Bill C-233 (Historical)

National Strategy for Alzheimer's Disease and Other Dementias Act

An Act respecting a national strategy for Alzheimer’s disease and other dementias

This enactment provides for the development and implementation of a national strategy for the health care of persons afflicted with Alzheimer’s disease and other forms of dementia.

Opposition Motion—Telecommunications

[Rob Nicholson, Conservative, Niagara Falls, ON]

Madam Speaker, I would like to thank the hon. member for Guelph, who was good enough to share his time with me, as well as all those individuals from different political parties who have been so supportive and helpful over the years.

It is with mixed emotions that I rise today to give what will be my farewell address in this chamber, the people's House.

Thirty-five years ago, the people of Niagara Falls first elected me as their member of Parliament, and I will be forever grateful to them.

I am proud today to be wearing the Nicholson tartan tie for this occasion. I am pleased as well to be wearing a medal that was given to family members of World War I veterans. I received this when I was over at Vimy Ridge a couple of years ago. I was told that the Borden government encouraged people who were related to people who served in World War I to wear the medal. I had two grand-uncles, Gordon Gunn and Stewart Gunn, who fought in World War I. I have been very proud to wear this in public since that time.

As a boy, I took an interest in Prime Minister John Diefenbaker during the Cuban missile crisis. We talked about it all the time and I got quite caught up with this. I wrote to Mr. Diefenbaker and told him of my support for him, and it started a fan club in my class on his behalf.

Among other things, I would like to point out to the chamber that on this day, June 10, 1957, John Diefenbaker won his first election as Prime Minister of Canada. That was a great day for ours country.

At the age of 13, I had the privilege of meeting the Right Hon. John Diefenbaker, who asked me if I wanted to become a Conservative MP some day. I said for sure I would.

What I did not know at the time was that since the creation of the Niagara Falls riding, the Liberals had won five straight elections. It came as no surprise to me that years later my teacher, Mrs. Gordon, told me that when she told other teachers I wanted to be a Conservative MP some day, one of them said she should have encouraged me to become the captain of the Zeppelin instead.

In my 24 years in the House of Commons, I have witnessed much, such as the rise and fall of governments, including my own. Regardless of political stripe, the important thing is that our democracy works. There is not another country in the world that does it better than Canada.

At citizenship courts and others, I always say that to be a Canadian means that one has won the lotto of life. That was consistently true in the roles I have had as defence minister, foreign affairs minister and justice minister.

Wherever I went in the world, representatives of other countries were always and completely consistent. They were appreciative of and grateful to Canada.

I remember being in Afghanistan a few years ago, talking with government officials. They wanted to talk about the difference Canada and our allies had made in that country. They told me that in 2006, 75,000 girls went to school in Afghanistan. They pointed to me and said that two million girls now went to school in Afghanistan, that this was the difference Canada and its allies had made. What we heard was so consistent with what we hear wherever we go.

One of the other things that always struck me was Canada's influence. I remember getting off a plane in Ukraine and being asked if I would wear a poppy on my left lapel. This was in March. I said I would. Everywhere I went I could see posters of people wearing poppies. I checked my briefing notes, but I did not see anything on this in particular. When I asked about it, I was told that up to a couple of years ago Ukraine had commemorated its war dead the way the old Soviet Union did, but had decided to do what Canada did, which was to wear a poppy. It is a perfect example of Canada's influence.

I remember getting off the plane in the United Arab Emirates and meeting Prince Abdullah, who was the foreign minister. We made a bit of chit-chat. He told me his son had just completed the Terry Fox run. I asked if he had visited Canada recently, to which he replied no, that the run was in Abu Dhabi, where 20,000 people participated in the Terry Fox run. He said that they got the idea from Canada, to which I replied “I know”.

This is so consistent with what we have heard about Canada. Canada has always been there for the right reasons.

Over the years, I have always emphasized the great opportunities for our country. Sometimes we do not underscore that enough.

I remember, back in 1988, I had a meeting with an American congressman. We were going to have an election later in 1988, and he said to me, “Do you have your money lined up?” I told him that my party had a few dollars in the bank and that we could spend only $50,000, because that was the limit. He said, “Fifty thousand? I don't think I could open an office for $50,000.” I asked him how much he had, and he said, “I am running for re-election as a congressman, and I have $2 million in the bank right now.” I thought to myself, what a wonderful country this is. One does not have to have a couple of million dollars to become a member of Parliament. We do not need that kind of money, and we are not dependent on people for that.

We are truly blessed to live in this country. In the words of Prime Minister Diefenbaker:

I am a Canadian, free to speak without fear, free to worship in my own way, free to stand for what I think right, free to oppose what I believe wrong, or free to choose those who shall govern my country. This heritage of freedom I pledge to uphold for myself and all mankind.

May all of us in this House continue to value those ideas, because that is what makes Canada great.

It was a great opportunity to be elected in 1984, and it was a great day for Canada when Brian Mulroney was elected prime minister. I have had so many amazing experiences that I would need much more time than I have today to recall them all.

I do remember, for instance, that very soon after being elected, Brian Mulroney sent several of us MPs over to Ethiopia and Sudan to observe that aid was getting through to the people of those countries. It was no surprise to me that it was getting through. Canadian aid was being delivered to the people of Sudan and Ethiopia. Again, this is one of the things that are so characteristic of this country.

I was proud to be a member of the government that enacted the acid rain treaty between Canada and the United States and the free trade agreement between Canada, the U.S. and Mexico, and I was proud of the fact that Brian Mulroney took such a determined stance against apartheid and was the first western leader to recognize the freedom of Ukraine.

One of the last pieces of legislation to be passed under that government was legislation that made the possession of child pornography illegal in Canada. I am most proud that as a government we stood to protect children from falling prey to this heinous crime.

I also had the honour of serving under Canada's first female prime minister, the Right Hon. Kim Campbell, first as her parliamentary secretary and then later as minister of science and small business.

Serving in the cabinet under the Right Hon. Stephen Harper was one of the great chapters of my life, first of all as his House leader, minister of justice, minister of national defence, and minister of foreign affairs. I thank him, because on the world stage, he stood up consistently for what is right. He stood up for the integrity of our justice system and the rule of law, and for victims of crime. I believe he will go down in history as one of Canada's greatest prime ministers.

During my time as an opposition member these last few years, I was very pleased to have passed my private member's Bill C-233, on Alzheimer’s disease and other dementias. One of the most poignant memories I have, after the passing of my friend and colleague Gord Brown, was my initiative to distribute aspirin pill holders in his memory.

I also want to thank the hon. Leader of the Opposition for having placed his confidence in me. I am grateful to have served under him as shadow minister for justice and shadow minister for procurement. I thank him for putting my name forward for the national security committee. Canada is fortunate to have the Leader of the Opposition.

There are many I would be remiss if I did not thank. The countless volunteers who gave up their personal time to elect me are all remarkable Canadians, and I owe them a debt of gratitude. I want to thank all those who worked on my federal campaigns, people like the Lyon, Gibson and Stockton families, and members of my own family who have helped me for over 35 years.

This is also for Maureen Murphy and the outstanding staff I have had the privilege of working with in my ministerial portfolios, on the Hill and in the riding. I cannot name all the people who worked in my Hill and constituency offices, but I will name those who are with me today: Stewart Graham, Tracy Alway, Anna Annunziata, Jenn Stockton, Billy Morrison and Cheri Elliott. I want them to know that it has been an honour to work with them, and a great privilege for me.

To my beautiful wife and partner, Arlene, so often she displayed extraordinary graciousness in not having her husband by her side when duty called. There were many special occasions I was not able to be present at. I often tell people, though, that if a spouse does not completely support them in their candidacy, they should not get into this job, because it is a 24-hour-a-day job. One of the blessings I have had is the unequivocal backing of my wife, and I thank her for her love and support. I am looking forward to being there for my wife and my family. I love Arlene dearly.

To my colleagues in the House and those who work with us, I am grateful. It has been a privilege serving with them, and Canada is a better place because of them.

There is a time for everything and a season for every activity under the heavens. Now is my time and season to say farewell to this venerated chamber.

This marks the beginning of a new chapter in my life for Arlene, myself and our three children, Rob, Peter and Christine. I have enjoyed the journey thus far and look forward to what the future holds. I have always been proud to be a loyal subject of Her Majesty the Queen, and I am proud that the people of Niagara Falls have given me the privilege of serving in this place.

I thank everyone for the memories, for they will last long after the goodbyes.

Criminal Code

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Madam Speaker, I am pleased to rise today and speak to Bill C-375, an act to amend the Criminal Code, to require that a pre-sentence report contain information on any mental disorder that an offender may have.

I understand and am sympathetic to those who suffer from mental health disorders. I proudly supported the private member's bill of my colleague from Niagara Falls, Bill C-233, which sought to address the challenges of Alzheimer's and other dementias on a national level. However, I am deeply concerned about this bill. This bill, when taken together with other legislation introduced and passed by the current Liberal government, continues a long and disturbing pattern of favouring the protection of criminals over the protection of the victims of crime.

Just last week, I stood in this place and compared the record of the last Conservative government on crime with the record of the current Liberal government. They stand in stark contrast. From day one of their mandate, the Liberals have demonstrated both an appalling indifference to victims and a disquieting compassion for criminals. We have seen this time and again. This is the government that willingly gave a $10.5 million payout to unrepentant convicted terrorist Omar Khadr, who killed American medic Sergeant Christopher Speer in a firefight in Afghanistan in 2002. Further, Tabitha Speer, Sergeant Speer's widow, was awarded a judgment of $134 million by a court in Utah against Omar Khadr. The Liberals could have, and I would suggest should have, waited to allow the courts to rule on an injunction for Mrs. Speer. Instead, they rushed payment to Khadr, making enforcement of the judgment unlikely.

What of our Canadian veterans who need help? To them, the Prime Minister had one thing to say, that they were asking for more than he was willing to give. However, for ISIS fighters, it seems the cash never stops flowing. The Prime Minister pledged to use taxpayers' hard-earned money to de-radicalize terrorists through such tried and tested means as reading Canadian poetry.

The Minister of Foreign Affairs, for her part, refuses to use the term “ISIS terrorists”, instead choosing to use the vapid term “foreign fighters”. When pressed on her plan for these so-called foreign fighters, she offered this gem of an insight:

With respect to the foreign fighters, I think we need to remember why they are where they are right now.

We all remember why they are where they are. We remember that they left Canada to engage in horrific war crimes against innocent men, women, and children halfway around the world, crimes like beheading innocents, throwing gay people off buildings, and stoning women to death for the crime of being raped. According to the Prime Minister, these hardened terrorists can be “an extraordinarily powerful voice” in Canada. One wonders what those voices are saying.

The Conservatives have fought this disturbing hippyesque Kumbaya session with criminals and terrorists every step of the way. When Bill C-75 was introduced, it weakened the penalties for many crimes, including terrorism-related charges, to possibly as little as a fine. The Liberals spent months defending this decision before finally backing down and supporting Conservative amendments that ensured that terrorists would face the consequences of their actions. It took months of pressure and hard work to make this one obvious change. However, even now the bill remains deeply flawed.

Health

[Ginette Petitpas Taylor, Liberal, Minister of Health]

Mr. Speaker, I thank the member for Don Valley West for his question and his work, along with the member for Niagara Falls, on Bill C-233.

This is a priority for our government and a priority of mine personally, as my mother lives with Lewy body dementia. This is why we are continuing to contribute $42 million to Baycrest Health Sciences to support new research and development, testing, and scale-up of products and services for brain health and aging. Last year we launched the largest-ever study in dementia in Canada.

We will continue to work to improve the lives of those with Alzheimer's and their families.

National Strategy for Alzheimer's Disease and Other Dementias Act

[Sheila Malcolmson, NDP, Nanaimo—Ladysmith, BC]

Mr. Speaker, the Nanaimo Alzheimer's walk raised $18,000 last year to promote critical research to reduce the effects of Alzheimer's, to provide services for those living with or assisting those with Alzheimer's, and to ease the personal consequences that exist for people and their families every day. I hope people in my region will come to the fundraising walk in Nanaimo on May 7.

It is in that spirit that I speak today on Canada's responsibility to improve care for the hundreds and thousands of Canadians suffering from dementia and to better support their families and caregivers. I support Bill C-233, which calls for the development and implementation of a national and comprehensive strategy to improve health care delivered to persons suffering from Alzheimer's disease and other forms of dementia.

Here is a call from Susan Barr, who wrote to me from the riding of Nanaimo—Ladysmith. She wrote, “I am a senior with Alzheimer's on my father's and mother's line, and am now starting down that dark path of dementia myself.... Unless a dementia patient has sufficient means they have to share rooms with others who often are difficult to live with and/or are violent. I urge you to go and spend two or three hours in a government funded senior's care home with a closed dementia ward and ask yourself — do you want to be treated like this?”

She also describes her brother-in-law, who used to be the gentlest, kindest soul. He has been held in hospital with Alzheimer's for long periods of time because there is no space for him in a care unit elsewhere on Vancouver Island. He has been tied on stretchers and denied showers because of fears about his aggressive behaviour. This is bad for caregivers, for families, and, of course, for the patients.

The need is great. Three-quarters of a million Canadians lived with dementia in 2011, which is 15% of seniors, and this costs our economy $30 billion each year in medical bills and lost productivity. Left unchecked, that number could skyrocket to $300 billion within 25 years.

Canada has fallen behind countries such as the U.S., the U.K., Norway, France, the Netherlands, and Australia, all of which have coordinated national dementia plans in place. Canada is one of the few G8 countries without one. As our population ages, we must prepare our health care system and communities for the increasing number of Canadians suffering from dementia. It is expected to double by 2031. To paraphrase Tommy Douglas, the father of medicare and a New Democrat, “Only through the practice of preventive medicine will we keep the [health care] costs from becoming...excessive...”

In talking last night with the Canadian Association for Long Term Care, I was reminded that Canada has had 40 years to get ready for this wave of aging baby boomers and yet our country had no strategy and failed to plan. The Canadian Association for Long Term Care notes that the proportion of long-term care residents with Alzheimer's disease or other forms of dementia has grown steadily, with 87% of residents affected by the disease since 2010. It also notes that modern home designs and increased privacy are increasingly important for residents with dementia, who could become upset and aggressive when they are unable to get the personal space they need.

Canadians have lost precious time on this, something that is especially important to those suffering from a degenerative and progressive illness. This has had real human impact. I have heard countless heartbreaking stories about the impacts of Alzheimer's disease and dementia on my constituents.

