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

This bill was previously introduced in the 43rd Parliament, 1st Session.

Sponsor

Len Webber  Conservative

Introduced as a private member’s bill.

Status

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

Summary

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

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.

Elsewhere

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

Votes

May 12, 2021 Passed 3rd reading and adoption of Bill C-210, An Act to amend the Canada Revenue Agency Act (organ and tissue donors)

Canada Revenue Agency ActPrivate Members' Business

May 7th, 2021 / 1:30 p.m.
See context

Bloc

Andréanne Larouche Bloc Shefford, QC

Mr. Speaker, I rise today to speak to Bill C-210 at third reading. I have already spoken to this bill in the past, last November.

This bill seeks to amend the Canada Revenue Agency Act to allow the CRA to enter into agreements with the provinces and territories to collect, via income tax returns, any information that Quebec and the provinces require to establish or maintain an organ donor registry. The second part of the bill would allow the CRA to disclose this information to the provinces and territories with which it has entered into an agreement.

I will discuss three different aspects of this bill. First, I will lay out our party's position on this matter. Then I will describe the state of organ donation in Quebec, Canada and the world, and share some examples of cases. Finally, I will talk a little about the ongoing difficulties caused by the pandemic for organ donation.

I will start by stating the Bloc Québécois's position even though this bill will not affect Quebec at all. Let me explain. We still want Quebec to administer its own single tax return. That is no secret. Even though we have not yet made that happen, Quebec can get all the information it needs to have its own income tax return. The Bloc Québécois therefore has no problem with this bill, but Quebec is unlikely to want to enter into an agreement with the Canada Revenue Agency because Quebec, as I said, already has its own tax return.

Let me reiterate that what the Bloc Québécois wants is to implement a single tax return—I am giving a shout-out to my colleague from Joliette—that is administered by Quebec, which means that this bill would not affect Quebec at all. Even if Quebec wanted to enter into an agreement, we would have no problem with the idea of sharing this information. Quebec is free to enter into an agreement or not. This bill does not commit Quebec to anything or limit it in any way. Allowing the Canada Revenue Agency to collect information as part of an agreement with a participating province 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.

I will give a few examples where that has already been put in place in Canada. Nova Scotia recently passed a law to reverse consent for organ donation. Nova Scotians are now deemed to be consenting unless they state otherwise. Nova Scotia's decision to adopt this policy of presumed consent to organ donation has pushed some provinces to consider whether that is the best solution to increase the number of donors. Survivors and loved ones think that it is, but the answer is not that simple for some experts.

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. While New Brunswick is looking at the idea closely, the governments of Quebec and British Columbia will be closely 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 similarly high organ donation rate.

What experts do agree on is that better training is needed for medical teams and, above all, people need to talk about organ donation with their friends and family. This is yet another argument for improving funding for the health care system.

This debate is gaining momentum in Quebec. I once had the opportunity to witness a heated debate on this topic at a policy convention. Quebeckers are supposed to indicate on their health card whether they consent to organ donation in the event of death. 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 that the Bloc Québécois is still advocating for, which is the importance of increasing health transfers to Quebec and the provinces. It is only logical. Without additional funding, it would be difficult for Quebec and the provinces to have these medical specialists. The federal government had a chance to increase these transfers in the latest budget, but all we heard was radio silence.

In addition, the number of potential donors is relatively limited, which further complicates things. Statistics drawn from current events speak for themselves. 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, or CIHI.

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, and 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. One of the reasons for the increased number of transplants is that many countries have expanded deceased organ donation practices 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. 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.

I will now talk about a few cases. I was recently very touched by the testimony of a mother who spoke about her son, Justin Lefebvre, who drowned at a party. He unfortunately died far too young. As we can read on the website, Justin, who was eight years old, became a superhero because, by donating his organs, he saved the lives of four children and helped them regain their health. One of his friends and his family had the idea of creating a foundation to honour his memory, but especially to promote organ donation, increase awareness and raise money for research. I therefore invite members to visit the Fondation Justin Lefebvre website to find out more about this touching story. His mother also wrote a book about his story, which I recommend reading.

I also already talked about Sammy, a young boy from Montreal who was diagnosed four years ago with Kawasaki syndrome, a childhood illness that leads to heart complications. He has been living with a new heart for three years now. He is in good health and obviously believes in mandatory organ donation.

Linda Paradis's life was turned upside down at age 60, more than two years ago, when her lungs started to deteriorate. This active businesswoman from Quebec suddenly learned she had a few weeks to live. She ended up getting a double lung transplant. She believes in presumed consent, but knows that no doctor can remove organs without the family's consent.

I would like to add that the pandemic has exacerbated problems with 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. 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. Despite the resumption of activities in April, 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 invite people to visit the Facebook page “Le Don d'organes parlons-en, parlez-en”. Beyond just talking about it, however, I would suggest that we do something about it.

Canada Revenue Agency ActPrivate Members' Business

May 7th, 2021 / 1:40 p.m.
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NDP

Gord Johns NDP Courtenay—Alberni, BC

Mr. Speaker, it is a huge honour to rise today to speak to Bill C-210.

I want to start by sharing a story with my colleagues in the House of a fellow Vancouver Islander, Paul Underhill. Paul lives with cystic fibrosis. This past April he completed a five kilometre run and a five kilometre walk to commemorate the double lung transplant he received 10 years ago.

Paul was raising awareness for BC Transplant who say that there are more than 700 people currently on a wait-list for an organ transplant in British Columbia. Around 5,500 British Columbians are alive today because of organ donation. In the past year alone, 451 lives were saved because of organ donors.

Paul stated:

I want people to realize how much of an impact it can have. Just two minutes out of your life to register and you can literally save a life.

Inspired by Paul and the stories of others, some not so fortunate, I am honoured to rise today to speak to this bill. The bill was tabled by my good friend from Calgary Confederation, who has been determined on this bill. In the last Parliament, he tabled Bill C-316, which I was honoured to be a seconder of, and also worked with my Liberal colleague from Oakville North—Burlington on this bill. This bill should not be a partisan issue. When it comes to saving lives, lives that could be saved through the help of others, we should be working collectively together. Again, I want to thank my good friend from Calgary Confederation for his determination to see this through.

Bill C-210 allows the federal government to coordinate with provinces and territories to allow Canadians to register as an organ and tissue donor through their federal tax filing. We know Canadians are currently dying, as I stated, on wait-lists because our organ donation rate is unacceptably low. At present, only 20% of Canadians have joined their province's organ and tissue registry. This is unacceptable.

At the end of 2018, the most recent year of available data, there were 4,351 people across Canada on a waiting list for an organ transplant, including 2,890 who were active on that list. In total, 223 people died while waiting for a transplant. In order to meet this demand, improved coordination across provinces and territories is critically needed.

As New Democrats, we believe that we must make every possible effort to ensure that every Canadian who needs an organ or tissue transplant receives it. One donor could save up to eight lives and benefit more than 75 people, and yet at 18 donors per million people, Canada's current donation rate puts us in the lower third of developed countries.

Allowing Canadians to register as an organ and tissue donor through their tax returns would help increase registration rates, improve consent rates and help build a donation culture in Canada.

As New Democrats, we support the adoption of presumed consent or an opt-out system for organ and tissue donation. We understand that such an approach would make a huge difference in the number of organs available to save lives.

One potential concern that has been raised in association with the bill is the unauthorized sharing of personal information. However, individuals would still be required to consent to the sharing of that information before the agency would share that information with other levels of government for the purpose of being added to an organ and tissue donor registry. That is covered.

In the previous Parliament, the Standing Committee on Health undertook a study on organ donation in Canada. It met with key stakeholders. This bill aligns with long-standing advocacy and legislative work of New Democrats around organ donation. In February 2016, the MP for Edmonton Manning, whose own son has been the recipient of three donated livers, reintroduced a private member's bill calling for a national registry. Similar bills had previously been introduced seven times, by a Liberal and two New Democrats. Lou Sekora tabled it. New Democrat Judy Wasylycia-Leis tabled it. Another New Democrat, Malcolm Allen, in 2009 and again in 2013 tabled it.

Unfortunately, in the last Parliament, the Liberal caucus voted to defeat the member for Edmonton Manning's bill. This bill aligns with long-standing advocacy and legislative work, as I have cited, of New Democrats around organ donation. The bill is essentially a critical piece to creating a pan-Canadian organ donor registry, and it needs to be pushed forward.

The previous bill, Bill C-316, which passed in the House of Commons, went to the upper house where it stalled and died in the past Parliament. It is shameful that people's lives are being lost because of politics.

