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Decentralized Democracy

House Hansard - 280

44th Parl. 1st Sess.
February 12, 2024 11:00AM
  • Feb/12/24 12:45:48 p.m.
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  • Re: Bill C-7 
Madam Speaker, in the question previous to that of the member, the government was accused of being too slow. Now my New Democratic friend is saying that we were too quick when it came to Bill C-7. In saying that we did not do enough background work, he implied that we were too quick. The Government of Canada, when we look at the broader picture of the Supreme Court decision back in 2015, brought forward very difficult legislation. As has been demonstrated, it was not perfect legislation. Given the very nature of it, one would be naive to think there was never going to be a need to make changes. That is why standing committees were mandated to meet on the legislation. It was because it was the first time we had substantive legislation of this nature.
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  • Feb/12/24 12:46:47 p.m.
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  • Re: Bill C-39 
Madam Speaker, it is almost one year to the day that the governing party proposed Bill C-39. I am glad we are once again talking about rushing through legislation to avoid extending medical assistance in dying for mental health. The parliamentary secretary asked a really important question. He asked in his speech if we are doing enough on these social issues. The answer is very clearly no because the government is not rushing through crucial legislation to address the housing crisis. It is not rushing through legislation to address legislated poverty for people with disabilities, and it is pretending its commitment to a $4.5-billion Canada mental health transfer never happened. Why is this the case?
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  • Feb/12/24 12:47:39 p.m.
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Madam Speaker, I would challenge the member to show me a government in the last 50 or 60 years that has been more progressive on social development than the Prime Minister and this government, whether we are talking about taking seniors and children out of poverty by the hundreds of thousands, or dealing with a wide spectrum of social issues through the child care program and the many senior supports we have put in place, not to mention the substantial enhancements to OAS and increases to the GIS, especially back in 2016 when we first became government. There is a long list. I could talk about the dental care program or the tax break for Canada's middle class. There is a whole list I could go through, but I do not have enough time.
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  • Feb/12/24 12:48:39 p.m.
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Madam Speaker, the parliamentary secretary can be an animated speaker, quite like myself, but he took the time to be very selective in his words to properly represent his constituents and his view. An hon. member: Oh, oh! Mr. Mark Gerretsen: Madam Speaker, I am already being heckled. What I found— Some hon. members: Oh, oh!
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  • Feb/12/24 12:49:04 p.m.
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Order. Hon. members know that, if they have not been recognized and do not have the floor, then they need to wait until the time for questions and comments or their turn for debate, which will come shortly. The hon. deputy government House leader.
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  • Feb/12/24 12:49:19 p.m.
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Madam Speaker, what I found most shocking was that, when the parliamentary secretary was trying to deliver his remarks, the member for Cumberland—Colchester immediately started heckling and yelling at him. It reminded me of when the member for Cumberland—Colchester, on October 25 at the health committee, said, “Don't worry, Canadians, because when you're addicted to these opioids that this Liberal-NDP coalition is giving you for free in its crazed experiment, what are they going to do? They're going to kill you.” Now Conservatives are clapping for his comments on that. I am wondering if— Some hon. members: Oh, oh!
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  • Feb/12/24 12:49:55 p.m.
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Order. If members want to participate in the debate, they need to wait until the appropriate time. The hon. deputy government House leader.
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  • Feb/12/24 12:50:05 p.m.
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Madam Speaker, I am wondering if the parliamentary secretary could provide his comments on whether he thinks that people who make comments like that should even be participating in a debate like this.
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  • Feb/12/24 12:50:21 p.m.
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Madam Speaker, it is disappointing in that this is such a serious issue. A member of the Conservative Party is being disrespectful to Canadians, as a whole, by taking the issue so lightly and making light of a decision that is so difficult. The member feels it is okay to say that well over 10,000 people were killed. How insensitive can a person be? These are decisions of the greatest difficulty, and the way the member has behaved is disrespectful.
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  • Feb/12/24 12:51:06 p.m.
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I know this is a piece of legislation that many are passionate about. There are differing points of view, and I would hope that each side will be able to respect each other, whether they agree with what is being said or not. Resuming debate, the hon. member for Cumberland—Colchester.
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  • Feb/12/24 12:51:26 p.m.
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Madam Speaker, I would like to seek the House's unanimous consent to split my time with the member for Peterborough—Kawartha.
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  • Feb/12/24 12:51:36 p.m.
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Does the hon. member have unanimous consent to split his time? Some hon. members: Agreed.
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  • Feb/12/24 12:51:50 p.m.