Lynn Myette gave me permission to read this note. She said:

Our Grandfather suffered from Alzheimer' an now our Mom is in a secure unit with Alzheimer's, too. We know what it is like to watch a loved one decline and loose all of their dignity to the point that they are no longer their former being. To be tied into a wheelchair and left to fall asleep sitting there, to loose all their appetite and not eat, to wear diapers and lose control of bodily functions, to no longer recognize close family members, to develop anger, these things along with drugs to numb their being to the point of comatose, happen.

Many cannot afford quality home care for their parents. I talk to so many people in my riding who are trying their very best to look after their aging parents at home. They are not getting the support they need. The smallest amount of support would make a big difference to them. They know they are saving the health care system money, and yet it is shameful that the Liberal government abandoned its election promise to invest $3 billion in home care.

The Liberals promised $3 billion over the next four years during the 2015 campaign. They separated this from the health accord. That means the money should have flowed in 2016, but it has not been delivered almost two years into their mandate. Instead, the Liberals are using home care dollars to try to lever agreement around the health accord. Provinces representing 90% of Canadians still have not received a nickel of this promised home care support. The need is pressing. The burden of caring for patients with dementia and Alzheimer's falls heavily on family members.

In Canada, family caregivers give millions of unpaid hours each year, caring for dementia patients. That represents $11 billion in lost income, and one-quarter of a million lost full-time equivalent employees in the workplace. If nothing changes by 2040, it is estimated that family caregivers in Canada will spend 1.2 billion unpaid hours per year caring for their loved ones. A quarter of family caregivers are seniors themselves.

Long-standing under-investment in care homes means that the alternatives can be dire. Lori Amdam from my riding writes the following:

Why does Canada need a national dementia strategy? We need one because the baby boomers I know are scared to death of developing dementia—they believe that life in a Canadian nursing home would be a fate far worth than death.

When I teach dementia care to students, I often ask them to bring to mind the worst care facility they have seen. They describe an old, hospital-like unit with narrow corridors, paint chipping off the walls and no access to the outside. Then I ask “What if we exchanged the twenty people with dementia who live on this unit with twenty children dying of cancer? Would this place be an acceptable environment for them to live out their last months?” Of course the answer is a resounding no. Why, then, is it an acceptable place for persons with dementia, who have no voice and no power, to live their last years?

...I see more and more incidences of unsafe and unethical practices in acute care. Recently, I had to intervene on behalf of a 90 year old woman with dementia when the hospital tried to admit a young man into the other bed in her double room. She was terrified, yelling “Get that man out of my house! Get him out!”

Creating the framework which would mandate provision of dignified and respectful care for this population of vulnerable people is simply the right thing to do. It is no less than they deserve—they deserve to live in comfort and safety—they built this country.

I can think of no better testimonial for the need for Canada to have a national strategy on Alzheimer's care. Canadians deserve no less. The New Democrats have a long and proud history of advocating for federal leadership on health care issues. We stood unanimously in the House supporting an NDP bill on a national dementia strategy in 2015.

We stood in the House in 2016 and will stand in 2017, despite the fact it was voted down by the previous Conservative government. We are very much encouraged that the member is bringing this bill forward today, even though he voted against our version of it.

We will stand in the House this year and we will vote in favour, and we will work so that every Canadian, every Canadian family, and every caregiver can have a world-class dementia strategy. All parliamentarians should continue to fight for this good cause.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Mr. Speaker, it is an honour to rise today to speak to Bill C-233 and to have the opportunity to speak about dementia.

I want to praise the hon. member for Niagara Falls and heartily agree with his sentiment that this issue does transcend partisanship.

Dementia is a syndrome caused by a variety of brain diseases, the most common of which is Alzheimer's, which is characterized by slow and progressive deterioration of cognitive function. It affects memory, thinking, language, and judgment, along with mood and personality. This is a most curious and mysterious disease.

As our population ages, dementia is of growing concern in Canada and internationally. From 2011 to 2030, the number of Canadians with dementia will double. Right now, more than 7% of Canadians over the age of 65 are affected by dementia. Over 35% to 40% will be affected by the time they reach 85.

My home province of New Brunswick is particularly sensitive to this issue. As it stands, New Brunswick has the highest proportion of population over the age of 65 compared with other provinces. Dementia is on the rise in New Brunswick with over 16,000 people diagnosed and another 3,000 diagnoses expected this year. The impact is compounded by the fact that many seniors are also dealing with additional chronic diseases.

Keeping seniors in their homes helps them to thrive. Knowing this, I am reassured that the provincial and federal governments have made home care a priority when addressing health care in New Brunswick. The Government of Canada has committed over $125.1 million over the next 10 years for home care in New Brunswick.

The fact that there is no current treatment to cure dementia can be devastating to people with dementia and their loved ones. However, we know that research can help find a cure or a way of altering the course of dementia.

I cannot emphasize enough that our government believes in the power of research evidence, which is what we have signalled strongly in the last months. The Government of Canada will undertake and use research evidence to make informed decisions concerning health care. Investing in health research is an investment in a healthier Canada and healthier Canadians.

Research drives the way we diagnose, treat, and care for those with dementia and their caregivers. It has not only helped improve our understanding of dementia and the neurodegenerative diseases causing it, but it created new possibilities for better diagnosis, treatment, and quality of life for patients and their families.

The Alzheimer's Society continues to promote the benefits of early diagnosis. As a 2011 study revealed, 50% of Canadians live for more than a year with their symptoms before seeking diagnosis. We need to do better.

Canadian research has highlighted a link between dementia and stroke. Dr. Sandra Black of the University of Toronto has been collecting brain scans of patients with dementia since 1995. These scans uncovered the prevalence of silent strokes, or strokes that leave small holes in the brain without any obvious symptoms. This research has opened the door to the possibility for earlier diagnosis for Canadians using brain scans. It suggests that reducing the risk of stroke may help prevent dementia. Continued research like this is vital. Our investments in this area are essential to changing the course of dementia and unlocking a cure.

The Canadian Institutes of Health Research, or CIHR, is the Government of Canada's primary vehicle through which we support research and move results into practice. In the last five years, CIHR has invested more than $193 million in dementia-related research. This funding supports the best, most intriguing research questions that Canada's brightest and most promising scientists have to offer. This is research that has the potential for big impacts for Canadians and the Canadian health care system.

For example, Halifax researcher Dr. Janice Keefe has spent 20 years focusing on at-home, family caregivers who she calls "the backbone of our current health system". As Canada's aging baby boomers increasingly care for a spouse or parent with dementia, these family caregivers need support to avoid becoming patients, and not necessarily for dementia. Dr. Keefe co-developed a ground-breaking, evidence-based questionnaire that captures the diverse and complex needs of family caregivers.

The C.A.R.E. tool is influencing policy development and support programs for this often overlooked but vital population. First piloted in Quebec and Nova Scotia, practitioners are now using C.A.R.E. in Ontario and Alberta and it has been culturally adapted for use in France and New Jersey. As the prevalence of dementia increases in Canada, so will the number of caregivers. A tool like this, which helps identify needs and therefore support programs for those who are dedicating themselves to others, is invaluable.

I am pleased to say that by leading its dementia research strategy, CIHR is acting strategically to focus research efforts not only in Canada but internationally. This approach brings together partners from different sectors to support the latest dementia research related to three specific themes: prevention, treatment, and quality of life for those affected by the disease and their caregivers.

The domestic component of the strategy, the Canadian Consortium on Neurodegeneration in Aging, is known as Canada's premier research hub on neurodegenerative diseases affecting cognition, including dementia. The number of funding partners CCNA has brought together is now up to 15.

With these funding partners from across Canada, CCNA helps accelerate the development of dementia treatments and care for Canadians. To do this, it involves over 350 researchers, who are examining issues important to all Canadians, including specific vulnerable groups, such as indigenous people and those living in rural communities. In this regard, dementia rates in Canada's indigenous communities have been steadily increasing for the last seven to 10 years. Alarmingly, the onset of dementia is now occurring an average of 10 years earlier than in non-indigenous communities.

Drs. Kristen Jacklin and Carrie Bourassa are leading research into how indigenous culture and community affect how people experience dementia. Their team is working with indigenous communities to develop culturally grounded approaches to dementia diagnosis, care, and health education. This research will produce a range of results to help clinicians. It will help them adapt their approach to ensure that indigenous people feel more comfortable and safe when meeting with health professionals. It will also help build appropriate community and cultural strengths into existing programming for people with dementia and their partners.

The dementia research strategy developed by CIHR also has an international component, which has enabled Canadian researchers to participate in key international partnerships across its three themes. Through this component, Canadian researchers have been able to collaborate with colleagues from across the globe.

Canada is recognized as a leader in this domain. For example, Canada was the first country outside of Europe to join the joint program on neurodegenerative disease, the largest global research initiative tackling the challenge of neurodegenerative diseases. Let me give members concrete examples of the research funded through the international collaboration.

This program funds the work of Drs. Jörg Gsponer and Paul Pavlidis from the University of British Columbia. They are working on an international team with researchers from Germany, Norway, and the Netherlands to shed light on the genetic risk factors of neurodegenerative diseases like Alzheimer's. This fundamental research will help us find new biomarkers as ways to measure deviations from healthy aging, along with novel treatments and diagnostic tools.

Together the scientific efforts through the strategy's domestic and international components have defined Canada as a leader in dementia research. We are proud to support world-class researchers as they participate in the global pursuit of finding a disease-modifying treatment for dementia by 2025.

Dr. Alex Mihailidis, from the University of Toronto, has developed a mobile robot to help people living with dementia. Sometimes people with Alzheimer's disease have a hard time remembering the sequence of steps required for everyday tasks. Dr. Mihailidis has created an automated prompting system, called the COACH, which helps them remember the steps required in basic tasks like handwashing. Already working well in long-term care facilities, his team is now adapting the COACH to help those living at home.

As members can see, the results of research provide hope that new tools, services, and treatments will soon be available to better prevent dementia and improve the outcomes for Canadians living with this terrible disease.

I am pleased to say that through CIHR, the Government of Canada has established a clear research strategy on dementia. This government will continue to invest in dementia research. We know that our investments in research will go a long way to improving the lives of Canadians living with dementia, their families, and caregivers.

It was an honour to participate in today's debate, which highlights the challenges and growing concerns surrounding dementia. My father, and by extension, my mother and my entire family, is currently struggling with the impact of this terrible disease. Knowing that such amazing research is happening right here in Canada is not only comforting but provides hope for all of us that we may someday find a cure that will allow more Canadians to live a longer, healthier, and happier life.

[Rob Nicholson, Conservative, Niagara Falls, ON]

moved that the bill be read a third time and passed.

It is a great honour to rise in this chamber to address my bill, Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias, on the occasion of its third and final reading. I am most gratified that, to date, this proposed legislation has had the support of the majority of the members of the House.

Alzheimer's disease currently affects three-quarters of a million Canadians and their families, and that figure is expected to double within a generation. In addition, three out of four Canadians know someone who is affected by Alzheimer's or dementia. That is 75% of all Canadians.

It is imperative as we prepare to cross the finish line with this legislation that we complete this task together. Canadians are counting on it. It is most heartening to know that in matters of great concern to the citizens of our country and their families that we, as members of Parliament, can work together across party lines to unite and advocate for research, collaboration, and partnerships to find cures, provide timely diagnosis, and offer support for treatment. This co-operation will lead to positive health outcomes for Canadians who suffer from Alzheimer's and dementia, and will reassure their loved ones who provide care. Canadians expect that parliamentarians will work on their behalf to resolve these critical issues.

Members from across the aisle have demonstrated their willingness to work together to ensure that a national coordinated strategy is put in place to alleviate the suffering of Alzheimer's victims and their families. They have brought the very best of Canadian principles to the floor of the House of Commons to ensure that Bill C-233 will be passed for the greater good of Canadians.

I reiterate that no one should have to witness the slow and painful deterioration of a loved one or a family member suffering from this cruel illness. Far too many Canadians endure the long goodbye.

I know that I do not stand alone, as I am joined by many of my colleagues in this House who have dealt with, or are dealing with, a family member, a friend, or a loved one who is suffering from various forms of dementia.

Alzheimer's is no respecter of persons. From former President Ronald Regan to our next-door neighbour, this terrible disease knows no bounds. It takes a terrible toll among its victims and their families.

It is important for me to once again acknowledge and express my gratitude to the member for Don Valley West for seconding this legislation when it was introduced in Parliament. The member has shared heart-wrenching stories of parishioners he dealt with in his work as a United Church minister, and I know he shares my desire to see this bill become a reality. I thank him for his support. I want to acknowledge as well the work of former member Claude Gravelle on this important issue. It once again demonstrates that we can work together in a non-partisan manner. When we do that, we can accomplish much for Canadians.

It is in this vein that I once again ask my colleagues in the House to walk shoulder to shoulder with us to ensure that Bill C-233 is passed into law for the millions of Canadians who will depend on it. We have come too far to let them down now. By acting now, we are remembering those who cannot.

The House proceeded to the consideration of Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias, as reported (without amendment) from the committee.

Alzheimer's Disease

[Rob Nicholson, Conservative, Niagara Falls, ON]

Mr. Speaker, I am pleased to rise in this chamber today prior to the third and final reading of my private member's bill, Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias.

I wish to sincerely thank my colleagues on this side of the House and members across the aisle for their support of this important legislation on behalf of the 747,000 Canadians living with this terrible disease.

Many of us have had to endure the very painful long goodbye to a loved one without the benefit a having a coordinated strategy.

I want to especially thank my colleague, the member for Don Valley West for his backing in seeing that Bill C-233 becomes a reality.

The non-partisan collaboration from all parties is a shining example of what we can accomplish in this House when we work together for the greater good of all Canadians.

Health

[Bill Casey, Liberal, Cumberland—Colchester, NS]

Mr. Speaker, I have the honour to present, in both official languages, the fifth report of the Standing Committee on Health in relation to Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias.

The committee has studied the bill and has decided to report the bill back to the House with amendments. I want to say that amendments were proposed by members of all parties on the committee, and we really feel that we have strengthened the bill as we present it.

[The Chair, Liberal, Bill Casey]

Okay, time is up.

We're going to five-minute rounds now, but the chair has to leave. I'm going to table our fifth report on Bill C-233, and I think that's quite an accomplishment for us. I'm tabling that this morning. When I table it, I'm going to say that every party had amendments that we think strengthened Bill C-233.

I'm going to turn the chair over to Mr. Webber, and I'll go to table Bill C-233.

