Bill C-304 (Historical)

National Strategy for the Treatment of Autism Act

An Act to provide for the development of a national strategy for the treatment of autism and to amend the Canada Health Act

This enactment requires the Minister of Health to convene a conference of all provincial and territorial ministers of health for the purpose of working together to develop a national strategy for the treatment of autism. It also requires the Minister to table a report in both Houses of Parliament specifying a plan of action to implement this strategy.
The enactment also amends the Canada Health Act to ensure that the cost of Applied Behavioural Analysis (ABA) and Intensive Behavioural Intervention (IBI) for autistic persons is covered by the health care insurance plan of every province or territory.

[Mike Lake, Conservative, Edmonton—Mill Woods—Beaumont, AB]

I'm not sure exactly what Ms. Savoie was asking. Was it whether we would just adjourn the meeting and come back some other time? What was the request? We're sitting here; we're supposed to be doing clause-by-clause consideration on this, and it seems that there is a pretty major issue.

I would note that we have many very important things we should be doing as a committee, and this is the third time we have been dealing with a bill that has some serious issues associated with it. We had the Bloc's Bill C-257. We had the NDP's Bill C-304. Now we have the Liberals' Bill C-284. All of them had things in them that were clearly not completely thought out before they came here. In every case there is an urgency for discussing these bills.

Of course, I understand that a private member's bill is never going to be perfect and there are always going to be things that you have to deal with in committee, but in each of these cases they had major flaws that probably should have been discovered by the parties sponsoring the bills.

It comes down to the fact that we have this employability thing that we're supposed to be doing. We have a poverty study that we're all on side with and want to get into. If we adjourn this meeting and then come back and have to have another meeting on this, it just seems like a crazy way to go about it.

I'm not sure what Ms. Savoie is talking about. Is that what your suggestion was, that we put this on the side and come back? If we do that, does it end the meeting and we waste another two hours?

National Strategy for the Treatment of Autism Act

[The Speaker, Liberal, Peter Milliken]

The House will now proceed to the taking of the deferred recorded division on the motion at second reading stage of Bill C-304 under private members' business.

The House resumed from February 14 consideration of the motion that Bill C-304, An Act to provide for the development of a national strategy for the treatment of autism and to amend the Canada Health Act, be read the second time and referred to a committee.

Autism

[Mike Lake, Conservative, Edmonton—Mill Woods—Beaumont, AB]

Mr. Speaker, today I need to address an issue of political gamesmanship taken too far.

My 11-year-old son, Jaden, has autism. Bill C-304 purports to help families struggling financially when a child is diagnosed with autism. However, this bill is simply a political manipulation.

The Liberal member knows full well that this is a bill he could never have supported when he was in government. If this bill were to pass, autism would be the one and only disease or disorder named in the Canada Health Act. Cancer is not named. Neither is diabetes nor cardiovascular disease.

The member knows that only the provinces can act on the provision of ABA treatment if we are to maintain the integrity of the Canada Health Act. Why in most cases are the provinces not taking urgent action? That is a question to which voters should demand an answer from their provincial governments.

What the member does not get is that this is not an appropriate wedge issue to exploit for political gain. These are real people with real challenges who are desperate for real solutions. Bill C-304 does nothing but give false hope to families who deserve more than to be treated as pawns in a political game.

National Strategy for the Treatment of Autism Act

[Shawn Murphy, Liberal, Charlottetown, PE]

Mr. Speaker, as the previous speakers have indicated, this is an extremely important issue, and I would suggest it is a raging issue right across the country. The prevalence of autism is extremely high and seems to be rising. The cause remains unknown, but we all know that early diagnosis and intervention is so important.

Let us make it absolutely clear to everyone in this room and everyone watching these proceedings that this is a health issue. That train has left the station; no one in this House is prepared to debate that issue.

However, autism is not treated as a health issue. Many provinces treat autism in the social services envelope. It is subject to a means test; people are told they will get money if they do not have any money. It is not treated in the same way as other health issues, such as cancer and heart problems. It is totally inconsistent from one province to another province. In some provinces it is a small amount of money from the social services envelope. Other provinces have more progressive plans that provide ABA and IBI treatment. While they are not totally accepted, they are the generally accepted treatment modalities for this particular problem.

We are talking of what I classify as orphans in the health system. It cries out for a response from the federal government, but also from the provincial governments. I suggest the provincial governments would certainly be willing to talk to the federal government and come forward with a combined response.

Let me be absolutely clear that this will happen. Whether it happens with Bill C-304 or a future bill, it is going to happen.

