moved:
That, in the opinion of the House, the government should establish a Pan-Canadian Palliative and End-of-life Care Strategy by working with provinces and territories on a flexible, integrated model of palliative care that: (a) takes into account the geographic, regional, and cultural diversity of urban and rural Canada; (b) respects the cultural, spiritual and familial needs of Canada’s First Nation, Inuit and Métis people; and (c) has the goal of (i) ensuring all Canadians have access to high quality home-based and hospice palliative end-of-life care, (ii) providing more support for caregivers, (iii) improving the quality and consistency of home and hospice palliative end-of-life care in Canada, (iv) encouraging Canadians to discuss and plan for end-of-life care.
Mr. Speaker, it is always a great honour to rise in this House representing the people of Timmins—James Bay. Tonight I am particularly proud to represent the New Democratic Party as we bring forward a motion that we believe is essential for the development of long-term planning for health in this country, which is a pan-Canadian strategy for palliative care.
I am very proud to be here this evening to move this motion on behalf of the New Democratic Party. We are asking the federal government and Canada's Parliament to establish a pan-Canadian strategy, ensure access to palliative care, and work with the provinces and territories so that all levels of government can develop a standard of care that ensures access to quality palliative care.
To begin, I would like to make note of a few things for the people watching across Canada.
I would like to thank the medical leaders, medical organizations, front-line service providers who are serving people in need, and the social workers, pharmacists, nurses and doctors, for the support that we received. I would also like to thank members of the various spiritual communities of Canada who have supported the New Democrats in this motion.
On a personal note, I would like to mention that my late brother-in-law John King, who was a close friend and a brilliant young man, lost his life much too early to cancer. After the 2008 election, I came home and spent the last few nights with John at Perram House, in Toronto.
Perram House was an extraordinary palliative care centre. At the time, I thought it was the norm. I thought that when Canadians became sick, there were Perram Houses everywhere. It was after Perram House closed, in the city of Toronto where my brother-in-law was dying, that I realized there was a lack of good quality palliative care beds.
Certainly there is good quality palliative care in hospitals. However, with regard to community-centred, spiritually centred, communal-familiar centred care, it made me realize that across this country we do not have a standard forum for ensuring that families and individuals have the support they need.
I would also like to thank the incredible work of the all-party committee. The Parliament of Canada is known as a relatively toxic place at most times, but members of all parties came together on this vital issue and worked hard. I would like to recognize the members of the Conservative, Liberal, and New Democratic parties who worked on the study and wanted to bring forward to Parliament the need for us to establish this pan-Canadian strategy on palliative care. I believe that the motion I am bringing forward on behalf of the New Democratic Party is carrying forward the work of this all-party committee.
One of its key recommendations is that the committee strongly urges that the federal government re-establish a palliative care secretariat for the sake of developing and implementing a national palliative and end-of-life care strategy. In honour of the work that my colleagues in the other parties and New Democrats did on that committee, we are bringing forward that motion tonight.
There has been much discussion lately in the media. Many terms are being used on the issue of dying with dignity and what it means. People are grappling with very complex and emotional issues that touch all of us.
Tonight I would like to use the definition of palliative care that has been offered by the Canadian Medical Association.
The Canadian Medical Association tells us the following:
Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with a life-threatening illness. [It involves] the prevention and relief of suffering by means of early identification, assessment and treatment of pain and other physical, psychosocial, and spiritual symptoms.
We can see from the Canadian Medical Association's definition that palliative care is not just about dealing with someone in their final bleak hours. It is the notion of an integrated health strategy that is there for families in their homes. It is not just about the alleviation of suffering, but allowing the individual to have a higher quality of life than they might have otherwise had. It also assures support for the family, community members, and loved ones, who sometimes face an extremely traumatic time.
The fact that we are having this debate today at the end of the national health accord is very timely. The New Democrats believe, and have believed this since our founding and the days of Tommy Douglas, that the federal government has an important role to play, not in the delivery of service but in working with the provinces and territories to establish norms across this country.
If we look at the situation with an aging population and our increasingly frayed health care system, and with the end of the health accord and less and less money to be delivered to the regions, urban and rural, it becomes incredibly important to ensure that we have an integrated health care strategy.
What would the strategy look like? We know that Parliament played a role before. In 2007, the Conservative government cancelled the palliative care secretariat that had been established and was beginning to do work in terms of a national vision. We had an all-party committee that came back and said we needed a strategy.
