Bill C-316 (Historical)

An Act to amend the Canada Revenue Agency Act (organ donors)

This enactment amends the Canada Revenue Agency Act to authorize the Canada Revenue Agency to enter into an agreement with a province or a territory regarding the collection and disclosure of information required for establishing or maintaining an organ and tissue donor registry in the province or territory.

The House resumed consideration of the motion that Bill C-316, An Act to amend the Canada Revenue Agency Act (organ donors), be read the third time and passed.

Canada Revenue Agency Act

[Marjolaine Boutin-Sweet, NDP, Hochelaga, QC]

Mr. Speaker, I am pleased to rise today to debate Bill C-316, an act to amend the Canada Revenue Agency Act with regard to organ donors, introduced by my colleague from Calgary Confederation.

My colleague's bill would authorize the Canada Revenue Agency to enter into an agreement with a province or a territory regarding the collection and disclosure of information required for establishing or maintaining an organ and tissue donor registry in the province or territory. With authorization from the taxpayer in their last tax return, the CRA could disclose to the province or territory the individual resides in the information collected under the agreement.

The NDP supports this bill. We firmly believe that we must take all necessary steps to ensure that every Canadian gets the organ or tissue transplant they need. This is not new to us. Since 2002, two NDP MPs on five occasions have introduced a bill to create a Canada-wide organ donor registry and to coordinate and promote organ donation across Canada.

This bill is essentially a weaker version of what we have been calling for for some time in order to allow anyone who needs a transplant to have access to the organs or tissues needed.

In this Parliament, the Conservative member for Edmonton Manning, whose son has received three liver transplants, had once again introduced a bill to establish a Canadian organ donor registry. Bill C-223 was debated in the House in 2016, but was defeated when the Liberal caucus voted against it. The health minister at the time, who is currently Minister of Indigenous Services, defended that Liberal Party decision by saying, “This is a matter that is under provincial jurisdiction, and it is for that reason that the bill was unsupportable.”

It is interesting that the Liberals claim to be the great champions of the provinces when it suits them, but then impose their decisions in other situations. That is another story.

That being said, we truly hope that this time the Liberals will support this new bill that essentially seeks to have the federal government collaborate with the provinces and territories to help them implement their own organ and tissue donor registry. What everyone in the House needs to realize is that Canadians registered on a waiting list to get an organ or tissue transplant are dying, in part because of our low donation rate.

Currently only 20% of Canadians are registered organ and tissue donors in their province or territory. Some provinces and territories are already taking steps to increase the number of registered donors, but, unfortunately, despite these initiatives, far too few people consent to have their organs or tissue removed and transplanted to people in need.

According to a recent study by the Standing Committee on Health, in 2016 alone, 260 out of 4,492 people registered on a transplant list died before getting the organ or tissue they needed to survive. These are our fathers, mothers, sisters, brothers and children. This has to stop. Losing one person is one too many.

The NDP believes that, by passing the bill, the federal government could help without interfering in provincial jurisdiction. I will say it again: if it is passed, the bill we are debating today will make it possible for the federal government to co-operate with the provinces and territories and make it easier for people to sign up to be organ donors.

Of course, special measures would have to be implemented to ensure that taxpayers consent to giving personal information to their province or territory of residence so they can be added to an organ donor registry, as it would otherwise not be possible to forward this type of information to other levels of government.

One donor can save up to eight lives and help more than 75 people by consenting to the harvesting of organs or tissue. Unfortunately, as I mentioned earlier, Canada is lagging behind when it comes to organ donation. In fact, Canada's donation rate of 18 donors per million people puts us in the bottom third of developed countries.

The objective of this bill is to increase the number of donors by making it possible for Canadian taxpayers to register with their province's or territory's organ and tissue donation registry by providing their consent on their income tax return.

This legislative change will improve the consent rate and promote a culture of organ and tissue donation in Canada. Many health professionals and organizations support this bill and additional incentives for people to consent to organ and tissue donation. All it takes is a little political will.

I would also like to take this opportunity to speak directly to everyone tuning in and strongly encourage them to sign up for organ donation using whatever procedure their home province or territory has in place and, most importantly, to discuss their wishes with their family members.

I really want to emphasize that last point because, unfortunately, even if a person has made the choice to be an organ donor, family members have the final say. According to a 2016 Ontario study in the Canadian Medical Association Journal, families vetoed the donor's wishes in one in five cases, which is huge.

I would also like Canadians to keep in mind what I said earlier, and that is that one donor can save up to eight lives and improve the quality of life of 75 people through tissue donation. What is more, age does not prevent people from becoming donors. In fact, the oldest organ donor in Canada was over 90 years old, and the oldest tissue donor was over 100. Medical history also does not prevent people from registering as donors. People with serious illnesses can sometimes donate their organs or tissue. Each potential donor is assessed individually.

If this bill is passed, Canadians will have a new way to consent to donating their organs and tissue. They will be able to do so via their income tax return and by consenting to allow their personal information to be shared with their province or territory of residence. If the bill does pass, I strongly encourage people to use this method. It will save lives.

I want to take advantage of this opportunity I have to address the House today to thank all those who work behind the scenes and who make us look good every day and to wish everyone an excellent Christmas break. With the subject of Bill C-316 in mind, I ask everyone to be very careful over the holidays, especially on the roads.

Mr. Speaker, I would like to wish you and all of my colleagues a very merry Christmas and a happy new year.

The House resumed from December 5 consideration of the motion that Bill C-316, An Act to amend the Canada Revenue Agency Act (organ donors), be read the third time and passed.

Criminal Code

[Len Webber, Conservative, Calgary Confederation, AB]

Madam Speaker, it is my pleasure to rise today to speak to Bill S-248, a Senate bill that was brought forward to the House by the Conservative member for Sherwood Park—Fort Saskatchewan. I know the member is passionate about this issue and has worked hard to bring this legislation to this point, so I thank him.

