Bill C-356 (Historical)

National Strategy for Dementia Act

An Act respecting a National Strategy for Dementia

This enactment requires the Minister of Health to initiate discussions with the provincial and territorial ministers responsible for health or health promotion for the purpose of developing a national strategy for the health care of persons afflicted with Alzheimer’s disease or other dementia-related diseases.

National Strategy for Alzheimer's Disease and Other Dementias Act

[Guy Caron, NDP, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Mr. Speaker, I thank the member for the work he has done on this extremely important file, which was also very dear to the heart of one of our former colleagues, Claude Gravelle.

Claude introduced a similar bill in 2012, Bill C-356, which sought to create a national strategy for dementia. Unfortunately, the bill was defeated by a single vote in 2015. Those who opposed it were mainly Conservative and Bloc Québécois members. In the end, because one Liberal member forgot to stand up and vote, the bill that Claude had been working on for a long time was defeated.

I would like the Liberal member to tell me why he wanted to introduce this bill. What is the difference between this bill and the bill that our colleague introduced a few years ago?

[Rachel Blaney, NDP, North Island—Powell River, BC]

Then I think it should be removed from the legislation.

I want to get on to another issue. Unlike Bill C-356, the national strategy for dementia act, this legislation doesn't contain any provisions to augment the capabilities of the voluntary sector. Can you explain why you chose to exclude any mention of the voluntary sector from Bill C-233?

[Rachel Blaney, NDP, North Island—Powell River, BC]

Thank you, and thank you to our witnesses today.

I spent many years volunteering for an organization that provided respite. A large number of the families that I worked with were dealing with dementia. I would either support the person with dementia or support the family in different ways. I have a great amount of compassion for the significant impacts this has on communities and the families.

My first question is going to you, Mr. Nicholson. You mentioned thanks earlier to Claude Gravelle, who introduced Bill C-356, a national strategy for dementia. Unfortunately, that bill was defeated. It was a very close vote: 140 said no; 139 said yes. The majority of the Conservative MPs, including you, did not vote positively for this bill.

Given how similar your legislation is to the last bill, why did you choose to narrow its focus?

[Rachel Blaney, NDP, North Island—Powell River, BC]

First, I want to thank you all so much for your amazing work. A special thank you to those of you who are in B.C. I am a B.C. MP, and I know exactly what time it is there, so I thank you so much for being here with us so early in the morning.

I want to first mention that in 2012, former NDP MP Gravelle introduced Bill C-356, a national dementia strategy, in Parliament. Unfortunately, his bill was defeated in May of 2015 by a single vote. It was a vote of 140 to 139. I think it was a really sad day for many of us. The Canadian Medical Association called this defeat “a lost opportunity to make lasting progress in the serious and growing problem of dementia in Canada”. The bill was opposed by a majority of Conservative MPs, including the member for Niagara Falls, who is the sponsor of today's bill, Bill C-233.

New Democrats, we will support Bill C-233, but it is less ambitious in its scope and implementation provisions than the former Bill C-356. Some of the concerns we have are around the establishment of the advisory board. In Bill C-233 there's a statement that says: “The board is to advise the Minister on any matter related to the health care of persons living with Alzheimer’s disease or other forms of dementia.” But unlike Bill C-356, the legislation offers no remuneration for the work of the advisory board members, nor any reimbursement for travel costs.

I come from a very rural riding, and I understand that the experiences of people across the country are very different. In your view, could this impact the formation and work of a national advisory board?

[Sheila Malcolmson, NDP, Nanaimo—Ladysmith, BC]

Mr. Speaker, last month, I joined my community in Nanaimo on the walk for Alzheimer's where our community walked in support of Alzheimer's patients and their families.

The honoree this year was the late Dale Horn. She was born in 1933 in Australia and she came to Canada at the age of 24. She was such a strong part of Nanaimo's community boards and the life of its community spirit.

At this Alzheimer's walk a month ago, her son, John Horn, honoured her at the walk for all the hundreds of participants ready to get started, saying: “Dale was a fantastic companion, fully engaged, witty and keenly observant. She drew you in and made you feel lucky to be included in her world.” With “a steely resolve and genuine grit,” Dale was unfazed by her disease, said John. “When affected by Alzheimer's, she insisted on helping others with the disease. She retained a wicked sense of humour and immense grace, right up to the end of her life.”

This year's Nanaimo Alzheimer's walk raised $18,000. This is to promote critical research to reduce the effects of Alzheimer's, but also to provide services for those living with, or assisting with Alzheimer's. This is really to ease the personal circumstances that exist for the people suffering and for their families every day.

It is in that spirit that I am pleased to stand and speak today in favour of the bill at hand and to speak about Canada's responsibility to improve care for the hundreds of thousands of Canadians suffering from dementia, and to give better support to their families and caregivers.

Bill C-233, which calls for the development and implementation of a national and comprehensive strategy to improve health care delivered to persons suffering from Alzheimer's and other forms of dementia is something we can and should all support. Canada has fallen behind other countries such as the United States, the U.K., Norway, France, the Netherlands, and Australia. All of these countries have coordinated national dementia plans in place already.

Past president of the Canadian Medical Association, Dr. Chris Simpson, spoke to this when he said:

We have the dubious distinction of being one of the few G8 countries without a national dementia strategy. Meanwhile, our acute care hospitals are overflowing with patients awaiting long term care placement and our long-term care facilities are understaffed, underspaced and underequipped to care for our most vulnerable seniors. This leaves patients and their families in limbo, struggling to fill these gaps in our system.

He also said:

The reason your father has to wait nine months for a hip replacement is that the beds are being used by dementia patients.... That is the single biggest reason why elective surgery wait times are so long.

Now, it was the NDP that first introduced a proposal to the House to create a national strategy for dementia. In 2012, former NDP MP Claude Gravelle introduced Bill C-356 in Parliament, prescribing a national dementia strategy. Unfortunately, that bill was defeated at second reading a year ago by a single vote. The bill was opposed by a majority of Conservative MPs, Bloc MPs, and, critically as it turned out, a single Liberal MP who failed to stand for the vote. I was watching it on CPAC. It was heartbreaking because it would have made a big difference in our communities.