However, what we are seeing across the country is a real patchwork of services. I believe there are only four provinces that even have a provincial strategy in place for palliative care. In some areas we see incredibly strong resources. For example, downtown Regina and Saskatoon have extraordinary services, but even in a city as big as the GTA or Montreal, we are dealing with a patchwork. In rural areas, sometimes it is almost non-existent.
There is a belief that somehow palliative care is done with volunteer money. That does not really understand its importance.
Let us look at the delivery of services in the rural regions. What I have seen in my own region is that when families do not have access to proper support, it causes immense stress to the patient. Many times I have dealt with this when people have come to my office. I have heard about an elderly woman trying to bathe her husband who is dying of cancer, but who has not been identified for palliative care. They are trying to get home support workers, who do extraordinary work.
The overall vision is that this is a palliative issue as opposed to just someone who needs home support. Too often the person ends up in the emergency room waiting for a bed. It is the locum or the emergency room doctor who has to tell them that they are actually suffering from an incurable illness, which can be very traumatic.
I have seen families almost torn apart because of the pressure. Someone has to stay home with the loved one. We know that in at least a quarter of the cases, Canadians have said that they have had to miss upwards of a month of work or have used personal savings to look after a loved one who has an incurable condition.
In areas where we have good palliative care, we can actually save about $8,000 to $10,000 per patient because they are not then being cared for in emergency wards and there is not the struggle to find beds, because there has been a whole approach.
In the rural northern Ontario region that I represent, the provincial allocation for palliative care for a region of more than 100 kilometres with three hospitals and about 20 communities is $70,000. What can $70,000 buy when one is delivering health care, when one has to do the audits and to ensure travel? That is not to say it is the only money.
The province, through its LHINS, has a pain management program, but it is not under the palliative program but through someone else, another organization that could be 200 kilometres or 400 kilometres away. They do good work as well, but it is not integrated. We have personal support workers, but they are not necessarily working under the palliative network.
To get that $70,000, the local organizations are supposed to raise $25,000. So they are already having to bring forward about a quarter of the money themselves. Meanwhile, there are numerous other agencies, all delivering fragments of the service, but if those fragments were put together into a cohesive whole there would be a better health outcome.
We can learn from each other in different parts of the country. This is a really important opportunity. We need to talk to the medical front line, the social workers and the people who are dealing with the sick and the aging. They understand that if we work together and worked on the models that work, we could learn from each other and deliver better outcomes.
There is clearly a need for this program across the country. Palliative care is excellent in some regions and virtually non-existent in others.
Quality palliative care means integrated care: home care, social services and medical care to help improve people's health, emotional and psychological support and support for families.
Currently, less than 30% of Canadians have access to quality palliative care. That is why New Democrats are asking the other parties to work with them to support this vision for a pan-Canadian strategy to help families and individuals facing this situation and to implement similar models in both rural and urban areas.
I believe this is a moment when all parliamentarians can come together in a positive way. We all have to face the death of a loved one. We have all faced it. We all have our own stories. These are moments in the life of a family that is at a crossroads, the closing of one chapter and the opening of another.
I remember when my grandfather died and the responsibilities that were transferred, the cultural roles, the leadership roles, and the spiritual roles that people play in a family when someone leaves and the next generation has to take those on. That is an extraordinary moment in the life of a family, but if it happens in a crisis unit, if it happens in an emergency ward, if it happens because some of the family members have to be out working in the oil patch and cannot get back to be there, the sense of guilt and anger can tear families apart or seriously damage the spiritual vitality of a family or community.
When there is a better model out there, one that saves money and that ensures better access for people, I think it is incumbent upon us to say, let us embrace this model and let us show what dying with dignity in 2014 should be about, to ensure that we have everything in place around the person, around the loved ones, around the families so that they can make that transition and so that we, as their family members and loved ones, will also be able to make that transition to the next level of our own communities.
I am hoping to get the full support of the members of Parliament. I am certainly counting on the members who did the extraordinary work on the palliative care committee. I think this is something on which we can all agree. I would ask my colleagues to work with us to support this motion and then begin to push for its full implementation.
From this Parliament, it is incumbent upon as well to begin this discussion in Canadian society. This is a common sense solution that is staring Canadians in the face. This is a discussion that we need as Canadians. It is a positive discussion. It is a discussion that brings people in to talk together, as opposed to leaving people on the outside.
I would like to think that out of this motion can begin a positive discussion across this country.
