Bill C-295

An Act to amend the Criminal Code (neglect of vulnerable adults)

This enactment amends the Criminal Code to create an offence for long-term care facilities, their owners and their officers to fail to ensure necessaries of life are provided to residents of the facilities.
The enactment also allows the court to make an order prohibiting the owners and the officers of such facilities from being, through employment or volunteering, in charge of or in a position of trust or authority towards vulnerable adults and to consider as an aggravating factor for the purpose of sentencing the fact that an organization failed to perform the legal duty that it owed to a vulnerable adult.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you very much, Mr. Chair.

I thank the three witnesses for being here today.

I will also take a moment to recognize National Nursing Week. This concerns today's witnesses. Nurses are doing an outstanding job.

To follow up on what Mr. Lake said in response to a question, I remain convinced that it is not just health care for seniors that is underfunded, but all health care in general in Canada. That is why I am making a heartfelt plea and, in solidarity with nurses, I continue to call for an increase in health transfers. This is one of the Bloc Québécois' positions, and today's topic is directly related to this increase. We have talked about the importance of the increase we are calling for to bring the federal share of funding up to 35%. We can't think about better funding and better support for staff if we don't also think about better support and more financial resources for the health care system.

That was my little introduction.

I would now like to turn to Ms. Hall.

In response to some questions, you said that Bill C‑295 targeted only specific types of facilities and, therefore, did not meet all the needs in terms of abuse. Abuse does not occur only in long-term care facilities or in one type of residence. We are also seeing a diversification of the types of places where seniors live, and we must take that into account when we talk about abuse. I know that in Quebec, in particular, there is a lot of scrutiny of home care.

You also say in your brief that Bill C‑295 targets only one specific type of abuse—physical abuse—while there are many other types of abuse, including financial abuse and emotional abuse.

Could you comment on the shortcomings of Bill C‑295 in this regard and on the measures that could be taken?

[Jodi Hall]

We remain deeply concerned about the overall scope and impact of Bill C-295 as presented. We feel that many of these challenges are already addressed within provincial legislation and within the Criminal Code as it exists today.

Certainly moving away from this legislation would be our first choice. Second to that, if the committee is putting this bill through, we would ask that they reconsider the definition of “manager”, in that it's specific only to the long-term care manager, as well as the definition of “long-term care facility”. We would recommend that they apply more broadly across the health care system.

For us, when we consider that the intent of this bill is to address elder abuse and that very similar staff would be providing very similar care in a hospital setting, for example, why would this legislation only target elder abuse that would be present in a long-term care environment and not in a hospital setting?

As for recommendations for amendments, it would be to focus on those areas and broaden out the setting and the professionals that the bill would apply to.

[Jodi Hall, Chief Executive Officer, Canadian Association for Long Term Care]

Members of the committee, I want to start by thanking you for inviting me to appear before you today to discuss Canada’s long-term care sector.

My name is Jodi Hall, and I am the CEO of the Canadian Association for Long Term Care. CALTC is committed to ensuring quality long-term care for all, and we advocate on behalf of seniors in long-term care homes and our members. Our members include many of the provincial long-term care associations and a range of long-term care operators from non-profit, faith-based, and private corporations.

CALTC appreciates that the spirit of the proposed bill is to protect vulnerable adults, and we support the introduction of legislation that would address elder abuse in Canada. However, the bill before the committee does not accomplish that. If it were to pass in its current form, I believe it is likely to have a devastating impact on the long-term care sector throughout the country.

Long-term care homes are currently facing a number of issues that impact their ability to be sustainable. First, the health human resources crisis is a critical challenge. The latest data from Statistics Canada from the final quarter of 2022 notes that there are over 38,000 vacant positions in Canada in long-term care homes. This is more than double the number of vacancies in 2019.

Provinces are making investments in long-term care, and the leadership and frontline teams in long-term care homes remain dedicated to providing high-quality resident care every day. However, they are doing so with limited resources, and many are in homes that have aging infrastructure.

Our sector needs support. We face significant, systemic issues, including widespread staffing shortages, aging infrastructure and chronic underfunding. These are not new issues. Decades of underinvestment laid the foundation for the perfect storm, which painfully played out through the pandemic and has left homes to continue to struggle today.

In the last election, the government committed to investing $9 billion in long-term care over five years. Unfortunately, we are still waiting for that commitment to be realized. These investments could be used to help support the recruitment of staff, to increase our standards of care and to invest in the much-needed infrastructure that's required.

While long-term care has received more attention as of late, we have not, as a country, come together to talk about creating a sustainable long-term care sector. In the next 15 years, there will be another 10 million seniors in Canada. We need to address the questions around long-term care sustainability, but today we are here to address Bill C-295.

CALTC members are unequivocal in our denunciation of elder abuse in all forms. This bill that has the potential to have a devastating impact on long-term care homes while not addressing the multi-faceted considerations that are needed for elder abuse legislation in Canada.

As well, “manager” is so broadly defined within this bill that it includes almost all long-term care staff. As it stands, this bill focuses on employees in long-term care and only in long-term care, as other settings—for example, a hospital—that provide similar care with similar employees, often to those who are waiting to be admitted to a long-term care home, are not noted.