Inexplicably, the member for Niagara Falls, the sponsor of the bill before the House today, voted against the national dementia strategy just a year ago. If the House had followed New Democrat leadership in the last Parliament, Canadians would have a national dementia strategy in place right now. Canadians would not have lost precious time, and that is something that is so precious to people suffering from a degenerative illness.

This has had real human impact. I have heard countless stories in my riding about the impacts of Alzheimer's disease and dementia on my constituents. Many cannot afford quality home care for their parents and it is especially shameful that the Liberals abandoned their election promise to invest $3 billion in home care.

I have heard stories from personal care workers, nurses, and physicians who report emergency wards overwhelmed with patients, long-term facilities that are understaffed, and long gruelling hours for caregivers. These are very often offering low-pay work in the homes of dementia patients.

These stories underscore the need for real leadership in this chamber. So many are affected. Three-quarters of a million Canadians were living with dementia in 2011. That is 15% of Canadian seniors. That might double by 2031. This costs our country $30 billion a year in medical bills and lost productivity. Left unchecked, that number could skyrocket to $300 billion within 25 years.

As Canada's population ages, we must prepare our health care system and our communities for the inevitable rise in the number of Canadians suffering from dementia.

To paraphrase Tommy Douglas, the father of medicare and a New Democrat, only through the practise of preventative medicine will we keep health care costs from becoming excessive.

The need is pressing. The burden for caring for patients with dementia and Alzheimer's falls primarily on family members. In Canada, family caregivers give millions of unpaid hours each year caring for their parents and family. That is $11 billion in lost income and a quarter million lost full-time equivalent employees from the workforce.

If nothing changes by 2040, it is estimated that family caregivers in Canada will be spending 1.2 billion unpaid hours per year providing care, and a quarter of family caregivers are seniors themselves.

Dementia also has a disproportionate impact on women. Women are two and a half times more likely to be providing care. Women themselves represent 62% of dementia cases and 70% of new Alzheimer's cases. That puts them at the epicentre of a growing health care crisis. Also, women are nearly twice as likely to succumb to dementia.

Another group of vulnerable patients are affected by another bill in the House, and that is the government's physician-assisted dying bill. We keep hearing arguments again and again that people with a dementia diagnosis should have a real choice over how their lives end. The federal government's legislation for assisted dying would not allow Canadians with a dementia diagnosis, while they were still of sound mind, to make an advance request for physician-assisted dying. This puts up an enormous barrier for thousands of Canadians with dementia or other degenerative illness.

Without the right to make advance requests for assisted dying, Canadians with a dementia diagnosis are faced with what the courts call a cruel choice between ending their lives prematurely or, potentially, suffering immeasurably and unbearably. This is completely unacceptable. To us it looks as if those who most need physician-assisted dying may inexplicably be excluded from it. We remain optimistic that amendments will be made to ameliorate that very serious flaw.

Let us go back to the national Alzheimer's strategy.

The New Democrats believe that the bill must be crafted correctly to ensure the best outcome for patients, their families, and their caregivers. While we support Bill C-233, it is less ambitious in its scope and implementation provisions than last year's New Democrat bill.

We will work constructively at committee stage to bring about meaningful and substantive amendments to strengthen the final version of the bill. Canadians deserve no less than the best national Alzheimer's strategy possible. The New Democrats have a long and proud history of advocating for federal leadership on health care issues.

In fact, as my colleague, the member forVancouver Kingsway likes to remind me, we invented it. The New Democrats stood alone in the House unanimously for a national dementia strategy in 2015. We stand in the House in 2016 and work so every Canadian, every Canadian family, every caregiver, can have a world-class dementia strategy, as the New Democrats have fought for in the last five years.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, I am pleased to rise today as health critic for the New Democratic Party, to speak to Bill C-233 and the urgent need to address the impact of dementia and Alzheimer's disease on patients, families, communities, and our public health care system.

Dementia disease is a progressive degenerative disorder that attacks nerve cells in the brain, resulting in loss of memory, thinking, language skills, and behavioural changes. The disease forms lesions in the brain cells of patients causing nerve connections to sever and nerve cells to die.

Alzheimer's is the most common form of dementia, which is a general term used to describe a group of systems, such as loss of memory, language, motor skills, and other brain functions. Alzheimer's is not part of the normal process of aging, and currently has no cure.

Bill C-233 calls for the development and implementation of a national and comprehensive strategy to improve health care delivered to persons suffering from Alzheimer's disease and other forms of dementia.

This legislation prescribes a number of elements that must be included in a national strategy, including greater investment in research, the establishment of national objectives for care, coordination with international bodies that fight dementias, assistance to provinces and territories to improve treatment, strengthening of prevention and early intervention, and disseminating best practices. As prescribed in the bill, the details and benchmarks for these elements would be determined at a conference convened by the minister with multi-stakeholder representation.

New Democrats have long believed that Canada needs an ambitious and comprehensive national dementia strategy to improve care for the hundreds of thousands of Canadians suffering from forms of dementia, and to better support their families and caregivers.

As Mimi Lowi-Young, CEO of the Alzheimer Society of Canada, has said:

By implementing a strategy, we will be able to enhance research efforts, raise awareness about the disease, provide support for people with dementia and their care givers, identify best practices for care and improve surveillance of the disease.

Particularly as Canada's population ages, we must prepare our health care systems and our communities for the inevitable rise in the number of Canadians suffering from dementia. To paraphrase Tommy Douglas, the father of medicare and a New Democrat, “Only through the practice of preventative medicine will we keep health care costs from becoming..excessive..”, and the need is pressing.

Recently, the former head of the Canadian Medical Association, Dr. Chris Simpson said:

our acute care hospitals are overflowing with patients [often dementia patients] awaiting long term care placement and our long-term care facilities are understaffed, underspaced and underequipped to care for our most vulnerable seniors. This leaves patients and their families in limbo, struggling to fill these gaps in our system....

