Framework on Palliative Care in Canada Act

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


Marilyn Gladu  Conservative

Introduced as a private member’s bill.


This bill has received Royal Assent and is, or will soon become, law.


This is from the published bill. The Library of Parliament often publishes better independent summaries.

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


All sorts of information on this bill is available at LEGISinfo, provided by the Library of Parliament. You can also read the full text of the bill.

Financial Statement of Minister of FinanceThe BudgetGovernment Orders

March 20th, 2018 / 4:20 p.m.
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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.

Financial Statement of Minister of FinanceThe BudgetGovernment Orders

March 20th, 2018 / 11:10 a.m.
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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.

Palliative CarePetitionsRoutine Proceedings

February 15th, 2018 / 10:05 a.m.
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Mark Warawa Conservative Langley—Aldergrove, BC

Mr. Speaker, I am honoured to present three petitions to the House today, the first being on palliative care.

The petitioners acknowledge that 70% of Canadian residents that need end-of-life palliative care do not have access to it. They are calling on Parliament to support Bill C-277 to ensure that every Canadian that needs palliative care has access to it, and that palliative and hospice care do not hasten nor postpone death.

HealthOral Questions

February 12th, 2018 / 3 p.m.
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Moncton—Riverview—Dieppe New Brunswick


Ginette Petitpas Taylor LiberalMinister of Health

Mr. Speaker, I would like to thank my friend and colleague the member for Cumberland—Colchester for his hard work on this matter.

As my colleague highlighted, in addition to Canada's health transfer, our government is providing $6 billion to provinces and territories to support better home care and palliative care services. We were also pleased to support Bill C-277.

Earlier today, I was very pleased to announce an additional $6 million in funding to Pallium Canada to train additional health care providers so that they can provide services to Canadians when at home. Bilateral agreements are in the process of being signed, with already two being done and many more to come in the very near future.

HealthOral Questions

February 9th, 2018 / 11:55 a.m.
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Moncton—Riverview—Dieppe New Brunswick


Ginette Petitpas Taylor LiberalMinister of Health

Mr. Speaker, we know that the majority of Canadians want to stay independent and receive the care they need within their homes. Quality in palliative care is critical to making this happen.

In addition to the Canada health transfer, our government is providing $6 billion in federal funding directly to provinces and territories to better support home care, including palliative care. Our government was pleased to support Bill C-277, and looks forward to working collaboratively with provinces, territories, and stakeholders as we move forward. Also, I am in the final stages of completing some bilateral agreements with several of the provinces and we look forward to working again with them.

November 7th, 2017 / 3:40 p.m.
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Student, School of Nursing, Trinity Western University, As an Individual

Melissa De Boer

Social inclusion and quality of life for Canadian seniors also extends to dying well. Nurses advocate for dying well as an extension of living well. It is estimated that 90% of Canadians will require care and support at the end of life, yet currently less than a third of Canadians are estimated to have access to high-quality palliative care services. Palliative care must extend beyond care for those who are dying from cancer to also support those who are dying from chronic conditions.

Professor Sheryl Reimer-Kirkham is involved with a University of Victoria research team led by Dr. Kelli Stajduhar on end of life care for persons who are under-housed. This research is showing how dying happens in the cracks between our health and social services, and that end of life care is often provided by volunteers and shelter staff who know little about how to care for the dying. Other times, vulnerable seniors are dying alone on the streets.

Bill C-277, a framework on palliative care in Canada, is a chance to address this. We need a coordinated approach to palliative care, coordinated across sectors, jurisdictions, and levels of government. Linking a national seniors strategy with a national home care plan and a pan-Canadian palliative care strategy will ensure that a shared-care model is coordinated, comprehensive, and effectively administered across governmental sectors.

June 5th, 2017 / 9:35 p.m.
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Karen Vecchio Conservative Elgin—Middlesex—London, ON

I apologize, Madam Speaker. That was my error.

The article states that:

The man advising [the Prime Minister] on building a new infrastructure financing agency was told the body could take on a “significant” amount of risk to help projects come to fruition.

The agency would “help bear a significant portion of the risk” in a project if the government took on an equity stake to make a project more attractive to private investors, says a confidential briefing package prepared for special adviser Jim Leech.

The Feb. 20 briefing document says the bank could take on debt that allows other debtors to be paid first in order to provide a “loss buffer” to the private sector, or invest on an equal footing “at concessionary terms.”

That latter reference could mean giving a private partner exclusive rights to use and receive revenue from a piece of infrastructure, like a rail line—such as the arrangement between the U.K., France and the private companies involved in the Channel Tunnel.

With reference to the infrastructure bank, we have asked time and time again in the House of Commons if there will be risk to the government and to the private sector. All the opposition side, whether the official opposition or members of the NDP, has heard is that the only person on the hook for this will be the taxpayer. The only way we were going to get this type of information was through an access to information request, and it was requested by the Canadian Press. The government has backgrounders on information and it is not willing to share because it is against its mandate and agenda. We see that with the carbon tax and the infrastructure bank. We are asking for some transparency on behalf of taxpayers. Somebody needs to be the voice of the taxpayers.