We believe that this will further increase the challenges around recruitment and retention. Creating further obstacles to recruitment and retention for long-term care is not the way to improve quality or safety in the homes.

All levels of government have the opportunity to work with the long-term care sector to build a resilient path forward. Unfortunately, I believe the bill as presented does not take advantage of that opportunity. Moving forward, the government should launch inclusive consultations with long-term care residents, families, providers and others in the health care system to identify existing gaps in elder abuse protections and how best to effectively address them without causing unintentional impacts, as this private member’s bill will do.

If the committee should choose to proceed with the bill, we ask that at the very least the scope of the bill be not limited to long-term care facilities and long-term care managers but be refocused on all health care settings and all health care professionals so as to not result in inequities in recruitment and retention being directed at long-term care homes alone.

I thank you for the opportunity to speak, and I'm happy to take questions.

[The Chair, Liberal, Randeep Sarai]

I call this meeting to order.

Welcome to meeting number 65 of the House of Commons Standing Committee on Justice and Human Rights.

Pursuant to the order adopted by the House on March 8, 2023, the committee is meeting in public to continue its study on Bill C-295, an act to amend the Criminal Code.

Today's meeting is taking place in hybrid format, pursuant to the House order of June 23, 2022. Members are attending in person and remotely by using the Zoom application.

I'd like to make a few comments for the benefit of witnesses and members.

Please wait till I recognize you by name before speaking. For those participating via video conference, click on the microphone icon to activate your mike, and please mute yourself when you are not speaking.

For interpretation, those who are on Zoom have the choice at the bottom of your screen of floor, English or French. Please adjust to the desired setting now. Those in the room can use the earpiece and select the desired channel.

I remind you that all comments should be addressed through the chair. For members in the room, if you wish to speak, please raise your hand. For members on Zoom, please use the “raise hand” function. The clerk and I will manage the speaking order as best we can. We appreciate your patience and understanding in this regard.

Now I would like to welcome our witnesses, who are all appearing by video conference today.

First we have, from BC Care Providers Association, Terry Lake, chief executive officer—

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

That's fair enough.

You highlighted that there's a new definition for “long-term care facility” and a definition for “manager”, but there's no definition in Bill C-295 for owner, yet owners—whatever or whoever that might be—could be criminally charged.

Wouldn't your legislation be improved by having a clear and concise definition of who an owner of a care facility is?

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you, Chair, and thank you very much, colleagues, for inviting me here to speak on my bill, Bill C-295.

I think it is an important bill, even though it sounds like a simple bill. It's an important bill, because the issue of long-term care is a provincial jurisdiction. It is not in the Canada Health Act. It's purely provincial jurisdiction. The only way the federal government can have a role is to do something within its jurisdiction, which is the Criminal Code.

What this bill is meant to do is amend sections 214 and 215 of the Criminal Code to protect vulnerable adults. It extends the definition to vulnerable adults. Currently, sections 214 and 215 deal with child abuse and negligence. We are now using it to extend the definition to vulnerable adults.

The bill puts in some specific definitions. It tells us what a vulnerable adult is. A vulnerable adult is a person who, by virtue of age, mental or physical illness, or disability, is frail. That's meant to be a vulnerable adult. The ability to take care of that vulnerable adult follows completely through with sections 214 and 215 of the Criminal Code with regard to children.

Why are we doing this? We're doing this because currently the only national standards that we have for long-term care, which is a provincial jurisdiction—and I want to keep stressing that—is a national voluntary set of standards. Everyone should and could try to...etc. There is no mandate for this. This continued on for a very long time, until COVID-19 exposed the vulnerability of that system.

As we well know, about 54% of all long-term care facilities are run by the private sector. Many of them are not-for-profit. Some are run by the church-based sector, but most of them are just private.

I think, again, it's what we saw after COVID-19. We found that while only 3% of people who got COVID-19 were in long-term care facilities, they made up 43% of those who died. That was really out of whack. It was an overbalance of that.

At the same time, while other countries had 41% of people in long-term care facilities dying from COVID-19, in Canada we actually were the worst. We had about 69% of our seniors getting COVID-19, and dying from it, as we well saw.

I think the reason is that we don't have mandated standards. The federal government cannot stand up and mandate standards. It is something the provincial government's going to have to do.

Currently, what this bill does is it defines who a vulnerable adult is. It expands the duty of care from a child to a vulnerable adult. It actually puts in some other definitions. For instance, it defines what a “long-term care facility” is. A long-term care facility is where three or more people are vulnerable by virtue of—as I said before—age, mental illness, physical illness, disability, etc. They are not related to the caregiver by blood or marriage. That rules out somebody who's looking after grandma or grandpa at home. This is about a facility. There must be three or more people in the facility.

Now, it defines “manager”. What is a manager of a long-term care facility? It defines what a manager is and the duty of that manager. It defines what that duty is. There is “failure to perform”. If that manager fails to perform a duty to provide the necessities of life and the appropriate care to vulnerable adults, then they would be liable, as obviously this bill tells you, to certain penalties—a fine or jail time.

