Hon. Mary Jane McCallum: Will the senator take a question?

Senator Cotter: Yes.

Senator McCallum: I want to go back to your statement about the Natural Resources Transfer Agreement that was done unilaterally without First Nations input. That is now a huge conversation and area of concern for First Nations, and they are going to be bringing it forward. Underneath that lies the Doctrine of Discovery and how it plays into the Constitution.

Is there any way that this portion of the bill could be sent to the Indigenous Peoples Committee to study? That is huge, and I think we need to settle that before you go any further.

Senator Cotter: Ever so briefly, I think the point you make is a matter of legitimate concern, but the Natural Resources Transfer Agreement is a recent Prairie-Alberta-Saskatchewan event that actually creates the same question across the country: Who are the owners of subsurface resources, not just in Alberta and Saskatchewan but more broadly across the country? I think that question, if it were to be studied, would need to be studied on a national basis, and this bill isn’t the right fit for it, with the greatest of respect.

Senator McCallum: Will the senator take another question?

Senator McCallum: First Nations are also masters of their own domain. How will First Nations’ leaders and advocates be informed in order to be prepared to present, and how will the committee ensure that they hear from Indigenous peoples?

Hon. Mary Jane McCallum: Honourable senators, I am compelled to rise again today to speak to Bill C-32, with specific reference to Division 3 of Part 4, that being the Framework Agreement on First Nation Land Management Act. My focus today will be on how the pre-study process commits an injustice to First Nations.

I have witnessed that with pre-studies we, as senators, cannot and do not attend to our matters as thoroughly as we should, and, therefore, are unable to apply proper sober second thought. Yet, as stated by other senators, pre-studies have become a normalized part of procedure, which creates problems.

As a senator who is First Nations, I am concerned about how this rush has breached my right of privilege. The interim report of the Standing Senate Committee on Rules, Procedures and the Rights of Parliament entitled A Matter of Privilege: A Discussion Paper on Canadian Parliamentary Privilege in the 21st century states that:

. . . in the late 20th and now in the 21st century discourse about parliamentary privilege centres on how privilege should function in a rights-based legal system exemplified here in Canada by the Canadian Charter of Rights and Freedoms, and where the public expects increased transparency and accountability for the decisions made by parliamentarians.

The report cites the Supreme Court of Canada in Canada (House of Commons) v. Vaid:

Parliamentary privilege in the Canadian context is the sum of the privileges, immunities and powers enjoyed by the Senate, the House of Commons and provincial legislative assemblies, and by each member individually, without which they could not discharge their functions.

Colleagues, my work and function rests with Indigenous peoples across Canada, including grassroots, leadership and specific interest groups. Part of my function is to bring their voices, which have been largely and historically unheard in this arena, to the Senate floor and into our committees. It is extremely difficult to do this with pre-studies.

In the artificially fabricated rush to deal with Bill C-32 via multiple pre-studies, I have been unable to ensure that the interested groups I represent have been empowered to be heard on relevant matters that are of critical importance. This has resulted from an inability to procure timely translation of their documents into French and an inability for them to bring proposed amendments forward due to the Office of the Law Clerk and Parliamentary Counsel being stretched too thin. This issue, which is of absolutely no fault of the Law Clerk’s office, as they provide a crucial service, has previously affected my work in the Standing Senate Committee on Energy, the Environment and Natural Resources.

Of great concern in such instances is that this issue has already impeded me from being able to best demonstrate to my colleagues, who are charged with making decisions that have direct bearing on First Nations’ lives and well-being, the impacts of the cumulative effects of resource extraction on Indigenous lives as well as on reconciliation efforts.

I’ll be interested to see how French translation will be handled with these new committee studies. Why are some bills allowed amendments and others are not? This is differential treatment.

Honourable senators, in this specific situation with Bill C-32, Grand Chief Garrison Settee of the Manitoba Keewatinowi Okimakanak, or MKO, only heard about this bill very late in the process. He immediately presented a written submission to the Standing Senate Committee on Indigenous Peoples and the Standing Senate Committee on National Finance.