By no means am I an economist. I like to look at things as simply as possible. I am looking at information from the Fraser Institute, which noted that in 2016-17 the combined debt of the federal and provincial governments will be $1.4 trillion. I know we have talked a lot about this. People have said that deficits do not matter. We have heard that over and over again. However, when the government continues to spend greater than the revenues received, it will matter. It will have an impact on those things that are vital and important to Canadians, our top priorities.

If we know we are spending billions of dollars, a lot of which is money that we have borrowed, imagine when we have to start paying interest on that, money that could benefit Canadian society. I believe the cost would be over $37,000 per person if we were to divide the debt among everybody. That is more than the cost of my new car. That means everybody would be able to buy a brand new car as of today. I want to put that into perspective, because most families are buying a used car or cannot afford a car at all.

The government is spending all of this money. If we are looking at $62.8 billion just in interest in 2015-16, let us put that into what really matters. The member who sits beside me could buy the Toronto Maple Leafs 62 times over. Everybody knows how wealthy the Toronto Maple Leafs team is. Our debt is 62 times the worth of the Toronto Maple Leafs. We could buy 315 F-35 fighter jets. Would that not be wonderful for our troops? Instead, we have to worry about a debt that will continue on.

I look at the effects this will have on our generations. We talk about the debt, but we really do not understand the effects of that debt. What will that mean to the future of our health care system or our our educational system? How will that affect the environment, something so important to the government? How will that affect the government if we spend all of the money today? Later on we will be unable to afford anything. It concerns me because as we move forward with the great plans of the government, all we see is debt. We have already discussed that the debt we are accumulating is all on borrowed money. Who is going to pay this debt back? Debt and deficit do not seem to be key words for the government, but for most families it is.

As the critic for family, children, and social development, what would happen if we budgeted that way in our own homes? We would lose our cars, houses, and everything we ever owned. We cannot max it out time and time again. This is what the government is doing.

A lot of times when we have this conversation, the government of the day will reflect back to the spending of the previous government when we went through a global economic downturn. There was one in 2008, 2009, and 2010. We were the first country to recover, and we did so very well. I would like to thank the late Minister Flaherty for doing such a phenomenal job in the work that was done in Canada. Out of that spending, there were new arenas, new roads, new facilities for our communities, and a lot of growth in the economy as we went forward.

Now we are spending for the sake of spending and it does not make sense. We are not in a global recession when we need to go up against huge debt. I do not know why the government is putting our future in debt time and time again. The next generation will pay for this. When we look at medical care, such as palliative care, as Bill C-277 put through, why are we not investing in things that are really important to Canadians? Why are we not investing in long-term plans? We are spending so much money. I could talk about the $130,000 spent by the Prime Minister to travel abroad. Something as simple as that reflects respect for Canadian taxpayer dollars, and we do not see that.

I will bring this back in layman's terms. A lot of times when we talk to Canadians, we often talk about such big numbers, and they cannot grasp it. We are talking about miles and miles of money. If we laid it down, how much would it look like? A lot of times Canadians cannot put it into perspective because it is so grandiose. We want to do a lot of things in Canada and I am really fearful of where this ongoing debt and bad plans, such as the infrastructure bank and all of the other things that are planned, are going to put our country. It is going to put our grandchildren far behind the eight ball. What is going to happen to their education and health care? These are so important that we have to step back and ask ourselves how we can do it better. We are spending and spending and there is no plan to get back to a balanced budget.

Again and again, the opposition side has asked the government for its plan to get back to a balanced budget. Unfortunately, I do not think any member on the government side has actually said there is a plan. All we are hearing is 2035, 2055, or whenever it may be, but it will not be in two or three years, as it should be. When the government was elected, you said there would be a $10 billion deficit and I am not sure why you, time and time again—

Framework on Palliative Care in Canada ActPrivate Members' Business

May 30th, 2017 / 6:20 p.m.
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Marilyn Gladu Conservative Sarnia—Lambton, ON

Madam Speaker, it has been heartwarming to see the way members of Parliament have worked together, from the beginning when the all parliamentary committee first studied palliative care, to the work of the Special Committee on Assisted Dying, to the discussions and the many heartfelt testimonies in the House from all parties as we studied this, to the amendments at committee and the collaborative way people worked together to bring improvements to the bill, to the Minister of Health who pledged $11 billion for home care, palliative care, and mental health care in the 2017 budget. This is how Parliament ought to be, addressing needs of Canadians and doing it in a way whereby we work together and come up with a better solution.

A growing number of individuals of all ages in Canada suffer from chronic pain or deadly diseases. Palliative care services can replace a wide ranges of services, such as short-term care, home care, crisis care, and psychological or spiritual assistance services.

Canadians need palliative care. It is hard to know how much palliative care is really available because the data is not that good. We have heard discussion tonight about the need to do more in collecting data on this situation. At least 70% of Canadians have no access to palliative care. We do not have enough palliative care physicians. Certainly from a cost perspective, palliative care done in different ways, by home care, by paramedics, can reduce the cost from $1,100 a day in a hospital down to $200 for hospice or $100 a day or less a day by paramedics. There is an opportunity to get more with our health dollars.

