Madam Speaker, I rise today to speak to Bill C-210, an act to amend the Canada Revenue Agency Act, which would enable the CRA to use tax returns to collect the information required for establishing and maintaining an organ and tissue donor registry in the province. The second part of the bill would allow the CRA to disclose this information to Quebec and the provinces and territories with which it has entered into an agreement.
Today I will talk about three different points connected to this bill.
First, I will talk about our party's position on this matter. Second, I will read some excerpts of articles and will share some cases that describe the state of organ donation in Quebec, Canada and the world. Third, I will talk a little about how the pandemic has made organ donation difficult.
I want to start by saying that the Bloc Québécois supports this bill, which should have absolutely no impact on Quebec. We also want Quebec to manage a single tax return. Even if that does not happen, Quebec will have to get all of the information required from its own tax returns. Allow me to explain. The Bloc Québécois has no problem with this bill, but Quebec is unlikely to sign an agreement with the Canada Revenue Agency, since Quebec already has its own tax return.
What the Bloc Québécois wants instead is a single tax return handled by Quebec, which means that this bill would not affect Quebec at all. Even if Quebec wanted an agreement, we would have no problem with sharing this information. Quebec is free to sign an agreement or not. This bill does not commit Quebec to anything or limit it in any way. It lets the CRA collect information if there is an agreement with participating provinces, and sharing that information with the provinces is not a problem. It actually makes sense because the CRA handles all the tax returns outside Quebec.
Now I would like to show how Nova Scotia recently legislated to reverse consent for organ donation. Nova Scotians are now deemed to be consenting unless they state otherwise. Quebec is just getting started on a debate to do the same as Nova Scotia. I had a chance to sit in on a passionate debate on the subject. Right now, Quebeckers have to indicate on their health card whether they want to donate their organs when they die. Quebec has all the information it needs to improve the situation.
According to experts, increasing the supply of organs would be very helpful, but we need more doctors who specialize in organ and tissue retrieval and transplants. This brings us back to the subject of the debate raised in the motion moved by the Bloc Québécois here today, that is, the importance of increasing health transfers. It is only logical. Without additional funding, it would be difficult for Quebec and the provinces to have these medical specialists.
As Raôul Duguay said, everything is in everything.
In addition, the number of potential donors is relatively limited, which further complicates things.
Second, I will share some statistics drawn from current events that illustrate some of the problems that exist in organ donation in Canada.
There is not enough supply to meet the demand. Even though the number of transplants has increased by 33% over the past 10 years, there is still a shortage of organs in Canada, according to the latest data published by the Canadian Institute for Health Information. In 2008, 4,351 Canadians were on a transplant waiting list according to CIHI figures. In the same year, 2,782 organ transplants were performed in Canada, while 223 people died while waiting for transplants.
The increased need for organ transplantation is in part being driven by the rising number of Canadians diagnosed with end-stage kidney disease, which went up 32% over the 10 years studied. According to Greg Webster, CIHI's director of acute and ambulatory care information services, improved organ donation practices across Canada have resulted in a 33% increase in transplant procedures over the last decade.
For most organs, patient survival is greater than 80% after five years.
One of the reasons for the increased number of transplants is that many countries have expanded deceased organ donation practice beyond brain death cases to include donation after cardiac death, meaning the heart has permanently stopped beating. This has led to an increase of almost 430% in the number of donation after cardiac death organs used for transplantation, from 42 in 2009 to 222 in 2018.
According to Dr. Gill, transplant nephrologist and associate professor of medicine at the University of British Columbia, with the increase in donation after cardiac death, there has been a substantial increase in the number of organ donors in Canada, and this has shortened wait times, particularly for those waiting for kidney or lung transplants.
The number of donors after brain death also increased by 21% between 2009 and 2018. That is an encouraging trend given that a deceased donor can provide up to eight organs.
Data published by CIHI also reveal that there were 555 living donors in Canada in 2018. These are people who donated a kidney or a lobe of liver. There were also 762 deceased donors in Canada. The number of deceased donors increased by 56% between 2009 and 2018, whereas the number of living donors remained stable.
Nova Scotia's decision to adopt presumed consent for organ donation has pushed several provinces to ask themselves the question. Is this the best way to increase the number of donors? Survivors and family members believe it is, but for some experts the solution is not that simple. As we heard earlier, we need more specialists.
I will talk about a few cases. Four years ago, Sammy, a young boy from Montreal, was diagnosed with Kawasaki syndrome, a childhood illness that leads to heart complications. He has been living with a new heart for three years. He is in good health. At age 11, Sammy is on the short list of patients who have benefited from organ donation.
Linda Paradis's life was turned upside down at age 60, two years ago, when her lungs started to deteriorate. This active businesswoman fit as from Quebec suddenly ended up with a few weeks to live, a few weeks away from death's door. She ended up getting a double lung transplant. Of course for her, automatic consent does not hurt. It also takes doctors who are able to perform the operation.
Nova Scotia adopting legislation that assumes all citizens are organ donors has given the rest of the country something to think about. The Premier of Nova Scotia, Stephen McNeil, hopes that his initiative will snowball, but for now, nothing is certain. New Brunswick is looking at the idea closely. The governments of Quebec and British Columbia are saying that they will be monitoring what happens in Nova Scotia, and Ontario says it is happy with its system.
Some European countries like France and Spain adopted presumed consent several years ago. At this time, the data do not show a clear correlation between presumed consent and an increase in the number of donors. Marie-Chantal Fortin, a nephrologist and bioethicist at CHUM, said that it is a simple solution to a complex problem. She pointed out that countries with presumed consent like Spain have excellent organ donation rates, yet the United States, which does not have presumed consent, also has a high organ donation rate.
What experts do agree on is that we need better training for medical teams and, above all, people have to talk about organ donation with their friends and family. I mentioned training for medical teams. This brings us back to the debate on increasing health transfers.
The pandemic exacerbated the problems related to organ donation. According to an article published in July 2020, the organ donation rate is the lowest it has been in five years because of COVID-19. That is what Transplant Québec warned. The provincial organization responsible for organ management counted only two people who donated organs to save five patients in April 2020, while the number of donors was already low. According to a press release from Transplant Québec, executive director Louis Beaulieu said, “The slowdown that occurred in April was mainly due to the exceptional circumstances we found ourselves in. The need to ensure the safety of transplant recipients and the massive reorganization that occurred in hospitals contributed to this situation.”
Despite the resumption of activities in May, Transplant Québec noticed a 50% drop in the number of organ donors and a 60% drop in transplants for the second quarter of 2020 compared to the same period in 2019.
In closing, I hope that we can come up with better solutions in this debate so that we can save lives without feeling uncomfortable talking about the signature on the back of the card. I would like to read a rather interesting testimonial from the oldest organ donor in Quebec. He said, “Just because I'm 92 years old, that doesn't mean that I can't donate an organ.” He gave part of his liver, and the recipient is doing well. As for Quebec's youngest organ donor, it is a much more tragic story. He lived only 48 hours, but he was able to donate his heart. Let's give from our hearts and sign the card.