Bill C-277 (Historical)

Framework on Palliative Care in Canada Act

An Act providing for the development of a framework on palliative care in Canada

This enactment provides for the development of a framework designed to support improved access for Canadians to palliative care.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Thank you, Chairs, and thank you to all our witnesses.

I want to talk about palliative care. As a result of the special committee that studied the Carter decision and their recommendation that in the absence of good quality palliative care, you actually don't have a choice, I brought forward Bill C-277 to create a palliative care framework, which I am very proud of.

The government pledged $6 billion over 10 years in the 2018 budget for palliative care. Sadly, what's happened is that they've spent only $200,000 of that, and it was bucketed together with MAID, which was never the intent. The World Health Organization has been clear that palliative care does not hasten death; that's a totally different thing from MAID.

My first question is easy and for each of you. We know that the framework was also looking at addressing the 60,000 missing resources in terms of palliative care doctors, nurses and other providers. Would you agree that the government should meet its commitment of $6 billion over 10 years for palliative care and address the gap of missing resources?

Dr. Buchman, I'll start with you.

[Dr. Leonie Herx]

Certainly there is renewed attention, as you said, on the importance of palliative care, and it was indeed positioned, by both the Supreme Court and in the Bill C-14 legislation, as something that could alleviate suffering that might lead to a request for hastened death. We were so fortunate to have supported, through the Canadian Society of Palliative Care Physicians, Bill C-277, which created the national framework for palliative care. What that really allowed us to do was to put together all the good work that's been done across the country, informed by international standards, to solidify what we need to achieve in Canada to make palliative care a reality.

Unfortunately, we haven't really done anything further than to put a framework on paper. What we need is the money and the infrastructure to get the boots on the ground. We now have clearly defined national competencies for all professionals who provide a palliative approach to care for their patients and for the specialist training that is needed, but they are not embedded into curricula across the country. We do not have quality standards to evaluate what palliative care is happening across the country. That goes back to the Health Canada data. We just don't know what's happening and who's providing the care, although now we have these credentialing programs.

We need a national system that's linked to Accreditation Canada's standards and that's administered so that provinces collect data on outcomes for patients that is patient-reported. We also need the quality standards to make sure that provinces are accountable for improving both the quality of palliative care and the access to it. Achieving that will take a sustained investment of resources over time to get those trainings embedded, to get the standards up and to hold the provinces accountable through accreditation standards. That's absolutely needed, and we haven't seen any of that. There was no money in the last federal budget, and that needs to change. At least 95% of Canadians don't want to die via an assisted death, so let's put some money into supporting the needs of all those people who don't want MAID.

Criminal Code

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Madam Speaker, I am happy to have the opportunity to rise today to speak to Bill C-7. It is a very serious matter. As the member for Fundy Royal just mentioned, it is a matter of life and death. I was part of the debate on the original bill, Bill C-14, and I am familiar with a number of the issues with that bill.

It is very disturbing to me. I understand with the Quebec court decision the government had to make a response of some sort, but the previous bill required them to do a fulsome parliamentary review, which was supposed to take effect this past summer. The government refused to let Parliament sit this summer and do the kind of fulsome work that needed to be done.

It is actually quite irresponsible that when the government introduced Bill C-7, instead of just addressing what was time sensitive in responding to the Quebec decision, it went further and took actions without doing that fulsome review of how things have been going with Bill C-14 in the last number of years.

For those watching at home who are not familiar with Bill C-7, the bill would repeal the provision that requires a person's death to be reasonably foreseeable. In addition to that, it would specify that people whose sole underlying condition is mental illness are not eligible for medical assistance in dying. It would create two sets of safeguards that have to be respected before medical assistance in dying can be provided to a person, and it would permit medical assistance in dying to be provided to a person who has been found eligible to receive it and whose death is reasonably foreseeable but who has lost the capacity to consent before the medical assistance in dying is provided. That is sort of an advance consent, and we will talk a bit more about that.

Bill C-14 was not without some issues that were not addressed in the previous legislation and will probably be considered in the fulsome review. There was a question about whether minors should be able to receive medical assistance in dying. There was significant discussion about advance consent. A lot of Canadians were demanding it, and I will talk a bit about some of the considerations that may have kept the government from moving ahead at that time. There was discussion of those who are not mentally competent to give consent. There have been a number of speeches today mentioning people with dementia, for example. That is another area where there was work done by the Council of Canadian Academies, the CCA. It did fulsome reports on a number of these things, and I will talk a bit about what was found.

There was discussion today about the protection of conscience rights, and I do not agree necessarily with the Parliamentary Secretary to the Minister of Justice. I see the charter provisions that were put into Bill C-14, but forcing somebody to refer, when they do not want to have anything to do with the process at all, is actually violating their rights. I am not a fan of violating one person's rights to give another person their rights. That is not good, so we need to have more discussion about that.

In its report, the special committee that studied the Carter decision said that, without good-quality palliative care, people really cannot make a true decision. They really do not have a choice. Obviously I have been an advocate for palliative care. My private member's bill, Bill C-277, on palliative care, was unanimously passed in the House and in the Senate. The government did a good job of putting the framework in place to get consistent access for all Canadians to palliative care.

The problem is that, once the framework was in, the government has since really not pushed ahead. There are 70% of Canadians who have no access to good-quality palliative care. Especially in the time of COVID, where people are dying, it is becoming even more important. The government needs to take action to up its game on palliative care to make it more available to Canadians.

There is an opportunity and a responsibility for the government to show leadership in how palliative care is being implemented in Canada. Right now, for example, British Columbia is violating the World Health Organization's requirements for where MAID should be performed. It has specifically said that palliative care is a different thing from medical assistance in dying and that they should not be performed at the same location because of a tendency by people wanting palliative care to be afraid that they will accidentally receive medical assistance in dying against their wishes. There is an opportunity for the government to revisit that and I am hopeful that it will.

With respect to the Council of Canadian Academies, many issues were studied. On the advance directives and advance consent issue, we see in this legislation that the government is allowing people who believe their conditions are going to decline and are eligible to receive medical assistance in dying to have a 90-day advance consent. It is not clear to me in the legislation when the 90 days start. Is it when patients first have discussions with their physicians? When does the clock start? That is a clarification that is needed in the legislation.

When the council looked at advance directives, it said there were a few difficulties. The first one was how to prove people have informed consent, what the criteria are and what the definition is of that. Therefore, that would have to be addressed. Who decides what is intolerable suffering, especially if the person has lost capacity? That is another question that needs to be and should be considered in this fulsome review that is required and that I would have preferred to have had before this bill came forward.