On December 1, 2022, MKO also requested to be invited to appear before the Indigenous Peoples Committee and the Energy Committee with regard to Part 4 of Division 3 of Bill C-32. To date, MKO has not received correspondence from either committee on the decision about their request to appear. More importantly, they have not been informed if or how their critical submission was taken into account.

Colleagues, MKO has championed thoughtful and determined efforts to uphold First Nations’ rights to enforce and adjudicate First Nations laws enacted pursuant to the First Nation Land Management Act and of bylaws enacted pursuant to the Indian Act. The MKO is underscoring that the intent behind Parliament establishing these law-making regimes further to the inherent right of self-government is to move towards establishing the third level of government in the nation-to-nation relationship that the federal government speaks about.

However, these law-making regimes in First Nations communities are currently being rendered inactive by the policies and inaction of the Government of Canada and of the RCMP. The result, Grand Chief Settee says, are “stranded regimes” of unenforceable First Nation laws and bylaws.

What are the results of these stranded regimes? MKO Grand Chief Settee wanted to share critical information with all honourable senators about the real-life experiences of MKO First Nations in their struggle to apply enforcement of the self‑governing law-making authorities of First Nations enacted through previous legislation, Bill C-49 in 1999 and Bill C-428 in 2015. Why do these uncertainties persist, despite legislation that was supposed to correct these injustices?

These real-life experiences impacted all communities that were then forced to scramble to best protect their people. This included lockdowns; social distancing; maximum number of patients in a dwelling, business or facility; trespass by prohibited persons during bans on non-resident travel; and health checks of persons entering the community — all protections afforded to other Canadians.

Honourable senators, one example that I previously read into the record recounts that the chief and council, First Nation safety officers and the pandemic response coordinator of the Misipawistik Cree Nation were abandoned by RCMP, who refused to enforce the COVID-19 emergency law enacted under the Misipawistik Land Code during the midst of a major outbreak of COVID-19 in the community.

The Public Prosecution Service of Canada has gone on record to say that PPSC has no mandate to prosecute offences under First Nation land code laws under the First Nation Land Management Act.

The First Nations Land Management Act was enacted to recognize the inherent right of self-government and the nation‑to‑nation relationship by providing the option to replace parts of the Indian Act. Where is this recognition of self‑government when First Nations laws enacted further to a land code to protect the health and lives of First Nations during a declared global pandemic are then not recognized, respected, enforced and prosecuted? Requests for help in an emergency situation must be acted upon in a timely manner. Such requests cannot wait idly for the Attorney General’s blessing — something that could take literally months to occur.

Colleagues, I concur with the statements by Senator Patterson that our pre-study of Bill C-32 has served only to rush legislation. I appreciate the senator’s view that:

. . . with Indigenous or grassroots organizations that often already face capacity issues, we need to give as much notice as possible to prospective witnesses. We need to slow down and make sure we are properly reviewing legislation, taking the time to hear from as many people and as many different perspectives as possible.

I acknowledge and concur with the statements made by Senator Francis that:

. . . we are responsible for ensuring that the voices of historically marginalized, under-represented and oppressed individuals and groups are heard and acted on.

I also share the view of Senator Francis that:

I further hope that the members of the Committee on National Finance have an opportunity to hear directly from MKO and perhaps others in relation to the proposed Framework Agreement on First Nation Land Management Act.

As requested by Senator Loffreda at the National Finance Committee, I, too, am looking forward to comments from the Deputy Prime Minister and Minister of Finance on the concerns about Bill C-32 raised by MKO, to which the Deputy Prime Minister and Minister of Finance advised as being, “Duly noted.”

Honourable senators, the two amendments identified and submitted by MKO refer to two other acts of Parliament that are not included in Bill C-32 but directly impact the ability of enforceability by the First Nations land code laws. These two acts that impact the enforcement and prosecution of First Nations laws enacted pursuant to a land code include the Royal Canadian Mounted Police Act, R.S.C., 1985, c. R-10, and the Director of Public Prosecutions Act, S.C. 2006, c. 9, s. 121.