The need for national leadership is urgent. Few Canadians are untouched by these diseases that often have shattering impacts on families. The struggle to cope with the deterioration of mental faculties and the loss of memory can be overwhelming and heartbreaking.

According to the Alzheimer Society of Canada, that disease and other dementias now directly affect 750,000 Canadian patients. This number is expected to double to 1.4 million by 2031. Current dementia-related costs, both direct medical costs and indirect lost earnings, have reached $33 billion per year in Canada, and they are projected to soar to $293 billion by 2040.

Currently the burden of care for patients with dementia and Alzheimer's disease falls primarily on family members. In Canada, family caregivers spend an estimated 444-million unpaid hours per year caring for dementia patients, representing $11 billion in lost income and 227,000 lost full-time equivalent employees to our workforce. If nothing changes by 2040, it is estimated that family caregivers in Canada will spend over one billion unpaid hours every year providing care. These numbers are staggering. Taken alone, they make the case for our desperate need for national leadership. Canadians overwhelmingly agree. A recent Nanos survey revealed that 83% of Canadians say that they want Canada to develop a national plan to address these diseases.

We must not forget that dementia also has a disproportionate impact on Canadian women. According to the Women's Brain Health Initiative of Canada, women represent 62% of dementia cases and 70% of new Alzheimer's cases, putting them at the epicentre of a growing health issue. In addition to this, women are nearly twice as likely as men to succumb to dementia, and two and a half times more likely to be providing care to someone with the disease.

Unfortunately, Canada is now one of the last developed countries in the world without a national strategy to address dementia. We have fallen behind countries such as the U.S., U.K., Norway, France, Netherlands, and Australia, all of which have coordinated national plans in place.

In Vancouver Kingsway, I have heard countless heartbreaking stories about the impacts of Alzheimer's disease and dementia on my constituents. Many cannot afford quality home care for their parents or face long delays in accessing long-term care facilities. Many do not even have access to the resources or information they need to make important decisions, as they witness the cognitive degeneration of a loved one. I have heard stories from personal care workers, nurses and physicians, who report emergency wards that are overwhelmed with patients, long-term care facilities that are understaffed, and long, gruelling hours for caregivers, often working for low pay in the homes of dementia patients. These stories underscore the need for leadership in this chamber.

As New Democrats, we are proud of our long history of leadership on health care, and specifically dementia care. In fact, it was the NDP that first introduced a proposal to this House to create a national strategy for dementia. In 2012, former NDP MP Claude Gravelle introduced Bill C-356 in Parliament, prescribing a national dementia strategy. That bill provided a comprehensive and cutting edge plan for a national strategy to deal with Alzheimer's and dementia. Unfortunately, that bill was defeated at second reading in May 2015 by a single vote. It was 140 to 139. The bill was opposed by a majority of Conservative MPs, Bloc MPs, and, critically as it turned out, a single Liberal MP who failed to stand for the vote. Conversely, our New Democrat caucus voted unanimously in favour of Mr. Gravelle's bill.

I must again mention that the member for Niagara Falls, the sponsor of the bill before this House today, inexplicably voted against that national dementia strategy just one short year ago. Most charitably, I might say that wisdom comes so seldom that it ought not to be rejected because it comes late. Less diplomatically, I might say that the hon. member owes Canadians an explanation and an apology for defeating the very concept that he proposes be adopted here today. What is indisputable is that if the House had followed New Democrat official opposition leadership in the last Parliament, Canadians would have a national dementia strategy in place right now. Canadians would not have lost precious time, something that is especially important to those suffering from a progressive illness.

New Democrats do not take lightly the opportunity to move forward with a national strategy for dementia. We believe this bill must be crafted correctly to ensure the best possible outcome for patients, their families, and caregivers. While we support Bill C-233, it is less ambitious in its scope and implementation provisions than the former bill, Bill C-356, the New Democrat bill. Important differences between those bills include the following: an absence of any provision to augment volunteerism for dementia and Alzheimer's-related causes, no remuneration of advisory board members, and only one public report required from the minister versus the yearly progress reports prescribed in the former NDP bill.

New Democrats will work at committee stage to bring about meaningful and substantive amendments to this bill to strengthen the final product. Canadians deserve no less than the best national Alzheimer's and dementia strategy possible. New Democrats have a long and proud history of advocating for federal leadership on health care issues. In fact, we invented it. It is critical that in a country like ours, the federal government works to ensure that all Canadians have access to the health care they need, no matter where they live, no matter what their income, and no matter their background.

New Democrats stood alone in this House unanimously for a national dementia strategy in 2015. We will stand unanimously in this House in 2016 and work so that every Canadian, every Canadian family, and every caregiver can have a world-class dementia strategy, as the NDP has fought for in the last five years.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, as my hon. colleague points out in his speech, it was the NDP that first introduced in the House a proposal to create a national strategy for dementia.

In 2012, former NDP MP Claude Gravelle, the great member for Nickel Belt at that time, introduced Bill C-356, prescribing a national dementia strategy in Parliament. That bill provided a comprehensive and cutting-edge plan for a national strategy to deal with Alzheimer's and other dementia.

Unfortunately, that bill was defeated at second reading in May 2015 by a single vote; 140 to 139. The bill was opposed by a majority of Conservative MPs, Bloc MPs, and critically, as it turned out, a single Liberal MP who failed to stand for the vote.

I must mention that, inexplicably, the member for Niagara Falls, the sponsor of the bill before the House today, voted against the the NDP bill to establish a national plan for dementia. I wonder if the member could stand in the House and explain to Canadians why he opposed a bill that would have brought such a great plan to Canadians a year earlier than his bill.

Alzheimer's Disease and Other Forms of Dementia

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Speaker, it is an honour to rise in the House today and speak on Motion No. 575, which I think is one of the most important motions that has come before the House in some time. This motion would create a pan-Canadian strategy for dementia.

Alzheimer's and other dementia diseases are a major health care, social and economic issue with enormous negative consequences for seniors, the baby boom generation and younger Canadians who are either living with the disease or living with family members and perhaps working as their caregiver. Some 15% of those affected by this suite of diseases are younger people. The number of Canadians with dementia is expected to double by 2031.