The Liberals, again, previously killed the pan-Canadian registry without studying it. The push for a rapid implementation of a pan-Canadian data and performance system for organ donation needs to be moved quickly, and we are offering our non-partisan support for this sensible proposal.

The Liberals saw this pass, it went to the Senate and they had ample time to implement the contents of the bill that could have saved lives. I urge the government for quick passage and for all members of Parliament to support the bill and get it to the upper house. I urge the upper house to pass this and give it royal assent quickly, because people's lives are at stake and the sense of urgency could not be greater.

I want to talk, more important, about some stories, but I will get to that in a second.

As New Democrats, we have consistently advocated for the adoption of a presumed consent or opt-out system for organ donation. It is an approach that would make a huge difference in the number of organs available to save lives. Unlike our current opt-in system, an opt-out approach would automatically register all citizens for organ donation unless they chose to indicate otherwise.

I will speak a bit about countries with opt-out systems that consistently record higher donation rates than opt-in countries like ours. Indeed, this approach has helped to make Spain a world leader in organ donation, which the previous speaker just spoke about, over the last 25 years. In Austria, the donor rate quadrupled after instituting opt-out legislation, and similar regulations in Belgium doubled kidney donations. The most important success of this system has been that it has led to organ donation being routinely considered when a patient dies, regardless of the circumstances of death.

I have heard from many people, stories of Canadians who have donated organs, and they inspire me.

Meghan Walker, a good friend of mine from Parksville, reached out to me last night to share her story. She donated her liver to her best friend, Michelle, saving her life. Michelle has two young children. She had one before the transplant and one since the transplant. She has a loving family, and that organ donation kept her alive. It saved her life.

Lorelie Rozzano from Nanaimo recently shared a story with me through my childhood friend, Bonnie Bartlett. It is about her daughter, Shannon McIntosh, who received a transplant. She told me this story, which I will share. She said, “I'll never forget hearing my daughter needed a liver transplant and that she only had a few months to live. I watched my daughter waste away as she fought to hold on. Then came the call. It was bittersweet. What brought us hope brought sorrow to another family.” This is too often the case.

She went on to say, ”On February 1, 2021, Shannon got her new liver. One day later, she was standing. A week later, she was walking around the hospital floor. Four weeks later, she was walking around the block. Eight weeks later, she was walking ten thousand steps at a time. Now I can barely keep up with her. Through the process, Shannon learned her donor was a young person. She cried when she heard that. There are no words big enough to describe our gratitude to the donor's family. I hope to meet them one day and to say thank you in person. Their decision to be an organ donor gave our family the most precious gift of all, the gift of life.”

Shannon, Michelle and Paul would not be here without donors, without the people who had the goodwill to put their names on these lists. Many others overlook that, but would like to be donors. We need to fast-track this legislation, because we know thousands of people are not as lucky as Shannon, Michelle and Paul. This is an opportunity for us to stand united.

Again, I want to thank my friend from Calgary Confederation for using his slot in the draw, he was first this time for parliamentarians, and for his determination to see this through. Let us get behind him, let us get behind all those people on those waiting lists and let us save some lives and work together.

Canada Revenue Agency ActPrivate Members' Business

May 7th, 2021 / 1:50 p.m.
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Conservative

Terry Dowdall Conservative Simcoe—Grey, ON

Mr. Speaker, it is an honour and a great pleasure to rise today in this chamber to speak to Bill C-210, An Act to amend the Canada Revenue Agency Act, organ and tissue donors.

This is a common-sense, non-partisan piece of legislation that should be supported by every single member of this House. I want to congratulate my friend, the hon. member for Calgary Confederation, for this great initiative.

Most Canadians would agree that donating their organs is an important thing to do. We all know that it can save lives. In fact, it is estimated that organ donation by one person can save up to eight lives. A single tissue donor can improve the lives of up to 75 people. Something that many people do not know is that there are three ways that they can donate here in Canada. The first is after neurological determination of death, what is commonly called brain-dead. The second is after circulatory death, or when someone's heart stops. Let us not forget the third one, which is living organ donors where someone can give away certain organs or parts of their organs while still alive. Living donors often give part of their liver, pancreas, intestine or a lobe of their lung to a family member in need, but it does not have to be a family member; living donors can donate to anyone in need.

While we often use the term organ donation, I want to make it clear that we are also including tissues and that tissues are also critical to improve the lives of others. In fact, tissue donation is often more commonplace. People may be surprised to learn that skin can be donated as well; so can tendons and even eyes. A donated heart valve can save a life. One can also be a living donor and donate tissues. Bone marrow is a common procedure that many of us are aware of and so is the most common tissue that we all donate, which would be blood.

To give everyone a sense of what impact the donation of one person's organs can make, let us look at the tragic case of Logan Boulet. Logan, who died on April 7, 2018, in the aftermath of the tragic Humboldt Broncos bus crash, was an organ donor. Six other people were able to have their lives saved through his organs. Our annual Green Shirt Day was created to honour, remember and recognize all the victims and families of that fatal crash and to continue Logan's legacy by inspiring Canadians to talk to their families and register as organ donors.

I have always figured that, if we ask them, most people would indicate an interest in donating an organ, but I also figured that the majority of them would not, for various different reasons. When preparing to give this speech, I learned the actual numbers. The difference between those who support organ donation and those who are organ donors is even more stark than I expected. Ninety per cent of Canadians approve of organ and tissue donation, but only 20% are actually registered as organ donors. That is an astounding 70% gap, which needs to be addressed. Only about 21 in a million Canadians actually become an organ donor. Spain has the highest organ donation rate. It is twice that of Canada, at 43.4 people per million. That still seems like a low number, but those extra numbers do save lives.

Every day in this country, close to 5,000 of our fellow Canadians desperately need an organ transplant. Hundreds of them die waiting for that transplant. What is the problem? Why are so many people who indicate an interest not registered to donate their organs? There are a number of factors, each of which is addressed by this excellent bill.

The organ donation network in this country is managed by each province and territory. Each one has a different system to encourage people to sign up as an organ donor. Some are more successful than others, but all are based on the opt-in premise and usually related to their driver's licence or their health care card. For those of us who have signed up as organ donors, it would appear to be a successful system, but that certainly would not be accurate. As I outlined earlier, using the existing opt-in method has given Canada one of the poorest organ donor rates in the industrialized world. In fact, compared to our peers, Canada comes in at number 19 globally. I know we can all do better.

When we talk to people in the field, they say it is always education that matters. Simply put, there is not enough awareness about how to become an organ donor. We need more people to know about it, but we also need to make it easier. It is not simple and it sure is not straightforward.

People have to sort through a lot of paperwork, and it is often the last thing people think of when getting their health care card or driver’s licence. In today’s busy click-based world, we need to make it as easy and straightforward as possible for everyone to do. We need to make sure it is right there in people’s faces so that saying yes to saving a life is just as easy as checking a box.

Also problematic, especially for those needing organ donations, is the declining rate of young people who have actually passed their driving test and received their driver’s licence in provinces where being an organ donor is linked to driver’s licences. Members may be surprised to learn that only 69% of 19-year-olds have a driver’s licence today. This is a 20% drop from the previous generation and a full 31% of our youth who could not agree to become organ donors even if they wanted to in some of those provinces.

Even more surprising is when we look at today’s 16-year-olds. We see an incredible 47% decline in licensed 16-year-old drivers today versus a generation ago. I would argue that if we broke these numbers down further, the numbers would be even lower for youth living in our major cities, where urban transit, biking and more walkable neighbourhoods further depress the need for a driver’s licence. That is a very low number of potential organ donors for the future, especially in major cities.

In short, if we are relying on driver’s licences to recruit the youth of today to be tomorrow’s organ donors, we are already facing an uphill battle. Using health cards may be more effective, but neither is as effective as it could be. We know that we can do better.

The member for Calgary Confederation has proposed a way to make organ donations easier for everyone. It is a way that will ensure that our youth are more likely to be included. It also makes doing something that we all find painful, which is taxes, a little more worthwhile. Bill C-210 would allow people to sign up to be an organ donor while completing their tax return. Put another way, doing taxes may help someone save a life. It takes a little sting out of doing taxes, does it not?

I think we can all agree that most Canadians know that they can register to be on the voters list when doing their taxes. In fact, I would estimate that is how most of us do it already. If passed, Bill C-210 would have a section added right there on page one of the tax form alongside the section from Elections Canada. If a Canadian agrees to be an organ donor, then their information will be provided to their respective province or territory. It is that simple. Even members of the House of Commons would be able to help promote it, as our staff would be able to highlight this section whenever our offices are put on clinics to help our constituents with their taxes.

For whatever reason, there will never be a 100% organ donation rate. I know that this simple and straightforward change would increase our dismal number and that it would save lives. The most surprising thing about the bill is that it actually needs to be done at all. It is such a practical solution that one would assume this is the way it always has been done, even though it is not.