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Madam Speaker, today, it is interesting to follow the member across the aisle when we are speaking about a matter of grave importance. I find it absolutely fascinating, in a very strange sense, that the member opposite would suggest that somehow MAID has saved lives, when, indeed, 13,200 Canadians have died because of MAID. On top of that, we know that is a 30% increase year over year. We also know that in California, which has a similar population, if I have my statistics correct, about 450 people died because of MAID. MAID for mental illness presents a serious difficulty for all Canadians, and thankfully, Conservatives on this side of the House are ready to stand up for those who have mental illness and who have suffered with it for a very long time. We know clearly, from the DSM-5, that there are many conditions that, if Canadians were aware were classified as a mental illness, they would find this legislation even more appalling than they do now. We know that over half of Canadians reject this terrible idea of MAID for mental illness. When Canadians think of mental illness, they think of things such as depression, schizophrenia and bipolar illness, all of which are chronic medical conditions with available treatment. However, we also know the reckless government and this reckless expansion of MAID is causing some of the major difficulties. In the DSM-5, what would also be classified as a mental illness would be things such as substance use disorder and autism, both of which are chronic illnesses. I believe Canadians specifically would find it appalling for the reckless government and its reckless agenda to suggest that Canadians who are suffering from a substance use disorder or Canadians with autism are never going to get better, and that they should be subjected to the MAID regime. When we begin to look at and understand the difficulties associated with the reckless, costly coalition's expansion of MAID, we also know that the 17 chairs of the departments of psychiatry from Canada's universities have spoken out specifically against this expansion of MAID. There are two things that are very important. Let us start with, perhaps, suicidality, which the member across did mention. I guess the question then remains how an experienced, or even inexperienced, primary care physician or nurse practitioner would be able to determine the difference between suicidality and a demand for MAID. The member across is right. I did practise as a family physician for more than 25 years. Practising in an emergency-room setting on a Saturday night when somebody comes in and is suicidal is probably one of the most stressful things someone can possibly deal with. I think every one of my physician colleagues across this country would admit to that. We are incredibly well trained, and we have incredible protocols for dealing with trauma, strokes and heart attacks, but when somebody comes in with suicidal ideation, it is incredibly personal. It is situational. It is related to medication. It is related to family. It is related to every single difficult relationship they have in their lives. If there is a physician out there who suggests that, when they go home after a shift Saturday night that ends Sunday morning where they told someone who was suicidal that they are okay to go home, and they know that person is fine, but they do not worry about that decision, I would challenge them on that. That, for me personally as a physician, was something that created significant distress and angst, and it should. What we are talking about is somebody's life and their decision to end it or not. We have a regime put forward by the reckless and costly coalition to have people with mental illness receive medical assistance in dying, to be put to death by the state. That is the suicide part of it, which, again, can be with respect to an acute or a more chronic condition. However, it is the irremediable aspect of the mental illness that creates significant difficulties for the reckless and radical expansion of the MAID regime. What does the word “irremediable” mean? It means, in basic terms, that the condition cannot be fixed, that the treatment that has been rendered is all the treatment available and that the condition is going to either continue the way it is or get worse in the future. Who is going to decide that? There is a Canadian Association of MAiD Assessors and Providers. The group is staffed by family physicians and nurse practitioners, despite the opposite thought of many Canadians who would think it would be psychiatrists who would be determining whether a condition is not fixable and chronic and that all of the possible treatment out there has been rendered. That is not the truth; at the current time, the decision would be rendered by two different care providers who are either primary care providers or nurse practitioners. That is incredibly important because we know that even the diagnosis of a mental illness is based on probabilities: Has someone had a particular set of symptoms for a certain amount of time over a certain amount period of time? It is not like high blood pressure, which a doctor can check and then have a concrete, objective answer. It is not like diabetes, where a person's blood work is done and they have a concrete answer that, yes, the numbers are elevated and the person does have diabetes and can be told what will be done to help them with it. Mental illness is very, very different, and Canadians need to know that; if they do already know it, they need to remember it. The other important thing is the terrible job that the costly NDP-Liberal coalition has done with respect to access to health care in general but more specifically to mental health care. We know that across this country, half of Canadians are extremely unhappy with their ability to access mental health care, and we also know that the waiting time for adults to access a psychiatrist in most parts of this country is about a year. This means very clearly that primary care physicians and nurse practitioners are providing the majority of mental health care for Canadians, deciding which treatments are working and which are not, when to increase medications, when to add on, etc. Very sadly, it is clear that for Canadians under 18, the wait time for mental health care access to a psychiatrist in Canada is more than two and a half years. The system is atrocious. The Prime Minister stood up and promised 7,500 doctors, nurses and nurse practitioners to Canadians. How many have we seen? I dare say it has been almost zero. The terrible situation with respect to access to care is most acute when people are seeking mental health care. Of course, from this side of the House, we do not want the legislation to proceed, but we see a government in panic mode that has no plan and no clear idea of what it is going to do, wants to do, or should do on behalf of Canadians. Here we are. Multiple times at the 11th hour, senior elected government officials across the aisle have said, “We have to rush this through; we have to get it done on behalf of Canadians.” What they fail to remind Canadians of is that it is the government's fault that we have arrived at this situation in the first place. The government members did not appeal the right decisions, allowed decisions to be added on in the Senate, and did not make a decision when they should have, on behalf of Canadians. Therefore, I would implore the House to understand clearly that MAID for mental illness is not the correct path to go down.