It also talks a little about what was wrong. Why did COVID-19 expose this problem that we didn't know about before? As a physician, I knew. I knew about the problem with long-term care units. I looked after patients in some of these units. We knew what the problems were.

After what happened with COVID-19.... As you know, the armed forces went in to help in some of these facilities. Their report is scathing. It talks about how, in fact, many of the people in these areas.... The cleanliness was lacking; protocols were lacking; most of the aides who were performing the work to take care of seniors had no formal medical education or health care education or training—they were just doing this. They were moving from patient to patient during COVID, using the same gloves and the same protective equipment; they did not often wash their hands, and I think those are the things that we saw.

What this bill is striving to do is.... The Canadian Standards Association has set standards that are very clear for what is required to care for vulnerable adults in these facilities. What this is doing is saying to managers and owners of these facilities, if you don't do it, you're going to be penalized. It brings in teeth and accountability to something. This is the only way that the federal government can intervene.

I'll leave it there, and I'll be happy to answer any of your questions.

Thank you.

[The Chair, Liberal, Randeep Sarai]

I call this meeting to order.

Welcome to meeting number 64 of the House of Commons Standing Committee on Justice and Human Rights.

Pursuant to the order adopted in the House on March 8, 2023, the committee is meeting in public to begin its study of Bill C-295, an act to amend the Criminal Code (neglect of vulnerable adults).

Today's meeting is taking place in a hybrid format, pursuant to the House order of June 23, 2022. Members are attending in person in the room and remotely using the Zoom application.

As you're all members, including the panellist, I won't go into how to use Zoom or your interpretation functions.

In the interest of time, I would now like to welcome Dr. Fry to our committee.

Dr. Fry, the floor is yours. You have five minutes. Then we'll have questions and answers right after.

Criminal Code

[The Deputy Speaker, Conservative, Chris d'Entremont]

Pursuant to order made on Thursday, June 23, 2022, the House will now proceed to the taking of the deferred recorded division on the motion at second reading stage of Bill C-295, under Private Members' Business.

The House resumed from February 17 consideration of the motion that C-295, An Act to amend the Criminal Code (neglect of vulnerable adults), be read the second time and referred to a committee.

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

Mr. Speaker, I am very happy to be here today as the seniors critic for the NDP to talk about Bill C-295, an act to amend the Criminal Code targeted at neglect of vulnerable adults.

This bill would do two things. First, it would amend the Criminal Code to create a specific offence for long-term care facilities, their owners and managers to fail to provide the necessaries of life to residents of the facilities. Second, it would allow the court to make an order prohibiting the owners and the managers of such facilities from being, through employment or volunteering, in charge of or in a position of trust or authority towards vulnerable adults and to consider as an aggravating factor for the purpose of sentencing the fact that an organization failed to perform the legal duty that it owed to a vulnerable adult.

I am going to be in support of this bill. We saw dreadful outcomes during the pandemic. So many seniors across this country faced challenges that we cannot imagine and then there were deaths beyond our imagination. It is really important, as we remember this time, to remember the men and women in uniform who serve this country, who were sent in to some long-term care facilities and saw things they were horrified to see in their own country.

It is really important to understand that when we ask those in our military to step up for us, they are used to stepping up outside of our country in these kinds of circumstances. They were in this country and saw seniors who had died just because of neglect, because they were dehydrated. This is Canada and that should never happen. Those folks did a huge service to us, something I hope they never have to do in their own country again.

It is also important to point out that the vast majority of seniors never enter long-term care. That is important. I hear from the Seniors Advocate in British Columbia all the time that we should remember most people stay at home and that is where they end their lives. However, when seniors move into such facilities, families and loved ones need to know those people are safe and that standards are in place, something they can put their trust in.

We know that sometimes families move their loved ones to be closer to them from one province or territory to another. What is surprising is that the standards are different in each part of this country, which really leaves increased vulnerability. I appreciate that the government did table some long-term care standards, but the thing that was terrifying to me is that they are voluntary. A lot of good work was done in looking at those standards, making sure they made sense for long-term care, and now we see that they are voluntary.

This worries me because it provides a huge risk to seniors and the people who love them most. Again and again, we see loved ones doing the best that they can. If they live far away or there are any kinds of challenges, knowing that their loved one is in a long-term care facility and not getting the support that they want makes people feel ill.

I am going to quote something important by Candace Rennick, CUPE's national secretary-treasurer, who said:

Voluntary standards did not protect the 17,000 residents of long-term care homes who have died so far because of COVID-19. Canadians want better protections for seniors. This country needs standards that are backed by the force of law. People need to know that their loved ones will spend their last days living with dignity and respect. They need to know that there will be penalties and consequences for long-term care service providers that don’t follow the rules.

If all we have in this country is a national voluntary standard, there will never be the level of accountability that I think Canadians want to see.

This bill would amend the Criminal Code, but I am afraid that it will not do all that it must to protect seniors. We need more long-term support for them and a practice of having more accountability. What this really means to me is that when seniors die in this situation, there need to be actual charges laid, and we are not seeing that. We are seeing families taking on long-term care facilities, and that is not right. There needs to be a process and we need to start having charges laid. That is a real deterrent.