When the bill went to committee, the members were very happy about the language around the defining of service. We modified some language to clarify the federal and provincial jurisdictions. We had discussion around the collection of the research data and made a slight adjustment there. We had some great additions to restore the secretariat for palliative care to ensure that action was driven as we move forward into the future. I was very happy with the amendments that were brought because they made the bill stronger. I think this measure will be supported in the Senate.

Everyone has shared a personal story and throughout all the times I have been here, I have never shared any stories.

First, I thank the member for Langley—Aldergrove for being my seatmate when he was on the Special Committee of Assisted Dying and for giving me a book called It's Not That Simple, which talks about palliative care. It was made me interested in bringing this bill forward.

Within my riding of Sarnia—Lambton, we have a hospice called St. Joseph's. My father-in-law died of cancer, and he was in hospice. As I watched him wilt away like a sparrow, at least he was surrounded by a caring environment. He was pain free. He was surrounded by his family. I began to appreciate the services. We have 20 palliative care beds, a great hospice, and an integrated home care system. To find out that most Canadians did not have that was just a shock to me.

I am happy to see the bill move forward. This is the right direction.

I want to thank the many organizations that supported the bill throughout its journey. I want to read them because there are so many. It is just amazing. These organization include the Canadian Medical Association; the Canadian Cancer Society; the Canadian Nurses Association; the Canadian Society of Palliative Care Physicians; Pallium Canada; ARPA; the Canadian Hospice Palliative Care Association; many member hospices like Bruyère Continuing Care, St. Joseph's Hospice, West Island Palliative Care Residence; the Heart and Stroke Association; the Kidney Foundation; the ALS Society of Canada; the Canadian Association of Occupational Therapists; more than 50 organization members of the Coalition for Quality Care and the Interfaith Groups, including the Centre for Israel and Jewish Affairs, the Canadian Conference of Catholic Bishops, the Canadian Council of Imams, the Evangelical Fellowship of Canada, the Armenian Prelacy of Canada, the Canadian Conference of Orthodox Bishops, and the Ottawa Muslim Association Ottawa Mosque. I thank them all for their ongoing promotion and support of the bill.

It is these kinds of organizations across our country that will help us to integrate palliative care and leverage our best practices.

I want to also thank all my colleagues for their support and encouragement. I want to encourage everyone to vote yes to Bill C-277.

Framework on Palliative Care in Canada ActPrivate Members' Business

May 30th, 2017 / 6:20 p.m.
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Mark Warawa Conservative Langley—Aldergrove, BC

Madam Speaker, it is a honour to speak to Bill C-277. I want to congratulate the member for Sarnia—Lambton on her good work.

I was honoured to sit on the special legislative committee that dealt with assisted suicide and euthanasia in response to the Carter decision. From that came a number of witnesses who highlighted two prominent needs.

First, there has to be a national palliative care strategy in Canada to prepare for our aging population. People who need palliative care are primarily elderly, at end of life. People do not have to be old to die, though. Palliative care provides those basic, dignified needs of people at the end of their lives, whether they are young or old.

The second issue was that we needed to provide conscience protection for physicians and health care institutions.

I am thrilled the member for Sarnia—Lambton received a low number in the private members' business draw and was able to have this bill presented. I am also thrilled this basically has been unanimously supported in the House and will very soon go to the Senate, with some very constructive changes.

This is needed in Canada. Right now there are more seniors in Canada than there are youth. One in six Canadians is a senior. In 12 short years, and I have been here 13 years, one in four Canadians will be a senior. Right now, 70% of people who need palliative care do not have access to it; 30% do.

As a civilized democracy, a western democracy, we need to provide for the basic needs of dignity. In testimony we heard different terms. We heard “medical aid in dying”, which is not assisted suicide. It is helping somebody die by reducing the pain and making them comfortable. That can be through visitation, drugs, palliative sedation, or medical apparatus. There is a number of ways.

I was shocked that our medical professionals received very little training in palliative care or end-of-life care. There is a very large interest in taking care of babies, in pediatrics, but for geriatrics, not so much. Babies are very cute. We desperately need to train Canadians in geriatrics.

With the massive change in our demographics in Canada, the aging population, where one in four will be a senior, it is not possible to build enough care facilities. Therefore, we need to train people so we can provide that home care.

Palliative care includes all of that, medical care and required infrastructure. We need to create this national seniors strategy. Again, I thank every member in the House who supports Bill C-277.

Then we need the investments in the infrastructure and the training to see this happen. The aging population is coming. It will be here in 12 years. We are not ready for it. I encourage the government and I thank it for supporting the member for Sarnia—Lambton and for its commitment to this bill. We all look forward to the investments in the next budget. Next spring when the government introduces the budget, there have to be those investments.

Framework on Palliative Care in Canada ActPrivate Members' Business

May 30th, 2017 / 6 p.m.
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Shannon Stubbs Conservative Lakeland, AB

Madam Speaker, I am honoured to speak in favour of Bill C-277, an act providing for the development of a national framework for palliative care in Canada. This bill is important. It would benefit Canadians right across the country and also at home in Lakeland. I would like to congratulate the member for Sarnia-Lambton for her steadfast advocacy and for highlighting this priority need across the country. I know that this bill is the result of months and months of hard work and dedication by the member, and I congratulate her.

