidson, Member of Parliament for Sarnia-Lambton, for bringing this important issue forward to the attention of the House of Commons and to all Canadians.

While I am the president of the Canadian Association of Optometrists, CAO, I am here speaking on behalf of the eye health profession, which includes 5,000 optometrists, 6,500 opticians and 1,300 ophthalmologists.

For the past 12 years, our professions have together been advocating for commonsensical legislation that classifies non-corrective contact lenses the same as corrective contact lenses.

I say ``commonsensical'' because there is literally no difference in the manner corrective and non-corrective contact lenses interact with the eyeball. Regardless of whether the refractive correction is plano, which is 0, or -2.75, the eye health risks are the same and the potential complications indistinguishable, and the safeguards in place should be identical.

These safeguards start with the medical device classification for non-corrective contact lenses and should extend to regulations at the provincial and territorial level to ensure the same regulatory environment that exists for corrective contact lenses also applies to contact lenses for purely aesthetic purposes.

We sit here today and have been on this road for the past 12 years because the wording in the Food and Drugs Act that defines a device has been deemed to not apply to non-corrective contact lenses. According to the Food and Drugs Act, a device is something that is used in ``restoring, correcting or modifying a body function.'' Whereas a corrective contact lens corrects a refractive error, a non-corrective contact lens does not restore or correct a body function. An argument has been made that they do modify a body function when they alter eye colour, restrict vision and, most important, restrict oxygen flow to the cornea. However, that argument has not led to their inclusion, and therefore we pursue legislation that Bill C-313 proposes to specifically classify non-corrective contact lenses as a medical device.

Our reason for pursuing this legislative change is simple: Contact lenses are medical devices, for good reason. There is risk of harm associated with placing a device in direct contact with one of the most delicate and sensitive organs of the human body, the eye. In this context, there is literally no difference between contact lenses that correct vision and those that provide purely aesthetic changes, such as non-corrective contact lenses.

All eye health professions assert that the risks for eye problems associated with non-corrective contact lens use, potentially as serious as vision loss, are higher than they are for corrective contact lenses due to the absence of regulations for these items. Without an eye care professional involved in the process of determining fit and counselling on the use and care, risk of harm increases.

A study from France identified a 12.5 per cent increased risk of eye infections with non-corrective contact lens wearers than those who use corrective contact lenses. The primary difference is cited as the lack of proper use and care instructions received at the dispensing location and the vulnerability, youth and inexperience with contact lenses of those who are most likely to wear the non-corrective contact lenses. The study further identified that people wearing non-corrective contact lenses have more severe lens-related infections.

While the majority of contact lens-related complications arise from improper use and care, a U.S. study found that consumers who bought contact lenses from a source other than their eye care practitioner were less likely to comply with good eye care health practices. This study referred to people with experience with contact lenses, and in the U.S., 50 per cent of non-corrective contact lens wearers are first-time contact lens users.

When fitting contact lenses, a regulated professional assesses eye health and lens fit on the cornea and provides training on proper use and handling of the lenses. We measure the base curve of the cornea and recommend contact lenses that have a corresponding base curve typically between 8 and 9.6 millimetres. There is no such thing as one-size- fits-all contact lenses.

In the case of non-corrective contact lenses, they are sold with no options for varying base curves. Inserting a contact lens on to the cornea without the proper base curve or in individuals with aggravating complications, those that are susceptible to eye infections, severe allergies, dry eye, can lead to eye complications such corneal abrasions, scarring and infection.

Placing a lens on the cornea affects the cornea's ability to obtain oxygen. This is important because the eye is the only organ in the human body that receives its oxygen supply directly from the external environment. Lack of oxygen, lens fit and lens type are important factors to ensure the cornea is receiving the oxygen it needs to be healthy. Individuals who are not assessed and fitted properly are at risk for eye damage.

Non-corrective contact lenses are particularly appealing to our youth, which are the major target for these products. This is a market segment that is prone to risk taking. The risks associated with the use of non-corrective contact lenses can be minimized with professional oversight and counselling on the fit, use and care of these products by regulated and knowledgeable professionals.

A medical device classification for these products is the first step to achieving a regulatory environment that reduces the risks associated with non-corrective contact lens use. A classification of non-corrective contact lenses as a medical device will ensure all manufacturers are held to a common standard in certifying quality and safety standards are observed and the reporting and labelling requirements are followed. A medical device classification provides retailers with confidence that distributers with an establishment licence must provide the labelling requirements and use and care instructions for their customers that are consistent with medical device regulations.

The requirement for manufacturers and distributors to apply for medical device and establishment licenses is not overly onerous. They currently do it for selling products in the U.K. and the U.S. They will have to do it very soon, if not already, for sales in China, Japan, France and New Zealand, to name several.

It is the hopes of those professionals that are regulated and trained in visual device dispensing and the diagnosis, treatment, prevention and care of eye health that the requirements articulated in the medical device regulations will apply to non-corrective contact lenses in Canada as well.

Bill C-313 is a common-sense initiative that aligns all contact lenses in the same federal regulatory environment. Bill C-313 makes sense from a vision health perspective and a consumer protection perspective and is justified based on the concerns and actions already taken and being pursued by governments around the world. Optometrists, ophthalmologists and opticians urge the federal government to place non-corrective contact lenses under the same federal regulations that currently exist for corrective contact lenses.

I would like to once again thank the committee for allowing us to be here today, for their support of Bill C-313 and their awareness of vision health as an increasingly significant consumer health risk.

The Chair: Thank you. I will now turn to honourable senators for questioning.

Senator Munson: Here you are, both of you, sitting side by side with different point of views. Has either side ever had a conversation or been invited to have this conversation?

