- Member of Parliament
- Member of Parliament
- NDP
- Courtenay—Alberni
- British Columbia
- Voting Attendance: 67%
- Expenses Last Quarter: $148,159.67
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- Apr/8/24 10:06:13 p.m.
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Madam Chair, I too sat on the Standing Committee on Fisheries and Oceans with my colleague, and I really appreciated her fighting for rural Canada. Whether it be her in Quebec or me in British Columbia, we work well together.
I was reading a quote that was sent to the Standing Committee on Finance. It was in a pre-budget consultation submission put forward by Paper Excellence. The company wrote:
Greater Support for Indigenous Lead Development in the Forest Bioeconomy—
We are advocating for increased support for economic opportunities in Indigenous communities to foster the development of the forest bioeconomy and promote partnerships and collaborations through the expansion of the Indigenous Natural Resource Partnerships (INRP) program.
Does my colleague agree? Again, while we see Liberals and Conservatives pointing fingers at who is to blame for 42 years of failed softwood, what I have really liked about the Bloc is that the members have brought forward solutions tonight. We have to talk about solutions because what the Conservatives and the Liberals have been doing is not working.
Does my colleague agree, in the upcoming budget, that the federal government needs to invest in and expand the indigenous natural resource partnerships program, and how critical it is that we support indigenous-owned and indigenous-led businesses and initiatives?
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Mr. Speaker, it is an honour to rise today on the unceded lands of Tseshaht and Hupacasath on Vancouver Island in Nuu-chah-nulth territory to speak to Bill C-62, which is calling for the extension of the temporary exclusion of eligibility for medical assistance in dying for persons suffering solely from a mental illness by three years, until March 17, 2027.
Clearly, without an intervention by Parliament, this expansion would come into effect on March 17, 2024, in just one month. New Democrats agree with the majority decision made by the Special Joint Committee on Medical Assistance in Dying, also known as the AMAD committee, which I will refer to it as in my speech. It reported that Canada is not adequately prepared to deliver medical assistance in dying to individuals whose sole underlying medical condition is a mental disorder.
The bill would allow more time to implement the necessary safeguards and address the capacity concerns that are expected to be the result of the expansion of medical assistance in dying for those with the sole underlying medical condition of a mental disorder. It would give medical practitioners more time to become familiar with available training and supports, while providing time for the public to become more aware of the robust safeguards and processes in place. I know this is a very sensitive and very personal matter to so many people around this country. Especially in my riding of Courtenay—Alberni, I have heard from many people about this.
We also need to ensure that we have the understanding and compassion to respect the right of an individual's choice of dignity when they have deep, prolonged and ongoing suffering. I will speak to that. Suffering from mental illness is extremely serious, and it is just as real as suffering from a physical illness. In our health care system, we clearly do not have parity when it comes to mental and physical health, and I will speak to that as well.
We must also affirm and protect the most vulnerable when we do any sort of decision-making on such a serious piece of legislation as expanding medical assistance in dying. This additional delay is necessary and needed right now to ensure that we have a health care system in place that can safely provide medical assistance in dying for those whose sole underlying medical condition is a mental disorder.
We know how we got here. The Liberal government made an ill-advised decision and did a complete 180° by accepting the Senate's amendment to Bill C-7 in the 43rd Parliament. That is what got us here. The government changed the law before any kind of comprehensive review had been conducted, and we have been trying to play catch-up ever since. I am going to speak about the important work that needs to be done, and I want us to be thoughtful in our approach to expanding medical assistance in dying.
As New Democrats, we take people's concerns and feedback very seriously. We are committed to helping find the best possible solution for Canadians in the policy of medical assistance in dying to ensure that it does what it was always intended to do. One of the biggest concerns New Democrats have with the expansion of medical assistance in dying is with the barriers that many Canadians face when they reach out for mental health treatment. Because of the Liberals, and the Conservatives before them, the chronic underfunding of our health care system has become even more apparent. It is now more than ever, as we see the disparity between mental and physical health and how people are taken care of.