Canadians work hard, live busy lives, and expect one day to have the option of end-of-life care. The goal of this bill is to support improved access for Canadians to palliative care by creating a national framework, with the intent of expanding the availability and quality of front-line services in communities across Canada. That result would increase options and reduce the burden on family members by providing vital end-of-life care for their loved ones. This aim supports the dignity and comfort all Canadians deserve in the final stages of their lives.

This bill is also the distillation of the work of my colleagues on the Parliamentary Committee on Palliative and Compassionate Care. The committee published an excellent report, which outlined the current Canadian landscape with respect to palliative care. Through studies and assessments, the committee conducted a full review of current palliative care options in Canada while identifying specific areas that require improvement. All Canadians and all political parties can and should support this bill.

Right now there are only 200 hospices across Canada, so there is clearly a need for universal palliative care options. The framework provided in this bill would provide a definition of palliative care and identify the training needed for palliative care in Canada. It would also consider amending the Canada Health Act to include palliative care as a guaranteed health care option. Additionally, the act would outline periodic report releases from the Minister of Health highlighting gaps and recommendations for the framework of palliative care.

I am concerned about the Liberals' approach to palliative care in Canada so far. Although the Liberals are supportive of this initiative to date, they started their mandate by making a significant promise to Canadians: an immediate $3-billion investment for home care, including palliative care. However, the Liberals have changed course a bit. They are using the urgency of palliative care in communities as a bargaining tool, a stick, in negotiations with provinces. Those provinces that have agreed to the Liberals' terms when renegotiating the health accord were given funding for both mental health and home care, while others that had not yet agreed to those terms received nothing.

This priority is too important to use as political leverage like that, because the need for palliative care will never go away. In fact, 80% of Canadians receiving palliative care are cancer patients. Right now, two out of five Canadians will develop cancer in their lifetimes, and that statistic is expected to increase by 2030. These patients deserve a comfortable end-of-life option. The problem is that 30% of Canadians do not have access to palliative care services.

The Canadian Society of Palliative Care Physicians says that palliative care should be available in homes, hospices, hospitals, and long-term care centres throughout Canada, but it is not. Availability depends on where one lives, how old one is, and what one is dying from. This needs to change. The CSPCP goes on to say that strategic investments in palliative care have been shown to reduce the cost of delivering care by about 30%. Presently it costs about $1,200 a day to remain in the hospital, $400 a day to remain in hospice care, and $200 a day to receive home care. To reduce these costs by at least 30% would offer more opportunities for Canadians, free up scarce resources in health care facilities, and ultimately improve the quality of life and care for patients suffering from serious and terminal illnesses.

This is important, because Canadians are suffering from chronic and terminal conditions in growing numbers. Good palliative care covers a wide range of services, such as acute care, hospice care, home care, crisis care, and spiritual and psychological counselling.

Support from Canadians is evident across the country. There have been 83 petitions on palliative care presented in the House by members of Parliament in this session alone. Thousands of letters have been received by members of Parliament on all sides of the House. I personally have received dozens of letters from constituents across Lakeland outlining the need for palliative care options, particularly for seniors, who have limited options for end-of-life care. Right now, Statistics Canada confirms that there are more seniors in Canada than children. With an increased demand for health care, hospitals, and clinics, the option for hospice care has clearly never been more important.

Communities in Lakeland are fortunate to have access to health care and consultants in all regions of the riding, but more can be done and needs to be done to ensure greater access for everyone. Remote and rural regions of the country like Lakeland do not always offer the same robust services as urban centres and highly populated areas. Regional accessibility is an important consideration for a national strategy, and one we cannot ignore.

The current palliative care options in Canada are inadequate and do not meet the needs of Canadians. That is what this framework seeks to address.

In 2011, it is estimated that only 16% to 30% of those in need were receiving proper palliative and end-of-life care. The current health care system favours short-term acute care, which it does extremely well, but experts report that the system lacks the capacity and the funding to properly and consistently provide quality long-term palliative care. The cost of acute care is four times that of hospice palliative care, so clearly there is an opportunity to provide long-term, consistent care responsibly. It is a challenge that provincial governments and elected representatives at all levels face and must take on.

The proper training of medical practitioners and nurse practitioners is an important step in creating a comprehensive and well-equipped palliative care structure. On average, medical and nursing students spend as little as 20 hours of their four years of study learning about palliative and end-of-life care. In 2011, there were fewer than 200 geriatricians in Canada. Today, the estimated need is upwards of 600.

Bill C-277 would also have a positive impact on the lives of caregivers. In 2011, there were an estimated four million to five million family caregivers in Canada. They contribute $25 billion to the health care system. These same selfless caregivers often bear a heavier financial burden and have to miss one or more months of work because of their duties. Family caregivers provide 80% of all home care in Canada, and 77% of these caregivers are women.