Graham Webb, executive director and former staff lawyer of the Advocacy Centre for the Elderly, has called the Criminal Code amendments “a very viable approach”. However, he said, “I'm really not aware of a single charge ever having being laid for the neglect of a long-term care resident. I think it’s important that the criminal justice system is able to respond when we see such flagrant cases of institutional abuse and neglect of older adults.”

I think that is startling. Even if we see a minor change to the code, it is still not fulfilling the other end, which is the actual movement toward laying those charges and holding people accountable.

Members know just as well as I do that when people are held to account, other people observing start paying attention. I think it is shameful that in this country seniors are so vulnerable that they can be sacrificed without a thought. They built our country. We owe them so much more, and we owe them dignity.

One of the things I found particularly painful in my role as the seniors critic is how many people with loved ones in a seniors facility have come to my door and talked about how hard they worked to try to look after them. They could not always be there the way they wanted to, because they had to work or because they had children. Then, when they went to visit, they saw things that horrified them, and they fought in that system the best that they could and with everything they had. Now that their loved one is gone, the pain is so raw that they do not want to talk about it because of the guilt they feel. They feel guilt because our system is broken. That is wrong, and that is why we must fix this.

To me, it goes back to the simple reality that we need to see the long-term care standards in legislation. We need to raise the bar. I get that every province and territory wants to do their own thing. I respect that, but let us make this the bar. If any province or territory wants to be higher than that bar, good for them. Let us make sure that no senior in all of Canada falls below it. Let us make sure that no family is in a position that they would think of moving their loved one from one province to another, simply so that they get better care. That is ridiculous.

I think Canadians need to listen to those on the front lines. For example, Natalie Mehra, executive director of the Ontario Health Coalition, noted that there has been “no consequence whatsoever” for the abuse and neglect that was exposed during the pandemic, or for the needless deaths of residents due to poor infection control and non-COVID-19 reasons, such as dehydration and starvation. How could a senior be starved to death in this country? This is Canada. She further noted, “I think we need to search our conscience if the lives of the elderly are not worth a formal government bill and real change with teeth.”

As we vote on the bill before us, which hopefully people will support because it is a small change in the right direction, I hope we all think about our commitment to the people who built this country. Those people are increasingly vulnerable as they age. Think about the hard-working families who are doing everything they can to support that loved one. Think about the fact that we still do not have legislation that has teeth so that we can make sure to support seniors as they age.

In closing, as a person who represents a rural and remote community, we also have to recognize that those in small communities often see their loved ones go far away to get long-term care. They have to travel a great distance, which means they cannot be with them. Let us all fight to make sure that wherever one's loved is, they are safe.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Mr. Speaker, today I rise to talk about Bill C-295 and the new offences it would create in cases of neglect of seniors. The neglect of seniors and vulnerable people is a serious problem in Canada, and abuse is endemic.

Ensuring the protection of vulnerable seniors is a very personal matter for me. My grandfather and his companion were defrauded by a caregiver. They were vulnerable seniors who were victimized by an individual who they had every reason to believe they could trust. The circumstances are sadly familiar to thousands of other families who have endured senior abuse. They spent the final months of their lives worrying about money.

My grandfather's companion of nearly 30 years not only endured my grandfather's final months of illness and death, but also feared confrontation with the individual who defrauded them and remained in their neighbourhood. She worried about running into her at the grocery store or other places. My grandfather, who was 90 years old and in ill health at the time, did not live long enough to see justice done.

The police did not treat the case as a priority despite the case being relatively simple and straightforward. There was a poster in the police station that invited members of the public to report situations of abuse. The public communication around this problem is that it is a problem and should be reported to police, yet the police are slow to act and did not act within my grandfather's remaining time alive.

My grandfather was luckier than many. He had the support of family and was not ruined financially by the fraud. The particular fraud was not sophisticated and it was detected. Eventually, charges were laid and an arrest was made. He was not injured in body and was not denied physical care, but he was a vulnerable person like so many other Canadians.

I thank the member for drawing attention to the issue of vulnerable Canadians through this private member's bill. This bill is welcomed.

Sadly, neglect does not only occur in institutional settings, but this bill would address issues where neglect within institutions occurs by making changes to the Criminal Code that would hold operators and managers of such facilities to account when they neglect to provide the necessities of life to people in their care. I think all Canadians would agree that this level of neglect is a criminal matter and ought to be a criminal matter.

This bill would also allow courts to make an order prohibiting persons charged with certain offences from working in proximity to vulnerable Canadians. That is a good step forward as well.

There is so much that could be done. With private member's bills, we are very limited in what we can do with the one chance we get if we draw a low number for Private Members' Business. I certainly do not blame the member for all the things her bill does not do. However, there are many problems that need to be addressed, including fraud, emotional abuse, violence against seniors, abuse, neglect and other harms that occur outside of institutional settings. These are pressing issues the government needs to deal with.

