Bill C-218

An Act to amend the Excise Tax Act (psychotherapy services)

This enactment amends the Excise Tax Act in order to exempt psychotherapy services from the goods and services tax.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair. Through you to all the witnesses, I thank them for their testimony here today.

Ms. Woo Dearden, I'd like to start with you. In 2021 my colleague Lindsay Mathyssen introduced Bill C‑218. That legislation would exempt psychotherapeutic services delivered by psychotherapists and counsellors from the GST/HST. That was almost three years ago. I understand that she was inspired to introduce that important piece of legislation because you asked her to take action on the issue. I want to thank you for your advocacy on this. Because of your tireless advocacy and that of your colleagues, the government has agreed to include the provisions of Bill C‑218 in the fall economic statement, as you know. The implementation legislation is before us today. I think it's a good-news story when it shows citizens working positively and influencing policy.

Now, we've heard clearly, from you and others already today, the positive impacts that this measure will have on clients. I'm curious to know how the elimination of the GST/HST on counselling therapy and psychotherapy will impact the overall health care system, in your view.

Ways and Means Motion No. 19

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, the second point of order is a little more detailed.

I rise to respond to a point of order raised on Tuesday, November 28, by the member for Regina—Qu'Appelle respecting the inadmissibility of the notice of Ways and Means Motion No. 19 and two items of Private Members' Business.

The crux of the argument by the member opposite is on the principle of a bill at second reading stage. This is the heart of the argument. I would humbly point to the purpose of the second reading debate and the vote at that stage, which is on the principle of the bill.

Before I get into the specific matters involved in the member's argument, I would like to remind my colleagues across the aisle of what a debate and vote on the principle of a bill entails.

Members of the House know that our Standing Orders and practices derive from those of Westminster. If a member would like to look into how debates at Westminster are handled at the second reading stage, they might be surprised. The British House of Commons has 650 members, yet the debate on any government bill at the second reading stage very rarely exceeds one sitting day.

Now I will go to the specific argument raised by my colleague across the way. The two bills in question that are subject to certain provisions containing Ways and Means Motion No. 19 are Bill C-318, an act to amend the Employment Insurance Act, and Bill C-323, an act to amend the Excise Tax Act (mental health services).

With respect to the first item, Bill C-318 requires a royal recommendation which would govern the entire scheme of a new employment insurance benefit for adoptive parents. As a result, the bill cannot come to a vote at third reading in the absence of a royal recommendation provided by a minister of the Crown.

The bill was drafted by employees of the law clerk's office who would have notified the sponsor of this requirement. While I would not want to speculate on the intentions of the member who sponsored this bill, there is little doubt that the member knew this bill would not pass without royal recommendation.

As a result of a ministerial mandate commitment to bring forward an employment insurance benefit for adoptive parents with an accompanying royal recommendation, the government has brought forward this measure for consideration of the House in a manner that raises no procedural obstacle to providing this important benefit for Canadians. It is the sole prerogative of the executive to authorize new and distinct spending from the consolidated revenue fund, and that is what is proposed in the bill that would implement the measures contained in Ways and Means Motion No. 19.

Now I will go to the point of a similar question. The example my colleague raised with respect to the Speaker's ruling on February 18, 2021, concerns Bill C-13 and Bill C-218 respecting single sports betting. Both bills contain the same principle, that being to allow certain forms of single sports betting. The approaches contained in Bill C-13 and Bill C-218 were slightly different, but achieved the same purpose. As a result, and rightly so, the Speaker ruled that the bills were substantially similar and ruled that Bill C-13 not be proceeded with.

The situation with Bill C-13 and Bill C-218 bears no resemblance to the situation currently before the House, and the member opposite has been again helpful in making my argument. The member cites the situation with Bill C-19 and Bill C-250 concerning Holocaust denial.

The case with this situation, and the case currently before the House, is instructional for the question faced by the Speaker, which is whether the principle of the questions on the second reading of Bill C-318 and Bill C-323, and the question on Ways and Means Motion No. 19, are the same.

The answer is categorically no. The question on both Ways and Means Motion No. 19 and the question should Ways and Means Motion No. 19 be adopted on the implementing of a bill are vastly different. The questions at second reading on Bill C-318 and Bill C-323 are specific questions on the principle of measures contained in those private members' bills.