I believe that it was a serious oversight that these two statutes were not amended when this Framework Agreement was enacted in 1999. The problems with enforcement and prosecution were known in 1999 when Bill C-45 was first enacted, but they were thought of as being part of an ongoing, longer term discussion that never took place. The COVID-19 pandemic starkly illuminated the effects of the failure to enforce and prosecute.

Honourable senators, when I speak about the gaps created by legislation we pass, this is but one example. Because of this legislation, which is, once again, being rushed through this place, we are unable to do our fulsome research on the impact this legislation has on First Nations impacted by the bill. It also precludes us from identifying what recourse we have to best speak for the people for whom we have responsibilities. How can we practice reconciliation under such conditions?

It makes it very difficult to come up with solutions to help First Nations navigate the injustices created by siloed legislation. We must acknowledge the reality that we are seeing that pre‑studies only add to the silencing of First Nations’ voices. We must do better, and we must demand better. Kinanâskomitin. Thank you.

[Translation]

Senator McCallum: Senator Cotter, there are a lot of unresolved issues here for rights holders in this bill. How will the lived experiences of rights holders in the Prairie provinces be meaningfully addressed when you see Alberta and Saskatchewan, with Manitoba not far behind, ignoring the rights holders in the acts that they are bringing forward? How do you see that being addressed in this bill?

Senator Cotter: As you will see in the bill, Senator McCallum, there is a requirement of consultation and dialogue with Indigenous leadership in the Prairies. That’s a mandate imposed upon the minister who coordinates this work, and, I presume, the other ministers who will have a role here.

Maybe I could answer this with an example of what I think is an opportunity lost in the past, but may be there in the future.

When you think about economic opportunity — let me focus on that first — the opportunities for Indigenous people, but particularly First Nations, have been badly circumscribed by treaties, treaty lands and reserves. I think you and I are on the same wavelength there. In fact, a lot of those, if you look at the maps — Saskatchewan is, perhaps, the worst case — are not just being put on small, postage stamp-sized reserves, but also at the margins of a productive economy in the province, at least in the days when agriculture seemed like the story. So Indigenous people and communities never had a chance to get off the ground.

The place where those conversations have been the richest have been in relation to traditional territories. Not the postage stamp-sized reserves, but the areas where First Nations tended to live traditionally, which often covered vast areas.

One of the ways of trying to build an economy is to create opportunities for Indigenous people and communities to tap into those resources. It’s tricky if you’re a provincial government because usually tapping into those resources — which conventionally provincial governments have understood to be theirs or belonging to all the people — are a source of revenue to run the programs of the province. What you need is a partnership with the province and the Government of Canada because in the Constitution Indians and land reserved for Indians are the constitutional responsibility of Ottawa. It’s possible for the Government of Canada to support those developments, sometimes with support for equity, but also support for sharing the constraints or the opportunity costs for the provinces.

Ottawa has not always been open to that. I don’t know where this will go. I am hoping that imaginative ideas to unlock that potential that was taken away will occur. There are people a lot smarter than me coming up with these ideas, but I think there is a remarkable amount of potential to do that if the goodwill is there.

Provinces are vulnerable in some respects. Sometimes when oil revenues and others are really good, it looks pretty good, but provinces are vulnerable to having to give up large amounts of their tax base. But partnerships with the Government of Canada, which has a fiduciary obligation here and was the mechanism for taking away that opportunity, I think there is a duty that rests with Canada.

I hope that is at least partly helpful.

Hon. Mary Jane McCallum: Honourable senators, I rise today to speak to Bill C-31, An Act respecting cost of living relief measures related to dental care and rental housing.

I would like to thank Senator Yussuff, Senator Seidman, Senator Omidvar and Senator Simons for their previous speeches, which have increased our awareness and knowledge about dental care in Canada.

As many of you will know, I have been invested in the provision of dental care for 48 years of my life. Dental care is near and dear to my heart, and through my work I have given dentistry the worth that it deserves.