To date, the government has only supported a national research strategy. As important as research is, we on this side of the House believe that there is not the same comprehensive approach in this motion that the bill introduced in the House by my hon. colleague from Nickel Belt would have obligated the government to pursue. That would have been a national strategy to broadly help patients, support caregivers, help the dementia workforce, provide a strategy for early diagnosis and prevention, and provide a continuum of care for people in their homes, the community and formal care.

We in the New Democratic Party believe that respecting provincial and territorial jurisdiction is important in health care delivery and any other matter of provincial jurisdiction. We believe that the federal government needs to lead a pan-Canadian dementia strategy than can immediately help the millions of Canadians who are affected by Alzheimer's and related dementias, including the patients, families, caregivers, the dementia workforce and so on. We believe that this will have the additional benefit of freeing up scarce acute care beds in hospitals and helping caregivers who often must give up work to care for loved ones, as well. There is a very important economic and health care resource aspect to this motion.

I will not belabour this point, but it is important for Canadians to know that the Conservatives voted down a bill that would have required the Canadian government by law to implement a national dementia strategy just weeks ago. Instead, we are tabling a private member's bill by the Conservative member that would not obligate the government, because a motion is not obligatory on the government at all. We have replaced a New Democrat proposal that would have provided a mandatory legislative framework for a national dementia strategy, which was voted down by the Conservatives, with a discretionary motion that obligates the government to do nothing, only weeks ahead.

The member for Nickel Belt's bill, Bill C-356, would have gone much further than the present motion to guarantee Canadians that the federal government would finally take action to help their loved ones who are suffering from dementia. Despite being disappointed that the Conservatives rejected that opportunity to take decisive action, as the New Democrats' bill would have done, we will support this motion because we support all efforts to move on this important issue, even if they are not all that is needed.

The statistics and the real face of dementia are sobering. According to the benchmark Rising Tide study by the Alzheimer Society of Canada, the number of Canadians living with Alzheimer's disease and other dementias now stands at 750,000 people and will double to 1.4 million by 2031. Canada's health care system is presently under-equipped to deal with that staggering number and the costs associated with it. The combined direct medical and indirect costs, including lost earnings, of dementia total some $33 billion per year. By 2040, this figure is expected to skyrocket to an almost unbelievable $293 billion per year.

Pressures on family caregivers, however, are mounting today. In 2011, family caregivers spent 444 million unpaid hours per year looking after someone with dementia, representing some $11 billion in lost income and 227,000 lost full-time equivalent employees in the workforce. By 2040, they will be devoting a staggering 1.2 billion unpaid hours per year.

Lost in these numbers, perhaps, is the human face of this disease, the moms, the dads, the brothers, the sisters, the friends, the neighbours, the work colleagues, the grandfathers and the grandmothers who are involved in this disease.

While an elderly face typifies most people dealing with dementia, as I said, 15% of those people living with Alzheimer's or related dementia diseases are under 60, so it is important to note that dementia is not an issue that only affects people in their aging years.

The Canadian Medical Association estimates that patients who should be elsewhere occupy about 15% of the acute care hospital beds across Canada, one-third of them suffering from dementia, so we can see that not dealing with this disease in an appropriate national strategic sense is extremely expensive because it is causing us to spend unnecessary health dollars when we could be dealing with it in a better way.

The NDP history on this issue is well documented. At the 2012 NDP convention, delegates from across this country passed a resolution calling for a national dementia strategy. I want to pause and say that this shows the health of our Canadian political party structure. I can speak particularly of the New Democratic Party, whose delegates come to a convention every two years and put forward ideas from their communities that then make their way into the New Democratic caucus and into this House. I want to congratulate the New Democratic delegates from across the country who played such an important and visionary role in this issue here today.

We have also found strong support, however, among labour members, among seniors, and in all aspects of civil society. Inevitably, the interest is personal. It comes from the direct knowledge or experience of someone living with the disease or burdened and often economically suffering from caring for a loved one with the disease. It comes from personal experience. I think that informs this issue in a very real and direct way.

Internationally, many countries are moving forward with their own national strategies. The Paris declaration in 2006 lists among the political priorities of the European Alzheimer movement the call for national governments to recognize Alzheimer's disease as a major public health challenge and develop national action programs.

It is interesting that this was in 2006. Here we are, nine years later. The current government was first elected in 2006, and nine years after international calls for a national dementia strategy, the government has yet to act.

We are here in the dying days of the 41st Parliament with a backbench motion coming forward that does not obligate the government to do anything. To me, that does not speak of a responsible governmental response on an extremely important medical issue facing our population at this time.

There was also a G8 summit on dementia in the United Kingdom in December of 2013. The call for a national dementia strategy was made there as well. It is clear that Canada today has no national plan and has been lagging behind our closest economic partners—the United States, the U.K., France, and Australia—all of whom have national dementia plans.

Here is what the New Democrats propose. We want Canada to develop a national dementia strategy with leadership from Ottawa. We want a national plan that can and must respect provincial and territorial health care jurisdictions. We want one plan to be developed, a plan that coordinates all of the provincial priorities and is tailored to meet the needs of each province or territory. We think that would be far better than 13 separate plans carried out in isolation from one another. We want a national dementia strategy that includes but goes beyond research to help those now living with the disease, their caregivers, and the dementia workforce.

Quoting some of the many people who work with this issue every day is the best way to close my remarks today.

The Canadian Association of Retired Persons said this about the NDP's Bill C-356:

[The NDP plan] calls for a national strategy that includes increasing funding for research into all aspects of dementia, promoting earlier diagnosis and intervention, strengthening the integration of primary, home, and community care, followed by enhancing skills and training of the dementia workforce and recognizing the needs and improving supports for caregivers, all of which CARP advocates for and supports.

The Alzheimer Society of Canada has said that “83% of Canadians reported they believe Canada needs a national dementia plan.”

The society stated:

As our population ages, Canadians will be at an increased risk of developing dementia or caring for someone with it.

“Everyone owns this disease.”

