Bill C-434 (Historical)

An Act to amend the Criminal Code (assault against a health care sector worker)

This enactment amends the Criminal Code to require a court to consider the fact that the victim of an assault is a health care sector worker to be an aggravating circumstance for the purposes of sentencing.

Criminal Code

[Gord Johns, NDP, Courtenay—Alberni, BC]

Madam Speaker, like my colleague before me, I also want to pay my respects to all those who have been impacted by the terrible bus crash in the Prairies, and their family members. I thank all the first responders and everybody in our health care system especially. It is a traumatic experience for them and for everybody in those communities.

We are in the middle of a crisis in my riding. There are wildfires that have cut my riding right in half. Over 30,000 of my constituents are cut off from the rest of Canada. Many of them are struggling. I have to give a shout-out to all those people who are fighting the wildfires, all the first responders and the people in our community who are stepping up, like those who work at the food banks. We are looking out for each other. It is what we do in Canada and across this country, especially in rural Canada; we look out for each other.

It is a tremendous privilege to rise to speak to this bill. I have worked with my colleague from Cariboo—Prince George since we both got elected in 2015. He brought forward a bill for a PTSD strategy. He has experience in this area, or at least knowledge of it. He has been a strong advocate for first responders and people working in health care since I have gotten to know him, and I do appreciate his bringing forward this bill. We are both from rural B.C., and we understand the importance of looking out for our health care workers, especially in rural Canada.

We know this bill would amend the Criminal Code to require a court to consider the fact that the victim of an assault was, at the time of the commission of the offence, a health care professional or first responder engaged in the performance of their duties, and that that would be an aggravating circumstance.

The main thing that we, members of the NDP, want to say is that, clearly, no health care worker or first responder should ever be subjected to violence in the workplace. Bullying, abuse, racial or sexual harassment and physical assault should never be considered part of the job. Health care workers take care of us at our most vulnerable times; they look out for us. We rely on them. We have a responsibility to take care of them in return. That has not been happening. I am going to speak to that in depth.

Violence against health care workers is a pervasive and growing problem in the Canadian health care system. Both the number and the intensity of attacks are increasing at an alarming rate. Assaulting a health care worker not only harms the individual person but also puts our entire health care system at risk. I am going to speak to that in more depth. Workplace violence is a major factor driving Canada's dire health care staffing shortage. We know that workplace violence is a pervasive problem in health care settings across the country. However, prior to COVID-19, health care workers already had a fourfold higher rate of workplace violence than people in any other profession. We know it has gotten worse since then. Incidents of violence against health care workers have escalated dramatically during the pandemic and postpandemic.

We were already in a crisis, like I said, prepandemic. We have seen that there is a labour market shortage in the health care system. We have seen the increased demands on the health care system. In 2017, a survey cited that 68% of registered practical nurses and personal support workers experienced violence on the job at least once that year. Imagine someone going to work and that, at least once a year, there will be a violent attack committed against them. Who wants to work in that environment? It is just terrible to hear these stories. Nearly one in five of the RPNs and PSWs surveyed said they had been assaulted nine or more times in that year alone. We have heard, from the Canadian Federation of Nurses Unions, that violence-related incidents and claims for frontline health care workers have increased by almost 66% over the past decade, which is three times the rate of the increase for police and correctional service officers combined, who are also facing an increase.

We really need to step back and look at how, over the last couple of decades, we have seen a huge erosion of our health care system. I am going to speak a bit more about that.

If we look at Canada's ratio of nurses to patients, we have one of the worst in the world. In universal health care, we are at the bottom. We are just above the U.S. That is just a terrible stat on its own. Nurses know this full well. Their patients see them running from patient to patient and the stress this creates.

Nurses are really the victims of the failure of consecutive federal and provincial governments to stabilize and strengthen our health care system. They have been dealing with the huge erosion of cuts. They are dealing with the people at the front line. When there is a wait at an ER or a wait to get the services people so desperately need in their vulnerable state, it is the frontline health care workers who are dealing with a political problem. The cuts from all levels of government are falling on the people on the front line, and that is creating a huge strain on the patients and on their families, as we know. It is slowly eroding staff levels as well because people are having to make difficult choices.

