Health Committee on Nov. 24th, 2016

[Rob Nicholson, Conservative, Niagara Falls, ON]

It's hard to say. In an effort to shorten my comments, I didn't get into all that.

I think there is a greater awareness. It's not just the G8. I think I mentioned the United Nations, in terms of kind of coordinating this information. It's a greater realization of the globalization of this world that we have to share this information, that we are not alone on any of these issues here. If you go back 50 or 70 years, research was done exclusively and it wasn't shared. There's a greater realization today, and I think it's a step in the right direction that we share information. Again, it's a function of the globalization of the world. It's what we have to do. It benefits all of us.

[Rachael Thomas, Conservative, Lethbridge, AB]

I think this is what I'm hearing you say, and I simply want to make sure. With regard to the language, using Alzheimer's versus forms of dementia in general, if we were to put a focus on Alzheimer's, it could mean we would find a cure. The probability of that is quite high, based on the research that's taking place in Canada, and could further take place with greater funding and expertise on this matter, and in partnership with other countries. Whereas if we were going to take that same chunk of money and spread it over, let's say, 10 different dementias, it wouldn't go nearly as far and it wouldn't produce a cure.

Am I understanding you correctly on this?

[Rob Nicholson, Conservative, Niagara Falls, ON]

I'm hoping.... We want to solve all these different issues, but I've come to the conclusion that if it is one of the focuses of governments and government coordination and internationally on Alzheimer's, we can and will make a substantial difference with respect to this particular disease. Those are my thoughts on it.

[Rachael Thomas, Conservative, Lethbridge, AB]

The last thing I would ask you then is, do you have any stats? If we look at the whole spectrum of dementias, is Alzheimer's the one that the greatest percentage of the population suffers from?

[Rob Nicholson, Conservative, Niagara Falls, ON]

I would say it is.

[Rob Oliphant, Liberal, Don Valley West, ON]

What I've read is it's about half. About half of dementia is Alzheimer's and the other half is the collection of a variety of ones. It's tough, though, when you look at a family. If the focus is on research, absolutely there's some really important stuff happening there. A family's life is really more than disrupted, it's overturned by any of those dementias.

My problem is, as a pastor dealing with families—and I'm the bleeding heart at this table—I want to help them all. I've just seen too many families where they simply don't know where to turn. I am looking for federal government leadership in that way. It'll be up to you to decide how much you want to focus on precision and how much you want to broaden that mandate. It'll be up to you.

[Rachael Thomas, Conservative, Lethbridge, AB]

Thank you.

[The Chair, Liberal, Bill Casey]

Thanks very much.

Ms. Blaney, welcome to the committee. You have seven minutes.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Thank you, and thank you to our witnesses today.

I spent many years volunteering for an organization that provided respite. A large number of the families that I worked with were dealing with dementia. I would either support the person with dementia or support the family in different ways. I have a great amount of compassion for the significant impacts this has on communities and the families.

My first question is going to you, Mr. Nicholson. You mentioned thanks earlier to Claude Gravelle, who introduced Bill C-356, a national strategy for dementia. Unfortunately, that bill was defeated. It was a very close vote: 140 said no; 139 said yes. The majority of the Conservative MPs, including you, did not vote positively for this bill.

Given how similar your legislation is to the last bill, why did you choose to narrow its focus?

[Rob Nicholson, Conservative, Niagara Falls, ON]

I thought about this, as I say, about six months ago, and I remembered the bill because.... I started reading about the problems with Alzheimer's and indeed other dementias while I experienced this in my own family. When I looked at it, I thought the bill we had before Parliament would have required a royal recommendation. That was what we heard at the time. That means it wouldn't have gone forward.

The other problem with it was in regard to the timelines. If you'll notice, in mine I made it that the minister will convene a meeting within a 180 days, within six months, basically. I thought that was more realistic than a statute requiring the minister to move on this thing in several weeks. I didn't think that was realistic. Plus the feedback that I received at the time was that a royal recommendation would be needed; therefore, it wasn't going to proceed.

That being said, when I thought about it, I thought okay, if we can modify it, modify those challenges, then I believe the bill should be able go forward. My colleague Mr. Oliphant will confirm this. At the time I spoke with him about this, he analyzed the bill just on those counts alone. As it comes before you today, I don't think you've heard anybody say or had any advice that it will need a royal recommendation, because we tried to be very careful. I believe the timelines are very realistic.

At the same time, the overall concept of getting into this area, on every occasion, I have mentioned Mr. Gravelle. When I have spoken to people privately, who, as you can probably imagine, have engaged me on this, I have pointed out that this is not the first time Parliament has had a look at this. I hope that it goes forward.

Again, I asked a colleague from another political party to second this bill here. I do want it to be accepted by everyone.