The question on Ways and Means Motion No. 19 and the question at second reading on the bill to implement those measures is much broader. As the member stated in his intervention yesterday, Ways and Means Motion No. 19 contains many measures announced in the 2023 budget as well as in the fall economic statement. While the measures to implement the fall economic statement are thematically linked to the issue of affordability, they contain many measures to address the affordability challenges facing Canadians. As a result, the question at second reading on implementing legislation is a very different question for the House to consider.

In conclusion, while there have been precedents respecting similar questions on similar bills which propose a scheme for a specific issue, namely Bill C-13 and Bill C-218, this and other precedents do not in any way suggest that the questions at second reading on Bill C-323 and Bill C-318 in any way resemble the question on Ways and Means Motion No. 19 and the question at second reading on the implementing bill for the measures contained in the 2023 budget and the fall economic statement.

Excise Tax Act

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Mr. Speaker, I thank my colleague for Cumberland—Colchester for tabling this important bill, Bill C-323, an act to amend the Excise Tax Act, mental health services.

As members know, the bill would expand the category of health care services exempt from point-of-sale taxes to include psychotherapy and mental health services. Members also know that physical health services, such as chiropractic and physiotherapy services, are already exempt from federal sales taxes. Eliminating that sales taxes from psychotherapy and mental health services would be one step further and would only be fair, because there are so many other services that are so similar that do not have to provide that federal sales tax on their services.

There should not be any health care service taxes in this country. Furthermore, all services, be it mental health care, dental care, pharmacare, physical health care, need to be covered in a way that is universal and free for all people in this country. A tax exemption is a small step in the right direction, which would reduce the cost of these services directly and increase access to them, so this is an important bill.

In December 2021, I had the honour of introducing my private member's bill, Bill C-218 in the House. Interestingly, my bill would also have amended the Excise Tax Act to exempt psychotherapeutic services delivered by psychotherapists and counsellors from the goods and services tax. They say imitation is the highest form of flattery, so once again, I thank the member for Cumberland—Colchester. Ultimately, Bill C-323 is so similar to my own bill, but as someone who is 175th on the list of precedence in private members' bills, I am happy to see this bill being brought forward. I am happy to support it.

I want to bring a little bit of historical context for the introduction of why I introduced Bill C-218. It was because of a local psychotherapist in London, Stephanie Woo Dearden, a registered psychotherapist, who asked me to take action on the issue. She contacted me in the fall of 2021, and so I did my research. I discovered that this bill had actually already been previously introduced by an NDP MP, Pierre-Luc Dusseault, in 2017, and I would like to thank him for his work on this issue. Like Bill C-323, our private members' bills work to ensure that psychotherapists are treated fairly, the same as their fellow practitioners in other health care fields. This bill would work to create equality among those who do the same kind of work and are exempt from the excise tax.

I was very happy to hear my colleague's speech earlier saying that the Liberals will be supporting the bill to go to committee. However, I urge them to fully support this very simple but necessary bill so that they can rectify the blatant tax inequality that has occurred. The government says that Canadians' mental health is a priority, and this is a key opportunity for it to do something that is very easy to do to ensure that something good is done for Canadians' mental health.

Just this past March, I presented a petition in the House of Commons to remove GST from counselling therapy and psychotherapy services, and that petition received over 14,000 signatures. I thank Barbara MacCallum for bringing that forward. There were so many signatories, 14,000, because they saw that the government must act to rectify this error, and it is quite a simple thing that the government can do.

According to the Canada Revenue Agency, if a profession is regulated as a health profession by at least five provinces or territories, the services of that profession are exempt from GST/HST. Now, the profession of counselling therapy or psychotherapy meets this criteria, and it has for some time. However, a tax exemption was refused because the provinces regulating the profession had different titles, but counselling therapy and psychotherapy are the same profession, as demonstrated by a shared scope of practice, comparable qualification requirements and aligned codes of ethics. They are also recognized under the Canadian Free Trade Agreement. The federal government must respect the expertise and practices of provinces and territories in the health care field with regard to naming their professions. My bill, Bill C-218, as well as Bill C-323, demand just that.