If parliamentarians in the House of Commons are not prepared to deal with it, there is another body that will deal with it and that is the courts. Someone is going to bring it to court and the judge is going to ask, “Is it a health issue?” Yes. “Is this the accepted modality of treating the health issue?” Yes. Then that judge is going to say, “I am not prepared to discriminate between someone with this particular problem and someone with cancer”, and the judge will order the provinces to pay for it.

I would ask the members of this assembly to be bold and courageous and do the right thing. I urge them to pass this legislation before we are dragged into the courts kicking and screaming.

There will be people who will stand up, and some have already, and give all kinds of excuses. One member said earlier that it is a provincial issue. I find that somewhat hypocritical. It is a provincial issue, but the federal government has a responsibility.

Only about 40 minutes ago we passed a private member's motion. The government members all stood up and voted for it. I will read the motion:

That, in the opinion of the House, the Minister of Health should continue to work collaboratively with Statistics Canada, the provincial and territorial cancer registries, and key stakeholders towards the ultimate goal of creating uniform national standards and guidelines for the surveillance of all malignant and benign brain tumours, including data collection, analysis and reporting.

That is a cancer issue. I would suggest that is a provincial issue if we accept the arguments of the members across. That is only an excuse.

I would suggest that the people of Canada are watching us on this particular issue. Just last week George Bush, who represents a country that does not have a public health system, passed a bill and voted a billion dollars on this particular issue. I would hope that we would not fall behind George Bush when dealing with this particular issue.

On this very important issue I urge everyone to do the right thing and support Bill C-304.

[Brian Murphy, Liberal, Moncton—Riverview—Dieppe, NB]

Mr. Speaker, I am pleased to say a few words on Bill C-304, An Act to provide for the development of a national strategy for the treatment of autism and to amend the Canada Health Act.

First, I would like to congratulate the hon. member for Charlottetown for the work done in this House on this bill.

Bill C-304 is a very important bill, as we can see from the debate on it, although a private member's bill may well work toward defining and differentiating different parties views of who will be left behind and who will not.

I am very pleased to rise and offer my support to Bill C-304, as it provides a national strategy, in law, for the treatment of autism.

The bill incorporates three main provision.

First, we are asking the Minister of Health to convene a conference involving the ten provincial and territorial health ministers to discuss the important issue and begin crafting a national strategy for the treatment of autism.

Second, we are asking the Minister of Health to table a formal strategy for the treatment of autism before the end of 2007.

Third, the bill asks that the Canada Health Act be amended to include applied behaviour analysis, ABA, and intensive behavioural intervention, IBI, as medically necessary for required services.

These measures are considered provisions designed to address a very real health problem in our country, one that affects thousands of Canadian families, no less detrimental than the diagnosis of terminal cancer or any other maladies that affect Canadians in general.

Let me tell members about a real life situation in my province of New Brunswick. I know a couple who have three children. They are seven, five and three years old. The first two of these children were diagnosed with autism. One of the children did not speak until he was three and a half years old. He had been very aggressive and he had many odd self-stimulatory behaviours. The parents did not know how to cope with the problem. He was described by a pediatric neurologist as severely autistic. The second child appeared to be less severely autistic, but she did not learn to speak until she was three years old, did not interact with her peers and seemed withdrawn from the outside world.

When the diagnosis was made some time ago, the discussion centred around appropriate treatment. Unfortunately, ABA was just in its infancy with respect to recommended treatment in the province of New Brunswick. There was no funding available and no professional help available.

These two very fine people, Charlotte and Luigi Rocca, read books. She retired from her law practice and devoted herself to her two autistic children. Through ABA and the expenditure of hundreds of thousands of dollars over the years, the results are astounding. These two children, to use one example of their achievements, at the grade two level lead the class now in their reading skills in English. They are involved in soccer and tae kwan do, not exactly sports that require retreat from the madding crowd around us. They are two very well developed, normal children. However, this did not happen with the help of the New Brunswick medical care system or the Canadian national Health Act.

ASD is a complex of potentially devastating problem for parents such as the Roccas. It affects people's ability to communicate, form relationships and interact with their environment. Within the spectrum there are specific diagnoses: pervasive development disorders, Rett syndrome, Asperger syndrome and child development disorder.

Symptoms can vary widely. Some who suffer from ASD are capable of leading normal, healthy, happy, productive lives. Many more, however, require extensive treatment to mitigate or compensate for unresponsive, uncommunicative and sometimes violent and self-destructive behaviour.

After a diagnosis, if children receive treatment early enough, typically before the age of six, and intensively enough, typically 30 to 40 hours per week, studies have shown that up to 50% can recover to the point of being indistinguishable from their peers. Even those who do not recover completely can show great improvement.