Those are my comments.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Mr. Nicholson, if you're concerned that the legislated remuneration requirement would act as a barrier to this bill's or the past bill's passage, why is it necessary that in your bill you actually explicitly forbid any form of remuneration?

[Rob Nicholson, Conservative, Niagara Falls, ON]

I didn't want to have anything on which the argument could be made. You know what happens on these things. People will make the argument that this is going to require money from the government, that the government is going to have to spend money. I tried to be as careful as possible, because I know there are people across this country who are prepared. You meet them all.

You talked about yourself and your contributions. I've met many people like you in my own constituency of Niagara Falls, Niagara-on-the-Lake, and Fort Erie who just contribute their time. They're volunteers. They're not in it to be paid. I believe that there are experts who would come together for this.

By putting that in there I hope to avoid the argument that this would need a royal recommendation, because I didn't want to have any technical reason for why something like this would not go ahead.

Those are my reasons.

[Rob Oliphant, Liberal, Don Valley West, ON]

I would like to add to that.

Back in 2011 the people spoke and sent me home from this place, and they brought me back in 2015. Between 2011 and 2015, I was president and CEO of a national health charity for people with asthma—another “A”. The way we would focus as a health charity is that we would prefer not to have remuneration at a government advisory board, because that is part of our job as a society. We would like expenses paid for going to meetings.

However, to maintain our independence, to maintain our integrity as a not-for-profit and charitable organization, and we were both a patient organization as well as a health charity, we would think it's actually appropriate for us to work in that charitable sector advising government. That doesn't mean we don't want government funding for various projects. We were always looking for PHAC, Public Health Agency of Canada, funding, etc.

However, I would say that part of the bill is not a negative; it is a positive in the health charity world. It's the way we work. It's the way we keep our independence, the way we do it.

In terms of caregivers and patients going to those meetings, again, we think expenses, obviously...and that's the way meetings happen; there's a budget for a meeting. But remuneration in terms of a per diem payment for your expertise would not be appropriate.

[Rachel Blaney, NDP, North Island—Powell River, BC]

When I talk about remuneration, refunding expenses is part of what we're talking about. One of the challenges, because this is very clear, and nothing that's in the legislation.... I also ran a charity for eight years, and one of the challenges that I feel could come to this bill is that we're losing people. We saw the witnesses who were here earlier this week, and they were people who are working very hard, especially when you think about direct caregivers. We heard about the direct caregiver and how financially significant the impacts were. If we offer absolutely nothing, it potentially cuts off some groups of people.

[Rob Oliphant, Liberal, Don Valley West, ON]

I disagree that nobody would receive remuneration for the performance of their duties. In my mind that very much is payment for expertise. Absolutely, if you're having an advisory committee meeting, you would follow Treasury Board rules, etc., that would work into current departmental budgets.

[Rachel Blaney, NDP, North Island—Powell River, BC]

I look forward to seeing that happen.

[Rob Oliphant, Liberal, Don Valley West, ON]

There was never an intention to not refund expenses for meetings that should be paid.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Then I think it should be removed from the legislation.

I want to get on to another issue. Unlike Bill C-356, the national strategy for dementia act, this legislation doesn't contain any provisions to augment the capabilities of the voluntary sector. Can you explain why you chose to exclude any mention of the voluntary sector from Bill C-233?

[Rob Nicholson, Conservative, Niagara Falls, ON]

The voluntary sector is an inherent part of what this is all about: people who volunteer. We are trying to bring together people who have expertise, and their expertise could be in many ways. We try to be as inclusive as possible with respect to the legislation to bring together this advisory board, and this is a step in the right direction.

[Rob Oliphant, Liberal, Don Valley West, ON]

It's there, the lay advocacy sector.

[Rob Nicholson, Conservative, Niagara Falls, ON]

Yes, it's there, so it is not restrictive, and indeed the volunteer sector is huge in all aspects of looking after people who suffer from diseases such as this. Again, I use the word “remuneration” specifically, which is—and this is the lawyer in me—the payment for expertise. The expenses of getting to the meeting here, or the hotel over there, are not included in this.

[The Chair, Liberal, Bill Casey]

Mr. Kang, you're next.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Thank you, gentlemen, for bringing this bill forward.

As we discussed before, almost everybody is affected by some kind of mental disease in their family or friends. This is a good bill, and of course you're going to have my support.

At the first meeting on Bill C-233, on November 17, Mimi Lowi-Young—

[Len Webber, Conservative, Calgary Confederation, AB]

Mr. Chair, I understood that we were going to go through seven minutes for each party and then we would end the questioning at that time.

[The Chair, Liberal, Bill Casey]

We're going to do the first seven-minute round of questions, so it's Liberal, Conservative, New Democrats, and Liberal.