The RCMP has stated the obvious. It says that there are far more people in the world in need of a new organ than there are organs available. As in any market where a dollar can be made because demand far outweighs supply, people can turn to the black market to find what they need. When a person's life is on the line, the will to survive may override morals.

As members in the House may know, I have been a passionate advocate for finding improvements to Canada's organ and tissue donation systems. While 90% of Canadians support organ donation, just 20% are registered as organ donors. There are 4,500 Canadians desperate for a life-saving transplant, and 250 die each year before that life-saving transplant becomes available.

If we can increase the supply of organs, we can reduce or eliminate the desperation that leads people to take such drastic measures to save their own lives.

The problem of organ trafficking is not just a Canadian problem. The World Health Organization says that 10% of all organ transplants involved a trafficked organ. This is about 10,000 a year, every year.

The country of Iran stands alone in the world as the only nation with a legal organ trade. However, the trade is closely monitored and it has eliminated the wait-list for kidneys. However, I do not believe the end justifies the means either.

On a positive note, it has spurred the rate of donations from deceased donors in Iran. It is important to note that deceased donors are not paid.

Organ trafficking is a horrible phenomenon that can be crudely reduced to this: Rich nations take advantage of poverty in poor nations to satisfy their need for organs. A Harvard study showed that the main purchasing nations were the United States, Australia, the United Kingdom, Israel, Japan and, yes, Canada. We target nations in South America, Asia and Africa. In Indian alone, it is estimated that 2,000 kidneys are sold each year.

This trade is big business. Profits are estimated to be between $600 million U.S. and $1.2 billion U.S. per year.

Organ trafficking is done through what is generally known as “transplant tourism”. Those in need of a transplant travel to one of these poorer nations to undergo their transplant under the auspices of a vacation. There are even websites that offer all-inclusive transplant packages for these so-called tourists. A kidney transplant, for example, will mean a transplant vacation costing anywhere from $70,000 U.S. to $160,000 U.S. Canada does not have a law that prevents this.

While kidneys are the most commonly traded organ, it does not stop there. Other common transplants involve hearts, livers, lungs, pancreases and corneas. Human tissue is also illegally traded.

The trade involves three basic groups, according to the United Nations' global initiative to fight human trafficking: traffickers, who force or deceive victims into giving up an organ; victims who have their financial desperation used against them to give up their organs; and victims who are deceived into a medical procedure during which they have an organ removed without their prior knowledge.

Like any other illegal trade supported by organized crime, there are many layers of offenders. There are the recruiters, both for donors and recipients; the vulnerable people, who are the victims; the immoral medical people and facilities; the buyers; the facilitators; and more.

What do we do to address this problem? Of course, if we had enough donors in Canada, people would not be desperately mortgaging their homes or spending their retirement savings to get that life-saving transplant.

I do not blame people who are facing death for taking whatever steps they can to save themselves. They are just as much a guilty party in this trade as they are a victim of the trade. However, we need to take a stand on this issue if we are to stop it.

Before I go any further, it is important to clarify this would not prevent a truly informed and consenting person from donating an organ to someone in need. We are talking about unethically obtained organs.

Bill S-240 seeks to amend the Criminal Code to create new offences in relation to trafficking in human organs. It would also amend the Immigration and Refugee Protection Act to provide that a permanent resident or foreign national would be inadmissible to Canada if the Minister of Immigration, Refugees and Citizenship were of the opinion that he or she had engaged in any activities relating to trafficking in human organs.

We face an interesting problem in the world of illegally obtained organs. Unlike other contraband items, customs officers cannot just seize an organ at the border. How can we tell if that tourist coming back to Canada has the same heart he or she left with weeks earlier? It would be a very difficult crime to detect. In many ways, the only way to detect this activity would be when those Canadians would go to their doctor, who suddenly would notice they had surgical scars and signs of a new organ.

Section 240 of the bill would require health professionals to notify a designated authority of such activity for investigation. Anyone found guilty of contravening these new prohibitions would be subject to up to 14 years in prison. I have concerns about the kind of relationship this would set-up between doctors and patients, but there really is no other way to do this.

Where does that leave us today? There is a saying that I think is very appropriate here, “When all is said and done, there is often a lot said and little done.” There have been four bills before Parliament in the past 10 years on organ trafficking, but yet we stand here today and continue to talk. It is time we get something done instead. Until we take aggressive steps to stop organ trafficking, the practice will continue to victimize thousands more every year.

Let us get the legislation enacted before the next election. If we do not, the whole process would have to start all over again. What a waste of time and money that would be. Thousands more could be victimized in the process.

At the same time, let us pass legislation like Bill C-316, my bill, which would help eliminate the demand for organ trafficking. Let us also focus more effort on acting on the recommendations of the health committee to improve our domestic supply of organs and tissues. Let us better promote the registration of organ and tissue donors, so our supply will exceed our demand. Honestly, imagine a day when people come to Canada to get a life-saving transplant because we have too many available organs. Would that not be an amazing goal?

Again, I applaud the Conservative member for Sherwood Park—Fort Saskatchewan for putting the legislative proposal forward in the House. I look forward to voting in support of it.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

Thank you.

My colleague, Mr. Webber, introduced Bill C-316, which was agreed to unanimously. We are all following this issue closely. Many of my colleagues and I would like this to be implemented as quickly as possible.

You raised another important topic. There has been an increase of $500,000 for the purpose of education and awareness-raising about the effects of cannabis, following its legalization last October.

How are you going to approach public education on cannabis? It's not about advertizing, but about providing information to young people and their parents Canada-wide. Young people will become adults, and they will be able to consume cannabis, or not. Before consuming cannabis they have to know what it is.

How do you intend to better inform the population on the adverse effects of cannabis, particularly young people of less than 25? It has been shown very clearly that cannabis has deleterious effects on young people. What are the next steps?