The debate is over. ABA and IBI treatments work. Both are designed to teach autism sufferers how to function in the world. When they are employed, the results can be dramatic and encouraging.

Until recently our understanding of both the incidence and special costs of autism was fairly primitive. However, the most recent, reliable information suggests that as many as one in 167 Canadian children suffer from some form of ASD.

We also know there is no cure and that there are financial burdens borne by families mostly in this country. The treatments can be as high as $60,000 a year. It is an extraordinary load to ask average Canadian parents who are victimized by this disorder to carry for even a short period of time, but the evidence is clear that the money spent on the treatment is effective and we can do something about it by making it a national health question. What can parliamentarians do to help lighten the load? They can do as the hon. member for Charlottetown has done in proposing this bill.

The courts have already rejected the argument that governments share a responsibility to treat autism and there are other constitutional issues to consider. How far should the federal government go on a health issue that properly falls within provincial jurisdiction? This has been referred to by my colleagues. However, the member for Charlottetown and I believe that the House has a moral responsibility to do everything it can. Make no mistake, we can do a lot. The Canada Health Act comes from Parliament.

Currently, medicare does not provide for the treatment of autism. Without sufficient public health care coverage, families will continue to mortgage their homes, extend their lines of credit or even bankrupt themselves as they desperately search for ways to pay for the cost of treatment. Many who run out of options will simply have no choice but to select treatment on the basis of affordability rather than clinical need.

How is that different than an American system of medical care delivery? How is it different to say that if parents have money they can get ABA or IBI, the treatment necessary to make their children performing members and integrated into society. The treatment works. It is very expensive and it should be afforded under any national health care scheme.

The act is not asking that much. It is asking, first, that the Minister of Health convene his counterparts, the ministers of health throughout the provinces and territories. In my province of New Brunswick the minister of health is very open to this suggestion.

The second suggests that the Minister of Health, who may be well on the road to doing this, posits and strategizes a national strategy to combat autism. While this may have been done outside the confines of this place, we think the bill before us, presented by the hon. member for Charlottetown, is the appropriate way to ensure that it is done in a proper manner.

It is not fair, equal or just. Protecting all of the citizens of Canada from crippling illnesses that financially burden families unfairly and end up in treatment of maladies different throughout the provinces and different according to one's means could not have been the vision of Tommy Douglas. This could not have been the vision of those who have modified the health acts across this country over the last 40 years.

Beyond this, there is a big difference in the availability of treatment across Canadian provinces, as we have just indicated. In Alberta, for example, children have full access. In Ontario, kids have access up to a certain age. In other provinces, such as in my province of New Brunswick, it is simply not available except perhaps through means tested social services or welfare programs.

Again I ask you, Mr. Speaker, and all members of the House: Is that fair, particularly when we have the Canada Health Act to help us develop new policies and programs that will benefit our most vulnerable citizens? Clearly, we must acknowledge that provincial health care plans are just that, provincial. We must respect the division of powers between federal and provincial levels of government, but that does not mean that we should abrogate our responsibility as parliamentarians within the constitutional framework.

Again, Bill C-304 is a noble effort to deliver a national health care strategy for the treatment of autism and to treat all Canadians afflicted by this in a fair and equal manner.

[Dean Del Mastro, Conservative, Peterborough, ON]

Mr. Speaker, I thank the House for the opportunity to participate in the debate on Bill C-304.

The title of the bill is a national strategy for the treatment of autism act. However, what the title does not make clear is the fact that the bill is calling for an amendment to the Canada Health Act.

I will take this opportunity to address why the concerns raised by the hon. member should not be addressed under the Canada Health Act. Although the care for individuals with autism and their families is of great concern to the government, the Canada Health Act is, in my opinion, the wrong instrument to achieve this objective.

The Canada Health Act sets out the broad principles under which provincial plans are expected to operate. The act establishes certain criteria that provincial plans must meet in order to qualify for their full share of federal health transfer payments. Federal transfer payments may be reduced or withheld if a province does not meet the criteria and conditions of the act.

These criteria are the cornerstones of Canada's health care system. They are as follows: reasonable access to medically required hospital and physician services, unimpeded by charges at the point of service or other barriers; comprehensive coverage for medically required services; universality of insured coverage for all provincial residents on equal terms and conditions; portability of benefits within Canada and abroad; and public administration of the health insurance plan on a non-profit basis.

In addition to the above criteria, the conditions of the act require that the provinces provide information as required by the federal minister and give appropriate recognition to federal contributions toward health care services in order to qualify for federal cash contributions.

