Bill C-277

National Strategy on Brain Injuries Act

An Act to establish a national strategy on brain injuries

This enactment provides for the development of a national strategy to support and improve brain injury awareness, prevention and treatment as well as the rehabilitation and recovery of persons living with a brain injury.

National Strategy on Brain Injuries Act

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

moved that Bill C-277, an act to establish a national strategy on brain injuries, be read the second time and referred to a committee.

Madam Speaker, it is indeed a great and rare honour to be able to stand in the House of Commons to sponsor and present a piece of legislation for all of my colleagues to consider. With that being said, I am pleased to kick off the debate respecting Bill C-277, the national strategy on brain injuries act. Before I get into the details of the bill, I want to start by sharing three personal stories so members of the chamber who are listening can get a real sense of why the national strategy is so important.

I want to tell the story of Kyle Mockford from my riding, who in 2012 was brutally attacked from behind, being struck up to 20 times in the head before collapsing, unconscious. For months after, he experienced severe headaches, balance problems, fatigue, poor coordination, and reductions in reasoning skills, concentration and memory. This was followed by bouts of depression, anxiety, compulsive-aggressive behaviour and PTSD, all of which got progressively worse after the attack. In his words:

I expect I’ll never get back to being completely normal, but I’m finally doing the proper things to get back to normal as much as is possible after falling through the cracks for so long. I want to shine a light on how serious brain injuries can be, and that they can and will have long-lasting consequences and effects on a person’s life.

I also want to tell you the story of Derrick Forsyth from Victoria, a man who has 85 criminal convictions and who was caught up in a vicious, repeating cycle of doing time in prison, getting out and doing time again. A series of undiagnosed brain injuries dating back to his childhood led to frequent interactions with our criminal justice system and to an addiction to drugs. However, with proper support, he has turned his life around. Derrick still faces symptoms of brain injury, including extreme fatigue, which will never go away, but he says that dealing with the injury has taught him how to be more giving, understanding and compassionate.

Finally, I want to tell you the story of Abbotsford resident and school trustee, Shirley Wilson, and her late son Jacob:

Jacob suffered a traumatic brain injury after he was struck by a pickup truck in August 2018 at the age of 21 while he was walking along Marshall Road in Abbotsford.

He was resuscitated three times by medical teams that night.

Over the last years of his life, the devastating injuries he sustained led to isolation, psychosis, drug addiction and [eventually] his death by an accidental fentanyl overdose on Nov. 11, 2021.

He was just 24 years old.

Here are the statistics. Brain injuries are often known as the hidden epidemic because the people who have them do not always bear physical scars. Acquired brain injuries can very generally be separated into the traumatic and the non-traumatic kind. Traumatic brain injuries can come from assault, from playing sports or from motor vehicle accidents. Non-traumatic acquired brain injuries can come from strokes, overdoses and aneurysms.

It is estimated that over 160,000 new cases of brain injury happen annually in Canada, and that there is an estimated national prevalence of over 1.5 million cases. Traumatic brain injuries are 44 times more common than spinal cord injuries, 30 times more common than breast cancer and 400 times more common than HIV/AIDS. In fact the incidence and prevalence of brain injuries surpass that of HIV/AIDS, spinal cord injury, breast cancer and multiple sclerosis combined.

We know that brain injuries contribute to homelessness, incarceration, substance use and mental health issues. We know that brain injury survivors face a 200% increased risk of struggling with addictions, and their risk of suicide increases by 400% after a brain injury.

Despite these stark statistics, funding for awareness, prevention and treatment pales in comparison with that of many other ailments impacting the health and well-being of Canadians. We all know about Heart and Stroke Foundation of Canada and the Canadian Cancer Society, and the good work that they do, but knowledge of Brain Injury Canada and how common brain injuries are in Canada pales in comparison.

The rate of traumatic brain injury increases in older groups. We do have an aging demographic, and we know that those over 60 account for 29% of all head injury hospitalizations. We also know that seniors with brain injuries can experience accelerated aging effects and that there can be an increased risk of Alzheimer's disease and dementia.

In response to all of these facts and to the many champions who are working to get this strategy into place, I worked to introduce Bill C-277, the bill that we are considering this evening.

This bill did not develop in a vacuum. I want to single out a particular individual from my riding, from the city of Langford, Janelle Breese Biagioni. I have known her for quite some time. She is a very persistent constituent who is very passionate about these issues. It was through conversations with her that I first came to develop the idea of putting in place a national strategy to address brain injuries. Her story is very personal. Her late husband, Constable Gerald Breese, was once a member of the RCMP. While he was on duty on his motorcycle he was involved in a motor vehicle accident. He went into a coma and unfortunately, eventually, succumbed to his injuries. For her, this is very personal.

This eventually led to my introducing the original Bill C-323 in the previous 43rd Parliament. It was then that it got the attention of Brain Injury Canada. I really want to recognize the people at Brain Injury Canada, especially Michelle McDonald. It is a tremendous organization. It does such incredible work from coast to coast to coast. Through consultations with Brain Injury Canada, we developed the bill we see today. This bill was very much co-written with Brain Injury Canada. I cannot thank it enough for its valuable input and the stakeholders it has reached out to.

