Bill C-210 (Historical)

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

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

Canada Revenue Agency Act

[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.

[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.

The House proceeded to the consideration of Bill C-210, An Act to amend the Canada Revenue Agency Act (organ and tissue donors), as reported (without amendment) from the committee.

Health

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Mr. Speaker, I have the honour to present, in both official languages, the third report of the Standing Committee on Health in relation to Bill C-210, an act to amend the Canada Revenue Agency Act with regard to organ and tissue donors. The committee has studied the bill and has decided to report the bill back to the House without amendment.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Thank you to all the MPs who have provided substantive feedback on their views. I'm going to take this on a couple of levels, and I'll answer Mr. Webber's question. It's a very important question because to say that we're in favour of the intent of the bill, for me, means that we're in favour of the effectiveness of the bill and the final result we'd get from the bill, which is increasing the number of individuals who will have signed up to become registered tissue and organ donors. That has to be the goal of the bill, and this is a very important issue for many Canadians and for the organizations you highlighted.

There's always a balance in crafting legislation and getting legislation done, and there are many stakeholders and many points of view. As I know Mr. Barlow commented, what does it mean to listen to bureaucrats and other representatives? We need to take advice from our government officials and listen. Obviously, the final decision is with the government in terms of the direction, but it is pertinent and very imperative for them to provide that feedback to parliamentarians. It doesn't mean that we don't see issues or flags or say yes or no, but it is important to receive that feedback, in this circumstance, from the CRA officials.

In my gut, in my honest estimation, in this process that I've been involved with in examining Bill C-210, I would like to see, as Mr. Van Bynen commented, at the end of the day, the bill moving forward, absolutely. What I would like to see is a separate page within the tax package that clearly states...and that we could utilize with the provinces in a very quick and efficient manner. It would say what we could agree on with the provinces and what descriptive information may be needed to be put in there.

Again, I take it back. This is not simply, if I can use the analogy, our asking people if they wish to pass on their information to be registered by Elections Canada. Elections Canada is a federal agency. They pass on the information to them. They then make sure that individuals are on the electors list, and that is on the front page. On this example here, there are jurisdictional issues. Regarding the opt-out by Nova Scotia, I know Ms. Rempel Garner has commented on that. I'm going to take another look at that because I'm obviously always open to constructive feedback and learning if I've erred in interpretation.

Again, in terms of efficiency, effectiveness and getting this in the tax package, the quickest way to do that is to have it on a separate page, not on the T1 form, but within the tax package. It's still there. It would still be for everybody to see. We know that when the tax filers are preparing their information, it is important to ask. We need to ensure that Canadians have the information they need to make those decisions that are very personal in nature, including becoming a registered tissue and organ donor.

To Mr. Webber, that's a very long way of saying yes. I believe this still maintains the effectiveness of Bill C-210.

Thank you.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Thank you, Chair, and good afternoon, everyone.

Clerk, I believe you received the amendment and have distributed it to all committee members.

Chair, I will obviously be moving this amendment on Bill C-210, and then I wish to speak on it.

Thank you, everyone, for making yourselves available and hearing me out for a few minutes.

First, it's great to be here. It's great to be speaking on a bill that I know is very important to deputy Webber and is very important to MPs on all sides of the aisle. I'm very galvanized by that. It is within that spirit that I present this amendment. In my view, at the end of the day, it's about increasing the number of registered organ and tissue donors in Canada.

I have some prepared remarks for everyone. I thank you for the opportunity to join your committee today as we look at this legislation that seeks to promote a cause that, it's fair to say, all parliamentarians support—namely, increasing the number of registered organ and tissue donors in Canada. This is an extremely important issue to assist Canadians in desperate need. It is truly a matter of life and death. We need the best legislation possible.

I know we all support the intent of the legislation. I do personally, and I applaud the member for Calgary Confederation for his work and his desire to get this bill passed in the House and the Senate. I too am committed to advancing the bill's objective. That's why I'm advocating certain amendments to make Bill C-210 more workable for the Canada Revenue Agency so that it can be implemented as soon as possible. Hopefully, if Parliament can pass it quickly enough, it would be in for the 2021 tax-filing year. We need to ensure that the legislation proposes the most efficient and effective way for the Canada Revenue Agency to collect this information, and for the process to be efficient and useful for the provinces and territories, who are ultimately responsible and within their jurisdiction for organ and tissue donation.

