January 31, 2017

LIB

Mike Bossio

Liberal

Mr. Mike Bossio (Hastings—Lennox and Addington, Lib.)

Mr. Speaker, I am pleased to have the opportunity to speak today on the bill brought forward by the member for Dartmouth—Cole Harbour, an act respecting the development of a national strategy for the safe and environmentally sound disposal of lamps containing mercury.

Bill C-238 would build upon efforts already under way across Canada to reduce mercury emissions to the environment. Reducing mercury emissions is an important goal, given the serious effects mercury can have on human health and the environment. Mercury is a potent neurotoxin. It can cause damage to the brain, central nervous system, kidney, lungs, and is particularly damaging to the development of the human fetus, infants, and young children.

In terms of environmental impacts, mercury biomagnifies as it moves up the food chain, meaning that higher levels of mercury are found in animals higher on the food chain. This can lead to increased exposure for fish and wildlife, as well as humans who consume certain kinds of fish. Increased exposure means increased health problems, including slower growth, reproductive failure, and the development of abnormal behaviours. Mercury can travel long distances in the atmosphere. It has been found to accumulate in Canada's Arctic.

Given these impacts on human health and the environment, the Government of Canada is committed to minimizing and, when feasible, eliminating human sources of mercury emissions.

Domestic mercury emissions have been reduced by approximately 90% since the 1970s, thanks to a wide range of initiatives to address mercury emissions. However, more can be done.

In 2010, the Government of Canada released the risk management strategy for mercury. The strategy provides a comprehensive description of the government's plans and progress in managing the risks associated with mercury. One example is the products containing mercury regulations, which came into force in November 2015. These regulations prohibit the manufacture and import of products containing mercury, with some exemptions for essential products that have no technically or economically viable alternatives. In the case of lamps, the regulations set mercury content limits for fluorescent and other types of lamps that require labels to inform consumers about the presence of mercury.

In April 2016, Environment and Climate Change Canada published the proposed code of practice for environmentally sound management of end-of-life lamps containing mercury. The code provides guidance and information relevant to managing these lamps at the end of their life. The final code of practice was expected to be published by the end of 2016.

International initiatives to address mercury pollution are another important element of the Government of Canada's approach. It is estimated that 95% of human caused mercury deposits in Canada come from foreign sources. To help reduce the impact of transboundary pollution on Canada, and particularly impact on Canada's Arctic where mercury tends to deposit, the government signed the Minamata convention on mercury in 2013. We are in the process of finalizing the necessary implementation measures required to ratify the treaty.

The bill introduced by my colleague, the member for Dartmouth—Cole Harbour, would complement these and other existing measures to address mercury pollution by focusing on one particular source of emissions, light bulbs. Many energy efficient bulbs, including compact fluorescent lamps used in the homes and workplaces of many Canadians, contain a small amount of mercury. This mercury may be released if the lamp breaks or is improperly disposed of as regular garbage.

The bill would mandate the development of a national strategy for the safe disposal of lamps containing mercury. Amendments made to the bill at committee serve to reinforce the purpose of the bill and the need for co-operation across jurisdictions in the development of a national strategy. For example, the bill now speaks of safe and environmentally sound disposal.

The environmentally sound end-of-life management of lamps containing mercury involves a range of activities, including collection, processing, recycling, diversion, and storage. The national strategy contemplated by the bill would capture any number of these activities, rather than the disposal of lamps containing mercury in a landfill. This terminology is consistent with the proposed codes of practice for end-of-life lamps containing mercury.

The amendments made at committee also strengthen the bill by recognizing the jurisdiction over the protection of the environment, including matters related to waste management, is shared among all levels of government in Canada. Removing the requirement on the minister to implement the national strategy recognizes this fact as the minister cannot implement the national strategy on her own. As a result, the bill would require the Minister of Environment and Climate Change to work with other parties, including the provincial and territorial governments, in developing a national strategy.

The bill also intends to capture other interested governments such as municipal and indigenous governments that may have important roles in the implementation of a national strategy. The minister will need to co-operate with them, but also consult with other interested parties, including stakeholders, in developing a national plan of this kind.

The bill lists examples of the kinds of things that the national strategy could include. Possible elements set out in the bill will not only help guide collaboration and consultation with other interested parties, including stakeholders, but will also help ensure that the national strategy does not duplicate efforts already under way.

The strategy can evolve to ensure that the range of perspectives are considered in the development of the strategy. One possible element of the national strategy is a plan to promote public awareness of the importance of disposing of mercury containing lamps safely and in an environmentally sound manner. Many Canadians are currently unaware that these bulbs should not be disposed of in regular garbage because they may break and release mercury into the environment.

The bill sets out a flexible framework for development the national strategy, but also contains important mandatory requirements. In particular, it requires the Minister of Environment and Climate Change to develop and report on the national strategy.

The first report to Parliament setting out the national strategy must occur within 15 sitting days of December 31, 2018, or within two years after royal assent, whichever is later. Every five years following the initial tabling, the minister must report on the strategy, including his or her conclusions and recommendations regarding the strategy. These reporting requirements promote transparency and accountability, and will help ensure that the national strategy achieves its intended purpose.

I sit on the environment committee along with the member for Dartmouth—Cole Harbour. As we were going through the bill to make amendments, the importance of this issue became really apparent. I happened to be looking up at the ceiling and I noticed all the lights. I started to count them. There were over 70 fluorescent lights in the one committee room. Then I just happened to be in the Library of Parliament, looking over the speech. when I looked up and started counting lights. I got to over 250 and I still had not counted all of them. These are just two rooms in the millions of rooms in up to 10 million homes in our country that presently use compact fluorescent light bulbs.

It is so important that we develop a national strategy that can work with industry, that can work with all levels of government, that can work with innovation to try to drive forward new technologies, as we are presently, which are more efficient and more cost effective and will eventually eliminate the need for fluorescent bulbs altogether.

Once again, I would like to thank the member for Dartmouth—Cole Harbour for bringing the bill forward. The government supports the bill, as amended, and looks forward to working with other governments, indigenous groups and stakeholders to develop an effective national strategy for the safe and environmentally sound disposal of lamps containing mercury.

Topic:   Private Members' Business
Subtopic:   An Act respecting the development of a national strategy for the safe and environmentally sound disposal of lamps containing mercury
Permalink
LIB

John McKay

Liberal

Hon. John McKay (Scarborough—Guildwood, Lib.)

Mr. Speaker, I am pleased to rise today in support of Bill C-238, the national strategy for Safe and Environmentally Sound Disposal of Lamps Containing Mercury act.

First, I want to thank my colleague, the member for Dartmouth—Cole Harbour, for bringing the bill forward. The bill serves an important purpose by contributing to efforts to reduce mercury emissions and releases. Mercury is a toxic subject that is harmful to the environment and human health, which is why the Government of Canada is committed to eliminating human sources of mercury emissions when feasible.