Truly, this bill has taken on a life of its own. There are so many people with lived experience and so many organizations and people working in research who have reached out to my office and who are mounting a campaign outside of my efforts inside of the House of Commons to raise awareness. I think of March of Dimes Canada, all of the provincial injury associations, the Cowichan Brain Injury Society from my own riding of Cowichan—Malahat—Langford, the Concussion Legacy Foundation of Canada, but also prominent individuals like Dr. Gabor Maté, who has also lent his support to this bill. What an honour to have such a learned individual, who has been so active in this field, lend his support.

Now, to the language of the bill, essentially this is a national strategy that is going to require the Minister of Health to consult with representatives of provincial governments, with indigenous groups and with relevant stakeholders to develop this strategy to support and improve awareness, prevention and treatment as well as the rehabilitation of persons living with a brain injury.

The strategy includes a number of measures, 11 in total. I will not go through all of them in detail, but very briefly, they include measures like identifying the training, education and guidance needs of health care and other professionals who work in this field; promoting research and improving data collection on the incidence and treatment of brain injuries; promoting information and knowledge sharing; creating national guidelines on the prevention, diagnosis and management of brain injuries; and also fostering collaboration with and providing financial support to those associations that do this important work.

However, there are two items I really want to highlight. The bill would ask the Minister of Health to encourage consultation with mental health professionals, particularly in educational institutions, sports organizations and workplaces, to provide persons who are suffering from the effects of a brain injury, including mental health and addiction problems, with a support system within the community. It also asks the minister to identify challenges resulting from brain injury, such as mental health problems, addiction, housing and homelessness issues and criminality, including intimate partner violence, and to work to develop solutions in collaboration with stakeholders.

I think if we canvass members in the House, we can all agree that those are issues affecting all of our ridings and all of our communities within them.

Let us get to why we need this bill. I first want to apply a gender lens to this bill. Professional sports get a lot of attention with respect to head injuries, but I want to leave people with this startling fact: For every NHL hockey player who suffers a concussion in sport, more than 5,500 Canadian women sustain the same injury from domestic violence. Women in families also tend to have a disproportionately higher burden in terms of the responsibility of providing care to loved ones.

I also think we need to spend time talking about the intersection of brain injury with our criminal justice system. Brain Injury Canada has done a lot of work on this. Evidence shows that sustaining a traumatic brain injury increases the risk of involvement with the criminal justice system. There are many common cognitive, emotional and behavioural symptoms or impairments that can increase the chance of a negative interaction with police and the justice system. These can include anger management issues, challenges with processing information, engaging in high-risk behaviours, inappropriate emotional responses, lack of impulse control, memory impairments and poor judgment.

I know this from speaking to police in my role as the public safety critic. I have also spoken with members who work in our federal correctional system, both the program officers within and the parole officers who work on the outside. Certainly, their first-hand accounts of undiagnosed brain injury within our prison system was absolutely startling testimony to hear directly. Therefore, it is a very real problem, and if we want to be serious about addressing some major societal issues, such as criminality, addressing undiagnosed and even diagnosed brain injuries is going to go a long way to helping these people lead productive lives.

I also want to talk about the intersection with opioid use in our communities. One existing challenge with the treatment of substance use and brain injury at the same time is that current programs are not equipped to handle both. The majority of brain injury rehabilitation, community and support programs require participants to be sober. Similarly, the centres and programs that specialize in addiction support are not able to handle the complex needs of someone who has a brain injury. Again, these are two very real problems that are often interconnected, but we do not yet have adequate support and treatment systems to deal with them at the same time. I know this is an issue in the communities I represent, and I think it is the same right across Canada.

I want to wrap up by saying that there is very much a poor understanding of brain injury and its consequences in both the health and social care systems. I think it is well-known among some segments of the population, but I do not think we have a firm grasp on the situation policy-wise. I believe that, by legislating this requirement for a national strategy, we can truly start treating this major societal problem with the urgency and resources it needs. I hope all members will support me in this. It is a bigger problem than any one province or territory can handle on its own. We know that, with proper treatment and support, many people with brain injuries can return to productive and engaging lives.

It is amazing that I already have support from the cities of Victoria, Langford, Nanaimo and the municipality of North Cowichan. I think many more municipalities are going to follow suit, given the problems they are dealing with in their populations.

I sincerely hope all colleagues are going to join with me in supporting the principle of this bill and send it to the health committee where it belongs.

I want to end with a quote from Dr. Gabor Maté, who stated:

Brain injury is one of the hidden epidemics, too often unrecognized, that exacts a heavy toll on sufferers and their families and caregivers. It has many health implications, which may last a lifetime. Children with brain injuries, for example, are at elevated risk for depression. Other potential consequences of traumatic brain injury include loss of behavior control, aggression, memory loss, dementia and, potentially, substance abuse. Nearly half the homeless population have endured brain injury. A national strategy that entails the proper education of health personnel, teachers, social workers, law enforcement people, service providers and policy makers at all levels is urgently needed. Based on my clinical work and on my extensive reading of the research literature, I fully support this initiative.

