Evidence of meeting #34 for Public Safety and National Security in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was criteria.
A video is available from Parliament.
4:45 p.m.
Conservative
4:45 p.m.
NDP
Libby Davies NDP Vancouver East, BC
Okay.
Could you name any other health facility or health service that has this kind of detailed criteria for potential approval?
4:45 p.m.
Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health
I'm afraid I can't speak to health facilities or health services because it's more a provincial jurisdiction. I'm not involved in those sorts of decisions.
Mr. Chair, I'm just wondering, with your permission, if my colleague could comment. She feels she needs to add a point to something that I said.
4:45 p.m.
Diane Labelle General Counsel, Legal Services (Health Canada), Department of Justice
Briefly, it's to bring about the very purpose of Bill C-2, which is to provide the legislative framework for the minister to exercise her exempting powers in keeping with the direction given by the Supreme Court of Canada. The Supreme Court of Canada didn't take issue with the discretion exercised by the minister but, rather, the manner in which the discretion is exercised. Therefore, under the proposed bill the information would be provided in support of a request for, or information obtained in relation to, an exemption to conduct activities with illicit substances at a supervised consumption site. This would inform the minister's assessment. The minister understood that she must make an assessment of the public health considerations as well as the public safety considerations that arise in a particular case. This would assist her in balancing these considerations in accordance with the section 7 rights to life, liberty, and security of the person guaranteed by the charter and in the manner described by the Supreme Court of Canada.
4:50 p.m.
Conservative
The Chair Conservative Daryl Kramp
Thank you very much for the additional clarification.
We will now go to Ms. Ablonczy, please.
October 27th, 2014 / 4:50 p.m.
Conservative
Diane Ablonczy Conservative Calgary Nose Hill, AB
Thank you.
Thank you, witnesses, for being here.
These discussions about process are certainly to be expected, but I'd like to go back to the principles of the bill. As you know, my friend Ms. Davies points out that there are certain emphases that perhaps different parties put on this kind of exercise, and I don't think that's to be wondered at. There are always balances in how we deal with these issues and, as you know, the Controlled Drugs and Substances Act, which would be amended by this legislation, really has a dual purpose, as the minister stated: the protection of public health and the protection of public safety. Some questions put more emphasis on the public health aspect, and some questions put more emphasis on the protection of public safety, but we have to assume that the two are not mutually exclusive, that you can have an “and” to that.
I'm really interested in how the regime that's being put forward would assist the minister in doing an “and” in ensuring the protection of public health and the protection of public safety. The community consultations, of course, are really the public input into this whole process.
How do you see a proper balance being achieved by the process that's being recommended by the bill?
4:50 p.m.
Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health
As the member mentioned, the purpose of the act is public health and public safety and balancing of those two, as acknowledged and supported by the Supreme Court. When you look at the 27 criteria and actually try to divide them between public health and public safety—and a few are clearly both—you'll find that the balance between them is fairly even. Asking for that range of information will allow the decision-maker to balance those two in a very clear fashion.
4:50 p.m.
Conservative
Diane Ablonczy Conservative Calgary Nose Hill, AB
That's a good observation. You started to go through the criteria and ran out of time, and although I'm very fond of my colleague, I'm not going to reopen that. But it is important that we get the balance right. That's always up for debate, and I think it's a healthy debate, but at the end of the day, that's what we're trying to achieve.
When we look at the community input aspect of this, how important do you feel that is to achieving the kind of balance that the minister, through objective and subjective criteria, will have to use to make her or his determination?
4:50 p.m.
Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health
As the minister said, views of community support or opposition are one of the five factors that the minister must consider. I don't think it's possible for us to say that any one factor is more important than another or any one criterion is more important than another. It's about the whole, and then balancing the whole. Clearly, it is critically important. It must be considered, but it's impossible for us to say what its relative weight would be.
4:55 p.m.
Conservative
Diane Ablonczy Conservative Calgary Nose Hill, AB
We talk about public safety and we know that injection sites have certain impacts on health of people using them. There have been some studies that show that there have been health outcomes for some of the users. What are the kinds of security and public safety concerns that members of the community may speak to when they're asked to bring forward their input?
4:55 p.m.