It says:

The approach we're proposing has worked for the Canadian Partnership Against Cancer and the Mental Health Commission of Canada. It can work for dementia and ensure that we get the best return on investment and available resources.

The Canadian Medical Association, every single major group across the country that works with seniors, and the medical profession support the cause of a national dementia strategy. The New Democrats support that, and when we are the government in 2015, after October, that is exactly what our government will deliver for Canadians.

[Claude Gravelle, NDP, Nickel Belt, ON]

Mr. Speaker, I am always humbled by the privilege of standing in the House to represent the people of Nickel Belt. On this motion, on this issue of a national dementia strategy, I realize I stand to represent not only the people of Nickel Belt but also the millions of Canadians who are demanding a credible, real, national dementia strategy.

What is at play here is self-evident to many Canadians. This motion perfectly captures the Conservatives' politics, which have been on display here in Parliament time and again on issues vital to Canadians. This motion is more a child of spin and politics than a commitment to the leadership we are looking for. It gives the appearance of doing something to really help Canadians while staying the course on their own priorities.

Members will know that this motion appeared out of the blue a week before debate on my bill, which proposed a real, credible, national dementia strategy. It was a plan that would be anchored in a law, with leadership mandated from Ottawa. Canadians clearly wanted that.

The minister indicated that while initially opposed to the legislation, she had a change of mind. I believe the change of mind had something to do with the dozens of petitions being tabled in the House in support of a national dementia plan, the hundreds of municipal resolutions backing Bill C-356, and the growing number of provincial governments seeing the value of leadership from Ottawa that still respected provincial jurisdiction.

Canadians changed the government's mind. During many discussions with the minister and her representatives, we on this side of the House accepted all the amendments proposed to address their reservations. However, in the end, the government showed its true colours and abandoned its leadership and any legislative measure that it would be required to implement. This government's ideology and practice is to disregard authentic national strategies containing real measures that make things easier for Canadians.

This brings me to the vote held on May 6. Despite the fact that the government is now opposed to the bill and even though it has a majority in the House, the bill was defeated by one vote, 139 to 140. The media first talked about the confusion at the time of the vote. One Conservative member voted twice before withdrawing his support for the bill. Let me quickly say that the vote of 140 to 139 is a sharp reminder of the importance of every member's vote. Yes, bills can be passed or defeated by a single vote. The Conservatives have also heard about what their vote means since that night.

However, the vote was also a clear reminder of how we need to listen to the will of Canadians. Nine members of the Conservative caucus did so, voting for the legislation. I have recognized their votes in public comments. There were nine government MPs who joined our party and other parties to support real help for the 747,000 people now dealing with Alzheimer's or related dementia disease, plus the millions of people caught up in providing care and health services.

This motion cleverly includes so many elements from my bill and what is needed for a genuine national strategy, but this motion will not here and now help any of the people who are so in need of help.

This motion recognizes the important research initiatives that we on this side of the House enthusiastically applaud. It recognizes the federal-provincial discussions under way, while deploring the fact that they are painfully slow. The motion includes many of the basic elements of a strategy, but it makes no commitment to accomplish what that it sets out.

The real problem of the motion before us not being as binding as legislation is that, in the words of my colleague the member for Victoria, it risks being a “feel-good, do-nothing motion”. I will say more about motions versus legislation later, but in terms of recognizing what Canadians really need from the current government, we need to hear what they said in the wake of the defeat of Bill C-356 by one vote. Some of what they said, I cannot repeat. “Shame” and “disgrace” were some of the more polite words.

The Canadian Medical Association lamented the lost opportunity. Dr. Chris Simpson, president of the CMA, said:

The defeat of Private Member's Bill C-356 Wednesday night represents a lost opportunity to make lasting progress in the serious and growing problem of dementia in Canada. We remain one of the few industrialized countries to be without a national dementia strategy.

... Bill C-356 would have called on the government to set up a national dementia strategy. Canada would have been able to get to work making sure the health care system has the right resources to deal with this problem before it becomes overwhelming.

However, a national strategy would involve all levels of government and introduce benchmarks, standards of care as well as timeframes. It would also give other levels of government and stakeholders a forum to point out the need for resources. Instead of a series of ad hoc initiatives, a national strategy is a long-term solution for a problem that will be with us for a long time.

Canadians want a real national strategy enshrined in law. That is what we have heard from municipalities, doctors, people with dementia, their caregivers, the Canadian Conference of Catholic Bishops, other religious leaders, CARP and other seniors' organizations, unions and many others.

The motion moved in the House reproduces, almost word for word, many of the provisions in Bill C-356. There is heavy emphasis on research, something we have always considered essential to any strategy. That is something that will only contribute to other aspects of a well thought-out strategy.

However, when we unpack this motion, and all its phrases, again we see that it will stay the course on what Ottawa has been doing, slowly and with so few results. There will be research. There will be discussions with the provinces. There is a nod to sharing of best practices and reports to the public, but with no real accountability or timelines.

There is little evidence of a comprehensive plan that also provides for early diagnosis and treatment. I do not see the continuum of care for people to remain at home and in the community, which is critical as our scarce acute care beds have many people who do not need to be in hospitals.

A real credible national dementia strategy would also now help those overwhelmed in the dementia workforce. For example, the motion mentions support for caregivers, but nothing about how and when. What resources will be given to these people now?

We on this side know the difference of a motion versus legislation. In another Parliament, we saw the passing of Mr. Broadbent's motion to end child poverty by the year 2000. It was unanimous. There was good will on all sides, but we know what happened with that motion. What will happen to this motion when there is no will of governments to follow up with real action and leadership.

We are reaching the end of this Parliament next month. We or others representing our parties will all have to face the voters in our ridings. Organizations like the Canadian Medical Association, CARP and others are advising voters to remember their MP or party votes on dementia. We are pleased on this side for having done our part in education, advocacy and building the momentum for a genuine national dementia strategy. There is no turning back.

Through Bill C-356 and our debate on this motion, Canadians will not be fooled by words any longer. They want a national dementia strategy to actually show up in their community to help their loved ones, their neighbours, their work colleagues, now. Canadians will not stomach more press releases, motions, promises or explaining of votes.