As a point of information, Belgium and Luxembourg only allow an advance directive when a person is permanently unconscious. That is the only way they will allow a person to have an advance directive in place: If they become permanently unconscious, they will receive medical assistance in dying.

On the issue of minors, “mature minors” would have to be defined. In Quebec, that is defined as people aged 14 to 17. However, we have to make sure they have the capacity to make medical decisions and confirm they understand that it is voluntary and they are not under duress. There are not many jurisdictions that have extended this to mature minors. The Netherlands does allow people aged 12 to 16, with parental permission, to have medical assistance in dying, and those aged 16 to 18 with parental consultation. Belgium allows it if the person is terminal, but pediatric palliative care has to be provided as an option. Therefore, there needs to be further discussion on that one.

Then there are those who suffer from mental illness. I was very pleased to see that it is clear in this legislation that they would not be eligible. It was very controversial. The council that studied it could not agree. There was discussion about the capability for informed consent and the fact that people with depression could have good and bad days and may change their minds, which again points to the need for some kind of cooling-off period. The Netherlands allows this but for dementia only, and there is still a lot of controversy about that.

The safeguards that were in the bill originally seem to have been removed. I am not a fan of doing that because I would say that if we remove the conditions that have to be met in order to get something, more people will take advantage of it. I am concerned with a broader creep on this, but I am sure there will be fulsome discussion about this at committee.

In Canada, everyone has the freedom to express themselves, to believe what they want and to choose what they want, and we should treat everyone's individual choices with respect.

[Sharon Harper]

We are planning a series of indicators to address the action plan and how it's being implemented. We expect those to be available in fall 2020. There is also a parliamentary review that will require a report on palliative care in June 2020. Also Bill C-277 requires the minister to provide a follow-up report on palliative care in December 2023.

[Kyle Seeback, Conservative, Dufferin—Caledon, ON]

Mr. Speaker, I am happy to stand today to add my voice to this debate. I think it is a particularly important debate. It is an important subject, and I think there are a lot of issues that need to be discussed.

I am going to confine my comments to issues I have with the bill, things I am concerned about, and my genuine belief that the government will take a very collaborative approach to this legislation. If we take a collaborative approach to this legislation, Canadians will have trust and faith that we developed legislation to actually address their needs and protect their concerns.

Speaking of concerns, I have a number of them. I will start off by talking about what I consider to be a significant lack of consultation.

This legislation will come up for review in June. It is the five-year mandated review of the legislation. My understanding is that the government has applied for a four-month extension with respect to the implementation of this legislation, which the Quebec court struck down.

If we have this four-month extension and have the mandated review of the legislation scheduled in June, what is the rush? Why have we rushed to introduce legislation prior to that mandatory review, which would, of course, be extensive and broad and far more in depth than any consultation that has been done with respect to the current legislation? My understanding is that there was only about two weeks of public consultation for this legislation. In my opinion, that is woefully deficient given the gravity of the topic we are discussing today.

This is my first real concern. What is the hurry? What is the rush? The court has given us more time to do this, and I believe we should be taking the time to go through the mandatory review and consult with Canadians, and then decide on the path forward. That is my number one concern.

I want to mention that I will be sharing my time with the member for Langley—Aldergrove. My thanks to the page for bringing that to my attention. She is doing an excellent job.

The next thing I want to talk about is palliative care. The minister has made comments in the House today espousing the great investments that are being made by the government in health care, but has not really talked about any specific investments with respect to palliative care. I think that is a critical thing to look at when we discuss this legislation. I want to remind the minister that Bill C-277, an act providing for the development of a framework on palliative care in Canada, was passed in the previous Parliament in 2017, and clearly states in the preamble:

Whereas the Final Report stated that a request for physician-assisted death cannot be truly voluntary if the option of proper palliative care is not available to alleviate a person’s suffering;

This was passed by Parliament, so if we are looking to expand the scope of medically assisted death without also expanding the availability of palliative care, we are doing an incredible disservice to Canadians, because the availability of palliative care in this country is poor at best. I am going to speak about this personally just for a moment.

Both of my parents suffered from terminal cancer. My mother was not able to get into a palliative care facility because there was no palliative care facility available for her, so she passed away in the hospital. My father was also not able to get into palliative care, but fortunately his illness was longer than my mother's, or unfortunately, depending on how one looks at it, and we were able to get private home care that eased his suffering and made sure he was being taken care of. However, there was no way that he was going to be able to get into palliative care within the scope of his illness.

This is affecting Canadians from coast to coast to coast, and the minister has rushed to introduce this bill. Why would the minister not have introduced corollary legislation, or legislation in tandem, or announced increases in funding for palliative care?

In my riding of Dufferin—Caledon, there is a fantastic hospice for palliative care. It is called Bethell Hospice. It only has approximately 15 beds. That is the palliative care option in my riding. For approximately 200,000 people, there are 15 palliative care beds.

Members can imagine that there is a significant number of people who are not able to get into palliative care. Therefore, the option of medically assisted death becomes far more attractive for someone who is not able to enter into a palliative care facility.

I will repeat that it is clearly a violation of legislation that was passed by the House. When people do not have the option for proper palliative care, their consent for a medically assisted death is significantly in question. I am extraordinarily concerned by the lack of any plan by the government to deal with investments in palliative care.

The minister has suggested that there are significant safeguards in place for people who suffer from any type of mental illness. However, I am not sure what those safeguards are. She suggested that just having that condition would exclude someone from obtaining a medically assisted death. What is the definition of that? How are we proving that is the only issue?

There is no requirement for individuals to go to a psychiatrist in order to assess that they are not suffering from a severe bout of depression. In my own life, I have gone through extraordinary stages and phases of depression during which I actually did not want to live anymore. I was not seeing a psychiatrist at the time. Would I have then been able to avail myself of these services while I was in a period of particular darkness? We know that mental health is an issue that is rampant throughout this country.

Again, I will go back to my first point, which is: Why are we rushing to do this? Why are we not taking the time to go through the five-year review? We need to take the time to find ways to make sure we are safeguarding all Canadians in providing them the option of medically assisted death, if they want it, but also ensuring that people who are choosing this, maybe because of a lack of palliative care, or maybe because of underlying mental health issues, are going to be protected.

These are some of the major concerns I have with respect to this piece of legislation.

Going back to the consultation, two weeks for online submissions with respect to concerns by Canadians is not anywhere near a sufficient amount of consultation. My understanding is that it was mostly online submissions. This is not a way to get the pulse of Canadians with respect to a very significant issue that is going on in this country. I will continue to ask why there was not a longer or broader consultation.