The act also discourages the application of extra billing, or user charges, through automatic dollar for dollar reductions or withholding of federal cash contributions to a province or territory that permits such direct charges to patients. In fact, the fear that user charges and extra billing would erode accessibility to needed medical care was a major impetus in the development of the act.

The Canada Health Act was enacted to protect the fundamental principles of our publicly financed, comprehensive, portable and universally accessible health insurance system. I think everyone would agree that these are laudable objectives.

Our system of national health insurance, or Medicare as it is popularly known, is close to the hearts of Canadians and something too precious to tamper with. Canadians support the five principles of the Canada Health Act and feel that Medicare is a defining feature of Canada. Time and time again, polls demonstrate high support for Medicare.

If adopted, the amendments presented by my hon. colleague in this bill would affect the definition of insured services under the act. This means that if Bill C-304 is passed by the House, the provinces and territories will be required to provide, on an insured basis to all of their residents, behavioural therapy treatment for individuals with autism spectrum disorder. This is not the purpose of the Canada Health Act. I want to emphasize that the Canada Health Act was not meant to address issues such as behavioural treatment for autism spectrum disorder.

Introduced in 1984, the Canada Health Act brings together previous legislation, the Hospital Insurance and Diagnostic Services Act, 1957 and the Medical Care Act, 1966, to ensure that all Canadians have prepaid access to medically necessary hospital and physician services without financial or other barriers. The Canada Health Act references insured services and medical necessity, but does not define specific services for specific illnesses or conditions.

Insured health services under the Canada Health Act are defined as medically required/necessary physician services, hospital services and surgical dental services when a hospital is required. Hospital services considered to be medically necessary are outlined in the act and include, among others, such services as nursing, the use of operating rooms and drugs administered in hospitals.

Services provided by other health care practitioners outside a hospital are not considered to be insured health services under the act. This includes intensive behavioural therapy services for autism spectrum disorder since these services are generally provided outside hospitals by non-physicians. These services are considered to be additional benefits and may be insured at the discretion of the province or territory. They are not subject to the act's provisions.

The decision to provide services to individuals with autism spectrum disorder as part of a package of insured health services should be left to the provinces and territories. Each jurisdiction has mechanisms in place to examine the insured status of health services.

Provincial and territorial ministers of health consult with the members of the medical profession to determine which services are medically necessary and should be covered by their plans. They are then determined by physicians at the point of service.

Such consultations have proven to be an effective method of ensuring that Canadians receive appropriate medical care. Clearly, the Canada Health Act is not the proper place to regulate matters such as behavioural therapy services, which properly fall under the provincial jurisdiction and are better handled at that level.

We also have to recognize that even if the Canada Health Act were the appropriate place for such a provision, it probably would not achieve its objective. The act places conditions on payments to the provinces and territories and can reduce or withhold transfers if these are not met. It cannot dictate to a province or territory how to run its health care plan.

The federal government recognizes that the provinces and territories have the primary responsibility for the organization and delivery of health care services and that they require sufficient flexibility to operate and administer their health care insurance plans in accordance with their specific needs and situations.

To date, this approach has served us well and there does not see to be any reason to change it at this time. This is why the flexibility inherent in the Canada Health Act has always been one of its strengths. Since the enactment of the act in 1984, the federal government has always attempted to work with the provinces to make the act a viable piece of legislation. It could be dangerous to tamper with the provisions of the act when they have received such wholehearted support.

This does not mean the federal government has no interest in the issue of autism spectrum disorder. Quite the contrary. As demonstrated by the announcement on November 21 of the five new initiatives aimed at laying the foundation for a national strategy on autism spectrum disorder, Canada's new government is clearly committed to helping individuals with autism and their families. However, while autism spectrum disorder and treatments for the disorder are serious concerns, the Canada Health Act is not the appropriate vehicle to address these issues.

The proposal put forward by my hon. colleague is commendable, however, I cannot support the bill. The proposed amendment is inconsistent with the purpose and intent of the Canada Health Act.

[Rick Dykstra, Conservative, St. Catharines, ON]

Mr. Speaker, it has been a little while. I think I got about three minutes of my speech in prior to the break and it is good to get back into it.

The Canada Health Act discourages the application of extra billing or user charges through automatic dollar for dollar reductions or withholdings of federal cash contributions to a province or territory that permits such direct charges to patients.

Under the comprehensiveness criteria of the Canada Health Act, provincial and territorial health insurance plans must ensure coverage of all insured health care services. Insured health services under the act are defined as medically required or necessary physician services, hospital services, and surgical dental services when a hospital is required. In this way the Canada Health Act defines a minimum range of services to be insured on a national basis in our country.