Bill C-238 calls for a national strategy for the safe and environmentally sound disposal of lamps containing mercury. The bill would fill gaps within the existing framework governing management of mercury in Canada. Although robust measures are already in place to manage mercury emissions and products containing mercury, many Canadians are unaware of the dangers of improper disposal of lamps containing mercury. Many Canadians do not have ready access to facilities where lamps containing mercury can be disposed of safely and in an environmentally sound manner.

The Standing Committee on Environment and Sustainable Development studied the bill. I was there for one meeting. In a very collaborative way and arguably a way which all committees ideally would operate, adopted amendments that would facilitate a co-operative and collaborative approach to the development of the national strategy. These amendments are consistent with the purpose of the bill. The member for Dartmouth—Cole Harbour has noted that the bill is meant to be the beginning of a conversation. The amendments made at committee facilitate that goal by expanding the range of perspectives to be considered in the conversation and by ensuring flexibility in determining the elements of the national strategy.

The amendments made at committee strengthen the bill by recognizing that jurisdiction over waste management is shared between different levels of government. The national strategy is to be developed by the Minister of Environment, in cooperation with representatives of provincial, territorial, and other interested governments. The addition of “other interested governments” improves the original bill by capturing other governments, such as municipal and indigenous governments, that would like to have a role in developing and implementing the national strategy.

A related amendment is that the minister shall consult with “all interested persons and organizations”, rather than only requiring consultation with environmental groups and industry. This would help to ensure that a range of perspectives would be considered in the development of the strategy.

There are a number of reasons why the co-operative, flexible framework set out in the bill is essential to the success of the national strategy.

First and foremost, co-operation is important because jurisdiction over matters related to waste management is shared among different levels of government. The Government of Canada currently regulates international and interprovincial movements of hazardous waste, manages waste on federal lands, and has extensive authorities to regulate toxic substances and products that contain them. Provincial and territorial jurisdictions regulate waste management operations and facilities and the end-of-life management of products. Municipal governments collect and manage waste for recycling and disposal. Bill C-238 recognizes that these various levels of government have a role to play in the safe and environmentally sound disposal of lamps containing mercury.

A collaborative approach to managing mercury emissions is nothing new. For years, important work has been coordinated by the Canadian Council of Ministers of the Environment to address various sources of mercury pollution, including lamps containing mercury.

One example of action at the CCME level is the Canada-wide action plan on extended producer responsibility. In 2009, all provinces and the federal government committed to implementing the Canada-wide action plan, which includes action on mercury lamps. Extended producer responsibility, or EPR, is an approach where producers are responsible for dealing with products at their end of life. Essentially, EPR shifts responsibility for dealing with waste products upstream to the producer and away from municipalities and general taxpayers. EPR can be an effective way to divert certain products from landfills and we have seen some success in the context of mercury lamps. Four provinces, British Columbia, Manitoba, Quebec, and Prince Edward Island, have implemented specific regulatory programs to collect and recycle mercury lamps.

This brings me to another reason why the co-operative approach put forth in the bill is so important. This approach recognizes that a number of efforts are already under way in different jurisdictions to minimize pollution from lamps containing mercury. Some provinces, and even certain areas within provinces, are further ahead than others in terms of managing lamps containing mercury in an environmentally sound manner. In other areas, such as much of the north, the infrastructure to properly divert these lamps from landfills simply does not exist.

There are also a number of federal initiatives to address mercury lamps. For example, in April of 2016, the Government of Canada published a Proposed Code of Practice for the Environmentally Sound Management of End-of-life Lamps Containing Mercury. I do not know how these titles are arrived at. It seems there is kind of an art form that goes with the creation of law that there has to be a title that runs for about four paragraphs.

The code of practice is a voluntary tool developed to complement provincial, territorial, and municipal initiatives and to promote the best practices for managing lamps containing mercury at the end of life. By setting out a co-operative framework, the bill would allow the national strategy to complement, rather than duplicate, existing federal, provincial, and municipal efforts to manage lamps containing mercury. The bill would not mandate what the national strategy must include. Instead, it would require that the strategy be developed co-operatively.

The bill would provide guidance by setting out certain elements that could be included in the national strategy. For example, the national strategy could include guidelines for facilities involved in the safe and environmentally sound disposal of mercury. This could be a facility like the recycling facility in Dartmouth—Cole Harbour and similar facilities across Canada. However, the elements of the national strategy are not predetermined by the bill. Rather, the strategy may include any elements to reflect the work and consultations that the minister will undertake with provinces, territories, municipalities, and other interested parties in the development of the strategy.

The bill focuses national attention on an important issue, an issue on which we have a real opportunity to reduce mercury emissions. I want to again thank the member for Dartmouth—Cole Harbour for his initiative and for bringing the bill forward. I expect that a national strategy will have an important impact on ensuring environmentally sound management of lamps containing mercury.

Topic:   Private Members' Business
Subtopic:   An Act respecting the development of a national strategy for the safe and environmentally sound disposal of lamps containing mercury
Permalink
LIB

Anthony Rota

Liberal

The Assistant Deputy Speaker (Mr. Anthony Rota)

Seeing no one rise on debate, the hon. member for Dartmouth—Cole Harbour has five minutes of reply.

Topic:   Private Members' Business
Subtopic:   An Act respecting the development of a national strategy for the safe and environmentally sound disposal of lamps containing mercury
Permalink
LIB

Darren Fisher

Liberal

Mr. Darren Fisher (Dartmouth—Cole Harbour, Lib.)

Mr. Speaker, I am sure I will not need a full five minutes. I will say that I am truly humbled to rise again in this place to speak to Bill C-238, a national strategy for the safe and environmentally sound disposal of lamps containing mercury act. The member who spoke previously is correct; it is a mouthful.

I would like to start by thanking my amazing family. It is not always easy to come here to Ottawa. In fact, I am missing my son's hockey game right now; he will take the ice in about a minute. We miss a lot of things by coming here to do the good work for the people in our communities, and I am proud to do the work for the people of the community of Dartmouth—Cole Harbour.

I have to thank the members of my team for their incredibly hard work on Bill C-238. This started out as nothing more than a bright idea, and they have been able to turn this into something tangible, into a private member's bill that is now at third reading and hopefully, fingers crossed, knock on wood, on its way to becoming a law.

My riding of Dartmouth—Cole Harbour inspired this bill. We have many innovative businesses in the Dartmouth Burnside industrial park. One of them, Dan-X Recycling, caught my eye. I have mentioned Dan-X before, but this facility is able to efficiently dispose of mercury-bearing light bulbs in a safe and environmentally sound way. This facility is an excellent example of the clean tech industry, and I am proud to have it in my riding. Just think, if Bill C-238 passes, we could improve the green economy by encouraging more facilities like Dan-X right across the country. Now that is a clean economy.