I know this matter will be studied at committee, but having been a member of Parliament now for going on five and a half years, I understand the extreme limitations at committee. We will often have a panel of six witnesses. Those six witnesses will each get their 10-minute statement, and then members of Parliament might get a six-minute intervention to try and raise an issue.

If one is going to suggest that a committee study will be far broader in scope, or somewhat more encompassing than the mandatory statutory five-year review, I will respectfully disagree with that submission.

Committees absolutely do great work, but they also suffer from an extreme pressure of legislation and time. To suggest that one or two weeks or three meetings at committee is sufficient time to analyze, debate and discuss this legislation, I do not think that is the correct answer. We should be putting this legislation off until we have the mandatory five-year review in June, which would allow us to have a far more expansive discussion with respect to all of the issues that are being discussed in the legislation.

These are my comments and concerns with respect to the legislation. I certainly hope the government will listen to these concerns, act collaboratively and co-operatively, and not try to drive this legislation through without listening to legitimate concerns that are being raised by members of the opposition.

National Physicians' Day Act

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Mr. Speaker, I am pleased to rise in the House to speak to Bill S-248, an act respecting national physicians’ day.

This bill designates May 1 as national physicians' day. It seeks to recognize the importance of the 125,000 resident and student physicians across the country.

In coming to my decision to support this bill, I considered the following points.

Members who have been here for four years have seen a number of days, weeks and months of various sorts to recognize great things across the country, but what could be more important to recognize than our doctors? Doctors save our lives. Every one of us is going to need a doctor at some point in our life, and usually all the way throughout, from the time we are born to the time we go into palliative care and pass on from this life. It is definitely worthy to have a day to talk about doctors and all the things they do.

From the time people decide to go into medicine, it is an incredibly long journey. We know it is difficult to get into med schools, and once they are there, they study for extremely long hours. It is a very competitive field. Once they have finished their studies, they have to do their residency. This involves extremely long hours of work, very interesting work, when they get real experiences. My nephew is a doctor. He did undergraduate work in Michigan, but got his medical training in St. Martin, which sounds like a wonderful place to get medical training. He did his residency in the U.S., so he had the opportunity to work in Detroit and Long Island. One can imagine the excellent training he got in the emergency departments there. He and so many other doctors go through all of that, and at the end of their studies and just beginning their careers, many of them have racked up between $200,000 and $300,000 worth of debt in student loans.

It is really quite a commitment to embark on becoming a doctor in the first place, and one of the problems in Canada is graduating enough doctors. There is a certain number of spots for residents. When I became the shadow minister of health, I became aware that there was an issue with the matching of residents to positions and, in fact, some of them were unable to get a position. We can imagine, after all the training doctors have gone through, how devastating that would be not to be able to pursue their life's dream. I was able to work with the health minister to address that gap.

That being said, there is a huge doctor shortage right across the country. I have been able to go from coast to coast to coast to see the state of the nation in terms of doctor shortages, and I can say there are some very dire situations. Cape Breton is missing 52 emergency room physicians and a vascular surgeon. Individuals who cut an artery there would lose a limb or die because they cannot get to Halifax in time. In Ottawa, the wait time for a family physician is six years. In B.C., there is a huge shortage of doctors. There is an incentive system there that has resulted in having more emergency room doctors than family doctors. Rural and remote spots across the country are in dire need of doctors.

I have a list of the types of doctors missing in my own riding of Sarnia—Lambton. We're missing 10 family doctors, two geriatricians, one rheumatologist, three psychiatrists, one rural emergency physician and two other ER physicians, one plastic surgeon, two anaesthetists and an otolaryngologist, though I am not sure what that is.

The government should definitely be taking a leadership role. We recognize that, while health care is executed by the provinces, the federal government has a responsibility to address this gap. We have an aging population. One in six seniors right now will become one in four seniors in six to 10 years, so we are going to need even more doctors. We are short 600 palliative care physicians and innumerable doctors for seniors.

It is time to work alongside the provinces and territories to figure out how to address what is really a disastrous shortage. Without a doctor, how is someone going to stay healthy or deal with chronic disease?

It is worthwhile having a day to celebrate doctors, but it is a bit hypocritical for the Liberal government to be bringing this forward. It was a Senate bill originally brought forward by Senator Eggleton, but the Liberals have brought it forward. As a government, Liberals have not been kind to doctors. Remember, it was the Liberal government, under the finance minister, that called doctors tax cheats. It did not recognize that when doctors have their corporations and run their medical practices, they need to accumulate passive income to buy the equipment they need to run their practices. The government wants to tax them at a 73% rate. Again, the Liberals have not treated doctors well.

If we look at the medical assistance in dying legislation that was brought forward, it was the Liberal government that did not protect the rights of conscience of doctors in this country, even though it was brought to its attention. Most recently, the Ontario court has not allowed for doctors to have freedom of conscience with respect to assisted suicide in Ontario. That has never happened anywhere else in the country, in the world, and it was the Liberal government that began that path.

When doctors are becoming doctors, it is a very long and arduous process. However, once they become doctors, they face very strenuous working conditions with very long hours. They may be working 80-hour weeks, depending on whether they have someone helping them out in their practice. As well, the Standing Committee on Health is doing a study right now about the violence that health care workers experience. I was astounded to learn that more than 60% of health care workers, including doctors, are experiencing violence from patients, frustrated family members and people who suffer from mental health and addiction issues or dementia. There is a real and serious problem that we need to address on behalf of doctors.

Many people know that I am a passionate advocate for palliative care. While we are talking about having a national doctors' day, I send thanks to the doctors at the palliative care at St. Joseph's Hospice in Sarnia—Lambton. I thank them for everything they do. I also thank the palliative care physicians across the country and those who work in that area. With the aging population we have, we need to do more to make sure that Canadians can choose to live as well as they can and for as long as they can. There are 70% of Canadians who do not have access to palliative care today.

The palliative care framework brought in under my bill, Bill C-277, has certainly helped to advance the cause. I have worked with the health minister and the parliamentary secretary, who I see is here today, to try to make sure we have training for health care workers in palliative care and the infrastructure we need in terms of hospices and broadband Internet to access virtual palliative care. As well, we need to take the innovative ideas put in place across the country, with the paramedics, for example, learning palliative care and taking that to rural and remote places, and that we take all of those ideas and make sure we build our palliative care capacity in the country.