I will support this motion because I like mom, apple pie and everything that is said in Motion No. 575. Speaking of mom, the story of my mom and my family connected me to the millions of Canadians struggling with this health care crisis that dementia represents. She was a straight shooter. She would figure out fact from fiction about what the government says it does or will do.

We on this side are committed to continue the real work required to make this happen. I look forward to the new government in Alberta being part of that work. I look forward to a new government in Ottawa, a government led by my leader, that will lead on this file. Canadians deserve better than what we have.

[Murray Rankin, NDP, Victoria, BC]

Mr. Speaker, the member for Nickel Belt brought forward a private member's bill, Bill C-356, not long ago. It contained much of the same material that this expression of opinion, which is what a motion is, contains. Why did the member vote against that initiative. Why did the government defeat the private member's bill that would have created a national dementia strategy in Canada rather than simply, as in the motion before us tonight, an expression of the opinion of the House?

National Strategy for Dementia Act

[The Speaker, Conservative, Andrew Scheer]

The House will now proceed to the taking of the deferred recorded division on the motion at second reading stage of Bill C-356, under private members' business.

The House resumed from May 5 consideration of the motion that Bill C-356, An Act respecting a National Strategy for Dementia, be read the second time and referred to a committee.

[Robert Aubin, NDP, Trois-Rivières, QC]

Mr. Speaker, I am pleased to participate in this discussion, but I find it unfortunate that I have so little time to speak about such an important issue.

Obviously there are many issues where partisanship should be set aside so that a broad consensus can be reached. Clearly, one of those issues is dementia and treatment for those who are living with one form or another of this disease. For that reason, I am proud to be part of this discussion and to support Bill C-356, which was introduced by my colleague from Nickel Belt.

I wanted to provide some background and statistics to show how serious this situation is, but since I already know that I will not have enough time, I would like to instead focus on something extraordinary that was achieved in my riding of Trois-Rivières and that has now spread outside the riding, outside Quebec and even outside Canada. The knowledge and skills developed by Maison Carpe Diem, under the direction of Nicole Poirier, have made this organization an international source of expertise. Clearly, the national strategy that my colleague wants to establish with his bill could help Maison Carpe Diem and this organization could use its expertise to help with this strategy.

This organization, known as Carpe Diem, comprises a home and a foundation. My colleagues probably remember the well-known film Dead Poets Society, which popularized this expression. Carpe diem is usually translated as “seize the day”, in other words, seize the present moment and make the best of it. With its home and its foundation, the organization is a perfect example of the efforts that the Trois-Rivières community has already devoted to supporting and helping people living with Alzheimer's.

Maison Carpe Diem's mission is to provide services and resources tailored to the specific needs of people with Alzheimer's disease and their loved ones. Maison Carpe Diem has decided to take a bold, innovative approach. The organization realizes that research results are rarely conclusive. That is not to take anything away from the importance of research and the need for investments in research, but simply to say that from the moment a study begins until conclusive results are reached, it is important to find ways to make life bearable for those living with this disease. With that in mind, members and administrators at Maison Carpe Diem decided to focus their approach on supporting patients and their families during these difficult times.

The approach taken by Maison Carpe Diem is so effective because of its perspective on those living with this disease. More specifically, the staff uses language in such a way as to ensure that residents there do not feel like simple patients. Instead of defining them as patients or clients, the staff creates an environment in which people living with this disease are able to feel comfortable and feel at home. This approach is original in that Maison Carpe Diem views and addresses this disease from a social perspective. Internationally renowned neurologists have validated the methods used by this organization.

On February 12, 2015, a conference focusing on supporting people with Alzheimer's was held at the Trois-Rivières conference centre. More than 400 people attended, including foreign scientists who are interested in the approach taken by the staff at Maison Carpe Diem. The founder of this organization, Nicole Poirier, drew the interest of participants because of her novel approach to the disease. The organization takes an overall perspective that helps staff identify the different aspects of Alzheimer's and that focuses on both the disease and the person living with it. This organization and its approach are now seen as a model, both within the grassroots movement and in the public health network.

What I want to say is that by being part of a national strategy, this organization could easily share its best practices and more effectively assist those suffering from dementia and their family members. My hope is that a national strategy will lead to an increase in the number of organizations like the one in my riding across the country and around the world. Furthermore, public health networks could further benefit from this expertise and share what they learn with their partners.

I was going to cite some statistics, but it seems to me that 100% is the most convincing one.

In my opinion, at some point, when we cannot remember an expression we want to use, 100% of us will wonder if that is the onset of Alzheimer's. Even though we often joke about it, these words are always on our lips.

I will conclude with a quote from the website of Maison Carpe Diem, the organization I spoke about:

If Alzheimer's is marked by forgetfulness, the discussion around it often forgets about those most concerned, the people suffering from it.

[Rathika Sitsabaiesan, NDP, Scarborough—Rouge River, ON]

Mr. Speaker, I stand today to support Bill C-356, an act respecting a national strategy for dementia, introduced by the member of Parliament for Nickel Belt.

This is proof that the NDP is standing for our future. Right now, the increased cases of dementia among older Canadians is having a huge impact in Canada. Our current system needs support if it is going to grapple with the social, health and economic impacts of dementia, which affect patients, their caregivers and their communities.

We know this is a growing crisis because if we do not develop a comprehensive set of supports to address this issue now, it will then be 10 times worse as the baby boomer generation enters the senior years.

I remember being a delegate at the 2012 NDP convention, and our delegates passed a resolution calling for a national dementia strategy. We found strong support among organized labour, seniors and our NDP members in electoral districts across the country.

Their interest is personal, coming from knowing someone who is living with the disease or a caregiver who is caring for a loved one with the disease. We introduced Bill C-356 in late 2011. Since then, over 75 petitions supporting this idea have been tabled here in Parliament. Over 300 municipalities have passed supporting resolutions.

There is strong support from seniors, heath care, labour, faith and many other networks. A national dementia strategy also links well to the NDP seniors strategy. Our seniors need our support, especially when dementia makes them vulnerable and disoriented, and in need of care.