I want to thank our guests. I'm sorry I'm going to miss the rest of this. It's very interesting, and you're bringing new perspectives that we hadn't heard. Anyway, I have to go.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Thank you, Mr. Chair.

I'll start again. At the first meeting on Bill C-233 on November 17, Mimi Lowi-Young, former CEO of the Alzheimer Society of Canada, told the committee that women are most affected by the disease, that 65% have the disease and 72% are primary caregivers. Do you anticipate that a gender-based analysis plus assessment will form part of the discussion leading to establishing a national strategy on Alzheimer's disease and other forms of dementia?

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Thank you, gentlemen, for bringing this bill forward.

As we discussed before, almost everybody is affected by some kind of mental disease in their family or friends. This is a good bill, and of course you're going to have my support.

At the first meeting on Bill C-233, on November 17, Mimi Lowi-Young—

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

Then I think it should be removed from the legislation.

I want to get on to another issue. Unlike Bill C-356, the national strategy for dementia act, this legislation doesn't contain any provisions to augment the capabilities of the voluntary sector. Can you explain why you chose to exclude any mention of the voluntary sector from Bill C-233?

[Rob Nicholson, Conservative, Niagara Falls, ON]

Mr. Chair, vice-chairs, and members of the committee, it's an honour to be here today to present my private member's bill, along with my fellow colleague, the member for Don Valley West, Mr. Rob Oliphant.

Bill C-233, is an act respecting a national strategy for Alzheimer’s disease and other dementias. This bill calls upon parliamentarians to enact legislation for a national coordinated strategy for what has been termed Canada's invisible killer. Alzheimer's and dementia are major health problems that transcend partisanship and are affecting a staggering number of Canadians currently. I believe you have heard that 740,000 Canadians currently suffer from Alzheimer's, and ever more concerning is the fact that this number is expected to double in the next 20 years.

This is why I believe Canada needs to have a plan. I'm certain Mr. Oliphant will touch upon his experiences with Alzheimer's and dementia when he speaks, so I would like to take a moment to note the work on this topic by a former member of Parliament, Claude Gravelle. It's most heartening to know that in matters of concern to Canadians and their families, MPs can work together across party lines to unite and advocate for research, collaboration, and partnership, to find cures, timely diagnoses, and other support for treatment. This co-operation will lead to positive outcomes for Canadians who suffer from Alzheimer's and dementia, and will reassure their loved ones that people who are suffering from this will have the proper care. Canadians expect that their parliamentarians will work on their behalf to resolve these critical issues.

The impact on families whose loved ones are suffering from Alzheimer's or dementia is extensive. Three out of four Canadians know someone living with dementia. I can't tell you how many people have approached me over the last couple of months to tell me the stories they have experienced within their families. This not only takes an emotional, psychological, and physical toll on those who are providing support for loved ones, but it also has a severe financial effect.

In 2011, caregivers provided 444 million hours of care, representing $11 billion in lost income, and about 230,000 full-time jobs. By 2040, caregivers will be providing 1.2 billion hours of care, over two and a half times the number of hours they provide today.

Alzheimer's and dementia are no respecters of people as they rob them of their dignity, independence, memory, and time. They know no bounds and are not restricted to social or economic factors. No one is immune to these terrible diseases and the suffering that follows.

It brings to mind the late United States President Ronald Reagan. The former leader of one of the most powerful and wealthy nations on earth could not be safeguarded from the ravages of Alzheimer's. On November 5, 1994, I remember him as the 40th president of the United States, addressing the American people by writing, in part, “I now begin the journey that will lead me into the sunset of my life.” That journey took 10 slow and painful years. His loving wife Nancy referred to it as the long goodbye.

Far too many Canadians endure the long goodbye. My own father, who I cherished, passed away from complications due to Alzheimer's, and I am joined by many who have dealt with or are dealing with a loved one suffering from one of the various forms of Alzheimer's and dementia. Again, we know that this is going to increase.

The bill I have put before you, first of all, proposes to establish a round table to receive input from all Canadians. It would develop a national strategy, while ensuring the autonomy of the provinces remains intact. Second, it would encourage greater investment in all areas related to Alzheimer's and dementia, in addition to coordinating with international bodies to fight against the disease. Third, it would seek the assistance of the provinces in developing and disseminating diagnostic and treatment guidelines based on new research. All of these measures have been thoroughly considered to ensure the successful passage of this legislation.

Importantly, please note that this bill does not restrict timelines or financial criteria. This is a deliberate intention to remove potential barriers, such as the need for a royal recommendation. Simply put, this bill is crafted for implementation, achievement of deliverables and, ultimately, resilience at third reading. The objective is to enact legislation that would provide solutions to assist those who suffer from Alzheimer's and dementia, and to aid family members and caregivers.

The World Dementia Council was created by the G8 in 2013 as a global coordinating movement against Alzheimer's and other dementias. It's trying to harmonize those efforts and bring together global know-how.

Canada, along with its G8 partners, had convened a meeting in London, England, in December 2013. The sole purpose of that meeting was to provide a structure for a worldwide response to this crisis. It was the first time that the G8 countries had gathered together to address a health care issue. It's clear that Canada has already agreed to work with our partners to address Alzheimer's.

In order to fulfill this mandate, we have to develop similar programs here at home. Bill C-233 would help achieve this outcome through the national strategy. I would reiterate that Bill C-233 would respect the health care accountability of each province. I was very careful in the drafting of this bill to ensure that it does not require a royal recommendation.

I would be remiss if I didn't acknowledge and thank the Alzheimer Society of Canada for their unwavering support of this bill. Their mandate and the objective of this bill closely align and support one another. The Alzheimer Society stated that it was pleased to see political parties working together to address dementia. It urged all members of Parliament to get behind this bill, suggesting that a national strategy focusing on research, prevention, and improved care is the only solution to tackling the impact of this disease.

I believe that support for this bill is the right thing. Alzheimer's and other dementias are major health issues that impact hundreds of thousands of Canadians, and it is a problem that is growing every day. Canada needs a strategy now, so Canadians can be prepared to take on this health crisis in the future.

Thank you for your support.

I'd like to now turn it over to my colleague, Robert Oliphant.

Dementia

[Rob Nicholson, Conservative, Niagara Falls, ON]

Mr. Speaker, today I am pleased to present to the House of Commons a petition with respect to my private member's bill, Bill C-233. The bill supports developing strategies for patients and families of Alzheimer's and dementia victims. It has been certified by the clerk of petitions. I am proud to present this petition.

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

First, I want to thank you all so much for your amazing work. A special thank you to those of you who are in B.C. I am a B.C. MP, and I know exactly what time it is there, so I thank you so much for being here with us so early in the morning.

I want to first mention that in 2012, former NDP MP Gravelle introduced Bill C-356, a national dementia strategy, in Parliament. Unfortunately, his bill was defeated in May of 2015 by a single vote. It was a vote of 140 to 139. I think it was a really sad day for many of us. The Canadian Medical Association called this defeat “a lost opportunity to make lasting progress in the serious and growing problem of dementia in Canada”. The bill was opposed by a majority of Conservative MPs, including the member for Niagara Falls, who is the sponsor of today's bill, Bill C-233.

New Democrats, we will support Bill C-233, but it is less ambitious in its scope and implementation provisions than the former Bill C-356. Some of the concerns we have are around the establishment of the advisory board. In Bill C-233 there's a statement that says: “The board is to advise the Minister on any matter related to the health care of persons living with Alzheimer’s disease or other forms of dementia.” But unlike Bill C-356, the legislation offers no remuneration for the work of the advisory board members, nor any reimbursement for travel costs.

I come from a very rural riding, and I understand that the experiences of people across the country are very different. In your view, could this impact the formation and work of a national advisory board?

[Dr. David Henderson, President, Canadian Society of Palliative Care Physicians]

Thank you very much, Mr. Casey, honourable members, and guests.

It's with great pleasure that I'm here to speak on this, because not only am I the president of the Canadian Society of Palliative Care Physicians but I am also the son of a lovely lady with dementia. It's very timely for me to come and speak on this.

Today we have several members here who will be speaking about personal experiences and such, so I'll keep my comments to the palliative care aspect of this issue.

Our society is made up of around 500 physicians from across the country, and that includes regional leaders in palliative care, residency directors, clinicians, educators, and family physicians with a special interest in palliative care. Our society is proud to say that we support Bill C-233. I'm going to start off by giving you a few of our key messages that we want to get across.

Alzheimer's disease and other dementias are a tremendous challenge for many Canadians and their families. The needs of caring for someone with dementia are many. A national strategy clearly identifying and developing mechanisms to help Canadians manage the needs is essential, given the expected increase in the diagnosis with our aging population. Clear direction, goals, and funding for further research is imperative. Education on prevention needs to be expanded, and education on a palliative approach to care for dementia patients and families needs to be enhanced.

As we've just heard, Canada has an aging population, with one in six people having reached their 65th birthday by July 2015. That number is going to exponentially increase over the next few years. By 2024 the number of people over 65 will be more than 20% of our population. Again, as we've heard, the number of people up to age 14 is less and less. What that's telling us is that the baby boomers are climbing, we have an exponential rise in people over 65, and we don't have the same number of youth, coming up behind, to become caregivers. That will be quite an added load for everybody to be carrying.

As we've heard, dementia is a progressive deterioration of memory, reasoning, communication, orientation, judgment, and abstract thinking capacities, leading to the loss of ability to perform independent activities of daily living and eventually all activities of daily living. These are life-limiting conditions, and there are no curative treatments. Only about a third of people get a formal diagnosis. Changes in behaviours and emotions are common reasons for placement in residential care. Often these people receive very poor end-of-life care.

There are several dementia subtypes. Alzheimer's disease makes up about 47%. You can have a mix of Alzheimer's disease with other types of dementias, accounting for about 27%. There are vascular dementias, fronto-temporal dementias. With Parkinson's, you can get a Lewy body dementia. These all carry different sequelae with their symptoms.

The illness trajectory can often be long, with great disability along the way compared with that of other life-limiting conditions. From a physician point of view and from a health care point of view, communication with the person and their family early on is essential to determine their values, wishes, and goals. Within palliative care education, we spend time teaching approaches to having these conversations with primary care physicians, home care nurses, long-term care nurses and physicians, PSWs or personal support workers, and social workers.

Recently we had a wonderful education tool developed through Pallium Canada. There is education material we've been using for palliative care called “LEAP”, or learning essential approaches to palliative and end-of-life care. They recently developed “LEAP long-term care”. We were part of a pilot project with them, this being a country of pilot projects. It's amazing, even for someone who's been working in palliative care for a number of years, to look at the difference between what we're teaching for an adult and youth population versus what we're talking about for a more geriatric population. There are significant differences. You don't tend to see cancer near as much in that elderly population, basically because they have outlived the time when they are most likely to develop some of the cancers. Much more often, you're seeing multiple comorbidities such as heart disease, lung disease, and certainly cognitive diseases with dementias.

It is a wonderful nationally recognized and nationally accepted education tool. The key is to get that education out there so more practitioners and health care providers get that education. It's also multidisciplinary. This isn't something that just physicians need to be dealing with—we need our social workers, our pharmacists, our nursing staff, our PSWs, who make up much of the workforce in long-term care, to truly understand how to manage these conditions.

With palliative care in general, we're talking about a health-discipline focus on improving quality of life for people living with serious life-threatening illnesses. We have something now we've developed nationally, called the palliative approach to care. We will never have enough specialty palliative care teams to be able to care for everyone who needs access to palliative care, and nor should we. A palliative approach is really coming back to the grassroots and ensuring that we educate up our home care nurses, our family doctors, our nurse practitioners, and also our specialists, even within gerontology, to help ensure they have good palliative care knowledge and skills to be able to translate that care to the community and the home. Our cardiologists, our nephrologists, our oncologists all need to have these skills.

Grief and bereavement is something I want to make sure we bring up with too. It was alluded to earlier. As you can all imagine, if you get a diagnosis of cancer, that's a pretty shocking thing to hear. Most people will automatically think they're going to die, and you start on that trajectory and you may or may not. We don't often get told of a diagnosis of dementia until quite far into the diagnosis. So the person sometimes has a harder time understanding and coping with it.

You can only imagine what somebody goes through with a diagnosis of dementia. We all forget where we put our keys sometimes, but sometimes we start to recognize that this is getting worse and worse as time goes on. You go through repetitive losses with that. You're starting anticipatory grief earlier on, starting to recognize that you've experienced this, especially more and more now that perhaps you've seen somebody else in your family, a grandmother or great-grandmother, go through this. So you kind of know what to expect. That can be pretty devastating.

In my family, we are scattered across the country. I have sisters living in British Columbia, Alberta, and New Brunswick, and I'm in Nova Scotia. Families are more typically scattered now, and often lack the family support required to care for people. So now you often end up with a single caregiver, who is often elderly as well, often with comorbidities of their own, other health issues, trying to care for somebody with dementia. They're going through anticipatory grieving as well, and their entire lives end up being changed. There's much that needs to be done to help support these people.

I also want to point out that men who lose their wives, whether through cancer or dementia, are at a much higher risk of suicide. It's often not recognized that way. Our health system isn't necessarily responsive to that and doesn't always recognize it. It is a population to which we have to give a little extra care and do good risk assessment for bereavement.

To conclude—to take Mr. Trudeau's comments—we're palliative care and we're here to help. Our society is committed to help support Canadians with life-limiting illnesses, especially with Alzheimer's and dementia. We're happy to be part of any strategy that moves forward to try help develop a good system for Canada.

Thank you.

[Mimi Lowi-Young]

Thank you very much, Dale.

I come to this committee as a former CEO of the Alzheimer Society of Canada and the author of the “Canadian Alzheimer's Disease and Dementia Partnership” and the national strategy and action plan submitted to the government about four years ago now. I've also held positions as a regional health authority CEO, and I've worked in probably every segment of the health system, including acute care, rehab, and long-term care. I was also recently appointed to the institute's advisory board of CIHR as a member of the institute on chronic disease. My work will continue in an effort to help people with dementia and their families.

My mother also suffered from vascular dementia, but in those days it was identified as senile dementia. She suffered for many years, and she died spending the last month of her life in the ICU with a breathing tube.

Ladies and gentlemen, the time has come that Canada moves from writing reports, number-crunching, and vague statements about a national dementia strategy. There is a need now to make a firm commitment to a national dementia strategy and action plan, including a pan-Canadian, non-partisan entity, the Canadian Alzheimer's disease and dementia partnership, with a commitment of funding of $30 million per year, which is just less than a dollar per Canadian per year, to invest in research and knowledge translation; prevention; and living well with the disease. These are the three critical pillars of a national dementia strategy and action plan.