In summary, there is more to be done. There is more to be done to support doctors, and not just their rights of conscience or the tax laws that allow them to operate here. We have to also listen to the doctors when they provide advice. The Canadian Medical Association provided a lot of input on the cannabis regulation, and it was largely ignored. While having a day for doctors to celebrate is great, there is a lot more that we could and should do to celebrate how important doctors are to each one of us. They save our lives and help us throughout our lives. I am certainly happy to stand here today with Bill S-248 and say that I will support this bill. Happy national doctors' day.

Member for Langley—Aldergrove

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

Mr. Speaker, it is my birthday.

[Members sang Happy Birthday]

Mr. Speaker, I was in the hospital recently for 15 days, and I had zero interest in politics since I was in the hospital and possibly facing the end of my life. In just a few minutes here in Parliament, I am interested in politics again.

I am not running again; I announced that. However, I wanted to make a farewell speech. It is tradition in this House to be able to say goodbye and thank members of this House. I have surgery for colon cancer coming up on May 22, and my only opportunity to say goodbye was this week. I am here to give the House an update and thank members.

I was an election observer with a colleague, and I had to come back early because I was turning yellow. I was very jaundiced. I came back, went to the hospital after a few days, and doctors found that I had a pancreatic tumour. They then found that I had colon cancer and then that the pancreatic cancer, which is the same as what Steve Jobs had, had spread to my lungs. The prognosis from the doctors is not great. However, I have a strong faith in God; and the God who created me can heal me.

I want to share a little about my life. Throughout my life, there have been some wonderful little God moments, nuggets and interventions of guidance. People ask me why I became involved with politics in the first place, and it started with a dream back in 1990. I had a dream that there was an upcoming municipal election and that I was elected. This was out of the blue; I had no interest in it.

Later that day, somebody came up to me and said that they had a dream about me. “Oh, really?” I asked. “What did you dream?” The person dreamed that I ran in the election and was elected. When those little nuggets happen, one has to listen. So often we get busy and do not. I put my name on the ballot, and surprise, I was elected. That was in 1990.

I served on Abbotsford council with the wonderful, intelligent, good-looking member for Abbotsford. I served there for 14 years, and what an honour it was.

Then there was another God moment. I was with my beautiful wife, Diane, and we were going out for our anniversary. I said to her that one day before I retired I would love to get into managing or owning an auto body shop. I had just sold a business and everything, and she told me not to start a new business. I told her that I was just thinking out loud, because I loved cars and would like to do that. That happened on Saturday. On Monday morning, the phone rang and this fellow said that he was Gary down at the so-and-so avenue body shop. He said that he was looking to retire and asked if I would be interested in managing his auto body shop.

From that I then went to ICBC, and then brought money into Langley and started fixing up things. I became known, and the next thing I knew, I was running for federal politics. Again, there are these little voices, these little nuggets in our lives where we need to listen and follow God's leading. That is why I am here. I am just an average guy who has had an incredible honour serving with members and serving our community.

I want to thank God. I want to thank my family.

Diane and I were married in 1972, almost 47 years ago. She is my best friend. We have five kids and 10 grandkids. We are so blessed.

My passion has always been the environment, justice, family, seniors, children's issues and respecting life right from beginning to end.

Diane and I met at Trinity Western University, and on the weekends, as I did not have a lot of money as a student, I would take her on a date to a seniors place, where we would play the guitar and sing. We just loved dealing with seniors. We did not have to be great singers for the seniors to like us.

We are so blessed with our kids and grandkids: Jon and Jen with Carrington and Rich; Ryan; Eric and Carolyn with Christian, Jonah, Jeremiah and Jakob; Nathan; and Kristen with Russel, Mya, Mark and Will.

I have always been involved with sports over the years, and I know the importance of teamwork. We cannot get anything accomplished as a lone wolf; we have to be part of a team. I understand the importance of this in politics as well, and I have this incredible team that I get to work with, my staff. I could not have accomplished anything without them. They are Annette, Kim, Jane, Liat, Monique, Megan and Rebeca.

As members all know, the best part of the job is being able to help people, and it has been such a blessing. We love our community, and it has been an incredible honour.

When I announced that I was not going to be running again, I felt that God was creating a new chapter of my life. I was preparing to be a chaplain giving pastoral care to seniors. I was doing this studying and reading, and lo and behold, I got sick. I was reading all these case studies about whether to operate or whether to give palliative care and I was honoured by our leader to be given the responsibility for palliative care. Then I found myself in the hospital, a surprise, and experiencing what it is like to face end of life. With all that reading and preparation, maybe it was not for me to administer to others but to prepare myself for this trial. I want to thank everyone so much.

When someone is first given the diagnosis that there are some serious problems, doctors are dealing with the physical person, but there is more than just the physical to us. There are the spiritual and the emotional sides, the psychosocial, but that was left unadministered to. While the doctors were looking at my physical condition, that was being ignored. This is tremendously important. Doctors give a diagnosis and look at how they are going to fix a patient, at what kind of operation is needed or what chemo, but what about the person? What about the family and the distress? We need to encourage our medical system to make sure that they are providing a ministry for the rest of the person.

I was at the Vancouver General Hospital, which is an incredible hospital with incredible physicians and surgeons, but that need was left unmet.

I asked for palliative care. I was there for 15 days. Of the thousands of doctors, there are two palliative care physicians at VGH, and I never saw them. They came once while I was recovering and groggy and sleepy, so that need was unmet, unfortunately.

I have experienced first-hand the difficulty of accessing palliative care. We know from statistics that it is not available to 70% to 84% of Canadians, a tragic number. Our system is not designed to meet that need. We are trying to fix the body, but in some cases it is better not to do the heroic thing, not to remove the organs or use chemo and that sort of thing. Science has shown us that people can live longer and have a better quality of life, in some cases, if they are given palliative care, but those options were not provided to me. Why is that?

The system is broken and needs to be fixed. We passed Bill C-277. This Parliament is coming to an end, but I hope that the next Parliament will make a commitment to fix that and provide leadership in Canada, maybe through a university chair or something, so we can fix this situation. People are left in despair, emotions are raw and family support is not there, but they are not given the opportunity for palliative care. What is the only remaining option? If it is not surgery, it is maybe that they should consider MAID, medical assistance in dying. I was on the legislative committee when we discussed that proposal and passed it. We had to, because of the Carter decision.

We have a situation in Canada of basic needs not being met, and out of desperation people are saying that the easiest way is to end their life through an injection. They are saying that would be the humane thing to do, but we cannot force people into that kind of a choice. We have to provide palliative care.

It has been such an incredible honour to work in this House. I was first elected federally in 2004, and 15 years went by just like that. It has been such an honour.