Veterans Affairs

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Madam Speaker, before I get to the topic of my late show question, I do have to say that it is disappointing this evening to again see the government talk out, and therefore deny, the opportunity to expedite a good private member's bill. Bill C-316 was debated tonight, and it would have been excellent if that debate had been allowed to collapse so that we could have ensured that it would meet the CRA deadline to get organ donor information included on tax forms. However, as we have seen on a number of occasions from this government, it insisted on filling the time and thus not allowing this good private member's to pass, even at the risk of the bill not now passing in time before the next election.

Nonetheless, I do want to address the issue of Christopher Garnier tonight. This issue has really captured the attention of Canadians. He is a person who received veterans benefits even though he never actually served in the Canadian Armed Forces. He received benefits related apparently to PTSD he acquired as a result of his commission of a terrible crime. The crime was the murder of Constable Catherine Campbell, who did serve her country as a volunteer firefighter and a police officer.

This obviously offends the sensibilities of veterans, as well as all Canadians, who were shocked to learn that someone who had committed a crime in Canada and never served in the Canadian Armed Forces was and is receiving benefits that are supposed to go to Canada's veterans. The government at the time did not provide meaningful answers. Subsequently, in response to our questions and advocacy, the Liberals have brought in policies that, hopefully, will prevent this kind of situation from happening again. Obviously, that is a positive step, but it remains the fact, as far as we know and have been told, that Mr. Garnier continues to receive those benefits.

Notwithstanding any policy changes in the future, I want to ask the parliamentary secretary about this specific case. Does he believe that Mr. Garnier should be receiving these benefits, which arise not from his service to this country, but rather from the apparent PTSD he got as a result of his terrible crime of murdering Constable Catherine Campbell? Does the parliamentary secretary believe that Mr. Garnier should still be receiving those benefits? Does he believe that? If he believes Mr. Garnier should not be receiving those benefits, then why will the government not act to ensure that in this specific case those benefits will not continue? If he does not believe that, maybe he should explain why he believes this person should still receive those benefits.

Again, should Christopher Garnier continue to receive benefits from Veterans Affairs despite never having served his country?

Canada Revenue Agency Act

[Bernadette Jordan, Parliamentary Secretary to the Minister of Democratic Institutions, Lib.]

Madam Speaker, I am extremely pleased to rise today in support of Bill C-316. I would like to thank the member for Calgary Confederation for bringing this forward.

One of my friends once told me that the best speeches are given from the heart, that it is not about great notes or somebody who writes us a good speech. My speech today is coming from the heart. I am going to tell a little story about Nick. I did speak to Nick and I asked him if I could speak in the House on why this was so important and why it was important to him.

I first met Nick 21 years ago when he showed up at my door with my oldest son. He was an eight year old. As soon as he walked into the house, I noticed he was coughing. I asked him if had a really bad cold and he said, no, that he had a chronic disease called cystic fibrosis and because of that he had a hard time breathing and a lot of digestive problems. He explained the whole disease to me. Nick became a huge part of our lives. He was my son's best friend through his whole time growing up.

Nick's medication was kept in our cupboards. Oftentimes Nick would spend the night and he needed it to survive. Nick would come to the cottage with us and he would bring his breathing machine and his medications, but he never let it slow him down. There were a couple of times as Nick was growing up that he ended up in intensive care in the Halifax hospital because of his condition. A number of times we sat our son down, because they were very close, they had been friends since they were very young, and we told him we did not know if Nick would get out of the hospital. We had those conversations and we always knew it was a possibility. It was always really tough, when dealing with a young child and our own kids, trying to explain to them that this could happen.

Nick was amazing. He continued to beat the odds and he got out of the hospital both times. I remember when the Children's Wish Foundation asked him what his wish would be. Unfortunately, at that point in his life, he was very sick. He said that what he really wanted to do was make memories with his best friends. Therefore, Nick, my son and one of their other friends went to the big city for the weekend. The foundation gave them money to go shopping. They went to movies, ate steaks and they made memories. To this day, at 29 years old, when they get together, they still talk about it. It was just such a wonderful thing.

However, as everyone else was moving on, going to school and getting degrees, Nick was struggling more and more as he got older. Nick continued to go to university. He would oftentimes go for a semester and then have to take a semester off because he was too sick to continue. His dream was to become an architect. He continued to go to university and then he would take time off because of his health.

About a year and a half ago, Nick got very sick. I remember talking to him and him saying to me, “It's like I'm breathing through a straw”. If we think about that, how would that feel? Every breath we take and feeling like we are breathing through a straw.

Nick was put on the waiting list for a double lung transplant and he continued to deteriorate. One of the challenges for individuals who are that sick is having to deal with this. We live in a province that does not do transplants. Nick had to go to Toronto to have this transplant. His family needed $20,000 to be raised in our community in order for him to live there while he waited. Unfortunately, Nick ended up in intensive care on life support, waiting, because he was failing so badly.

However, this is a great news story. In July, Nick got a double lung transplant. It was a 10-hour surgery. He was on life support before the surgery. He is doing great. He is out of the hospital. He is back home. He says that he will never take for granted every breath he takes. One of the things he is also very cognizant of is that somebody else died in order for him to have the transplant.

It took almost two years for him to get a lung transplant. It is so important for us to sign donor cards and to ensure we have bills like this that will encourage more people to become donors so people like Nick are not left waiting for two years.

I am really pleased Nick is doing as well as he is. I want to thank the member opposite for the bill. It is very important that we continue to support these initiatives, that we continue to work with the provinces and territories and ensure we play a leadership role in transplants, ensuring they are available to people.

It would be great if there were some way we could also support people financially so the communities do not have to raise as much money to send people to places like Toronto for their surgeries.

[Yvonne Jones, Parliamentary Secretary to the Minister of Intergovernmental and Northern Affairs and Internal Trade, Lib.]