Let me set the context for the specifics, which should be articulated in Bill C-233, that will lead to action by the Government of Canada and the jurisdictions who have the responsibility of delivering health care services in accordance with the BNA Act and the Canada Health Act.

I would be remiss if I didn't acknowledge the outstanding and comprehensive report issued by the Senate Standing Committee on Social Affairs, Science and Technology on Tuesday of this week, chaired by the Honourable Kelvin Ogilvy and the deputy chair, Honourable Art Eggleton, P.C. This report speaks to the urgency for action and the areas of focus for the Canadian Alzheimer's disease and dementia partnership and a national dementia strategy and action plan, which I will cover in some detail shortly.

Please indulge me to give you a few numbers, even though I just said we shouldn't be number-crunching anymore.

In Canada, dementia has touched over half a million people with the disease, and it has touched many more. The number of people with dementia will double in less than 20 years. Unpaid caregivers, families, and friends involved in the care and support of individuals with dementia are also directly impacted. They are touched in so many ways by this disease, which is progressive. We have no cure or disease-modifying therapy to avert or curtail the disease.

Women are most affected by the disease, both by having the disease, at 65%, and being the primary caregiver, at 72%. Over 65% of individuals currently residing in long-term care homes have some form of dementia. A number of them could and should be being cared for in the community if there were adequate services in home and community services. Our emergency wards care for many individuals with dementia, as there are few services to deal with the many challenges of this progressive disease.

Overall, this disease has significant impact on the social and economic fabric of this country at a cost of $10.4 billion per year. This number will double in the next few years as the population ages. We have more people over the age of 65 than under the age of 14.

Another cruel reality of dementia is the stigma related to the disease. Individuals with the disease become terribly isolated from their friends and family, which leads to further deterioration of their condition. As well, physicians are reluctant to provide an individual the diagnosis of dementia, as they know they have no treatment or cure to offer.

In Canada we have research initiatives and we have programs and services available to individuals with dementia and their families, but the amount of research is very limited. Only 5% of CIHR funding goes towards dementia. The number of such programs and services is also very limited, and access depends on where the individual lives. There is poor and inconsistent coordination of care and services among health care providers in different parts of the health system. Evidence from research and best practices are inconsistently implemented, or not implemented at all: Canada is known as “pilotville”.

Is there a solution to this compelling national public health priority? Ladies and gentlemen, the answer is, yes, of course.

We need the commitment from Parliament that a national dementia strategy and action plan will be established with oversight provided by a newly established Canadian Alzheimer's disease and dementia partnership.

What are the components of a strategy and action plan? There is a desperate need to increase the investment in research. As well, the Canadian Alzheimer's disease and dementia partnership could and will bring together researchers and institutions to reduce duplication, promote sharing of information, and determine effective knowledge translation and exchange strategies, which means using evidence to improve practice and care and delivery by practitioners. Efforts to encourage innovation, investment, and drug discovery is really important.

In the area of prevention, the second pillar, the government should complete the implementation of the surveillance system for dementia by the Public Health Agency of Canada. The government should set targets for health practitioners to achieve with regard to early and improved diagnosis of the disease. The government should actively promote the evidence-based actions Canadians can partake in to reduce the risks, such as exercise, diet, blood pressure control, and the elimination of smoking, just to name a few.

The last pillar is living well with the disease. Ongoing support of Dementia Friends, with an emphasis on developing dementia-friendly communities, will assist in reducing the stigma of the disease and will improve public awareness. In an effort to maintain the independence of persons with dementia for as long as possible, the Alzheimer Society's First Link program, which is a referral program, should be standard in every community in the country.

Improved access to home and community services provided by health care providers who are trained in the delivery of care for individuals with dementia is critical. The federal government should continue to pursue efforts to support unpaid caregivers through employment insurance reform initiatives.

Finally, to prepare for the rising tide of dementia, the amount of ongoing training and education of health professionals in geriatric medicine and care must be improved and increased as soon as possible.

There is truly a window of opportunity for this government and the Parliament of Canada to provide the necessary leadership to implement a national dementia strategy and action plan for the following reasons. The conditions are right and ripe.

First of all, there's a commitment by this government to add $3 billion for home and community care, including palliative care. There is the ability to negotiate a new health accord.

There is the desire by Canadians to have a national dementia strategy. Eighty-three per cent have told us that they want one.

The Council of the Federation has identified dementia as a key priority for its health committee. Many provinces are creating provincial dementia plans, and some have already implemented them.

People with the disease and their families have growing needs and a desire to be directly involved in decision-making and policy development.

There is a rising tide of aging and dementia in Canada.

Let me conclude with a short story about Mr. and Mrs. G. Mr. G was a very successful restauranteur, and his wife worked in a hairdresser's shop serving many customers for 30 years. Mr. G had a stroke three years ago, with limited physical deficits, and Mrs. G retired two years ago.

Mrs. G needed a haircut but delayed having one for nearly a year, as she forgot about the appointments and kept calling to make the same appointment over and over again for her and Mr. G. As a result of the stroke, Mr. G now has vascular dementia. Their daughter lives with them at home but travels extensively. Mr. G still drives and Mrs. G still cooks. They're both emaciated and probably don't eat or cook very much anymore.

This situation can turn into a major disaster. Is there no safety net for a situation like this? How many more Mr. and Mrs. Gs are there in Canada?

For my final comment, I would like to quote Margaret Chan, Director-General of the World Health Organization, who captures the essence of the dementia crisis. She said:

I can think of no other disease that has such a profound effect on loss of function, loss of independence, and the need for care. I can think of no other disease so deeply dreaded by anyone who wants to age gracefully and with dignity. I can think of no other disease that places such a heavy burden on families, communities, and society. I can think of no other disease where innovation, including breakthrough discoveries to develop a cure, is so needed.

Mr. Chairman and members of HESA, please ensure that any modifications to Bill C-233 will only strengthen what Canada needs, a national dementia strategy and action plan, and the Canadian Alzheimer’s disease and dementia partnership. No more studies. No more number-crunching. We need action now.

Thank you for giving me the opportunity to present my perspective. I am committed to seeing Canada implement the strategy and plan so that Canadians with dementia and their families now and into the future will know that they can depend on their country for care and support.

Thank you very much.

[Dale Goldhawk, Vice-Chairman, Alzheimer's Disease International]

Good morning, Mr. Chair, honourable members, ladies and gentlemen.

Alzheimer's disease killed my father. The unrelenting emotional and physical stress also led to the death of my mother. That was 30 years ago, when we knew very little about this disease.

Dr. Alois Alzheimer first studied it in 1901, 115 years ago, and still there's no effective treatment, let alone a cure. I think that underlines the vital importance now of the passage of Bill C-233, and, following that passage, meaningful funding to help people whose lives are being profoundly affected by the heartbreak of dementia.

Just three years ago, there were only 13 countries in the world with dementia strategies. Now we have 28. I can say that after years of inaction and little progress, enthusiasm, optimism, and real action appear to be at hand. For one thing, the World Health Organization at its assembly in May of next year hopes to pass a global plan of action on dementia. It has a very blunt message: governments must implement national plans to fight dementia, take action, and do it now.

Alzheimer's Disease International research says that every three seconds, a new case of dementia is recorded in the world. Momentum, of course, is building in Canada. It begins with the passage of Bill C-233, which we need, and the Senate report on dementia released yesterday, which we also need, to help build that forward motion to chart a course of action behind the bill.

I know of no one better equipped to talk about that course of action than my colleague Mimi Lowi-Young. She has worked hard formulating that action for several years now.

Mimi.

[Mimi Lowi-Young, Former Chief Executive Officer of the Alzheimer Society of Canada and Health Care Executive, As an Individual]

Good morning to the chair, Mr. Casey, to the two vice-chairs, Mr. Webber and Mr. Davies, and to the members of the Standing Committee on Health.

I'm Mimi Lowi-Young, and I'm very honoured to be a witness for this committee's examination of Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias.

Presenting with me today is Mr. Dale Goldhawk in his capacity as vice-chair of Alzheimer's Disease International. Mr. Goldhawk is a veteran journalist and broadcaster. For the past 20 years, he has been an Alzheimer's volunteer and a former president of the Alzheimer Society of Canada.

[The Chair, Liberal, Bill Casey]

Okay. So that's all right with you.

It was moving testimony. I know I certainly felt the emotion in the words from the presenters. It was hard to miss how urgent the situation is.

So I will add those comments when I table the report.

This morning we're having our first meeting on Bill C-233, An Act respecting a national strategy for Alzheimer’s disease and other dementias

To our guests this morning, welcome. We look forward to your testimony.

We have Mimi Lowi-Young, who I understand is working with Dale Goldhawk, the vice-chair of Alzheimer's Disease International; from the Canadian Society of Palliative Care Physicians, Dr. David Henderson, who's from Truro; and from the Council of Senior Citizens Organizations of British Columbia, by video, Kathleen Jamieson, chairperson, and Sheila Pither, treasurer.

We welcome you all to our committee.

I understand we'll start with you, Mimi Lowi-Young, and you're going to share your time with Mr. Goldhawk. You have 10 minutes. Thank you.

[John Oliver, Liberal, Oakville, ON]

Mr. Chair, I move:

That the Committee dedicate the meetings of Thursday, November 17, Thursday, November 24, Tuesday, November 29 and December 1, 2016, to study Bill C-233, An Act respecting a national strategy for Alzheimer’s disease and other dementias.

(Motion agreed to)

[Colin Carrie, Conservative, Oshawa, ON]

I am going to agree with my colleagues. There are many things on the table that are extremely important, but perhaps the analyst can get back to us with potential witnesses for Bill C-233 because we might be able to get the whole thing done in two meetings. I think we are all in agreement on moving forward on that.

[John Oliver, Liberal, Oakville, ON]

I think Bill C-233 is a very important bill that we should give full time and attention to as a committee. We need to make sure we get it onto our work plan. It seems to enjoy the support of many people in all parties in the House.

I would like to recommend that we dedicate at least two meetings, if required, to hear witnesses. November 17 and 24, Thursdays, would be dedicated to Bill C-233 for witnesses, if required, and we would do our clause-by-clause study on either November 29 or December 1. We've only done one bill to date, so I don't know how much time is required between witnesses before we do the line-by-line consideration, and whether there's any work to be done by the analysts after the witnesses do their piece. If there's no time required for the analysts, then I suggest we do the line-by-line consideration on November 29. If time is required, then I suggest we target December 1 for the clause-by-clause review.

My understanding is that we need to have our work completed by December 8 or the bill will go back to the House unamended.

[Debbie Benczkowski]

First of all, I think we should talk about the financial investment we're requesting the government to make. It's $30 million a year over five years. That is really less than $1 per Canadian, per year, for a disease that's already costing well over $1,000. So it's a modest investment.

We already have Bill C-233, which is a private member's bill, as you know. It's been through second reading and it's at the health committee right now. It's really for direction to Canada to have a strategy on Alzheimer's disease and dementia. The money that is being requested is to establish the Canadian Alzheimer's disease and dementia partnership, which is a suggestion to the government on how we develop a strategy. Thirty countries around the world already have dementia strategies in place. All the G7 countries except for Canada and Germany have dementia strategies in place. We have taken the best of all of those strategies, which are now being evaluated at an international level. The World Health Organization has also called on all member countries to really make sure that countries address the rising tide of dementia and the increased numbers of people who will be affected.

As I said, there are three areas of investment that we're looking at. There's research. There's prevention, with early diagnosis and early intervention, making sure that people get an accurate diagnosis so that they can avail themselves of the proper care and support they need. Then there are the medical and clinical interventions that will help them to lead a better quality of life.

We feel we've addressed the jurisdictional issues between the federal government and the provinces, because all of the areas we've suggested to be part of the partnership are within the jurisdiction of the federal government. One of those key areas is that we develop plans and then make sure that indigenous communities have access to culturally specific and appropriate care and services across Canada.

[Debbie Benczkowski, Chief Operating Officer, Alzheimer Society of Canada]

Good morning, Mr. Chair. On behalf of the Alzheimer Society of Canada, let me thank you all for the opportunity to appear before you and the members of this committee today.

We did submit a pre-budget submission. We recommended that the government invest $150 million over five years for the creation of a Canadian Alzheimer's disease and dementia partnership to support the implementation of a national dementia strategy for Canada. I have a copy of our partnership document here that we can make available to all of you. Today I'd like to talk a little bit about how the CADDP, or what we call the partnership, and the national dementia strategy would help Canadians living with this disease as well as their caregivers.

Dementia is a chronic, progressive health condition, and it has no cure. Today 564,000 Canadians live with dementia, and we expect this number to rise to 937,000 by 2031. This is an increase of 66% in just 15 years. Some of you seated around the table may know someone or may be related to someone who has dementia. In fact, three out of four Canadians do. I lost my own mother to dementia just this past July.

Dementia's growing numbers are further complicated by soaring costs. According to the national population health study of neurological conditions, which was funded by the Public Health Agency of Canada, in 2016 our economy is spending $10.4 billion on health care and caregiver costs. By 2031 this figure is expected to increase by 60% to $16.6 billion. These numbers are too big to ignore. Nor can we ignore the people behind these numbers who struggle to cope with the malicious effects of this disease each and every day. Women are especially affected. They represent 60% of Canadians with dementia and 70% of caregivers.

Caregiving is another aspect of dementia that we can't afford to ignore. In 2011 alone, family caregivers provided a staggering 19.2 million unpaid hours of care, which is expected to double by 2031. The amount of time and stress involved with caregiving can result in losses in productivity for our economy, including lost work days and underperformance on the job, losses that our economy and my co-presenters who are here today can't afford to ignore. Worse yet, it forces many caregivers to have to leave their jobs.

Clearly we're facing a challenge, but there are solutions. We welcome the recent action by Minister Duclos to seek the views of Canadians on providing a more inclusive caregiving benefit for those who provide care to a family member. Even the smallest level of financial assistance will allow family caregivers to remain employed and in the workforce for longer.

A change in policy will reduce the number of lost work days and boost our GDP. While this is a small but positive step, dementia requires bold action. It requires a comprehensive approach. The best thing we can do for Canadians and their families is to adopt a national dementia strategy, and that's why the Alzheimer Society has proposed a Canadian Alzheimer's disease and dementia partnership to guide the development and implementation of a national strategy. It would involve multiple stakeholders working together and a public health approach.