I urge all members to listen to those wise words. I would ask the many people campaigning for this bill to give their support to send it to the standing committee. I thank all members in the House for their consideration.

[Lloyd Longfield, Liberal, Guelph, ON]

Madam Speaker, it is great to work with the member for Cowichan—Malahat—Langford in the House and on committees. I am very interested in the proposed bill and how it might be embedded in some of the work that I have always been involved in with Brain Canada and Dr. Viviane Poupon, such as the $80 million over four years in budget 2024 for Brain Canada research looking at stem cell treatment for things like injuries or conditions that result in behavioural or other problems, and the Canadian Brain Research Strategy with Dr. Jennie Young and the work she is doing. I think the collaboration around the brain and our understanding of the brain could be enhanced by including the work that the member is doing on brain injury.

Might the member make a comment on how the bill could be embedded in some of the larger strategies in Canada?

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, I thank my Liberal colleague for his kind words. I do recognize that there are many organizations out there doing great work. There is funding available from private individuals, from non-profits and from government. I do not want this strategy to interrupt that but to add to it as a sort of legislative requirement, so that we do not suffer from policy lurch, because one of the key components of this bill is a reporting requirement to Parliament. It would put in an important accountability measure for parliamentarians, as representatives of the people, to ensure that this national strategy and all of its key components are being met and that we have those legislative requirements to promote knowledge transfer on a national strategy for how we best approach this.

I see this bill very much as a complementary thing, but also with key accountability measures so that we have those legislative guardrails against policy lurch, whenever we have a potential change in government.

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Madam Speaker, my colleague and I work well together on the agriculture committee, and this is something we have talked about before.

The one question I have is simple: Have there been conversations with the provincial health ministers and groups like that to make sure we can have this?

Obviously, health is provincial jurisdiction and we do not want to infringe on that jurisdiction. We should make sure we have those conversations, so that, if we do bring forward the national strategy, we have provincial buy-in. That is very important. Does my colleague have a couple of comments on that?

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, I have not yet had the time to consult widely with the provinces, but I do not see Bill C-277 as in any way interrupting their clear jurisdiction over health policy. This really would be putting in a legislative requirement for our federal Minister of Health. It is spelled out right in clause 2 that the Minister of Health cannot develop this strategy without consulting with provincial representatives, with representatives of indigenous government and with stakeholders.

What I am really positively influenced by is the sheer number of people with lived experience, their friends, their families, their loved ones, researchers, provincial and national organizations, and people who represent retired athletes who are all clamouring for this bill to be passed. I think that kind of pressure is going to lend itself to the provinces doing the right thing.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, is my colleague open to amending his strategy in order to respect the jurisdictions of Quebec and the provinces? Many of the national strategies that are being introduced in the House often overlook that vital requirement.

Is he prepared to consider that?

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, I am certainly open to considering any and all amendments, should this bill reach committee. What I am asking for members to do now is to support the principle behind this bill. As I answered my Conservative colleague, I do not think this bill, as written, infringes on provincial jurisdiction over health. This is really asking the federal government to work with provinces, recognizing that this is truly a national problem that is bigger than any one province or territory can handle.

People in every single province suffer from brain injuries, and their effects are just as debilitating whether someone lives in Quebec or in British Columbia. I am certainly going to be open to any amendments. I am just hoping that we can have a unanimous vote in support of the principle of this bill, given the extreme importance it has for so many people.

[Brendan Hanley, Liberal, Yukon, YT]

Madam Speaker, I am pleased to speak in support of the bill my hon. colleague for Cowichan—Malahat—Langford has presented. He has been a champion of this issue for a long time, and I believe that Bill C-277, the national strategy on brain injuries act, is an important piece of legislation that I hope all members of this chamber will be able to support.

By the time I finish my remarks in nine or 10 minutes, another three Canadians will have suffered a traumatic brain injury, or TBI. That is right. It is one every three minutes or 450 a day. These are estimates only, because these types of injuries, often known as “invisible injuries”, are recognized to be under-reported and therefore undiagnosed.

When we discuss injury, we are not just talking about falls in a bathtub or a trip on the ice. In addition to TBI and concussions, there are developmental brain injuries; physical trauma, including through intimate partner violence; toxic trauma, such as through destructive substance use; and then organic injuries like strokes.

One of the challenges posed by brain injuries is that they are a silent epidemic. In many cases, there are no external physical indicators. There is no one test to prove with certainty that a person has a concussion or how serious it is. That means that people are not getting the treatment and support they need, which impedes their recovery and can sometimes even make their symptoms worse.

The issue is particularly marked in rural, northern and remote areas. Like many parts of the north, including the Yukon, it is estimated by Brain Injury Canada that concussions in rural areas appear more frequently than in urban areas, and I would like to add my thanks to Brain Injury Canada for its advocacy and for bringing to public notice the importance of this issue. However, given the lack of access to medical care, recovery supports and imprecise diagnoses available for some types of TBI to begin with, it may be that the incidence of under-reporting is higher in our rural communities as well.

