44th Parl. 1st Sess.
February 13, 2023 11:00AM
Mr. Speaker, today we are seeing an admission of a process that was far too rushed. Just two years ago, the Minister of Justice appeared at a justice committee one morning and said that there was not a consensus on how to move forward with expanding medical assistance in dying to those whose sole underlying condition is mental illness. However, later that day, after the Senate had amended the legislation to include mental illness, the minister suddenly said in the House that he was confident there was a consensus. The minister's own charter analysis of Bill C-7 said that those whose underlying condition is mental illness needed to be protected.
Therefore, we see evidence now that 70% of Canadians are opposed to this expansion. We know that many Liberal members are voicing their concerns. Will the minister consider delaying this expansion indefinitely, so that those who are suffering with mental illness, such as our veterans with PTSD, are protected?
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Mr. Speaker, I thank the hon. member for his work on the special committee, and we look forward to the recommendations of the special committee. One of the reasons to have a delay is precisely to take what that special committee might recommend better into account.
Mental illness is an illness, and I strongly support initiatives to better resource the encadrement, the support we are giving to people suffering from mental illness. It is something that our government has recognized.
We put $5 billion into the system a number of years ago. However, when we did that for mental illness, we found that we could not guarantee that the provinces would actually spent that money on mental illness. In the current set of negotiations between the Minister of Health and his counterparts, as well as the Prime Minister and his counterparts, we are trying to build some accountability into that system, but we definitely do agree with the need to invest in greater mental health resources, particularly in this case. We want people to be able to live a dignified life with the supports they need to accomplish that.
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Mr. Speaker, some have opined that the extension sought today is potentially for re-debating the issue of mental health as a sole and underlying condition for MAID. I am wondering if the minister could outline why that is not the case.
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Mr. Speaker, we passed the law in 2019. Part of the parliamentary process was the interactions between the House and the Senate. We came to a compromise at the end of that process with the Senate to include mental illness as a sole criterion with a two-year delay.
We felt at the time that this could be done in two years. COVID intervened and an election intervened, but we do feel that a great deal of work has been done, in particular, by the expert committee. However, in order for everyone to internalize those recommendations, and for faculties of medicine, provincial and territorial bodies, and expert groups to build out the didactic materials, we need another year, but this is only a year extension. Of course, this would also give us time to look at what the special committee reports on this particular area, as well as evaluate other suggestions it makes.
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Mr. Speaker, I thank the hon. member for his work as a critic and his work on committee.
We are in a far different place than we were two years ago. We have now done a great deal of the work, particularly at the federal level, on mental illness as the sole criterion for seeking MAID. As I said, a number of leading experts feel that we would have been ready next month to have moved forward. We are trying to be prudent and to allow others to internalize the learning that has been developed over the last two years.
I mentioned before, and I will repeat it again, that this is a small fraction of people who are in the non-end-of-life scenario. Indeed, the people in the non-end-of-life scenario generally are a small fraction of those who seek MAID. It is not the case that somebody will simply be able to get MAID by going to their doctor and saying that they are contemplating suicide. That is not the case, and we are misleading Canadians if that is what we say.
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Mr. Speaker, I want to thank the member for Montcalm, who serves on the special joint committee and is a very thoughtful member on it.
At the end of the day, the member is arguing that somehow expanding MAID in cases of mental illness could be appropriate, but what he is demonstrating is exactly the opposite. He is highlighting why it would be inappropriate, given the fact that suicidality is a symptom of mental illness and given the fact that 90% of persons who commit suicide suffer from a diagnosable mental disorder. I think that all underscores the fact that this is not acceptable.
Expanding MAID for mental illness is not an appropriate treatment. It is not an appropriate solution for mental illness. What the government should be doing, instead of offering the mentally ill death, is offering the mentally ill hope, support and the care they deserve.
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Mr. Speaker, the member for Cowichan—Malahat—Langford has contributed thoughtfully to the special joint committee.
In answer to his question, I note that during the 2021 election campaign, the Prime Minister claimed that mental health was a priority of the government. He committed to a $4.5-billion mental health transfer, but none of that money has gone out the door. There is no mental health transfer.
Instead of providing support and help, the government has been almost singularly focused on offering death, on offering MAID to persons who are struggling with mental health. It speaks to how misplaced the priorities of the government are. It also speaks to the fact that once again, like so much of what the Prime Minister says, his words are nothing more than empty words.