Mr. Mehta: We have not ever been contacted by the Canadian Association of Optometrists. A number of our customers have been contacted, and there have been almost scare tactics on the product.

Senator Munson: I am sorry?

Mr. Mehta: They relate that our product is unsafe, which is untrue, from our sales history. We would welcome working together with the optometrists to ensure safe products for Canadian consumers and products that would meet the labelling and packaging requirements.

Dr. Linton: It is not a matter of packaging. The problem is that fitting a non-corrective contact lens is the same as fitting a corrective contact lens. We believe that without a fit it will not matter what the packaging says.

Mr. Mehta: On that point, the product that we are currently marketing in Canada is an occasional-wear product, typically for a couple of hours a day. We have had no adverse reports on the use of our product.

Senator Munson: Dr. Linton, what is wrong with keeping the status quo? I have not heard much about this. We heard about the debate in the house and so on, but what in your estimation is wrong with keeping the situation as it stands now?

When we buy glasses, we can go to our local eye doctor to get a prescription and get it all done, but it seems to me large number of people go to Asia and do it online.

Dr. Linton: We are not talking about eyeglasses.

Senator Munson: I know, but that is another important issue in terms of dealing with the safety of our eyes or health.

The Chair: Please stick to the topic as it relates to the lens.

Senator Munson: As it relates to the safety aspect of it all.

Dr. Linton: The problem as it relates to a non-corrective contact lens is that you are still putting it on the eye. They are one base curve; they are not one-size-fits-all. It is how the lens interacts with the eye. If the lens is too tight, it can cause damage. If it decreases the amount of oxygen to the eye, it can cause damage.

Senator Munson: Mr. Mehta, I think you said in your statement that in every recorded case, the health risks are related to user error. What do you mean by that? Do we have cases of people in this country?

I assume it is young men and women mostly who would wear these non-corrective contact lenses. Do we have any statistics that show that there have been some serious issues wearing these non-corrective contact lenses?

Mr. Mehta: No, we do not.

Dr. Linton: We have incident reports that have come across from CAO. The Canadian Ophthalmological Society has also reported incidents. We have received incidents, and 17 per cent of the incidents that have been reported are related to Internet-based eyewear.

Senator Munson: I know my colleagues have many questions —

Mr. Mehta: That would be correct, and you are driving more consumers to the Internet by restricting the product sale in Canada.

Senator Munson: It would seem to me, just from a preliminary look at this, that young consumers are already on the Internet. I do not know about driving them to the Internet to obtain these.

Mr. Mehta: You are driving them to obtain these products there as opposed to purchasing them in a controlled environment from a responsible seller.

Senator Munson: I have many questions on this issue.

The Chair: Can I put you on the second round?

Senator Munson: Yes, I want to be fair to the other senators.

Senator Seidman: I would like to go to a statement that Dr. Linton made and have your reaction to it, Mr. Mehta.

Dr. Linton said that this is a common-sense piece of legislation because there is literally no difference in the manner in which corrective and non-corrective contact lenses interact with the eyeball.

Thinking of the logic — if this is common sense — why would non-corrective contact lenses be classified independently from corrective lenses if they interact with the eyeball in the very same way?

Mr. Mehta: The assertion Dr. Linton and the eye practitioners are making is that the product is unsafe because of the way it is prescribed, or not, untrained for the user.

However, by the literature we have reviewed, 50 per cent of users of contact lenses who have purchased the product from an eye care practitioner have had adverse conditions or effects. The risk is not inherent in the product itself. It is inherent in the usage of the product.

Let us also say that all of Dr. Linton's assertions are correct; let us assume she is right. How does she respond to the grey market, which will be worse than the current status quo?

Senator Seidman: Let me put it back to you. At least from what I heard, Dr. Linton in her statement said very clearly to me and to all of us sitting here that there is no difference in the manner corrective and non-corrective contact lenses interact with the eyeball. I think the basic issue here is that the eyeball is at risk of lack of oxygen and other things with the use of contact lenses, whether they are corrective or non-corrective. That is the way I have understood what she said.

As far as your statement on the grey market, I would like to ask you whether you think that individuals do indeed have to take responsibility for their own actions. A government can try to protect Canadians as best they can through legislation. I think that is the government's responsibility. However, if individuals want to go on the Internet and do things that can harm them, that is their right.

Mr. Mehta: The concern here would be driving more individuals to purchase an unlicensed product or a product of poor quality from the Internet. With respect to your question on the contact lenses, I would like to direct that to Dr. Allan West, who can answer the question in more detail.

The Chair: He is not part of the witness list; it has not been agreed to. You are the president and CEO of the company. You must understand the nature of your business, so please answer the questions.

Senator Seidman: Are there cost implications for your business, Mr. Mehta, if non-corrective contact lenses are regulated as medical devices?

Mr. Mehta: My business, Camden Passage, is purely an importer and distributer. We sell many products on the Canadian market, of which a percentage of our product base is cosmetic products. We strongly believe in the products we sell and are happy to sell this type of product in the pharmacies, drugstores and fashion stores. It is a product we enjoy selling.

There might be a financial consequence, to a degree, but it could be any product we could sell tomorrow.

Senator Merchant: Thank you very much. Welcome to both of you. I think this is a novel kind of idea. However, I also think from both of your points of view, am I correct to say that money comes into play for both of you? You may lose some sales.

However, I would think that if these devices are regulated, you said — and I do not know if the doctor agrees with it — that these same products will increase in price. It is the same identical things, because she is not saying we should buy something different, just that these devices should be dispensed by ophthalmologists, optometrists and opticians. I do not know what training opticians have that is medical.