Services provided by other health care providers outside a hospital are not considered to be insured health services under our act. That includes intensive behavioural therapy services for autism spectrum disorders since these services are generally provided outside of hospitals by non-physicians. These services are considered to be additional benefits and may be insured at the discretion of the province or territory, but that is their decision. They are not subject to the act's provisions. However, there is nothing in the Canada Health Act that stops provinces and territories from providing these services on an insured basis if they so wish to.

The bill presented by my hon. colleague, if adopted, would affect the definition of insured services under the act. In short, that means if Bill C-304 were to be passed by this House, provinces and territories would be required to provide applied intervention therapy services on an insured basis to all their residents, in addition to hospital and physician services.

The purpose of the Canada Health Act is to ensure that Canadians have access to medically necessary hospital and physician services without financial or any other impediments.

Hospital services that are considered to be medically necessary are outlined in the act and include, among others, such services as nursing services, the use of operating rooms, and drugs administered in hospitals. Medically necessary physician services are agreed upon through consultations by members of the medical profession and provincial and territorial governments. They are then determined by physicians at the point of service.

Referring to specific services in the Canada Health Act would be incompatible with its overall structure and intent.

The Canada Health Act references “insured services” and “medical necessity” but does not define specific services for specific illnesses or conditions. This is critical to the act and it needs to be clearly understood within the context of this private member's bill.

In provinces and territories there are mechanisms in place to examine the insured status of health services. Provincial and territorial ministries of health consult with members of the medical profession to determine which services are medically necessary and should be covered by their plans. Such consultations have proven to be an extremely effective method of insuring that Canadians receive appropriate medical care.

The second concern that this bill presents is with regard to the respective roles and responsibilities of the federal and provincial and territorial governments.

As we know, under the Canadian Constitution, the responsibility for matters related to the administration and delivery of health care services falls primarily under the jurisdiction of provincial and territorial governments. It is part of our Constitution and one that we must ultimately respect.

While we may not always agree, it is the responsibility of the provincial and territorial governments to set their priorities, administer their provincial health and social services budgets and manage their resources in the manner that best suits provincial and territorial needs while still upholding the principles that are in the Canada Health Act.

The federal government, for its part, by law, is responsible for the promotion and preservation of the health of all Canadians. It is appropriate, when describing federal responsibilities in health care, to note that the federal government cannot interfere in provincial-territorial responsibilities as defined under the terms of our Constitution, neither can we be seen as infringing upon those responsibilities.

Unfortunately, Bill C-304 attempts to require provinces and territories to provide behavioural treatment services for autism and to do so on an insured basis. As it is the provinces and territories that are responsible for matters dealing with the delivery of health services, the bill would be perceived as an unacceptable intrusion on provincial and territorial responsibilities across the country.

Amending the Canada Health Act would be viewed by the provinces as a unilateral imposition by the federal government and could potentially upset the longstanding federal, provincial and territorial relationship that we now have and that has been encouraged to develop and has developed the health care system that we as Canadians are truly proud of.

Clearly, the Canada Health Act is not the proper place to regulate matters such as behavioural therapy services which fall under provincial jurisdiction.

Finally, even if such an amendment were made to the Canada Health Act, it is not certain that it would actually achieve its objective. While the act places conditions on payments to the provinces and territories and can reduce or withhold transfers if these are not met, it cannot dictate to a province or territory how to run its health care plan, much less still how to run the institutions.

There is no question that individuals affected by autism spectrum disorders and their families may experience tremendous worry and significant financial and social implications. We are not here to debate that. That is why the government recently announced the package of new initiatives on autism spectrum disorders.

These initiatives are consistent with the federal roles and responsibilities in the health sector and there is no intrusion in provincial jurisdiction. The focus is on research, surveillance and information dissemination.

The House resumed from December 7, 2006, consideration of the motion that Bill C-304, An Act to provide for the development of a national strategy for the treatment of autism and to amend the Canada Health Act, be read the second time and referred to a committee.

[Rick Dykstra, Conservative, St. Catharines, ON]

Mr. Speaker, I have ultimate faith in you that you will ensure that whatever remaining time I have in the second hour of debate on this issue you will give to me and I appreciate that.

It is a great opportunity to speak to the bill that is before us today.

As a former chief of staff to the minister of community and social services and our current Treasury Board president, I had the opportunity to participate in and help formulate the first preschool program in the province of Ontario. While this is an issue that impacts us on a nationwide basis, it certainly is a good feeling to have been able to contribute to a program that was the first to start here in Ontario.

I also want to speak to private member's Bill C-304, An Act to provide for the development of a national strategy for the treatment of autism and to amend the Canada Health Act. This bill would extend provincial and territorial health care insurance to cover the cost of applied behavioural analysis and intensive behavioural intervention treatment services for persons with autism spectrum disorders.