Madam Speaker, it is a pleasure to rise to speak to Bill C-316. I want to start by congratulating the member for Calgary Confederation for bringing the bill forward to the House of Commons and doing it in a manner that sought the support and input of many Canadians, and members of the House as well.

The bill itself recognizes the value of organ and tissue donation and transplantation and the important role that plays in protecting the health and safety of Canadians. I think all of us at some point or other in our lives have known people who have been confronted with that situation, whether a family with a loved one who is on a wait-list, or someone else needing an essential organ or transplant for their future survival and ability to continue to live a good quality life, or a family that has to deal with the grief of losing a family member and is faced with a difficult decision at the time of their sudden death. That cannot be easy. I think we have all heard of many of these stories and situations.

The bill allows people to reflect upon their own lives and those of others around them. It gives them the opportunity to make a very important decision on what will happen to their organs and tissues upon their death, so those kinds of decisions are not left to others and family members at a time of tremendous grief.

My colleague, the member for King—Vaughan, who spoke earlier was very emotional in her speech, but was certainly able to relate to this particular situation in a way that many of us cannot. She talked about her own family and how this issue has hit the heart of it, with the emotional decisions and trauma of having a family member who might need an organ transplant at some point, and their reflections on that decision. Obviously, this bill will go to heart of what many Canadians and many families might face in this difficult situation they might face in the future.

We also know that the bill before us today is one of the pieces of legislation the Minister of Health and our government have been following through on in their mandate. The minister has been working with provinces and territories on this very legislation to try to facilitate some collaboration, some partnership, across the country when it comes to an organ and tissue donation and transplantation system that would give Canadians timely and effective access to the kind of care they need.

I think most of us who listened to our colleague from the NDP cite the statistics of the numbers of people currently on wait-lists for organ and tissue donations and transplantation and of those who have died waiting can agree that far too many people are still on those wait-lists.

We can also agree that far too many Canadians die waiting, waiting for organ and tissue transplants that are necessary for them to continue to live and have a good quality of life.

I do not think any Canadian wants that to happen. It is all our responsibility to allow for a system that will ensure more people become organ donors, that there is a system in place to allow those who need transplants to get them. It is all our responsibility as Canadians that if we can bring life to someone, we bring life to that person.

In my riding, I have a very close friend and a family that went gone through such an experience. The family was faced with the decision upon the death of its son, which was very sudden, on whether to donate his organs for transplantation. That was a difficult decision, one I cannot even imagine. At a time when his parents were already shocked, heartbroken and in despair, they made a decision that their son's organs would be donated and used for transplantation.

Just recently, they had the opportunity to meet an individual who received one of those organs, an individual who today is enjoying a good quality of life, bringing joy to his family, to his grandchildren, watching his grandchildren and his children continue to grow and be a part of their lives.

As difficult as it was for her, her husband and her daughter at that time, knowing that in some way their son had been able to give this gift of life helped them through what had been one of the most tragic and difficult situations in their lives. It has helped them look at grief in a different way.

It was probably a couple of weeks ago when I was listening to CBC Radio's The Current one morning. She was on the radio, talking about this situation and so was the recipient who had received the heart as part of that donation. It was one of the saddest yet most inspiring stories I had heard in a very long time.

I do not think any of us wish for any family to be placed in that situation. By allowing this as a question, as a part of the Canada Revenue Agency work that it does through the application process, in reaching out to all Canadians, creating that awareness and allowing Canadians to make that decision to become a donor, we not only give them a sense of comfort in the decision they make, but we give their families a sense of comfort as well. Hopefully, at the end of the day, we are able to bring light to more Canadians who need it.

I am happy to support Bill C-316. I know many members of the House will, including government members. I am proud of the fact that as a government we have already stepped up to do many of the things outlined in the bill. In addition, we have been able to invest more into research related to transplantation, this year it is $100 million additional, to ensure these transplantations are successful.

We are continuing to work with research agencies, with science, along with families to ensure we can improve the system of organ and tissue donation in Canada.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, I am pleased to stand on behalf of the New Democratic Party of Canada. All my colleagues in our caucus and I offer our support to this important bill.

Canada's New Democrats believe that we must make every possible effort to ensure that every Canadian who needs an organ or tissue transplant receives it. We know that one donor could save up to eight lives and benefit more than 75 people, yet at 18 donors per million people, Canada's current donation rate puts us in the lower third of developed countries. Therefore, I particularly welcome this bill as an attempt to try to remedy that unfortunate state of events, because allowing Canadians to register as an organ donor through their tax returns will no doubt help increase registration rates, improve consent rates and help build a donation culture in Canada.

By way of background, Canadians are currently dying on wait-lists because our organ donation rate is so unacceptably and unnecessarily low. At present, only 20% of Canadians have joined their province's organ and tissue registry. Provinces like Ontario are taking steps to make it easier by asking about organ donations on health card and driver's licence renewals, which has increased registration. However, even with everything in place, some 20% of families refuse to transplant a registered donor's organs.

In its recent study on organ donation, the House of Commons Standing Committee on Health learned that of the 4,492 Canadians currently on the wait-list, 260 died waiting for an organ in 2016. In order to better meet that demand, improved coordination across provinces and territories is absolutely required.

Bill C-316, the bill before the House, allows the federal government to coordinate with provinces and territories to allow Canadians to register as organ donors through their federal tax filing. In this case, individuals would be required to consent to the sharing of their information before the agency would share that information with the provincial and territorial levels of government for the purpose of receiving information that hopefully would result in their being added to an organ donor registry.

I pause here to say that, in my view, it would be better if there was a box on everybody's tax return that taxpayers could check off to directly indicate they want to be a donor and the information would go straight to an actual organ donor registry. That is not what this bill does; however, in my opinion, it is worthy of support, because I think it will improve the situation, but I think that a more direct portal and a national registry is ultimately a better way to go.