I have stated before that Bill C-238 is about working together, but I do not think I realized how true this would be. I have been humbled by the supportive and kind words I have received from colleagues throughout this House. Bill C-238 as amended passed unanimously at the Standing Committee on Environment and Sustainable Development. Many members have spoken to this bill in the several readings in this House, but my favourite comment so far has to be from the member for Yellowhead who said, “this bill is a winner”. I thank my friend for that comment. I would be remiss if I did not mention the member for Abbotsford, who through this process has become a friend. He sits on the environment committee with me and he has had some very good, supportive words to say about this bill.

Bill C-238 has created an incredible dialogue around mercury pollution, but it has also shown that when we care about the environment, when we care about Canadians, and when we care about making real change, we can work across party lines to make it happen. This is what Canadians want and this is what they expect from us in this House. I firmly believe that Bill C-238 has the potential to solve the issue of mercury-bearing light bulb pollution in our lands and in our waters. I encourage all members of this House to support Bill C-238, regarding the development of a national strategy for the safe and environmentally sound disposal of lamps containing mercury act.

Let us continue to work together. Let us solve this issue together to ensure that we leave this country a better place for all Canadians to enjoy.

Topic:   Private Members' Business
Subtopic:   An Act respecting the development of a national strategy for the safe and environmentally sound disposal of lamps containing mercury
Permalink
LIB

Anthony Rota

Liberal

The Assistant Deputy Speaker (Mr. Anthony Rota)

The question is on the motion. Is it the pleasure of the House to adopt the motion?

Topic:   Private Members' Business
Subtopic:   An Act respecting the development of a national strategy for the safe and environmentally sound disposal of lamps containing mercury
Permalink
LIB

Anthony Rota

Liberal

The Assistant Deputy Speaker (Mr. Anthony Rota)

(Motion agreed to, bill read the third time and passed)

Topic:   Private Members' Business
Subtopic:   An Act respecting the development of a national strategy for the safe and environmentally sound disposal of lamps containing mercury
Permalink
LIB

Anthony Rota

Liberal

The Assistant Deputy Speaker (Mr. Anthony Rota)

Pursuant to Standing Order 30(7), the House will now proceed to the consideration of Bill C-277 under private members' business.

Topic:   Private Members' Business
Subtopic:   An Act respecting the development of a national strategy for the safe and environmentally sound disposal of lamps containing mercury
Permalink
LIB

Anthony Rota

Liberal

The Assistant Deputy Speaker (Mr. Anthony Rota)

Resuming debate. The hon. member for Abitibi—Témiscamingue has eight minutes to complete her speech.

Topic:   Private Members' Business
Subtopic:   Framework on Palliative Care in Canada Act
Permalink
NDP

Christine Moore

New Democratic Party

Ms. Christine Moore (Abitibi—Témiscamingue, NDP)

Mr. Speaker, I did not think I would have the chance to complete this speech, so I am pleased to use the eight minutes I have left to do that.

In the first part of my speech, I had noted some things that the bill’s sponsor could come back to in committee. I had also suggested that she include the first nations governments in the consultation, because that is crucial. Often, the cultural approach to death is not really incorporated. Given the federal government’s duty to the first nations communities, it is essential that they be at the discussion table to express their needs.

In addition, there are enormous needs for palliative care in indigenous communities, because there are virtually no projects. Often, the communities are too small, so the feeling is that resources cannot be allocated specifically to palliative care. A number of first nations communities have no long-term care facility. Elders are therefore cared for by their province’s health care system.

When we go out and meet with the people who provide palliative care, we see that they are interested in developing projects. I have been to the Maison du Boulot Blanc in Amos, right next to the community of Pikogan. It sometimes takes in people from the Pikogan indigenous community who need its services. The people who work there are very happy to do that, but they say themselves that it is not the same, that the community is much more involved and there are a lot of people who come to support the dying person.

They do what they can in terms of needs, but if there were some openness to allocating federal funds for specific projects for the first nations, they would very definitely be open to having a room set up and decorated based on the person’s needs. That would reflect the desired approach, which is to accommodate clients who need palliative care.

This is something that will have to be discussed in committee. I urge my colleague to give immediate thought to people from indigenous communities who might be interested in talking about their situations and how they could be involved in delivering palliative care.

Although the administration of palliative care itself falls under provincial jurisdiction, I believe that the federal government has a role to play in bringing all the stakeholders together to discuss best practices. It is not about taking a paternalistic approach and bringing everyone together to tell them to look at the best practices happening elsewhere. It is about creating room for dialogue, where everyone can share their successes and failures in order to move palliative care forward.

We often forget certain particularities associated with palliative care. Pediatric palliative care is extremely difficult. How do we support a child who is dying of cancer or some genetic disease? We have a lot to learn by sharing ideas on this.

For instance, it is important to ensure that children who need palliative care are not forced to choose between being close to home or in a pediatric care centre. They are often hospitalized for long periods and find themselves far from home. Parents sometimes decide to bring their child home when it is time for palliative care to begin. When we talk about a special client group, it is often those in remote areas who have a hard time getting the care they need.

It would be helpful, then, to be able to talk about our practices in order to overcome these challenges. If the various ministries, provinces, and agencies involved could share tools with the rest of the country, we would all be better off.

Other patients are often neglected. For example, how does one help a person with a fairly serious intellectual deficiency prepare for death?

I have had to do it over the course of my career and it is not easy. Caregivers do not always have all the tools they need. They are used to working in a context where the person understands death and what is happening to him or her. However, it is often more difficult to help someone outside that context. I therefore think it is important for caregivers to have that skill.

When it comes to palliative care, for example, some deaths will affect caregivers more than others. That is why it is also important to talk about the distress they experience. Regardless of where the caregiver works, some cases will cause a lot of pain and sorrow. It is also important to be able to talk about that aspect of palliative care so that caregivers do not carry that pain and sorrow with them throughout their careers and can resist breaking down at some point.

Take, for example, soldiers who are deployed overseas and who have to be there for someone who is dying because there is no other choice. Sometimes these experiences are traumatizing and become difficult to live with after many years in the field.

In my opinion, it would be worthwhile adding this other element to the bill on palliative care, that is, monitoring the distress of caregivers, because we are hearing more and more about this issue.

Working with death every day is difficult. I believe it would be beneficial to monitor the distress of caregivers, especially those working in palliative care centres and paediatric and neonatal departments, who do their best to save infants, but are sometimes confronted by the reality that there is no other option but to let them go. These life situations can be difficult, and it would be advisable to monitor this aspect of public health.

I would like to thank my colleague and the House once again for letting me finish my speech. I look forward to my colleagues' comments.

Topic:   Private Members' Business
Subtopic:   Framework on Palliative Care in Canada Act
Permalink
CPC

Bernard Généreux

Conservative

Mr. Bernard Généreux (Montmagny—L'Islet—Kamouraska—Rivière-du-Loup, CPC)

Mr. Speaker, I am pleased to rise in the House today to support my colleague, the member for Sarnia—Lambton, and her Bill C-277, an act providing for the development of a framework on palliative care in Canada.