None of us are here by accident. I believe that strongly. I have a strong faith in God. If we are not here by accident, then what is the responsibility for each of us that goes along with that?

To whomsoever much has been given, from him much will be required.

Therefore, we have a responsibility to do what is right, to be truthful, to be people of integrity in making Canada better and working with one another when it is appropriate to do so.

I have not always done things right. I have a very mischievous nature, as chairs of different committees can attest, so I would like to apologize for some of the problems I created.

Death does come to each of us, and to some very early. We just said goodbye to a very dear friend. He had an aneurysm and he was gone. God has given me some time. I may be around for a long time or I may be around for a short time. We do not know.

This is the most important part: It is that I want to encourage each of you to love one another, to encourage each other, because God loves us. Pray for another. Pray about what is really important. Help one another. Seek God's will for you each day. Do what is right. Be honest.

We read in Galatians:

But the fruit of the Spirit is love, joy, peace, forbearance, kindness, goodness, faithfulness, gentleness and self-control. Against such things there is no law.

It is all legal. It is all good.

Life is precious. Life is sacred. I have been reminded very freshly of how valuable and precious life is, from beginning to end.

God bless you. I love you all. I will look forward to being able to serve. Until October, it will likely be out of my constituency office, but to God be the glory.

[Michael Villeneuve, Chief Executive Officer, Canadian Nurses Association]

Thank you, Mr. Chair and members.

My name is Mike Villeneuve, CEO of the Canadian Nurses Association. I've been an RN for the past 35 years, and I worked for 40 years in the health care system in a couple of other roles.

I would like to thank the Standing Committee on Finance for the opportunity to present recommendations from CNA, which is the national and global professional voice of registered nursing, representing over 139,000 registered nurses and nurse practitioners across Canada.

Our submission highlights four recommendations, but I'd like to focus on two of them today.

Our first recommendation calls for the creation of a health care innovation agency for Canada. CNA believes that the federal government has an opportunity to build on what provincial and territorial counterparts have already achieved by facilitating new opportunities for health care innovations across Canada. We see the spark. There are some successful innovations right across the country, but there is no mechanism to help spread them and scale them up. A new federal agency would target funding on innovative health projects to ensure that they are adopted more widely for everyone in Canada, including indigenous peoples, wherever they live.

The new agency, for example, could lead efforts to evolve medicare to help overcome the sometimes fragmented nature of our health care system. To drive the notion of the right care provided by the right provider at the right time in the right place and delivered at costs we all can bear, we need innovations that will accelerate the de-hospitalization of health systems, not unlike what you just heard from the Canadian Medical Association president. Nurses work at all points in health systems, and we recommend that nurses have a strong leadership role in any such new agency. There are nearly 428,000 regulated nurses across Canada, and we're well poised to dig in and help.

The second recommendation I'd like to highlight today and encourage the committee to support is the third one in our submission, which is about improving access to palliative care and support for people in Canada who are acting as caregivers.

I am pleased to inform the committee that CNA is a member of the Quality End-of-life Care Coalition of Canada, and I serve as co-chair of a committee of the national network along with 38 other national organizations whose vision is that all Canadians have the right to quality end-of-life care that allows them to die with dignity, free of pain, surrounded by loved ones and in the setting of their choice. Most Canadians tell us that they want that care, and we know they could benefit from it. Better palliation drives down costs. Most Canadians never receive that care.

The challenges we face in palliative care are compounded by our country's aging demographics. As I always remind people, we are set to become one of 13 super-aging nations by 2020, just 18 months from now. Nearly one in four Canadians will be over 65 by 2031.

We recommend that the Framework on Palliative Care in Canada Act, which was passed into law in December 2017, must include targeted federal investments for both new and existing federal programs to improve standardization of delivery of palliative care for people across Canada. We were happy to support Bill C-277, tabled by the shadow minister of health. We acted strongly to help that move along.

New federal funding that is predictable and sustained would help to address the gaps that currently exist in palliative care across Canada. We are pleased that the framework recognizes the palliative care training and education needs of health care providers as well as other caregivers, and we urge the committee to support our recommendation to provide funding for early career access to palliative care training and education to nurses and all other health care providers.

Research tells us that our country does not have adequate palliative care training for health care providers. One way to address the gap is to include education and training in core curricula for students, but we also need to create structures to provide that education soon after licensure. We are also calling on the federal government to provide increased financial support for the country's 8.1 million caregivers by making refundable the former family caregiver amount tax credit, which is now under the new Canada caregiver credit, and extending the compassionate care benefits to include a two-week period of bereavement.

In its current form, the tax credit is not paid to recipients as a direct cash benefit. We support the drive to move care out of hospitals, but we have also pushed significant costs on ordinary people. Many caregivers face high out-of-pocket expenses for specialized medical aids, medications, transportation, hiring staff, lost wages and so on. A refundable tax credit could help ensure that all eligible households receive something in return for those expenditures of time and money.

Regarding the CCB, CNA believes that adding a two-week period for time for bereavement would allow flexibility for caregivers, many of whom are employed, after a patient's death. Such a measure also allows for a more reflective and humane palliative care process.

Currently, support that's provided for successful applicants only covers the caregiving period for up to 26 weeks and not bereavement. Adding that two-week bereavement period would surely provide caregivers with some important financial support after such a profound loss.

Thank you for hearing our ideas, and I look forward to our conversation.

Palliative Care

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

Mr. Speaker, it is an honour to present two petitions.

The first petition asks Parliament to establish a national palliative care strategy. It highlights that in the last Parliament, a motion was unanimously passed calling for the government to create a national palliative care strategy, and that in this, the 42nd Parliament, Bill C-277 passed unanimously, saying that it is impossible for a person to give informed consent on assisted suicide and euthanasia if palliative care is not available. The petitioners are calling on Parliament to establish a national palliative care strategy.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Once again, Ms. Gladu, we were very pleased, as the government, to be able to support your bill, Bill C-277, and we're very keen to move forward on its implementation and the work that needs to be done in that area.

We certainly recognize that all Canadians want to stay home as long as they can, but to do so, we certainly need to make sure they have the quality care and necessary care they need to live the rest of their days in comfort. Those support services are absolutely critical. We are very pleased, as I've indicated, to support Bill C-277 and to work on the development of a framework that promotes palliative care.