We heard the Prime Minister promise to implement a new mental health transfer of $4.5 billion over five years, but he has still not done that. Even with the bilateral agreements, the Liberals are falling far short, and that would not even be enough. Everyone should be able to access mental health supports when they need it, but under the Liberal government, and that of the Conservatives before it, this has not been the reality. It is the same with all provinces and territories.
New Democrats wholeheartedly support the delay in expanding medical assistance in dying for those who have a mental disorder as the sole underlying condition, but the Liberal government needs to ensure that proper consultation happens between now and the expansion date, or it would need to be extended again. It needs to ensure that people will be protected while respecting their individual choice.
The Liberals cannot just delay the expansion either. They need to fund adequate supports and treatment options for people dealing with mental illness. Members have heard me say this repeatedly, but we need a pathway, a road map, to how we are going to achieve parity for mental and physical health and ensure people get the timely help they need when they need it.
Seven of the provinces and all three territories have said that they are not ready and have signed a joint letter to that effect, including my home province of British Columbia. That was signed by the ministers of health in those provinces and territories. They are calling for an indefinite pause on the expansion for individuals whose sole underlying medical condition is a mental disorder. That is what those ministers identified.
As New Democrats, we want to see a MAID regime where guardrails are in place to protect vulnerable populations while still allowing for personal bodily autonomy and end-of-life choices. We must make sure that people do not request medical assistance in dying because they do not have access to treatments, supports and services. This has to be absolute. The Liberals need to make sure everybody can access mental health supports. However, after nine years of carrying forward with the Conservative cuts to health care, this is where we are at right now right across the country. Help is out of reach for many people. This needs to change before medical assistance in dying can be expanded.
We know that the housing, toxic drug and mental health crises that are happening are not being addressed. I see that I do not have a lot of time left, but I want to ensure I outline that the AMAD committee heard from plenty of witnesses who cautioned the committee on expanding MAID in cases of persons suffering solely from a mental illness. I want to share what a couple of those experts had to say.
Professor Brian Mishara, who is with the Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices at Université du Québec à Montréal, said, “The expert panel report on MAID and mental illness states that there are no specific criteria for knowing that a mental illness is irremediable”, and that there is absolutely no “evidence that anyone can reliably determine if an individual suffering from a mental illness will not improve.” He warned us that “any attempt at identifying who should have access to MAID will make large numbers of mistakes, and people who would have experienced improvements in their symptoms and no longer wish to die will die by [medical assistance in dying].”
We heard from many experts. The CAMH raised similar concerns.
Because I see that I only have a couple of minutes left here, I want to talk a bit about the system and the lack of access. We are talking about a crisis going on from coast to coast to coast, according to a poll done just a year ago. The Mental Health Commission of Canada and the Canadian Centre on Substance Use and Addiction released a report talking about postpandemic findings. It cited that 35% of respondents reported moderate to severe mental health concerns.
This is alarming. It should also be alarming to all parliamentarians that it found that fewer than one in three people with current mental health concerns accessed services. The report identified key barriers to accessing services as financial constraints and help not being readily available. We know that right now we are in a financial crisis, and I am sure those numbers have only gone up. It identified that one of the top stressors was between income and unemployment with mental health concerns.
We need to create a system of parity with mental and physical health. The government has not delivered when it comes to a plan, a road map, on how we achieve parity with physical and mental health. I hope in this budget, it is going to release funding on top of the bilateral agreements directly to community-based organizations as a COVID emergency recovery response because, post-COVID, we know some people are struggling financially, but the biggest concern right now and the biggest epidemic post-COVID is in mental health. I hope the government is hearing that.
I see that I have run out of time. I have a lot to say on this matter. I look forward to taking questions from my colleagues.
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- Dec/11/23 7:53:28 p.m.
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Madam Chair, I want to thank my colleague.
The member talked about consultation and right now, Indigenous Services Canada, or ISC, has been changing funding formulas for education without even talking to the nations that are impacted, so it is hard for them to continue doing their programming with new formulas. It has a huge impact on children, of course.