A pan-Canadian dementia strategy would ensure that all Canadians with dementia and their caregivers will have access to the same level and quality of care and services no matter where they live. This strategy would be based on a number of priorities and objectives that clearly fall within the federal government's mandate. It would ensure tangible benefits for people affected by dementia.

We have three priorities for a national strategy. These include investing more in scientific and medical research and innovation; prevention, early detection, and early intervention; and living well with dementia—ensuring people with dementia and their caregivers can live as well as possible as they progress through this disease.

We are running against the clock. Each year, 25,000 Canadians are diagnosed with dementia.

I firmly believe that solutions are within reach and that we can make a difference for hundreds of thousands of Canadians. On behalf of the Alzheimer Society, I ask you first to commit to an investment of $150 million over five years to create a Canadian Alzheimer's disease and dementia partnership. Second, I ask you to support private member's Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias, when it returns to the House—shortly, I hope—for third reading.

Mr. Chair and committee members, thank you so much for your time. I'd be pleased to answer any questions you may have.

National Strategy for Alzheimer's Disease and Other Dementias Act

[Cheryl Hardcastle, NDP, Windsor—Tecumseh, ON]

Mr. Speaker, I am pleased to speak today to Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias.

The New Democrats believe that a national strategy for dementia is long overdue. In fact, one should already be in place, and would be, had the current sponsor of this bill, the member for Niagara Falls, and his party not voted down a similar yet more comprehensive NDP bill that was tabled in the previous Parliament.

Dementia disease is a progressive degenerative disorder that attacks nerve cells in the brain, resulting in loss of memory, thinking, language skills, and behavioural changes. The disease forms lesions in the brain cells of patients, causing nerve connections to sever and nerve cells to die.

Alzheimer's is the most common form of dementia, which is a general term used to describe a group of systems, such as loss of memory, language, motor skills, and other brain functions. Alzheimer's is not part of the normal process of aging, and currently has no cure.

The New Democrats ardently support the need for national leadership to develop and implement a comprehensive strategy across Canada to address Alzheimer's and other dementias. Our caucus unanimously supported former NDP MP Claude Gravelle's bill in May 2015 to create a national dementia strategy. Further, in election 2015, the NDP committed $40 million toward the implementation of a national Alzheimer's and dementia strategy.

Our party recognizes the crisis facing Canadian health care as our country's population ages, including the growing prevalence of dementia among the elderly. We believe immediate action must be taken to tackle these serious challenges on a comprehensive basis. Accordingly the New Democrats are concerned by the decision of the Liberal government to abandon its home care promise in budget 2016. By abandoning the necessary investments now, the Liberal government will only further exacerbate the costs and suffering down the line .

A national strategy for Alzheimer's and other forms of dementia must include mechanisms to ensure that staff have the necessary knowledge about the disease and the skills to deal with it. This means that people have to share information. The purpose of a national strategy is to share that information. People should not be working in isolation.

We have to find a way to ensure that everything we learn, everything that might be useful, such as best practices, is communicated to people struggling with the same problems. It is essential for people to have ways to talk to each other. The goal is not to step in for the provinces, but to ensure that communication channels remain open and people work together. Real collaboration needs to happen so people can share best practices. We have to ensure that nursing staff, doctors and other professionals, such as police and emergency responders, know and understand how to deal with dementia. They need to have the right skills and knowledge to work with people with dementia and provide them with quality care that is appropriate for their situation.

They are often forgotten, but the volunteers who work in this field need to be able to understand the reality of a person living with dementia. It is not always an easy thing to do. There are certain situations that are very difficult to go through on a daily basis, and it is hard to know how to intervene. The volunteers who work at these centres must have access to the knowledge and skills they need to properly understand the reality of the field they have chosen to work in.

As far as research is concerned, we have extraordinary Canadian researchers. However, we could also form international partnerships to further our knowledge. In my opinion, the quality of daily life for people with dementia is an essential area of research. Lately, a lot of research has been done on daily life, and we have learned how significant and deeply impactful this research can be.

In many places there has been a shift from a very medically-based approach to one focusing on the daily experience of dementia sufferers. The goal is for the transfer to long-term care to go as smoothly as possible. For that to happen, the person with dementia needs to be able to create reference points.

A lot of advances have been made because of these various approaches that focus on quality of life and ways of providing care and intervention. Not only is this helping those living with dementia to live much more happily, it is enabling families to be an integral part of the care process.

There is a lot to do. With the challenges this will present in the coming years, it is essential to share information in order for us to adopt an effective national strategy for dementia. According to the Alzheimer Society of Canada, as we heard earlier tonight, the disease and other dementias now directly affect 747,000 Canadian patients, and this number is expected to double to 1.4 million by 2031. Current dementia-related costs, both medical and indirect lost earnings, of $33 billion per year are expected to soar to $293 billion by 2040.

Sadly, the burden of caring for patients with dementia and Alzheimer's falls primarily on family members. In Canada, family caregivers spend 444 million unpaid hours per year caring for dementia patients, representing $11 billion in lost income and 227,760 lost full-time equivalent employees in the workforce. Providing millions of hours of unpaid caregiving has forced people to cut back or leave work altogether, which harms them and our economy. I want to talk about that this afternoon.

I learned from the Canadian Medical Association that 15% of scarce acute care beds are occupied by people who could be placed elsewhere, and half of them are dementia patients. Beyond those statistics, I have learned the real face of the problem. The real face of dementia is not just older people. I learned that 15% of dementia patients are under 60 years of age. I learned that we have a health care crisis and a social and economic crisis that we must address.

This is therefore an issue that cries out for leadership from Ottawa, working with the provinces and territories, which of course, have primary jurisdiction duties for health care delivery. I want the leadership from Ottawa to tackle five main elements: early diagnosis and prevention; research; a continuum of care for people and families in the home, the community, and institutions; real help for caregivers; and training for the dementia workforce.

Alzheimer's disease puts enormous emotional stress on millions of families in Canada and costs our health care system billions of dollars every year. Delaying the onset of Alzheimer's by two years could save our health care system $219 billion over a 30-year period. A national strategy for dementia may be able to make an astounding difference in advancing research to work toward achieving this goal, which would diminish this enormous economic hardship and subsequently, and most importantly, improve the lives of those affected Canadians.

The challenge caregivers face needs to be discussed. Over the years, I have known people who have been forced to take a leave of absence without pay to take care of a loved one suffering from dementia, sometimes for several years. In such situations, money gets tighter as families try to keep their loved ones in their homes for as long as possible. They often have to draw on savings that were meant for their own later years.

Canada needs a national strategy for dementia that comes from Ottawa but one that respects provincial and territorial jurisdiction over health. One strategy tailored to the needs of each province or territory would be far better than 13 separate strategies implemented in isolation. We want a national strategy that goes beyond research to also help those now living with the disease, their caregivers, and the dementia workforce.

[Mark Warawa, Conservative, Langley—Aldergrove, BC]

Mr. Speaker, it is a real honour to be here as official opposition critic for seniors and to speak to Bill C-233, the national strategy on Alzheimer's disease and other dementias.

I would like to begin by thanking, particularly, the member for Niagara Falls for introducing this important bill. The secret to the success of the bill moving forward is his non-partisan approach. This is not an NDP, Liberal government, nor an official opposition Conservative Party issue, it is a Canadian issue on which we need to work together as parliamentarians. It is moving forward because of his non-partisan approach and I congratulate the member for Niagara Falls. He is a well-respected member in this House.

Bill C-233 provides for the development and implementation of a national strategy for the health care of persons affected with Alzheimer's disease and other forms of dementia.

Just to divert for a moment, my understanding of what my NDP colleague said was that people with dementia, with Alzheimer's disease, deserve to have assisted suicide. I hope that is not what she meant because people with dementia already feel bad and they may feel stigmatized.

They realize that their brain is getting a little fuzzy and they are forgetting. It is frustrating for them and maybe even a little bit embarrassing. We would not want them to think people expect them to take the obvious choice, and we heard that from Dying With Dignity, saying that it would be sensible for persons with dementia, lying in bed in the last years of their life with an adult diaper, to ask for assisted suicide.

That would not work in Canada. It is not dignified to expect people to leave this world because they are in a state of dementia. We need to show them dignity, show them love and support, and only in the most extreme cases should assisted suicide be considered.

When someone's pain is intolerable, irremediable, that is what the court said, and in extreme cases, but assisted suicide and euthanasia should not be considered the norm because it is a horrible loss when someone finds themselves in that situation. We should never put this on to people who are suffering with dementia through Alzheimer's disease or any other dementia disease.

As the seniors critic, I have met with the Alzheimer's Society and many other seniors organizations which are very supportive of this bill. Mimi Lowi-Young, the CEO of the Alzheimer Society of Canada had this to say about Bill C-233:

We’re thrilled that parties are working together so soon after the election to address the urgency of dementia. We all need to get behind this bill. We strongly believe that a national dementia strategy that focuses on research, prevention and improved care is the only solution to tackling the devastating impact of this disease. We’re ready to collaborate with our federal, provincial and territorial partners to make this a reality.

I am really thankful to her and the Alzheimer Society of Canada for supporting Bill C-233. According to the research done by the society, 83% of Canadians have said that they want a national dementia strategy.

I would like to give a brief summary on the issue of dementia. Alzheimer's disease and other forms of dementia are progressive, degenerative, and eventually fatal. They impair memory, judgment, and the ability to reason, think, and process information. Changes in personality and behaviour also result from dementia.

Currently, 747,000 Canadians have some form of dementia. This number is expected to nearly double to 1.4 million in my lifetime. Three out of four Canadians, 74%, know someone who is living with dementia. As Canada's population ages, the number of Canadians diagnosed with dementia is expected to double.

Research, collaboration, and partnership remain the key to finding a cure. Early diagnosis and support for treatment can lead to positive health outcomes for people with any form of dementia. Early diagnosis also has a positive impact on the family and friends providing care for their loved ones.

The Government of Canada, in consultation with the ministers responsible for the delivery of health care services in each province and territory, should encourage the development of a national strategy for the care of people living with Alzheimer's disease or other forms of dementia.

What is dementia? Dementia is a difficult disease, but it does not define the person who has it. People with dementia are people first. They can lead happy and vital lives for a long time, especially when the right care and support and understanding is in place. Timely diagnosis is very important. It opens the door to treatment and connects people with the disease and their families with helpful resources like the Alzheimer's Society.

While there is no guarantee, Canadians can reduce their risk of dementia by eating a healthy diet, doing more physical activity, learning and trying new things, staying socially active, quitting smoking, and watching their vitals.

While dementia is not a part of growing old, age is still the biggest risk factor. After age 65, the risk doubles every five years. Seniors represent the fastest growing segment of the Canadian population. Today, one in six Canadians is a senior. In thirteen very quick years, it will be one in four. That is a major demographic shift. Dementia also occurs in people in their forties and fifties, in their most productive years.

A good question that needs to be asked, and is asked, is this. What is the impact of dementia on families and the Canadian economy? For every person with dementia, two or more family members will be providing direct care. The progression of dementia varies from person to person. In some cases it can last up to 20 years. Because of its progression, caregivers will eventually provide 24/7 care.

In 2011, family caregivers spent 444 million hours providing care, representing $11 billion of lost income and about 230,000 full-time jobs. By 2040, caregivers will be providing 1.2 billion hours of care per year.

Dementia is a costly disease, draining approximately $33 billion per year from our economy. By 2040, it will be very close to $295 billion every year.

There is a need for a strategy that includes awareness and research.

It is commonly believed that dementia is a normal part of aging, but it is not. This kind of attitude means too many Canadians are diagnosed too late, and their caregivers seek help when they are in crisis mode. The causes of dementia are still not fully understood. Nor do we have a cure for dementia. Effective treatments are lacking and there is no proven prevention. Dementia can lie dormant in the brain for up to 25 years before the symptoms appear.

Alzheimer's disease is the most common form of dementia and accounts for over two-thirds of dementia cases in Canada.

What would Bill C-233 achieve? It would achieve a national strategy. The minister or delegated officials would work with representatives of the provinces and territories to develop and implement a comprehensive national strategy to address all aspects of Alzheimer's disease and other forms of dementia. Within two years of passing the legislation, every year after that the minister must prepare a report on the effectiveness of the national strategy, setting out his or her conclusions. The national objectives need to be given priority. A report will be tabled in the House during the first days of the sitting after the report is complete.

A number of western countries have a national dementia strategy: the United States, Mexico, Argentina, Belgium, Denmark, the United Kingdom, Finland, France, Luxembourg, the Netherlands, Norway, Switzerland, Japan, Israel, South Korea, New Zealand, and Australia. It is Canada's time to have a national strategy.

I again want to thank the member for Niagara Falls for bringing this forward. Together, if we work as a Parliament, we can pass the legislation quickly. It is needed in Canada.

[Sheila Malcolmson, NDP, Nanaimo—Ladysmith, BC]

Mr. Speaker, last month, I joined my community in Nanaimo on the walk for Alzheimer's where our community walked in support of Alzheimer's patients and their families.

The honoree this year was the late Dale Horn. She was born in 1933 in Australia and she came to Canada at the age of 24. She was such a strong part of Nanaimo's community boards and the life of its community spirit.

At this Alzheimer's walk a month ago, her son, John Horn, honoured her at the walk for all the hundreds of participants ready to get started, saying: “Dale was a fantastic companion, fully engaged, witty and keenly observant. She drew you in and made you feel lucky to be included in her world.” With “a steely resolve and genuine grit,” Dale was unfazed by her disease, said John. “When affected by Alzheimer's, she insisted on helping others with the disease. She retained a wicked sense of humour and immense grace, right up to the end of her life.”

This year's Nanaimo Alzheimer's walk raised $18,000. This is to promote critical research to reduce the effects of Alzheimer's, but also to provide services for those living with, or assisting with Alzheimer's. This is really to ease the personal circumstances that exist for the people suffering and for their families every day.

It is in that spirit that I am pleased to stand and speak today in favour of the bill at hand and to speak about Canada's responsibility to improve care for the hundreds of thousands of Canadians suffering from dementia, and to give better support to their families and caregivers.

Bill C-233, which calls for the development and implementation of a national and comprehensive strategy to improve health care delivered to persons suffering from Alzheimer's and other forms of dementia is something we can and should all support. Canada has fallen behind other countries such as the United States, the U.K., Norway, France, the Netherlands, and Australia. All of these countries have coordinated national dementia plans in place already.