We know that indigenous communities face these injuries with a higher risk for poorer outcomes, in part due to the socio-economic factors that continue to disadvantage many indigenous communities compared to their non-indigenous counterparts. We can add to that the lack of diagnostic availability as well as a lack of culturally appropriate treatment and care, particularly in remote communities.

Brain injuries, in sum, can occur at any time and do affect Canadians from all walks of life and all regions of Canada. However, because of how different these injuries are and how differently they can affect people, there is no single approach to manage and respond to this epidemic. It is critical that we move to develop a national strategy to both support and improve brain injury awareness as well as to provide treatment, so that those who experience brain injury and their families have the supports they need to live as active and productive a life as they can.

After a brain injury, many people have a hard time readjusting to normal life. As a result, they may resort to maladaptive coping strategies, such as self-medication, substance abuse and withdrawal from social circles, which we all need to thrive. All that does is make the suffering of these individuals and their families worse.

Fifty percent of people with a head injury suffer from depression, post-traumatic stress disorder and other mental health issues. The long-term complications can last for years.

There has been a growing realization across Canadian society over the past years that more attention needs to be paid to traumatic brain injury and related brain injuries. Brain Injury Canada and its provincial and local counterparts have long been advocates for this issue.

For more than 30 years, the Constable Gerry Breese Centre for Traumatic Life Losses has been working to support and service individuals and their families whose lives have been radically changed by brain injuries. Competitive sports and athletics, from professional teams to peewee hockey, have also been integral in moving this issue forward by educating athletes and their families about the risks and by putting in reasonable measures to improve that education and reduce the risk of TBI. In 2013, for example, Hockey Canada implemented a new rule barring body-checking in younger age groups, resulting in a 70% reduction in the risk of concussion or about 5,000 fewer concussions amongst youth in Canada, who, along with seniors, are more vulnerable to experience concussions.

Rowan's Law, passed in Ontario in 2019, mandates that sport organizations operating in the province must ensure that athletes under 26 years, parents of athletes under 18, and all coaches, team trainers and officials annually review the Ontario concussion awareness resources and establish codes of conduct to support concussion prevention and establish a “removal from sport and return to sport” protocol.

Like many important steps forward, Rowan’s Law was introduced after a tragic event. In 2013, a young high school rugby player named Rowan Stringer from Ottawa died of second impact syndrome, which is a swelling of the brain caused by a subsequent injury that occurs before a previous head injury healed. Rowan had not known about her risks and continued to play after her first concussion. The law was passed in her memory to raise awareness, educate athletes and others about concussion risk, ensure that the necessary measures were put in place to protect young people, and ensure they could get the help and support they needed after a brain injury.

One of my staff members has been an athlete at Carleton University, and he has had to participate in annual, mandatory training sessions, along with all other university athletes in Ontario and Quebec.

The associate director of the BC Injury Research and Prevention Unit at BC Children’s Hospital, Dr. Shelina Babul, who developed a widely used concussion awareness training tool, or CAT, said of the project “Athletes are starting to take concussion more seriously”.

As I explained, this is not just about athletes. In fact, Canadian society still presents major disparities when it comes to education about and treatment for brain injuries.

There are a lot of things that we do not know. The absence of a comprehensive strategy means that we cannot educate the public and ensure consistency and continuity of care in every region and for every demographic.

Brain Injury Canada can only offer us an extrapolation of data from the United States, as we currently lack the strategy to compile statistically important information about brain injury in Canada. One of my constituents, Lis Pilon, who founded and supports Concussion Cafe Yukon, has been struggling to pull together statistics on brain injuries in the Yukon. Because these are so often hidden injuries, it is not an easy task for researchers, advocates and legislators.

We need this information, and we need to act to educate and raise awareness amongst Canadians about this issue, as well as develop a strategy to respond to appropriate resource and treatment needs for our different communities, whether for large urban centres or whether small, rural communities like in my riding. We cannot afford not to act. Even based on the known incidence of brain injury, it is projected that hospitalization costs for TBI in Canada will increase to $8.2 billion by 2031.

My colleague’s bill calls on the Minister of Health to work with the different levels of government, indigenous groups and relevant stakeholders to support and improve awareness, prevention and treatment, as well as the rehabilitation and recovery of persons living with brain injury.

This type of strategy will contribute to guiding the response of health care workers and other professionals involved in the diagnosis, reduction and management of brain injuries and to promoting research and the collection of indispensable data.

Such a strategy can also contribute to coordinating resources, both for the response and for research and data collection on brain injuries and related conditions.

I hope the consultations undertaken as part of such a strategy will include people such as Lis, who recently joined a committee to establish a charter of rights for people with brain injuries in Canada. The text of the bill does recognize that the rights of individuals living with brain injuries will be protected, supported and accommodated in their lives.

I ask members to remember that three more Canadians have experienced a traumatic brain injury since I began this speech. Perhaps that includes someone members know or love.