These numbers are not to be taken lightly. Caregivers experience financial, social, and physical burdens that can have lasting effects on their lives. The Canadian Cancer Society says that Canadian caregivers are the invisible backbone of the health care system, providing $25 billion in unpaid care.

This added support would encourage palliative care in the home, which has been demonstrated to be beneficial for everyone involved. Allowing patients to stay in their homes for as long as possible is a compassionate choice that should be available to every Canadian. We have a duty to those Canadians.

Many Canadians who require palliative care are seniors or veterans. Seniors built our communities, founded our businesses, created opportunities for future generations, and supported our economy. Seniors built this great country, fought in wars, raised their kids, and laid the foundation for the free and prosperous Canada in which we are so fortunate to live.

It is our fundamental responsibility to ensure that the most vulnerable are taken care of, and when these individuals, who have done so much for us, need the most support, it is Canada's turn to give back to them. That is a core reason that I support this important bill. I encourage all members of the House to do the same.

I thank my colleague again for all of the good work she has done in bringing forward this pressing need.

Framework on Palliative Care in Canada ActPrivate Members' Business

May 30th, 2017 / 5:50 p.m.
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Sonia Sidhu Liberal Brampton South, ON

Madam Speaker, it is an honour to rise today to speak about Bill C-277, an act providing for the development of a framework on palliative care in Canada.

I first want to congratulate my colleague, the member for Sarnia—Lambton, for bringing this forward. I also want to congratulate my fellow members on the health committee for working so collaboratively on this bill at committee stage. I think our work and amendments improved this legislation to become something positive for all Canadians.

It is essential for us to be talking about palliative care. It is something I heard about a lot during my election campaign and continue to hear about from community members. Palliative care and access to end-of-life care are important issues for all Canadians.

Brampton South is a riding with a significant population of seniors, who brought this forward as an issue of dignity and quality of life. A strategy to address this need is an important step. I want to thank them for raising their voices and for championing this in my community.

As members know, palliative care is for all, regardless of age, who are approaching the end if life. It is for all people who desire a compassionate and comfortable place to receive care. In our conversation about medical assistance in dying, I raised the need for palliative care and home care to be involved in that discussion. That is why I am extremely proud that our government responded to all aspects of this issue in our relatively short time, so far, in government.

As members know, we will be investing $6 billion in home care through the provinces and territories; $2.3 billion will be going to fill needs in Ontario, which I hope will serve to fill the gaps that exist in our rapidly growing Peel region. Home care is about responding to Canadians' overwhelming desire to be at home, to receive care at home, and, sadly, if needed, to live out their end-of-life stage at home when possible. Palliative care is the other option that serves to make life more dignified for our most in-need people.

I would like to mention that palliative care workers and PSWs deserve our utmost respect for the difficult but important job they do for people in our communities.

I strongly support Bill C-277's goals to make a strategy and to incorporate work governments have been doing on this already. A strong evidence-based approach will deliver real results. That is the approach our government ran on and the one Canadians endorsed when they elected us.

Please know as I give my comments today that we recognize and respect that the provinces play the principal role in the delivery of health services, including palliative care. This bill, with the proposed amendments, understands that the federal role in health lies in coordinating and ensuring that there are the same services available for all. I am very pleased that the government will support this bill, with amendments.

The proposed amendments respect the intent of the bill but seek to align it with the scope of federal roles and responsibilities in relation to palliative care. They also seek to build on existing palliative care frameworks, strategies, and best practices being undertaken by provinces, territories, and stakeholder groups.

To ensure that Canadians have access to the best quality of palliative care, it is important that we do not reinvent the wheel. In many provinces, there are existing frameworks and policies. As such, it was important to me and my colleagues on the health committee to ensure that any new work on this would build on what exists already.

We also know that when it comes to caring for Canada's seniors in need of palliative care, the job falls not only to health care professionals but to other caregivers, including family members. As such, our committee made changes to the bill to ensure that all who provide care at this stage are supported and have their needs considered in the establishment of a framework for palliative care.

With our government's focus on evidence-based policy, it was also very important to ensure that any new work on this issue include the promotion of research and data collection so that we can ensure that the care provided to Canadians is based on the most relevant research, best practices, and up-to-date evidence in this area.

This is a very important part of the picture, as we all know very well that the incredible ongoing research in the Canadian health care field is innovative, leading to new opportunities for greater care. It is essential that this new knowledge be considered as we develop and maintain a framework for palliative care across Canada.

Our proposed amendments would facilitate federal support for improved palliative care in relation to three pillars, which are aligned with the objectives of the bill: training for health care providers; consistent data collection, research, and innovation in palliative care; and support for caregivers.

We continue to support pan-Canadian initiatives that enhance Canada's capacity to provide quality palliative and end-of-life care as well as a range of programs and services, such as family caregiver benefits and resources, that address the actions proposed in the bill.

Our government's investments in the provinces to in turn deliver health services are outpacing inflation, ensuring that they can deliver better health outcomes. I want to commend the Minister of Health on the recent health accord agreements.

I am also very proud to say that we are also working with first nations and Inuit stakeholders to identify options for building on current resources and services to provide increased access to palliative care.