On ISC engagement with indigenous communities, first nations, Inuit and Métis people, does the member agree that it should be an absolute requirement to obtain their free, prior and informed consent before changing any funding formulas in all areas of service delivery?
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Madam Speaker, I have a lot of respect for my colleague, but I have deep concerns when I hear Conservatives talking about human rights in China. The Conservatives signed the Canada-China Foreign Investment Promotion and Protection Agreement, which locked us into an agreement for 31 years, to 2045. In fact, the Hupacasath people in my riding had to go to court to defend their section 35 rights against that very treaty. The Conservatives were not there respecting indigenous rights or protecting their rights, which were under threat when it comes to the environment and the concerns they have around food security and land security, so enough of the past.
With respect to this bill, does my colleague share the concern that this bill would still not provide assurances to indigenous people or consultation to indigenous people? Does he share concerns of how important and significant those are, and how they need to be respected and ensured in this legislation? Enough of just counting on the minister to do the right thing. This needs to be dealt with in the legislation.
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Mr. Speaker, I really am enjoying my colleague's speech today. One thing I want to raise is with respect to the national council on reconciliation. It is so important to have measurements, timelines and commitments from the government, but they need to be followed up with action. My hon. colleague and I have been working together and calling on the government to deliver on its promise of a $4.5-billion mental health transfer of new money, which it has not delivered.
Call to action 19 cites:
We call upon the...government, in consultation with Aboriginal peoples, to establish measurable goals to identify and close the gaps in health outcomes between Aboriginal and non-Aboriginal communities....
It includes mental health.
Through you to my colleague, does she feel that the government is living up to its responsibility when it comes to the calls to action, and even today with respect to the spirit of delivering to indigenous peoples to close those gaps and deliver on those outcomes?
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Madam Speaker, I want to thank my colleague who tabled this bill for bringing it forward and for recognizing that we must do more to support people dealing with substance use disorders.
As we know, Canada is experiencing multiple crises: a mental health crisis, a toxic drug crisis, a housing crisis and a worsening affordability crisis. There are links between these crises, and they are impacting the quality of life for Canadians in communities across the country. It is incumbent upon us, as parliamentarians, to present and debate solutions so we can move forward in the best interests of Canadians.
In developing possible solutions, I believe it is critical to listen to both experts and those with lived or living experience. Last year, I was honoured to be named the NDP critic for mental health and harm reduction. I promptly tabled Bill C-216, the health-based approach to substance use act. This bill was aligned with the recommendations of the expert task force on substance use that was commissioned by Health Canada to make recommendations on federal drug policy.
Earlier this year, as I travelled across the country to speak to Canadians about Bill C-216, I had the opportunity to meet with many individuals directly affected by the toxic drug crisis, either personally, through someone they love, or because they were working on the front lines. I consistently heard that we need more supports for people struggling with mental illness, trauma, problematic substance use and housing precarity.
I also heard that there is no silver bullet. We know these are complex issues that require multi-faceted solutions, such as investing in the social determinants of health like housing and income security, increasing the focus on prevention and early prevention, and making a full range of mental health and substance use supports available on demand.
While Canada is facing an intersecting crisis, we are not making adequate investments into urgently needed solutions. Relative to the disease burden caused by mental illness, and compared to some of our G7 peers, Canada is underspending on mental health. France spends 15% of its health care budget on mental health, whereas the U.K. spends 13%. By comparison, mental health spending makes up between 5% to 7% of health care budgets in Canada, depending on the province or territory, so underinvestment in prevention and evidence-based care has come at a tragic cost to our communities.
Canada has now lost more 30,000 lives since 2016 because of drug poisonings, in addition to more than 44,000 hospitalizations. This public health emergency has been escalating for seven years, yet the government has only committed $800 million to date for its substance use and addictions program. Meanwhile, the expert task force on substance use found that current ineffective policies are costing us billions every year in health care, policing and criminal justice expenses.