I think this bill is a logical step forward on an increasingly critical issue. I will be supporting it in the House. I hope to be able to support its passage through committee and through the rest of the legislative process. I hope my colleagues from around the House will do the same.

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Madam Speaker, it is my pleasure to take to my feet today and talk about something that is pretty close to my heart. I have constituents who have lobbied for a national framework on a brain injury strategy. I would like to thank Barb Butler from Wilcox, Tammie Gall in Regina—Lewvan and, from when I was growing up, my babysitter in Rush Lake, Saskatchewan. They came to my office during the January break, when we were in our ridings, and talked about how important this strategy was to them. They talked about their experiences and what happened with their accidents and how their lives were changed forever. I am grateful that they came to me.

With that being said, I am very happy that we will be supporting this bill going forward. I am happy to support the member for Cowichan—Malahat—Langford. We work on the agriculture committee, and I am happy he brought this bill forward. He has outlined a lot of the numbers when it comes to how 1.5 million Canadians are affected by brain injuries.

It is not just the people who suffer the injuries. It is their families, their friends and everything that goes with these very traumatic injuries that happen and these accidents. It goes beyond that. Both speakers before me said that addictions happen with this. The member who brought the bill forward talked about the difficulties and the high price that professional athletes pay, as well as the 5,500 women who are suffering injuries to the brain from domestic violence.

Why I think this is so important is that two of my friends had very traumatic experiences. I grew up with Derek Boogaard. He was an NHL hockey player, and his dad was an RCMP member in Herbert, Saskatchewan. Derek and I played minor hockey together. I always thought I wanted to be in Derek's shoes. He made it. He played junior and then played in the NHL. He played with the New York Rangers and the Minnesota Wild. Derek was a monster of a man. He was six-foot-seven and 260 pounds, I think, on his lightest day. He was the team's enforcer.

When people get concussions and brain injuries, they walk around and nobody sees it. They wonder why the people are not playing and what is going on, because they cannot see the concussion. It is inside. That wears on people a lot also. It is very mentally draining, because everyone thinks, “Why aren't you on the ice?” What happened with Derek was that he was injured and then he got addicted to pills. I always really wanted to be Derek. I thought I might have really been able to take him back when we were young kids.

It really dawned on me when I was a staff member in the Saskatchewan legislature. I actually wrote the statement when Derek died, that the member delivered in Saskatchewan. That just struck home, thinking of his father, mother and brothers. Aaron is still in White City. It is amazing how someone so big, larger than life, can get tackled and taken down by something that no one can ever see. No one knew how much pain he was going through; that is what happens to some of these people. I am just so happy that we are able to come together as the whole House of Commons and realize that this is a silent killer, really, as it has been described to me before.

Another good friend I played hockey with is Rick Rypien. He was the captain of the Regina Pats and played for the Vancouver Canucks. He had similar experiences. Pound for pound, he was probably one of the toughest kids I had ever seen in my life. He had some injury problems and addictions took over for him as well.

We see these larger-than-life people whom this is happening to. I know it is not all about the professional athletes, as the member talked about. However, these people are going through so many difficult situations. When we can make this strategy a national concern and bring it to the forefront and bring more attention when there are injuries to people in our country, it means a lot, not only to the people who are suffering but also to their families. I have talked to lots of families that have had these experiences, and it is something we do not talk about enough.

The member for Cowichan—Malahat—Langford is right. We talk about cancer, and I am wearing my MS carnation today. Those are all very important. To finally have something such as this brought forward on the floor of the House of Commons is a good step forward, in the right direction.

Having Brain Injury Canada on board, and after looking at the statistics Tammy and Barbara forwarded to me, it is overwhelming to see how many people suffer with brain trauma due to car crashes, accidents and lots of times, as the member said, domestic violence. There is something that can be done to help these people if we come together.

My question earlier was about the provincial aspect of this. I know the bill proposes that the minister must consult with provincial health ministers, and that is so important to have in this piece of legislation. I believe health ministers across the provinces will more than engage. I talked to the Saskatchewan health minister previously, and I look forward to having a conversation with the new minister, just to make sure they also have the tools they need and to make sure they come together on this.

I hope that a federal-provincial-territorial meeting can be put on the agenda for health ministers. I hope the Liberals will bring that up in their next conversation to make sure they are talking about this. I love the idea that the minister has to report back to the House of Commons so there would be some accountability when this private member's bill is passed. Accountability is extremely important.

It is nice when we can work together in the House as a unit. This is something that should bring people together. We should be able to have fruitful discussions with health experts and take it to the health committee. I know there are doctors on the health committee. The Conservative shadow minister on health is very keen to help move this forward as well. I listened to the speech by the member for Yukon, and I appreciate his expertise when it comes to the medical field.

I want to bring a personal perspective to what this means to the people in my riding, myself included, when we have the opportunity to stand up and show our constituents that we can work together to move something like this forward. They are very passionate about this. The member who presented the bill said there was passionate advocacy across the country. So many groups came together to make sure this bill gets passed. I am happy that we can work together to make sure we get this done.