The long-term health care system is now over 50% privatized. Privatization has a huge impact on the health care system as well, as there is a lack of protection for workers, inadequate wages and staffing levels that are quite low. The health care system is in deep trouble, and staffing is a major issue. There is frustration in the lack of care, like I said earlier, and the burnout it is causing people on the front line. This is a crisis, and it is propelling these terrible statistics.

One thing I wanted to highlight is that we need to do a few things to help fix that. We need to invest in our health care system, stop for-profit health care and ensure that we are supporting the staff. The bill before us is a really important start to that, but there is also the burnout.

We are hearing from nurses, and they are saying they have three options. The first is to leave the field. The second is to get burnt out and make a mistake while practising their care. This is falling on them. The overburdening of our health care system is falling on them. Can members imagine going to work, worried they would make a mistake while trying to take care of somebody? The third option nurses have is to reduce to part-time hours, but that creates even further erosion of the health care system.

There is a lot of compassion fatigue happening as well. I really appreciate my colleague before me talking about the lack of mental health support. We now have a two-tiered health care system. Our mental health care system is a two-tiered health care system. There are people who need care. We are hearing from people who cannot get access to that care. They have to get arrested just to get the care they need. That is absolutely ridiculous. They have to get arrested. What kind of state are they in at that point?

When they go to the ER and they are in that kind of state, it is health care workers who are dealing with them. This is not acceptable. We need to ensure that we create parity with physical and mental health, and that we are not reactionary. Right now our health care system is reactionary instead of preventative, and we need to get to a preventative state.

It is an uphill battle, and it is exhausting everybody in this country.

I do want to highlight that our critic from Vancouver Kingsway tabled a very similar bill, Bill C-434, to ensure that we are on this path, and I believe my friend from Cariboo—Prince George tabled a very similar bill.

We want to make sure that we get the definition of health care professional or first responder right, so we are supportive, obviously of this legislation, and we can work on that with our colleague at committee. I am sure we can find a pathway to doing that. This legislation is an important legislation that we have heard support for from the Paramedic Association of Canada, the Paramedic Chiefs of Canada and all important stakeholders.

I have to highlight something before I finish. The majority of health care workers who experience workplace violence are women, and this violence is often connected to gender-based discrimination and harassment. This needs to stop. According to the Canadian Institute for Health Information's 2019 report on health workplace statistics, women account for approximately 82% of Canada's regulated health professionals, which includes nurses, midwives, physicians, dentists, pharmacists and other health professionals.

We have lots of work to do. We are very supportive and appreciative of this bill and legislation.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, I am pleased to rise today to express, on behalf of my New Democrat colleagues, our support for Bill C-321, an act to amend the Criminal Code, assaults against health care professionals and first responders. Once again, I would like to offer my gratitude and congratulations to my colleague from Cariboo—Prince George for his constant attention and care to our frontline responders in this country. This is a continuation of his fine work in this area.

In brief, this legislation amends the Criminal Code to require courts to consider the fact that victims of an assault were at the time of the commission of the offence a health care professional or a first responder engaged in the performance of their duty as an aggravating circumstance when they are the victim of that offence.

I think it goes without saying that no health care worker or first responder, in this country or anywhere, should ever be subjected to violence in the workplace. Bullying, abuse, racial or sexual harassment, and physical assault should never and can never be considered just part of the job. These workers care for us at our most vulnerable, and I think we have a responsibility to care for them in return.

Violence against health care workers in specific is a pervasive and growing problem in the Canadian health care system. Both the number and intensity of attacks are increasing at an alarming rate. Assaulting a health care worker or a first responder not only harms the individual involved but also puts our entire health care system and first response system at risk. Workplace violence is a major factor driving Canada's dire health staffing shortage, and I am sure it is a dissuading and discouraging factor for people pursing this career.

Workplace violence is a pervasive problem in health care settings across Canada. Prior to COVID–19, health care workers had a fourfold higher rate of workplace violence than any other profession. Incidents of violence against health care workers and first responders escalated dramatically during the pandemic. I might say as well that first responders are often the first people on the scene when we are dealing with Canada's overdose crisis, and I do not think I need to point out how pervasive that is in every corner of the country and the danger it presents to them.