However, would you agree, Dr. Linton, that the cost of these very same lenses will go up, or will it stay the same for the consumer?

Dr. Linton: The actual product cost will not go up. There is a fitting fee that is associated. The bottom line is whether it is worth ensuring that we have children, teens and whomever with proper fittings. Yes, I think that is a price that is very much worth it. It will cost the system far more if we do not get this under control.

Senator Merchant: Have other countries regulated these devices?

Dr. Linton: Yes, the U.S. and the U.K. have already, and other countries are looking into regulating it, as well.

Senator Merchant: Will there be penalties for people who go to the Internet and buy these devices and damage their eyes? How will this work?

The Chair: Perhaps you can hold that question.

Senator Merchant: Yes, I should hold that. I will leave it at that.

Senator Cordy: I want to go back to Senator Munson's comments about the Internet. I would think the purchasers of cosmetic lenses would be young adults, for the most part. They are the ones who are most likely to use the Internet for purchasing any product, whether it is eyeglasses, as Senator Munson said, or music or whatever it is.

Will this drive substantial numbers of young people to purchase online where it will be much cheaper, and what will be the ramifications of that? I think you are both saying that the product itself is not the problem; it is the misuse of the product.

Dr. Linton: It is not only the misuse. Complications can arise from the product not being fitted, as well. I think it is important to look back.

In September 2003, Health Canada did its own study entitled Human Health Risk Assessment of Cosmetic Contact Lenses, which indicated there was no difference between corrective and non-corrective contact lenses in the manner they interact with the eye. The report concludes by stating:

. . . Health Canada may wish to consider placing restrictions on the manner in which these products are sold to the consumer, such as requiring prescriptions for the use and/or restricting their sale to regulated eye-care professions.

Mr. Mehta: For the products we bring to the market, the manufacturers have produced and sold over 10 million pairs worldwide. It is a very safe product we bring to the market, and we cannot comment on the manufacturing quality, materials or dyes used in offshore sources.

We strongly believe that no teen is going to see an optician for a $60 to $80 dispensing fee to purchase the product; they will go online. It will cause problems for our youth, as opposed to having the product available in Canada at a reasonable price through responsible importers and retailers.

Senator Cordy: I am not sure how we can monitor what is sold online, but it is an issue that must be brought up.

Mr. Mehta: It is impossible.

Senator Cordy: What studies of public safety have been done regarding cosmetic lenses? Have studies been done?

Mr. Mehta: We have studies on contact lenses that show that the risks exist based on not following instructions.

We have studies that show there are damaging consequences from the use of mascara and eyeshadow —

The Chair: Let us stick to contact lenses.

Mr. Mehta: These are all products that work within the ocular area and will have the same consequence to a user. You can get bacteria from these products, and consumers have had eye infections from the use of other ocular cosmetics.

Dr. Linton: The key point is that there is still the fit. If the contact lens does not fit, there will be more complications. Our biggest concern is the fit of the contact lens. They are not one-size-fits-all.

The Chair: Let us clarify the term ``one-size-fits-all.'' I think you are implying that the cosmetic lens is a one size.

Dr. Linton: Exactly.

The Chair: Thank you. You are saying the cosmetic lens is one size, whereas in the normal lens —

Dr. Linton: The normal lenses come in different base curves, and whether you have a flat or deep base curve determines the fit. If the contact lens does not move, it does not receive oxygen supply and the tear exchange. There are many factors; there is more than one thing involved in the fit of the lens.

The Chair: I wanted to correct that because the way you used the term caused some confusion.

Mr. Mehta: If a consumer finds it uncomfortable, they would take it out. It is not for vision. It is purely for cosmetic or theatrical use.

Senator Eaton: I wear contact lenses, but the curve is different for everyone's eye so it is not one-size-fits-all.

Dr. Linton: It is not.

The Chair: In the prescription it is not, but the cosmetics are one size.

Dr. Linton: Yes, they are one size.

Senator Martin: Thank you. Mr. Mehta when you talk about the risks that are involved in prescription contacts and 50 per cent of users face complications, I would think the same statistics could potentially apply, but I will not imply what the statistics may be for non-prescription contacts or cosmetic contacts. However, my question is this: We are doing a study on post-approval prescription drugs and collecting data for adverse effects. I am curious what mechanism, whether it is with your retailers or on your own website, is used for how that data may be collected. If consumers are facing complications with their eyes, they would not tell you per se. They would go to clinics and optometrists. The data they would have would be reflective of the industry. Do you follow up with your clients as to how it is fitting? How would you collect that data? Is there a mechanism?

Mr. Mehta: The mechanism we have in place is that if a consumer finds the product uncomfortable, they contact us. The immediate reaction for any consumer purchasing a product they are unhappy with would be to contact the responsible party. We have had a 15 such cases in the last two years. We have asked the consumers to refrain from using the product and to visit an eye care practitioner, and we have refunded them for the product.

Senator Martin: Dr. Linton, you say that you and some of your members have patients come in?

Dr. Linton: I am not sure whether they come from Camden Passage Inc., but I assure you that I have patients who have come in to my office who have been wearing these cosmetic contact lenses and they have complications. They come in one base curve. Nothing is taken into consideration for what they need for their eye health when they are buying them online. The factor we are talking about is eye health. We are not talking about price. Is that price too high to pay? I believe it is.

Senator Martin: I have a question, but I think I will have to ask you separately because it is not directly related.

Mr. Mehta: The literature we have reviewed is the risk to the consumer in the use of the product, not to the fit of the lens. It is mainly the post-purchase misuse and not following the instructions.