Hopefully, we can get a strategy in place that helps people such as Derek and Rick, so when people sustain those injuries, they can get the help they need and do not turn to self-medicating. That is something that people do way too much when it comes to injuries like these. The medication is what starts them down the road to a place where they sometimes cannot get back from.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I will end the suspense by announcing right away that the Bloc Québécois will be voting in favour of the bill. Still, I would like to emphasize our reservations regarding the creation of multiple national strategies. First, they often disregard the jurisdictions of Quebec and the provinces. Second, they sometimes seem to disregard, or at least fail to take into account, what is already being done in Quebec.

The bill seeks to make the federal government the puppet master, when Quebec already has its own unique approach to treating traumatic injuries, which include brain injuries. We did not wait for a federal brain injury strategy before taking action. Let us look at what is in the bill. Let us examine the points one by one:

(a) promote the implementation of preventive measures to reduce the risk of brain injuries;

That is a good thing. Specifically as an employer, but also as a contributor to a number of organizations and events, the federal government must ensure that brain injuries are prevented as much as possible.

(b) identify the training, education and guidance needs of health care and other professionals related to brain injury prevention and treatment and the rehabilitation and recovery of persons living with a brain injury;

Training health care professionals falls to the provinces, to professional associations. Furthermore, brain injuries are treated by hospitals, which are also under provincial jurisdiction. Therefore, the federal government cannot identify anything, but it can certainly help identify needs and participate in the collective effort to address the concussion epidemic.

In order to address brain injuries, Quebec has its own organizational model, known as the trauma care continuum. This model has four objectives: accessibility, efficiency, quality and continuity of care and services. The program was implemented in the early 1990s and continues to evolve by encouraging co-operation mechanisms, research and an assessment process implemented with trauma care continuum assessment functions. This involves collaboration between Quebec's ministry of health, the Institut national d'excellence en santé et en services sociaux or INESSS, the Société de l'assurance automobile du Québec, and the Commission des normes, de l'équité, de la santé et de la sécurité du travail or CNESST.

Regarding brain injuries more specifically, Quebec also has an action plan for the prevention and management of concussions in sports and recreational activities, and it has had a concussion management protocol since 2019. The protocol includes a tracking sheet for recording information to be shared with participants, parents, and recreational, school or sports organizations, as well as health care system personnel. It outlines the steps to take based on a participant's condition after an incident, though it should not be used to diagnose a concussion and is not a substitute for a medical opinion.

I also want to note that Quebec and its specialists, like all the provinces of Canada, train their workers and establish guidelines for their professionals in the treatment of brain injuries. For example, INESSS partnered with the Ontario Neurotrauma Foundation to publish the Canadian Clinical Practice Guideline for the Rehabilitation of Adults with Moderate to Severe TBI. The INESSS even has a tool called “Decision Algorithm for Serious Neurological Complication Risk Management Following MTBI, Adult Clientele” to assist professionals with their decision-making.

(c) promote research and improve data collection on the incidence and treatment of brain injuries and on the rehabilitation and recovery of persons living with a brain injury;

Promoting research is an essential role for the federal government. It is something the government is doing and should be doing. One example is Université de Montréal's research centre in the psychology department.

This Canada research chair in paediatric traumatic brain injury does rather extraordinary work and she does indeed receive funding. The chair is trying to better understand traumatic brain injury in young children.

(d) promote information and knowledge sharing with respect to brain injury prevention, diagnosis and treatment and the rehabilitation and recovery of persons living with a brain injury;

The promotion of information and knowledge here and abroad is a mission the federal government is asked to do and is participating in. For example, it is working with the Parachute organization on the publication of the Canadian guideline on concussion in sport.

(e) create national guidelines on the prevention, diagnosis and management of brain injuries in all communities, including recommended standards of care that reflect best methodological, medical and psychosocial practices;

As previously mentioned, Quebec already does this with its own model. As long as the federal government is trying to collaborate and not establish or impose, then we support the initiative.

(f) promote awareness and education with particular emphasis on improving public understanding and protecting the rights of persons living with a brain injury;

For an awareness campaign to be effective, it must be adapted to its context. Given that the Quebec government provides the services and resources, it is in the best position to run those campaigns. In fact, it is already doing just that. There are many websites and brochures available to the public that are designed to prevent or recognize the symptoms of brain injuries.

(g) foster collaboration with and provide financial support to national, provincial and local brain injury associations and brain injury service providers to develop and provide enhanced and integrated mental health resources for persons living with a brain injury and for their families;

If the federal government wants to use tax tools to help families facing additional costs or loss of income because of a brain injury, the Bloc Québécois invites Ottawa to do so. I would add that the EI reform promised by the Liberals has yet to happen.

(h) encourage consultation with mental health professionals, particularly in educational institutions, sports organizations and workplaces, to provide persons who are suffering from the effects of a brain injury, including mental health and addiction problems, with a support system within the community;

Encouraging consultation is all well and good, but where mental health is concerned, access is the problem. Quebec lacks the resources needed to train more psychologists and social workers. It also needs resources to provide better working conditions for its professionals to retain them in the public system and in community organizations. If the federal government wants to financially support our health care systems, it will come as no surprise to anyone that increasing health transfers is the way to go about it. The Bloc Québécois supports that.