In a 2017 survey, 68% of registered practical nurses and personal support workers reported experiencing violence on the job at least once that year. Nearly, one in five said that they had been assaulted nine or more times that year. According to the Canadian Federation of Nurses Unions, violence-related lost-time claims for frontline health care workers have increased by almost 66% over the past decade. That is three times the rate of increase for police and correctional service officers combined. First responders, notably paramedics and firefighters, also experienced violence and threats on a shockingly frequent basis.

That is why on February 28, 2019, I introduced Bill C-434, an act to amend the Criminal Code, assault against a health care sector worker. That legislation would have amended the Criminal Code to require a court to consider the fact that the victim of an assault is a health care sector worker would also be an aggravating circumstance for the purpose of sentencing. I reintroduced that legislation in successive parliaments in February 2020 and December of 2021.

Although the present bill, Bill C-321, before the House today is very similar to Bill C-434, it does not define a health care worker as broadly. This bill is limited to an assault against “a health care professional or a first responder”, but does not define the terms. The bill I introduced was specifically drafted to ensure that, when we talk about a health care worker, we include not only professionals, but everybody who works in a health care setting, from the porter who greets people at the door, to the orderly and the admin clerk, many of whom experience bullying, abuse and violence. I know my colleague has already indicated that he is willing to look at a broadened definition, and I thank him for that because we want to make sure that this contemplated measure does not exclude any health care sector workers who are not members of professional bodies.

As has been pointed out by my colleague on the government side, in December of 2021, Bill C-3 was passed in the House, which amended the Criminal Code to enhance protections for health care workers, those who assist them and those accessing health care services, and it received royal assent at that time.

Among other measures, Bill C-3 amended the Criminal Code to make it an aggravating factor in sentencing for any offence when there is evidence that, one, “the offence was committed against a person who...was providing health services, including personal care services,” as a part of their duties or, two, where there is evidence that the offence “had the effect of impeding another person from obtaining health services, including personal care services”.

By the way, I also think it is important to point out that we ensure that this bill is broadly defined to include any setting in which a health care worker may perform health care services, including in the home, long-term care centres or any other non-conventional place other than a hospital.

Unlike Bill C-3, the bill before the House, Bill C-321, broadens that protection, I think very laudably, to apply to first responders who are engaged in their duties but not necessarily engaged in providing health services. This is a welcome improvement. Again, I thank my hon. colleague for broadening this important protection.

Assaulting a peace officer is already a stand-alone offence under section 270 of the Criminal Code. The punishment for assault of a peace officer is no more serious than the legislated sentence for common assault. However, the court is likely to consider that the victim, as a peace officer, is an aggravating factor at sentencing.

The Criminal Code offences in sections 129 and 270 do define public officer and peace officer, but case law on the interpretation of section 2 shows the varying occupations that have been counted as peace officers for the purposes of prosecutions under the Criminal Code in particular contexts. They have been included to define members of the Anishinabek Police Service and military police. However, despite the existence of cases which mention paramedics or firefighters that cite section 270 of the Criminal Code on peace officers, there are none that I am aware of where the person assaulted was a paramedic or firefighter. Therefore, current case law suggests that first responders are not considered peace officers under the Criminal Code. This omission must be rectified and would be rectified by this bill that is before the House.

I have already talked about Bill C-321 employing the term “health care professionals” and how that is not defined in this bill, so we are going to work, I hope collaboratively, to ensure that that definition is broadly expanded. It is similar with first responders, who are not defined in this bill because the Criminal Code does not define this term. Other federal statutes do not either, so it will be important for us to have a good, broad description of that to ensure that any person in this country who is providing first response services in our communities is covered by this legislation.

I want to just mention that this is an important step because the Criminal Code is an expression of society's values and priorities. I think sending a message to the Canadian public that these health care workers are taking care of us, that they deserve to be protected and are inviolate is an important message for Parliament to send.