Before continuing, I must first congratulate my colleague for her hard work since she was elected in 2015, and for earning the title of most collegial MP. She was awarded that title by her colleagues in the House, from all parties, when the prize was given by Maclean's and L'Actualité last fall. It speaks to the unstinting work done by my colleague, particularly on her present bill.

We are therefore very happy to have an engineer in our Conservative caucus as opposition science critic. That is why I am happy to speak today in support of her Bill C-277, a bill that has attracted attention from key health care stakeholders in my riding, Montmagny—L'Islet—Kamouraska—Rivière-du-Loup.

Like a number of rural ridings in Canada, we find that we have an aging population, and we can already anticipate that the demand for palliative care will rise considerably over the coming years. It has already started. It is therefore important to talk about it and give ourselves time to be well prepared.

Following a Supreme Court decision in Carter, last year, this Parliament passed Bill C-14, which provided a legislative framework for physician-assisted dying. Although the bill was well received by some people who wanted to avail themselves of this right, others had some concerns, because they wanted to make sure that this was not the only option available. In my riding, just like elsewhere in Canada, this is a real question: will we provide only a bill like that, or will we provide other types of care? The other types of care are much needed.

As my colleague from Sarnia—Lambton noted, in the final report of the external committee on options for a legislative response to Carter v. Canada, the Supreme Court stated that a request for physician-assisted death cannot be truly voluntary if the proper palliative care is not available to alleviate the suffering of patients.

This is where we are today. The bill proposed by my colleague seeks to improve the options available to Canadians at the end of their lives. It truly seeks to encourage consultations and dialogue with the provinces to develop a national framework so that palliative care is a real option. In fact, the plan highlights the importance of having access to palliative care of higher quality than what is currently available.

It is important that our seniors and other people with terminal illnesses are protected with healthy, safe, and comfortable options in the last stages of their lives if they do not wish to avail themselves of medical assistance in dying. This is an extremely important point. People must have access to high-quality care to be able to live as long as possible in palliative care facilities. This will prevent many people from even thinking about requesting that their lives be terminated. The dignity of people depends on it.

I would like to highlight the incredible work done in my riding by the Maison Desjardins de soins palliatifs in Rivière-du-Loup, which has provided an enormous amount of care since it opened in 2009. I should also mention the mission of the Fondation Hélène-Caron, which will soon be serving the region of Montmagny and l'Islet through the Maison d'Hélène. Passing Bill C-277 will send a message to organizations like those, all across Canada, that their work is recognized and greatly appreciated.

Last month, Dr. Louise La Fontaine, vice-president of the Société québécoise des médecins en soins palliatifs and a resident of Notre-Dame-du-Portage in my riding, wrote to me to say that Canadians across the country have joined together to draw attention to the importance of palliative care.

She recommends that a national policy be developed in order to considerably improve the quality and consistency of palliative care and access to it. She recommends examining and assessing new models of integrated care, broadening accreditation standards throughout the entire health network, and focusing on areas such as symptom management and advance care planning. Practitioners must also be trained so that they can work in accordance with the various models for integrating palliative care into the management of severe chronic illness.

That is convenient because many of the things she mentioned would be part of the legislative framework if my colleague's Bill C-277 passes.

By asking the Minister of Health to consult with her provincial counterparts, we can ensure that every region of Canada is included in the discussion and that best practices and innovative ideas in the palliative care field are shared. I want to emphasize that because it is an extremely important aspect of the bill. My colleague who just spoke mentioned first nations. Canadian regions differ from one another, of course. One feature of this bill is that it takes all those differences into account and creates a framework for sharing the good practices that some regions are using and looking at which ones would work elsewhere.

I encourage all of my parliamentary colleagues to join me in supporting Bill C-277 so that we can help people across our great nation. If passed, this legislative framework will meet their medical needs and give us a plan that reflects the looming new demographic reality.

I will close by saying that the Lower St. Lawrence region, where my hometown of La Pocatière is located, is the oldest in Canada. What my colleague wants to put in place to facilitate the aging of the population affects us in particular. The bill proposes to provide quality care and enable people to make a fully informed and conscious decision, and to live out their days in an environment where their dignity will be respected.

My brother-in-law died last year after having cancer for seven years. He was treated at a hospice in the Eastern Townships. I had the opportunity to visit him twice. My sister stayed with him for three months.

The Eastern Townships, where Magog and Sherbrooke are located, is well developed. The care offered in the region is already excellent. The experience that these people have developed over the years can most certainly be shared with Canada's other regions.

From what I could see, the quality of care that my brother-in-law received was incredible. I think it is important to mention that.

My colleague came to my riding last week. Our plan was to have her come to my riding to visit palliative care homes, but unfortunately, the weather did not co-operate. I want to thank her for making the effort to meet with my constituents, who have spent a great deal of energy and time fundraising. Palliative care homes are often autonomous thanks to the donations they receive. Donations keep these homes open and operating, as is the case in Rivière-du-Loup.

In Montmagny, Hélène Caron, who is in charge of the project, has cancer. She gives a lot of her time to ensuring that this home exists. It is not a self-serving gesture. She devotes her time to the people and the good of her community.

The bill is unifying. I think that all parties should support it and see it through. Then we could have a national framework for all palliative care homes and the necessary funding to ensure that they are operational.

Topic:   Private Members' Business
Subtopic:   Framework on Palliative Care in Canada Act
Permalink
LIB

Francis Scarpaleggia

Liberal

Mr. Francis Scarpaleggia (Lac-Saint-Louis, Lib.)

Mr. Speaker, a few years ago, members from all parties in the House, including myself, established a committee on palliative and compassionate care. The mandate of the committee was to study the nature and scope of palliative care in Canada. I would like to congratulate the member for Sarnia—Lambton for following up on the committee's work with this important initiative.

My inspiration for joining the all-party parliamentary committee on palliative care, which was an ad hoc committee, was Teresa Dellar, a friend and Montreal social worker who founded the West Island Palliative Care Residence in my riding of Lac-Saint-Louis in Montreal's West Island

The residence has 23 beds making it the largest palliative care facility in Canada. It is a model for palliative and end-of-life care across Canada and throughout the world.

I had the joy and honour of being present at Rideau Hall this past November 25 with Teresa's husband, Gavin Fernandes, and sons Jonathon and Nicholas, when Teresa was awarded the Meritorious Service Cross by the Governor General for her vision and pioneering work in palliative care—and I would underscore that the member for Sarnia—Lambton happened to be there as well that day.

Some amendments will be necessary to make the bill better fit the constitutional and practical realities of health care in Canada.

For example, clause 2(1) calls on the Minister of Health to:

develop and implement a framework designed to give Canadians access to palliative care—provided through hospitals, home care, long-term care facilities and residential hospices—that, among other things,

(a) defines what palliative care is;

Unfortunately, it is not within federal jurisdiction to give, or require provinces and territories to give, access to palliative care.

That said, the federal government is well placed to support the efforts of the provinces and territories and stakeholder organizations, by focusing on aligning and extending federal levers in relation to health care system improvements.

