National Strategy for Eye Care Bill
Third Reading
November 5, 2024
Moved third reading of Bill C-284, An Act to establish a national strategy for eye care.
He said: Honourable senators, I rise today as Senate sponsor of Bill C-284, An Act to establish a national strategy for eye care and to designate an age-related macular degeneration awareness month. I would like to acknowledge the tireless efforts of MP Judy Sgro, who has championed a national strategy for eye care in the other place and raised awareness around age-related macular degeneration, or AMD, and other vision health issues. The bill’s unanimous passage reflects a shared recognition of vision care’s importance in our society.
I wish to begin by expressing my sincere gratitude to the Standing Senate Committee on Social Affairs, Science and Technology for their dedicated study and review of this bill. Over four insightful meetings, the committee heard from key stakeholders, including the Canadian Council of the Blind, Vision Loss Rehabilitation Canada, Indigenous Children Eye Examination and Health Canada. Their careful work underscores the Senate’s commitment to improving health care outcomes for all Canadians. The bill was reported back to our chamber without amendment.
I would like to thank Senator Cormier and Senator Mégie for their observations, including that Health Canada should effectively consult official language minority communities if this bill is duly passed and that the national strategy explicitly consider regular eye care follow-ups as part of its prevention methods, recognizing that regular eye care follow-ups are not always systemically practised. Collectively, the committee supported the need to reduce preventable blindness and improve eye health for Canadians through a coordinated approach.
One of the most celebrated aspects of Bill C-284 is its broad and inclusive design. It creates an opportunity to include everyone impacted by vision loss. This framework, which is intentionally not prescriptive, allows its potential to evolve and encompass a wide range of voices and needs as it develops.
The bill that is before us today is straightforward. It calls on the Minister of Health, in partnership with provincial governments, Indigenous communities, health care providers, researchers and other stakeholders, to develop a national strategy for eye care. It is designed to address essential elements such as prevention, early detection, treatment and accessibility for all Canadians, including enhanced access for Indigenous communities. The strategy would also encourage the development of innovative therapies and aim to standardize eye care practices across Canada’s health care systems.
Like other strategy or framework bills, it has reporting requirements, in this case, 18 months after the day on which this bill comes into force.
Through designating February as AMD Awareness Month, this bill recognizes the unique challenges posed by AMD. This progressive condition affects millions of Canadians over the age of 55 and has widespread impacts on their independence, mental health and quality of life. As our population ages, we must continue to increase awareness and ensure accessible treatments are available.
Why February? Having Canada formally recognize February as AMD Awareness Month aims to commit the nation to a focused effort in raising public awareness and understanding of this significant eye condition. The Canadian Ophthalmological Society, the CNIB Foundation and non-profit organizations like Fighting Blindness Canada already lead educational campaigns during February that stress the importance of early detection, prevention strategies and effective management of AMD.
These campaigns include webinars, public workshops, vision screenings and outreach programs offering comprehensive print and digital resources. Pharmacies and local health authorities also play a key role by promoting eye health through informational displays and community events. Collectively, these initiatives emphasize regular eye exams and proactive measures to help Canadians safeguard their vision and navigate the challenges of AMD. Formally recognizing February as AMD Awareness Month would reinforce these efforts, highlighting the importance of education and support in promoting eye health and empowering individuals with the knowledge and resources they need.
During committee discussions, it became evident that the gaps this bill seeks to address are critical. We need to increase access to eye care services in both urban and rural areas, making screenings and treatments affordable to all. We need comprehensive educational campaigns to highlight the importance of early eye checkups to prevent common conditions like cataracts and glaucoma. We must train more optometrists and vision health professionals and better integrate technology — including telemedicine and advanced diagnostic tools — to improve access, particularly in remote areas. Additionally, we must ensure that Indigenous communities can address their unique eye care needs.
While Bill C-284 doesn’t stipulate funding for these gaps — after all, it is a private member’s bill — it is a starting point that can catalyze conversations about future investments. A national framework would bridge the inconsistencies in eye care across our provinces and territories and address the rising prevalence of vision-related health concerns across our country. It would also support culturally appropriate, inclusive services tailored to the needs of our diverse communities.
Jurisdiction, often seen as divisive and complex, was an important point of discussion that also brought valuable insights. How do we ensure federal coordination without stepping on provincial jurisdictions?
Health Canada representatives assured us that this collaborative approach is well established. Previous strategies, whether for diabetes, palliative care, PTSD or autism, show how the federal government can successfully play a unifying role, bringing stakeholders together, reducing duplication and fostering solutions that benefit all. Canada has the opportunity to lead globally in delivering comprehensive eye care.