My colleague from Calgary Confederation came close in the last Parliament to making it reality. This bill could be passed quickly and unanimously through all stages in the House. It is my hope that in this same spirit, it continues to move quickly through this Parliament again. There are thousands of Canadians and their families counting on us to do the right thing. I want to thank the member for Calgary Confederation for introducing this excellent piece of legislation.

My father passed away during the election process. I had to drive to see him with my sister. He was 80 years old. He unfortunately had not filled that out. He had a brain aneurysm. They asked whether he would want to donate his organs and my sister and I knew my father would want to do that if given the opportunity. We did sign off on that, but I think if it was simpler, my father would have made that decision ahead of time and it would not have been something that we had to do.

I thank my friend, the member for Calgary Confederation, for this bill. I urge all members to push this through as quickly as possible.

Canada Revenue Agency ActPrivate Members' Business

May 7th, 2021 / 2 p.m.
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Sackville—Preston—Chezzetcook Nova Scotia

Liberal

Darrell Samson LiberalParliamentary Secretary to the Minister of Veterans Affairs and Associate Minister of National Defence

Mr. Speaker, I am also very pleased to speak to the importance of creating and maintaining an organ and tissue donor registry for every province and territory in Canada.

There are currently far too few Canadians on the list of organ and tissue donors, and that needs to be remedied. The Government of Canada is firmly committed to improving the organ and tissue donation and transplantation system in Canada for Canadians to have quicker and more efficient access to this care.

I have to thank the member for Calgary Confederation for bringing attention back to the issue of organ and tissue donation by introducing Bill C-210, an act to amend the Canada Revenue Agency Act with regard to organ and tissue donors. Making this change to the Canada Revenue Agency Act will certainly benefit Canadians by considerably increasing the number of potential donors in Canada.

The Government of Canada will support Bill C-210.

The Government of Canada recognizes the value of organ and tissue donation and transplantation. It also recognizes the important role it has to play in protecting the health and safety of Canadians, and has made several investments to date to support this goal. For example, since 2018 Health Canada has been leading the organ donation and transplantation collaborative. In addition to Health Canada's professionals, this collaborative engages with the provinces and territories, patient and family groups, representatives, researchers, clinical organ and tissue donation organizations and Canadian Blood Services.

I want to note that Canadian Blood Services, a not-for-profit charitable organization funded by the Government of Canada, manages the national waiting list and interprovincial organ-sharing registry. Part of the collaborative's mission is to improve the efficiency of the donation and transplant system in Canada. I can assure members that, in partnership with the Government of Canada, it is working hard to establish leading practices, strengthen professional education and raise public awareness to improve organ tissue donations in Canada.

Second, as a reminder of the Government of Canada's commitment to organ and tissue donation and transplantation, I would like to mention the investments made in budget 2019.

Our government allocated $36.5 million over five years starting in 2019-20 and $5 million a year after that to Health Canada. This money is earmarked to develop a pan-Canadian data and performance system for organ donation and transplantation. Improving consistency and quality in data and allowing more donors and recipients to be effectively matched are priority objectives of this investment.

The Government of Canada is investing these significant amounts to help Canadians move to a more coordinated and effective approach to organ and tissue donation and transplantation. Bill C-210 would do this through the addition of subsections 63.1(1) and (2). I firmly believe that we will be taking another step towards increasing the number of donors on the waiting list in Canada.

Currently, each province and territory in Canada is responsible for creating and maintaining its own organ and tissue donor registry. Each province and territory is also responsible for obtaining informed consent from every enrolled donor. The legal requirements for donor suitability and informed consent, which fall under provincial and territorial jurisdiction, are complex and vary widely across Canada.

For this reason, the amendment to Bill C-210 would allow the CRA to work in partnership with each jurisdiction to reach an agreement under the modification of paragraphs 63.1(1) and (2). In implementing some of the amendments in Bill C-210, the CRA would continue to respect the important role of the provinces and territories in organ and tissue donation, as well as to ensure the personal information of Canadians is handled in a secure manner.

The Government of Canada has full confidence in the CRA's ability to negotiate these agreements and to prioritize the safekeeping of Canadians' personal information. Ultimately, this initiative would advance the partnerships with provinces and territories that are essential to making real, positive changes for Canadians in organ and tissue donation.

That said, I should point out that the member for Vaughan—Woodbridge proposed a much simpler, faster and more direct method that would have achieved the same result.

Rather than having the Canada Revenue Agency directly collect donor consent on behalf of the provinces and territories, which would involve long negotiations because each province and territory has different eligibility criteria, the member for Vaughan—Woodbridge proposed asking Canadian taxpayers whether they would like to receive information about organ and tissue donation in their province or territory so they could decide whether to register to be added to the donor list.

The CRA would then confidentially provide the names of these potential donors to the provinces and territories in question, which would then send documentation to these potential donors and get the appropriate registration process started.

For this reason, the amendment proposed by the member for Vaughan—Woodbridge would have deleted the reference of proposed subsections 63.1(1) and 63.1(2) in the current bill, which refer to the income tax returns filed under paragraph 150(1)(d) of the Income Tax Act.

This method was inspired by the approach taken by the Government of Ontario, which includes a separate page in the Ontario taxpayers' income tax return for provincial benefits. Once the CRA has processed an Ontario tax return, this benefit information is forwarded to the Ontario government, which processes the benefit using its own system and methodology.

While I regret that the amendments proposed by my colleague from Vaughan—Woodbridge were not adopted, the government and I will nevertheless continue to support this bill.

In conclusion, there are far too few organ and tissue donors on waiting lists in Canada. However, by working together at the national level, we can improve the organ and tissue donation and transplantation system to ensure that Canadians have timely and effective access to care. Furthermore, if this bill is passed, which we hope it is, the government sincerely believes that the Canada Revenue Agency can play a significant role in this process.

Canada Revenue Agency ActPrivate Members' Business

May 7th, 2021 / 2:10 p.m.
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Conservative

Doug Shipley Conservative Barrie—Springwater—Oro-Medonte, ON

Mr. Speaker, I am happy to be here today with my colleagues to speak to Bill C-210, an act to amend the Canada Revenue Agency Act (organ and tissue donors), which was tabled by my colleague and friend from Calgary Confederation. It is important to note that this critical legislation was tabled in the House in the previous session, passing the House, but dying on the Order Paper in the Senate when Parliament dissolved for the last election. When the hon. member for Calgary Confederation tabled the bill, it was seconded by members from all parties and supported by numerous transplant organizations and doctors.

Currently, 4,600 Canadian are awaiting a life-saving organ transplant. Polls have shown that 90% of Canadians approve of organ and tissue donation, but the reality is about only 25% of Canadians have registered their consent with the province or territorial registry where they live. This creates numerous issues that I will address shortly, but Bill C-210 is simple. The legislation asks Canadians when filing their taxes if they consent to having the provincial or territorial government informed of their desire to be added to the organ and tissue donor registry in the province or territory.

One hurdle to this is that currently the Canada Revenue Agency forbids the use of the income tax form for any purpose other than tax administration. For this simple change to be implemented, asking a simple question regarding organ and tissue donation, a legal exemption needs to be created. This has been done before to allow Elections Canada to ask Canadians for updated contact information, so it is not out of context.

Making a simple line addition to the tax form would have little to no cost implications and it would not infringe on any provincial jurisdictional concerns or create any privacy concerns. The legislation would allow for the use of established protocols for information sharing between the federal government and provinces as they currently use an encrypted method to share sensitive information. Another reason that this simple addition to the tax form makes sense is that we see the current voluntary method of registering is not proactive or effective.

Another unfortunate complicating factor with donation, particularly when someone passes away, is a grey area that exists for hospitals and families. Sometimes there is confusion between family and what exactly the wishes of the deceased are with respect to organ and tissue donation.

In the Standing Committee on Health report on organ donation in Canada, Dr. Levy, vice-president of Medical Affairs and Innovation at Canadian Blood Services, says, “it behooves us not to miss the opportunity...to use that donation of an organ or set of organs.”

In 2016, 260 Canadians died while waiting for a transplant. While Canada has seen an uptake in living and deceased organ donations, Canada ranks among the top 20% of countries in the world when it comes to deceased donor rates. It was also noted that those rates were half the rate of some other high-performing countries in the world, for example, Spain.

Dr. Levy noted to the committee “Our living donation rate, on the other hand, compares quite favourably internationally...Canada ranked 14th internationally for living donors in 2016”, even with the rates declining or staying stagnant. We can do better; we need to do better. If we do not make changes now, the issue is only going to get worse.

