Health Committee on Feb. 9th, 2017

[The Chair, Liberal, Bill Casey]

Go ahead, Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

My concern, without having this important amendment put forward and accepted, would be that it allows for the shutdown of any community input.

We're talking about a permanent injection site. First of all, we know from our testimony that for this to be a success, you want to have community support. Does a 45-day consultation change anything? I know the Liberals did MyDemocracy.ca, and that was 45 days. For consistency across government consultations, I think 45 days is the minimum that's out there.

Could you comment on those two points?

[Kirsten Mattison]

To the first point about whether a consultation would change anything, maybe I'll speak to the proposed changes as compared to the bill as drafted.

The bill as drafted allows the minister to post a notice of public consultation if she requires additional information to make her decision after considering the application. In the current drafting that's before you as Bill C-37, it would be discretionary for the minister to determine whether the applicant had submitted sufficient information for her to balance public health and public safety or whether she felt the need to seek additional information. The amendment proposed before you would make that consultation a requirement for 45 days. That would be the difference.

With regard to a set time or a minimum period for government consultations, I don't have experience with the consultation around the issue to which the member referred. I can say that under the CDSA, we post notice of consultation for various reasons. Often it's for notices of intent to propose orders of the Governor in Council, to propose regulations to be made by the Governor in Council, or to propose changes to policies, procedures, guidelines, templates, and that sort of thing. I have seen those consultations range from 30 to 75 days. That's typically decided on a case-by-case basis, based on who you're trying to reach and how much time they require to gather the information to respond to the government consultation.

[Colin Carrie, Conservative, Oshawa, ON]

Basically there's a usual period, as you said. It could be 30 to 75 days—that's very common—but to have zero days, as it's written now, makes it at her discretion as to whether or not she wants to consult with anybody. She may decide on zero consultations, as my colleague said, and just move ahead with what she wants to do.

[Kirsten Mattison]

In the context of this proposed subsection 56.1(4), that's correct, but that's paired with the application requirements, which would be that the applicant would be asked to submit information on any expressions of community support or opposition. Those would often be obtained after the applicant had conducted a consultation. The minister would determine whether she had sufficient evidence or whether she chose to consult.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you.

[The Chair, Liberal, Bill Casey]

Dr. Eyolfson is next.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

I have a very quick point to the question that was asked about what the harm would be in 45 days and whether it would matter.

The question I would ask in return is if there's an urgent enough need. For instance, as Mr. Davies pointed out, the day that Insite opened, they reversed 15 overdoses. Multiply that by 45 potential deaths. Does that matter? I would say it does.

[The Chair, Liberal, Bill Casey]

Go ahead, Mr. Oliver.

[John Oliver, Liberal, Oakville, ON]

I'll speak to Ms. Harder's points.

I think it's really important that we remember what we're doing here. This isn't designing the treatment programs and the whole care model around people with drug addictions. That's the province's responsibility. It's a public health area of responsibility. The gathering of people that she described for input is about care and treatment.

What we're doing here is deciding who would be exempted from the Controlled Drugs and Substances Act because of medical conditions. The fact is that the data being gathered, the information being assembled, is quite different. I agree the necessary, really important consultation with other providers would be done through a provincial or local public health authority as part of an overall care plan, but it's not relevant to this exemption.

[The Chair, Liberal, Bill Casey]

Seeing no other comments....

Go ahead, Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

I would reiterate that the current bill as proposed does invite and permit the consideration of local conditions and of support or opposition. The opportunity for community consultation is currently in the act. I think it's important to remember that.

The reason I'm opposed to this provision is that it sets out a minimum barrier of at least 45 days before an exemption could be granted. I think everybody on this committee knows that in my province of British Columbia there aren't just two supervised injection sites open right now: there are about six. Four sites opened up spontaneously, regardless of the law, to save lives. These were called pop-up overdose prevention sites. They popped up not for ideological reasons but because people were dying.

I was going to pick up what Dr. Eyolfson said. In British Columbia we had 1,000 deaths last year—914 officially, but probably closer to 1,000, if you count the deaths that probably eluded the coroner's diagnosis. That means that in British Columbia we have about 20 people dying per week, which would mean that in five weeks, 100 people would die. The Vancouver Police Department tracks the number of overdose deaths in Vancouver itself, and in the second week of January they found 15 overdose deaths per week. In 45 days, that means 75 people dying.