I am not sure I understood completely the comments by my hon. colleague from the Bloc Québécois. He did mention some important points about broadening this protection to many other kinds of workers, but there is one key difference. Health care workers and first responders do a job that we ask them to do. We ask them to be there for people when they are in trauma, and we are putting them in a situation that regular workers are not often in. They have no choice but to be there. They have to be there. That is why I think it is particularly important to send the message that they are inviolate and we must protect them. We have to send a message that under no circumstances is it ever acceptable to violate those people, either by word or deed.

Finally, I want to recognize that, as important as this bill is, it is only a first step. To keep health care workers and first responders safe, they need resources and tools. We want to prevent them from getting assaulted in the first place so they need proper security. They need proper physical barriers. They need sufficient staffing.

We all need greater mental health supports because we also have to recognize that many times the people who are doing the assaults are in some cases victims and are suffering from mental illness and trauma themselves. We have to recognize that we need a comprehensive holistic approach to this problem so we are doing everything we can to prevent the situations that often lead to assaults from happening in the first place instead of dealing with the sentencing after the assault occurs.

[Matthew Green, NDP, Hamilton Centre, ON]

Madam Speaker, I rise quite sheepishly, having not received the memo on the festive tone of this afternoon's debates, so I will ask members to indulge me. In my community, plain talk is not bad manners, and I have prepared a full speech that does identify some gaps, which I think are germane to the conversation. This is not intended in any way to end off on a bad note or a sour note, but to really contemplate deeply what is at stake here in the House. It keeps me up at night, like many members I am sure, and it wakes me up early in the morning.

While there remains much to be said about the timing and need of the last election called by the Prime Minister, I have to admit the opportunity for me to retreat from this place of privilege and return to the doorsteps of my constituency provided me with an invaluable grounding for what is at stake among these future proceedings of the session. This is a monumental day, and I do not want to take anything away from that. It is a burden that we carry. In fact, we have asked millions of Canadians to carry a very heavy burden in order to make it through this COVID pandemic.

While returning to this topic and supporting Bill C-3, having heard the various interventions pertaining to the same, many members have questioned the relationship between the first two parts of this bill, which would amend the Criminal Code, and the third part, which would be establishing something under the Canada Labour Code.

For those from the public, and who may be tuning in to this debate through livestream, or perhaps reading it in the Hansard, I will provide a summary of Bill C-3. The first two parts would amend the Criminal Code by creating two new offences relating to the protection of health care professionals and patient access to health care. The first offence would apply to any act of intimidation that is intended to cause fear in a patient, health care professional or any person who supports them and prevents them from accessing or providing health care services. The second offence would also cover intentional acts that prevent a person from accessing services provided by a health care professional. Both offences would be punishable by a maximum term of imprisonment of up to 10 years and up to two years on a summary conviction.

Part three, which seems to be where perhaps some people have the disconnect between these two, pertains to amending the Canada Labour Code to establish 10 days of paid sick leave. This leave would be available each calendar year to employees in federally regulated private sectors who have been continuously employees for more than one month.

In fairness, perhaps on the surface these two policies under different acts may not appear to be connected. It is in fact my intention today to offer my support for the deep relevance between these two interconnected parts. I would argue that the deep despair and well-documented societal impacts of four consecutive waves of COVID, each with its own circumstances of social isolation and economic hardships, are ultimately due to all levels of government's failure to adequately respond to the scale and the scope of this pandemic.

The utter fear, uncertainty and doubt experienced by segments of our population have made them especially susceptible to this anti-science, anti-government and, by extension, anti-health care movement, from which come many of the targeted and vile attacks we are now legislatively responding to.

Since the beginning of the pandemic, health care workers have faced a high risk of infection and violence. In fact, since long before the pandemic health care professionals are four times more likely to experience violence in the workplace than other professions. Unfortunately, many of these acts of violence go unreported. According to the Canadian Federation of Nurses Unions, in 2019 61% of nurses reported experiencing violence, harassment and assault on the job, and because women make up a significant portion of the health care workforce, they are disproportionately victimized by these acts of violence.

