Health Committee on May 4th, 2017

[The Chair, Liberal, Bill Casey]

I call this meeting to order. Today at our health committee meeting we're going to talk about two bills, and then we're going to do a little bit of committee business at the end of the second bill.

The first issue we're going to talk about is Bill C-211, and we have as witness MP Todd Doherty, who is going to give us opening remarks on Bill C-211.

Mr. Doherty, the floor is yours.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Mr. Chair, I just want to say thank you for the opportunity to be here today. Thank you to you and thank you to my colleagues for allowing me to be here to speak with respect to Bill C-211, an act respecting a federal framework on post-traumatic stress disorder. I'd also like to thank all members of Parliament for their support at second reading, when all 284 MPs present voted in favour of sending Bill C-211 to this committee. I'm hoping that we can see the same show of support at third reading.

I think we've done something unique in this Parliament. We've been able to show support across all party lines for a very worthy cause, and that is getting our warriors the support they need and deserve when it comes to post-traumatic stress disorder. Bill C-211 seeks to establish a cohesive and coherent national framework to ensure our military; first responders, including firefighters, paramedics, police personnel, and emergency dispatch; our veterans; and our correctional officers timely access to the resources they need to deal with PTSD and mental health injuries.

We're only just beginning to understand the term PTSD. In truth, even in the three years of working towards getting elected and tabling this legislation, the discussion has grown even louder. This is good, but it is very easy to forget that it was only 30 years ago that there was no classification and no name given to the demons we now know to be PTSD.

When I first started doing research for this bill, I was shocked to read that PTSD wasn't even officially recognized until 1980, when the American Psychiatric Association added it to the Diagnostic and Statistical Manual of Mental Disorders. There are generations of individuals who have lived this nightmare that we are only now starting to talk about publicly. There are generations of individuals who have struggled with PTSD who we have lost.

I know some of you in this room better than others, but I think we all have one thing in common, and that is, at our very core, when we chose to put our names forward, it is and it was because we hope to inspire change and to do better for future generations than had been done in the past, irrespective of party lines.

I was told from the outset that the likelihood of getting Bill C-211 passed was slim to none, that I shouldn't get my hopes up, and that, since I am an opposition member, the government would never let this pass. As I met with people first from my riding, then from all across this country, and indeed, across party lines, I began to see what I already knew. This is not a Conservative issue, it's not a Liberal issue, nor is it an NDP issue. I've heard very real stories from our brave men and women who have made sacrifices. I also heard from the families and colleagues of those who lost their fight and those who are still in the thick of this terrible disease.

Colleagues, by getting Bill C-211 to committee today, we've already beaten the odds and the naysayers. We have proven that we can put aside party politics and work together to leave a legacy, or have we? Will C-211 die at committee stage? That's the message we've received, that this is a feel-good moment, that the box has been checked off, but it now affords the excuse that there was no consensus at committee.

We've heard that before in this Parliament, haven't we? I apologize for this comment, but you have to understand that lives are at risk here. Every minute we delay or decide that we need to study something further, lives are lost. It has been 563 days since those around this table were elected. It has been 556 days since I first landed in Ottawa with the background for Bill C-211. It's been 462 days since I first tabled C-211, and 57 days since we stood together. In all that time, we have lost lives.

Mr. Chair, I offer to you that a mere one year ago, only about 800 metres from here, an RCMP member chose to end his battle mere steps from the front of Parliament. We need to be better, and I challenge all of you that we can do better. There is so much work that needs to be done. The message we have delivered to this point has been that we have heard the stories, that we believe the stories, and we will act. In doing so, we have given our warriors hope, and this, indeed, is a heavy burden to carry.

We have an opportunity before us today to get this bill through committee because as it stands, the standard of care, education, and even our terminology, be it OSI or PTSD, still varies from one province to the next.

Our government has said that PTSD is a priority and it is outlined in the mandate letters of the Ministers of Public Safety, Veterans Affairs, and Health. This is our chance to align all of our work done to date on this issue and get a line item on the federal books, so that no government, present or future, will be able to move forward without our warriors.