It is crucial that any work we do regarding the health of Canadians reflects the different realities of the many communities across the country. Specifically, we know that the health care needs of first nations and Inuit communities deserve special attention to respect the traditions and existing frameworks that have been developed from community to community.

Overall, I cannot say enough how pleased I am that this important discussion is happening in this place. I do not doubt that this conversation will and must continue. The health committee, on day one, agreed that this was something we should look at, because it is an important issue for seniors and for us, too.

We have many important pieces of business before us at committee, but I imagine that a review of this strategy and of strategies stakeholders or provinces currently are using could be a full study in the future.

Palliative care and end-of-life options are the kind of hard but real topics that are our responsibility as leaders to address. These are the things that make us think of our loved ones and our own futures in personal ways. Regardless of our own views or choices, we are setting up a system that is fair, compassionate, and just. By taking a public health approach to issues like this, we are doing the responsible thing that serves as a framework for all Canadians.

I want to thank the parliamentarians in this House for supporting the bill and for all the contributions so far. It is something I have followed closely in the House. Today we continue to move this forward towards action.

Again, I congratulate the member for Sarnia—Lambton on Bill C-277 and her work to promote its aims. It is a noble quest that aligns with the priorities of this government to bring positive change to our health care system and with my own priorities to ensure that Canadians have access to the best possible health care services. I hope all members will join me in supporting the bill again at the next opportunity to vote for it.

Framework on Palliative Care in Canada ActPrivate Members' Business

May 30th, 2017 / 5:40 p.m.
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Kelly McCauley Conservative Edmonton West, AB

Madam Speaker, I am proud to rise today in support of Bill C-277, which calls for the development of a framework to increase access to palliative care. I would like to personally thank the member for Sarnia—Lambton for introducing this private member's bill.

Years ago, while I was living in Victoria, I had the honour of serving as the president of the Greater Victoria Eldercare Foundation, Vancouver Island's largest seniors foundation, supporting six extended care hospitals. The Greater Victoria Eldercare Foundation, under my good friend executive director Lori McLeod, has developed leading community programs to assist seniors, including the annual Embrace Aging month, with initiative raising awareness about the wealth of resources and opportunities available year-round to help seniors and their families navigate the journey of aging.

I was pleased to hear recently that it has added additional palliative care facilities at its Glengarry facility. It was through my involvement with the Eldercare Foundation that I encountered first-hand the many issues that seniors and their families face now: the difficulty of obtaining proper care for seniors, proper facilities, and proper understanding of the unique situations and issues they face. I owe a lot to the many volunteers and staff whom I worked with at the Greater Victoria Eldercare Foundation, and I know they too would be supporting this excellent bill.

Alleviating the suffering of Canadians is a collective duty of the House, regardless of political agenda or party affiliation. Whether in hospitals or at home, Canadians should not have to go without the care they need simply because there is not sufficient support. Our society is capable of providing the best care for our citizens, and Bill C-277 provides a framework to utilize and implement these resources. This bill helps to promote good health while preserving the independence of Canadians in need of health support. As a Conservative, I am a proud supporter of this bill, which will invest in long-term and palliative care, which the Liberals have failed to do despite their many promises.

In 2015, the Supreme Court of Canada's decision in Carter v. Canada established that Canadians have a right to physician-assisted dying. We debated Bill C-14, and while I opposed the legislation, the House and Senate passed it and it received royal assent almost a year ago. One of the key aspects of the Carter decision, however, was its call for an advancement of palliative care as a means of increasing Canadians' access to compassionate health care. The Carter decision is intended to ensure that Canadians can make a legitimate choice regarding their own health care, and one of those options is to receive adequate palliative care, care that is focused on providing individuals who have a terminal illness with relief from pain, physical and mental stress, and the symptoms of their illness. It is intended to ensure that those who are at the end of their life can pass peacefully, with dignity and without pain.

The Carter decision enabled Canadians to pursue assisted dying, but it also established an obligation on the government to ensure all Canadians can access proper, adequate, and compassionate end-of-life care. Right now, we are not getting the job done. We are not in any imagination fulfilling our obligations as a society in caring for those in need of care. For example, a survey of pre-licensure pain curricula in the health science faculties of 10 Canadian universities shows many would-be doctors receive less training in pain management than their counterparts in veterinary medicine. I am sure my dog Hailey, who is no doubt at home on my couch right now as I speak, finds this reassuring, but as someone formerly involved in senior care, I find it quite distressing.

A survey of more than 1,100 doctors and nurses shows that those who treat fewer terminally ill patients, therefore knowing the least about symptom management, are most likely to be in favour of assisted suicide, while those with more experience in symptom management and end-of-life care tend to oppose it. Dr. Max Chochinov, a noted specialist on palliative care, explains that the will to live is directly inverse to the amount of pain, and that loss of dignity drives wanting to die and treatment of pain can improve sense of dignity.

We also have to remember the impact of terminal illness on a family: the emotional, physical, and financial struggle of caring for a loved one at the end of their life. Under the current regime, it is up to families to carry the overwhelming bulk of this burden. This system is not fair. People should not have to choose between paying bills and caring for their spouse, their parents, or their siblings.