As Parliamentary Secretary to the Minister of National Revenue, I've made it a priority to examine the legislation in great detail and to discuss it with experts at the CRA who would be asked to implement it. I truly believe this committee should hear directly from those professional experts at the CRA regarding this legislation, especially their experiences with the precursor legislation to Bill C-210 from the last Parliament, Bill C-316, and the CRA's interactions with the provinces and territories on that legislation that occurred.

Nevertheless, I am proposing a strongly recommended amendment to make the legislation more straightforward for the CRA to implement with the provinces and territories, and also to make it so that it can be implemented in the quickest fashion possible. This amendment does not change the objective of the bill, but rather the manner in which the objective will be achieved, to remove potentially significant roadblocks and time-consuming delays.

This simple amendment would do as such. Rather than having the CRA directly collect organ and donor consent on behalf of the provinces and territories, the CRA would collect and share the personal information of individuals wishing to become organ and tissue donors with their respective provinces and territories, which would then obtain direct consent. The amendment, accordingly, would remove references set out in proposed subsections 63.1(1) and (2) of the bill, which would make reference to returns of income filed under paragraph 150(1)?(d) of the Income Tax Act.

Rest assured that under this approach, a form would be included within the T1 return, both a paper format and in certified tax software, asking if the individual wishes to be sent information by their province or territory on becoming an organ and tissue donor. It should also be noted that the notice of assessment would still advise the individual that, in accordance with their request, their information has been forwarded to their province or territory as a potential organ and tissue donor. Once the information would be sent to the relevant province or territory, the province or territory would then be able to follow up with the individual on the actual consent to organ and tissue donation.

This is an important and appropriate role for provinces and territories to undertake, as it is within their jurisdiction as opposed to that of the Canada Revenue Agency. Legal requirements for donor eligibility and informed consent are very complex and vary greatly by jurisdiction in Canada, meaning different provinces and territories have different roles. By having provinces and territories play their proper roles in obtaining consent, we are not only respecting their jurisdiction, but equally important, we are removing an obstacle by eliminating the need for protracted negotiations and complicated agreements with each of the provinces and territories on legal requirements for collecting the proper consent.

With the amendment I am proposing today, our hope is that we would put the federal government in a position to reach swifter agreements with provinces and territories on a more straightforward, simple and efficient approach, which, I understand from CRA officials, might need only months instead of potentially years to achieve.

I repeat, we all want the objectives of Bill C-210 to become a reality, and sooner rather than later. However, for the CRA to meet the earliest window of the 2021 tax-filing year—next year's income earned, when you file your taxes in January to March or the period in 2021—the provinces and territories have to come on board. We need to create the quickest path to make that happen.

I would like to add that the approach taken here, for the MPs who have been elected from the beautiful province of Ontario, would be a similar approach to where information is collected for what's called the Ontario trillium benefit, where a separate page is provided in the tax package, whether it is online or in paper format, and where the information is then passed to the Province of Ontario.

I am confident that our amendment today will do that and make the member for Calgary Confederation's objective a reality, potentially—and most likely—saving the lives of thousands of Canadians.

Chair, thank you for the time today.

To the committee, I wish to again applaud deputy Webber for his efforts over the years in making the bill come to fruition and bringing it this way.

We are with you in the spirit of the bill, Mr. Webber, and I applaud your work on it.

I thank my colleagues for listening to me this afternoon.

[The Chair, Liberal, Ron McKinnon]

The meeting is now resumed.

We are proceeding pursuant to the order of reference of Tuesday, December 1, 2020, on Bill C-210, an act to amend the Canada Revenue Agency Act related to organ and tissue donors.

We will now begin our clause-by-clause consideration.

(On clause 1)

We have an amendment on the floor. I believe Mr. Sorbara wishes to move it.

Mr. Sorbara, please go ahead.

[The Chair, Liberal, Ron McKinnon]

I call this meeting to order.

