Senator Gold: I will certainly add those to my inquiries. Thank you for the question.

Senator Gold: I guess I cannot get tired of responding to these allegations of fraud and corruption, which are not founded on the facts. ArriveCAN cost far too much, and the real problems have been revealed and are being explored. It was used by 60 million Canadians during the pandemic to facilitate their travel across the borders.

Again, I will continue to answer questions so long as it continues to serve your purposes.

Senator Gold: I’m not sure that that’s the only consequence, if there still remain differences of opinion between clinicians, and I think it would be idle to assume that what is necessary is that every clinician, whatever discipline or specialty, is of one mind, leaving aside issues of conscience and the like.

I think what is necessary, though — and that is what we are told by the Centre for Addiction and Mental Health, or CAMH, the Ontario Hospital Association and others — is that there needs to be much more specific criteria developed within that community for deciding exactly what measures, for example, might need to be taken before one could conclude that all steps have been taken to no avail to alleviate suffering.

I have confidence in the medical community. I have confidence in the regulatory bodies that are working on this. People are working hard at this and in good faith. In jurisdictions like my own in Quebec or like in British Columbia, these are not jurisdictions that are ideologically opposed to MAID generally or to MAID Track 2 or to MAID for mental illness. It is simply not the case that they are looking for an extension because they wish the thing would go away. They say, “We are working really hard at this, but we need to do more, and we need to drill down deeper. We need more assessors trained. The take-up has been reasonable but not overwhelming.” It is a long process to get fully trained, as the Minister of Health said.

I have confidence in our systems to get ready, because I think the extension requires them to get ready, and they have been working really hard at it. We are just not there yet.

Senator Gold: Thank you for the question, Senator Kutcher, and also for all the work you have done in educating us and advancing this issue and putting it on the legislative agenda, as we in the Senate did.

In pointing out that only 2% of psychiatrists are trained, it was not to say anything other than the assessment of irremediability and the assessment of someone who is seeking MAID on the basis of mental illness will fall to a large degree — though not completely — on those with psychiatric training and who have received MAID assessment training.

Again, there is no qualitative difference in the suffering at issue, but it may be — and it is believed by many from whom we heard — that there is a more challenging assessment process and a need, perhaps, for greater safeguards with regard to people who present with a mental illness as a sole underlying condition than those who present in the advanced stages of an incurable physical disease and the like.

It’s not a question of why it’s okay for one and not for the other. What we are being told, Senator Kutcher and colleagues, is that the system as a whole is not ready and that even at Track 2 there is a challenge, in some jurisdictions especially, to respond, in their view, adequately to the demand. And the worry, as was expressed, I believe, by CAMH or other testimony, is that simply the system is not ready to provide all of the support needed, not only for the assessors but for the related personnel and the like.

That’s the position of the government with regard to the number of trained assessors at this juncture.

Senator Gold: Thank you for the question, senator.

The Government of Canada has been supporting provincial governments and their health care systems for many years with large sums of money. Most recently, as we know, the federal government has entered into bilateral agreements with all the provinces and territories respecting, as it must, the constitutional jurisdiction of provinces to determine what their priorities are.

As the Minister of Health shared with us at the Committee of the Whole, each of these bilateral agreements will have funds dedicated for different purposes, and some — but I can’t give you a figure — are going as well to enhance mental health supports. And the government will continue to work with the provinces and territories to do its part to improve access to mental health supports and other ancillary supports in the provinces and territories and in Indigenous communities as well.

We will never have a system that is perfect, and the government is not pretending that everything will be perfect in three years. There will always be — regrettably, tragically, and one can even say shamefully — inequities in access to health care services. It’s not only urban versus rural. It’s even within classes of people within any given area.

The Government of Canada is continuing to do its part with the provinces and territories to provide as much support as it can. Provinces are doing their part as well. The expectation is that with all of the measures that are being done — within the profession, within the provinces and territories, within the institutions such as the hospitals of Ontario or the hospitals in my province and elsewhere — the system will be ready.

Senator Osler: Thank you, Senator Gold. I would suggest that now more than ever when it comes to health care, the federal government should take a leadership role in the spirit of cooperative federalism.

You mentioned the bilateral health care agreements. The health ministers met with Minister Holland in November, and I believe health care agreements have been signed with all but one province/territory.

Are you able to share if a plan for helping the health care system issues was discussed at any of those tables?

Senator Gold: The answer is no, senator. The fact is that investigations are under way. Allegations and fingers are being pointed in all kinds of directions. It may serve your partisan or fundraising purposes to continue trying to paint this as a political cover-up. It is not the case. I am happy that you feel as if you are doing your job as you see fit. I’m doing my job as I see fit to give you the answers regarding what the government is doing to get to the bottom of this, including — as I said on a number of occasions — a number of steps that have already been taken to ensure this kind of fiasco vis-à-vis a particular project doesn’t happen again.

Senator Gold: No amount of allegation and innuendo about corruption and the like — upon which there is no evidence — can replace the fact that police investigations are under way. The facts will be revealed when those investigations are completed.

Senator Gold: Again, that is an important question and a complicated one with regard to — as is too often the case — matters of jurisdiction and provincial responsibility. However, I can say that the government remains committed to supporting all Canadians with their mental health needs and challenges, including substance use challenges, and I will certainly raise this with the minister as well when I have the first opportunity.