We have heard horror stories time and time again from families who were completely ambushed by palliative and in-home care costs after their loved one got sick, and these instances are becoming more and more common. The health minister herself has acknowledged many times that Canada has a deficit in access to quality palliative care, yet despite her pledges to do more and provide more, she has neglected to take meaningful action to date. Canada's population as a whole is growing older, and seniors now outnumber children.

I said before in my speech to the RRIF financial security act—another bill that would have helped seniors, which the Liberals voted against—that we need to be ready to have the proper programs and mechanisms in place to adapt to our shifting demographics.

A recent Globe and Mail article states that, according to the 2016 census, we have seen “the largest increase in the share of seniors since the first census after Confederation”. Across Canada, the increase in the share of seniors since the 2011 census “was the largest observed since 1871—a clear sign that Canada’s population is aging at a faster pace”. That figure is projected to rise even more in the coming years. The proportion of those aged 65 and older climbed to 17% of Canada's population. This is not a new phenomenon obviously.

A September 2015 Statistics Canada report noted that, by 2024, 20% of our population will be over the age of 65, so we need action plans in place to address this shift, this massive wave that is going to be overtaking our health care systems. The provinces are going to be faced with an epidemic soon enough of people trying to access systems that are not capable of supporting the demand. Less than 30% of Canadians have access to this vital service, which allows them to choose to live as well as they can for as long as they can.

It is time for the government to fulfill its obligations to provide quality palliative care to all Canadians. This framework answers some of those calls, and it represents the needs of the aging population across Canada, including those in Edmonton West. The percentage of individuals in Edmonton aged 65 or older has risen to 14%, a significant figure representing thousands of individuals who will benefit from universal palliative care.

I know this bill will serve the aging population in my own riding, particularly those who find comfort in knowing that their family members and loved ones will receive the best care. No one should have to suffer through ailments alone, without the support of well-trained and compassionate health care practitioners.

Bill C-277 is required to define the services covered, to bring standard training requirements for the various levels of care providers, to come up with a plan and a mechanism to ensure consistent access for all Canadians, and to collect the data to ensure success. Good palliative care can cover a wide range of services, such as acute care, hospice care, home care, crisis care, and spiritual and psychological counselling. The creation and implementation of a palliative care framework will give Canadians access to high-quality palliative care through hospitals, home care, long-term care facilities, and residential hospices.

We need to ensure that our communities support the aging population with respect and dignity. As parliamentarians elected by our respective communities, reacting to this shift should be a priority and cannot be ignored. When I introduced my private member's bill last fall, which sought to help seniors who were being disproportionately targeted by an outdated tax measure, I heard from countless seniors across Canada who felt they were being left behind. While it is important to ensure the provinces are not pigeonholed by federal legislation, we need to acknowledge a legislative gap when we see one. Seniors need help, and no amount of discussion papers, working groups, or committee meetings will make this issue go away. We know what the issue is and we need action.

Bill C-277 is a step toward providing the much-needed support for seniors today and seniors to be. Palliative care is good, compassionate, and meaningful. Providing access to quality and affordable palliative care can help make painful decisions a little more manageable for those suffering from a terminal illness. It can also significantly help the families of those suffering, who carry the disproportionate financial and emotional burden of end-of-life care. The government needs to pass this legislation to begin the development of a framework on increasing access to palliative care.

When the Supreme Court's decision in Carter v. Canada was delivered, it included a significant and serious obligation on the government to ensure that Canadians could make a real decision on their end-of-life care. The ability to make that decision requires that the options are actually available, and today's unfortunate reality is that our palliative care system is inadequate.

As I mentioned, I would like to thank the member for Sarnia—Lambton for bringing this fantastic private member's bill forward. I am very pleased to hear my colleagues in the NDP speak so favourably toward this, and to hear that they will be supporting it. I am extremely proud that I and other members of the Conservative caucus will be supporting this very important bill.

The House resumed consideration of the motion that Bill C-277, An Act providing for the development of a framework on palliative care in Canada, be read the third time and passed.

Framework on Palliative Care in Canada ActPrivate Members' Business

May 30th, 2017 / 5:30 p.m.
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Don Davies NDP Vancouver Kingsway, BC

Mr. Speaker, I rise today to speak to Bill C-277, an act providing for the development of a framework on palliative care in Canada.

The legislation would require the Minister of Health to develop and implement a framework designed to give all Canadians access to palliative care provided through hospitals, home care, long-term care facilities, and residential hospices. The bill would also require the health minister to convene a conference within six months of the act coming into force, with provincial and territorial governments and palliative care providers, in order to develop a framework on palliative care in Canada. Finally, the bill would require the Minister of Health to table the framework in Parliament within a year and post the framework online within 10 days of tabling it.

New Democrats will be supporting the legislation because we believe that palliative care is a vital part of comprehensive health care provision, and we believe that every Canadian has a right to high-quality end-of-life care. New Democrats have a long history of strong advocacy for better palliative care services for Canadians. We are proud of the New Democrat motion adopted in the last Parliament with all-party support, which laid out a pan-Canadian strategy for palliative and end-of-life care. Launched October 31, 2013, my colleague the member for Timmins—James Bay's Motion No. 456 called for the establishment of a pan-Canadian palliative and end-of-life care strategy in conjunction with provinces and territories on a flexible and integrated model of palliative care. It passed with almost unanimous support on May 28, 2014.