Currently, donation rates are not meeting the needs of patients' needs. There is a fragmented approach across the country with respect to donation programs and some areas are considered the gold standard while others are facing challenges. It is incumbent upon us in the House to ensure that provinces have the tools to deliver for those in need. Supporting the private member's bill of my colleague from Calgary Confederation is the smartest and most effective way of doing that right now.

Several issues with respect to organ donation in Canada were highlighted to the committee in testimony. Some gaps in the systems and reporting and classification of the need and type of donation needed are a couple.

A couple of things jumped out to me as I was researching for this topic. The total annual costs of dialysis range from $56,000 to $107,000 per patient, where the cost of a transplant is about $65,000 in year one and $23,000 in subsequent years. It is estimated the health care system would save up to $84,000 per patient per transplant annually.

The National Transplant Research Program explained to the committee that organ transplantation was not only a treatment option for people facing organ failure, it was becoming the preferred treatment for ailments such as type I diabetes, kidney disease, cystic fibrosis, heart failure and congenital heart disease, lymphoma, myeloma and leukemia.

Giving the provinces the ability to obtain accurate and up-to-date information on donation intentions allows them to ensure their wait-lists are accurate. Knowing who intends to donate through a legally binding declaration would further address consistency for provinces when it comes to measuring and reporting those willing to donate so that they can better prepare. The member for Calgary Confederation's private member's bill would address all of these. This is not a political issue. As my colleague said in his original speech in the previous session, this is a human issue.

Anyone in this House, family or friends, could need donor organs or tissue at any time. Adding a simple line item to the tax form could save hundreds of lives. If we couple that with increased public education and awareness, we could see even more registrations. We saw in the fall of 2018, in the tragic accident with the Humboldt hockey team, that one of the victims, young Logan Boulet, had registered for a donation. That donation saved six lives, as Ms. Ronnie Gavsie, President and Chief Executive Officer, Trillium Gift of Life Network noted at committee when testifying.

The time has come for this legislation to pass this House and the Senate. My colleague from Calgary Confederation has spoken eloquently and dedicated his efforts to his friend, Robert Sallows. The legislation has received support from all parties in this House and stakeholders have been universally supportive of the bill. Families who have loved ones awaiting this are welcoming this legislation. It is now up to everyone in this House to make sure that we do not delay this much-needed legislation any further. We owe it to the hundreds of people who pass away every year on the wait-list. We owe it to the organizations on the front lines and we owe it to the provinces to give them the tools they need to adequately support and deliver their donation programs.

Canada Revenue Agency ActPrivate Members' Business

May 7th, 2021 / 2:15 p.m.
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Conservative

Len Webber Conservative Calgary Confederation, AB

Mr. Speaker, as you know very well because it was mentioned numerous times today, this bill got its second chance in this Parliament when my name was drawn first in the private member's bill lottery. It was you, Mr. Speaker, who drew my name out of a hat, so I owe you big time. I thank you sincerely.

This was first introduced in the last Parliament as Bill C-316 and it passed unanimously at all stages. Unfortunately, it died in the Senate when the 2019 election was called. Here we are today with Bill C-210. It also enjoyed the same unanimous support at all stages. Hopefully an election will not be called before the Senate has the opportunity to pass this into law, assuming it passes in the House next week.

There are so many people I need to thank, I do not even know where to begin. First and foremost is my assistant, Terence Scheltema. His help throughout this whole process has been immense and I cannot thank him enough. Of course, I also thank the member for Oakville North—Burlington, the member for Vancouver Kingsway and the member for Courtenay—Alberni, who kindly helped on my behalf to ensure unanimity and a quick passage.

I thank my colleagues on the health committee, who went above and beyond to ensure that the organ donation question would be on the front page of the income tax form. It was clearly identified at committee that they wanted this question on the front page of the income tax form, along with the Elections Canada question. I thank them sincerely for that. I thank the 20 members from all parties who seconded my bill and the ones who spoke on this bill throughout the entire process.

There are also some people behind the scenes who made this bill a reality and did some of the heavy lifting and careful navigation through this process. I need to thank procedural clerks Marie-France Renaud, Caroline Massicotte and Isabelle Dumas, and legislative counsel Nathalie Caron and Sylvie Bednar. As well, I want to thank three government staff, in particular, for their non-partisan assistance and co-operation: ministerial assistants Janick Cormier and Christina Lazarova, as well as parliamentary assistant Christopher Lalande.

As I have mentioned before in the House, my inspirations for this bill were Karen Korchinski and my late friend Robert Sallows. I pray the day will never come when Karen will need that liver transplant, but if it does, then perhaps the chances of her getting one will be that much better. Robert Sallows is a double lung transplant recipient who sadly passed away just before my Bill C-316 passed in the House in 2018. We need to get this bill passed so that we can finally tell Robert we finished the job for him. He fought so hard to help others also get a second chance at life. We need to finish this for him.

Finally, I want to thank the many Canadians who shared their personal stories with me along this journey. Some were tragic and some were remarkable, but all of them came from the heart. Let us not delay this any longer. Everything that needs to be said has been said. It is time to get Canada's organ and tissue procurement system on track and give hope to the thousands of Canadians awaiting transplants.

Canada Revenue Agency ActPrivate Members' Business

April 12th, 2021 / 11:05 a.m.
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Conservative

Len Webber Conservative Calgary Confederation, AB

moved that the bill be read the third time and passed.

Mr. Speaker, I am pleased to rise today to speak to my private member's bill, Bill C-210, at third reading. For those who may not be familiar with Bill C-2l0, it is a proposal that would allow Canadians to indicate their interest in being an organ and tissue donor through their annual tax forms. Right now the tax forms can only be used for the collection of taxes. The bill would create a legal exemption, just like that made to Elections Canada, to allow for its important question of organ donation to be added to the tax form.

The bill was unanimously supported at both second reading and at committee. The bill was also my bill, Bill C-316, in the last Parliament where it was also unanimously supported, however unfortunately, it died in the Senate. It did get a second decent life in this Parliament when I won the PMB lotto. I was picked as number one, so I resurrected the bill.

It is very timely that we are speaking about the bill today as April is Organ and Tissue Donation Awareness Month. It is also two weeks away from the tax filing deadline in Canada, so it is ironic to be speaking here today on this. If we have any hope of getting these changes to the tax form implemented in time for the next year, the 2021 tax year, we need to move the bill through both the House and the Senate before the summer. If we miss that deadline, the Canada Revenue Agency will not be able to implement the required changes for yet another year. We just cannot let that happen.

I want to convey my sincere thanks to all parties in the House for showing such strong support and offering genuine co-operation to move this proposal forward. Members' unanimous support and unwavering support at every stage has been heartwarming and shows we really can pull together for Canadians. I specifically want to thank all my colleagues from all parties on the health committee, both currently and in the past when I served on the health committee, who have been vocal, determined and dedicated supporters of the bill.

I also want to thank the government for the allocation of funding in the past fall economic statement to facilitate the implementation of this legislation. Governments do not often commit funding ahead of legislation passing, especially when it is for a private member's bill from an opposition member of Parliament. That funding is very much appreciated and it signifies a shared will to see the bill pass.

I want to bring out the matter that came up at committee. First of all, for this initiative to be most effective, the question on organ and tissue donation needs to be placed on the front page of the tax form. The committee members made this very clear to the CRA. In fact, they specifically voted down the idea of suggesting that the CRA had latitude to move it to some back page in oblivion. Parliament has spoken and it wants this on the front page along with the existing Elections Canada question.

I was pleased that individuals from the CRA have acknowledged that this is a priority of Parliament and committed to putting this on the front page. I implore the folks at the CRA to dig deep and push forward to make sure that we get this done as soon as possible. Their work will have life-changing consequences.

One other aspect I want to spend a few minutes on is something that the bill does not directly address, but is a significant problem here in Canada. This is the reason we have Organ and Tissue Donation Awareness Month. Research has shown that as many as one in five potential organ and tissue donors have their final wish overturned by their family at the time of death. That is 20% of families overturning the wishes of their deceased loved ones. This decision by their families is robbing those in need of a life-saving transplant of a chance to live. It is robbing their loved one of their final wish. This is unconscionable and it has to change.

We can do better and we must do better, and that is why it is so important to talk to family members about final wishes when it comes to organ and tissue donation.

I have met with many people who have allowed the donation of organs and tissue of their deceased loved ones, and every single one of them without exception has said that it was an essential part of their grief and healing process. The ability to find some good in a time of utter grief is profound and everlasting. They want other families to know that sharing a loved one makes accepting the loss so much easier. Their loss has purpose, and their gift has brought unimaginable relief and joy to another family in need. That is the legacy to leave for a loved one.