We have already seen the government move in this direction during negotiations over a new health care accord, when it offered $5 billion over 10 years to the provinces for home care, a commitment that Marie-France Juneau, executive director of NOVA West Island, formerly the Victorian Order of Nurses, no doubt welcomed.

NOVA West Island offers indispensable services in a home setting to Montreal West Islanders dealing with cancer and other debilitating diseases like ALS.

Federal funding would benefit NOVA and its patients and leverage the efforts of its volunteers. In 2015–16 alone, 16,532 volunteer hours were donated by 232 active volunteers lending a hand with respect to a number of NOVA's services.

Clause 4(1) of the bill also requires amendment. Currently, it requires that the Minister of Health undertake a review and table a report on the effectiveness of the stipulated palliative care framework every five years. However, this would require the minister to report on progress in an area where the government has few levers to directly make change.

Instead, therefore, it would be more advisable to have the government simply report on the state of palliative care in Canada after five years, in this way aligning the bill with the law on medical aid in dying, which requires a parliamentary review on the state of palliative care in Canada within five years of its coming into force.

The federal government is also not in a position to dictate to the provinces what specifically constitutes medically necessary services that must be provided to be eligible for federal funding under the Canada Health Act.

It is further worth noting that there is, in fact, no positive right to publicly funded health care in Canada. This was affirmed in the 2005 Chaoulli decision, where the Supreme Court said, “The Charter does not confer a freestanding constitutional right to health care”, even though medicare is rightly considered a de facto right by Canadians—an entrenched, morally rooted societal norm, I would argue.

The federal government has never waded into defining what actually constitutes a medically necessary service. Nonetheless, I believe Canadians will come to expect palliative care as something that should morally and ethically be broadly made available to them at end of life—in other words, a de facto right.

The question is how this right will come to be realized. Some believe it will materialize through the courts. There are those who argue that under section 7 of the charter, the section that affirms the right to life, liberty, and security of the person, individuals must be afforded autonomous choice at the end of life, the basic principle at the core of the medical aid in dying legislation. However, if the degree of pain control provided by palliative care is not available, an individual's choice has in fact been limited.

In terms of section 15, the charter's equality provision, others make the argument that current provincial palliative care programs, although not technically viewed as medically necessary since the aim is not to cure but to care, de facto discriminate according to disability because they are generally aimed at those dying from cancer. It is interesting to note in this regard that the West Island Palliative Care Residence, once again a leader, caters not only to cancer patients but also to those with other terminal illnesses. A 2014 Globe and Mail article highlighting the residence stated:

At the outset, 98 per cent of palliative-care patients had terminal cancer...Increasingly, however, the hospice is seeing more patients with end-stage cardiovascular and renal disease, and with conditions such as ALS and multiple sclerosis

Also, palliative care is generally needed by those who are older. Therefore, some argue that the absence of broad access to palliative care amounts to a form of age discrimination.

I would like to take a moment to discuss the West Island Palliative Care Residence's vision for expanding palliative care in Canada. I believe it dovetails with the general framework and intent of Bill C-277. In particular, I would like to propose that the government partner with the residence, given its reputation as a national leading edge centre of excellence in palliative care, in advancing the palliative care agenda in Canada.

The residence draws on a community, namely Montreal's West Island, which harbours a critical mass of resources, including the leadership talents of medical practitioners connected to the McGill University and Université de Montréal medical centres. The residence has an important role to play in education and training and in the transfer of practice-based research and knowledge to the broader Canadian community. It intends to play this role by creating a newly formed division called the Montreal institute for palliative care. It is my hope that the minister will seize the opportunity to partner with the institute in fulfilling the government's expressed commitment to palliative care.

It is often said that the measure of a society's degree of enlightenment and civilization is found in how it treats its minorities and the extent to which it internalizes the principle of the equality of all its citizens, in the manner in which it accepts and integrates those with disabilities, physical and intellectual, and in how compassionately it embraces those struggling with mental illness. However, I would add to this list how it supports and comforts its citizens at the most vulnerable moment of their life; that is, at the end of life itself.

I recently read some interesting words of our Governor General, His Excellency, the Right Hon. David Johnston, which I am paraphrasing now. He said that the idea of Canada was worthy of expression and refinement. If the Canadian idea is embodied in, among other things, our national publicly funded health care system, then to make palliative care a more prominent part of that system is to further refine the idea of medicare and of what it means to be Canadian.

Let Canada show the world once again, like we have so many other times before, what it means to be a profoundly civilized nation, a nation that gathers its collective resources to enhance the dignity of the individual at the very moment when dignity itself is everything.

Topic:   Private Members' Business
Subtopic:   Framework on Palliative Care in Canada Act
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NDP

Cheryl Hardcastle

New Democratic Party

Ms. Cheryl Hardcastle (Windsor—Tecumseh, NDP)

Mr. Speaker, anyone who has watched a loved one suffer through the ordeal of a terminal illness understands the profound importance of palliative and hospice care on behalf of the patient and for the families and loved ones.

I join my caucus in stressing, over the course of this debate, the fundamental right we also stressed in debate on Bill C-14. The New Democrats believe that every Canadian has a right to high quality end-of-life care.

According to the government's own mortality projections, the mortality rate will increase by 33% by 2020, making the need for palliative care as a thoughtfully laid out national strategy an increasingly urgent one, even more imperative within the context of medical-assisted dying.

Current, nearly 25% of the total cost of palliative care is borne by families, and significant disparities remain across Canada with respect to access to end-of-life care, quality of care and those out of pocket expenses. At least 50% of hospice palliative care services are funded by charitable donations, which continues to restrict the size, scope and access Canadians have to palliative programs.

Very few Canadian provinces have designated hospice palliative care as a core service under their provincial health plan. In the remaining provinces, hospice palliative care may be included in provincial home care budgets or other health service budgets, leaving the funding vulnerable to redistribution and cuts. That is why the New Democrats believe we must have a national strategy that can protect the palliative care of Canadians who have access to it, expand access to care for Canadians who do not have it, and improve the quality and affordability of care for all.

I am happy today to speak in support of the bill.

The New Democrats were surprised to find this year's federal budget contained zero federal funds earmarked for palliative care, especially after we fought to incorporate palliative care into the Liberal majority joint committee report on physician assisted dying.

Earlier this year, New Democrat Charlie Angus tabled Motion No. 46, which would accomplish much of what this bill would.

Topic:   Private Members' Business
Subtopic:   Framework on Palliative Care in Canada Act
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LIB

Anthony Rota

Liberal

The Assistant Deputy Speaker (Mr. Anthony Rota)

I just want to remind the hon. member that it is the member for Timmins—James Bay and she should not mention his name.

Topic:   Private Members' Business
Subtopic:   Framework on Palliative Care in Canada Act
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NDP

Cheryl Hardcastle

New Democratic Party

Ms. Cheryl Hardcastle

I am sorry, Mr. Speaker. It was a slip of the tongue.