I was also very pleased that we were able to make some announcements this year, and I believe you were with me for the funding announcement of $6 million for Pallium Canada. Those monies were put in place to expand existing services, called the learning essential approaches to palliative care program. That money will go specifically to front-line service providers, like ambulance attendants or EMTs, to provide them with the training they need so that when they go to homes, especially in rural areas where they can provide direct services to people at home, they will be able to provide people with the additional quality services they need so they won't have to go to community centres or hospitals to receive those services. We're certainly moving forward in that direction and making sure that investments are made in that area.

I was also pleased that we've invested $184.6 million over the next five years to improve home palliative care for indigenous communities. We recognize that an awful lot of work needs to be done in that area, and we certainly recognize that those investments will help moving forward.

Finally, we recognize as well that research is key in this area, so we're investing over $2.8 million over the next four years to support two research teams, which I'm sure you're probably well aware of. We certainly want to generate high-quality research and evidence to inform professionals in health care with respect to best policies as we move forward in end-of-life care and the policies that we need to put in place.

Finally, Mr. Chair, with respect to the investments that we've made in home care in budget 2017, $6 billion has been put aside, and I'm in the process right now of completing bilateral agreements with provinces and territories. In the ones that I have seen thus far, palliative care services are absolutely mentioned in those, as well. They may not be a line item in the budget, but we certainly know that provinces and territories, especially with our aging population, and people who want to make sure they expand palliative care services see it as a priority.

Budget Implementation Act, 2018, No. 1

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Mr. Speaker, it is a pleasure to be here to speak to this budget implementation bill. My speech today will be called “promises, priorities and plans”. When we put a budget together, we should consider the amount of money we will need to keep all the promises we have made. Of course, there is not an endless amount of money in the world so there is a need to prioritize those promises we have made to ensure we hit the important ones and put those first.

Then it is important to have plans. We all know that without plans, we may spend a lot of money and not really accomplish anything, which we have seen an incredible amount of from the Liberal government.

With respect to promises, one of the early promises made by the government, which we hear repeatedly, was that it would run very small deficits, a small deficit of $10 billion in the first year, coming to balance in the fourth year. However, we have seen double that deficit in the first year, double the deficit in the second year, and triple that deficit in this budget. There is no end in sight with respect to balancing the budget. It is certainly not going to be in the fourth year of the mandate. Now it looks like it may not be until 2045. This is promise was broken into about 1.5 trillion pieces.

The other thing is that a lot of promises were made that were extremely important to rural communities across Canada. The first one was the restoration of home mail delivery, which for people who are living in very rural places, especially those who are elderly, is a very important service.

Even more important than that was the promise about infrastructure money. Members can remember that we were going to spend infrastructure money to create jobs and get the economy going, and that money was going to be spent on roads and bridges in municipalities. This is a critical thing in ridings like Sarnia—Lambton, where we have a lot of roads and bridges that need to be fixed, and the municipality certainly does not have the money to fix them. I was disappointed with the last budget when the government took $15 billion from those municipalities and put it into the infrastructure bank. Of course we have seen nothing come out of that whole situation.

Then there was the Asian Infrastructure Bank to which the government gave another half a billion of taxpayer dollars to build roads and bridges in Asia, which is not helping the rural community at all. Thus was another broken promise.

One of the most disturbing promises broken by the government was that of openness, transparency, and a higher ethical standard. Every time we ask questions about what is in this budget, such as the carbon tax that is outlined heavily in the budget, the government refuses to say how much it will cost the average Canadian taxpayer. The average Canadian taxpayer wants to know. If it is not a bad number, then why is it afraid to say it? Obviously, if it does not want to tell Canadians, it is because it is bad news.

Beyond not telling them how much it will cost, it will not even tell us what it will accomplish. The environment minister has been asked multiple times at committee, and here in the House, what kind of a greenhouse gas reduction she expects from this, and she has no answer. There is a huge amount of money being spent in the budget in this area. There is a huge amount of tax that will be paid by Canadians, yet there is no openness and transparency from the government with respect to those issues.

The government promised not to use omnibus bills, and here we are again with this huge budget bill. So many things have been snuck into this bill that if we did not really read all the pages, we might not be aware of them. My colleagues to the left have already talked about the medicinal marijuana issue and the taxes associated with that. However, more so, there is language in the budget bill that suggests that if people had a drug information number, they would be exempt. The fact remains that there is no drug exemption number for any medicinal marijuana because of the variability of all the components. Therefore, that is just another misrepresentation in the budget bill.

With respect to the taxes on cigarettes' portion of the bill, there is an escalating tax that continues to go up in perpetuity, without any parliamentary vote and without Canadians being able to talk about that. This is the same kind of deceptive tax that was put on beer and wine. It is fine for the government to put a sin tax on something when it wants to, but when it wants to hide a tax in there that continues to go up and generates revenue for the government, and it sneaks it onto page 324, Canadians may never get to that.

Therefore, there is no openness and no transparency in omnibus bills.

As members know, I am a passionate advocate for palliative care, so I was very excited when the government said it would spend $3 billion on home and palliative care in the 2016 budget. Then the government updated the 2017 budget and said that it would spend $6 billion over 10 years. It was a little more paced out, but at least it was something. I was really disappointed to see the word “palliative” removed from the 2018 budget. It was taken out altogether, even though the government supported my private member's bill, Bill C-277, on consistent access for palliative care for all Canadians. Surely, if we want there to be consistent access, we know we will have to plan something to back up that promise and put money in the budget. I was very disappointed there was nothing in the budget on that.

I will go to priorities.

One would think that in a country with one person out of six being a senior, maybe seniors would be a priority, but no. The Liberal government took position of minister for seniors away, and there is relatively nothing in budget 2018 that will help seniors, many of whom really struggle to afford to live and pay for many of the things they need, such as cataract surgery, perhaps hearing aids or dentures. I certainly heard this when I went door to door. A priority has been missed.

Then there is the agriculture sector. Agriculture is hugely important in Canada. Everyone can agree that we need to eat. This is one of our largest industries. What is the government doing? First, it is loading all kinds of bureaucracy on the Canadian agriculture industry that does not apply to other people. It has taken away pesticides without any replacement. Those very pesticides are used by countries that then import their food to Canada, putting us at a competitive disadvantage. Most recently, it decided it would not allow the sale of premixed feed that contains antibiotic. This product has been sold safely for quite a number of years. Again, it is a burden on our industry that is not on other industries outside of the country that ship products into Canada.

There is very little support for research in agriculture, very little support for the industry overall, and total betrayal when it comes to the agreement that was made with respect to the TPP, that farmers would be compensated for the quota they had to give up. That is gone. They still have to give up the quota, but they do not get the compensation. It is another broken promise for the agriculture industry.