Of course, this bill aligns with the long-standing advocacy and legislative work of New Democrat members of Parliament around organ donation. This bill is essentially a version of a previous proposal to create what I just referred to, a pan-Canadian organ donor registry, that would coordinate and promote organ donation throughout Canada. That bill had previously been introduced seven times both by Liberals and New Democrats. Judy Wasylycia-Leis, a New Democrat member of Parliament from Winnipeg, introduced a bill in 2002, 2003 and 2008. Malcolm Allen, who was a New Democratic Party member of Parliament from Welland, introduced a bill in 2009 and 2013. Unfortunately, of those five times that New Democrats have introduced bills to set up a pan-Canadian organ donation registry, neither the Conservative nor Liberal governments have ever taken up that excellent idea that would save lives.

I want to share some facts with members and any of the Canadian public who might be watching this debate.

While 90% of Canadians support organ donation in concept, less than 20% have made plans to donate. Unlike the United States, Canada does not have a centralized list of people waiting for an organ. The current Liberal government voted against a bill in 2016 that would have supported the creation of a national registry to align with the United States to help identify those wishing to donate an organ and those who need them.

That leaves us with a patchwork of provincial and territorial systems, the efficiency of which varies greatly from province to province. In the case where someone dies outside of the province where the individual is registered for organ donation, it is unlikely that the hospital would be able to identify the individual as a donor. This is one of the reasons that a centralized national registry is so much better.

Online registration is available in only five provinces: my province of British Columbia, Ontario, Alberta, Manitoba and Quebec. Even if someone is registered as a donor, the family always has the final say. In Ontario, about one in five registered organ donors have their wishes overridden by family members, according to a 2016 report in the Canadian Medical Association Journal.

To put this into perspective, for every patient in Canada who does receive an organ transplant, there are two more on the wait-list. In 2016, over 4,500 people were waiting for organ transplants, 2,800 organs were transplanted and, again, 260 people died waiting for a transplant that never came.

In the past 10 years, the number of deceased organ donors has gone up, but the number of people needing a transplant has also gone up. In fact, over 1,600 Canadians are added to organ wait-lists yearly. While most Canadians consent to donate after death, it is also possible to donate organs while one is still alive. Living donors who are the age of majority and in good health can donate a kidney, part of their liver or even a lobe of their lung. About 1% of Canadians who die in hospital donate an organ, but 99% do not, which works out to about 18 per million, about half the rate in countries such as Spain, which is 34 per million, and the United States at 26 per million.

I want to talk about the presumed consent system, because that is why countries like Spain and other European countries have organ donation and transplant rates that are twice as high as Canada's. It is because they have moved to a presumed consent system, which means that every citizen is presumed to consent to be an organ donor unless they choose otherwise. Individual choice, of course, is respected, but it vastly increases the pool of people who are available for organ donation.

The truth is, as I said earlier, over 90% of Canadians agree with the concept of organ donation, but it is difficult or confusing for them to know how to do that, and so most of those wishes go unexpressed. However, if we changed our system to a presumed consent system, we would have the best of all worlds. We would still respect individual choice for those who, for a variety of reasons, do not want to donate, but we would vastly increase the number of organs and tissue available for donation and hence save the lives of so many more Canadians who are waiting for an organ transplant.

It is funny that Canada is the only developed country without national organ donation legislation such as the 1984 U.S. National Organ Transplant Act. The comments that I am making were borne out repeatedly when we studied this bill at committee, and I will read some of the comments we received from people with respect to a national database.

Dr. Norman Kneteman, professor and director, Division of Transplant Surgery at the University of Alberta said that:

...the Canadian Transplant Registry that CBS has built is in place; the computer system exists. The challenge is how we get the information into it. In Canada, all the reporting and transplant and donation in our history has been voluntary, and because of that, it's full of defects; it's not reliable. We have to get beyond that, and we need to be thinking about how we are going to fund the activity of getting the information into the database so the professionals, the researchers...have something to work with.

The Kidney Foundation of Canada backed that up. It said:

Currently, there is a lack of data concerning missed donor opportunities in Canada, which stems from inconsistency in the frequency, methods, and scope of data collection between jurisdictions. Furthermore, this data is not centrally accessible to patients on the waitlist, researchers, clinicians, administrators, or policy makers. Current Canadian approaches to measurement and reporting of potential donor identification and referral are fragmented and lack consistency, timeliness and accessibility of information.

It is rare that one can identify a policy response to a problem that is so obvious and achievable. We need a national organ donor registry in this country. We need a presumed consent system in this country. Why? It is because those two policy initiatives have been identified by all the stakeholders and all the experts. We know that it will increase organ and tissue donation in Canada and save lives. The New Democrats will continue to work towards those ends.

[Deborah Schulte, Parliamentary Secretary to the Minister of National Revenue, Lib.]

Madam Speaker, first, let me thank the member for Calgary Confederation for introducing his private member's bill and for his tireless and passionate work on this issue. His personal commitment to this and the co-operative way he has worked with MPs from all parties has moved members of the House, as demonstrated by the unanimous all-party support Bill C-316 received at second reading.

I would also like to acknowledge the member forEdmonton Manning for his early advocacy on this issue and his private member's bill and, more recent, Motion No. 189, organ and tissue donation, brought forward by the member for Thérèse-De Blainville.

Our government understands that organ and tissue donation and transplantation is an important part of our health care system that relies on the generosity of Canadians to give the gift of life. We know many Canadians, when approached, are willing to be a donor, however, reaching them to get that consent is hit and miss.

We all recognize that more work is needed to address the chronic shortages of organ and tissue donations for transplantation across the country. It goes without saying that transplants not only save lives, but also drastically improve the quality of life for the recipients. In some cases, transplants are the only treatment for end-stage organ failure.