I am disappointed by the government in this case. It has taken a private member's bill to make any headway on this issue, despite the Minister of Justice's own mandate letter, which calls upon him to take action. His mandate letter calls upon him to finalize a proper definition for “elder abuse”. It calls upon him to get better data on this problem and to establish new offences and penalties. He has not done so. This bill from a private member will, but the government, which has said this is a priority, has failed to do so.

The bill would actually fulfill a piece of the Conservative platform that my colleagues and I were elected on, so I certainly support the member in this. It does not matter to me who gets credit in this kind of thing. We want to improve the lives of Canadians, and that is what we can often do in Private Members' Business, so I support her efforts, but I am disappointed in the government for its lack of progress in this area.

We have a minister who was tasked with this, and I wish he had spent more time on protecting vulnerable Canadians than he has on expending enormous effort on Bill C-21, where the Liberals have had to backpedal on those amendments they put forward at committee. There was Bill C-5 that the minister put forward, which would actually weaken penalties and sentencing for violent crimes and other crimes.

Therefore, it is disappointing that we do not have a minister who will take this seriously, but fortunately we do have a private member who is taking a positive step forward.

We know the vulnerabilities of seniors in institutional care, like the vulnerability to neglect. This was all laid bare during the pandemic. We heard other members comment on this. The abandonment of vulnerable seniors, the failure to supply the necessities of life to seniors, is appalling. It was appalling to many Canadians, so action needed to be taken.

It is outrageous, really, that the Canadian Armed Forces would be called in to provide care in seniors facilities. That is not the purpose of our armed forces. That is not something we would normally think of in terms of aid to civilian authority by the Canadian Armed Forces. We are thankful for their ability and the work they did, but what a failure it was, down to an individual level in some cases, and certainly a failure of the management of facilities to ensure that vulnerable Canadians are able to get the necessities of life.

On the data, the minister's own report says there is an enormous gap and a failure to understand the extent and patterns of types of abuse, but Statistics Canada knows a bit about that. It says that between 2014 and 2019 the rate of violence against seniors grew faster than for any other age cohort, so we know that violence against seniors is on the rise. We know that fraud among seniors is on the rise.

I support what this member is doing with her bill. I am glad that this House is now taking time for us to give public voice to the vulnerable and to ensure that, I hope, fewer families and fewer seniors spend their final months as victims of crime. With that, I thank the member for her private member's bill.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Mr. Speaker, I thank the member for Joliette, because I want to take the extra minute that he left on the table.

I am pleased to have the opportunity to participate in the second reading debate of Bill C-295, an act to amend the Criminal Code, neglect of vulnerable adults.

At the outset, I would like to start by applauding the member for Vancouver Centre for her leadership on this file and for emphasizing that caring for and protecting vulnerable persons and adults is of the utmost importance. It is an important topic of discussion, not only to me personally, but also to my constituents at my seniors community council meetings.

I would like to acknowledge the following private and public long-term care facilities, along with their staff, for the great service they have been providing to the community of Richmond Hill: the Mon Sheong Care Complex, the Revera Elginwood Long Term Care Home, the Richmond Hill Retirement Residence, Delmanor Elgin Mills, Sunrise of Richmond Hill, the Langstaff Square Care Community and Mariann Home Richmond Hill.

Protecting vulnerable residents in long-term care is a laudable and important goal, not only for me and my constituents, but also for many Canadians. This issue is of national importance. Canada's population is aging, and more persons may find themselves living in institutional care or will be in the near future. Statistics Canada reported that the number of people over the age of 65 has increased by 42% since 2010. This is the fastest-growing rate among all G7 countries. As our national demographics shift, there will likely be a corresponding increase in the number of residences offering long-term care and the number of adults residing in them.

In addition, more than one-third of women 85 years of age or over live in care facilities. In Ontario, for example, approximately 54% of residents in long-term care are over the age of 85, and approximately 10% are over 95 years old. Importantly, it is not only seniors who live in long-term care. In Ontario, 6.6% of all residents are 64 years of age or younger.

All residents have diverse needs, and we have a responsibility to protect them from abuse. We are so grateful for the many excellent health sector professionals who take care of our vulnerable populations. We want to ensure that all residents of long-term care facilities receive the high-quality service they deserve.

Beyond individual harms, we must also be mindful of systemic issues that adversely impact the quality of life of residents. Systemic practices, such as understaffing, overcrowding and insufficient resources, can all harm those whom have come to care settings precisely because they cannot receive the care they need at home. In light of these statistics and issues, Bill C-295 will address the systemic challenges and the harms that would continue to potentially impact a growing part of our population.

Our criminal law already contains a wide range of measures to address the abuse and neglect of vulnerable persons, including offences of assault, fraud and failure to provide the necessaries of life. Bill C-295 will build on this framework and improve protections in the context of long-term care accommodation. Residents of long-term care facilities accounted for 43% of the COVID–19 deaths in Canada from 2020 to 2021. They were 13 times more likely to die of COVID than non-residents 69 years of age or older.

We have seen too many harrowing situations involving seniors in recent years, and it is our responsibility to ensure that they are provided with an environment free of neglect. This is why our government doubled down on its strong leadership and action to support vulnerable adults all across the country. It will continue its collaborative work with provinces and territories to help support improvements in long-term care, including $1 billon for the creation of the safe long-term care fund and $740 million in the safe restart agreements.