We have our own reasons for supporting this legislation. Some of those reasons are closer to home for some members than others. Some members themselves or their family members have medical conditions, which means that they know one day they may require a life-saving transplant. Other members in the House are able to love, laugh and live with loved ones because they received a life-saving transplant and are still here with us today. No matter the reason for supporting this bill, it is very much appreciated.

Canada Revenue Agency ActPrivate Members' Business

April 12th, 2021 / 11:15 a.m.
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Liberal

Majid Jowhari Liberal Richmond Hill, ON

Madam Speaker, first, my thanks to the member for Calgary Confederation for bringing this issue back to the attention of Canadians and the House. We will also be recognizing National Organ and Tissue Donation Awareness Week, which will take place from April 18 to 24 this year.

This is a timely discussion, as this upcoming event raises awareness about the critical need for more donors across the country and encourages Canadians to register their decision and talk to their loved ones about organ donation. This topic hits close to home for me as my family and I are all registered organ and tissue donors. I believe more Canadians should at least consider this option as we see rising numbers of people added to wait lists each year.

According to the latest data from the Canadian Organ Replacement Register, in 2019 a total of 3,014 organ transplant procedures were performed in Canada, which is an increase of about 42% since 2010. Despite this good news, the national data shows that approximately 4,400 people in Canada are waiting for organ transplants, and more than 1,600 people are added to the list each year. Sadly, due to this, an estimated 250 people die each year while waiting for a transplant. As our population ages, the need for organ and tissue donations keeps increasing.

The Government of Canada recognizes the value of organ and tissue donation and transplantation. Since 2018, the government has supported an initiative called the organ donation and transplantation collaborative, led by Health Canada. The collaborative’s goal is to achieve organ donation improvements that result in better patient outcomes and increase the number and quality of successful transplantations.

The government recognizes that too many Canadians are on organ wait lists. We are committed to improving the organ and tissue donation and transplantation system. Alongside the provinces, territories and key stakeholders, we are establishing leading practices, strengthening professional education and raising awareness to improve organ and tissue donation. The Government of Canada continues to work collaboratively with organizations such as Canadian Blood Services, as well as with the provinces and territories, to encourage public participation and increase organ donation rates across Canada.

Additionally, I am proud to say that in the 2019 budget, the government allocated $36.5 million to develop a pan-Canadian data and performance system for organ donation and transplantation.

I would like to briefly note that my colleague, the member for Vaughan—Woodbridge, suggested certain amendments at the committee stage to make Bill C-210 easier for the CRA to implement. While these were not adopted, I believe it is important to review and discuss the intentions behind the amendments. I want to emphasize that we all want the objectives of Bill C-210 to become a reality sooner rather than later. At any moment anyone in this room or their loved one could be in need of an organ. I sincerely hope that it will be there when they need it. Therefore, I want to take a moment to address some concerns regarding the implementation of this bill.

The current legislation, which has the CRA directly collecting organ and donor consent on behalf of the provinces and territories, could potentially cause significant roadblocks and time-consuming delays. For the CRA to implement Bill C-210 in time for the tax filing season next year, we need the quick engagement and support of the provinces and territories.

We have spoken in the past about the need for efficient implementation of this bill. The member for Vaughan—Woodbridge proposed an amendment that would have the CRA collect and share the personal information of individuals wishing to become organ and tissue donors with their respective provinces and territories. The provinces and territories, in turn, would obtain consent from Canadians to share this information and store it in a database. Although this amendment was defeated, I still emphasize the critical role of the provinces and territories in the administration of this bill as the maintenance of donor information is legally within their jurisdiction.

Additionally, the legal requirements of donor eligibility and informed consent are very complex and vary greatly by jurisdiction in Canada, so the bill would have different applications for each province and territory. This is why my colleague, the member for Vaughan—Woodbridge, proposed a separate sheet for organ donation that could be inserted into T1 income tax packages. This sheet was modelled on the insert page for the Ontario Trillium benefit, which is inserted into the tax packages of Ontario residents and then provided directly to the Province of Ontario.

Despite these concerns, I want to reiterate that the CRA will continue to respect the role that the provinces and territories play in organ and tissue donation, ensuring that Canadians' personal information is handled securely. I believe strongly that this collaboration between the CRA and the provincial and territorial governments is essential to delivering real, positive change to Canadians. In fact, I believe that having a pan-Canadian data system in place would support decision-making and improve patient care. It would also help create better records, which could be used for both monitoring and forecasting purposes.

Despite the concerns about the manner of implementation, rest assured that the Government of Canada will fully support Bill C-210. The CRA will continue to work with all parties to make the member for Calgary Confederation's objective a reality, which would make the dream of saving the lives of thousands of Canadians a reality. It is only by working together that we will continue to improve organ and tissue donation progress, along with the transplantation system, and ensure that Canadians have timely and effective access to care.

I encourage all members in the House to vote in support of this bill once again.

Canada Revenue Agency ActPrivate Members' Business

April 12th, 2021 / 11:25 a.m.
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Bloc

Luc Desilets Bloc Rivière-des-Mille-Îles, QC

Madam Speaker, I want to say hello to all of my colleagues. I am very pleased to see them again after the two weeks that we spent in our ridings.

The debate on Bill C-210 is timely because National Organ and Tissue Donation Awareness Week is set to take place from April 18 to 24. This bill seeks to amend the Canada Revenue Agency Act.

First, the bill would authorize the Canada Revenue Agency, or CRA, to enter into agreements with the provinces and territories to collect, via the income tax return, the information required to establish or maintain an organ donor registry. Second, the bill would authorize the CRA to disclose that information to the provinces and territories that have entered into such an agreement.

Just as a reminder, this bill was first introduced in 2016 by our colleague from Calgary Confederation as Bill C-316. Unfortunately, it did not get past first reading in the Senate. This iteration of the bill has a new number, but the contents are the same. As such, the Bloc Québécois's position on this bill remains unchanged. Quebec is just fine with Bill C-210, and the Bloc Québécois fully supports it.

However, as I have already told my House colleagues, it is highly unlikely that Quebec would sign an agreement with the CRA because it already has its own tax return. It is also no secret that the Bloc Québécois is fighting for a single tax return managed solely by Revenu Québec, so why delegate to the CRA a health matter that Quebec is perfectly capable of handling and that is under its exclusive jurisdiction?

Basically, the Bloc Québécois supports this bill because we believe it will benefit the inhabitants of other provinces and territories where the CRA administers the tax system.

We have absolutely no issue with allowing the CRA to collect and share information related to organ and tissue donation. If the Quebec National Assembly were to sign an agreement with the CRA, we would fully respect that decision. Quebec is free to sign or not sign an agreement, and my tone would be completely different if we were to assume otherwise.

According to the most recent data from the Canadian Institute for Health Information, in 2019, 3,084 whole organs were transplanted into 3,014 recipients. This includes 1,789 kidneys, 610 livers, 212 hearts, 404 lungs and 68 pancreases. This might seem like an odd list, but it demonstrates the magnitude of the situation. Furthermore, although the total number of transplants has risen quite dramatically compared to ten years ago, I would remind the House that there is still a significant gap between the number of transplants performed and the number of people on waiting lists. In 2019, of the 4,352 people waiting for a transplant, 249 unfortunately died before getting their surgery. This is appalling, and it could be described as a deadly wait. The governments of Canada, Quebec and the other provinces must do better, and everyone needs to do their part.

The COVID-19 pandemic certainly has not made things easier in that regard. In 2020, Transplant Quebec recorded a 20% drop in organ donation and transplantation activity, both in terms of referrals and actual donors and transplant recipients. Quebec is not alone. Other provinces and other countries have seen a similar decline. The pandemic is hitting us hard, but thanks to the tenacity and remarkable adaptability of our medical community in Quebec, things have returned to a semblance of normality in the past few months.

Before I go any further, I would like to take a minute to sincerely thank all the donors who have signed their card and consented to organ or tissue donation. I know that it is not an easy decision for everyone to make.

I also want to take this time to commend the work of doctors who specialize in organ procurement and those who perform the transplants. They do remarkable work. We can never say it enough. Thanks to them, 13,000 people in Quebec and Canada are living with a transplanted organ. It is amazing. However, we cannot rest on our laurels. We must do more, and Bill C-210 will help us do that.

As I mentioned before, this bill will probably not affect Quebec in any way because Quebeckers have their own tax return, and Quebec could collect the required information for its own registry if it wanted to. So much the better if Quebec does not have to do it and Ottawa manages this matter. However, the last time I checked, health is almost exclusively a provincial jurisdiction. In this great and beautiful Canada, geographical distance is a significant problem for the successful completion of transplants. In light of the fact that a transplant must be completed within 12 hours for a liver and eight hours for a lung, for example, it is obvious that the proper administration of registries is crucial. In my opinion, the provincial centralization of data collection and registry maintenance is a win-win proposition.