Past president of the Canadian Medical Association, Dr. Chris Simpson, spoke to this when he said:

We have the dubious distinction of being one of the few G8 countries without a national dementia strategy. Meanwhile, our acute care hospitals are overflowing with patients awaiting long term care placement and our long-term care facilities are understaffed, underspaced and underequipped to care for our most vulnerable seniors. This leaves patients and their families in limbo, struggling to fill these gaps in our system.

He also said:

The reason your father has to wait nine months for a hip replacement is that the beds are being used by dementia patients.... That is the single biggest reason why elective surgery wait times are so long.

Now, it was the NDP that first introduced a proposal to the House to create a national strategy for dementia. In 2012, former NDP MP Claude Gravelle introduced Bill C-356 in Parliament, prescribing a national dementia strategy. Unfortunately, that bill was defeated at second reading a year ago by a single vote. The bill was opposed by a majority of Conservative MPs, Bloc MPs, and, critically as it turned out, a single Liberal MP who failed to stand for the vote. I was watching it on CPAC. It was heartbreaking because it would have made a big difference in our communities.

Inexplicably, the member for Niagara Falls, the sponsor of the bill before the House today, voted against the national dementia strategy just a year ago. If the House had followed New Democrat leadership in the last Parliament, Canadians would have a national dementia strategy in place right now. Canadians would not have lost precious time, and that is something that is so precious to people suffering from a degenerative illness.

This has had real human impact. I have heard countless stories in my riding about the impacts of Alzheimer's disease and dementia on my constituents. Many cannot afford quality home care for their parents and it is especially shameful that the Liberals abandoned their election promise to invest $3 billion in home care.

I have heard stories from personal care workers, nurses, and physicians who report emergency wards overwhelmed with patients, long-term facilities that are understaffed, and long gruelling hours for caregivers. These are very often offering low-pay work in the homes of dementia patients.

These stories underscore the need for real leadership in this chamber. So many are affected. Three-quarters of a million Canadians were living with dementia in 2011. That is 15% of Canadian seniors. That might double by 2031. This costs our country $30 billion a year in medical bills and lost productivity. Left unchecked, that number could skyrocket to $300 billion within 25 years.

As Canada's population ages, we must prepare our health care system and our communities for the inevitable rise in the number of Canadians suffering from dementia.

To paraphrase Tommy Douglas, the father of medicare and a New Democrat, only through the practise of preventative medicine will we keep health care costs from becoming excessive.

The need is pressing. The burden for caring for patients with dementia and Alzheimer's falls primarily on family members. In Canada, family caregivers give millions of unpaid hours each year caring for their parents and family. That is $11 billion in lost income and a quarter million lost full-time equivalent employees from the workforce.

If nothing changes by 2040, it is estimated that family caregivers in Canada will be spending 1.2 billion unpaid hours per year providing care, and a quarter of family caregivers are seniors themselves.

Dementia also has a disproportionate impact on women. Women are two and a half times more likely to be providing care. Women themselves represent 62% of dementia cases and 70% of new Alzheimer's cases. That puts them at the epicentre of a growing health care crisis. Also, women are nearly twice as likely to succumb to dementia.

Another group of vulnerable patients are affected by another bill in the House, and that is the government's physician-assisted dying bill. We keep hearing arguments again and again that people with a dementia diagnosis should have a real choice over how their lives end. The federal government's legislation for assisted dying would not allow Canadians with a dementia diagnosis, while they were still of sound mind, to make an advance request for physician-assisted dying. This puts up an enormous barrier for thousands of Canadians with dementia or other degenerative illness.

Without the right to make advance requests for assisted dying, Canadians with a dementia diagnosis are faced with what the courts call a cruel choice between ending their lives prematurely or, potentially, suffering immeasurably and unbearably. This is completely unacceptable. To us it looks as if those who most need physician-assisted dying may inexplicably be excluded from it. We remain optimistic that amendments will be made to ameliorate that very serious flaw.

Let us go back to the national Alzheimer's strategy.

The New Democrats believe that the bill must be crafted correctly to ensure the best outcome for patients, their families, and their caregivers. While we support Bill C-233, it is less ambitious in its scope and implementation provisions than last year's New Democrat bill.

We will work constructively at committee stage to bring about meaningful and substantive amendments to strengthen the final version of the bill. Canadians deserve no less than the best national Alzheimer's strategy possible. The New Democrats have a long and proud history of advocating for federal leadership on health care issues.

In fact, as my colleague, the member forVancouver Kingsway likes to remind me, we invented it. The New Democrats stood alone in the House unanimously for a national dementia strategy in 2015. We stand in the House in 2016 and work so every Canadian, every Canadian family, every caregiver, can have a world-class dementia strategy, as the New Democrats have fought for in the last five years.

[Joe Peschisolido, Liberal, Steveston—Richmond East, BC]

Mr. Speaker, I too am pleased to rise today to speak in support of Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias.

Just like the member of Parliament for South Surrey—White Rock, I was in a similar situation. I was not the caregiver, but my parents were the caregivers to my beloved grandma, my beloved nonna. As was eloquently, passionately, and poignantly pointed out by the member for South Surrey—White Rock, there are 750,000 people suffering from all types of dementia. As the proposed act properly states, it is Alzheimer's and other forms of dementia. Our family's situation was a bit different from that of the member for South Surrey—White Rock. My parents were able to give everything up and basically they became the caregivers. I would try to get home as much as I could to see a bittersweet situation. I always referred to my grandmother as Nonna Me, because as a little boy I was unable to say her name, Domenica. I saw first-hand where my grandma became a child. My mother and father had the resources and the time to stay home. My aunts and uncles also had the time to take care of my nonna.

However, a lot of folks are not blessed. We have many situations throughout Canada of different family dynamics and situations from coast to coast to coast, and that is why I am very pleased to rise today in full support of Bill C-233.

I am also very pleased to note that this bill has bipartisan support. I listened to the eloquent and passionate presentation by my colleague from South Surrey—White Rock and also to the member of Parliament for Niagara Falls who put forth this piece of legislation; as well as to my colleague, the member of Parliament for Richmond Centre. The Parliamentary Secretary to the Minister of Health also spoke eloquently as did the co-sponsor, the member of Parliament for Don Valley West and the member of Parliament for Vancouver Kingsway.

As well, I believe the member of Parliament for Abitibi—Témiscamingue spoke eloquently about not the exact bill but a similar bill put forth by the former NDP member of Parliament, Claude Gravelle, back in 2012. While not exactly the same approach, it was a similar bill to deal with a national strategy on dementia. We need a national strategy on dementia because Canada is big.

As others have done, I will talk about the elements of the bill. After 180 days, the Minister of Health would put forth a conference, bringing experts from all the provinces and territories, from all the stakeholders and people. There would be an advisory board of no more than 15 folks from different sectors of Canadian society who would advise. As well, every two years the minister would report to Parliament on the approach and the success of the national strategy.

There are big buzz phrases such best practices and evidence-based. Ultimately, what this means is that the Parliament of Canada would work with the provinces and also with the levels of government closer to the people: the municipalities, health boards, and universities.

Kwantlen College in my riding of Steveston—Richmond East is also doing research. Yes, we need a national strategy to deal with the folks who are suffering from a horrific disease. I saw that with my nonna, my grandmother. We also have to figure it out. Dementia or Alzheimer's should not be part of the natural process of aging. It does not have to be that way. It will be tough. It will require the investment and the research. I am not a scientist but it requires research with respect to how the brain works and how everything is connected.

This strategy would do that. It is the first step, but it is a very important step. I urge all members of the House to fully support the bill.

[Dianne Lynn Watts, Conservative, South Surrey—White Rock, BC]

Mr. Speaker, I rise in the House in support of Bill C-233.

The bill calls for the development and implementation of a national strategy for Alzheimer's disease and other dementias. We need to develop and implement concrete plans and actions to address the needs of those suffering from these diseases. As well, we need strategies to support those who care for family members and friends who are living with and struggling with these diseases.

It is a staggering number, with almost 750,000 Canadians living with Alzheimer's or other forms of dementia. Of that, 72% are women. Equally concerning is that 70% of the caregivers are also women. My mother was one of the 72% and I was one of the 70%.

I can personally say that my journey with my mother was an extremely difficult one, especially because she lived in Alberta and I lived in British Columbia. Initially, she refused to believe that she had Alzheimer's, but knew that something was wrong.

She like many others are often afraid to confront the disease. She found ways to mask the daily symptoms, wanting to give the impression to her loved ones that everything was okay. It became very problematic because my mother was a diabetic and she could not remember how much insulin she was giving herself or if she had taken any at all.

As the caregiver, trying to navigate the medical system in another province was simply a nightmare. I tried to get her transferred from Alberta to B.C., but I had no other choice, no other alternative, than to take her from her home and into the emergency department where I knew the hospital system would keep her safe. That was in the month of September. By November, she was placed in a facility, and by April she had died.

During that time, I flew to Alberta every few weeks to see her for a few days. However, during those times, I came to realize that there was no standardized care, nor a full understanding of Alzheimer's or dementia at staff levels.

When she fell and broke her collarbone, they waited two days to get her to the hospital for X-rays. The nurses and caregivers would ask her if she was in pain, and she would say no because she did not remember falling. She did not remember breaking her collarbone, so they gave her nothing. A broken collarbone and no pain medication.

I can list hundreds of times when they asked questions about her well-being and they took the answers to be the truth. The only problem was that she had Alzheimer's and did not know who these people were nor why they were asking her those questions. When I came to visit, she always wanted me to stay with her because she knew me and I was her sense of security and comfort.

I tell this story because of the many others across this country where loved ones are suffering with this terrible disease. We need a strong national strategy because of the 750,000 Canadians who are currently suffering, but also for those yet to come.

Early detection, research, collaboration, and partnerships remain key to early diagnosis and treatment, and to ultimately finding a cure.

Research is currently underway in my community between the Simon Fraser University and an incredible partnership with the Sagol Neuroscience Center at Sheba Medical Center in Israel to identify the correlation between diabetes and Alzheimer's. As this begins to be proven out, one can only imagine the impact of Alzheimer's and dementia on those suffering from diabetes.

We need to be ahead of the curve. We need to put measures in place to assist those who are potentially at risk. There is excellent research being done currently right across the country, but a national strategy will bring all of those pieces together to ensure a solid plan is in place.

I have walked down this road with my mother. I have seen and experienced significant gaps within the system. I have lost my mother to a terrible disease that many do not fully understand.

This is the first step of many more to follow, and I am proud to give my support to Bill C-233 today.

The House resumed from May 4 consideration of the motion that Bill C-233, An Act respecting a national strategy for Alzheimer’s disease and other dementias, be read the second time and referred to a committee.

[Kamal Khera, Liberal, Parliamentary Secretary to the Minister of Health]

Madam Speaker, as the Parliamentary Secretary to the Minister of Health, I appreciate the opportunity to speak about Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias. I would like to thank the hon. member for Niagara Falls for introducing the bill, and the member for Don Valley West for his continued advocacy on this very important public policy.

Dementia is an issue that is close to the hearts of many Canadians, including my own. Indeed, many of my hon. colleagues know someone who is living with dementia or who is providing care and support to a friend or family member with dementia.

This is a piece of legislation that I am pleased to inform the House the government will support. I would like to take this opportunity to speak about our government's efforts on this very noble cause.

As the population ages, Alzheimer's disease and other forms of dementia are expected to increase. Canadians are concerned about how they will care for and support their loved ones should this happen to them.

Fundamentally, we ask ourselves how we as a country can do more to address the challenges presented by dementia and are we doing enough.

Living with dementia means progressively losing the things that we hold most dear: memories, independence, communicating with others, and doing the activities that we enjoy most. Over time, independent living and daily routines become more challenging.

As the title of Bill C-233 suggests, there are many types of dementia. Alzheimer's disease is the most common cause of dementia, accounting for approximately 60% of all dementia cases. Other types, such as vascular dementia, which can result from strokes and other cardiovascular problems, also need our attention.

Recent estimates indicate that about 395,000 Canadians 40 years of age and older have dementia. Due to the aging population, this number is expected to double by 2031. Similarly, direct health sector costs are projected to double to $16.6 billion by 2031.

Unfortunately, currently there is no cure for dementia and no treatment that will stop its progression. It is important to understand that, as stated by my colleagues, dementia is not a normal consequence of aging. It can result from a variety of diseases and conditions.

The frequency with which the issue of dementia comes to our attention speaks to its importance to Canadians.

In calling for the development and implementation of a national dementia strategy, Bill C-233 entails a number of complex activities that require close co-operation with the provinces and territories. Clearly, addressing the significant public health challenges posed by dementia requires co-operation between all levels of government as well as with other sectors of society.

While a national strategy in and of itself does not guarantee success or progress, we are committed to advancing this work in a manner that will be meaningful for the hundreds of thousands of Canadians affected by dementia. This is consistent with the concrete steps we have already taken to address this pressing issue. We are treating dementia as a priority.

Bill C-233 aligns closely with much of the work currently under way.

At the federal level, we are developing an in-depth action plan that sets out federal goals, guiding principles, and priority areas for action, as well as current initiatives and future directions to guide our efforts and investments on dementia. Our action plan will be released shortly and it will help us mobilize even more partnerships and action on dementia. I know the minister looks forward to discussing this further in the weeks and months ahead.

I would like to share some of the federal investments and initiatives well under way to advance collective efforts on dementia. Many of these initiatives involve the public, private, and not-for-profit sectors, including different levels of government within Canada and other countries.

Budget 2016 extended funding for the Canada brain research fund with up to an additional $20 million over the next three years. Established by the Brain Canada Foundation with government support, this fund leverages matching funding from private donors and charitable contributions to support collaborative, multidisciplinary brain health and brain disorder research projects, including on Alzheimer's disease and other forms of dementia.

In addition, through the Canadian Institutes of Health Research, the Government of Canada has invested over $297 million in dementia-related research.

The Canadian Consortium on Neurodegeneration in Aging is supported by government and partner funding of $32.1 million over five years. Partners include the health research organizations of several provinces. By combining scientific talent and funding, we can accelerate discoveries and their use to benefit Canadians.

The international component, the International Collaborative Research Strategy for Alzheimer's Disease, facilitates Canada's participation in key international partnerships, and has over $14 million in commitment investments between 2010 and 2019.

Surveillance activities are also being strengthened. As an outcome of the Public Health Agency of Canada's collaboration with a consortium of neurological health charities and researchers, the first comprehensive analysis of the rates of neurological conditions and their impacts on families and communities was developed. We are providing also $42 million over the next five years to Baycrest Health Sciences to help establish the Canadian Centre for Aging and Brain Health Innovation. Funding for the centre will support the development, testing, and scale-up of products and services that will have a positive impact on aging Canadians, with a focus on those living with dementia.