Senator Seth: Thank you for the knowledge. Non-corrective lenses can be ordered without prescription on the Internet?

Dr. Linton: Exactly.

Senator Seth: That means a patient or person has not been seen and it is just for a cosmetic purpose. Okay. How will you stop that?

What is the difference between corrective and non-corrective contact lenses? Do we have the complications, statistically? What are the complications we get with the non-corrective contact lenses and the corrective lenses? Do we have data to prove why we should be using non-corrective contact lenses? Do we have that to prove?

Dr. Linton: We have statistics that tell us that people who are using non-corrective contact lenses are more likely to have problems because they are first-time wearers. They have not been fitted with contact lenses. There are complications with corrective contact lenses, but increased complications with non-corrective contact lenses.

Senator Seth: Do you see more patients in your office who have been using non-corrective contact lenses?

Dr. Linton: We find there are increased complications from non-corrective contact lenses.

Senator Seth: The reason you have given is because of the oxygen supply to the cornea and all of those things.

Dr. Linton: Exactly.

Senator Seth: How will we stop that? Even having this bill —

Dr. Linton: It will be a first step. There is no difference in a non-corrective contact lens use versus a corrective contact lens use; the way they fit the eye is the problem. You will have complications from the corrective contacts, but increased from non-corrective contact lenses because they have not been fitted.

Senator Seth: How has the Food and Drugs Act allowed this to happen?

Dr. Linton: It is unfortunate, and that is why we have brought it to your attention.

Mr. Mehta: I would like to add that I have not seen any such research or literature noting the difference between the two products, and I would be very happy to review the statistics or evidence if it exists.

Dr. Linton: I can tell you that I am grassroots and I see these patients every day.

Mr. Mehta: However, the difference in the number of incidences —

The Chair: We will not get into a debate between the two of you. Thank you.

Senator Eaton: Dr. Linton, if this bill passes and non-cosmetic contact lenses become medical devices, it means a person must go and have them fitted properly. Is that correct? In the case of non-corrective contact lenses they are sold with no options for varying base curves.

Dr. Linton: Exactly.

Senator Eaton: Inserting a contact lens into the cornea without the proper base curve or in individuals with aggravating complications can lead to eye complications.

In other words, if I want to have non-corrective lenses, I will go to a proper optometrist and get them fitted, just the way I would for glasses or corrective contact lenses. Is that what you are saying?

Dr. Linton: I am saying that you would go there first. There will be cases where you cannot wear non-corrective lenses.

Senator Eaton: I will go to an optometrist?

Dr. Linton: They will tell you whether you can or you cannot.

[Translation]

Senator Verner: I will speak to you in French. Like many of my colleagues, I wear contact lenses, and I have for just over 30 years now. Dr. Linton, when you say a contact lens has to be adjusted to the base curve of the eye, I can say, from experience, I know what you mean. I never miss my yearly exam, for that matter. Personally, I can tell you that I cannot wear improperly fitted contact lenses for more than five minutes. All contact lens wearers will tell you that. If the lenses are not properly fitted, if the base curve is not right, you cannot wear them for more than five minutes. I could not even leave my house with them on.

My question has to do with the discussion around cosmetic lenses not being properly fitted. How would someone who buys and wears improperly fitted lenses develop a wound or a problem as a result?

Frankly, that person would really have to enjoy pain to wear lenses that do not fit. How, then, could someone wear them long enough to do damage to their eyes?

[English]

Dr. Linton: That is interesting, because teenagers like to look good and they really do not care if it is a little uncomfortable, and it is what happens over an extended period of time. Keep in mind you are wearing contact lenses that are comfortable, but there are many youth that like to look good and they really do not care. It might hurt a little bit, but you can develop a corneal abrasion quite easily or if the lens does not move properly you can also have the blood vessels grow into the eye, an encroachment over an extended period of time. It is important, and some people will accept that discomfort, unfortunately.

We are trying to make sure they get the best advice they can and they be fitted properly, and first do no harm.

[Translation]

Senator Verner: I maintain what I said. In the past, I have worn contact lenses that were not comfortable, and I can tell you that I never wore them long enough to experience that degree of irritation. It hurts to wear lenses that do not fit properly. A simple speck of dust can irritate the eye. Perhaps it is simply a matter of endurance or age, but that was the question I had.

The other question I have is for the president of the company. If you had to provide consumers with lenses of varying curves in response to what optometrists are asking, would the prices be so high that you would lose market share?

[English]

Mr. Mehta: The base curve and size that have been chosen for our product would be your best fitting average. A few people on either side of that average may find a product uncomfortable, and those are the people who have contacted us. You are correct; if a product is uncomfortable, they would not be able to wear it, at least not long enough to create an infection from it.

We would be very happy to work with the eye care practitioners and offer more sizes if that would make the product more suitable for Canadian consumers. The biggest concern we have here is opening the market to product of inferior quality with unknown materials that could have further or worse consequences.

Dr. Linton: The key point is that they will still not know what base curve will fit them. They still need to be fitted. That is the key.

Senator Enverga: Assuming Bill C-313 passes, would you expect only opticians to be giving out and prescribing these contact lenses? Should it be restricted to specified retailers only, or can anyone else sell the product?

The Chair: The question is, if this bill goes into place, will there be any change in who dispenses the lenses?

Dr. Linton: There are three professionals that fit contact lenses now: opticians who are contact lens fitters, which is a licence; ophthalmologists; and optometrists.

The Chair: Are you saying that they will now be required to be involved in fitting these lenses?

Dr. Linton: Exactly.

Senator Enverga: Can they sell the lenses, or can anyone else sell the lenses?