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Mr. Speaker, the message it is sending to persons who are struggling with mental illness is that their life is not important and that we are going to offer them death instead of help and support.
The member raises the issue of veterans who are offered MAID completely inappropriately and, frankly, in contravention of the Criminal Code. The Minister of Veterans Affairs, when he came to the veterans affairs committee, said that it had happened once or twice and that he had undertaken a thorough review. We now know that is not true and that it has happened multiple times. It speaks more broadly to how the government has mishandled MAID in so many different ways.
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Mr. Speaker, I thank the member for Montcalm for his speech.
I have to say that it has been a pleasure working with him over the last several months at the AMAD committee. He is an exceptionally thoughtful individual and I have learned a great deal from him.
Based on his numerous years of experience with MAID, and this particular issue of mental health as the sole underlying condition, could he outline for us, in a very short way, why he thinks there is a need to extend the deadline for the implementation of this provision?
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Mr. Speaker, I want to start by saying that before I dove into this subject, read the expert panel's report multiple times and asked endless questions, I was among the unconvinced.
Second, because we cannot cut corners on this issue, the entire community of professionals in mental health care, mental wellness and mental illness needs to be informed and trained. It will require an adequate number of service providers and assessors. It will require guidelines. Each of the regulatory bodies from coast to coast will need to establish standards of practice for their members, so as to ensure safe, effective and adequate implementation.
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Mr. Speaker, as I clearly outlined in my speech, the safeguards are very clearly laid out, not only in the Criminal Code, but also in what we believe the standards of practice should be, and that is going to apply to the medical community. That being said, the medical community has indicated it does need more time, hence the need for Bill C-39. I would just remind the hon. member that many stakeholders in the field of mental health have underlined the fact that the Liberal government needs to step up to the plate and increase the funding and the resources to appropriately address this major crisis happening from coast to coast to coast.
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Madam Speaker, first of all, I do not think that MAID has been abused, especially as it relates to mental health. As I intervened, I lost my father to cancer back in 2016. At that time I wished the MAID option were available to us. Having said that, we have felt in our government that the base of 219 cases is not representative enough of the data that we want. We want to ensure that the safeguards we should have are in place and strengthened. This is the fundamental reason that we are extending the timeline by a year and introducing this bill. If this bill is to protect those individuals who are dealing with mental illness, then they need all the supports to be able to make that decision.
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Madam Speaker, my colleague from Thunder Bay—Rainy River is well aware of my great respect for him. However, in listening to his speech, I found it riddled with confusion.
I wondered whether he read the expert panel's report on mental illness as the sole underlying medical condition. I believe that our thinking may not be quite so different. I think that his practice has shown him the need to take care in adopting such an approach. However, in reading the report, he will see that there are many precautions in place and very specific guidelines.
Indeed, just because there are not very many mentally ill people experiencing tremendous suffering does not mean we must not move forward. One person experiencing unimaginable and intolerable suffering is, in my opinion, one too many.
I would like to know my colleague's thoughts on this.
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Madam Speaker, there is another crisis underlying the discussion we are having right now, and that is the mental health crisis in this country. The government promised to put funding in place for Canadians to get help, but the Liberals have really been dragging their feet on that.
I would like to hear my colleague's thoughts on the current situation. Does she think the government should provide more resources and make sure that mental health issues really are recognized as a serious problem?
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Madam Speaker, the member is absolutely right. Mental health is a very serious issue in our society. Rather than talking about medical assistance in dying for people with mental health disorders, the government should make funding available, and quickly, so that everyone in this country living with mental health challenges, whether in rural or urban areas, has access to care.
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Madam Speaker, I believe that we should be viewing mental health in parity with physical health. Yes, there are a lot of different things that contribute to one's mental health, such as affordability, access to food and homelessness. We should be making sure that we are doing everything to raise people up and offer the supports that they need. First and foremost, the government needs to follow up and actually follow through with its mental health act promise that it made during the previous election.
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Madam Speaker, I thank you for that astute advice. I really appreciate it.
This article said, “because mental health should be a priority.” That is the article I am quoting, which has the Prime Minister's name. It is important that Canadians understand that.
“But despite the sense of urgency in [the Prime Minister's] remarks last year,” and I have changed that word to satisfy the chamber, because we all know who the Liberal Prime Minister is, “no money has yet materialized for this new Canada mental health transfer”.