That said, I would like to share some more thoughts about this bill. This amendment to the Canada Revenue Agency Act is truly a step in the right direction, but there is no evidence to show that it will have a direct, noticeable impact on the number of deceased donors, so long as we do not do more to promote awareness and education of organ and tissue donation. I remind the House that there is still a significant gap between the number of people who say they are in favour of organ donation and those who explicitly consent to it. I signed these papers when I turned 18 because I had a teacher at the end of high school who told us about the importance of organ donation.

I do want to commend the Government of Nova Scotia, which officially adopted an opt-out system in January. This system is the complete opposite of the opt-in system that exists in the rest of North America. Quebec has been considering this issue for some time now. I would be interested in seeing how this system unfolds with our maritime neighbours. I think it could be very worthwhile. I remind members that there is no data to establish a clear link between the implementation of an opt-in system and an increase in the number of transplants.

That has been demonstrated by Spain, which is a leader in this medical field. The opt-in system expands the pool of deceased organ donors, but that is only useful if we have the appropriate and necessary infrastructure. One of the keys to reducing the gap is to increase investments in medical infrastructure related to organ donation and transplants. There is no point in having more donors if there is a lack of trained staff or if the registry is not administered properly.

Another key is awareness, and I have a special interest in that. In addition to family refusal, there is also a widespread belief that minimal effort will be made to save the lives of those who agree to be organ donors. We need to counter this type of misconception through education and awareness.

I want to take this opportunity to recognize the work of an organization in my riding in Quebec called Chaîne de vie. Chaîne de vie's team of health and education professionals have been visiting high schools across Quebec since 2007 to educate young people between the ages of 15 and 17 about organ and tissue donation. This tremendous work does not just raise awareness among youth. It also encourages family discussion—

Canada Revenue Agency ActPrivate Members' Business

April 12th, 2021 / 11:35 a.m.
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NDP

Rachel Blaney NDP North Island—Powell River, BC

Madam Speaker, I am here today to speak to Bill C-210. This bill would change the Canada Revenue Agency Act to allow for people in Canada to sign up for organ donation on their income tax form.

I want to thank the member for Calgary Confederation for bringing forward this bill for a second time. As this is National Organ and Tissue Donation Awareness Month, it is important that this is the debate we are having at this time.

This is a hard one to talk about because of the emotional nature of this process. Currently, we know that there is a provincial and territorial jurisdiction. This means, sadly, that someone could be in desperate need in one province or territory and have no way to access organs that people have identified they want to donate. This means that people cannot get their second chance.

As a New Democrat, I fundamentally believe that we must make every possible effort to ensure that every Canadian who needs an organ or tissue transplant receives it. This is so important, and I support this because it allows people, while they are doing their taxes, to check another box, to show that this is something, if they were in the saddest circumstances, they would be able to provide.

We know that one donor could save up to eight lives and benefit more than 75 people. That is a tremendous generosity. Yet, at 18 donors per million people, Canada's current donation rate puts us at the lower third of developed countries.

Allowing Canadians to register to donate their organs and tissues through their tax return would help increase registration rates. This would improve consent rates and also help to build a donation culture in Canada. If we think about this being something that we do once a year to review, it would give that opportunity for us to have conversations with our loved ones about the decisions we have made.

We know that across Canada people are dying on wait-lists because our organ donation rate is so low. At present, only 20% of Canadians have joined their province's organ and tissue registry.

This is such an important bill because it allows the federal government to coordinate with provinces and territories to allow Canadians to register as an organ and tissue donor through their taxes.

There is a lot of concern here, sometimes, about the bill with its unauthorized sharing of personal information. This would allow for individuals to be required to give consent.

In my riding, I have read multiple articles about constituents, or have talked to constituents themselves, who have talked to me about the gift that it is when they receive a transplant. What I hear from people, again and again, is how they do not take a moment of their life for granted, as a donor. The gratitude they have for the person who gave them their second chance is incredibly powerful.

Not too long ago, I read about a constituent named Darvy Culleton, who received a double lung transplant. He was born with cystic fibrosis, a genetic disorder that affects the lungs and other major organs, and was told from a very early age that he would potentially only live until around the age of 29. When he was 29, he got his transplant, and now has married his wife, Megan, and they have a baby. Although he did not know much about his donor, he said that every day he lives with a deep and profound gratitude, one that is shared by his family.

In the last Parliament, the same legislation, then Bill C-316, was passed unanimously by the House of Commons. Unfortunately, it did not get passed through the second House, the Senate. In 2016, we know there was some concern that the Liberals brought forward about this bill, and it did not move forward in the way that it should have, because it was under provincial jurisdiction. I am very happy to see that people are coming together, understanding that this is the way we could make this work through the system.

I know that for New Democrats in this House, the opt-out system is something we are very supportive of. We know that countries that have an opt-out system, which means people are automatically put into the list unless they take themselves out of it, see record-high donation rates. This is part of the approach that has made Spain a world leader in organ donation over the past 25 years. We know that in Australia the donor rate grew tremendously through the opt-out legislation that was put forward.

This is always a hard thing to talk about, because it is really about a sad situation that leads to somebody else having an opportunity. I want to thank the member for bringing it forward. I want to thank all the people across Canada who put their names forward to be organ or tissue donors. I want to stand in solidarity with the people who live life because somebody else was generous with theirs.

Canada Revenue Agency ActPrivate Members' Business

April 12th, 2021 / 11:50 a.m.
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Liberal

Mark Gerretsen Liberal Kingston and the Islands, ON

Madam Speaker, it is also an honour to rise today to speak to Bill C-210, introduced by the member for Calgary Confederation. I understand, based on some of the discussion today, that he had also introduced a similar bill to this one in the last session of Parliament.

I know from my own experiences how challenging it can be to work and navigate through the system and to hit those pitfalls and challenges along the way when trying to introduce a private member's business. However, to have the opportunity to come back and do it again, I really admire the passion the member has shown in his determination to get this issue on the table and in the centre of the public's attention.

When it comes to a tissue and donor registry, as I indicated in the question I had asked earlier, I often wonder why it has taken so long just to get to this stage in having this discussion. I will focus on that for a bit and then I want to talk about the significance of putting this on the tax form and the intuitive way the member has gone about doing this, which I think is really going to highlight the need for this for so many Canadians.

First, I will talk briefly about an experience I had as it relates to organ and tissue donation.

I am not familiar nor do I know of anybody who has received an organ or has had his or her life significantly altered as a result of receiving an organ. However, when I was mayor of Kingston, going back seven or eight years, I was invited to a ceremony at the Providence Motherhouse in Kingston. As politicians, we are invited to so many of these various events and after a while they all start to appear to be the same. However, this one really sticks out in my memory. This was an opportunity for people who had received organs from other people to celebrate that they had those organs.

Different speakers spoke about the way that getting the organ had changed their lives and how their lives had been impacted by the new opportunities they had. They talked about their lives before versus after. It truly, for me, was an eye-opener to what it meant to somebody. Sometimes, with the scientific talk and everything that goes on in the medical field, when we learn about these things, we quite often think it is pretty neat and interesting stuff. However, until we start to really hear the stories from the people who are impacted by these changes in medicine and these ways we can now save lives where we never were able to before, until we have the opportunity to experience that, I do not know if we really can appreciate the contribution that something like this has to somebody's life.

I will always remember this, because part of the push at this event was to celebrate the lives saved and to hear the stories, but also to bring about awareness as to why it was so important to ensure that registries existed and that people got on the registries. As we know, it is an opt-in system in most parts, if not all, of Canada, and previous people talk about this, and that is one of the struggles. A lot of people do not want to think about this kind of thing. I will be totally honest with everyone that before I had been to this event, I had never wanted to actually think about dying and what would happen to my organs. It is something I think that, very innately, people do not want to think about, and so people try to push it off and say they will maybe think about it another day.

However, when we consider the impact that we could have in saving lives and the impact it has on the families, as the member for Calgary Confederation mentioned in his speech, of the individuals who have passed on, knowing that they have contributed to another life that has been saved truly, is remarkable.

Going back to this event, I will never forget talking to some people there and thanking them for having invited me. I remember going straight home and telling my wife about this. Because people in Ontario can indicate it on a driver's licence or health card, I immediately signed up as a donor. I knew that if anything was going to happen to me, being totally honest about it and thinking clearly about it, there was nothing I could do to prevent or stop it, but what I could do was improve somebody else's life. Why would we not want to do that? Why would people not have that desire, knowing that if they were in a fatal accident, unfortunately ending their lives, why not use that as a way to improve somebody else's life moving forward?