On January 31, 2023, the Government of Canada welcomed the release of complementary, independent long-term care standards from the CSA Group and the Health Standards Organization, or HSO. Together, these standards provide guidance for delivering services that are safe, reliable and centred on residents' needs, that foster a healthy and competent workforce and that create safer physical environments by promoting a culture of quality improvement and learning across long-term care homes. Additionally, budget 2021 provided $3 billion over five years to support provinces and territories in their efforts to improve long-term care in their jurisdictions.

Currently, there are 2,039 long-term care homes in Canada. Forty-six per cent of them are public and 54% are private. The percentage of facilities that are public versus private varies considerably from province to province. For example, 86% of long-term care facilities in Quebec are public, while only 16% are public in Ontario. Whether for profit or otherwise, the operators of such facilities have significant responsibilities to their residents, and this bill would ensure that those responsibilities are fulfilled regardless of the environment where care is provided.

Bill C-295 would provide important new tools to respond to practices that fall below the standard expected and that put seniors and other vulnerable persons at risk. COVID-19 strained our long-term care facilities and shone a spotlight on system weaknesses, offering us a key opportunity to introduce reforms and do right by our elderly and vulnerable populations.

Bill C-295 provides us with this opportunity by introducing the following three major improvements to our Criminal Code.

First, the bill would add a category of persons in section 215 under “Duty of persons to provide necessaries”, specifically targeting owners and managers of these facilities who fail to provide the necessities of life to their residents.

Second, it would create a prohibition order against these people so that for a period of time determined by a judge, they are prohibited from seeking, accepting or keeping any employment, even as a volunteer, where they would be responsible for adults who are vulnerable.

Third, as the sentencing stage is an integral part of the criminal process, following a conviction, a judge must consider a variety of factors to determine the best sentence to impose in the circumstances of the crime committed. This means that Bill C-295 would create aggravating factors at sentencing for an organization that has failed to meet its legal obligations to a vulnerable adult.

I think the reasoning behind Bill C-295 is quite simple: that organizations have a responsibility to the vulnerable, and failure to meet this obligation must be punished in a clear and unequivocal manner.

The situation of vulnerable people in long-term care facilities has been repeatedly denounced over the past few years, with the conditions of these facilities and the care provided coming under increased scrutiny, particularly at the height of the COVID-19 pandemic. While law reform alone will not eliminate neglect and abuse in long-term care facilities, it will send an unequivocal and clear message.

I am proud to fight on behalf of our seniors and other vulnerable populations who use Canada's care facilities. Through this bill, we can inform all facility residents that we care about their well-being and are looking out for them. We can also support the many wonderful health sector professionals who provide care to residents every day by fixing operational problems and systemic challenges in facility management.

In closing, Bill C-295 is a crucial first step in providing a level of accountability and restoring the public's trust in Canada's long-term care system. Focusing on the role of owners and managers by proposing measures to target their criminally negligent behaviour is important. I support Bill C-295 because it recognizes the responsibility that long-term care organizations have to their residents. Neglect cannot and will not be tolerated. I urge all members to do the same.

The House resumed from November 29, 2022, consideration of the motion that Bill C-295, An Act to amend the Criminal Code (neglect of vulnerable adults), be read the second time and referred to a committee.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, I am pleased, as always, to stand and speak on behalf of the people of Vancouver Kingsway, bringing their concerns, ideas, hopes and aspirations to this chamber.

As health critic for the New Democratic Party, I am always happy to see a bill that addresses the state of health in our country and proposes a solution. This bill is very specific. Bill C-295, an act to amend the Criminal Code, targeted at the neglect of vulnerable adults, would do two things.

First, it would:

[amend] the Criminal Code to create a specific offence for long-term care facilities, their owners and their managers to fail to provide the necessaries of life to residents of the facilities.

Second, it would:

[allow] the court to make an order prohibiting the owners and managers of such facilities from being, through employment or volunteering, in charge of or in a position of trust or authority towards vulnerable adults and to consider as an aggravating factor for the purpose of sentencing the fact that an organization failed to perform the legal duty that it owed to a vulnerable adult.

All Canadians were horrified over the last two years to see residents in Canada's long-term care homes living in the deplorable and, frankly, outrageous conditions that so many of the people who built this country are forced to live in. We saw how seniors in long-term care homes have been disproportionately impacted by the COVID-19 pandemic. In Canada, long-term care residents accounted for 43% of all COVID-19 deaths.

Between March 1, 2020, and August 15, 2021, over 56,000 residents and 22,000 staff in Canada's long-term care and retirement homes were infected with COVID-19, resulting in more than 14,000 deaths among staff and residents. Frankly, the most astounding figure that I saw was that Canada had the worst record of all OECD countries, the highest percentage of deaths in long-term care homes on a per capita basis of any OECD country. That speaks to a deplorable and long-standing issue in our long-term care sector.