At present, only 16% to 30% of Canadians have access to formalized palliative or end-of-life care services. Even fewer receive grief or bereavement services. With the subsequent legalization of physician-assisted dying, the provision of high-quality palliative care services has now become more important than ever, since it provides meaningful options for end-of-life decisions. It is well past time for the federal government to act.

Palliative care is the health discipline focused on improving the quality of life for people living with life-threatening illness. The World Health Organization defines it as follows:

Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. Palliative care:

provides relief from pain and other distressing symptoms;

affirms life and regards dying as a normal process;

intends neither to hasten or postpone death;

integrates the psychological and spiritual aspects of patient care;

offers a support system to help patients live as actively as possible until death;

offers a support system to help the family cope during the patients illness and in their own bereavement;

uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated;

will enhance quality of life, and may also positively influence the course of illness;

is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.

There is consensus among academics, health professionals, and the public that improvements in the palliative care system in Canada are desperately needed. Without clear national standards, individual jurisdictions are left to develop their own policies, programs, and approaches, resulting in inconsistent and inadequate access across the country. In Ontario, for instance, 40% of cancer patients do not receive a palliative assessment in their last year of life. In some regions of Atlantic and western Canada, data shows that less than half of people who die in a hospital receive palliative care.

The number of individuals actively caring for a friend or family member is expected to increase as Canada's population ages. On average, Canadians estimate that they would have to spend 54 hours per week to care for a dying loved one at home, and two-thirds say they could not devote the time needed for this care. Currently, family caregivers provide more than 80% of care needed by individuals with long-term conditions at home, in long-term care facilities, and in hospital. Replacing family caregivers with a paid workforce at current market rates and usual employee benefits has been estimated to cost about $25 billion.

Furthermore, according to a synthesis of the empirical literature, palliative family caregiving for older adults is gendered. When acting as caregivers, women experience a greater degree of mental and physical strain than their male counterparts. This is linked to the societal expectation that women should provide a greater degree of care at the end of life for family members.

Remarkably, there are many jurisdictions across the country where we do not even know how many Canadians receive quality palliative care. We lack consistent and ongoing data collection at a systemic level, which leaves us unable to effectively hold our health care systems accountable.

Indicators such as location of death, use of acute care before death, and referrals to formal palliative care show that there is significant room for improvement. Many Canadians who require palliative care receive it in acute and emergency care, if they receive it at all. Not only are acute care settings more costly than dedicated palliative care, but they are also not as well equipped to provide the most appropriate treatment and care for patients and their families.

It is vital that any national palliative care strategy take into account the geographic, regional, and cultural diversity of urban and rural Canada. It must also respect the cultural, spiritual, and familial needs of Canada's first nations, Inuit, and Métis people. According to Dr. Mary Lou Kelley, research chair in palliative care at Lakehead University, the federal health care dollars that would help indigenous people receive end-of-life care at home have not kept up with the increasing demand. Health care for first nations is the responsibility of the federal government, of course, and it does provide some home care services, but the system was never designed to provide complex health care to people with chronic or advanced terminal diseases.

Finally, I would be remiss if I failed to note that, although the bill is sponsored by a Conservative member, the previous government eliminated the federally funded national secretariat on palliative and end-of-life care when it first took office in 2006. If it had not been for this cut, we would have developed a palliative care framework a decade ago.

From 2001-06 the federal government funded the secretariat through Health Canada with an annual budget ranging from $1 million to $1.5 million, virtually nothing in terms of the federal budget. However, when the Conservative government disbanded the end-of-life care secretariat, it stopped working on a national palliative and end-of-life care strategy.

In 2011, the Conservative government made a one-time commitment of $3 million to fund the study and framework creation of community integrative models of hospice palliative care. This initiative was led by the Canadian Hospice Palliative Care Association, but according to Dr. Greg Marchildon, Ontario research chair in health policy and system design at the University of Toronto:

There is no national policy on palliative care in Canada. Instead, there are national guidelines developed by community-based palliative care organizations operating at arm's length from government.

Although Conservative support for palliative care had previously been absent, it is certainly better late than never. That is why New Democrats reached across the aisle at the health committee to successfully move an amendment to the bill requiring the federal government to evaluate the advisability of re-establishing Health Canada's secretariat on palliative and end-of-life care.

I will give credit where credit is due. The member for Sarnia—Lambton responded to our proposal thoughtfully, saying: “I'm a fan of doing that. As I said, I was not here during the Harper regime, so I can't fix the past. I can only improve the future.”

New Democrats, in keeping with that sentiment, will work together to improve the future. I will conclude my remarks by reiterating the NDP's support for this vital initiative and affirming that all Canadians deserve to live their final days in dignity and comfort. We look forward to contributing to the framework development process and sincerely hope that it will provide the strongest possible palliative care strategy for every Canadian from coast to coast to coast.