Senator Gold: Honourable senators, I give notice that, at the next sitting of the Senate, I will move:

That, notwithstanding the order adopted by the Senate on September 21, 2022, the sitting of Wednesday, February 28, 2024, continue beyond 4 p.m., if Government Business is not completed, and adjourn at the earlier of the completion of Government Business or midnight; and

That the Standing Senate Committee on Foreign Affairs and International Trade be authorized to meet after 4 p.m. on that day for the purpose of considering Bill C-57, An Act to implement the 2023 Free Trade Agreement between Canada and Ukraine, even though the Senate may then be sitting, with rule 12-18(1) being suspended in relation thereto.

Senator Gold: Senator Woo, Canada is not committing war crimes. It is not complicit in war crimes. Therefore, I think we as lawmakers have nothing to fear for actions that Canada has taken on the world stage to try to bring an end to the conflict, to provide humanitarian assistance to those in need and also to defend Israel’s right to defend itself against terrorist attack.

Senator Gold: Thank you. The government is committed to working with producers and other businesses, grocers and stakeholders to avoid increasing the cost of food and increasing food waste. My understanding is that the government has been very clear that it wants to collaborate with such stakeholders, producers and grocers on implementing solutions that exist, while avoiding the negative consumer and environmental outcomes.

[Translation]

Senator Gold: Thank you for the question. The challenges that Indigenous communities face with inadequate access to health care and the high rates of despair and suicide are tragically well known. Therefore, I have been advised that the subject of MAID is one, frankly, that many communities don’t even want to talk about; consultation and engagement are a two-way street. It’s not something that one can insist on or enforce.

I’ve been advised that it has taken time to bring people to the table and to explore the fact that Parliament has passed a law that says, subject to the sunset clause, access to MAID — where mental illness is the sole underlying condition — will be in effect in three years, and is working with and funding Indigenous communities to better understand. Also, it’s important to listen to and hear from Indigenous communities about what their needs are because their needs are enormous in order to provide care and support for people who find themselves in desperate circumstances, and for whom the resources to support, treat and heal them are inadequate.

The government is doing what it can at the pace that the communities are willing to engage in, and will be reporting on a regular basis to Parliament on the progress of that as well.

Senator Gold: I’m not privy to the details of the discussions between the ministers, and I’m not sure that it is a matter of public record. I do know that the Minister of Health and his counterparts are in constant discussion, as are officials, on these matters. I know that this government and this particular minister feel very strongly that the federal government should continue to do its part with the provinces and territories to help them get ready.

Cooperative federalism also means respecting the sovereign jurisdiction of the provinces to decide exactly what their greatest needs are and where to put them. Some provinces are focusing more on services in rural areas, others perhaps in other areas, and that’s just an ongoing give and take between the federal government and its counterparts.

Senator Gold: Thank you for the question. The government has agreed to balance its national and international commitments while actively increasing its defence spending. As the Prime Minister said during his visit to Ukraine, a lot remains to be done regarding defence spending, and the government is determined to meet the 2% target in due course.

Senator Gold: As I tried to explain in my discussion of the Charter, the position of the government is that it is not discriminatory because the nature of the cases is different. When there is a grievous and irremediable physical condition, whether or not it’s accompanied by a mental disorder, that is a qualitatively different kind of assessment, it is submitted, than if someone is presenting only with a mental disorder as the underlying condition.

The suffering is the same. The desire for access to MAID is the same, but the actual assessment is going to be done differently because, unless I am incorrect, I believe that those who qualify for MAID under Track 2 — or Track 1, for that matter — are qualifying because of the irremediable physical disability or ailment, and not because they have, as some do, though not all do, a mental disorder that accompanies it.

Senator Gold: I’m not in a position to answer the question of what steps have been taken. I will certainly raise that with the minister at my earliest possible opportunity.

Senator Gold: Again, senator, there’s no question that the experiences of other jurisdictions have been taken into account by policy-makers in the drafting of this bill. I look forward to these questions being asked in the other place when it becomes a subject of debate on the floor, in committee and certainly when it comes here. I think the ministers and the officials will be in a better position to answer the questions than I am — at least on this first day that the bill was tabled.

Senator Gold: Thank you for the question. I will have to go reread my speech. I’m not sure I cited that issue as the central reason as to why, in fact, there is not a consensus within the communities of physicians, regulators, health care ministers and the like. Nor am I in a position to competently predict what kind of consensus may emerge among assessors — psychiatrists, notably, but others — because other health care professionals are involved in the process.

Work is being done on that, to be sure, and one of the reasons that has been cited for needing more time is to translate the fairly general practice guidelines into more specific guidance for those in the assessment process, within individual institutions, individual provinces or across this country.

Hansard will reveal what I said, but the purpose was not to zero in on that specific issue.

The government is confident that three years is a reasonable time. It’s a clear target as opposed to an indeterminate one, and, therefore, the system will be sufficiently ready so that MAID can be administered more consistently and safely across this country.

Senator Gold: Thank you for that question. The government has announced what is called the Recognized Employer Pilot, or REP, which will help streamline processes for employers with the highest standards of worker protection. REP will be more responsive to labour market shortages and will reduce the administrative burden for repeat employers who demonstrate a history of program compliance while ensuring that temporary foreign workers are protected.

Senator Gold: It is unacceptable for a company or an individual to try to circumvent a policy designed to support and encourage certain businesses, whether they are Indigenous or they work in any other context. Again, the investigation will shed light on the situation because it is unacceptable for such things to happen.

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