I really commend this. I had always wondered why we did not have an opt-in system. My NDP colleague from North Island—Powell River brought the point up about why we did not have a default system where everybody would be in and people could opt out based on personal, religious or any reasons individuals might have. They should have the right to make that choice, but by default, that would put so many more people into the system, people like me who did not want to think about it but when I did, recognized I did not have an issue with this, that it was really a good thing.

What the member for Calgary Confederation has proposed recognizes that we might not be able to have that system given the complexities of the way our provinces work together and with the federal government in whose jurisdiction this might be under. However, it would put this right on the front of a form that Canadians are responsible to fill out every year. If accountants fill this out every year, they will ask their clients how they would like them to check the box off. It would force people to make that decision on an annual basis.

I know that by default, this would generate so much more interest in it and would force people to have to think about it. As I said earlier, I did not want to think about this until I was confronted with the realities of about it. Knowing people will have to think about it and make that decision is important. It puts the onus on individuals to make a decision and this way their families do not have to be put in that position later on. People can declare early on whether they would like their tissue and organs to be donated.

The government spent just under $37 million in budget 2019 specifically to work on collecting data and putting it together in a more cohesive way so it could be shared throughout the country. Various territories and provinces have been working on this information. If my memory serves me correctly, I believe Quebec is an observer to that and might not be in this group.

All of that aside, this takes on a whole new dynamic, a dynamic that would put this in front of people when they do their tax returns. It is a form that every Canadian has to fill out. Therefore, it is a great opportunity to push this issue and put it at the centre of people's attention.

I want to thank the member for Calgary Confederation for bringing this forward. In minority Parliaments like this, it is very easy to bring other ideas forward, some that might be a lot more partisan and political in nature, but the member has truly hit the nail on the head in finding something that appears to have bipartisan support throughout the House. I applaud him for that.

Canada Revenue Agency ActPrivate Members' Business

December 1st, 2020 / 5:25 p.m.
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Bloc

Andréanne Larouche Bloc Shefford, QC

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.

Canada Revenue Agency ActPrivate Members' Business

December 1st, 2020 / 5:35 p.m.
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NDP

Don Davies NDP Vancouver Kingsway, BC

Madam Speaker, it is a real pleasure to stand in the House today and support Bill C-210, with great thanks to my hon. colleague from Calgary Confederation. I had the immense pleasure of serving with him on the health committee for a number of years. I cannot think of a finer parliamentarian and a more collegial, publicly minded representative than he. I am so pleased to support legislation that I know he has fought so hard to make a reality in this place.

This legislation would amend 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. In short, what the act would do is allow Canadians to indicate on their tax return that they wish to have their information shared with a provincial or territorial organ and tissue donation program to help facilitate and expedite the donation of organs and tissues in the country.

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. Just one donor can 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. Allowing Canadians to register as an organ and tissue donor through their tax returns will help increase registration rates, improve consent rates and help build a donation culture in Canada.

This legislation was first introduced in the 42nd Parliament as Bill C-316. Despite passing unanimously in the House of Commons, Bill C-316 was one of several bills that unfortunately were allowed to die on the Order Paper in the Senate before the last election. By the way, the Senate also blocked legislation to give mandatory sexual assault training to federally appointed judges, implement the United Nations Declaration on the Rights of Indigenous Peoples and ban unhealthy food and beverages marketing directed at children.

However, this was a life and death matter. Canadians are currently dying while on wait lists simply because our organ and tissue donation rate is so unacceptably 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 and tissue donations on health card and driver licence renewals, which has increased registrations. However, even when everything is in place, some 20% of families refuse to transplant a registered donor's organs and tissue.

In our recent study on organ and tissue donation at the Standing Committee on Health last Parliament, we learned that of the 4,500 Canadians on the wait list, 260 died waiting for an organ in 2016 alone. In order to better meet this demand, improved coordination across provinces and territories is needed.

Bill C-210 would allow the federal government to coordinate with provinces and territories to allow Canadians to register as an organ and tissue donor through their federal tax filing.

The act would align with the long-standing advocacy and legislative work of New Democrat MPs around organ and tissue donations. The bill is essentially a version of the previous proposal to create a pan-Canadian organ donor registry to coordinate and promote organ and tissue donations throughout Canada.

In February 2016, Conservative MP for Edmonton Manning, whose son had been the recipient of three donated livers, reintroduced a private member's bill calling for a national registry. That bill had been previously introduced seven times by both the Liberals and two New Democrats, Lou Sekora, Judy Wasylycia-Leis and Malcolm Allen.

Unfortunately, the Liberal caucus voted to defeat the member for Edmonton Manning's bill. The Liberals defended their decision to kill the bill, without study, by claiming that it was a matter that was under provincial jurisdiction and it was for that reason the bill was unsupportable.

Leaving that question aside, I want to quote from a couple of important stakeholders. The Kidney Foundation of Canada says, “In an environment where the supply of donor organs is so low and demands are so high, missed opportunities for donation are literally a matter of life and death. Donor organs are rare and precious and every opportunity needs to be pursued to ensure that no potential donation is missed or lost because it also means lost lives of those waiting for transplant.”

Dr. Philip Halloran, professor of medicine at the University of Alberta, said, “Donations in Canada are not performing at the standard that our colleagues in the United States are performing and there isn’t really any excuse except organization and accountability.”

I was therefore quite disappointed to see jurisdiction thrown out by the Liberals as being a barrier to facilitating organ and tissue donation.

Here are a few facts.

While 90% of Canadians support organ and tissue donation, 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 or tissue transplant.

The efficiency of donor registration varies greatly from province to province to territory. In the case where someone dies outside of the province where they are registered for organ and tissue donation, it is highly unlikely the hospital would be able to identify them as a donor. Online registration is available only in five provinces: British Columbia, Ontario, Alberta, Manitoba and Quebec.

Even if someone is registered as a donor, the family has the final say. As I pointed out, about one in five registered organ and tissue donors had their wishes overridden by family members, according to a 2016 report in the Canadian Medical Association Journal.

For every patient in Canada who does receive an organ transplant, there are two more on the wait-list. In the past 10 years, the number of deceased organ donors has gone up by 42%, so there is progress, but the number of people needing a transplant has also gone up at the same time. Over 1,600 Canadians are added to the organ wait-lists yearly.

Canada is the only developed country without national organ donation legislation, such as the U.S.'s 1984 National Organ Transplant Act, so it is time that parliamentarians united and addressed this very pressing need. We cannot let jurisdiction, difficulty, party interests and technicalities get in the way of doing what we all know is necessary: We must make it much more efficient and simple for Canadians, who overwhelmingly want to donate organs and tissue, to do so to save their family members and other Canadians.

It is my view that the best system of all is an opt-out system, where everyone is considered to be an organ donor unless they specifically opt out. This respects the rights of everyone who does not, for various reasons, whether religious, philosophical, health or any other reason at all, want to be an organ and tissue donor. There are many countries around the globe that have such a system, and what we see in those countries is that their rates of organ and tissue donations and transplants dwarf Canada's rates. This saves lives.

I hope that all parliamentarians can work together, support the bill, expedite it through this place and ensure that the Senate passes it as soon as possible. Let us do everything we can in this country to facilitate organ and tissue donation and transplantation as soon as possible.

Canada Revenue Agency ActPrivate Members' Business

December 1st, 2020 / 5:40 p.m.
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Conservative

Ziad Aboultaif Conservative Edmonton Manning, AB

Madam Speaker, at the beginning I would like to congratulate the hon. member for Vancouver Kingsway for his speech and his call for support for this very important issue. It is very close to my heart and I have always hoped to see this debated on the floor of the House of Commons.

After five years in the House, I cannot think of a bill that I have agreed with more than this one, Bill C-210, which was proposed by the hon. member for Calgary Confederation. He is to be commended for his vision and desire to help Canadians.

Bill C-210, an act to amend the Canada Revenue Agency Act regarding organ and tissue donors, is a short bill that has only two clauses. It is a simple, effective and life-saving act. With a “yes” vote, we can all save lives. Bill C-210 authorizes the Canada Revenue Agency to ask those filling out their tax forms if they wish to be organ donors. It allows the CRA to provide that information to provincial health authorities for their organ donor lists.

When we talk about organ donation, we frequently talk about facts and figures. I intended to give some of those today. Sometimes, though, we forget that behind each number there is a human being involved. Lives become impacted for better or worse, depending on the availability of a much-needed transplant. It is that human element that makes this bill so important.