The Bloc Québécois would remind members that one of the major problems with Canada's health care systems is federal government under-investment. The federal government needs to increase transfers to 35%.

(i) identify challenges resulting from brain injury, such as mental health problems, addiction, housing and homelessness issues and criminality, including intimate partner violence, and work to develop solutions in collaboration with stakeholders;

Health, including mental health, falls under provincial jurisdiction. The same goes for addiction, housing and homelessness. If the federal government wants to fund research on those topics, then we invite it to do so. When it comes to criminality and violence, that is an area in which the federal government can and should take action.

(j) maintain, in collaboration with Brain Injury Canada, a national information website providing current facts, research and best practices related to the diagnosis and management of brain injuries, as well as other relevant resources;

When I read that, I found it a bit strange that a bill would explicitly give an organization the responsibility to maintain a website on brain injuries. In any case, we believe that Quebec and the provinces are in the best position to inform people of the resources that are available and of the action they should take if they experience a brain injury.

(k) establish a task force to include policy makers, stakeholders, community agencies, brain injury associations and Indigenous groups, as well as persons who have experienced a brain injury and their families, to make recommendations in relation to the national strategy.

We agree on that, and as I said earlier, we look forward to taking this to committee so we can make some adjustments. Then we can vote in favour of the bill.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Madam Speaker, it is a huge honour today to rise and stand in solidarity in support of Bill C-277, a national strategy on brain injury. It is a bill that I have had the fortunate honour to be the seconder of. It was tabled by my good friend, the member for Cowichan—Malahat—Langford. I am so grateful that he chose to move the bill in his order of precedence, because brain injury is such an important injury.

I also want to give a huge shout-out to the people from Brain Injury Canada for the important advocacy and work they do. I was fortunate to stand alongside them today at a press conference here, just outside the House of Commons, in solidarity with the important work they are doing in their advocacy.

We see again and again in Canada that justice issues are health issues and that health issues are often injustices in our country. The epidemic of brain injuries, with more than 165,000 traumatic injuries per year, is without question a significant health issue. Nobody can dispute that. What Canadians need to know is that brain injuries are an issue, like I said, of justice, but that we also need better treatment, better prevention and better information to keep people safe from these injuries and to help survivors, their families and others who love them to move forward.

We need a national strategy on brain injury, or we will really be turning a blind eye to an injury that affects the most vulnerable in our society and makes their lives worse. I have to say that it was just overwhelming to hear today's speeches from the Liberals, the Conservative Party and the Bloc, all in support of this very important initiative. I hope we will see unanimous support for the important bill before us.

We all agree that our health care system is a two-tiered system when it comes to physical and mental health. We need to achieve parity between mental and physical health; that is something that we have long been advocating for as New Democrats. When it comes to brain injuries, this is something that collectively we can work on.

We know that not all people who suffer brain injuries suffer them in the same way. I want to note that many of the most vulnerable Canadians, those who have been overlooked and underestimated by our government and society, are the people who are most likely to suffer brain injuries. Every year, thousands of Canadian women receive brain injuries from the abuse of their domestic partners. Fifty-five hundred Canadian women suffer a concussion from their partners for every NHL player who has had a concussion. That is unbelievable. We need to understand that brain injuries are a matter of gender justice.

Children who are the survivors of abuse are, likewise, more likely to grow up with a traumatic brain injury. They are less likely to attend university, and by the time they enter the job market, they are less likely to find well-paying jobs and are less likely to escape the very same cycles they were raised in. People with traumatic brain injuries are more likely to perpetuate physical abuse within their own families. Brain injuries are a matter of intergenerational justice.

Indigenous Canadians are disproportionately likely to have suffered brain injuries, and in most rural and northern communities, there are few or no resources available for people who have incurred concussions or other traumatic brain injuries. We know that brain injuries are a matter of reconciliation and indigenous justice.

Three-quarters of brain injury survivors are unemployed. That is totally unacceptable to every member of the House. More than half of Canada's unhoused population have suffered some kind of head injury.

The financial impact of a brain injury can be devastating. Canadians may lose the ability to commute to work, to perform their job or to move at all because of their brain injury. Also, survivors are more likely to live in poverty. Brain injuries are a matter of economic justice.

Canadians with brain injuries are twice as likely to succumb to addiction and to substance use disorder. Those Canadians are more likely to receive further brain injuries because of long-term poisoning from toxic drugs or immediate damage from overdoses. We know about the toxic drug crisis that is ravaging not just Canada but also the United States and the rest of North America.

I sat at the health committee last week and listened as leaders of Canada's police forces and the B.C. chiefs of police talked about the toxic drug crisis. The message I heard was clear and unequivocal: We cannot have justice without a health-based first approach when it comes to the toxic drug crisis.