Similarly, through the networks of centres of excellence program, the government is supporting the AGE-WELL network with a total investment of $36.6 million from 2014 to 2019.

In collaboration with the Alzheimer Society of Canada, Dementia Friends Canada is receiving an investment of more than $2 million over two years. This digital engagement campaign targets individuals where they live and work to increase understanding of what it is like to live with dementia and how those affected can be better supported in day-to-day activities.

We are cognizant that while a national dementia strategy can help guide Canadian efforts, it cannot replace the need for integrating dementia into a comprehensive approach to health and health care.

Our government appreciates that Bill C-233 continues to bring attention to the challenges presented by dementia and the need for collaboration. While legislation is not required to support pan-Canadian action or strategies, it can serve to highlight a matter of significant importance to Canadians.

Bringing Alzheimer's disease and dementia more fully into our collective consciousness and mobilizing action on a topic of such profound importance to Canadians is a goal we all share. While Bill C-233 as drafted presents some challenges for implementation, the importance of the issue at hand cannot be overstated.

Dementia is a significant public health challenge and it will continue to be a priority for our government. Considering the significant federal investments in dementia and current discussions with the provinces and territories towards a new health accord, it can be stated with assurance that a comprehensive approach to addressing dementia, as well as other intersecting chronic diseases and healthy aging overall, is well under way.

I am convinced that we are moving in the right direction, and I am inspired by what we can continue to accomplish together. In closing, I would like to note that I very much appreciate the opportunity to speak about this very important issue. I encourage my hon. colleagues to support Bill C-233 as it aligns with the current federal direction on Alzheimer's disease and other forms of dementia.

[Alice Wong, Conservative, Richmond Centre, BC]

Madam Speaker, I am honoured to rise as the former minister of state for seniors to speak to Bill C-233, An Act respecting a national strategy for Alzheimer’s disease and other dementias.This bill is specifically close to my heart because 25% of constituents in my riding of Richmond Centre are seniors.

I would like to thank the member for Niagara Falls for bringing forward this very important bill, and the Liberal MP who sponsored it. Bill C-233 would provide for the development and implementation of a national strategy for the health care of persons afflicted with Alzheimer's disease and other forms of dementia.

This bill is what Canadians are asking for. The Alzheimer Society and other seniors organizations are very supportive of this bill. Mimi Lowi-Young, CEO of the Alzheimer Society of Canada, had this to say about Bill C-233:

We all need to get behind this bill.... We strongly believe that a national dementia strategy that focuses on research, prevention and improved care is the only solution to tackling the devastating impact of this disease. We're ready to collaborate with our federal, provincial and territorial partners to make this a reality.

According to Alzheimer Society research, 83% of Canadians have said that they want a national dementia strategy. Here is a summary of the issue.

Alzheimer's and other forms of dementia are progressive, degenerative, and eventually fatal. They impair memory, judgment, and the ability to reason, think, and process information. Changes in personality and behaviour also result from dementia.

Currently, 747,000 Canadians have some form of dementia. This number is expected to nearly double, to 1.4 million in less than 20 years. Three out of four Canadians, being 74%, know someone living with dementia. As Canada's population ages, the number of Canadians who are diagnosed with these diseases is expected to double within a generation.

Research, collaboration, and partnership remain the key to finding a cure. An early diagnosis and support for treatment can lead to positive health outcomes for people with any form of dementia. Early diagnosis also has a positive impact on the family and friends who provide care for them. The Government of Canada, in consultation with the ministers responsible for the delivery of health services in each province and territory, should encourage the development of a national strategy for the care of people living with Alzheimer's disease or other forms of dementia, as well as for their families and caregivers.

What is dementia? Dementia is a difficult disease, but it does not define the person who has it. People with dementia are people first. They can lead happy and vital lives for a long time, especially when the right care, support, and understanding are in place. Timely diagnosis is important. It opens the door to treatments, connects people with the disease, and connects their families with helpful resources like the Alzheimer Society. While there is no guarantee, Canadians can reduce their risk of dementia by eating a heart-healthy diet, doing more physical activity, trying and learning new things, staying social, quitting smoking, and watching their vitals.

Who is at risk? The answer is largely seniors. While dementia is not a part of growing old, age is still the biggest risk factor. After 65 years of age, the risk doubles every 5 years. Seniors represent the fastest growing segment of the Canadian population. Today, one in six Canadians is a senior. In 14 years, one in four Canadians will be a senior. That has already happened in my own riding.

Dementia also occurs in people in their forties and fifties, in their most productive years. As of 2008, there were 71,000 Canadians age 65 and younger and 50,000 Canadians age 50 and under living with dementia.

What is the impact on families and the economy? For every person with dementia, two or more family members provide direct care. The progression of dementia varies from person to person. In some cases, it can last up to 20 years. Because of its progression, caregivers will eventually provide 24/7 care. In 2011, family caregivers spent 444 million hours, representing $11 billion in lost income and about 230,000 full-time jobs. By 2040, caregivers will be providing 1.2 billion hours of care per year.

Dementia is a costly disease, draining $33 billion per year from our economy. By 2040, it will be $293 billion per year. When I was minister of state for seniors, we created a portal on the seniors.ca website specifically for family caregivers to outline the kind of awareness and help that is available. I am glad it is still there. I encourage everyone to visit the website. However, more needs to be done.

There is a great need for a strategy that includes awareness and research. Here are the reasons. It is commonly believed that dementia is a normal part of aging. It is not. This kind of attitude means too many Canadians are diagnosed too late and caregivers seek help when they are in crisis mode. We still do not fully understand the causes, nor do we have a cure. Effective treatments are lacking and there is no proven prevention. Dementia can lie dormant in the brain for up to 25 years before symptoms appear. Alzheimer's disease is the most common form of dementia. It accounts for over two-thirds of dementia cases in Canada today.

I would like to thank the sponsor of the bill for acknowledging that the former government got the ball rolling. We did a lot of work in research, like the longitudinal study which for a period of time follows people from the age of 45 to age 65 at every step. Some day that useful data will help us find out the where and why of dementia inclination in detecting this kind of brain disease, and hopefully we will be able to generate good ideas for a cure.

We have been asked why we did not support the former bill. My colleague has already mentioned that. It is not important just to get the bill passed. We wanted the right bill passed, which is also very good in a sense that it can be carried. I do not wish to list all the things which we cannot do under that bill. However, I am so glad that we are able to do it now, because now we have time to consult the general public.

A national strategy would ask the minister or delegated officials to work with representatives of the provinces and territories to develop and implement a comprehensive national strategy to address all aspects of Alzheimer's disease and other forms of dementia.

I strongly encourage every member of Parliament to support Bill C-233.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, I am pleased to rise today as health critic for the New Democratic Party, to speak to Bill C-233 and the urgent need to address the impact of dementia and Alzheimer's disease on patients, families, communities, and our public health care system.

Dementia disease is a progressive degenerative disorder that attacks nerve cells in the brain, resulting in loss of memory, thinking, language skills, and behavioural changes. The disease forms lesions in the brain cells of patients causing nerve connections to sever and nerve cells to die.

Alzheimer's is the most common form of dementia, which is a general term used to describe a group of systems, such as loss of memory, language, motor skills, and other brain functions. Alzheimer's is not part of the normal process of aging, and currently has no cure.

Bill C-233 calls for the development and implementation of a national and comprehensive strategy to improve health care delivered to persons suffering from Alzheimer's disease and other forms of dementia.

This legislation prescribes a number of elements that must be included in a national strategy, including greater investment in research, the establishment of national objectives for care, coordination with international bodies that fight dementias, assistance to provinces and territories to improve treatment, strengthening of prevention and early intervention, and disseminating best practices. As prescribed in the bill, the details and benchmarks for these elements would be determined at a conference convened by the minister with multi-stakeholder representation.

New Democrats have long believed that Canada needs an ambitious and comprehensive national dementia strategy to improve care for the hundreds of thousands of Canadians suffering from forms of dementia, and to better support their families and caregivers.

As Mimi Lowi-Young, CEO of the Alzheimer Society of Canada, has said:

By implementing a strategy, we will be able to enhance research efforts, raise awareness about the disease, provide support for people with dementia and their care givers, identify best practices for care and improve surveillance of the disease.

Particularly as Canada's population ages, we must prepare our health care systems and our communities for the inevitable rise in the number of Canadians suffering from dementia. To paraphrase Tommy Douglas, the father of medicare and a New Democrat, “Only through the practice of preventative medicine will we keep health care costs from becoming..excessive..”, and the need is pressing.

Recently, the former head of the Canadian Medical Association, Dr. Chris Simpson said:

our acute care hospitals are overflowing with patients [often dementia patients] awaiting long term care placement and our long-term care facilities are understaffed, underspaced and underequipped to care for our most vulnerable seniors. This leaves patients and their families in limbo, struggling to fill these gaps in our system....

The need for national leadership is urgent. Few Canadians are untouched by these diseases that often have shattering impacts on families. The struggle to cope with the deterioration of mental faculties and the loss of memory can be overwhelming and heartbreaking.

According to the Alzheimer Society of Canada, that disease and other dementias now directly affect 750,000 Canadian patients. This number is expected to double to 1.4 million by 2031. Current dementia-related costs, both direct medical costs and indirect lost earnings, have reached $33 billion per year in Canada, and they are projected to soar to $293 billion by 2040.

Currently the burden of care for patients with dementia and Alzheimer's disease falls primarily on family members. In Canada, family caregivers spend an estimated 444-million unpaid hours per year caring for dementia patients, representing $11 billion in lost income and 227,000 lost full-time equivalent employees to our workforce. If nothing changes by 2040, it is estimated that family caregivers in Canada will spend over one billion unpaid hours every year providing care. These numbers are staggering. Taken alone, they make the case for our desperate need for national leadership. Canadians overwhelmingly agree. A recent Nanos survey revealed that 83% of Canadians say that they want Canada to develop a national plan to address these diseases.

We must not forget that dementia also has a disproportionate impact on Canadian women. According to the Women's Brain Health Initiative of Canada, women represent 62% of dementia cases and 70% of new Alzheimer's cases, putting them at the epicentre of a growing health issue. In addition to this, women are nearly twice as likely as men to succumb to dementia, and two and a half times more likely to be providing care to someone with the disease.

Unfortunately, Canada is now one of the last developed countries in the world without a national strategy to address dementia. We have fallen behind countries such as the U.S., U.K., Norway, France, Netherlands, and Australia, all of which have coordinated national plans in place.

In Vancouver Kingsway, I have heard countless heartbreaking stories about the impacts of Alzheimer's disease and dementia on my constituents. Many cannot afford quality home care for their parents or face long delays in accessing long-term care facilities. Many do not even have access to the resources or information they need to make important decisions, as they witness the cognitive degeneration of a loved one. I have heard stories from personal care workers, nurses and physicians, who report emergency wards that are overwhelmed with patients, long-term care facilities that are understaffed, and long, gruelling hours for caregivers, often working for low pay in the homes of dementia patients. These stories underscore the need for leadership in this chamber.

As New Democrats, we are proud of our long history of leadership on health care, and specifically dementia care. In fact, it was the NDP that first introduced a proposal to this House to create a national strategy for dementia. In 2012, former NDP MP Claude Gravelle introduced Bill C-356 in Parliament, prescribing a national dementia strategy. That bill provided a comprehensive and cutting edge plan for a national strategy to deal with Alzheimer's and dementia. Unfortunately, that bill was defeated at second reading in May 2015 by a single vote. It was 140 to 139. The bill was opposed by a majority of Conservative MPs, Bloc MPs, and, critically as it turned out, a single Liberal MP who failed to stand for the vote. Conversely, our New Democrat caucus voted unanimously in favour of Mr. Gravelle's bill.

I must again mention that the member for Niagara Falls, the sponsor of the bill before this House today, inexplicably voted against that national dementia strategy just one short year ago. Most charitably, I might say that wisdom comes so seldom that it ought not to be rejected because it comes late. Less diplomatically, I might say that the hon. member owes Canadians an explanation and an apology for defeating the very concept that he proposes be adopted here today. What is indisputable is that if the House had followed New Democrat official opposition leadership in the last Parliament, Canadians would have a national dementia strategy in place right now. Canadians would not have lost precious time, something that is especially important to those suffering from a progressive illness.

New Democrats do not take lightly the opportunity to move forward with a national strategy for dementia. We believe this bill must be crafted correctly to ensure the best possible outcome for patients, their families, and caregivers. While we support Bill C-233, it is less ambitious in its scope and implementation provisions than the former bill, Bill C-356, the New Democrat bill. Important differences between those bills include the following: an absence of any provision to augment volunteerism for dementia and Alzheimer's-related causes, no remuneration of advisory board members, and only one public report required from the minister versus the yearly progress reports prescribed in the former NDP bill.

New Democrats will work at committee stage to bring about meaningful and substantive amendments to this bill to strengthen the final product. Canadians deserve no less than the best national Alzheimer's and dementia strategy possible. New Democrats have a long and proud history of advocating for federal leadership on health care issues. In fact, we invented it. It is critical that in a country like ours, the federal government works to ensure that all Canadians have access to the health care they need, no matter where they live, no matter what their income, and no matter their background.

New Democrats stood alone in this House unanimously for a national dementia strategy in 2015. We will stand unanimously in this House in 2016 and work so that every Canadian, every Canadian family, and every caregiver can have a world-class dementia strategy, as the NDP has fought for in the last five years.

[Rob Oliphant, Liberal, Don Valley West, ON]

Madam Speaker, it is a great privilege today to rise in support of Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias.

I would like to commend the hon. member for Niagara Falls. We were speaking earlier today. He has not had opportunities to bring forward private members' bills as a member of government for many years. I am both pleased and proud to be part of this effort he has engaged in. Sometimes it is the right time to do the right bill, and I believe he has spotted that this is the right time to do the right bill.

As he did, I also want to acknowledge the tremendous work of the former member for Nickel Belt, Claude Gravelle. He had inspiration, tenacity and he did everything right in his bill for that time. However, it did not pass. We now have a chance to have a better bill to ensure that Canada has the appropriate strategy to deal with dementia and Alzheimer's.

I want to begin by talking very personally about my friend and my former administrator when I was a United Church minister at Eglinton St. George's United Church in Toronto. Her name is Marian Ritchie. While she was working with us in the Church, she recognized that there were many people either facing both dementia in their own lives or were caregivers for people who were suffering either early or even advanced signs of dementia.