The Canadian Transplant Society notes that more than 1,600 Canadians are added to organ wait-list every year. In 2017, more than 4,333 people were waiting for transplants across Canada. That same year, 2,979 organs were transplanted.

Over the past decade, the number of deceased organ donors has gone up by 42%, so that is good news. While that is encouraging, unfortunately, the number of people needing a transplant has also gone up during that same time. In many ways, we are not making progress and many people are continuing to suffer.

Hundreds of Canadians could no longer wait, and did not get a transplant in time. In 2017, 242 people died while waiting for a transplant.

As our population ages, the need for transplants will only increase. Any one of us could one day find ourselves in need of a donation. As I have mentioned before in previous debates on the bill, and I am sorry, I am getting a little emotional, my sons have a very rare genetic condition resulting in serious heart disease. The only option currently for my eldest when his heart fails to pump effectively is to have a heart transplant. I am hopeful for more options in the future through cardiac and transplant research. However, we must do more to ensure Canadians have timely and effective access to the care they need.

That is why the government is standing in support of Bill C-316. By working together, we can improve the organ and tissue donation and transplantation system and ensure that Canadians have timely and effective access to that care.

Bill C-316 would enact a provision that would authorize the Canada Revenue Agency to enter into an agreement with a provincial or territorial government to collect information required for establishing or maintaining an organ and tissue donor registry in the province or territory.

Specifically, the CRA would collect and share personal information for individuals who wish to receive information from their provincial or territorial government on becoming an organ or tissue donor. A memorandum of understanding with the willing provinces and territories would need to be signed so the CRA could share information from potential donors. To this end, the CRA would work diligently with provincial and territorial governments to put these agreements in place.

Canadians can be assured that we are committed to improving the organ and tissue donation and the transplantation system.

In the meantime, people need to know that registering to donate is not complicated and that registration can be done at any time. We know one organ donor can potentially save as many as eight lives and a tissue donor can improve the quality of life for up to 75 people. This is the gift of life, not only for the individuals with the serious health problems who are direct beneficiaries, but also for their family members and loved ones.

I want to mention again the significance of this gift of life, as we saw in the Humboldt disaster. I am sure people have heard the stories by the member opposite.

I have my own story in my own community. A vibrant, loving young mother, an inspired teacher, suddenly lost her life when she suffered a stroke. She had signed up to be a donor and was able to give the gift of life and improve the outcomes for eight other people. Out of one family's pain came joy for eight other families who were forever grateful for her final act of kindness.

Living donors who are at the age of majority and in good health can donate a kidney, part of a liver and a lobe of a lung and continue to lead full and rewarding lives. We know that one donor, as I said, can potentially save up to eight lives and improve the quality of life for up to 75 people. Lives are transformed through these miracles.

Canadians can count on this government to continue to improve the organ and tissue donation and transplantation system. To demonstrate this commitment, the Minister of Health announced on October 18, 2018, renewed funding of $3.3 million for the Canadian donation and transplant research program, CDTRP. This funding allows the CDTRP to continue its research to advance organ and tissue donation and transplantation in Canada. It is through research that we can increase the availability of transplants for Canadians and transform clinical outcomes for transplant patients from coast to coast. It is absolutely incredible what is being done in research institutions in Canada.

I had the opportunity to see the work being done in Toronto at the Peter Munk Cardiac Centre. They were working on keeping a cow's heart alive outside of the body for weeks, which would provide an opportunity to do external repairs to fix damaged organs and potentially allow for treatments that would not be possible implanted in a body. This is most promising research to be able to make best use of all the organs donated, as many get rejected due to defects or disease.

Our government is committed to supporting Bill C-316. We will collaborate with the provinces and territories upon royal assent to implement this legislation as quickly as possible to be in place for the beginning of the 2019 tax filing season.

[Len Webber, Conservative, Calgary Confederation, AB]

moved that Bill C-316, An Act to amend the Canada Revenue Agency Act (organ donors), be read the third time and passed.

Mr. Speaker, it is my honour to rise to speak to my private member's bill, Bill C-316, at third reading.

For those who may not be familiar with Bill C-316, it is a legislative proposal that would allow Canadians to indicate their interest in being an organ and tissue donor through their annual tax forms. It is just that simple.

Right now, the tax forms can only be used for the collection of taxes. This bill would create a legal exemption, just like that made for Elections Canada, to allow this important question to be added to the tax forms.

If we have any hope of getting these changes to the tax forms implemented in time for the 2019 tax year, we need to move this through both the House now and the Senate early next spring. If we miss that deadline, the Canada Revenue Agency, CRA, will not be able to implement the required changes for another year. We cannot let that happen. We need to get this done quickly.

This bill was unanimously supported at both second reading and committee, and has progressed from its first debate in the House to its last debate in just 23 sitting days. I think that is a record.

I do want to reiterate my sincere thanks to all the parties in the House for showing such support and offering their genuine co-operation to move this proposal forward so quickly. In particular, I must express a great debt of gratitude to the hon. member for Red Deer—Lacombe for the quick progress of this bill. The bill was not actually scheduled to be back for third reading debate until February 25 of next year, but the hon. member for Red Deer—Lacombe graciously traded his position in the PMB calendar with me to make this debate possible today and to further ensure that this legislation is passed. I know the member for Red Deer—Lacombe is a strong supporter of improving Canada's organ and tissue donation system, and his willingness to help prioritize this bill demonstrates that. His graciousness might be proven one day to have resulted in the saving of hundreds of lives. I sincerely thank the hon. member.

I also want to thank all of my colleagues on the health committee who have been vocal, determined and dedicated supporters of this bill. As I said in the health committee the other day, “I have referred to this bill several times as 'my bill', as it stands in my name, but I do want to say that this is really our bill.” It is our bill, because we worked together in committee as a single team to make it a reality. We found a shared goal and a sensible solution, and worked together to make it happen.