I am going to say that again, just to make sure that everybody has heard it. No money has yet materialized, “including an initial $875 million that was supposed to have been spent or budgeted by now, according to the Liberal party’s 2021 election platform.”
“The Liberal platform document included a line-by-line costing of all its election promises, and it outlined a promise to spend $250 million in 2021-22 on the new mental health transfer, and then $625 million in the current 2022-23 fiscal year, with additional amounts over the next three years adding up to $4.5 billion total.”
“None of the promised spending over the last two fiscal years has yet been allocated or spent.”
To me, that is important. Again, I will quote from the Liberal Prime Minister, “because mental health should be a priority.”
Where is the priority of mental health, and why is it not materializing?
We know that my hon. colleague, who spoke just before me, talked incessantly about a three-digit suicide prevention hotline, which was harder than giving birth to a baby elephant to make it happen. It is absolutely shocking to think about how the government wants to talk about being helpful to Canadians and how it has their proverbial backs, etc. I just do not see that. That is absolutely atrocious.
This article goes on to talk about the national director of public policy for the Canadian Mental Health Association, and they pointed out that the “April budget contained no money earmarked for this new transfer.”
“Let’s be clear, for it not to be in Budget 2022, at least with a timeline of ramp up to the $4.5 (billion), you know, it was really concerning to us.” That was stated by the Canadian Mental Health Association.
After eight years, why does the government continue to fail Canadians? That would be a great question to know the answer to.
We also heard in the health committee last week that counsellors and psychotherapists are required to charge GST on their services. We know that, sadly, many Canadians do not have private coverage for those services, but to add insult to injury, to pour salt in a wound, what we are now requiring is for Canadians to pay GST on those services. How does that make any sense?
It goes on to say that, “psychiatrists across the country [are] 'incredibly concerned' about patients needing better access to care, including addiction services”. These are addiction services that the government would tout are a whole other kettle of fish and are quite shocking.
There is still controversy around providing medical assistance in dying for people with mental disorders among providers. Obviously, one of the other things that I think is very important is the fact that the government has not transferred any, zero, nada, zilch, of the $4.5 billion. Think of my riding of Cumberland—Colchester and the difficulties that rural Canadians are suffering.
Because of their geography, rural Canadians are struggling not only to get access to mental health, but also to put gas in their cars to get them to the actual appointments. The punishing carbon tax that the government wants to put on everything in this country is really affecting their ability to have the money to pay the extra GST required for counselling and psychotherapy.
We all know that if people are struggling to put food on the table, and if Canadians have to choose between eating and looking after their mental health, they are likely going to choose eating. This is a sad commentary on life in Canada where it appears that everything is broken. The sad commentary will continue in this country because of the punishing taxes the government wants to continue levying on Canadians, which is making life unaffordable.
We know the crisis in mental health is going to continue. It would appear that approximately one in three Canadians is struggling with their mental health. We know that the government has put out its own projections to say, if we read the report on departmental results, it would expect that 22% of Canadians would not be able to access mental health care, and the actual result is 25% of Canadians cannot access mental health care. This is unacceptable. Zero percent of Canadians should have this issue, and we have a government that thinks 25% is acceptable.
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Madam Speaker, I have been sitting on the special MAID committee with the member for some time, and I appreciate his contribution.
I take issue when he said that the conversations have been heated and personal. I do not remember it being that way. There were passionate discussions, but it was certainly never personal. I hope he did not find that I ever contributed to that impression.
We can disagree all day long on whether the government has been making mental health funding a priority. He has made a point of talking about the mental health transfer. If the mental health transfer had happened yesterday, is there any scenario in which the member would agree that mental health is appropriate grounds for MAID, or is it just full stop for him?
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Madam Speaker, I do not recall my hon. colleague making anything personal in the MAID committee, so I am thankful for that.
There is one thing that is very important. We can talk about scenarios, what-ifs, therefores and plausibility, but let us be clear. What we know is that the Liberal government committed $4.5 billion to fund the Canada mental health transfer, and it sent none of it, zero, zilch, nada.
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Madam Speaker, when I look at the plight of our veterans, I know many of them suffer from PTSD. Can anyone imagine a veteran walking into an office and asking for help? They say they need mental health supports and are asking for help. They are begging the government and the response is, “I am sorry. Why not consider medically assisted dying?” That is not acceptable.
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