According to the benchmark study, Rising Tide by the Alzheimer Society of Canada, the number of Canadians living with Alzheimer's disease and other dementia now stands at 747,000 and will double to 1.5 million by 2031.

Canada's health care system is ill equipped to deal with the staggering costs. The combined direct medical and indirect lost earnings costs of dementia total $33 billion per year. By 2040, this figure will skyrocket to $293 billion per year. Pressures on family caregivers continue to mount.

In 2011, family caregivers spent 444 million unpaid hours per year looking after someone with dementia, representing $11 billion in lost income and 227,760 full-time equivalent employees in the work force. By 2040, they will be devoting a staggering 1.2 billion unpaid hours per year. Lost in those numbers, perhaps, is the real human face of the disease, the moms, dads, brothers, sisters, friends, neighbours and work colleagues. While an elderly face typifies most people living and dealing with dementia, 15% of all who are living with Alzheimer's or related dementia diseases are actually under 60 years old. Dementia cuts across every demographic in our communities.

I want to share an example. Matt Dineen, who is 44, is a Catholic high school teacher in Ottawa whose wife, Lisa, 45, is already in secure long-term care with frontal-temporal dementia. Matt is helped by grandparents and siblings in looking after the three children he has with Lisa.

We need increased support for informal caregivers. Caregivers need to be recognized as individuals with rights to their own services and supports. This could take several forms. On financial support, the non-refundable family caregiver tax credit of up to $300 a year introduced in 2011 is really not enough. This does not adequately reimburse the cost of a caregiver's time, which studies have shown is much higher.

Programs are needed to relieve the stress experienced by caregivers. This can include education and skill-building, and the provision of respite care and other support services for the caregivers.

I want to read an account from Tanya Levesque, who lives here in Ottawa, which reflects the experience of many caregivers in Canada. Ms. Levesque states, “We need a national dementia plan to help caregivers. Following is a list of financial barriers I have experienced during my journey as my mother's caregiver: Unable to access my El benefits; I've been unable to qualify for social assistance; unable to claim the caregiver amount on my income tax, since my mother's net income is a few thousand more than what is listed; lack of subsidies for expenses which keep increasing (i.e. property tax, parking fees at hospitals for appointments, gas for travelling to appointments, hydro, water and sewage fees ... etc); I've changed my eating habits to save money, due to the increased cost of food, so my mother can eat well; and because of a lack of future job security, my retirement security is in question, I can't save, because I've chosen to care for my mother, who took care of me. Other difficulties I've encountered: No one-stop shop for information; lack of education of front line emergency room workers regarding the difficulty of long waiting times for a person with dementia; lack of funding for organizations that provide Day Program services .i.e. not being able to provide various activities to clients due to associated costs (i.e. pet therapy). I not only provide love, a peaceful environment, stability and familiarity to my mother - who has now stabilized with her disease - I also provide the government with health care cost savings.

She is clearly doing a lot for our community by helping her mother.

Supporting a national condition-specific strategy is something I think that we should look into for dementia. It is not a new thing. It is not a new idea for the federal government. It is just an an idea that the Conservative government is actually really dragging its feet on.

The Canadian diabetes strategy, for example, supports collaborating and developing community models to raise awareness, invest in tools and share information.

The Canadian Partnership Against Cancer, in 2011, received a renewal of funding totalling $250 million over five years. CPAC is implementing a coordinated, comprehensive approach to managing cancer care in Canada.

Using the Canadian heart health strategy and action plan as a guide, Canada is addressing cardiovascular disease through investments in health promotion and disease prevention.

Clearly, we know how to do this. It has been established. Dementia should be a disease, a condition for which we can have a specific strategy nationally.

In 2007, the Government of Canada established the Mental Health Commission by providing $130 million over 10 years, with a mandate to facilitate the development of a national mental health strategy.

Instead of a national strategy, what we are seeing is that the Conservative government has proposed research.

As important as research is, it is not the same as the comprehensive approach that the bill would promote: help for patients, caregivers, the dementia workforce; early diagnoses and prevention; and a continuum of care for people in their homes, in the community and in formal care.

The national dementia strategy proposed by my colleague from Nickel Belt, in Bill C-356, would provide leadership from Parliament that would work with and respect the lead jurisdiction for health care delivery for the provinces and territories; increase funding for research into all aspects of dementia; promote earlier diagnosis and intervention; strengthen the integration of primary, home and community care; enhance skills and training of the dementia workforce; and recognize the need and improve support for caregivers.

We respect that provinces and territories have jurisdiction over health care delivery; however, municipalities, patients and caregivers are calling upon Ottawa to show some leadership. Ottawa needs to take the lead on a pan-Canadian dementia strategy that could immediately help millions of Canadians affected by Alzheimer's and related dementia diseases: the patients, families, caregivers and the dementia workforce. This would free scarce acute-care beds in hospitals and help caregivers, who often must give up their work in order to care for loved ones.

I shared the example of Ms. Levesque with members earlier.

Also, Mimi Lowi-Young, the CEO of the Alzheimer Society of Canada, stated the following:

In a recent Nanos survey, 83% of Canadians reported they believe Canada needs a national dementia plan. As our population ages, Canadians will be at an increased risk of developing dementia or caring for someone with it. Everyone owns this disease.

The approach we're proposing has worked for the Canadian Partnership Against Cancer and the Mental Health Commission of Canada. It can work for dementia and ensure that we get the best return on investment and available resources.

The Canadian Association of Retired Persons, CARP, and the Canadian Medical Association both echo the sentiment of Ms. Lowi-Young.

In conclusion, instead of putting forward a non-binding motion, Motion No. 575, the government brought forward that would not lead to a study in committee and support research when our country is actually calling out for a plan, a real plan, a strategy, the government needs to really take action to build a national strategy for dementia and and support Bill C-356 proposed by my colleague from Nickel Belt.

[Judy Foote, Liberal, Random—Burin—St. George's, NL]

Mr. Speaker, it is a pleasure for me to rise today in support of Bill C-356, An Act respecting a National Strategy for Dementia.