Kathy Thompson Assistant Deputy Minister, Community Safety and Countering Crime Branch, Department of Public Safety and Emergency Preparedness
As was described in the criteria that are being put forward, the local chief of police, whoever that may be—whether local police or RCMP who are contracted as the local police—would be asked to submit a letter with any views with regard to how this would impact public safety, in his or her view. In addition, whether it's the local chief of police or the applicants, they will be asked to provide statistics and literature in relation to their own community in terms of the current crime rate, use of illicit drugs in their community, number of arrests, and so on. That information has to be provided with the application.
4:55 p.m.
C/Supt Eric Slinn Director General, Support Services, Federal Policing, Royal Canadian Mounted Police
I'll just add that, from the RCMP's perspective, wherever you have illicit drugs you have an abundance of other criminality that could take place. A lot of drug users, particularly the addicts, rely on a steady supply of drugs and, hence, require money to purchase those drugs. They may not be employed and so they have to rely on criminality to obtain the money they need to purchase those drugs. That's disturbing.
You get other criminal offences that can be linked to drugs, of course. There is the downstream impact of the addicts, and the RCMP is concerned about the organized crime groups behind it, which continue to proliferate, and many of the social problems that come with drug use. So there's an abundance of criminality that can be associated with illicit drugs.
4:55 p.m.
Conservative
Diane Ablonczy Conservative Calgary Nose Hill, AB
On the public health side, we have the national drug prevention strategy. Just quickly, in addition to what's being proposed with the safe injection sites, there are other ways that these issues are being addressed through the strategy. Is that not correct?
4:55 p.m.
Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health
Yes, that is correct. It is a three-pronged strategy: prevention, treatment, and enforcement. Certainly through any of those pillars you can see that they would have an impact in the ultimate objective of preventing drug abuse and treating those who fall victim to it.
4:55 p.m.
Conservative
The Chair Conservative Daryl Kramp
Thank you, Ms. Ablonczy.
Thank you to our witnesses.
Now we will go to Ms. Fry for seven minutes, please.
4:55 p.m.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
Thank you very much, Mr. Chair.
I was a little concerned to hear your answer to Ms. Davies' question about whether this exemption would include InSite. If you look at all the criteria that are set up here for the minister to be able to approve a safe injection site or a safe consumption site, InSite has fulfilled every single one of them over and over. I think it's really interesting to find that it will have to then do this all over again.
I just wanted to read the Supreme Court's page 187, that said:
Insite saves lives. Its benefits have been proven. There has been no discernable negative impact on the public safety and health objectives of Canada during its eight years of operation. The effect of denying the services of Insite to the population it serves is grossly disproportionate to any benefit that Canada might derive from presenting a uniform stance on the possession of narcotics.
InSite has proven its outcomes. Over that period of time it has saved 366 overdoses that used to end, many of them, a large of percentage of them, in death. Its objectives are pretty clear. Its outcomes are clear. Its risks had brought down crime in the area, and that is again well documented, and in the Supreme Court ruling they spoke to that. My concern is simply this: I understand your wanting or a need to apply criteria for exemptions in the rest of Canada, but for eight years InSite has proven itself to fulfill every criteria. The provinces said it was okay. It was the provinces that took the government to court. Their health authorities have been supporting this with professionals who know what they're doing and who are doctors and nurses who are duly qualified under the licensing body of British Columbia. You have seen the police locally. There were huge community consultations before InSite was put down. I was the minister in charge of Vancouver East at the time, and so I know this. All the public were consulted. So every criteria except one: the RCMP are the only police force that said no. The Vancouver police and the police in the surrounding municipalities supported it.
I can understand your wanting to apply your criteria to other groups. InSite has fulfilled this criteria in spades, and the Supreme Court has said so. Why would you require that InSite go over it? The time it takes to do this, you do something that the Supreme Court asked the minister not to do, which is not to go against the Constitution, section 7, “the right to life, liberty and security of the person”. During the wait time many of these people who currently use InSite will be subjected to overdose deaths, to illnesses, etc., because there'll be no way for them to do....
How does this balance what the Supreme Court asks? The Supreme Court said that the minister's discretion is not absolute. Ms. Geller, I heard you say that the minister has no limits on what she can make a decision on. It is my understanding that the limits are there. There's section 7 of the charter on the issue of fundamental justice, so those are your limits.