Let me say at the outset that I am understandably sympathetic to the concerns raised in this bill. Although services for individuals with autism spectrum disorders are important and they need to be dealt with, the Canada Health Act is the wrong instrument to achieve this objective. I would like to address the difficulty of reconciling the proposed bill with the fundamental purpose and intent of the Canada Health Act. In addition, passage of the bill would mean imposing on an area of provincial and territorial jurisdiction.

The Canada Health Act is the cornerstone of the Canadian health care system. The aim of the act is to ensure that all eligible residents of Canada have reasonable access to medically necessary services without direct charges. This essential act is based on the government's commitment to a universal, accessible, comprehensive, portable and publicly administered health care system. The act protects the access of Canadians to health care by establishing criteria that the provinces and territories must meet to receive the full amount of federal cash contribution owed to them in respect of health care.

Mr. Speaker, I look forward to continuing discussion on this bill as we move forward in the second hour of debate.

[Blair Wilson, Liberal, West Vancouver—Sunshine Coast—Sea to Sky Country, BC]

Mr. Speaker, as members know, in recent weeks this House has reflected extensively on what it means to be Canadian, yet regardless of our sociological or cultural differences, all Canadians share common values on what kind of country we have worked so hard to create together, a country where each and every citizen has an equal chance to make the most of the great opportunities here in Canada.

All Canadians share the same values and want a country where everyone has an equal chance to seize the wonderful opportunities here in Canada.

We have had remarkable success, yet today we are failing over 300,000 Canadians. Every 166th child born in Canada is afflicted by autism spectrum disorder. Either those children are left unable to function in society or their families face a crushing financial burden, and all the while our universal health care system is silent to this suffering. Canada has neglected autism for too long and the time has come to begin to address it.

Autism affects more than 3,000 Canadians. We have long neglected autism, and the time has come to address this problem.

Autism has a devastating effect on a child's quality of life. I think all members can agree on that.

Autism is a neurological disorder that causes developmental disability. It affects the way the brain functions, creating difficulties in communication and social interaction and unusual patterns of behaviour, activity and interests. Its symptoms, as we know, vary widely. Some autistic children display repetitive behaviour. Others suffer self-inflicted injuries. Some cannot even speak and must communicate through the use of computers and full time support staff in schools.

Autism not only affects the individual, but also the individual's family, friends and caregivers who must cope with the individual's difficult childhood.

There is hope for these children. Applied behavioural analysis and intensive behavioural intervention have been shown to dramatically improve social and intellectual functioning of autistic children and thereby their quality of life.

It is critical to get these children the treatment that is required as soon as possible, as soon as they are diagnosed in their formative years. Proper treatment gives autistic children the chance they deserve to enjoy all the joys and opportunities that other children do.

Autism has a devastating effect on a child's quality of life. Autism affects not only the individual, but also the individual's family, friends and caregivers. But there is hope. Some treatments are producing dramatic results. With help, these autistic children can have the same opportunities as other Canadian children.

While the courts have rejected the idea that governments have a legal obligation to treat autism, we parliamentarians here in this House have a moral duty to uphold the promise of all those who have worked to build our country. Treating autism, I would argue, is a matter of equality of citizenship.

But we are not fulfilling that commitment today. Medicare does not provide for the treatment of autism. Some provinces offer limited programs for autism as has been discussed here already and other provinces offer nothing at all. Without medicare coverage, families with autistic children are left to bear the crushing financial burden of treatment on their own at a cost of approximately $45,000 to $60,000 a year. Some families mortgage their house to pay for treatment; others simply go bankrupt. Some parents must choose whether they can afford to give their child certain therapy.

The cost of treatment ranges from $45,000 to $60,000 a year, and this is quite simply beyond the means of most Canadians. We should not and cannot ask a family to choose between a normal life for a child and financial security.

No family should have to bear such an enormous, arbitrary burden. We have recognized the importance of this principle in other areas, such as the deepening of our catastrophic drug coverage.

How should the House address this issue? First, we should acknowledge from the outset that provincial health plans are not within our jurisdiction and that we must respect the divisions of power between our two levels of government. However, the federal government can and I would argue indeed must play a constructive role to ensure that Canadian families have equal access to treatment.

The federal government must lead a national strategy because the cost of treatment is so great that a lack of a national standard will create what I call medical arbitrage. Families with autistic children will be forced to leave their communities to move to the provinces with the best programs. No province will push to create more comprehensive treatment when it is being penalized by inflows of patients. There will be a race to the bottom, not a race to the top.