The Liberals have long called for federal leadership in establishing a pan-Canadian dementia strategy and we believe the federal government must work with the provinces to establish such a strategy.

Families throughout our country are having to deal with loved ones who have dementia and they need our help and our support. They need that national strategy so they can cope, and this private member's bill aims to do that.

According to the Alzheimer Society of Canada, in 2011, 747,000 Canadians were living with Alzheimer's disease and other forms of dementia. That means, 14.9% of Canadians 65 and older were living with cognitive impairment. Without intervention, the society projects that figure will increase to 1.4 million Canadians by 2031.

The demographic population of Newfoundland and Labrador is aging at a faster rate than the rest of Canada, which means this increase will hit my home province particularly hard. In 2011, 16% of the population was 65 years or older, a number expected to increase to 20% by 2016. Unfortunately, as the age of the population increases, research has shown that the prevalence of Alzheimer's disease and other forms of dementia does as well.

The Canadian Medical Association raised this issue in its 2013 paper, “Toward a Dementia Strategy for Canada”. It said:

Given the terrible toll that dementia currently takes on Canadians and their health care, and given the certainty that this toll will grow more severe in coming decades, the CMA believes that it is vital for Canada to develop a focused strategy to address it.

Clearly this is a pressing problem requiring urgent action. Yet, despite pledging in 2013 to find a cure or treatment for Alzheimer's by 2025, we remain one of the only G7 countries without a strategy. Australia, Norway, the Netherlands, France and the United Kingdom all have national strategies to address this growing problem, but Canada does not. This is unacceptable, especially given our aging population.

Alzheimer's disease puts enormous emotional stress on millions of families in Canada. One in five Canadians 45 and older provide some sort of care to seniors living with long-term health problems. In 2011, that amounted to 444 million unpaid hours spent by family caregivers looking after someone with cognitive impairment such as dementia.

From an economic perspective, this amounts to $11 billion in lost income and a loss of 227,760 full-time equivalent employees in the Canadian workforce. The impact to the Canadian economy is matched only by the enormous strain on those family members who provide care for their loved ones.

The emotional stress caregivers face was highlighted in a recent report by the Mental Health Commission of Canada, as well as a report from the World Health Organization, which stated that between 15% and 32% of caregivers would experience depression and up to 75% would develop psychological illnesses as a result of caring for others. These family members are doing what they can, but they need our help.

One of the major reasons patients end up in long-term care is because their caregivers are simply overwhelmed. According to Dr. Roger Butler of Memorial University Faculty of Medicine, “If you’ve got a well-educated, trained caregiver feeling supported in their community they won’t burn out as quickly as if they’re left to their own devices.”

A comprehensive strategy that supports caregivers is essential for the well-being of both the patient and the caregiver. A truly comprehensive pan-Canadian dementia strategy would not only have a positive impact on patients and their families, but delaying onset of Alzheimer's by two years could save our health care system $219 billion over a 30 year period.

Patients with dementia often occupy acute care hospital beds, while waiting for placement at long-term care facilities. This only serves to exacerbate the problem of waiting lists and increased health care costs. Without action, this problem will continue to grow.

During the 2011 federal election, the Liberal Party of Canada laid out a clear, comprehensive dementia strategy, including support for research, families, patients and communities. The plan called for increased funding for research to target new treatments and therapy, and to accelerate our progress in understanding, treating and preventing brain diseases.

It called for increased awareness, education and prevention programs to support families and combat the social stigma of dementia. It also called for stronger support for home and long-term care, as well as protection of income security for families struggling to cope with the cost of caring for a loved one with dementia.

Another key element of that strategy was the introduction of legislation that would prohibit denial of life, mortgage and disability insurance, and rejected employment based on genetic testing that showed risk of future illnesses.

Canada is the only G7 country without legal restrictions on access to genetic test results. This forces many Canadians to make an impossible choice: obtain genetic testing results for illnesses, including Alzheimer's, and face discrimination, or avoid testing and taking steps that could prevent or mitigate illness in the hope of obtaining things like life insurance.

This regulatory void perversely promotes the avoidance of potentially life-saving tests. Action is needed urgently, yet despite pledging action in the 2013 throne speech, the only action the Conservative government has taken is to block efforts on this front in the Senate.

Despite government inaction, individual Canadians are working together to develop treatment and prevention protocols and to improve the lives of patients and their families.

This year, volunteers across Newfoundland and Labrador will be participating in seven “Walks for Alzheimer's” to raise money for support programs and services for those living with dementia in their communities.

Families are also helping other families by participating in province-wide family support groups, accessible by phone and Skype, reducing isolation and providing much-needed support to caregivers in remote communities like those in my riding of Random—Burin—St. George's. This is one way of ensuring that families are able to cope. We need to ensure more of that happens.

The things is that it needs to be part of a national strategy so it is not left to those who are caregivers to do things to help those who they and others love who are hit with Alzheimer's and other forms of dementia.

I take pleasure in raising awareness of the important work being done on dementia treatment and prevention in my home province of Newfoundland and Labrador.

Dr. Anne Sclater, professor of medicine at Memorial University, has done incredible work on the development of provincial strategies on healthy aging and Alzheimer's disease, as well as on the prevention of elder abuse.

Elders with dementia have the highest incident of mistreatment and abuse in long term care, and the prevention of this sort of terrible abuse is a topic on which Dr. Roger Butler, associate professor of family medicine at Memorial University of Newfoundland, has worked extensively. He is also currently engaged in a new project using telegerontology as a novel approach to optimize health and safety among people with dementia in Newfoundland and Labrador. For his work as a teacher, family physician and on behalf of the Alzheimer's Society, he was recognized by the College of Family Physicians of Canada as Newfoundland and Labrador's family physician for the year in 2013.

Drs. Sclater and Butler, along with some of their colleagues throughout the country, are making incredible progress on this important and increasingly prevalent issue. Imagine what they could do with more resources and support.

What we need is coordinated support from the top. Federal leadership is needed to develop a truly pan-Canadian dementia strategy to support the important work of these individual researchers.