Throughout the pandemic, there was a difference between for-profit long-term care facilities and public or non-profit facilities. The for-profit facilities had much worse patient outcomes than not-for-profit homes in general. According to an analysis by the Toronto Star, residents of for-profit facilities have been more three times as likely to catch COVID-19 as those in a non-profit facility, and for-profit facilities have seen more than twice as many staff infections per bed. Resident deaths have also been more common in for-profit facilities.

All Canadians were stunned when we saw that the provinces of Ontario and Quebec had to call for the Canadian Armed Forces to be deployed in some of the hardest-hit long-term care homes across Canada, where they documented horrific accounts of inhumane treatment, abuse and substandard care. “Assault” is not too strong a word.

According to the CAF reports, residents in two Ontario nursing homes died not from COVID-19, but from dehydration and neglect. The stories were documented by soldiers. I have read those documented notes of CAF soldiers, who simply wrote down in unembellished form what they saw when they entered those homes. They read like a horror story from a third world. They found residents lying in bed in soiled underpants. They found instructions that care aides were not allowed to change the bedding on a bed for 24 or 48 hours, even when the patient had an incontinence problem. Incorrect medications were given to patients. Patients were malnourished and were not fed properly. This was simply outrageous.

I want to make the point that COVID did not cause these problems. COVID exposed these problems in Canada's long-term care sector.

To date, more than 30 proposed class actions have arisen from the COVID-19 pandemic across Canada, and several of them allege that the owners and operators of long-term care and retirement facilities failed to take appropriate health and safety measures to protect their residents from COVID-19. Several provincial governments have adopted legislation limiting the potential liability of long-term care owners and operators.

For example, under the Supporting Ontario's Recovery Act, 2020, plaintiffs now need to show that those operating long-term care centres were grossly negligent to avoid statutory liability protection. That is a higher standard than applies to ordinary negligence claims. In this country, what provincial Conservative governments have done is to act not to protect the vulnerable patients in long-term care homes, but to protect the managers and owners of those long-term care homes who were responsible for unbelievable incidents of abuse and neglect. That is shameful.

The courts have not yet considered the meaning of “gross negligence” under that legislation, but the phrase has been defined by the Supreme Court of Canada going back 80 years. I can state that it is a very marked departure from the generally required standard of care or even simple negligence.

Under section 215 of the Criminal Code, it is currently an offence for a person to fail to provide the necessaries of life to a person under his or her charge if that person is “unable by reason of detention, age, illness, mental disorder or other cause, to withdraw himself from that charge,” and “is unable to provide themselves with necessaries of life”, and “the failure to perform the duty endangers the life of the person to whom the duty is owed or causes or is likely to cause the health of that person to be injured permanently.” That is a very high standard, because it requires death or a permanent injury to be the foreseeable outcome.

Bill C-295 would create a specific offence under section 215 of the Criminal Code where a person is an owner or manager of a long-term facility and fails to provide necessaries of life to residents of the facility, and where “the failure to perform the duty endangers the life of the person to whom the duty is owed or causes or is likely to cause the health of that person to be injured permanently”.

We have some concerns about even that test, but the point is that bringing the attention of Canadians and members of the House to the deplorable conditions in the long-term care sector in this country is a valuable and worthy exercise of our time in this place. Anything that we can do to address that is needed.

We think that Canada's New Democrats have a much better and more structured approach to this problem. We want to end for-profit long-term care and bring long-term care homes under the public umbrella.

Long-term care is part of our health care system. When seniors are in hospital, they are in a health care system. Very often after that they are transferred to a long-term care home and suddenly they drop off the health map. That is incomprehensible and it endangers these people. The COVID-19 pandemic has underscored the reality that for-profit companies cannot be reliably counted on to protect our loved ones and keep workers safe.

We also believe that the victims of negligence in Canada's long-term care facilities deserve justice. That is why, due to the confidence and supply agreement, the one that the Conservatives scoff at, the New Democratic Party was able to force the Liberals to commit to tabling a safe long-term care act, to ensure that seniors are guaranteed the care they deserve no matter where they live.

I was in this House for nine years of the Conservative government. It never passed a long-term care act. With the current government, in the seven years since the Liberals have been in power, they have never passed a long-term care act. It took the New Democrats to come to this House and demand that on behalf of Canada's seniors. That is a positive step that we look forward to enshrining in this place.

Although Bill C-295 is a step in the right direction, it of course will not solve the problem. Rather than addressing the issues through a private member's bill, Canada's New Democrats expect the Liberal government to honour the confidence and supply requirements through government legislation. We will be present for that.

Finally, the Liberal Party promised in the last election to invest $6.8 billion in long-term care, $1.7 billion to ensure personal support workers are paid $25 an hour and $500 million to train personal support workers. That money has not flowed yet and New Democrats are calling on the government to honour its commitments and start putting money into the long-term care sector so that every senior in this country, no matter where they are, gets access to safe, quality, long-term care as their age and their contributions to our society so dearly benefit and deserve.

[Rhéal Fortin, Bloc, Rivière-du-Nord, QC]

Madam Speaker, Bill C-295 is a bill that makes sense. It is a bill that we want to study in committee, that we want to support so that it moves forward. Like most bills in their original form, it is far from perfect, but it is worth examining.