Welcome, everyone, to meeting number 13 of the House of Commons Standing Committee on Health. The committee is meeting today to study the Patented Medicine Prices Review Board's guidelines. Then we will proceed to the clause-by-clause consideration of Bill C-210, an act to amend the Canada Revenue Agency Act, regarding organ and tissue donors.

I thank the witnesses for appearing today. From Best Medicines Coalition, we have John Adams, who is the board chair. From Boehringer Ingelheim Canada Limited, we have Mehmood Alibhai, director, national policy and patient access, and Annie Beauchemin, executive director, patient access, pricing, health care affairs solutions. From Canadian Life and Health Insurance Association, we have Stephen Frank, president and chief executive officer, and from Independent Voices for Safe and Effective Drugs, we have Colleen Fuller.

I will start the meeting by providing you with some information, following the motion that was adopted in the House on Wednesday, September 13, 2020. The committee is now sitting in a hybrid format, meaning that members can participate either in person or by video conference. All members, regardless of their method of participation, will be counted for the purpose of quorum. The committee's power to sit is, however, limited by the priority use of House resources, which is determined by the whips. All questions must be decided by recorded vote unless the committee disposes of them with unanimous consent or on division. Finally, the committee may deliberate in camera, provided that it takes into account the potential risks to confidentiality inherent to such deliberations with remote participants.

The proceedings will be made available via the House of Commons website and, so you are aware, the webcast will always show the person speaking rather than the entirety of the committee.

To ensure an orderly meeting, I will outline a few rules to follow. Members and witnesses may speak in the official language of their choice. Interpretation services are available for this meeting. You have the choice at the bottom of your screen of floor, English or French. Before speaking, click on the microphone icon to activate your own mike, and when you have finished speaking, please put your mike on mute to minimize any interference.

As a reminder, all comments by members and witnesses should be addressed through the chair. Should members need to request the floor outside their designated time for questions, they should activate their mike and state that they have a point of order. Members should do likewise if they wish to intervene on a point of order that has been raised by another member. In the event that a debate ensues, members should use the “raise hand” function, which will signal to the chair your interest to speak and create a speakers list. In order to do so, you should click on “Participants” at the bottom of the screen. When the list pops up, you will see next to your name that you can click “raise hand”.

When speaking, please speak slowly and clearly. Unless there are exceptional circumstances, the use of headsets with a boom microphone is mandatory for everyone participating remotely. Should any technical challenges arise, please advise the chair. Please note that we might need to suspend a few minutes, as we need to ensure that all members are able to participate fully.

For those who are participating in person, proceed as you usually would when the whole committee is meeting in person in a committee room, keeping in mind the directives from the Board of Internal Economy regarding masking and health protocols. Should you wish to get my attention, signal me with a hand gesture, or at an appropriate time, call out my name. Should you wish to raise a point of order, wait for an appropriate time and indicate to me clearly that you wish to raise a point of order.

With regard to a speaking list, the committee clerk and I will do the best we can to maintain a consolidated order of speaking for all members, whether they are participating virtually or in person.

Thank you all for listening to that long housekeeping speech one more time.

Before I ask the witnesses to make their statements, I will advise the committee that we have received a letter from the law clerk indicating the status of the document production order. I would ask the committee for authorization to make this letter and its addendum public.

Do I have the approval of the committee to do this?

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Davies.

Thank you to all of our witnesses. It has been a great panel. Thank you all for your time today and for sharing with us your expertise. It's a real help for our study.

I'd like to advise the committee members that I was unable to get all the pieces to align, all the parts to align, for doing Bill C-210. I'm still hopeful we will be able to do it after our two panels on Friday. Stay tuned, and we will get back to you.

Thank you, everybody—

Canada Revenue Agency Act

[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.

[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.

[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.

[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.

The House resumed from October 26 consideration of the motion that Bill C-210, An Act to amend the Canada Revenue Agency Act (organ and tissue donors), be read the second time and referred to a committee.

[Scott Aitchison, Conservative, Parry Sound—Muskoka, ON]

Madam Speaker, I want to thank my friend and colleague, the hon. member for Calgary Confederation, for sponsoring this bill, for his perseverance through our legislative process, and for his lifetime of advocacy and action on the issue of organ and tissue donation. I am honoured to second Bill C-210, a bill which would improve organ and tissue donation registration in Canada.