We all know the impact that COVID-19 has had on people's mental health, and it was certainly a crisis before the pandemic. However, we are seeing the consequences on folks now, and I see it my riding.

People are stressed out, and they are worrying increasingly about their skyrocketing mortgage payments, the increase in food prices and increases of the climate crisis. All of this stress builds up, and people need more and more support. The bill is a small but good first step toward helping people, but there are a lot of barriers that get in the way of the availability of psychotherapy and counselling to the degree people need it.

As we know, right now in Canada, provinces are spending about 5% to 7% of their budgets on mental health. Some percentages, sadly, are even lower. In my province of Ontario, it is at 3% under the Conservative government, yet many OECD countries spend about 12% to 14%. In the U.K., it is higher than that.

We have a two-tiered health care system in this country when it comes to mental health. This is a huge part of the problem. Getting help should not be dependent on how much money one has. New Democrats believe that everyone should have access to mental health supports, including psychotherapy, and we believe everyone deserves timely access to a full range of mental health treatments and services.

Last spring, I held a round table and a town hall in my riding, and I would like to thank the member for Courtenay—Alberni for joining me in that discussion to discuss those key issues around mental health care. I was honoured to speak with key community leaders and hear about their challenges. We talked about the need for parity between physical and mental health in our country.

According to the report by the Mental Health Commission of Canada, fewer than one in three people with current mental health concerns is accessing mental health services. Key barriers to accessing these services are, of course, financial constraints and long wait-lists. The people around that table spoke to me about the need to meet people where they are in this discussion, so just like everyone is an individual, their mental health journey is an individual journey. Just because one form of help is right for someone, it may not be something that someone else needs, and we need to work together to figure out all those different layers and forms of help people need.

Another thing we need to change in our system is how we treat key people who are delivering the mental health care we need. Many of those frontline professionals are in jobs that do not pay them a living wage. Because they are providing urgent care or social work, they told me, they felt less valued by the system. They also felt that governments do not fund those programs adequately. Governments think these workers do these jobs solely because they want to help people, as though that altruism should be free and as though those workers do not have student loans, mortgages or bills to pay.

Many attended that round table, and they warned us that, like the frontline workers we see in the health care sector right now, mental health care workers are leaving their professions in droves because they do not have adequate pay, stable pensions, the benefits they need or safe working conditions. These services are critical, and it is up to governments to ensure that those workers have the supports they need to be able to provide the services others need.

Other mental health care workers told me that, while they see people in extreme crisis, mental illness is not the sole cause. Yes, there are people who live with a number of diagnosed psychiatric ailments, but so many whom they treat now are dealing with prolonged stress and post-traumatic stress disorder. These are caused by other factors, such as homelessness, physical sexual abuse and poverty, and these are things that the government has to address as well. The workers demanded that the government deal with these problems so that people could move away from relying so heavily upon mental services while dealing with the man-made stresses we create, ensuring that people live in these debilitating cycles.

In conclusion, the bill is a good step forward, as I have said. It is a small step, but a good step forward, and I support it because I support my own bill, so I support this one.

Canadians who are seeking help with mental health services should not be reliant upon the fact that they cannot pay for them, so I and New Democrats support the bill. I want to thank everybody who helped me to develop Bill C-218 and who will continue to work to force things such as this bill and this issue to move forward.

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

Mr. Speaker, before I get started, I want to spend a minute thanking my colleague from Cumberland—Colchester for tabling this important bill, Bill C-323, an act to amend the Excise Tax Act for mental health services. As we know, this bill would expand the category of health care services exempt from point-of-sale taxes to include psychotherapy and mental health services. As I stated earlier, my colleague from London—Fanshawe tabled a very similar bill a while ago, and I was glad to see that my Conservative colleague stepped forward and moved forward with this bill, because he is much higher in the order of precedence.

We know that physical health services such as optometric, chiropractic and physiotherapy services are already exempt from federal sales taxes. Eliminating federal sales taxes from psychotherapy and mental health services would be a step forward, but, really and truly, there should be no taxes on any health care in this country. A tax exemption would reduce the cost of these services directly, by increasing access to them, but it is not the complete solution, as I stated earlier. Taxes are certainly a barrier, and it would help with that, but many Canadians still cannot afford these services, which are critical, especially in the crisis that we are seeing right now with mental health. In terms of increasing the availabilityof these services, it does not do that, but it does reduce barriers for those who can afford, or barely afford, to access these services.

