Evidence of meeting #46 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was study.
A recording is available from Parliament.
Liberal
The Chair Liberal Bill Casey
I call this meeting to order.
We're here to do clause-by-clause on Bill C-277, a very controversial and difficult bill that everybody's had a lot of trouble with.
At any rate, we're going to do clause-by-clause on this and we have some proposed amendments.
Pursuant to Standing Order 75(1), we will postpone consideration of the preamble and the short title and go right to clause 2.
(On clause 2)
We have a Liberal amendment proposed by Ms. Sidhu.
Ms. Sidhu.
Liberal
Sonia Sidhu Liberal Brampton South, ON
Good morning, Mr. Chair.
I want to amend Bill C-277 in clause 2 by replacing lines 21 and 22 on page 1 with the following:
care providers, develop a framework designed to support improved access for Canadians to palliative care—pro-
Liberal
Liberal
Sonia Sidhu Liberal Brampton South, ON
Yes. It is not under federal jurisdiction to require provinces and territories to give Canadians access to palliative care. We are seeking that it would be revised so the minister would instead commit to establish a framework by realigning and building upon federal efforts to support improved access to palliative care.
Liberal
The Chair Liberal Bill Casey
You're good?
Is there any other debate?
Seeing no other issues, all those in favour of Liberal amendment 1?
Yes, Dr. Carrie.
Conservative
Colin Carrie Conservative Oshawa, ON
I have a question.
That was just paragraph (a) that you said. You didn't do (b) yet. I do have some questions on (b).
Liberal
Sonia Sidhu Liberal Brampton South, ON
Yes. I also would replace lines 11 to 19 on page 2 with the following:
takes into consideration existing palliative care frameworks, strategies and best practices.
Conservative
Colin Carrie Conservative Oshawa, ON
On that line, Sonia, what do you mean by “existing” frameworks? Are we looking at provincial frameworks? Are we looking at international ones? What specifically will this improve there?
Liberal
Sonia Sidhu Liberal Brampton South, ON
As the Canada Health Act doesn't specify any particular medically necessary sources, we are proposing that this clause be removed.
Conservative
Colin Carrie Conservative Oshawa, ON
So you don't want it to be specific and look at provincial or international.... It just takes into consideration existing palliative care frameworks, strategies, and best practices from provinces, internationally...or you don't want it specified.
Liberal
Sonia Sidhu Liberal Brampton South, ON
I think they already have that access. Those services have already been there, and I think this will leverage extensive previous work on the question of palliative care.
Liberal
Conservative
Colin Carrie Conservative Oshawa, ON
Looking again at (b), Sonia, I have a question about proposed subclause 2(2). In this amendment you mention the word “initiate”.
Liberal
Sonia Sidhu Liberal Brampton South, ON
Yes:
initiate the consultations referred to in subsection (1) within six months after the day on which this Act comes into force.
Conservative
Colin Carrie Conservative Oshawa, ON
The challenge I have is that you took out the word “convene” and you put in “initiate”.
Conservative
Colin Carrie Conservative Oshawa, ON
One of my worries is that you could “initiate” something within six months or a year, but then you don't finish it or you don't do anything else, whereas “convene” means that you'd actually get everybody together and do something to develop the framework. The way I see it, “initiate” may be a start, but it may not give us anything as far as a final conclusion of it is concerned.
Would we be able to add a friendly amendment so that we initiate the consultations within six months but we have a full meeting within the year? Or could we put some type of timeline in there so that the minister knows that we are taking this seriously?
One of the challenges or push-backs we had when we did Bill C-14 was that a lot of people expected a palliative care type of framework to be initiated at the same time. I'm just worried that “initiate” gives a kind of open end to it.
Liberal
Sonia Sidhu Liberal Brampton South, ON
I think the Canada Health Act doesn't specify any particular medically necessary service. We are proposing this clause. I think its framework is flexible enough to complement the diversity of approach.
Conservative
Colin Carrie Conservative Oshawa, ON
With this kind of discussion, though, about convening a conference and meetings with the representatives of the provinces and territories responsible for health and getting that going within six months, and moving the words “initiate the consultations referred to in subsection (1)”, my concern is that you can say that you're starting on this and not do anything. That's my point. I am wondering if we could have some type of definitive timeline there so we know that things will actually get done.
Liberal
Sonia Sidhu Liberal Brampton South, ON
But is that not leveraging or extending the previous work done on palliative care?
Liberal
John Oliver Liberal Oakville, ON
I'm just following through on what Sonia has been saying. I think there's already a broad understanding of the types of programs that we need in palliative care. There have been ongoing studies and reports on this for quite a long time. Subclause 2(1) begins with, “The Minister of Health must, in consultation with the representatives of the provincial and territorial...”.
It already lays out in the beginning statement of subclause 2(1) that this has to occur. The consultation has to occur. Speaking to Mr. Carrie's concerns, there's nothing that says that the conference will produce a report at the time of the conference. It's simply assembling people from across Canada for discussion about this. It doesn't mean that that's the date the report gets finished. It can take any amount of time to continue.
And as Sonia said, there's also a huge cost to getting people.... It would cost hundreds of thousands of dollars when there's already, I think, a good understanding of what palliative care framework we need in Canada. I think it's done through the consultation process, so bringing people together for a conference didn't seem to be additive to developing the framework. What we really need to do is get the consultation done, get the framework written in a way that's acceptable to Ps and Ts, get on with it, and not stall it by waiting for a conference to happen.