Dr. Linton: They would still be able to sell the lenses, but by prescription only.

Senator Enverga: Does that mean that other retailers can sell them?

Dr. Linton: There would still have to be a fit.

The Chair: It would be a prescription, meaning it would be a defined prescription. It would define what the individual can get in return.

Senator Enverga: Will they be able to provide a prescription the way it was prescribed?

Mr. Mehta: Can you repeat that?

Senator Enverga: Can your retailer or supplier supply the same curve or the same product that the opticians can sell?

Mr. Mehta: Do you mean with varying base curves and such?

Senator Enverga: Yes.

Mr. Mehta: That would not be within the realm of a cosmetic contact, no. A cosmetic contact is purely a simple product for very occasional use at a certain price point.

Senator Munson: When we have prescription drugs or vitamin pills, we are told what is in the bill. I would like to know what makes these corrective contact lenses turn all these different colours and what the materials are in there.

I also have a more substantive question. Camden Passage Inc. states on its website that its cosmetic contact lenses are not medical devices but, rather, are managed by the cosmetics division of Health Canada. The Food and Drugs Act, which regulates cosmetics, defines a cosmetic as ``any substance or mixture of substances manufactured, sold or represented for use in cleansing, improving or altering the complexion, skin, hair or teeth, and includes deodorants and perfumes.''

Are the contact lenses currently sold by your company regulated as cosmetics? If not, what do you mean by the phrase on your website, ``managed by the cosmetics division of Health Canada''?

Mr. Mehta: They are regulated by the cosmetics division of Health Canada. We are registered with the cosmetics division of Health Canada, providing all the pertinent information of the product, the makeup and the dyes used.

Senator Munson: I would like to get an answer to the materials. We all would like to know what is in those non- corrective contact lenses. What is in there that makes your eyes go blue, pink or yellow?

Mr. Mehta: We have a proprietary polymer blank, which would be the base of the material. It is not a contact lens product. It is a proprietary product, which is a polymer blank, and then it is applied with cosmetic grade colourings. I can provide you all the scientific data on the product and all the scientific studies we have undertaken or the manufacturers have undertaken with respect to the product.

Senator Munson: These are all done in a plant in the U.K.?

Mr. Mehta: They are all manufactured in a plant in the U.K., correct, all governed by U.K. law. I do have samples of the product here.

Senator Munson: I just needed a clarification. Thank you.

The Chair: I would like to come back and try to make sure that our committee is clear about the essence of this issue. I think Dr. Linton successfully clarified for the committee that, in the case of normal prescription lenses, the individual's eye is examined carefully and a prescription is given for a lens that would fit that eye curvature and character to the best degree possible; is that correct?

Dr. Linton: Yes.

The Chair: I believe you also said — and I believe Mr. Mehta confirmed this in response to a recent question — that the cosmetic lenses are sold as one size only; is that correct?

Mr. Mehta: Correct.

The Chair: Thank you.

Did we understand, Dr. Linton, that you said that when this bill comes into effect, the individual will need to come for a prescription? Additionally, if I understood Mr. Mehta correctly, he indicated that they would continue to sell one size. Dr. Linton, was your answer to the question ``Would they need a prescription?'' that the professional who is authorized to write such a prescription would prescribe it only for those eyes that would accept the standard product; was that what you were saying?

Dr. Linton: Yes.

The Chair: Thank you very much. I want to ensure we have these important issues clarified.

I want to again come to a couple of other issues with regard to the marketplace and the international market. We heard you say, and could you confirm, that the U.K. and the U.S. have regulations that are similar to the regulation coming forward?

Dr. Linton: Yes.

The Chair: Thank you. I think those questions clarify the issues that I was interested in. Senator Martin, were you satisfied with the follow-up?

Senator Martin: When you talked about importing, I wondered where it came from.

Senator Seth: Did it come from the U.S. only?

The Chair: No.

I just have a technical question about your summary with regard to your polymer, which is the base for the various colours, I would assume. Is that applied on the surface or integrated into the material of the lens?

Mr. Mehta: The colourants are —

The Chair: Your proprietary materials that you described as having a polymer base.

Mr. Mehta: That is the polymer blank, which is a base. Scientifically, I could not answer that with any degree of accuracy, but it is the base material upon which the dyes are baked.

The Chair: I understand the chemistry. I just wonder whether it is incorporated into the substance of the lens or whether it is a coating on the surface.

Mr. Mehta: The dyes would be a coating on the surface of the lens.

The Chair: Thank you.

Mr. Mehta: Regarding the U.K. and U.S. markets, in the U.K. market, our product is currently being sold as approved by the General Optical Council, GOC, in the U.K. as a safe product for sale within the United Kingdom.

The U.S. does allow the sale of cosmetic contacts. Some of the states do regulate the products and have a very strong grey market, and some states do not regulate other prescription products and are over the counter normally. We are in the final process of FDA approval, just dotting the i's and crossing the t's.

The Chair: Thank you very much. We understand how they will be prescribed. They are one-size-fits-all. Having exhausted this line of questioning, we will transition immediately to the next panel.

It is my pleasure to welcome Patricia Davidson, Member of Parliament for Sarnia-Lambton, and the sponsor of this bill. We are pleased to have you here and we would welcome your presentation. Then we will open for questions, following which we will proceed to clause by clause.

Patricia Davidson, Member of Parliament for Sarnia-Lambton, sponsor of the bill: Thank you very much, chair and members of the Standing Senate Committee on Social Affairs, Science and Technology. I appreciate being allowed to appear before you to speak in support of my private member's bill, Bill C-313. I believe you have heard from previous testimony of the need for a more robust regulatory presence in the non-corrective contact lens industry to better protect Canadian consumers. These lenses are also known as cosmetic lenses.