As it pertains to this bill, colleagues, I have concerns regarding the lack of adequate responses to questions raised by me and by other dental health professionals. I’m concerned about this short‑term approach when the effective prevention and management of most dental disease requires a long-term view. Moreover, we have provincial models of public health dentistry that provide care already. These clinics need to be better supported and funded to enable them to provide continuing additional care.

Most dental care systems are still structured around acute care service delivery, including emergency care such as pain relief. This traditional approach based on high-risk individual treatment is costly and research has proven its weak effectiveness.

Honourable senators, I have witnessed the children’s dental programs that existed in the provinces of Manitoba and Saskatchewan in the 1970s and 1980s. They were successful in completing school-based dental care on school-aged children, mainly in rural areas. The majority of children in the rural towns in Saskatchewan were eventually placed on maintenance, costing the government and taxpayers approximately $80 a year per student. Despite the success stories in these two provinces, the programs were phased out due to pressure from the provinces’ dental associations. Here, we can see the struggle between the public health model of dentistry and the business model. Which model will be encouraged to flourish in the proposal before us?

Colleagues, I further noticed in the bill that dental therapists are not included in the bill’s definition of “dental care services.” The dental therapists both federally and provincially trained in Saskatchewan and Manitoba are licensed health professionals who today provide the majority of services to children in dental offices. However, there are some federally trained dental therapists in Manitoba who are not recognized by the Manitoba Dental Association, or MDA. They continue to work on reserves without licences and without malpractice insurance, to their detriment. These federally trained therapists were trained through the dental faculty at the University of Toronto. I approached the MDA to question why the licensing of these two groups differed, but I did not receive an answer.

There are also Children’s Oral Health Initiative, or COHI, workers hired under a federal program who are trained at the community level but work without a diploma. They are allowed to provide treatment of fluoride application even though trained dental assistants are forbidden to do so through their provincial standard of care. It’s unimaginable that we have unrecognized, unlicensed providers without malpractice insurance permitted to work on children simply because these children live on-reserve. This is what we call geographic and systemic health racism.

As such, one big question lingers: Will this act be amended to include dental therapists, especially since they license and regulate their own profession in Saskatchewan and are looking at doing the same in Manitoba?

Honourable senators, one example of the fallout from decommissioning the children’s dental program was the closing down of the federal dental therapy school in Prince Albert, Saskatchewan, in 2011. The federal dental therapy school, supervised by dentists from U of T, was originally situated in Hay River, Northwest Territories. Yet, because the dental therapists had successfully completed treatment of all the citizens in the town, they had to move the school in Prince Albert. I understand that a new dental therapy school will be ready to start in La Ronge through the faculty of the University of Saskatchewan. I also understand that there are talks ongoing with different schools about dental hygienists who will be trained to be dental therapists.

This issue of a sustainable workforce continues with the other dental health professions. There are existing challenges with the recruitment and retention of oral health clinicians to provide care. When I was in Winnipeg, I asked dentists how they would be able to absorb the influx of children that this bill will result in, and who would be advising these children which offices would provide care. There are over 650 offices in Winnipeg but adequate infrastructure is not in place to handle this increased workload, which they are expected to absorb. I also do not know who would head such an initiative. Many dentists are already booking with their own patients months in advance. Will dentists be willing to displace some of their own patients for an interim program with unknown levels of bureaucratic involvement?

Colleagues, under the heading “Application” in section 8, it states that the application must include the name, address and telephone number of the dentist, denturist or dental hygienist — this is where dental therapists are missing — the applicant intends to have provide dental care services for the person for whom the application is made. The application also requires the month during which the services were provided, or when the applicant intends to have the services provided.

Based on what I have seen working in the field, I can say that very few dentists will provide care while expecting payment at a later date, despite what was said last night at the Finance Committee meeting. Furthermore, many First Nations are refused service due to an inability to prepay.

There are other situations at certain times where insurance companies will inadvertently send cheques to the patient instead of the provider, and then the provider has no recourse to payment when the patient doesn’t return the cheque to the office.