I appreciate the bill's intent. It seems to provide a route of access to treatment for those with substance use disorders and reduces the impacts of problematic substance use on individuals and their communities. However, I have some concerns about some of the assumptions that may have been made in formulating the bill, and I cited some of them earlier, as well as how it may play out in practice if passed.
In doing research and consultation on this bill, a theme that has come up consistently is that prisons are currently places of punishment and not care. The United Nations Nelson Mandela rules provide that the quality of health care provided to incarcerated persons must be equivalent to that available to the general population. However, concerns have long been raised about the quality of care in Canadian prisons and inherent conflicts that arise when correctional authorities are responsible for delivering health care.
Catherine Latimer, the executive director of the John Howard Society of Canada, has explained this conflict as follows, “Whenever you have correctional authorities delivering health care, there’s going to be irreconcilable conflict between the institution and the health-care needs of the individual”. She continues, “Security issues will always trump the health needs of the individuals.”
Emilie Coyle, the executive director of the Canadian Association of the Elizabeth Fry Societies, echoed that perspective in conversation in my office and commented that, if we try to insert care into prisons, people will continue to be harmed by our overly punitive prison systems.
Today, my office spoke with an individual with lived experience of opioid use disorder and criminal justice involvement. This individual is now doing advocacy work in recovery and shared the perspective, “Prisons do not breed success.” Indeed, the shortcomings of mental health care in federal penitentiaries has been well documented, such as reports by the correctional investigator and the final report of the National Inquiry into Missing and Murdered Indigenous Women and Girls.
Before establishing a regime of designated addictions treatment facilities in penitentiaries that will necessarily require significant investments, it is important to pause and ask: Where can someone get the best care? Where will they receive care that is evidence-based, trauma informed and culturally appropriate? Where are they most likely to achieve their treatment or recovery goals?
The answer we have heard consistently from those working with incarcerated individuals or with lived experience is that people are better served by accessing mental health and substance use care in their communities. Unfortunately, across Canada, there are barriers to accessing community-based mental health and substance use services, such as stigma, out-of-pocket costs, lengthy wait-lists, admission criteria and lack of detox facilities. Last year, the Expert Task Force on Substance Use recommended that the government make significant new investments to provide supports to people who use drugs, but that call has not been heeded, and the level of funding committed to date remains inadequate to meet the needs in communities across the country.
I welcome the opportunity to work with the member on initiatives that will remove barriers to substance use treatment and recovery services so that all Canadians can get the support they need in their communities. No one should have to go to jail to get help. That is just a fact.
I am also concerned that the bill may prevent people who want help from accessing it. In its current form, the bill proposes to exclude individuals convicted of certain offences, including drug trafficking offences, from its scope. This seems to ignore the fact that some individuals with substance use disorders become involved in subsistence trafficking. Exclusions in the bill could create barriers to accessing treatment in federal prisons.
Indeed, the individual with lived experience I spoke of earlier would not have benefited from the bill, having been convicted of trafficking. He was, fortunately, able to access treatment prior to sentencing and while in recovery, he has remained gainfully employed and involved in community service. After reviewing the bill, he asked how many people serving federal sentences might benefit from the bill, given the excluded offences. It is a good question, and a question that needs to be answered.
While I appreciate the bill's intent to create pathways to treatment, I think we must be careful to avoid introducing new barriers. We must also think about where we can make criminal justice reforms and investments in substance use services that will increase the likelihood of successful outcomes.
I really want to thank the member for prompting this debate. I look forward to further dialogue with my colleague and other colleagues in the House. We have to work together. This is a parallel crisis right now, which we have been dealing with throughout COVID, and the government has not paid enough attention to it. It has not acted with a sense of urgency. People's lives are at stake. This is impacting our communities, our health care system, penitentiaries, policing and the judicial system. Most of all, it is impacting people's lives and those of their families.
Again, I look forward to working with all members in the House to try to provide solutions so that we can tackle this crisis. It does require a sense of urgency and immediacy.
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