As we know, right now in Canada, provinces are spending about 5% to 7% of their budget on mental health. Actually, some are even lower. Ontario is at 3%, under its Conservative government. OECD countries are at 12% to 14%. The U.K. is at the higher end of that.

We know we have to do more to create parity between mental and physical health in this country. We have a two-tiered health care system when it comes to mental health in this country; we truly do. We know that Conservatives believe that we should have a two-tiered health care system when it comes to our physical health in this country. As New Democrats, we believe that everybody should have access to mental health supports, including psychotherapy, and we believe that everybody deserves timely access to a full range of a mental health treatments and services regardless of their ability to pay. We talked about the need for parity between physical and mental health in our country and the importance of that.

Like I said, my colleague from London—Fanshawe tabled Bill C-218 to take a step forward and to remove barriers. According to a report by the Mental Health Commission of Canada, almost 35% of respondents report moderate to severe mental health concerns. Fewer than one in three people with current mental health concerns are accessing mental health services. A key barrier to accessing services includes financial constraints and long wait-lists, so this does move a few people along. It is really important that we move forward. We know that counselling and psychotherapy are the most unmet needs of Canadians seeking help with mental health care. We are very appreciative of this bill.

My colleague highlighted earlier, and I really appreciate his doing this, that Canadians' mental health concerns have worsened throughout the pandemic. We have seen that. Again, Canadians are experiencing more and more difficulty making ends meet as they deal with increased inflation, a cost of living crisis and stagnating wages, so reducing the cost of access to services and, of course, treatment is important. Increasing the access to treatment for all Canadians who need it, by reducing financial barriers, is critical. We just want to highlight that one in four Canadians cannot pay right now for a $500 emergency. Mental health treatment can easily far exceed this cost.

I want to talk a bit about our party's history on this. A 2017 NDP-sponsored bill would have removed GST from psychotherapy services. Bill C-218, sponsored by my colleague from London—Fanshawe, would also have removed GST from psychotherapy services. It is currently out of the order of precedence, so, again, we commend our colleague for moving this forward. The same colleague from London—Fanshawe presented a petition to the House of Commons to remove GST from counselling therapy and psychotherapy services. That petition received over 14,000 signatures.

When the Conservatives' order of precedence comes forward, we do like it when they take NDP bills. This is something we are just starting to get used to.

Members will recall that Scott Duvall, my friend from Hamilton, a former MP for Hamilton Mountain, brought forward a bill on pension theft to protect pensioners and their pensions from corporations that were going after their pensions. We were glad to see that a Conservative colleague took his bill and advanced it. The Conservatives had voted against a very similar bill when they were in government before the current Liberal government.

Also the small business transfer really started with the late Jack Layton. He brought that idea forward. It was carried by Guy Caron. We were glad to see the Conservatives advance another NDP bill.

These are important bills. I really think that is the spirit of Private Members' Business, members working collectively together trying to find pathways to support Canadians. This is another example of that.

A 2023 finance committee report included the following recommendation:

Recommendation 32

Exempt counselling therapy and psychotherapy from the application of GST/HST.

This is something that was supported at finance committee and now is being advanced here in the House. This is great news.

We hear from stakeholders who are concerned about the lack of access to mental health services and the lack of availability. As New Democrats, we want to increase both. I stated that this bill might not increase availability, but it will certainly increase access to services by reducing costs.

Almost all Canadians support publicly funding mental health care, making it the same as physical health care, creating parity. Ninety-four per cent of Canadians think that provincial and territorial government health plans should cover mental health care. This was according to a study done as recently as 2019.

My colleague talked about New Democrats always going for the home run. If we want to talk in baseball terms, I would say this is a bunt. It is getting some people to first base. We actually could go for the home run. As New Democrats, we have proven that with our dental care plan to make sure that children under 12 get access to dental care. We hit second base this year with seniors and people living with disabilities. Next year we hit third base with all families that earn $90,000 or less.