It is clear that the federal government can play an important role in autism, but it must also respect provincial jurisdictions. Bill C-304 lays out avenues for dealing with autism.

The bill before the House lays out a way forward. It addresses the two most important steps that Canada must take to address autism.

First, this bill would require the Minister of Health to convene a conference between all provincial and territorial health ministers for the purpose of developing a national strategy for the treatment of autism. To address autism we must work with the provinces. They have the responsibility here, but not the funds. One solution that could emerge from this conference is the development of a funding mechanism to assist provincial governments in providing the support that Canadians with autism need.

This bill would also amend the Canada Health Act to make applied behavioural analysis and intensive behavioural intervention defined as medically necessary for persons with autism.

It is somewhat absurd to suggest that therapy is not necessary for an autistic child. Without therapy, an autistic child simply cannot live a normal life. For the child's humanity, treatment is necessary.

This bill lays out avenues that involve the provinces. It is time Canada took action against autism, a blight on society. We must support this bill.

Funding autism treatment means the investment of not insignificant funds in our children. As such, it must be carefully considered, but it has to be considered. Simply putting funds into websites and public relations does not nearly do enough for these families, and the reward of turning a dysfunctional, socially troubled child into a productive member of Canadian society is worth it.

It is time we stood shoulder to shoulder with all our fellow Canadians. Treating autism is an important step in the never-ending march toward realizing the Canadian dream of equality.

[Shawn Murphy, Liberal, Charlottetown, PE]

moved that Bill C-304, An Act to provide for the development of a national strategy for the treatment of autism and to amend the Canada Health Act, be read the second time and referred to a committee.

Mr. Speaker, I am pleased to rise in the House today to start off the second reading debate on this bill. Bill C-304 acknowledges the seriousness of this issue in this country. It clearly enunciates that we are talking about a health issue.

The bill has three provisions. We are asking the Minister of Health , acknowledging of course that this involves primarily provincial jurisdictions, to convene immediately a meeting with the 10 provincial and territorial health ministers to discuss this very issue. We are asking that the minister table before the end of 2007 a national strategy on the treatment of autism. We are also asking that the Canada Health Act be amended as follows:

Section 2 of the Canada Health Act is renumbered as subsection 2(1) and is amended by adding the following:

(2) For the purposes of this Act, services that are medically necessary or required under this Act include Applied Behavioural Analysis (ABA) and Intensive Behavioural Intervention (IBI) for persons suffering from Autism Spectrum Disorder.

Members will conclude from my remarks that the overarching issue I want to make in this debate is that we are talking about a health issue and that the treatment modalities that I refer to be made available to all residents of Canada pursuant to the provisions of the Canada Health Act.

Again, if it is a health issue, I would urge and ask all members in the House to support it. If members feel on the other hand it is not a health issue, then of course the bill is flawed and it is not worthy of support.

Bill C-304 does not stand alone. There is a whole array of extremely important bills and motions on this extremely important topic. I would suggest the debate is raging.

A similar bill was tabled by the member for Sackville—Eastern Shore, Bill C-210. Motion No. 172 introduced by the member for Fredericton calls for a national strategy. It calls for standards, surveillance, and research. That passed on December 5, 2006 with support from all four parties.

Ongoing as we speak are the hearings at the Senate Standing Committee on Social Affairs, Science and Technology dealing with the funding of autism. I have seen the blues. There are very extensive hearings going on now. I expect sometime early in the new year there will be a report from that Senate committee.

There are numerous court cases that have been decided and there are numerous court cases being litigated as we speak right across this country.

I believe that colleagues on both sides of the House know, acknowledge and appreciate the seriousness of this issue.

I should point out also that the polling that has been done indicates that 84% of all residents of Canada support the concept that these treatment modalities should be financed under the provincial health care programs. About 84% of the constituents that we represent support the general thrust of this bill.

I am not an expert on the subject, but I do want to point out for the record that autism spectrum disorder is a complex developmental disorder. It affects people's ability to communicate, form relationships and react to their environments. It is caused by a neurological disorder that impedes normal brain development in the areas that affect social interaction and communication skills. It is a spectrum disorder.

The severity of the symptoms differs widely. Many people with ASD are perfectly capable of leading happy, healthy lives as functional members of society and require no treatment whatsoever. On the other hand, many people require very extensive treatment.

Within this spectrum, we include disorders such as pervasive development disorder, Rett syndrome, Asperger syndrome and child development disorder.

Tremendous changes are going on in society. At one time, going back 20 or 25 years ago, this was thought to be an extremely rare condition. I believe the numbers were 1 in 10,000. Now the most recent statistics that I have been given estimate that 1 in 167 children are affected by ASD. It affects four times as many boys as girls and is pervasive across all ethnicities and classes. We do not know the cause of the syndrome.