To discourage these acts of violence, the Canadian Federation of Nurses Unions has recommended amending the Criminal Code, which is what is before us today, so I commend them on their long-standing work. This request was also the subject of a 2019 health committee recommendation. Specifically, the committee recommended amending the Criminal Code to require that it be considered an aggravating factor in sentencing if the victim of assault is a health care worker. This recommendation was based upon the NDP's bill, Bill C-434, introduced by my dear friend and NDP caucus colleague, the hon. member for Vancouver Kingsway.

As it pertains to putting the 10-day paid sick leave issue into context, people should never have to choose between their income and their health. Since the beginning of this pandemic, the NDP caucus has been demanding that the Liberals provide workers with 10 days of paid sick leave.

After winning an initial concession on this leave by offering it to people with COVID-19, we succeeded in forcing the Liberals to offer two weeks of federally funded leave through the CRB sickness benefit. The New Democrats not only support 10 paid sick days, we led the calls for it in the House. My hon. colleague for Rosemont—La Petite-Patrie fought hard at committee, where he tabled four amendments, two that were unanimously supported and two that were rejected.

I feel it important to note on the record today that the NDP fought for amendments that were accepted unanimously. One is that an employer cannot request a doctor's certificate for less than five consecutive sick days. This is major because stakeholders say that asking for a doctor's certificate is a barrier to its use and people would rather go to work than chase an appointment. Plus we know that it clogs up the health care system when it does not need to.

The second amendment that passed due to the hon. member is after 30 days of employment, the employee gets one day of sick leave. In the original version of the law, it was at the beginning of each month, which would have meant that someone hired on January 1 would have to wait until March 1 for their first accrued day.

Both amendments were intended to make sick days more accessible and the NDP forced the issue to make the program more accessible to workers and more responsive to their needs. This is a victory. The five consecutive days before the employer has the option to request a doctor's certificate will make a significant difference.

We did, however, have two other amendments that failed. The first amendment opposed by the Liberals was that all employees, upon hiring, would have access to four paid sick days. They would accumulate another six, one per month, as proposed in the bill, of up to 10 per year. Having four days right from the start is very important because stakeholders tell us that very rarely do people take a day off work and an illness often requires a few days off.

The minister, in his testimony yesterday morning, said that he was open to such an amendment, speaking of the urgency of the current omicron context. By voting against the amendment, the Liberals have refused to speed up access to paid sick days in the midst of another pandemic winter. Workers will continue to go to work sick since they will not have access to enough days to isolate themselves at home until next November at the earliest. This is irresponsible.

The second amendment that the Liberals opposed was that all employees with two or more years of seniority would get 10 sick days when the law came into effect. This would have provided access to the full strength of the program immediately for the majority of employees under federal jurisdiction. Since this amendment was rejected, all employees will begin accrual as if they were newly hired. I suggest that this is precisely because of these types of gaps in our social safety nets that we ultimately remain in this mess of targeted attacks on our hospitals and health care workers.

Last week, I called on the hon. member on the Conservative side to join our calls for more advances and protections. We have the opportunity to take a first step in the right direction in the House today as an informal form of sectoral bargaining for workers. We know this is going to be a vital protection.

This past election allowed me to speak to my constituents on their doorsteps. It is heartbreaking to feel as though people who I know to be rational, family members and classmates who I grew up with, neighbours I have known to be caring and compassionate, have been manipulated by the rhetoric of right-wing populism, grifters and agitators who would seek to turn this profound moment of suffering into some sort of personal sales pitch or nationwide tour targeting our frontline health care workers fighting the onslaught of successive waves of COVID.

For those caught up in this fear and confusion, I offer to endeavour to work harder as a member of Parliament to ensure that their basic needs are met and the most current evidence-based information is communicated without political interference or manipulation.

I call on the members of the House, who have rightly identified the divisions in our country, to recognize its root cause. It is the failure of all levels of government to adequately take care of the basic needs of all people, not just throughout COVID but in the decades preceding it.

I will close with the simple reassertion that these three parts of Bill C-3 are the cause and the effect of the social isolation, political estrangement and economic isolation felt by everyday people and, most unfortunate, targeted at our frontline health care workers. In taking better care of them, we will take better care of each other.