As medical eye experts all agree, my bill will effectively and efficiently enhance eye care protection for Canadian consumers and allow an immediate remedy to some of the dangers associated with this growing industry here in Canada. For the purposes of our discussion this morning, we shall call these lenses simply ``non-corrective lenses.''

Canada lags behind our trading partners in the U.S. and European Union by not having any regulatory oversight on cosmetic lenses. The same type of classification I am seeking with my bill for non-corrective lenses in Canada is already in place in jurisdictions like the United States. The lack of regulatory oversight on these products, despite the fact they have the same effect on the human eye as prescribed contact lenses, which are already Class II medical devices, has long warranted our government's taking a sober second look at this situation to see if we cannot better protect Canadian consumers.

The Internet has taken the decorative contact lens industry to new heights that regulators could not have foreseen a decade ago. Yet today when your teenage son, daughter or grandchild can order these products effortlessly and with little caution to medical oversight for their own eye health, we need to consider potential remedies.

What I have proposed will allow for the continued trade in the marketplace of such products, albeit at a higher standard of quality and with some actual concern for the consumer. I have uncovered numerous media stories over the course of my research through work on my private member's business that shed light on the growing list of product recalls from some of these Internet vendors.

Many of these Internet vendors operate from non-Canadian locations. However, there are a handful of Canadian operators. Although many of these Canadian operators appreciate the positive intentions of Bill C-313, it appears others seek to thwart the legislation for whatever reason they deem necessary. As legislators, we must concern ourselves with the standards in place to oversee this type of transaction to ensure some sort of measure is in place for consumer protection.

Making non-corrective lenses a Class II medical device will serve to increase the oversight on these products and, more important, their distributers. That is why these measures have been long called for by the medical eye care industry, such as the experts you have heard from in your previous witness testimony this morning.

It is clear that my bill intends to prevent a growing issue, one that can largely be addressed by ensuring a Class II medical device status on non-corrective lenses to allow better regulatory oversight of these products literally flooding our marketplace to uninformed consumers in most cases.

Upon the introduction of Bill C-313 in the forty-first Parliament, I have been again positively impressed with the work of my colleagues from all parties who have seen this issue as a true health concern for Canadian consumers and have again pledged their unanimous support to the bill.

With that in mind, I am keen to continue this discussion with you today on my legislation. I will present a few brief facts on this issue of to non-corrective lenses.

It is now an established scientific fact that national distribution of non-prescriptive contact lenses without professional oversight, fitting and training significantly increases the risk of public harm. Today we know the warnings on cosmetic lenses dating back to October 23, 2000, by Health Canada were warranted and now require a legislative recourse to alleviate the potential harm that could be done to consumers of these products.

A short list of the complications that could occur due to unsafe handling and wearing an improperly fitted lens in your eye includes the following: conjunctivitis, corneal abrasions, giant papillary conjunctivitis, microbial keratitis and other forms of bacterial, allergic and microbial infection as specified by the eye care industry.

We already know these complications occur with prescribed corrective lenses, which is exactly why Health Canada regulates use of these products through opticians and regulatory bodies.

Through peer-reviewed studies, we have learned that non-prescribed cosmetic lenses are more likely to cause complications to users. This is due to a combination of factors, including lack of oversight in how to use the product and the potential quality of the product. Usually, the distributer does little to proactively discuss potential eye health ramifications with the consumers of these products.

As legislators, we must rely on the scientific facts regarding the risk of these products. To date, we have seen several studies on the issue of decorative lenses and the harm they can cause to consumers. Perhaps the most well-known study in Canada is Human Health Risk Assessment of Cosmetic Contact Lenses conducted by Dillon Consulting Limited. Also known as the Dillon report, the final assessment was submitted to Health Canada in September 2003 and outlined the scientific evidence — which at this point was still being debated by public health officials — that the level of risk associated with the use of cosmetic contact lenses is comparable to that associated with corrective lenses and may be potentially higher.

In addition, research conducted at the Department of Ophthalmology at Strasbourg University Hospital in Strasbourg, France, clearly indicates:

Patients who acquire cosmetic contact lenses are less likely to be instructed on appropriate lenses use and basic hygiene rules. Consequently, cosmetic contact lens wearers are experiencing acute vision-threatening infections.

There is no reason to believe that the situation is any different in Canada. In fact, the Dillon report of 2003 also came to the same conclusions as the French study in 2011.

Colleagues, I feel it is essential that we work together on this important issue to ensure that the eye health of Canadians is protected because I feel that under the current regulatory regime there is no oversight of these non- corrective lenses. In fact, many Canadians could be placing their vision at risk.

We have a chance to work together on this legislation to ensure that the concerns of the eye care industry are taken seriously and that we take Health Canada's own warnings on non-corrective lenses seriously as well. It is time to bring them under the same regulations as prescriptive contact lenses.

I believe this is the proper recourse for us, as policy-makers, to consider. Thank you for your time today and I am prepared to assist you with questions.

The Chair: Thank you very much. I will turn to my colleagues.

[Translation]

Senator Verner: You mentioned, in your presentation, a report that went to Health Canada in 2003. Did Health Canada come out with any statistics on the number of complaints it received about the product over the past 10 or so years?

[English]

Ms. Davidson: Certainly there were concerns reported to Health Canada much earlier than this. I do not have those statistics. Health Canada would be the one to ask for that.