The reality is that this bill addresses an issue that touches the lives of countless Canadians: access to vision care. Our ability to see allows us to experience the beauty of our world, connect with others and navigate daily life. Yet for many Canadians, vision care remains out of reach, a luxury rather than an accessible component of our health care system.
I have personally seen the impact of this gap during my years as a family physician, and I know many of my colleagues have had similar experiences. Whether directly or indirectly, vision impairment affects us all. Over 8 million Canadians have an eye disease, with 1.2 million experiencing vision loss or blindness. Despite being largely preventable, 75% of vision loss cases remain undiagnosed and untreated due to gaps in accessibility and early detection.
Vision care is a crucial element of our health care system, yet many Canadians face barriers, particularly those in rural or remote areas or without private insurance. COVID-19, colleagues, has only amplified these challenges, causing missed appointments and delays in critical eye care.
Honourable senators, access to vision care and prioritizing eye health is a matter of collective responsibility. This bill is long overdue and one step in the right direction toward offering timely, essential supports to the millions of Canadians affected by vision loss. I strongly urge you, colleagues, to support this important piece of legislation without delay.
Thank you. Meegwetch.
One of the problems with being a critic to a bill, especially if you are a friendly critic, is that much of what you want to say has probably already been said. My remarks will be brief, but I want to make a few comments on this very important bill. I rise, of course, to speak to third reading of Bill C-284, An Act to establish a national strategy for eye care.
I want to thank both Senator Ravalia, my good friend across the way who sponsored the bill in the Senate, and, of course, my very good friend and member of the House of Commons Judy Sgro for bringing forward legislation on the important topic of eye care in Canada. Again, I can see where a good, staunch Liberal and a good Conservative can actually agree on good legislation, and I think this bill is one such example. Another was, of course, Bill S-269, which we just passed a few minutes ago.
As a reminder, Bill C-284 provides for the development of a national strategy to support the prevention and treatment of eye disease as well as vision rehabilitation to ensure better health outcomes for Canadians. It also designates February as Age‑related Macular Degeneration Awareness Month.
During its study in committee, witnesses shared the many needs of eye care in Canada and how Bill C-284 is needed to help meet those needs. For my third reading speech today, I want to share a little bit about what the committee has heard and how Bill C-284 would begin the conversation of a better-coordinated approach to eye care in Canada. I want to begin, colleagues, by sharing a snapshot of eye care in Canada.
The proportion of the population in 2020 that reported having good vision without correction was about 75% among youth aged 12 to 19. Unsurprisingly, the proportion was lower as the respondents were older, to about 25% for those aged 55 years and older. In terms of global numbers in the country, approximately 1.2 million Canadians are blind or partially sighted, while over 8 million are at significant risk of blindness.
The number of Canadians living with vision loss is on the rise. Further, I was surprised by a 2022 report from Statistics Canada that states few studies have been done in Canada on eye health. This sentiment was echoed during committee study by Larissa Moniz from Fighting Blindness Canada, who said, “. . . vision health has been undervalued for a very long time . . . .”
Statements like that, colleagues, further prove that vision health in Canada needs help, and Bill C-284 will help get the ball rolling. For example, of the four measures in the national strategy for eye care, the second measure proposes to “promote research and improve on eye disease prevention and treatment . . .” and vision rehabilitation. The committee heard throughout its study about the need for better research, and their plea was corroborated by the report by Statistics Canada.
During committee study, Jennifer Jones, President and Chief Executive Officer of Fighting Blindness Canada, explained why Canada needs an eye care strategy:
. . . In truth, what we really need is a consistent application of care to national eye care. That’s the reason this strategy is so important to us. We want to make sure there is a comprehensive and consistent focus on the full spectrum of eye health care, which we are all going to speak to in turn — better education and awareness, better access to diagnosis and treatments, and more investment in research that will drive better outcomes and an improved quality of life.
Colleagues, we can all agree that we need better education and awareness, which translates to better prevention. With eye care, like health care, prevention is the best approach, and it starts from a young age. As I stated earlier in my speech, eyesight gets worse as we get older. One of the leading causes of blindness in Canada, and the leading cause in North America, is age-related macular degeneration, or AMD. According to the Canadian Association of Optometrists, AMD is a progressive disease, with symptoms worsening over time. In the early stages, while no symptoms can be felt, AMD can be detected with an eye exam. As time goes by, various treatments are available to slow down the disease as well as prevent severe vision loss. The key element to AMD, like many eye diseases, is early detection.
Bill C-284 would also raise awareness on AMD by designating the month of February as “Age-Related Macular Degeneration Awareness Month.”
Colleagues, over 1.5 million Canadians live with AMD. Canadians need to know before their diagnosis what can be done to slow down the progression of AMD, not when it is too late.