Organ and tissue transplants improve life, extend life and save life for thousands of Canadians every year. In fact, one deceased donor can potentially save up to eight lives through organ donation and improve the lives of 75 more through tissue donation. This is an incredible field of medicine, which Canadians wholeheartedly support. In fact, 90% of Canadians indicate that they support organ and tissue donation.

Canada has been a world leader in the development of transplant surgeries, having performed the world's first successful heart valve transplant in Toronto in 1956, the world's first successful lung transplant in 1983 and the world's first successful double lung transplant in 1986. All were performed right here in Canada. However, despite Canada's pioneering role in transplant medicine, the undeniable success of these life-saving procedures and the overwhelming support of 90% of Canadians, merely 20% of Canadians have registered for organ and tissue donation.

Sadly, the impact of this gap between intention and action can be measured in lives lost. In 2019 there were 4,527 Canadians waiting for transplant surgery. Of those 4,527 people, 710 either withdrew from the list or died. Those 4,527 Canadians do not tell the full story. The Kidney Foundation of Canada reports that of the 22,000 Canadians whose kidneys have failed, only 16% are on the transplant wait list. Why the discrepancy in the face of such need and also such support?

In testimony before the Standing Committee on Health in 2018, Ms. Ronnie Gavsie, the president and CEO of the Trillium Gift of Life Network, explained that the variety of reasons for this discrepancy includes misconceptions about donation. Some people think that their age or health may prohibit them from being a donor, or that becoming a donor would affect their care in the hospital. Another factor is, quite simply, procrastination. Ms. Gavsie also explained that in 10% to 15% of circumstances, organ donor registrants' wishes are overturned by their loved ones at the time of their death.

Remarkably, the most common reasons for the gap in organ donor registration could be solved with a conversation. Canadians need to be reminded of their intention, and Canadians need to be encouraged to have a conversation with their loved ones about organ donation. Public education, awareness campaigns and greater opportunities to register could most certainly help, and as we have heard, tragedies have spurred Canadians to register as donors as well. An option to register for organ donation on the federal income tax form will spur the conversation, and it will save lives.

Laurie Blackstock was among the witnesses the Standing Committee on Health heard from while preparing its 2018 report on organ donation in Canada. Laurie arrived home one day to find her husband unconscious and suffering multiple seizures. He was rushed to the hospital where he then suffered a heart attack. The medical staff at The Ottawa Hospital brought him back to life, but he was transferred to the intensive care unit and put on life support.

After he had been in the intensive care unit for two days, Laurie knew that her seemingly healthy 57-year-old husband, Stephen, would not survive. Stephen had told Laurie that he had checked the organ donor registry and the doctors knew that Stephen was a registered donor. Laurie, along with Stephen's mother, met with the Trillium Gift of Life coordinator in the hospital and the decision was made. Through their despair, they knew that potentially eight families could be spared their grief and pain, and that their loved ones could be saved and go on to live a much healthier life.

Many weeks later, Laurie received a thank you note from a young man who had been the recipient of both Stephen's lungs. She described how in that note he wrote that he thinks of his donor family every time he breathes and that the word “grateful” could not begin to describe his feelings. He thanked her and her family for saving his life.

Laurie went on to say:

I'm here to emphasize that organ and tissue donation doesn't just help the recipients and their families. It doesn't just reduce the tremendous cost of long-term kidney treatment. It can also be an incredible gift to bereaved families like mine, because when presented gently and ethically, at the right time, when there's little or no hope of a loved one's survival, it is a gift. Knowing that five people's lives probably improved dramatically with Stephen's lungs, kidneys, and corneas doesn't change his death and the intensity of our grief, but it gives us moments of relief.

Stephen lives on through those five people.

What an extraordinary gift.

Today, all members of Parliament have an opportunity to come together to give the gift of life. We have a chance to work together in a non-partisan way to help our constituents. Let us rise to this opportunity. Let us show Canadians the best of this Parliament. For the sake of thousands of Canadians who desperately need an organ donation, I ask all members to support Bill C-210.