This has been a concern across the eye care industry for many years and also with Health Canada, which has been very supportive. As you may know, I brought a private member's motion forward in the Thirty-ninth Parliament. It was supported fully by the Minister of Health at that time, as well as Health Canada. In continuing on with this quest — this is now my third time — and a bill coming forward, it has always been supported by Health Canada. They feel this is the right way to go, and both health ministers through that time frame have supported it fully.

[Translation]

Senator Verner: I understand that Health Canada and ministers in different Parliaments supported it, but I see that that they did not move forward on it. That would suggest that the need for corresponding measures was not urgent enough to warrant action, since the community's concerns over the use of these lenses go back some 10 years.

Are you aware of any legal action taken against companies making or selling these kinds of lenses?

[English]

Ms. Davidson: From studies and reports that have been done by the eye care industry, we know these cosmetic contact lenses have caused damage to eyes. As was alluded to earlier, the main audience for these cosmetic lenses are our young people, and we all know that our eyes are extremely important. I see many of us sitting around here with glasses, and I heard several giving testimony about the fact they wear corrective contact lenses. I do not think I need to tell too many people around this table how important our eye health is.

However, I think it is incumbent upon us to put everything in place that we can to ensure the eye health of our young people, in particular. We have had some testimony and contact from some of the distributers of the cosmetic lenses. They have been very supportive of it, and clearlycontacts.ca, an Internet distributer, supported this bill and feel that it is the right way to go.

[Translation]

Senator Verner: The U.S. regulated the use of cosmetic contact lenses. Do we know what kind of an impact that regulation has had? Did it solve the problem? Did it address the concerns regarding young people? After all, they are the main wearers of these lenses. Do we know what outcome the regulation has had?

[English]

Ms. Davidson: It is my understanding that the regulations in place in the United States are the same as what my bill is asking for, so they would be classified as a Class II medical device.

We know that there are issues with regular contact lenses if they are not fitted properly, if they are not of a good quality. Those are the issues that we are hoping to address with this bill. Those are the issues that have already been addressed in the United States. Those safeguards are in place there. The protections are there now for more young people in the United States and in the United Kingdom. Other areas are already looking at this, and some may have moved forward since I last did my research and started this. I know other countries were looking at it as well. It is an issue that is recognized internationally and that has been acted on in other countries. Canada is lagging behind.

Senator Munson: Thank you for being here. I am a great believer in private member's bills.

You have heard the testimony from the gentleman who is head of Camden Passage Inc.?

Ms. Davidson: No, I did not.

Senator Munson: In his statement he talked about unintended consequences, which, in their opinion, will far outweigh any good achieved by Bill C-313. Mr. Mehta said that consumers will be driven to the Internet where they can obtain coloured contacts at a fraction of the increased cost from Asian sources that are not of the same quality as our ISO product standards. What do you make of that statement?

Ms. Davidson: The intent of this bill is to ensure that there are regulations in place. There has to be registration through Health Canada, to begin with, so they have to meet certain standards if this bill is passed. Those standards will include the quality of the product. I am not sure what he was inferring, whether he was inferring that the quality would be inferior, but that is exactly the purpose of this bill. It is to ensure that there is some regulation, and the people then will have to be registered with Health Canada so they can have their product registered as a Class II medical device. There are protections in place under this.

Senator Munson: I understand the regulations, but it seems that the market here is for young people and this may not stop them from going to another market to put these non-corrective contact lenses on.

Ms. Davidson: It may not, but I think it will stop some. I think it behooves us as legislators to make sure that we put the best protections in place that we can.

Senator Munson: You talked about the Dillon report, and that was 2003. It is now 2012. I know things work slowly, but this is almost a decade. Why so long to address this issue in a legislative way?

Ms. Davidson: As I said earlier, I started this process in the Thirty-ninth Parliament, and because of circumstances that have happened along the way, we are now in the Forty-first Parliament. Certainly, it has now finally been passed by the house and we are now at the Senate at committee hearings here. It does take a long time. I was hopeful that things would have gone through the first time I brought things forward but, because of different circumstances, they did not. The bill had to be reintroduced. The motion had to be reintroduced and then the private member's bill. As you have pointed out, it has taken a long time, and I think that is all the more reason we need to move on it in a timely fashion.

Senator Munson: Did this spark much of a debate in the House of Commons, for and against?

Ms. Davidson: No, actually it did not. It was supported by all parties in the House of Commons, and it was supported by all parties at the House of Commons Standing Committee on Health.

Senator Merchant: I have just a few points of clarification. You spoke about the regulation in the U.S. One of the previous speakers said that some states in the U.S. had approved this kind of legislation. Is it everywhere in the U.S. or just certain states that require this?

Ms. Davidson: It is my understanding that it is much the same as the Canadian process. In Canada, if this is passed, then it becomes the federal legislation that provides so much of the background, but this is only the first step. It requires also the provinces to get on board and be a part of it and look after the distribution end of it at the next level. There are federal and state responsibilities, and there are federal and provincial responsibilities, so it is a two-pronged process.

Senator Merchant: That answers my second question, which was that the doctor previously said that this legislation is just the first step. I was going to ask you what other steps we have to go through, but maybe you have answered it by saying that the provinces have to align themselves to it. Are there other steps?

Ms. Davidson: Yes. As I said, this is the first step and it has to be there to put the federal regulation in place, and then the provinces can add their non-corrective contact lenses to the same regulatory environment as corrective contact lenses. It is very much a two-step process.

Senator Merchant: Do you envision any penalties for people who continue to sell lenses, maybe under the counter? I do not think you can regulate the Internet, but do you foresee some place where there may have to be penalties imposed?

Ms. Davidson: That certainly is not part of this bill, but that is a good question to ask Health Canada, whether they have the latitude to police that. I do not know that, but it is not part of this bill.