We are going to hit a home run. Some day I hope that everybody in this country has access to dental care. If we brought forward a bill saying that we were going to remove GST from teeth cleaning, I do not think many kids would get their teeth cleaned. I will be really honest, it might be a step forward, and maybe a few might get their teeth cleaned, but we believe, as New Democrats, that we actually can hit some home runs in here.

I want to work with my colleague, and I hope he wants to work with me too, to hit a home run when it comes to mental health and making sure that people get access to treatment. I believe we can do it. I think we can do better than a bunt. We can get to first base, second base, third base and a home run, if we set out a plan and if we work together, which is really important.

One thing I was really disappointed about, and I have heard this from my colleagues on this side, is that the Liberal government is trying to find barriers to supporting this bill on a definition, on terms of what identifies psychotherapy and mental health. We have some really well-paid public servants who I am sure could make some recommendations at committee. Let us get the bill to committee. Let us do the right thing and work collectively.

This is a step. I support the bunt all the way. Let us get to first base. Let us get this to committee. Let us move this forward. However, the government has to get behind this. It always tries to find a barrier. I do not know what it is about Private Members' Business. Maybe the government feels like it is not going to get credit for it and it just wants to go out and oppose it. There are a lot of really smart people in this House. I want to thank my colleague, because he is one of them. He is a physician. He has experience in this, and he is trying to move things forward.

I want to support him. My team wants to support him. This is supported by a tax-free therapy campaign. This is really important. It is supported by mental health providers.

Also, when it comes to gender parity, women and gender-diverse people are disproportionately impacted by the costs of and barriers to health care. They would benefit from this bill. It is really important that we support the bill.

In closing, I want to thank my colleague. I hope all members in this House will get behind this bill, a bill that we clearly support. We tabled a bill almost identical to it earlier in this Parliament. Let us start removing more barriers from people getting access to mental health care in this country.

Taxation

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Mr. Speaker, I am honoured today to stand in this place to present a petition signed by over 14,000 people from across the country.

Due to the fact that counselling therapy and psychotherapy have long been extremely beneficial tools for those seeking mental health supports, and that registered therapists and psychotherapists in Canada are required to charge GST and HST, while other service providers are exempt from charging this tax, the petitioners are calling on the government to remove that unfair GST/HST requirement for all counselling therapists and psychotherapists.

I have a private member's bill, Bill C-218, that would actually do just that.

The signatories of this petition are calling on the government to make these changes in a budgetary bill so that they will not be charged GST.

Mental Health

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Madam Chair, one of the things I was surprised about, and I was approached by a constituent about this, was that counsellors, therapists and psychotherapists have to charge GST and taxes on their services, whereas other mental health professionals do not. This is actually a classification from CRA. It is a very simple change the government can make.

It is a drop in the bucket of what is necessary, but it would help those who are struggling to pay for some of these services. Until they are made far more available and without the idea of having to pay for them, which is also my goal, it is something that the government could do very quickly.

I have a private member's bill on that. It is Bill C-218. Would the member be open to supporting that bill?

Excise Tax Act

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

moved for leave to introduce Bill C-218, An Act to amend the Excise Tax Act (psychotherapy services).

Mr. Speaker, today I also have the honour to introduce a private member's bill that would amend the Excise Tax Act to exempt psychotherapeutic services delivered by psychotherapists from the goods and services tax.

I would like to thank my colleague, the member for Courtenay—Alberni who is the NDP critic for mental health, for seconding this bill today. I would also like to thank Stephanie Woo Dearden, a registered psychotherapist from the city of London, who asked me to take action on this issue.

This bill works to ensure that psychotherapists are treated the same as their fellow practitioners in other health care fields are, who do the same kind of work and who are exempt from the excise tax. I urge the government to get behind this very simple but very necessary bill to rectify this blatant tax inequality. The government says that Canadians' mental health is a priority, and this is an opportunity to do something good for Canadians' mental health and for tax fairness in Canada as well.

We all know the impact COVID-19 has had on people's mental health. It was a crisis before the pandemic, and we are certainly seeing the consequences on people now. This is a small but good first step to help people. I am grateful to the people who are working on this issue and who have been calling for tax fairness for psychotherapists for a very long time.

(Motions deemed adopted, bill read the first time and printed)