I also want to thank the government, yes, the government, for its allocation of $4 million in funding in the recent fall economic statement to facilitate the implementation of this legislation. Governments do not often commit funding ahead of legislation being passed, especially when for a private member's bill by an opposition member of Parliament. The fact that funding has been committed is very much appreciated and signifies an impressive willingness by the government to see this initiative happen.

I must also thank Mr. Terence Scheltema, my assistant here in Ottawa, for his tireless efforts throughout the entire process of this bill. Without him, this bill would not be before us today.

My final thanks go to my friend, Robert Sallows, a double-lung transplant recipient who recently passed away at the age of 31. He was, and always will be, a hero and a true inspiration.

At the health committee last week, we had an opportunity to hear from CRA officials. They told us that for this proposal to be in place for the 2019 tax season, the legislation needs to be passed by early spring. I think that is quite possible, again, thanks to people like the member for Red Deer—Lacombe.

A few other things became very clear in committee, and I want to talk about them for a moment. First of all, for this initiative to be most effective, the question about organ and tissue donation needs to be placed on the front of the tax form. The committee members made this very clear to the CRA. I was pleased that the CRA has acknowledged this as a priority of Parliament and committed to putting this on the front page.

I also think that the committee process was very informative and allowed the CRA to demonstrate its commitment to making this proposal a reality by working co-operatively with all provinces and territories on this matter.

The path ahead for the CRA will require a lot of work and dedication by many people to make sure this change happens smoothly. In advance, I want to thank all of the CRA employees who will work on this project for their dedication and persistence. I know there will be days of frustration as small details are worked out and circled back and forth in the consultation process with the provinces and territories. However, when the 2019 tax forms come out and thousands, perhaps millions, more donors register, they will know they have played a key role in saving the lives of some of their fellow Canadians. Therefore, I implore the people at the CRA to dig deep on those tough days and push forward to make sure that we get this done as soon as possible with the highest rate of effectiveness. Their work will have purpose and the results will be rewarding.

One other aspect I want to spend a few minutes on is something the bill does not directly address, but is a significant problem in Canada. Research has shown that as many as one in five potential organ and tissue donors has their final wish overturned by their families at their time of death. That is 20% of families who are overturning the wishes of their deceased loved ones. That is just sad. The decision by their families are robbing those in need of a life-saving transplant of a chance to live. To me, this is unconscionable and has to change. We can and must do better.

It is beyond my understanding how we can allow people to die at a rate of five a week, while at the same time burying, incinerating or putting to rest perfectly good organs every single day. My daughters know I want to be an organ donor, and they know I expect them to follow through on this wish.

As the Christmas holidays approach, families will gather in every corner of the country. I encourage willing organ donors to please speak to their families during this time, to make sure their families know that their final wish is to be an organ and tissue donor, and to let them know how they would feel if they were to find out the family failed to honour their wish.

Throughout my organ and tissue donation advocacy work, both here and in Alberta, I have been approached by many people who have donated the organs and tissues of their deceased loved ones. Every single one of them has made it clear to me that they found the ability to donate to someone in need as a very essential part of their grief and healing process. Their ability to find some good in a time of utter grief and loss was profound and everlasting. Without exception, they encouraged me to let other families know that sharing their loved one made accepting their loss so much easier.

Their loss has purpose, and their gift has brought unimaginable relief and joy to another family in need. By honouring the wishes of their loved ones, they have allowed grandparents, mothers, fathers, sisters and brothers to live. Their gift has meant that many parents have not had to see their children die. That is a legacy to leave for their loved ones.

We all have our own reasons for supporting this legislation. Some members in the House are living organ donors, the real heroes among us. Some members here have families in need of a life-saving transplant. Some members themselves, or their family members, have medical conditions that they know one day they might require their getting a life-saving transplant. Other members are able to love, laugh and live with loved ones because they got a life-saving transplant and are still with us here today.

No matter members' reasons for supporting the bill, it is very much appreciated.

The House proceeded to the consideration of Bill C-316, An Act to amend the Canada Revenue Agency Act (organ donors), as reported (with amendments) from the committee.

Health

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

Mr. Speaker, I have the honour to present, in both official languages, the 21st report of the Standing Committee on Health entitled, “Bill C-316, An Act to amend the Canada Revenue Act (organ donors)”. The committee has studied the bill and has decided to report it bill back to the House with amendments.

I would like to compliment the member for Calgary Confederation for tabling this important legislation.

After considerable testimony, Bill C-316 has received the unanimous support of the committee. I hope that all MPs take that into consideration at a later date.

I want to thank the CRA for its positive approach to help us get through and resolve this. I also want to thank the committee members for helping get the bill through to this point so quickly and efficiently.

[Frank Vermaeten, Assistant Commissioner, Assessment, Benefit and Service Branch, Canada Revenue Agency]

Good morning, everyone.

Thank you for the invitation to appear here before this committee and respond to your questions about Bill C-316 , an act to amend the Canada Revenue Agency Act regarding organ donations.

I'm Frank Vermaeten. I'm the assistant commissioner of the assessment, benefit and service branch of the Canada Revenue Agency.

My branch is responsible for administering key services on behalf of the CRA in support of tax and revenue generation programs. I'm accompanied today by my colleagues Sheila Barnard and Randy Hewlett.

Sheila Barnard is the manager of the legislation section in the individual returns directorate in my branch. Sheila is responsible for coordinating the implementation of the legislative changes affecting T1 returns.

Randy Hewlett is the director general of the legislative policy directorate, whose mandate is to manage the legislative and regulatory process within the agency. Randy's team also works with the provinces and territories to implement and administer provincial and territorial tax legislation.

Bill C-316 would enact a provision that would authorize the CRA to enter into an agreement with a provincial or territorial government to collect any information required for establishing or maintaining an organ donor registry in the province or territory.