Senator Cordy: It is always interesting to find out why someone brings forward a private member's bill. Can you tell us why you brought it forward? It was quite a while ago.

Ms. Davidson: I can still remember, though. I sat as a member of the Standing Committee on Health in the House of Commons for several years. When I first brought my private motion forward, I was a member of that committee. Because I have always had really bad eyes, that is something that always interested me. I had met with many eye care professionals. I had heard lots of stories about different things and then got talking to acquaintances and family members and found out that I actually had some people who were fairly close to me who had eye damage caused from non-corrective lenses. That made me look into it a little further. Fortunately, those people had corneal abrasions but they were healable and reversible. However, that is not always the case. Everyone does not have that advantage of their being reversible. It is what got me interested in it, and as I looked further I learned more about it.

Senator Cordy: It is always interesting hearing because it is always stories you have heard.

Both the former health minister, Minister Clement, and Minister Aglukkaq supported that bill. Is there a reason that the minister did not bring it forward as a government bill?

Ms. Davidson: This was something I brought forward. Whether it would have come forward through Health Canada if I had not, I do not know, but certainly they supported it wholeheartedly. I received a great deal of support from Health Canada and both of those ministers.

Senator Cordy: Most times, a government bill will move a little bit faster.

How will this bill change Internet sales? You rightfully said to us in your presentation that the Internet has taken the decorative contact lens industry to new heights. I would agree, because the market is comprised of a lot of younger people who do a lot of their purchasing online. Then you said that many operate from non-Canadian locations but that there are a handful of Canadian operators. How will this bill affect the majority of sales that will take place on the Internet?

Ms. Davidson: I think the largest change will be that they have to be certified and qualified under a Class II medical device. Each one that is offered for sale must meet the qualifications of Health Canada. Health Canada has the right to recall products all the time if they are not meeting the regulations. We know that there are always recalls happening.

They not only have to meet the Class II medical device qualification but they also have to meet the quality of the product legislation. Right now, I believe we would all agree that there have been questions about the quality in some instances. This bill is designed to see that the quality of the device meets Health Canada's standards.

Senator Cordy: This bill will cause a change of classification.

Ms. Davidson: Yes.

Senator Cordy: With that classification, Health Canada will then have the ability to recall.

Ms. Davidson: That is correct.

Senator Seth: This bill seems to be interesting and good for the prevention of eye damage. After implementing Bill C-313, have we thought about how we will facilitate things for youth who are keen to get these cosmetic contact lenses? Will we set up more eye clinics, ophthalmologists to facilitate things? Will they also reduce the prices for the lenses in order to avoid looking for these cheap lenses? Have we further thought how we will handle it?

Ms. Davidson: I think this is definitely a question that would have been a good one to ask the eye care industry. I cannot really speak for them and say how they would deal with it. I think your question is saying how they would handle an increased workload. Is that what you were asking?

Senator Seth: No. Suppose I need a cosmetic lens or non-corrective lenses, and I was getting them easily. Suddenly the law has come and I cannot buy them, and still I am looking. Will we not facilitate things so these youth can go to the clinic and easily things can be done in order to not look for the back door and buying these non-corrective lenses? Have we thought about how we will manage it?

Ms. Davidson: I am sure there will be opportunities for youth to be able to access the proper care needed for the fitting. That is the whole essence of the bill and that is the support that the eye care industry is giving. They realize and recognize that this needs to be done.

One of the basic problems with the non-corrective lenses is the fact that they are not fitted. Not only can they cause damage from scraping and scratching but, as has been pointed out before, the lack of oxygen allowed to get to the cornea is also a danger. The eye care industry is well aware of this and is prepared to address that issue.

The Chair: I have a couple of observations. I was interested in Senator Munson's question about the length of time. As I recall, he has expressed an interest in it and has had his own experiences with it; he has some familiarity with the time it takes for things to proceed.

Ms. Davidson, following up on the question from Senator Cordy asking about the interests of the health ministers, am I correct in my understanding that Bill C-51, which was a government bill, did not get to this stage for the various reasons you have implied? Regardless, was there not in that bill a definition that a contact lens is a medical device, and then that would have come under some of these regulations?

Ms. Davidson: That is correct, senator. Bill C-51 would have brought this forward in the initial stages of my private member's motion. However, as has been pointed out, Bill C-51 did not get passed.

The Chair: Thank you very much for joining us. Do colleagues agree that Ms. Davidson can stay at the table for clause by clause?

Hon. Senators: Agreed.

The Chair: Colleagues, are you prepared to move to clause by clause?

Hon. Senators: Agreed.

The Chair: I will proceed to the stages of clause-by-clause consideration.

Is it agreed that the committee proceed to clause-by-clause consideration of Bill C-313?

Hon. Senators: Agreed.

The Chair: Shall the title stand postponed?

Hon. Senators: Agreed.

The Chair: Shall clause 1 carry?

Hon. Senators: Agreed.

The Chair: Agreed. It is carried.

Shall clause 2 carry?

Hon. Senators: Agreed.

The Chair: Clause 2 carried.

Shall the title carry?

Hon. Senators: Agreed.

The Chair: The title is carried.

Shall the bill carry?

Hon. Senators: Agreed.

The Chair: Carried.

Does the committee wish to consider appending observations? Hearing none, no.

Is it agreed that I report this bill to the Senate?

Hon. Senators: Agreed.

The Chair: Thank you. It is agreed.

With that, I congratulate you, Ms. Davidson, on reaching this stage. However, with your experience you know that time still goes on. I will, as the committee has directed me, report this to the Senate.

(The committee adjourned.)