Among other things, the motion called for the government to work with the provinces and territories on a flexible integrated model of palliative care by establishing a universal right to palliative care and by implementing a pan-Canadian palliative and end-of-life care strategy that would be tied to dedicated funding.

As I said, we expected this funding to be in the government's first budget but it was not. Here we are in the House debating a private member's bill from a member of the Conservative caucus, which indicates to me that we are at a momentous point in time. There is broad agreement across party lines on this issue and so it is time to face our responsibility to governance that makes progress on human rights and end-of-life care. That we are ready to be progressive on palliative care is momentous and I applaud my hon. colleague for utilizing her private member's bill for this noble initiative.

I was disconcerted when the previous Conservative government eliminated the federally funded national secretariat on palliative end-of-life care. Had it left the support funding intact, maybe we would not be discussing this matter today but would have a resolution and the member for Sarnia—Lambton would not have had to table this bill. I am sure she has other noble causes she could turn her attention to.

As for the current government, the Liberals have had ample opportunity to enshrine quality palliative care as a right for all Canadians, no matter where they live. They could have developed a national strategy that would have eased the burden on both the dying and their families on one end and health care providers on the other, but it was not a priority. I am still flabbergasted when I think of the callousness demonstrated as debate on Bill C-14 was introduced with absolutely no indication that anyone in the government understood the responsibility to secure end-of-life care standards for human beings.

The most significant reason I asked to to speak to the bill today was I wanted to lament the unnecessary suffering in the reality of our systemic inadequacies. A national strategy would address these sufferings. I want to hear in person the government's rationale for choosing not to act on this issue.

The New Democrats were surprised to find that the 2016 federal budget contained zero federal funds earmarked for palliative care, especially after we fought for the joint committee on physician-assisted dying to incorporate palliative care.

Given the lack of health care spending in the federal budget, it is no surprise that palliative care was missing. Hopefully by now all of us understand this, that home care is very relevant to this issue. The fact that the Liberal promise of $3 billion for home care turned out to be fiction is also very disconcerting as we take stock of our health care system, its mandate and purpose and know that to move forward we have to include palliative care options that patients and their families deserve to expect.

The Canadian Cancer Society has stated that improvements to the palliative care system in Canada are desperately needed. Without clear national standards and accountabilities, individual jurisdictions are left to develop their own policies, programs, and guidelines, resulting in inconsistent or inadequate access across the country.

In Ontario, for instance, 40% of cancer patients do not receive a palliative assessment in their last year of life. In some regions of Atlantic and Western Canada, administrative data showed that less than half of people who died in a hospital received palliative care. Remarkably, there are many jurisdictions in the country where we do not even know how many Canadians receive quality palliative care. We lack consistent and ongoing data collection at a systematic level, which leaves us unable to more effectively hold our health care systems accountable to make positive changes.

Also, it is not just an issue of data collection. It is vital that any national palliative care strategy takes into account the geographic, regional, and cultural diversity of urban and rural Canada. It must respect our diverse cultural, spiritual, and familial needs, including Canada's first nations, Inuit, and Métis people.

According to Dr. Mary Lou Kelley, research chair in palliative care at Lakehead University in Thunder Bay, the federal health care dollars that would help indigenous people receive end-of-life care at home have not kept up with the increasing demand. Health care for first nations is the responsibility of the federal government, and it does provide some home care services, but the system was never designed to provide complex health care to people with chronic or advanced terminal diseases.

Members might imagine my disappointment that the words “indigenous”, “first nations”, “Inuit”, or “Métis” do not appear anywhere in the text of Bill C-227. However, that is not a deal breaker because it is something that can be addressed meaningfully as we move forward on a national strategy.

New Democrats believe strongly that any legislation that deals with the matter of palliative care must take into account the geographical, regional, and cultural diversity of our urban and rural Canada, and Canada's first nations, Inuit, and Métis people.

As our population ages, palliative care will become an ever-increasing function of the health care system. The federal government needs to support health care workers with the training and resources necessary to deliver it all across Canada. All Canadians deserve to live their final days in dignity and comfort. That is why there is an urgent need to address the significant disparities that remain across Canada with respect to end-of-life care, quality of care, and out-of-pocket costs.

For years now, New Democrats have worked to improve palliative care services for patients and their families. As the party that founded public health care in Canada—

Topic:   Private Members' Business
Subtopic:   Framework on Palliative Care in Canada Act
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LIB

Anthony Rota

Liberal

The Assistant Deputy Speaker (Mr. Anthony Rota)

Resuming debate, the hon. member for Oshawa.

Topic:   Private Members' Business
Subtopic:   Framework on Palliative Care in Canada Act
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CPC

Colin Carrie

Conservative

Mr. Colin Carrie (Oshawa, CPC)

Mr. Speaker, I am grateful for the opportunity to rise today in the House to support my colleague's hard work on Bill C-277, an act providing for the development of a framework on palliative care in Canada. We are in a time where Canada is seeing an aging population, and it is our role as parliamentarians to help prepare our economy and our health care system for the coming decades.

First, it is important to understand what exactly palliative care is. For someone who has a life-threatening condition or a serious illness, palliative care is used to help improve the overall quality of life, reduce and/or relieve any physical and psychological symptoms, help individuals have a more peaceful and dignified death, and provide support to families and friends while an individual is dying and afterwards.

Palliative care can be provided in a variety of settings. It is really dependent on the options and availabilities within a community. Palliative care is provided at hospitals, individuals' homes, long-term facilities, and hospices.

The bill ensures that all Canadians have a real choice in regard to their end-of-life plans, something that is extremely important now that physician-assisted dying is legal. The Supreme Court itself stated that a request for physician-assisted death cannot be truly voluntary if the option of proper palliative care is not available to alleviate a person's suffering.

As I've said in previous speeches, assisted suicide should only be made available on the rarest of occasions. Canadians expect and deserve a choice between quality palliative care and assisted death. The government has already committed to one of those, and it is now time for it to commit to the importance of high-quality palliative care in Canada.

We know that all parties are in favour of palliative care for Canadians, but we must ensure that all parties agree that the bill is in fact needed in Canada.

I will not lie, I do have some concerns about the current government's agenda when it comes to palliative care. The Liberals started off with promising all Canadians an immediate $3-billion injection for home care, including palliative care, but now the Liberals have changed course. The Liberals are using the urgency of palliative care in communities as a bargaining tool, and that, in my opinion, is absolutely offensive. The provinces that have agreed to the Liberals' terms when renegotiating the health accord were given funding for both mental health and home care, while others that have not yet agreed to the Liberals' terms have received absolutely nothing.

Again we see a lot of talk on home care specifically. I am not saying that home care should not be incorporated in the promised new funding, but to completely eliminate palliative care from the promised funding would be irresponsible.

