Health Committee on June 20th, 2023

[The Chair, Liberal, Sean Casey]

Mr. Aboultaif is next.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

This is on the same issue.

Judy is a very experienced member of Parliament. She's been here for a long time. I'm surprised to see this come up at the last minute.

We saw the first reading of the bill and the first version of it, and I was completely okay with it. I know that time is of essence to make sure this bill moves forward, but I'm not quite comfortable with these changes, to be honest with you, unless there's a better explanation in place, especially because it has come at the last minute. We thought that today we were going to move forward on the bill.

[The Chair, Liberal, Sean Casey]

Next is Dr. Kitchen.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you, Mr. Chair.

Further to my earlier question, ultimately I look at paragraph 2(2)(a), which says to “identify the training, education and guidance”. Using that word implies that the government and bureaucrats will determine what that training and education will be.

I guess my concern is that there's a better way. Change that word such that it doesn't imply or could be construed to say that you are dictating to the professions what they need to do for their training and education to ensure the professionals are appropriately trained and able to do the job. That is also for the rehabilitation specialists as well. That has now been added to that sentence.

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

If I can, Mr. Chair, adding vision rehabilitation in the various lines is the only change that we're referring to. I think you would find that highlighting different things, like vision rehabilitation, is just another positive way of trying to move forward with ideas and thoughts.

The last thing the government does, I would suggest, is decide and dictate training or any of those.... It's not within their ability, and I don't think that it really is calling on them to be responsible for that.

[The Chair, Liberal, Sean Casey]

Go ahead, Dr. Kitchen.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

With all due respect, I would disagree with that. Having been a regulator and having been involved with labour mobility within Canada, that is exactly what the government was trying to do to the professions: to tell them how to educate and how to train the professions.

I do have an issue in the sense that I want to make certain we protect all professionals and vision specialists on this avenue. I want to make certain that we aren't putting in more legislation such that the government would then turn around and say to the professionals, “Here it is. It's in law. Now you have to do it.” That is a concern for those professionals.

[The Chair, Liberal, Sean Casey]

Do you want to respond to that, Ms. Sgro? If not, we'll go to the next speaker.

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

I don't think the government is going to be dictating how the professionals need to be doing their jobs, especially talking about something like vision care, or anything else. I don't think that's the intent here at all.

[The Chair, Liberal, Sean Casey]

Ms. Lamoureux, do you want to weigh in on this?

[Emmanuelle Lamoureux, Director General, Health Care Strategies Directorate, Strategic Policy Branch, Department of Health]

I have nothing to add aside from the fact that the strategy itself, of course, will be presented at a later stage and would be, as per the draft bill, the subject of consultation with stakeholders.

[The Chair, Liberal, Sean Casey]

Thank you.

Mr. Perkins, please.

[Rick Perkins, Conservative, South Shore—St. Margarets, NS]

Thank you, Mr. Chair, and thank you, MP Sgro.

I've been dealing with a detached retina since last fall, which I'm still having trouble dealing with, and I'm looking forward to the end of session so that I can see my surgeon in July. In going through all of that process, both in Halifax and here, I can say the care has been very good.

Excuse me if I go over some ground that you may have already covered, but I'm trying to understand the dividing line here between federal and provincial roles and the professional association in this.

The bill is obviously well intentioned. It's just that I'm a little concerned that it's a bit of an intrusion into what provinces do. In response to MP Kitchen's comment on (2)(b), (c) and (d), they're fine with me, but I'm struggling with the term “identify the training”, which sounds to me like there are some national training standards which the government is being empowered to instate, which I don't think is our role, and it doesn't sound like that's your intent.

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

No, it's certainly not my intent. This is meant to establish a framework to begin consultations about vision care in Canada and what we can be doing to improve vision, what we can do on the preventative side together with the provinces and our stakeholders. It's the establishment of a framework that would begin the discussions.

The removal of clinical practice guidelines was specifically to be sensitive to the issues of the provinces. The provinces have their jurisdiction and we have ours. The federal government showing leadership on the issue of vision care will bring the parties together to design and move forward on how we get more attention on vision loss in Canada.

If one in five has an eye disease, how do we make sure that people are aware of that? It's awareness. It's leadership at the federal level.

[Rick Perkins, Conservative, South Shore—St. Margarets, NS]

I agree, because with my detached retina, I had no signs of it. It was just through my annual eye checkup that they discovered it and said that I had to get right in for surgery. I didn't have the usual symptoms of white lights and all of that stuff that you get with a detached retina. If I hadn't had the regular eye clinic, it would have been a challenge.

I agree with the idea that we need to have more advocacy for people to take advantage of the benefits they already have through most provincial health care systems to at least go in and do those checkups so that they get all the attendant things. There are lots of other health things unrelated to eyes that you can tell from the eyes.

I'm struggling with the word “identify”. It sounds like a standard. I don't know if there's another word that is more guidance as opposed to “identify”. I'm not a lawyer. I understand the struggle of dealing with some of this.

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

Especially when you're doing a PMB, you have to be very careful and structured with your language in order for things to qualify and move forward.

I thank you for sharing that issue with your retina as well, because part of this is education and awareness. If we come together and talk about it, there will be a variety of people who will go and get an eye exam who haven't had one for a very long time.

It's about awareness, prevention and moving forward to establish a framework. That's what I'm asking for in Bill C-284.

[The Chair, Liberal, Sean Casey]

Thank you.

Mr. Jowhari, please.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you, Mr. Chair.

I was going to ask Madam Lamoureux if she—

[The Chair, Liberal, Sean Casey]

Mr. Jowhari, I'm sorry to interrupt you, but the bells are ringing, so we require unanimous consent to continue.

Do we have consent to go for another 15 minutes? That would allow people time to get to the House if need be.

[An hon. member]

No.

[The Chair, Liberal, Sean Casey]

There's not unanimous consent.

The meeting is suspended.

[The Chair, Liberal, Sean Casey]

I call the meeting back to order.

We will resume where we left off. We were debating LIB-1.

Mr. Jowhari had the floor, and next on the speaking list is Monsieur Thériault and then Dr. Hanley.

Mr. Jowhari, please go ahead.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you, Mr. Chair.

I was going to ask Madam Lamoureux if she had any comments, but you beat me to it, and she responded to that. I will give you the time back.

[The Chair, Liberal, Sean Casey]

Go ahead, Mr. Thériault.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

During the break for the vote, I tried to solve the problem that was raised. When I read the text in French, I could see it was consistent with Ms. Sgro's intentions, and when I read it in English, I saw the problems the Conservatives pointed out. So I tried to come up with an English translation, hence this laborious result. I'm not an expert translator, but I was going for a translation into English that more accurately reflected the French text.

My colleagues are by now aware of my concerns with the jurisdictions of the various orders of government. We discussed that at length at the last meeting. It's important for me. So I sent you a text. I believe Mr. Kitchen has received it, but I'm going to read it. I have two amendments to propose.