Marian decided to chronicle the life she had with her husband Edwin and she wrote a book called The Long Way Home. Similar to the The Long Goodbye, The Long Way Home chronicles Edwin's decline from simple mistakes in grammar or vocabulary to eventually having a complete change in personality, not recognizing his family, his friends and not being able to engage in every day life.

This book was profoundly moving for me as it was non-medical and it was not from a professional. It was a book simply written to inspire, to comfort and to encourage people who had family members suffering from Alzheimer's disease.

I have not had the opportunity to do something legislatively about Alzheimer's. I am so pleased the member for Niagara Falls has given me and every member of the House the opportunity to come together to form a national strategy on dementia and Alzheimer's, to ensure that we have a unified approach to this disease and to begin to make important steps that make a difference in the lives of people like Edwin and Marian.

There is a real cost to dementia, an individual cost to families as well as a cost to society. Right now it is estimated that over 700,000 people in Canada have dementia, including Alzheimer's. That is expected to double in the next 20 as our population ages. Even though age, in and of itself, is not the cause of dementia, it is part of it. There are other root causes for dementia, but we still have research that is absolutely necessary so we can begin to understand how we can address this problem.

As everyone in this chamber knows, there is no cure for dementia. We continue to wait for new drugs, new treatment and new understanding of the brain itself.

I would also like to pay great tribute to the Alzheimer's Society of Canada. It is one of several patient organizations and health charities that is working on this important issue. I want to name two people, Mimi Lowi-Young, the CEO, and Debbie Benczkowski, the number two and the one who really runs the operation. These two women have been advocates for people with this disease for many years. I think tonight in the chamber we recognize that often people who work in health charities and work with patients are driving some of the things on which Parliament is often behind.

Last year, the World Health Organization declared that dementias were a public health priority requiring international action. This past October, health ministers at the Pan American Health Organization approved an action plan in response to the predicted rise in dementia cases across the hemisphere over the next 20 years. Among other actions, the Pan American plan encourages member countries, including Canada, to improve investment in treatment for dementias.

Most recently here at home, one of the recommendations of the Special Joint Committee on Physician-Assisted Dying was to establish a national strategy on dementia.

It is important, given the vote we just had in the House, to recognize that end-of-life care is complex. That report, of which I was proud to be a part, looked at the need to have a continuum of care. We needed to be sure we had better palliative care. We had to have better mental health strategies. We had to have better dementia care. We had to always be sensitive to specific populations and how they would respond to end-of-life situations.

Therefore, tonight, we are continuing on in that process and ensuring that we have the opportunity to have the very best, state-of-the-art, national dementia strategy of any country in the world.

However, we are not starting from nothing in this position in Canada. I even want to commend the previous government for its work in dementia strategy. It is not as though we have been doing nothing on this. The reality is that over the last 10 years, the Government of Canada has invested almost $300 million on dementia-related research, through the CIHR, the Canadian Institutes of Health Research. We have had many partnerships. We are attempting to do parts of the work all around the country.

This legislation attempts to bring them together in a national strategy so we can form a partnership with research, with caregivers, with people living with dementia, with patient groups, with experts, take international evidence and bring them together to ensure our Minister of Health, our Department of Health, have the best research available so we have the best possible care.

I am encouraged that members on this side of the House, as I believe members on the other side and in all parties, are supportive of the bill. I have been hearing positive stories from each one of them, often told with stories from their own lives. They have had a parent, or a partner or they themselves have had characteristics, so they are worried about dementia in their own lives.

We have a chance, with the bill, to do something historic and to come together to say that there is the possibility that provinces, territories and the federal government and researchers, clinicians and patients, together with civil society, can have the best strategy possible.

The bill is interesting in that it acknowledges the shared jurisdiction of the federal government and the provinces and territories. It is very clear that the delivery of health care will happen at the provincial and territorial level. We are not in any way stepping on anyone's jurisdictional toes with this legislation. Rather, the legislation calls upon the federal government to consult with provinces and territories to ensure we have the best care and know that the provinces and territories have an important part to play in this national conversation.

It also pushes us at research. If there is anything that we need to acknowledge, it is that the brain is the most complicated organ in the body. I am very proud that in Don Valley West we have Sunnybrook Health Sciences, Sunnybrook Hospital, which is attempting to draw together with partner organizations, and there is Baycrest in Toronto and others across the country, to bring research, clinical expertise, and patient experience together.

This bill would foster that information, not only top-down but also bottom-up. We can learn from the people who are working with this every day to ensure we have the best resources provided, that we have the best research happening, and that we take the steps so Canada can be a leader in the world.

I want to close by telling members another story about my church. One of the projects that we did at Eglinton St. George's was to form a corporation that built a housing project in Toronto called “Ewart Angus Homes”. This is one of those creative housing projects that involves having market housing and housing for seniors, as well as two floors of care for people with Alzheimer's and dementia. It is just one example of people getting together to say they needed to be a caring society.

If we are going to walk with people to the end of their lives, we need to have the best supports for them, the best medical research, the best care for their caregivers, the best laws in place and programs in place to ensure that our country is that leader.

Again, I want to thank the member for Niagara Falls for the opportunity to second the bill. I want to encourage every member to read it, as we sometimes forget to do, and to be sure to engage in the conversation on this bill. We look forward to members' support of the bill.

[Rob Nicholson, Conservative, Niagara Falls, ON]

moved, seconded by the member for Don Valley West, that Bill C-233, An Act respecting a national strategy for Alzheimer’s disease and other dementias, be read the second time and referred to a committee.

Mr. Speaker, it is my honour to rise in the House today to formally introduce my private member's bill, Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias. The title of the bill says it all. It calls upon parliamentarians to enact legislation for a national coordinated program for what has been termed Canada's invisible killer.

I would like to take this opportunity to thank the member for Don Valley West for supporting this bill. The member told me that when he was a United Church minister, he spent a great deal of time working with families who were wrestling with this disease. I would also like to take this opportunity to note the contribution of the former member of the New Democratic Party, Claude Gravelle, for his excellent work on this issue.

Alzheimer's and other forms of dementia transcend partisanship. This disease affects over 700,000 Canadians. It is estimated that if nothing changes in terms of a strategic approach, that number will increase to 1.4 million Canadians by the year 2031. Those figures are staggering.

It is heartening to know that in matters of great concern to Canadians and their families, we can work together. This co-operation will lead to positive health outcomes for families across this country. No one is immune from this terrible disease. It brings to mind the late president Ronald Reagan. The former leader of one of the most powerful, wealthy nations on earth could not be safeguarded from the ravages of Alzheimer's.

On November 5, 1994, the 40th president of the United States addressed the American people by writing in part, “I now begin the journey that will lead me into the sunset of my life”. That journey took 10 painful years. His loving wife, Nancy, referred to it as the long goodbye. I reiterate that no one should have to witness the slow and painful deterioration of a loved one or family member suffering from this cruel illness. Far too many Canadians endure the long goodbye.

My own father, Robert Nicholson, whom I cherished deeply, passed away from complications due to Alzheimer's in 1997. Witnessing his decline in health was, needless to say, extremely difficult for everyone who knew and loved him. It saddens me to say that so many other Canadians have a similar story to share. Today, I am joined by many of my colleagues in the House who have dealt with or are dealing with a family member, friend, or loved one suffering from Alzheimer's or one of the varying forms of dementia.

We all understand the emotional impact of this disease on Canadian families. As journalist Candy Crowley said, “I want to tell you how much I miss my mother. Bits of her are still there. I miss her most when I’m sitting across from her”.

As Canada's population ages, the consequences of not dealing with this issue worsen. The bill proposes to establish a national dementia strategy that would improve the lives of those living with this disease, as well as their family and friends. It would do so in a way that would ensure the autonomy of the provinces and territories. This strategy would encourage greater investment in all areas and have the objective of improving the present circumstances of people with Alzheimer's and other dementias by decreasing the burden on Canadian society.

It would seek to assist the provinces in developing and disseminating diagnostic and treatment guidelines based on new research. All of these measures have been thoroughly considered to ensure the successful passage of this legislation. Members will note that the bill does not include restrictive timelines or financial criteria. Again, this is a deliberate intention in order to remove any potential barriers, such as the need for a royal recommendation.

Simply put, the bill is crafted for implementation, achievement of key deliverables, and ultimately, its passage at third reading in the House. At the end of the day, the objective is to enact legislation that would serve to provide solutions and assist those who suffer with Alzheimer's or dementia, in addition to aiding family members and caregivers.

It is commonly believed that dementia is a normal part of aging. This is a fallacy. Dementia can occur in people as young as 40 or 50 years of age, thus affecting them in their most productive years.

While dementia is not a normal part of growing old, age is still the biggest factor. After 65, the risk of getting Alzheimer's or dementia doubles every five years, and three out of four Canadians know someone living with dementia. We still do not understand the cause, nor do we have a cure.

Canada has already agreed to work with neighbouring nations to address this issue. In order to fulfill that mandate, we must develop a strategy to combat the disease here at home.

I want to share the story of one Canadian family who suffered from Alzheimer's.

Norma died of Alzheimer's three years ago today in Carleton, Ontario. She had the disease for seven years. Her daughter recalls not being sure if her mother recognized who she was, or even if she was aware that she was there. After her mother's funeral, a family friend delivered a letter to her along with a bouquet. She had helped Norma craft it while she was still able to say “yes”, and it read in part:

My dearest...[this is] a note to thank you for all your help during the last few years. We were always close—friends even, but during my illness, we grew even closer. I know you bore the brunt of my daily care, not physical but emotional. You were always kind and attentive making sure I was comfortable. Thank you, thank you... I appreciated everything. Role reversal is a funny thing. As your mother, I was proud of you my daughter. As I grew weaker you grew stronger—strong enough for both of us. Remember my love for you is never ending and I will always be with you. Love, Mom.

Almost all of us can relate to this letter. It illustrates just how important family members and caregivers are. To all Canadians and their families struggling to care for loved ones with Alzheimer's, we owe adequate support, treatment options, and early diagnosis.

I would be remiss if I did not acknowledge and thank the Alzheimer Society of Canada for its unwavering support of this bill. I consulted and met with members of the organization a number of times during the course of preparing this bill. That is because we need to get it right from the start.

The Alzheimer Society provides information, resources, education support, and counselling to family members and loved ones. The society is the leading not-for-profit health organization in Canada working nationwide to improve quality of life for Canadians affected by Alzheimer's and other dementias, and advance the search for the cause and cure. Its mandate aligns with the mandate of Bill C-233.

The Alzheimer Society has stated that it was pleased to see parties working together to address the scourge of dementia. It urged all members of Parliament to get behind the bill, suggesting a national strategy focused on research, prevention, and improved care is the only solution to tackling the impact of the disease.

I, too, invite all hon. members in the House to stand shoulder to shoulder in support of this legislation. It is the right thing to do for our friends, neighbours, parents, and for loved ones across our nation. It is the right thing to do for the global community as a whole.

In the words of Martin Luther King Jr., “...there comes a time when one must take a position that is neither safe, nor politic, nor popular but he must take it because conscience tells him it is right.”

Simply put, it is the right thing to do to pass this legislation.

Canadian Organ Donor Registry Act

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

Madam Speaker, first I want to thank the member for Edmonton Manning for bringing the bill forward and also sharing his very personal story.

I am so pleased to speak in support of Bill C-233 . Last week, my son Henry donated blood for the first time. His commitment came from having a cousin who battled leukemia and at this point is healthy, as his mother watches and waits.

Often when we know what we can do to help, we do it. For many years I was a volunteer with a hospice. Every Saturday evening, I would sit with the palliative patients and their families. Some of these families were still holding out for an organ donation to save their family members. It was incredibly hard to sit with these families who could do nothing but hold onto hope.

We know that every year 1,600 Canadians will be added to the organ donor list, while 5,000 Canadians are still waiting. These numbers tell us a story. They tell us the story that we need to do better.

A national registry would make a significant difference. It would help people across this country. It would increase access, address disparities, and increase efficiency. It would be a national program that could bring all the provinces and territories together to make a difference, to give people a second chance in this life.

In my riding of North Island—Powell River, I have a constituent named Debbie Hooper, who is a 56-year-old grandmother. She has been waiting three years by her phone, waking every morning hoping the call will come that means her lung disease will be fixed by this amazing gift of an organ transplant.

Across this country, people are facing challenges that many of us have never experienced. We have to do our due diligence as people who have been elected to sit in this place to make sure we are helping save the lives of people in this country, and that we are creating accessibility.

I have heard from the other side, and I am so sad to see that the bill will not be passed by the other side.

We need to send the bill to committee. We need to be hearing those witnesses from across this country. We need to hear how it is going to work. We are asking that the bill be before committee so that we can see potential solutions that would make a difference and give people their lives.

Brenda Small is another constituent who received a transplant, and she said something extremely poignant. “It’s the worst day of somebody’s life and the best day of yours. I cry every time I think about it.”

If we are not doing our work, bringing forward this issue to committee, having the discussions we need to have so that we can make the best decisions, bringing together the provinces and territories to see how we can do this more effectively, then we are not doing our jobs.

I ask, please, for people to take this into their hearts, to think as we are supposed to in the House of Commons, and to make a decision that looks after the people of Canada.

I thank the member for his hard work. I am thankful for the history that we have in this place of multiple members bringing forward private member's bills in this same theme of creating a united country, acknowledging that we have a universal health care system, and making a change that will save lives.

National Strategy for Alzheimer's Disease and Other Dementias Act

[Rob Nicholson, Conservative, Niagara Falls, ON]

moved for leave to introduce Bill C-233, An Act respecting a national strategy for Alzheimer’s disease and other dementias.

Mr. Speaker, first I want to thank the member for Don Valley West for seconding the bill. Also, I want to acknowledge a previous member, Claude Gravelle, who also raised this matter.

The bill has a number of changes that I support, of course,. It calls on the provinces and all stakeholders to develop a plan to co-operate in finding a cure and dealing with the challenges of Alzheimer's disease and other dementias.

There is probably no family in the country that can say it has not in some way been hurt by these particular diseases. We know they are increasing. There are more than 700,000 Canadians currently suffering from Alzheimer's and other related dementias. As we know, as the population increases, the word is that this is going to increase.

The bill has the support of a number of stakeholders, particularly the Alzheimer Society of Canada.

I would appreciate if all members could revisit this area, have a look at it; and I hope it gets the support of everyone when it comes up for second reading.

(Motions deemed adopted, bill read the first time and printed)