As Ms. Davies asked, opinions don't cut it. An opinion is somebody's thought. With no disrespect a minister of health in most provinces, with the exception of Ontario, is not a physician. Their opinions are purely subjective. You are looking for objective evidence when it comes to people's lives and to health and to spread of disease. Excluding InSite, and making them go over this all over again, with the years it'll take to do so, how will this save lives?
5 p.m.
Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health
To start, no, it's absolutely clear that the minister's discretion is not absolute, and it must be exercised within the constraints imposed by the law and the charter. But it may also be worth noting that the Supreme Court did say, at paragraph 151, that their decision “...does not fetter the Minister’s discretion with respect to future applications for exemptions, whether for other premises, or for Insite”. I think, at a very basic level, this process will at least allow the minister to be informed of whether circumstances have changed, which is possible and conceivable. If circumstances have changed, the factors are different, the minister, in his or her discretion, may decide that a different response is appropriate—the reason for not grandfathering anybody, if you like, and requiring an application each time.
5 p.m.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
The criteria are pretty clear here, but I might tell you that I want to know the weight of these criteria.
What if the police force, the municipality, the provincial government, etc., and all of the health care authorities decide this is a good thing to do, given the status of safe injections and disease at that time in that particular area and place, and the community says no? How would that weigh? I need to know that this is not going to be weighted in a manner.... The name of this bill is community safety. It shouldn't be, I would like to suggest, because it isn't about community safety only. It is about the safety of persons, and that includes addicts and patients. I don't hear that anywhere here. It's just the safety of a community alone.
The community does not understand, in many ways, what the objective issues are. Will you weigh it only...? If the community were to say no, would that preclude putting down an InSite? None of this is very clear. The weight falls on the minister's shoulders. I did not hear either minister say a single word about the rights of the persons addicted and their right to life, liberty, and security of their person. It was about all of the other things. I need to know how that weighting is going to go.
5 p.m.
Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health
As the Supreme Court said:
Where the Minister is considering an application for exemption for a supervised injection facility, he or she will aim to strike the appropriate balance between achieving the public health and public safety goals.
What this means is it's not possible to assign a specific weight to any one of the 27 factors in and of themselves. The totality will be there before the minister, and he or she, at the time, will decide, based on that totality of information, what the appropriate decision is. Of course, a decision is always subject to judicial review.
5:05 p.m.
Conservative
The Chair Conservative Daryl Kramp
Thank you very much. Your time is now up.
Ms. Boutin-Sweet, s'il vous plaît.
5:05 p.m.
NDP
Marjolaine Boutin-Sweet NDP Hochelaga, QC
Thank you very much, Mr. Chair.
I thank you as well, ladies and gentleman.
Does the act really contain 27 criteria? Is that what you said? I see.
Ladies, I expect that you have a lot of experience. I wonder if such a large number of criteria might lead to discouraging people from making a request to open such a supervised injection site. People may feel there are just too many criteria. Often, community groups do not have the necessary financial resources to submit requests. I see that regularly.
Do you not think that this will discourage those groups?
5:05 p.m.
Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health
I don't think we can say if it will or it won't have a dissuasive effect. I think what we can say with confidence, though, is that we can map every single one of these criteria to one of the five factors the Supreme Court laid out as being important to consider in making a decision around a supervised injection site.
5:05 p.m.
NDP
Marjolaine Boutin-Sweet NDP Hochelaga, QC
Thank you.
I understand certain factors very well. Knowing about the local situation is important, certainly. However, we are talking about providing scientific proof showing a medical advantage, and we already have that proof. Earlier, I mentioned certain facts. For instance, I said to the minister that in Montreal, 68% of drug users are infected with hepatitis C, and 18% are HIV carriers. We already have this evidence, and we know that preventing one case of hepatitis C or HIV can be equivalent to the whole budget of a supervised injection site.
We also have general information on infectious diseases and overdoses related to the use of illegal substances. In my opinion, certain criteria are not necessary, since we already have that information.
Why, in this case, did you include those requirements in the bill? Why slow down the process and impede it by asking people to meet criteria, knowing what we already know?