Regarding health care, the government's priorities are really screwed up. The government putting $80 million in a budget to get people to stop smoking tobacco is a wonderful thing. However, to then put $800 million in the budget to get people to start smoking marijuana just does not seem like the right message from a health point of view, especially when we consider the danger to children.

Then there is the $7-billion slush fund. I am not sure what kind of priority that is backing up in an election year, but I can only guess. That is a disappointment as well.

Then there are plans. We do not see any plans. We have talked about how there is no climate change plan and no answers on the carbon tax. What about NAFTA? The Liberals have known for over a year that tariffs could be put on the steel industry. There is no plan and no money in the budget to address that whatsoever.

What about this $4.5-billion pipeline? Members can hear that my voice is a bit hoarse from having a $4.5-billion pipeline that is 65 years old being shoved down my throat. Where was the plan for that in the budget? It is missing.

Overall, when we look at this budget, we can see that when it comes to promises, priorities, and plans, the Liberals have broken their promises, their priorities are definitely screwed up, and they have no plan to achieve anything. That is a super disappointment.

Health

[Ginette Petitpas Taylor, Liberal, Minister of Health]

Mr. Speaker, we recognize that Canadians want to stay independent as long as possible and if they need services, they want to receive them within their home. In addition to the Canada health transfer payments, we have invested more than $6 billion to provinces and territories to ensure that better home care and palliative care services are in place. We recently announced $6 million to Pallium Canada to increase capacity to deliver palliative care to communities.

I look forward to working with provinces and territories as we move forward in the implementation of Bill C-277. We certainly want to make sure that the provisions of the bill are put in place.

Palliative Care

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

Mr. Speaker, I am honoured to present two petitions today.

The first petition relates to a national palliative care strategy. It highlights that 70% of Canadians who need end-of-life palliative care do not have access to it. The petition also points out that it was this Parliament's decision, passed unanimously, to create a national palliative care strategy in support of Bill C-277.

The petitioners call on every member in Parliament to support palliative care and respect the international definition of palliative care by the World Health Organization that palliative care neither postpones nor hastens death.

Financial Statement of Minister of Finance

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Madam Speaker, to get 10 minutes to talk about budget 2018, when I first got elected, I would have thought was a long time, but now it just does not seem to be that much time.

This budget was not well received by most Canadians. I am going to talk about health care, infrastructure, and some of the spending. I was always told that when one is bringing a critical message it is good to make a sandwich and say something nice at the beginning and something nice at the end. Therefore, I am going to say something nice at the beginning and something nice at the end.

The thing I will say at the beginning is that I was pleased to see that the response for science to the Naylor report was a good one. As the former science critic for our party, that was something I was looking for. I do not have anything bad to say about that, but now I will turn to the other issues.

The first topic of discussion of course has to do with palliative care. I was surprised that the word “palliative” does not appear once in this budget. After seeing the word “palliative" in budget 2017, and considering the unanimous support of the House of Commons and the Senate for my bill, Bill C-277, regarding palliative care, I was surprised that the word was not mentioned in this budget.

In 2017, the federal government proposed investing $6 billion over 10 years for home and palliative care, as well as $5 billion over 10 years to support mental health initiatives. These investments included improving home care services in Canada, as well as palliative care. In other words, there was $11 billion for mental heath, home care, and palliative care. However, budget 2018 announced different investments, specifically $11 billion over 10 years for provincial and territorial governments to support home care and mental health, but not palliative care. There is no mention of palliative care.

Palliative care is a necessary but extremely underfunded service in our country. By leaving palliative care out of the budget, the government is ignoring the needs of many desperate Canadians who need financial support not only to improve their living conditions, but also to help ease the burden on our health care system.

The second issue has to do with mental health, dementia, and PTSD. As with palliative care, budget 2018 fails to make investments in mental health care. As I mentioned earlier, only $11 billion was earmarked for mental heath, including home care. That is not enough. Canada is still in crisis, and we must do everything we can for all those in need.

To make matters worse, the federal government is investing only $20 million over five years and only $4 million a year after that for Canadians with dementia. Over 400 million Canadians have dementia, including Alzheimer's, and this disease disproportionately affects elderly women. That amount is simply not enough. Given our aging population, we need to prepare and invest in quality programs.

I would like to thank my colleague on this side of the House for all of the work he has done regarding injuries and post-traumatic stress. I believe that it is thanks to him and his efforts that investments were made in this area. However, the government is proposing to invest only $10 million over five years to create a pilot project. Research and pilot projects are important, but so are services for all those who are living with PTSD. I believe that this is a step in the right direction but that the government needs to do a lot more.

Another point worth noting is the $20-million investment, and $6 million a year going forward, to improve mental health supports for offenders in federal correctional facilities. Those funds are intended specifically to enhance supports for women inmates in those institutions.

Despite those small investments, the government is also proposing to provide $10 million over five years for the Mental Health Commission of Canada to assess the effects of cannabis use on Canadians' mental health.

The Liberal government is doing everything it can to control and limit cigarette use, yet it wants to legalize marijuana as soon as possible, despite knowing the mental damage it can cause to users. This $10-million investment proves that the government recognizes the dangers associated with cannabis, yet it is going ahead with full legalization anyway.

What really struck me in this budget is where the government put the priorities in terms of health. There is $80 million in the budget to get people to stop smoking, but there is $800 million in the budget to get people to start smoking marijuana. That seems like the wrong priority. At the same time, while people are dying across the country in the opioid crisis, there is $40 million a year being put toward that crisis. Again, in comparison to the legalization of marijuana, it just does not seem to be the right priority at all.

I talked about my disappointment that palliative care was not even mentioned in this budget. I had approached the minister with a plan for once the framework was put together to build palliative care infrastructure across Canada. When we talk about the infrastructure spending that was promised by the government at the beginning, that was the whole reason for going into deficit. However, it does not seem that the money is flowing to the municipalities. What could be a better example than my riding?

Most members know that on January 11, the Canadian Coast Guard decided not to close the channel, which it normally does when ice floes are heavy, and the resulting push from the icebreakers crushed the Sombra ferry causeway. That border has been shut since January. The Minister of Public Safety is in charge of the CBSA, which makes $3.3 million in duties from that crossing every year. I approached the minister to get the repair money to put that back together. At first there was no response, but then a denial. I approached the Minister of Transport, who has the responsibility for the trade corridor funding. Again, there was a refusal. I approached the infrastructure minister, who seems to be looking for somewhere to spend $186 billion. I only need $2.5 million. Certainly, he could spend it on the restoration of the Sombra ferry crossing, but again, that was refused.