In Quebec, like elsewhere in Canada, the pandemic tested us in ways we never wanted to experience. The worst of what we went through was the abandonment of our seniors. Some seniors had a much harder time during the pandemic than most people, particularly those living in long-term care facilities. They were sometimes left alone in wretched conditions. They were isolated from their loved ones. They were often inadequately fed or only given something to eat at odd hours. I think that is shameful. In this situation, we behaved like ungrateful children towards our seniors. I hope that this sort of situation never happens again. We have a duty to work on that.

In Quebec we have the law to combat elder abuse and the abuse of any vulnerable adult. This legislation provides for fines to be imposed and protects informants, because there are people in long-term care facilities who will testify and intervene to try to prevent certain situations from deteriorating. We need to protect those people. We must encourage people to blow the whistle on untenable situations. In Quebec, with this legislation to fight against abuse, we are able, or we try by giving ourselves the tools, to better protect people who assume their responsibilities and intervene in situations like that.

The federal government's legislation parallels Quebec's legislative provisions, but in my opinion, and at first glance, it is doing so within its own jurisdiction. For now, from what I have seen of Bill C‑295, I am satisfied. We will have to take a closer look at the bill. There are some aspects that could easily go off the rails. We know that the issue of protecting jurisdictions is relevant to almost every bill introduced in the House. We will have to look at this more closely, but I agree, at first glance, Bill C‑295 seems to stay within the parameters set for federal jurisdictions.

The bill refers to the Criminal Code, and that is obviously a federal law that was passed and amended under federal jurisdiction. That particular aspect seems to be appropriate. However, the bill must not push boundaries and lead to interference in Quebec's and the provinces' jurisdictions.

Having said that, I am somewhat concerned. When I look at Bill C-295, I am concerned that this bill will be considered as a panacea and that we will ease our consciences by believing that passing Bill C-295 means that we will have done what needed to be done to protect seniors and give them better living conditions. Everyone knows that is far from true. The federal government's first responsibility is to properly manage the taxes it collects. We know that the taxes the federal government collects far exceed the cost of its own responsibilities, which means that it must return some of that money to the provinces, especially for health care.

At first, 50 or so years ago, the federal government was paying around 50% of the health care costs of each province and Quebec. Today, the proportion is around 20% to 24%, and it keeps going down all the time. The provinces are calling for a health transfer equivalent to 35% of their expenses. That is a reasonable figure that takes into account all the formulas. I would even say that this figure is lower than it should be, but it is still too high in the eyes of the federal government. The provinces can no longer manage.

I was talking earlier about a scandal—elderly people left in beds without care, medication and adequate services for hours, people often not eating all day because there was no one to bring them a meal. These situations are unworthy of us as a society. They are 99% due to a lack of funding. The institutions are no longer able to pay the staff they need to take care of our seniors. How much longer will we tolerate this?

I think we have a responsibility to prevent this. The primary responsibility of the federal government is to give the provinces the excess money it has collected in taxes. It must transfer the money to the provinces so that the provinces can manage their health care institutions properly. That is the only way to address the problem.

I recognize that this bill is about looking after seniors, and of course that is commendable. I am certain that not one of the 338 members in the House would say that that is unimportant or that the money should be used for something else. We all agree it is important. However, we cannot lose sight of the fact that in order to run health care facilities properly and take care of our seniors properly, the money needs to be transferred. It is cruel and pointless to keep this money here in Ottawa when it is the provinces that need it. Health transfers are essential. We recognize this and the provinces are asking for it.

What is the federal government's response? It says there are conditions. It will transfer the money if we use it in a certain way, if we provide this or that type of care in a given facility, if we expand business hours, if we do this, that or the other thing. There are conditions.

Let us keep in mind that this money does not appear out of nowhere. It is tax money the government takes from Quebeckers. The government says it will give the money back, but only if they comply with its conditions. It can impose conditions when it has jurisdiction the other level of government does not.

If I give children pocket money, I may tell them they cannot spend more than a dollar on candy. I may impose conditions in an attempt to teach them to manage their money properly. The thing is, the federal government does not manage any health facilities. The federal government manages health care for indigenous people and veterans and looks after new drug approvals and quarantines, but it does not manage a single long-term care facility or hospital. What makes it think it has the authority to impose conditions?

The conditions that the federal government wants to impose on the provinces are very likely to do much more harm than good, not to mention that they will prevent a rapid resolution of the problematic situation that has continued year after year. The provinces do not have the money to operate hospitals. The federal government says that it will not provide funds unless the provinces agree to its conditions.

In my view, this stubborn refusal is unworthy of a responsible government and leads to situations such as those that occurred during the pandemic. I do not want to put all the blame on the federal government. We all have some soul searching to do, especially the governments of each province, and I am certain that is what they are doing. The Quebec law I mentioned earlier was passed specifically to prevent this type of situation from happening. That is a good example.

However, the money is there to provide dignified care for our seniors. I am asking our government to carry out its responsibilities, to be fair, to be responsible with respect to our seniors and to transfer the money to the provinces to provide better care.

Bill C-295 is a bill that we must study, that we are going to study and that we will probably improve. I think the idea behind it is good, and we will work hard on it.