In Alberta, probably 400 people died last year. That's eight per week. That's 40 deaths.

The difference is that every time we erect a barrier or delay in opening sites, we are handcuffing our ability to take measures when a public health emergency demands immediate action. Although in the normal course a city or municipality may apply for a supervised injection site and could wait, this provision, if it were adopted, would restrict the ability of the minister to grant an exemption on an emergency basis. That's what we need.

That's what has happened in British Columbia. Those four extra sites operating right now are saving lives now. I visited all four of them about three weeks ago. The last thing in the world we need to do is erect a legislative barrier that says they couldn't operate for 45 days.

Given that the spirit behind it is to make sure there's adequate consultation, a fact that's in the act, we can have that consultation as Ms. Harder wants. We can ensure that local conditions are taken into account and we can leave open the discretion of the minister to act quickly if need be.

[The Chair, Liberal, Bill Casey]

Mr. Kang is next.

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

Thank you, Mr. Chair.

I will echo Mr. Davies' words. Time is of the essence when we are setting up these clinics. This amendment will constrain or tie the minister's hands for 45 days in terms of taking any action. Look at all the lives that may be lost in that delay.

Those are my comments. Thank you very much.

[The Chair, Liberal, Bill Casey]

Go ahead, Ms. Harder.

[Rachael Thomas, Conservative, Lethbridge, AB]

Chair, I'll just echo my final thoughts on this.

I think we have to acknowledge the difference between an applicant during the consultation versus the minister making notice public. Those are two very different things. When the applicant does a consultation, of course that applicant gets to pick and choose who he or she consults. That's very different from the minister making a public notice that is on the public record and is available to every member of the public.

Those are two very different things. Let's be clear about that. One is more consultative. One is not. One is more open and transparent. One is not. That the Liberals would be against openness and transparency, against consultations, is in direct opposition to what they campaigned on and in direct opposition to what's in the mandate letter for the health minister.

The second point I wish to make is with regard to the 45 days and the fact that this requirement would somehow hold this up. Now, we can argue that there might be deaths that would result from this measure. I don't think it's fair to assume that every single one of those deaths would be saved, because I don't think it's fair to say that every single person in Alberta would all of a sudden come into that injection site and not overdose. That argument just doesn't hold water.

Nevertheless, I will acknowledge that, sure, I suppose 45 days could cause some delay, and I suppose that delay could have some negative impact, but I think the negative impact is very small in comparison with the positive impact from a coherent and cohesive effort that could be taken when community organizations and members of the public come together and have their input.

At the end of the day, of course I still stand in favour of my motion. I do believe it is in the best interest of Canadians that the minister does give a minimum of 45 days' public notice.

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

If I may, Mr. Chair, I disagree with Ms. Harder. I believe one death is one too many. If the delay causes one death, that's one too many. Thank you very much.

[Rachael Thomas, Conservative, Lethbridge, AB]

I didn't say anything contrary to that.

[The Chair, Liberal, Bill Casey]

All right. Seeing no further speakers on the list, I'll seek your direction.

Shall amendment CPC-2 carry?

(Amendment negatived)

Thank you very much.

I'll go now to PV-2— no; that was a little oversight on my behalf. We have to now adopt the clause.

Do you have another amendment, Mr. Davies?

[Don Davies, NDP, Vancouver Kingsway, BC]

Well, I think maybe we need some direction from our legislative clerk.

I see a number of amendments still on clause 42. There's Ms. May's amendment, PV-2, which is an amendment proposing a new clause, clause 42.1. I have an amendment for proposed clause 42.1 as well, which has been submitted. I actually had a second amendment, which is an alternative to the one that I mentioned, so I see three more amendments—two that have been before the clerk and one that I will read from the floor.

[The Chair, Liberal, Bill Casey]

PV-2 and NDP-3 are considered part of a new clause, not part of clause 42. We are seeking to approve clause 42.

Are there any questions?

[Don Davies, NDP, Vancouver Kingsway, BC]

I'm fine with that.

My binder goes from clause 42 to clauses 43 and 44, so that's why it was—

[The Chair, Liberal, Bill Casey]

We have a new clause proposed, clause 42.1.

[Don Davies, NDP, Vancouver Kingsway, BC]

Okay, so we'll move to that after we are done with clause 42. Is that right?

[The Chair, Liberal, Bill Casey]

Yes.