The epidemic of brain injuries across Canada is not a problem we can ignore any longer. I want to thank Leonard Krog, the mayor of Nanaimo, who constantly talks about the impact of not supporting those with brain injuries on Vancouver Island. He has been a strong advocate. I want to thank Leonard for the important advocacy he has done.

We know brain injuries are the number one cause of death and disability for young Canadians. The Comox Valley Head Injury Society wrote me a letter, which reads:

As outlined by the World Health Organization, Traumatic Brain Injury (TBI) is projected to surpass numerous diseases as a leading cause of death and disability by 2020. In Canada, the annual incidence of acquired brain injury (ABI) is alarmingly high, surpassing that of spinal cord injuries, breast cancer, and HIV/AIDS combined.

These are really terrible things, and they are big and important issues to all of us here, so members can image that combined. The letter continues:

Despite the staggering statistics, the true scope is likely underestimated due to unreported cases stemming from concussions, intimate partner violence, violence among the homeless, incarceration, combat injuries, and survivors of opioid/stimulant poisoning.

We talk about veterans and the impact on veterans. We heard that today at the press conference as well. I want to thank those who spoke today and mention the importance of the words they used.

For decades, successive Conservative and Liberal governments have ignored calls for a coordinated response on this file. Hopefully, today we are seeing everybody come together. In that time, though, the cycles of inequality caused by head injuries has continued. We can no longer turn our backs on the most vulnerable Canadians. We cannot let these injustices continue. Again, I am grateful to my colleague from Cowichan—Malahat—Langford for ensuring that does not happen by bringing forward this bill.

These issues cannot wait until the government finally decides to take action. Rates of brain injuries continue to rise. Our population is aging, and the toxic drug crisis, as I mentioned, is worsening. As a result of the number of Canadians living with brain injuries, this is rising.

Stephanie McGowan, the executive director of the Comox Valley Head Injury Society, told us that, if we do not get behind it now, it is going to cost a lot more people in the future, and their families, of course, who support them. If someone does not think this is an issue that affects them, I guarantee it does. According to Stephanie, everybody knows someone with a head injury, whether they know it or not. We heard about hidden injuries, and certainly brain injuries is an example of them. We heard that from a speaker today at the press conference.

Many people do not want to share their injuries. Women who have suffered domestic violence, for example, may choose to hide their injury for their own security. Certainly, this issue affects my riding of Courtenay—Alberni. Seniors, people involved in outdoor sports and the unhoused are all at higher risk of brain injuries, and those three groups are well represented in the population of the Comox Valley, which the Comox Valley Head Injury Society represents.

Again, one of my constituents in the Comox Valley has seen the injustices of traumatic brain injury first-hand. She lost her home after her injury put her into a position where she could no longer keep up with the cost of daily life. Now she has been in and out of shelters without a reliable place to stay. She has had her possessions stolen. Without a home, she has been unable to find bathrooms to safely use the medicine she needs for heart disease. She has been in and out of the hospital. With every single thing being more difficult for her as a result of her injury, she has been unable to escape from this cycle of injustice.

My constituent's story is not unique. In the same community, we have heard from survivors who are not able to rent an apartment because many landlords refuse to rent to someone without the money to pay upfront or with behaviour struggles. Other survivors have been exploited by their landlords, defrauded and stolen from because of their vulnerability. Some constituents leave the city for remote communities, where they can afford the cost of living but where there are no resources for brain injury survivors.

It is time for a national strategy on brain injuries. It is time for Canada to take responsibility for this issue and create a plan to tackle it. It is time for the federal government to start treating brain injuries as an issue of both health and justice. Again, Stephanie McGowan put it best when she said that, without brain injury resources, our unhoused population goes up, people self-medicate and our prison system becomes even more overburdened.

I have so many things I would like to continue to say. This bill would enable the development and delivery of enhanced and integrated mental health services for individuals living with brain injuries and their families. As the mental health and addictions critic for the NDP, I really do welcome this bill, and I want to thank my colleague again for bringing it forward.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, I want to congratulate the member for Cowichan—Malahat—Langford for bringing forward Bill C-277.

I have been listening to the debate today, and to be completely honest, I had not informed myself much on the bill until this point. I certainly think this strategy the member is proposing is an important one, for many of the reasons I heard in the House today about how brain injuries, specifically, are not as visible as other injuries people might sustain have from time to time. I really took to heart some comments I heard from my Conservative colleague today when he talked about the experience he had with a particular friend whom he played hockey with, the realities of brain injuries and what he witnessed someone close to him go through.

Quite frankly, I think it is time that we get to the point where we can send the bill to committee so that the committee can look at this. I do appreciate some of the concerns from the Bloc that perhaps there are some jurisdictional boundaries here, but I am convinced that we can work our way through those.

I look forward to the second hour of debate on Bill C-277 and perhaps adding a little more at that time and, ultimately, seeing the bill go to committee so that it can studied.

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

It being 7:29 p.m., the time provided for the consideration of Private Members' Business has now expired, and the order is dropped to the bottom of the order of precedence on the Order Paper.