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  • Feb/12/24 1:01:59 p.m.
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Madam Speaker, the member opposite from Nova Scotia is a fellow doctor. The legislation would put a hold on implementing MAID for mental illness. A year before the legislation would come into effect, the committee would have to be re-formed to reconsider the matter and call the experts again. Do you think that in two years' time there is going to be any more of a consensus on the issue than there is at the moment?
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  • Feb/12/24 1:02:28 p.m.
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The hon. member is to address questions and comments through the Speaker and not directly to the member. The hon. member for Cumberland—Colchester.
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  • Feb/12/24 1:02:31 p.m.
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Madam Speaker, the question from the member for Thunder Bay—Rainy River is a thoughtful one. I think, as I clearly pointed out, that the assessors and providers of MAID are not suddenly going to be psychiatrists. We do not have enough access to psychiatric care in this country, due to the terrible management of funds by the government. Am I hopeful that, suddenly, this is going to change in the next two years? With a new government, I suspect that things will be better from a fiscal perspective, but creating more access to health care is going to take some time because of the mess the current government has left it in. Am I hopeful that it is going to be better in two years? Absolutely not.
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  • Feb/12/24 1:03:22 p.m.
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Madam Speaker, with all due respect to my colleague, who sits with me at the Standing Committee on Health, I invite him to reread the expert report. Honestly, when I heard him talking in his speech about people with mental disorders being put to death by the state, I thought that was utterly outrageous. Recommendation 10 states, “The requester should be assessed by at least one assessor with expertise in the condition(s). In cases involving [mental disorders], the assessor with expertise in the condition should be a psychiatrist independent from the treating team/provider.” He talked about two doctors. There they are. What is more, “Assessors with expertise in the person's condition(s) should review the diagnosis, and ensure the requester is aware of all reasonable options for treatment and has given them serious consideration.” How can my colleague make such claims, when medical assistance in dying for mental illness has to be requested? Just because someone requests MAID does not mean they are eligible for it. Does he not trust the people who practice his profession?
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  • Feb/12/24 1:04:42 p.m.
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Madam Speaker, I think it is very important that Canadians understand that the vagueness of the language does not demand that it be a psychiatrist who would be making the determination of irremediability. As I clearly pointed out in my speech, the majority of psychiatric care in this country is and has been, over the last 50 years, delivered by primary care physicians. We must understand that this is where a person will primarily receive their diagnosis, that they will receive multiple different treatments if they have an illness that is very difficult to treat, and, again, that many Canadians, especially adults, will have more than a year's wait to see a psychiatrist. Therefore, depending on psychiatrists to provide intervention, along with diagnosis and treatment, is failing in this country. To go on and expect that they would suddenly be MAID assessors is folly.
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Madam Speaker, the member for Cumberland—Colchester had a couple of factual errors in his speech. The NDP voted against Bill C-7's amendment that brought this in. We supported the member for Abbotsford's bill, Bill C-314, and we support the majority report. We have never been for the expansion; let us put that on the record. We are at a moment in time this week, with an impending deadline, when we can throw blame at the Liberals, and they are well deserving of it, or we can rise to the occasion and be the adults in the room, given that there are only two sitting weeks left before March 17. Which are the Conservatives going to choose? Are they going to be on the side of getting the bill through the House to the Senate in the correct amount of time?
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  • Feb/12/24 1:06:40 p.m.
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Madam Speaker, clearly we know that the NDP, part of the costly coalition, will continue to not support the needs of Canadians and that it will continue to vote on all things with the reckless Liberal government, which has led Canadians to be, every month, $200 away from insolvency and to have the greatest numbers of auto theft crime in the most recent history. The chance to believe that it might do something right for Canadians is almost zero.
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