Combat engineers in my riding said that if the Minister of National Defence decides that it is in the national interest, he could send them to repair the bridge. They had done that in Laval and Guelph, and they could do it elsewhere. Again, there was a great opportunity, but the Minister of National Defence turned me down. I have escalated this to the Prime Minister's Office, but nothing has been done. When the government states that it wants to spend money on infrastructure and the municipalities, it falls on deaf ears for me and my constituents, who feel that there is no infrastructure money for the Sombra ferry restoration in Sarnia—Lambton.

That said, at the beginning of my speech I gave some commentary about the things I thought were missing in the budget, and said that I would say something nice at the end. I have a couple of nice things to say.

I was glad to see a reference to the thalidomide issue. We know there are people who did not qualify for their thalidomide claims because they could not produce the paperwork. I have brought this to the attention of the Minister of Health, and I am pleased to see that this has been put into the budget. No dollars were associated with it, but I am trusting that money will be parcelled out to those people who deserve compensation.

Other than that, the only other happy news is that most of the spending has been pushed out into the years after the Liberal government will have been defeated.

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

Mr. Speaker, I appreciate your leadership. I will be sharing my time with the incredible member for Milton.

It is a real honour to make comments today regarding the 2018 budget.

Canadians are looking to the budget with great hope that the government will be responsible in its spending, that its focus and priorities will be balanced and prudent, and that it will be careful with their tax dollars. The budget is about what we do with the resources, the taxes that are collected by the government from Canadians. Are taxes going to go up or down? Will things become more expensive and less affordable?

This is a political place where we have very interesting debates at times. However, it is important that we listen to some of the experts. One of those experts is the Parliamentary Budget Officer. It is important that we rely on the unbiased professional critique of this budget.

We have seen huge announcements in this budget. This is the third budget that the Liberal government has introduced. It has one more budget to bring in, in another year. Is the government doing a good or bad job? Is it responsible or irresponsible? We have seen hundreds of billions of dollars in announcements that have been made over the last almost three years, and the Parliamentary Budget Officer has provided an important critique.

After the budget was presented, it was recently reported that budget 2018 provides an incomplete account of the changes that the government has made to its $186.7 billion infrastructure spending plan. The PBO requested the plan, but it does not exist. Roughly one-quarter of the funding allocated for infrastructure from 2016-17 to 2018-19 was not spent and will lapse. The money was announced but was not spent. The mystery for Canadians is how these announcements can be made, how we can have a growing deficit, a growing debt in Canada, yet the money is not being spent. Where is this money going?

The Fraser Institute provided an analysis on this budget. It stated:

In the midst of serious concerns over Canada’s economic prospects, and challenges emerging from the United States, [the] Finance Minister[’s]...2018 federal budget does nothing to address these problems. In some respects, the budget makes matters worse by continuing the government’s self-destructive policies of chronic deficit-financed spending and new taxes on entrepreneurs.

It does not sound good.

Andrew Coyne stated:

Once upon a time the federal budget was about the budget of the federal government. It was an annual opportunity for Parliament and the public to examine the federal government’s program of expenses and revenues for the coming fiscal year.... All that is now in the past.

It sounds like what the Prime Minister said at the beginning, that budgets balance themselves. We all know they do not, and it is no mystery why we have this growing problem.

John Ivison of the National Post wrote, “as the Liberals have proven over the past two years, policies are adopted to get elected, not necessarily to be implemented.” We continue to hear announcements of hundreds of billions of dollars with no action taken.

I am particularly concerned that there is almost no mention of seniors in the budget. I am the critic for palliative care and income security for seniors. I listened intently to my colleague on the other side when he spoke about seniors. In budget 2018, there is no mention of seniors. He spoke about the national housing plan. That is reliant on the provinces buying into that plan, but the provinces have not bought into it. Again there are a lot of big announcements and confetti in the air, but no substance in those announcements. Just as we heard from the Parliamentary Budget Officer regarding the billions of dollars for a national infrastructure plan, that is fizzling. The Liberals are not getting it done.

As for seniors, the mystery is why there is no priority for seniors. We have heard announcements about how important seniors are to the government, but in the budget document, they are missing. There is no mention of seniors and the importance of seniors, except for one time. There is no minister advocating in cabinet for seniors. In the shadow cabinet on this side, in the official opposition, we have two members of Parliament appointed to deal with the issues of seniors. Why is that? It is because we have a growing aging population, and it is very important that we take care of our Canadian seniors. At least it is on this side of the House. Therefore, we encourage the government, as do stakeholders across Canada, to appoint a minister for seniors so that there is a strong voice at the cabinet table. Because that voice is missing, seniors continue to be ignored.

There were dollars in the previous two budgets for palliative care. Palliative care is end-of-life care that Canadians need. Seventy per cent of Canadians who need palliative care do not have access to it. That is why, with the passage of Bill C-277, this Parliament unanimously supported providing palliative care, but we have to have the dollars appointed to it in the budget, and they are missing. The dollars used to be there. They are gone. Hopefully the government will consider an amendment to its budget to include those dollars again for palliative care, because we will continue on a trajectory where we have Canadians not having the palliative care that is needed.

The healthy seniors pilot project was announced for New Brunswick on page 173. I would suggest another amendment to include the west. Where are most Canadian seniors going to retire to spend the last years of their lives? It is on the west coast in the Vancouver and Victoria areas. The west coast is where the climate is much more favourable. Accessibility is better year-round. Flowers actually are growing right now in that area, and people have already started to cut their lawns. Spring is coming to this cold, white area, but that is where seniors like to retire. Why was the west not included in a pilot project? It is because this is the government's riding. It is a partisan appointment, and dollars were appointed based on politics, not on the needs of seniors.

The other issue is the Canada summer jobs program, mentioned on pages 56 and 250. We had a very sad vote here in the House yesterday. Each of us, as members of Parliament, have received our list of applicants. I am going to be digesting that and going over it carefully, but it has really changed. It is not on par with previous Canada summer jobs programs. I looked very carefully, and it is primarily for commercial applications. The not-for-profit organizations have provided job experience and are very important to bless our communities. It is all gone, it appears.

I am concerned that this has affected my opportunity to carry out my responsibility as a member of Parliament. Every year for the last 14 years, I have gone over that list. Because of the government's discrimination against Canadians, because of its bias, it has introduced the new values test. Quality job experiences for our youth have been lost. It is not fair. It is not equitable. There are going to be fewer job opportunities because of what the government has done. It is not on par with previous years. Hopefully the government will consider an amendment to that too.