There is no definitive cure, however, in recent years a number of treatments have become available that can make a dramatic difference in the severity of the symptoms experienced by people with ASD. It is important to note that just as ASD affects individuals, in a vast array of ways, there is an extremely large range of support that is necessary for people affected by ASD. Some will need intensive help and constant supervision to get through the day, while others might simply need help with specific communication and social interaction skills.

The point I am making here today with this bill is effective treatment modalities exist.

The symptoms of ASD generally manifest themselves within the first three years of a child's life. It has been shown that when ASD is diagnosed early and the specific individual needs of the child are assessed and addressed, children with ASD can grow to exhibit much fewer or no symptoms.

There are two vital characteristics of this treatment, early diagnosis and consistent, long term care. We refer to these treatments as applied behavioural analysis and intensive behavioural intervention. These treatments include speech and language therapy. More important, ABA and IBI are designed to teach a child with autism a whole new way of learning. The treatment teaches them how to break down a task into its smallest components, and through constant, intensive reinforcement, to apply this method of thinking to everyday life as well as complex tasks.

Due to the intensity and time span of this treatment and the fact that it is almost exclusively conducted in a one on one environment, the treatment is costly; it is not cheap. When ABA or IBI are successfully applied, the changes in a child can be dramatic. There are stark differences as to the availability of this treatment across Canada. Some provinces offer it fairly generously. Some provinces include it in the social services or welfare envelope and it is means tested. We definitely have a two tier, or what I would perhaps better classify, a 13 tier health care system when we talk about the treatment of autism.

Again, it depends entirely on what province that particular child happens to be born in, and in some instances, the regions within the provinces where that child happens to live. For example, in Alberta, children have full access to treatment. In Ontario they have access up to a certain and I would argue arbitrary age at which time treatment is cut off. In other provinces, as I have stated, it is in the social services envelope. It is means tested and it is just not available in any way, shape or form the way it should be under our Canada Health Act.

As we go forward and we debate this bill, we as a society are judged on how we treat the most vulnerable among us. We owe it to all Canadians, all families dealing with this particular issue.

I realize that somebody will state that it is a provincial issue, but again we have the Canada Health Act. I realize we cannot dictate to the provincial health ministers, but we can come forward with a national strategy. We have to discuss it and debate it with the provincial ministers and we have to eventually amend the Canada Health Act so these children, these individuals, these families, can get the treatment that they deserve.

There is a national strategy with respect to cancer, diabetes and drugs. Why can we not have one for autism?

Again, I mention that it will not be cheap. It will cost a lot of money and the Government of Canada would have to pay its fair share. That will be one of the arguments from the provincial government. If they are being asked to do this, the federal government is going to have to pay its fair share.

However, on the other side of the coin, there are substantial and numerous benefits. A lot of individuals are not diagnosed early and do not receive the treatment to which they are entitled. They end up being institutionalized at considerable expense to society. The families have to incur hundreds of thousands of dollars treating these children with no reimbursement. The quality of life of the families suffers and, most important and tragic, the quality of life of the affected individuals suffers dramatically. We are judged on how we treat the most vulnerable among us, whether it is the disabled, sick, old, the infirm or people with autism.

I know people will say that it is a jurisdictional issue. I think I have dealt with that already. People will say that it costs money. Yes, it costs money, but cancer costs money, heart disease costs money, diabetes costs money. These are health issues. I go back to my original statement. If it is a health issue, let us move forward and deal with it. If it is not a health issue, let us put it to bed.

In conclusion, I ask every member of the House to do the right thing on this issue. I ask that we all show leadership. I ask members to vote for this bill and move forward on this issue as soon as possible.

[Shawn Murphy, Liberal, Charlottetown, PE]

moved for leave to introduce Bill C-304, An Act to provide for the development of a national strategy for the treatment of autism and to amend the Canada Health Act.

Mr. Speaker, I rise to introduce a bill that would provide much needed support for many Canadians and their families who are affected by autism spectrum disorder. This bill would see that two forms of very effective treatments, applied behavioural analysis and intensive behavioural intervention, be covered under the Canada Health Act.

It would also compel the federal Minister of Health to work with his provincial counterparts in developing a national strategy for the treatment of autism. The bill would require that a first ministers conference would be held this year before December 31, 2006, and that a national strategic plan be developed and tabled in the House before December 31, 2007.

I hope my colleagues in the House will join me in supporting this very important issue.

(Motions deemed adopted, bill read the first time and printed)