The government must assure Canadians that there will in fact be some designation of money to palliative care. As I already said, the need for palliative care services is increasing. Currently, only 30% of Canadians have access to good quality palliative care and this is problematic. We must ensure that the government properly allocates some of the promised investment into palliative care, and ensure that this bill be supported by everyone.

Bill C-277 will ensure that action is taken to define services that would be covered. It would introduce a standard training requirement for various levels of care providers, and it would help to collect the necessary data to ensure palliative care is successful in Canada.

There is no reason for any party to oppose such a well-thought-out bill that has the support of so many stakeholders across the country including the Canadian Medical Association, the Canadian Cancer Society, the Canadian Nurses Association, the Canadian Society of Palliative Care Physicians, Pallium Canada, ARPA, the Canadian Hospice Palliative Care Association, the Heart and Stroke Foundation, the Kidney Foundation, the ALS Society, the Canadian Association of Occupational Therapists, and the more than 50 organization members of the quality care coalition.

It is by working hard with organizations and bringing awareness to the need for palliative care that we can make a difference and ensure that individuals at the end of their lives are under the best possible care. This allows families to feel comforted and individuals to die with dignity.

In my riding of Oshawa, there is a wonderful individual by the name of Dr. Gillian Gilchrist. Dr. Gilchrist worked at the Oshawa General Hospital as the medical director of the palliative care team. She was the driving force behind the first palliative care unit at Oshawa General Hospital in 1981, and is considered a pioneer in providing palliative care within our community and raising awareness of the need for end-of-life care.

Dr. Gilchrist, along with her team, were on call 24-7, over all of Durham region.

Today, Lakeridge Health, which the Oshawa General Hospital has become a part of, and Queen's University, have partnered to create the first academic chair in palliative care. This chair will be named after Dr. Gillian Gilchrist. The idea is to ensure that we continue to focus on important areas within palliative care and be able to improve how future patients receive the best end-of-life care possible. According to Dr. Gilchrist, there is a lot that proper palliative care can do for an individual who is at the end of his or her life. lt provides patients and loved ones with the necessary support through a difficult time, not just physical support but emotional support as well.

Proper palliative care cannot be done without a team or proper training. This is why we must support this bill to ensure that the proper resources are there for Canadians when we need them. Experts themselves have said that if given the choice of good palliative care or to end one's own life, 95% of patients would choose to live.

As Dr. Richard Reznick, dean of the Faculty of Health Sciences at Queen's University, said, “We have no desire to treat tomorrow's patients the way we're treating today's. We [must] treat them better.”

In conclusion, we must treat those people better. Many of the people requiring palliative care are seniors or veterans. Seniors built our communities, developed our businesses, and supported our economy. Seniors built this great country, fought in our wars, raised their kids, and ultimately created this prosperous country that we are all so fortunate to live in. It is our responsibility to ensure that the most vulnerable are taken care of. When these individuals, who have done so much for us, need the most support, it is Canada's turn to support them. It is our job to make them comfortable. This is why I will support this important bill. I encourage all members of the House to do the same. I want to thank my colleague for all of the good work she has done bringing this issue forward.

Topic:   Private Members' Business
Subtopic:   Framework on Palliative Care in Canada Act
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LIB

Lloyd Longfield

Liberal

Mr. Lloyd Longfield (Guelph, Lib.)

Mr. Speaker, I thank the hon. member for Sarnia—Lambton for bringing this bill forward, for her leadership on palliative care in Canada, and for making sure that the conversation does not die between parliamentary sittings. I would also like to thank Hospice Wellington for helping me with its insights and input on what I am talking about tonight, and I thank the hospice centres across the country for the amazing work they do for some of our most vulnerable citizens.

This private member's bill aims to establish a national framework for hospice palliative care. My predecessor, Frank Valeriote, co-chaired an all-party parliamentary committee on palliative and compassionate care, along with the members from Kitchener—Conestoga and the former MP from Windsor—Tecumseh. Together the committee took the lead in crafting a report called “Not to be Forgotten”, which forms the foundation of Bill C-277.

The hard work demonstrated by this committee cannot be overstated. After a year of travelling, town halls, and consultations, the committee drafted a report that addressed at length the issues facing vulnerable Canadians, such as elder abuse, pain management, and family caregiver support. In speaking to Frank Valeriote about this bill coming back to Parliament, he said that it was one of the best experiences he had while he worked in this place.

This report establishes a clear and comprehensive guideline for the government to establish a national framework that will reinforce the fact that every Canadian life matters. This bill rejects the notion that Canadians who choose hospice palliative care are a burden on their families and on society. In fact, this bill acknowledges that palliative care offers patients time to live with dignity and to share precious time with loved ones.

Canadians deserve the freedom to make this fundamental decision about life and death without fear that their personal choices will be obstructed by politics or government. With 70% of Canadians left without access to adequate palliative care, we have a responsibility to act in the interest of patients and their families. This is why our government supports both access to palliative care and to medical assistance in dying.

End-of-life issues are as diverse as Canadians themselves, meaning that it is our responsibility as a government to provide as many options as possible for Canadians so that they can take these deeply personal choices and make them their own. This means that we must work with the provinces and territories to develop a flexible, integrated model of palliative health care delivery that takes into account Canada's geographic, regional, and cultural diversity, along with a funding strategy for implementation.

As was mentioned earlier, we have to work out how we work with provinces and territories on how we can deliver these services together. This system must be responsive to the needs of patients and create an environment that creates comfort and reassurance.

As discussed in the report, a hierarchy of care environments is an excellent example of how palliative care can adapt to the needs of patients and their caregivers. These environments offer a range of choices, from one to eight.

It is not the quality of care that determines why level 1 is better than level 3. For many people, level 1 or 2 is the best location, since it keeps them at home, where they can receive good physical, emotional, and spiritual support as well as informational care.

Level 7 is a more traditional hospital environment with more involved and expert care, which comes at the expense of a familiar environment for the patient. Patients have described being removed from their preferred surroundings as in itself a kind of dying, because removing what is valued increases the expectation that they will die sooner rather than later.

This system provides an appropriate space for terminally ill patients so that they can have access to the support they need and the dignity they deserve while retaining as much of their home environment as possible.

It is crucial that this palliative care framework provide for the medical, emotional, practical, and spiritual needs of patients. These are the four pillars of hospice palliative care.

Canada has played a proud role in developing modern hospice palliative care. Even the word “palliative” is a Canadian invention, developed in Montreal in the 1970s. Now we must take the final steps needed to make hospice palliative care available to all Canadians.

Many here in this House have heard me speak at length about the importance of innovation, and here too it has a role to play. Innovation can do more than grow our economy. It can also revolutionize how we protect and care for the most vulnerable in our society, including first nations and people who have difficulty getting to care.

A perfect example is the virtual hospice, an online exchange where ordinary people communicate with palliative care professionals to improve care. The virtual hospice uses readily available technologies to help Canadians living in remote areas access the medical professionals they need while remaining in the comfort and security of their own homes and their own communities.