By raising the awareness of the importance of eye exams, we not only help eye care in the country and improve quality of life, but we can also improve other health indicators found through eye exams. While the eyes are said to be the windows to the soul, they are also indicators of good overall health. While the eyes can indicate a variety of emotions — from kindness to happiness to sadness — they can also be early detectors of various health issues. According to an article by the American Academy of Ophthalmology, an eye exam can detect 20 various health problems, such as high blood pressure due to unusual bends, kinks or bleeding from blood vessels. It can also detect early signs of heart diseases, lupus, Lyme disease, multiple sclerosis, an increased risk of stroke and the list goes on.
While Bill C-284 focuses on vision health, the potential of having better eye care in Canada goes beyond vision. We sometimes treat various branches of care in silos, but they can interact together and be preventive. That certainly seems to be the case with eye exams, and, hopefully, part of the strategy can also expand upon the numerous health indicators eye exams can provide.
To understand the real need for an eye strategy, during the committee study, Dr. Martin Spiro, President of the Canadian Association of Optometrists, made a great case when he shared a story:
As an optometrist, I would like to share a recent experience that is a stark reminder of why Bill C-284 is vital. Recently, a new patient presented to my clinic complaining about a decrease in their vision. Like so many Canadians, he had long felt that, since his vision had been fine, he didn’t need to see an eye doctor. In fact, it had been over ten years since his last eye exam.
What he did not realize — and what we discovered during his exam — was that he had advanced glaucoma. By the time he sought care, the damage was significant and irreversible. If this patient had received routine care, this vision loss could likely have been preventible.
Stories like those are heartbreaking, colleagues. They are stark reminders of the importance of eye exams to prevent vision loss. Seventy-five per cent of vision-related diseases are preventable and treatable with early intervention. With better education and awareness of the importance of eye exams, we could significantly lower that percentage.
Jennifer Urosevic, President and Chief Executive Officer of Vision Loss Rehabilitation Canada highlighted the following:
. . . Today, more than 1.2 million Canadians live with blindness and low vision, and as our population ages, the number is set to double by 2050.
Just over 160,000 people access our services. Due to funding restrictions, we are only able to see a fraction of the 1.25 million people living with low vision or blindness who would benefit from our services. The Deloitte report in 2021 commissioned by the Canadian Council of the Blind indicated that vision loss costs to Canadians is $32.9 billion each year.
Vision loss costs our economy $32.9 billion each year. That is an astonishing number, even more so when you consider that 75% of vision-related diseases are preventable. With only 160,000 people accessing the services offered by Vision Loss Rehabilitation Canada, there is a large population not being served and whose quality of life could potentially be improved.
In the context of an aging population and multiple gaps in eye care in Canada, Bill C-284 would get the conversation going with partners across the country. By gathering provincial partners and various key stakeholders, the federal government can show real leadership to tackle vision loss in Canada.
Colleagues, this legislation aims to address serious issues in eye care in Canada.
I want to recognize Liberal member of Parliament Judy Sgro for putting this bill together. As a personal comment, senators who weren’t here in 2017 might be surprised to know it is not the first time MP Sgro and I have worked and supported legislation together. Back in 2017, I introduced Bill S-224, the Canada prompt payment act, which passed our chamber but got stuck in the House of Commons. As Chair of the Standing Committee on Transport, Infrastructure and Communities, MP Sgro saw Bill S-224 as good legislation and lobbied her own government to pass federal prompt payment legislation.
In June 2019, the budget implementation act received Royal Assent, and it included the Federal Prompt Payment for Construction Work Act. Thanks to collaborative work between MP Sgro and myself, we paved the way for trade contractors to receive prompt payment when working on federal projects. I am therefore proud today to help my friend get her bill across the finish line.
Since 2015, partisanship in this place has unjustly and unfairly received a bad reputation from the government. Colleagues, the fact of the matter is that we and I have never opposed legislation purely on partisanship. When good legislation is put in front of me, is thoroughly debated and can bring good to Canadians, we will support it, it doesn’t matter who the sponsor is or from which party. Bill S-224 was good legislation for trade contractors from coast to coast to coast, and MP Sgro made sure it became law regardless of the fact it was from a Conservative senator.
Bill C-284 is equally good legislation to improve eye care in our country, and regardless of it being from a Liberal MP, I am happy to help bring it over the line. It will help millions of Canadians who are living with eye disease, and at the end of the day, that is what matters: legislation that helps Canadians live a better life.
Therefore, I urge all senators to join me in supporting this bill today.
Thank you.
Are senators ready for the question?
Is it your pleasure, honourable senators, to adopt the motion?
Hon. Senators: Agreed.
(Motion agreed to and bill read third time and passed.)