Specifically, the CRA would collect and share personal information for individuals who wish to receive information from their provincial or territorial government on becoming an organ donor. The individual authorization to share personal information for this purpose would be collected with the income tax return.

Mr. Chair, we would now be pleased to answer the committee's questions regarding the implementation of Bill C-316.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you, Bill. I appreciate it.

I don't know if you recall, but a couple of years ago I was at this committee and I couldn't even speak because I had lost my voice. I'm getting there again, so it's bad timing, but I hope I can get through this.

Colleagues, it is my absolute pleasure to be here today to speak on my private member's bill, Bill C-316. Before I begin, I want to thank you all immensely for your unwavering support of this initiative. There is no question that we all share the common goal of improving our organ and tissue donation system here in Canada, so that Canadians no longer have to die awaiting a life-saving transplant.

As I have said before, this is not a political issue; this is a human issue, and our work on this issue is proof that when it really counts, we're able to leave our partisan stripes at the door. I also want to thank those who rose in the House to speak to this bill. I was moved by your kind words and your personal stories, and I think it's fair to say that many people had no idea how passionate we could all be about this issue.

Finally, I want to thank the analysts and the clerk for the work they have done on this issue. Your work on the committee report was excellent. You perfectly captured what we heard and what we want to see done, so I sincerely thank you.

As I mentioned in greater detail in my comments in the House during second reading, this bill would sensibly utilize the annual tax return process to allow Canadians to indicate their intention to consent to be organ donors. I have been afforded the opportunity to discuss my bill in greater detail with the Canada Revenue Agency, and I very much appreciate that collaborative gesture. I thank them for allowing time for me to meet with them.

This bill would enable the CRA to facilitate the registration of individuals with their respective provincial and territorial registries, but it will be the provinces and territories that will ultimately finalize the consent with those who wish to register.

This bill does not specify, at least at this point, the exact nature of the data collection process or the actual content that is to appear on the tax return. This bill is very narrowly focused on giving the CRA the legal exemption it requires to set up agreements with provincial and territorial partners, because existing legislation prohibits the use of tax returns for any purpose other than the collection of taxes, and of course allowing Elections Canada to pass on their information to them.

While I wanted to provide the CRA with a lot of working space and flexibility to implement the will of Parliament, I do have some concerns and I hope that we can put those to rest today when the CRA is up here and we're questioning them. I want to ensure that the CRA hears loud and clear that the expectation of Parliament is to have this addition made on the front page of the T1 tax returns in all provinces and territories. I also want it made clear that we expect people to have the option to tick a box on that front page—a call to action, if you will. We've all filled out forms before, and we know that unless there's a box to tick or a space to fill, we tend not to stop and read the fine print. We need to make sure that we have a front page that calls on tax filers to take a specific action to demonstrate their willingness to register.

I realize that the front page has very limited space, but it does have enough space to do what we all envision. In fact, the options I've offered would take less space than that afforded to Elections Canada on the front page. I think we can all agree that unless this initiative appears on the front page, we will lose a tremendous opportunity and dramatically reduce the impact of our work.

When it comes to the electronic filers, the e-filers, things should be quite simple, and of course the majority of Canadians, probably 90%, e-file. The CRA should make it a requirement of all tax software, which they certify annually, that the offer to consent appear prominently in the filing process. Based on residency, a tax filer should be afforded a secure connection to their own provincial or territorial registry to consent. A tax preparer should also have the option of requesting a consent package for those who are not physically filing their own return. We need to seize every opportunity to register as many as possible.

I should also mention here that I will be moving two minor amendments to my bill. These amendments are friendly amendments. They will simply change “organ donors” to “organ and tissue donors”. I believe, from my earlier discussions with colleagues and the chair, that this is not going to be an issue. We will ensure that we are not limiting ourselves from a legal perspective. I'll bring those motions forward during clause-by-clause.

I don't believe that we are intending any other amendments to the legislation, but I do welcome any that will help ensure we reach our goal to have more registered donors.

Of course, we will be hearing from the CRA officials, and I encourage my colleagues to implore a continued sense of urgency for implementation. It's always been my experience that a deadline focuses everyone and helps get the job done.

I believe that we could have this in place for the 2019 tax returns, but that would require everyone to continue pushing all involved in the process. This committee has shown its willingness to move quickly on the legislation, and I hope that those after us, meaning the CRA and of course the minister, are just as motivated to make this happen quickly, because once it leaves here, it's out of our hands.

We know that a Canadian dies almost every day awaiting a life-saving transplant. Every day sooner that we get this done means that we literally could save a life.

A while ago, the elections commissioner indicated to Parliament that if Parliament wanted to implement changes in time for the 2019 election, then legislation would have to be passed by a certain date. That was for changes to the elections laws. I would like to see the CRA provide a similar breakdown on their timelines to give us a sense of what needs to be done, and by when, for this to happen in 2019. This would be helpful for everyone in the process to have. It gives us a target to focus on.

Finally, I would like to thank the government. That doesn't happen too often. I would like to thank the government for committing the funding to this initiative in the fall economic update just last week. Governments don't often commit funding ahead of legislation passing, especially when it's from a private member's bill and, for that matter, an opposition private member's bill. The fact that this funding has been committed is very much appreciated by me, and it signifies an impressive willingness from the government to see this happen.

I have referred to this bill several times as “my bill”, as it stands in my name, but I do want to say that this is really our bill. This is our committee's bill, because we all worked together as a single team to make this a reality. We found a shared goal and a sensible solution, and we all worked together to make this happen.

I'm very proud of all of you who were here along this process with me. We are getting closer every day, but there still remains a lot of work ahead. I must be honest in saying that I am a bit concerned that we don't yet have a clear, unambiguous commitment on some important implementation aspects. Hopefully, we will deal with that today with the CRA. Nonetheless, we've gone a long way in a short amount of time, and I'm very proud of all you guys. I have to thank you all for the work you've done on this.

Thank you.