What happens if the applicant chooses to go to another provider — which is their right — or if they receive that cheque but don’t spend it on the intended care? This is a very profound possibility, as many of these individuals may have to decide if the money they receive is better spent on food or clothing so that their children can have basic living needs.

As we saw, the same situation occurred with the CERB where ineligible individuals sought the benefit because they needed it to meet basic needs. These are profound concerns to be addressed.

Honourable senators, I would like to speak to another successful dental program that is offered for children in Grades 2 to 6 at participating schools in the Winnipeg School Division, which has a high proportion of low-income households. This program is delivered by dental students in the college of dentistry at the University of Manitoba in concert with Variety, the children’s charity of Manitoba.

The third- and fourth-year dentistry students, who number 70, work with dental hygienists, dental assistants and supervising dentists to educate and screen children at school. Typically half of those screened require treatment. I was one of the instructors in the early 2000s, and I saw first-hand the extensive needs of children in these urban populations.

In their 2021-22 report, 17 schools were involved and 2,053 students were screened with 21% treated. Dental students administered 733 treatments, improving the lives of 199 children altogether.

Marsha Missyabit, the vice-principal of the Niji Mahkwa School stated:

This year, our school felt very supported by the dental outreach program. Students that attended the program were very comfortable and had pleasant things to say. Communication was effective and we were accommodated with respect. Thank you for all your support!

In 2019, Variety began supporting SMILE plus, a partnership between the University of Manitoba and the Winnipeg Regional Health Authority that provides free dental care for children in kindergarten and Grade 1 at select schools. These are done through private donations.

Honourable senators, I call attention to these successful programs as they can be used as models for implementation. The universities themselves are great sites for public health model delivery of dental care.

Yet, colleagues, a large concern I have with Bill C-31 arises from discussions I have held with various groups and individuals who are concerned about the inadequate amount of $650. It was quoted these children only require $650 worth of treatment. This amount would allow for an exam, radiographs and only two to three restorations. If this is all they require, then truly these children do not need a lot of work, but I don’t believe this to be the case. These children will need full-mouth comprehensive care, especially for groups that have had very little to no access to oral care, as has been stated by some senators.

When I appeared as a witness at the House of Commons Health Committee back in 2003, the committee looked at the amount offered in the Non-Insured Health Benefits program. At the time, it was $800. The committee indicated that this was inadequate, and they were instrumental in raising that amount to $1,000, a number that was still indicated to be inadequate.

Many health professionals have acknowledged that dental care is out of reach for many, including all age groups across the country. Who is most at risk and what is going to be done to provide some equality and equity to these groups?

Many people don’t have appropriate and timely dental care for reasons stated by the college of dentistry at the University of Manitoba, which include accessibility, availability, accommodation, awareness and acceptability.

I have said this before: That span between the $70,000 and $30,000 income brackets is huge and has the possibility of negative implications for the $30,000-to-$40,000 income group. In this group, they lack resources like the internet, phones, child care, transportation and the skills to navigate the new, incoming bureaucratic system, which already limited access to care when I was delivering dental care 20 years ago. It still continues to limit access today.

To add to the bureaucracy, the Canada Revenue Agency will be yet another major obstacle, especially if they do not have direct deposit accounts or access to computers.

What I heard in yesterday’s speech is that for Canadians to be able to receive their benefit payments swiftly, they will receive an upfront payment. That alleviates some of the burden for those who cannot prepay.

However, how will we assist those parents who do not have bank accounts or financial literacy? How will the government further ensure that this group will be able to access dental benefits equally with the $70,000 income group, who will have more resources?

Honourable senators, I would like to state my serious discomfort with the rushed manner with which this critical bill has proceeded. Is this because there has been a threat to trigger an election if this bill is not passed by December, or that the Canada Revenue Agency wants it passed by November 18?

It needs to be said that working under duress is no way to start this public health dental program. Spending public funding is a responsibility that we must consider diligently, not hastily.

[Editor’s Note: Senator McCallum spoke in Cree.]

Thank you.