For example, let me tell members about my son, Tyler. When a child is born, parents always have great dreams for them. There is unlimited potential. We are excited to see how they will fulfill it, and so it was with Tyler, who is now a young adult. My wife and I are very proud of him. Tyler is alive, thanks to not one but three organ donations. Without them, I would be standing here telling the story of a life lost, not a life saved.

Tyler was born with a defective liver. When he was very young it became apparent that without a transplant, he would die. The liver is a remarkable organ that can regenerate itself. That means that the transplant can be from a live donor, that is, if the two people are compatible. With any surgery there are risks, and 20 years ago, liver surgeries were much riskier than they are today. No one undergoes such a procedure without much thought beforehand.

I was a compatible donor. Would I risk my life to allow my son to live? Of course I would and the operation was a success. That, though, is not the end of the story. That first liver transplant did not last.

On Christmas Eve, 2003, it looked like Tyler's time had run out. His life expectancy was now days, perhaps hours. I was not allowed to make a second donation. Almost miraculously, a liver became available from a Quebec man who had just died. We were told it was not the perfect solution. It would only buy time, but time was what we were desperately looking for.

After a decade that liver also began to fail. One more time we entered the medical system. Our emotions were a mixture of hope and fear. There were no guarantees. We knew the statistics. We knew the odds and, as we had done before, we prayed for a miracle. Once again, a grieving family offered a loved one's organ for the good of the community and a match was made. Today, we are so grateful to have a healthy son.

There are no sufficient words in any language to express the gratitude my wife Liz and I still feel for the anonymous donors who saved Tyler's life.

Our family's experience is not unique, but there are not enough available organs to meet the need. Bill C-210 seeks to alleviate that.

When Tyler first began having problems, I became aware of the unmet need for organ donations in Canada. There are literally thousands of people waiting for the telephone call that will change their lives and the lives of those around them. Tragically, for more than 200 Canadians every year time runs out before the phone call comes.

More than 90% of Canadians support organ and tissue donation, which is a great yield, but in theory less than 25% make plans to donate. I will not embarrass hon. members by asking for a show of hands as to how many of them have registered to become organ donors should they die. It is probably not as many as one would expect.

Canada's organ donation rate puts us in about 20th place in international ranking. We need to do better. After all, one donor can benefit more than 75 people and save more than eight lives. A single donor can provide lungs, a heart, liver, kidneys, corneas and more.

According to the Canadian organ replacement register, in 2018 there were 762 deceased donors in Canada and 2,782 organ transplant procedures performed. However, there were 4,351 people on organ transplant waiting lists and 223 of those people died waiting for an organ to become available. That is a sad statistic. The demand for organs is increasing, but the supply is not maintaining the pace.

The number of patients on the waiting list for kidney transplants is approximately two and a half times higher than the number of transplants performed. More than 1,600 Canadians are added to the wait-lists each year, which means we are falling behind.

The various ways of registering to be an organ donor are good, but more effort is needed. It is not that people are opposed to the idea of organ donation, but we do not seem to be that great at putting the idea into practice. By expanding the number of those willing to be organ donors, Bill C-210 could help save lives. By allowing people to indicate their wishes before death, medical personnel would not have to approach a grieving family at the worst possible time to ask about the gift of life.

What if it was a member's son or daughter who needed a transplant? Would they not do everything in their power to make sure it could happen? By making a simple change to the income tax forms through Bill C-210, we would be giving Canadians an easy way to do the right thing.

We are talking a bill that could literally save thousands of lives. Think about that. Think about what we do here in the House and how we are frequently unsure of the effects of our actions. With Bill C-210, we know we would be doing good. How many lives lost is too many? In many ways that is the question we are asking today.

We have an opportunity to do good for all Canadians. Why waste it? I urge every member to support Bill C-210.

Canada Revenue Agency ActPrivate Members' Business

December 1st, 2020 / 6 p.m.
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Bloc

Alexis Brunelle-Duceppe Bloc Lac-Saint-Jean, QC

Madam Speaker, it is a real honour for me to rise today to speak to Bill C-210.

I believe that the subject we are discussing has the potential to meet the urgent needs of many Canadians, and I want to emphasize the word Canadians. It is true. Quebec can sleep well at night knowing that this bill will not really have any impact on it.

I commend Nova Scotia for the steps it has taken to make organ donation automatic and make opting out voluntary, rather than the other way around. Bill C-210 will facilitate this approach through close collaboration with Ottawa to get the relevant information from people's income tax returns.

As I just mentioned, Quebec will not be part of that Canadian collaboration because it is already collecting that information. However, members know me and I will not turn a deaf ear. It is clear that, in due course, the Quebec National Assembly will move forward and it will be very simple. I hope it will be simple for all of the provinces that have to manage their health care systems and meet an ever-growing need for organ transplants.

Provinces know what they are doing. Once again, the Quebec formula of national, responsible, grassroots governance is paying dividends. I can only agree with other provinces taking the same approach or with other governments choosing to collaborate, especially on a matter of health.

That is a welcome change from the arm-wrestling matches we too often see in this House. Actually, I will digress for a moment, because my fellow Quebeckers would be upset if I did not take this opportunity to remind all hon. members and everyone watching that Quebec is still asking for a single income tax return. I also want to point out that processing Quebec taxes costs the federal government an arm and a leg. With the spending announced yesterday and the looming deficit, I again urge the government to consider that option, which is completely in line with its willingness to listen and collaborate on this bill. Now might be the ideal time to go down that road since the federal government will need public servants to deal with all that was announced yesterday. A lot of elbow grease will be required if this country, now more generous than ever, is to also become more efficient than ever. Now back to the matter at hand.

It is up to Quebec and the provinces to decide what works best for them when it comes to organ donation and transplants. This issue literally speaks to peoples' values and intersects with different peoples' funeral rites. Society's many perspectives can create sparks when they intersect.

In the House, our colleagues in the NDP and in the Liberal Party are fighting tooth and nail for a centralized government. Our Conservative colleagues always wrestle with collective decisions that are connected to their social and religious beliefs. In the Bloc Québécois, we are working non-stop for Quebec's independence.

How does organ donation work elsewhere? This is not always a simple debate, and that makes sense. Brazil has even taken a step backwards. This is why every society needs to move at its own pace.

I would just like to be parochial for a moment. Things can be done locally to significantly increase the donor pool. On that front, people may be surprised to hear that few governments can match Saguenay—Lac-Saint-Jean. In my region, the number of donors per million inhabitants is neck and neck with Spain, which sets the bar. That is impressive, and it might raise a few eyebrows, but it is by design.

Where I am from, there is a strong culture of organ donation and health organizations identify potential donors. According to a 2019 La Presse article, my region is impressively effective, mainly because health professionals have access to training and there is constant follow-up. The author added that a culture of organ donation makes it easier to convince family members of the deceased, who always have the final say in Quebec, to consent to organ harvesting.

If I could just plant a seed, reading between the lines, what matters most is a solid, well-funded health network capable of innovation and adaptation. That is the foundation of a better health system.

This brings me back to one of our demands: increased federal health transfers. Quebec and the provinces are scrambling to support health care systems whose costs have increased exponentially. Meanwhile, the federal government expects us to welcome it with open arms as it dictates how long-term care centres should operate, when just yesterday it showed up to the family party empty-handed.

As they say, out of sight, out of mind. The federal government withdrew so much from health care that it ended up losing interest. Now it is suddenly newly aware that this is a big responsibility, and it wants to take some of it on.

This is totally inconsistent with its record of inaction. Members will recall that over the past few decades both Liberal and Conservative governments have systematically paid down their deficits on the backs of Quebec and the provinces. Today, as many regions teeter on the brink of disaster, Ottawa might have had the good idea of introducing Bill C-210, but that does not make up for the fact that it has messed up pretty much everything else. In the circumstances, the government should think long and hard before invoking the pandemic as an excuse to interfere in such clearly defined areas of jurisdiction.

All of this brings us back to the basic argument for Bill C-210, namely that the federal government can and must support the provinces and provide them with the tools they want, when they want them, and how they want them. In this case, that consists in the federal government's immediate and unconditional payment of $28 billion to Quebec and the provinces.

At its core, Canadian federalism was designed to prevent all levels of government from stepping on each other's toes. When Ottawa decides to encroach on the jurisdiction of health, it is essentially proposing to rewrite legislative jurisdiction. Before this government goes full-steam ahead, I would like to invite the federalists to think carefully about their role and the files they were entrusted with when they were elected to Parliament, this distinguished chamber.

Something tells me that my hon. colleagues have a lot of questions for me. Unfortunately I will not be able to answer them. We could always meet in the lobby.

In closing, I would like to wish the thousands of people waiting for a transplant the best of luck with this difficult ordeal, especially during these times and with the holidays right around the corner.