Dr. Valerie Schulz, of the Schulich School of Medicine and Dentistry in London, Ontario, has developed a simple and effective way to get medical students interested in palliative care. Each year, 12 students from the undergraduate program become hospice volunteers. Each student undergoes 30 hours of training and is mentored by an experienced hospice volunteer. The experience is priceless for the future doctors, as it gives them a chance to meet and converse with people outside the clinical environment and without the need to bring a clinical perspective to the relationship. Thankfully, this practice has taken root with great success in hospices across Ontario. It develops the relationships that future doctors will have with their patients facing similar challenges.

Students relate to the hospice clients as persons, learning how they feel about and react to the prospect of dying. Friendships are formed and lessons are learned, which will be of lifelong value to the future doctors. The clients also are transformed, touched that a future doctor cares enough to spend time with them in a companion role. This program is worth emulation and broader application.

In my riding of Guelph, Hospice Wellington has been in existence for over 30 years. Their residential program is noted for being one of the best performing, if not the best, in the province. It serves over 300 individuals and their families. It is my hope that this bill will allow terminally ill patients to receive this kind of care from coast to coast to coast.

I am proud of the work the government and this Parliament have initiated with respect to end-of-life issues. Bill C-277 will provide Canadian patients with a comprehensive system of palliative care as a first option before they consider other options, such as medical assistance in dying.

Additionally, this approach emphasizes the importance of living with dignity before dying with dignity. By creating a national framework for end-of-life treatment, Canada will plug the gap in its medicare program, ensuring that all Canadians, from the very beginning until the very end, have access to the compassionate care they are entitled to under our Charter of Rights and Freedoms.

I thank the member for Sarnia—Lambton for bringing this forward for us. I will be supporting this bill as it comes forward with amendments.

Topic:   Private Members' Business
Subtopic:   Framework on Palliative Care in Canada Act
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LIB

Anthony Rota

Liberal

The Assistant Deputy Speaker (Mr. Anthony Rota)

The hon. member for Berthier—Maskinongé has two minutes. That is all the time remaining. My apologies.

Topic:   Private Members' Business
Subtopic:   Framework on Palliative Care in Canada Act
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NDP

Ruth Ellen Brosseau

New Democratic Party

Ms. Ruth Ellen Brosseau (Berthier—Maskinongé, NDP)

Mr. Speaker, it is an honour to rise to speak even though I have only two minutes.

Obviously, I intend to vote in favour of Bill C-277. I want to congratulate and thank the member for Sarnia—Lambton for her bill, which seeks to develop a framework on palliative care in Canada.

This bill is very important and all Canadians have been waiting for it for a long time. Many Canadians are suffering because of the lack of clear national standards. There is also a lack of funding for palliative care.

In 2014, my colleague from Timmins—James Bay moved a very important motion calling for the creation of a pan-Canadian strategy for palliative and end-of-life care.

The population in my riding is aging. Approximately 17,800 people are over the age of 65, so people have been waiting for this bill for a long time. However, now we need to walk the talk and take meaningful action. We need to develop a national framework and ensure that there is funding for it. We must be proactive. I consulted my constituents and I know that family caregivers do extraordinary work. I recently lost my grandfather and I was able to see the excellent work that is being done in the area of palliative care, but again we need to support family caregivers.

I want to once again congratulate the member for Sarnia—Lambton. We are really proud of her. We are also pleased to see that the Conservative Party has woken up and seen the importance of providing palliative and end-of-life care in Canada. Congratulations and thank you.

Topic:   Private Members' Business
Subtopic:   Framework on Palliative Care in Canada Act
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CPC

Marilyn Gladu

Conservative

Ms. Marilyn Gladu (Sarnia—Lambton, CPC)

Mr. Speaker, Canadians need palliative care services now more than ever. Fewer than 30% of Canadians have access to this vital service that allows them to choose to live as well as they can for as long as they can. Bill C-277 is the next action required to define the services to be covered, to bring standard training requirements to the various levels of care providers, to come with a plan and mechanism to ensure consistent access for all Canadians, and to collect the data to ensure success.

Canada has an ever-growing number of individuals of all ages experiencing chronic and terminal conditions. Good palliative care covers a wide range of services, as we have heard, such as acute care, hospice care, home care, crisis care, and spiritual and psychological counselling. A palliative philosophy of care is needed to address a wide variety of needs through an adapted and patient-centred process.

Use of more home care and hospice care will bring a fourfold reduction in health care costs compared to acute and palliative hospital care. The creation and implementation of a palliative care framework would give Canadians access to consistent, high-quality palliative care through hospitals, home care, long-term care facilities, and residential hospices.

The bill is timely, as we have heard, since the special committee that studied the Carter decision on medically assisted dying said that without good quality palliative care, there really is no true choice, and we want Canadians to have a choice.

I want to thank many organizations. We heard them mentioned before. They are the Canadian Medical Association, the Canadian Cancer Society, the Canadian Nurses Association, the Canadian Society of Palliative Care Physicians, Pallium Canada, ARPA, the Canadian Hospice Palliative Care Association, many of the member hospices, Heart & Stroke, the Kidney Foundation, the ALS Society, the Canadian Association of Occupational Therapists, more than 50 organization members of the Coalition for Quality Care, and many faith organizations, including the Canadian Conference of Catholic Bishops.

There are so many Canadians who have said that they support this bill, and it is through organizations and groups like these that we can integrate palliative care into the current health care system and make a true difference for Canadians.

I want to thank everyone for their support and for continuing to bring awareness to this. I thank the all-party committee that studied this subject and assisted me in bringing forward this bill with these recommendations. I want to thank colleagues on all sides of the House, who have spoken passionately and in support of this bill, and the thousands of Canadians who have written letters to MPs and the Prime Minister and sent 84 petitions to the House asking for palliative care.

Some hon. members have indicated that they are prepared to support referring this bill to committee for amendment. I have heard the members' input on getting the balance right between what is under provincial jurisdiction and what is under federal jurisdiction.

I know that areas such as education are under provincial jurisdiction. However, with the provinces beginning to roll out services in fragmented ways, the federal government has an opportunity to provide the leadership needed to leverage best practices and to fill the possible gaps, because the work does not end with one plan.

We must develop the infrastructure we need in order to provide palliative care beds and hospice care. With our aging demographic, we are going to have to increase the number of home support workers, personal caregivers, registered psychiatric nurses, palliative care specialists, and those providing support services. The promise that the government made in its 2016 budget to allocate $3 billion for this is a good start.

I am happy to see this bill go to committee, with the hope that we will find a way to accelerate the process of making this framework a reality. As we begin the new year, we have a chance, as parliamentarians, to come together in a co-operative spirit to do the right thing for Canadians without partisanship.

I urge my colleagues on all sides of the House to support this bill going forward to committee. Give Canadians the palliative care they so desperately need. Let compassion make members' choices, and support Bill C-277.

Topic:   Private Members' Business
Subtopic:   Framework on Palliative Care in Canada Act
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January 31, 2017