A national framework would ensure that every year a conversation is happening on best practices, on treatment options, and on how best we can help as a society, so that no one is left behind.

I have said this before and I'll say it again. We have received many emails, many of them full of heartbreak and tragedy as a result of careers. I'd like to take a moment, if you will, to read one that I received a little over a year ago.

“As I write this, I'm trying hard to hold back the tears. The truth is I'm unsure how I even have tears left. I've cried every day since his death and it's been over a year. I can only manage a day at a time, and even that at times is too much. I don't know what tomorrow will bring. I guess no one really does. We were only married three years and he was my one true love. He would have been 30 this year. Our son will never know his father. He will never know the incredible man he was. My husband only wanted to serve and to save. Sadly, no one could save him. It's odd how everyone gathers around you at first, then life goes on. I don't get the invites anymore. It's like other wives don't want to be reminded of this, of how this could have been them.

“Mr. Doherty, your bill is too late for my family, but I hope you will be successful. My pain endures and I'm not sure there is a fix. I will tell my son that his dad was a hero and saved lives. I believe if my husband knew of you and your efforts, it just might have given him enough hope that he would have reached out, that he would have hung on. Please keep fighting for this. For us it is too late, but you and your colleagues will save the lives of others.

“Thank you.”

Mr. Chair, this is one of hundreds, maybe even thousands, of emails, messages, and comments on social media we have received and private meetings we have held, since tabling our bill. It truly is overwhelming. We have heard the stories of those who are struggling today, those who are receiving help, and those who are left behind to somehow pick up the pieces.

We have to come up with solutions, so we don't lose another life to PTSD. I'd like to ask the committee members—and I also mentioned it in my speech at second reading—if the cost of action on the national framework for PTSD is too great for our government, be it the federal government or the provincial government, what then is the alternative? What is the cost of inaction? How many more lives are we willing to lose before government steps up to the plate? What value do we place on those who we ask to serve our country without hesitation, to answer our call without hesitation, to run into burning buildings, to run towards gunfire? When we call, they answer, any time, any place, and for any reason, with no questions asked, but have we been there for them? Have we answered their call?

These are all questions we need to be asking ourselves today, for all of those who are still fighting. When they talk to one branch of government, are they then referred to another or a different office, or a different phone number, or shuffled to the next wicket? Have we turned a blind eye and said, “It's not my problem”? For those who have a friend, family member, or loved one who has lost someone to PTSD through our inaction, are they spending their lives on hold waiting for someone to listen to them?

This is unacceptable. We must and can do better for our fellow men and women. This begins with education and a willingness to learn. It begins with the bold action of saying, “Enough is enough”, so that regardless of our party politics, we can and will finally do something about this terrible disease.

Let's stop making excuses. Let's not further delay or deny action. Those of us, around this table and in this House, can do this. It is the federal government that can set the tone and provide leadership right across our nation on this terrible disease.

This issue has been studied by other committees. We can build on their work and move this legislation forward. Only through bipartisan support and co-operation can we hope to achieve effective and viable strategies, terminology, and education to help deal with PTSD. Let's choose to give back in the one small way that we are able to by ensuring that our protectors have the opportunity to receive basic, standard care and treatment to deal with their PTSD, and by ensuring that our terminology and laws are consistent across the country, and that our heroes in the east are treated the same as our heroes in the west, because for too long, we have left our first responders, our military, and our veterans behind.

Mr. Chair and colleagues, it has been an interesting spring session. I read earlier, from the wife of a fallen officer. One line sticks out, “I don't know what tomorrow will bring. I guess no one really does”.

For those who have been following our journey, those who are in the room with us today, and those who are watching across our nation and internationally, tomorrow is just another excuse for delay. Sometimes, tomorrow is too far away. Let's not wait for tomorrow, Mr. Chair and colleagues. We can make a difference today.

I'm asking for your support to ensure that Bill C-211 moves forward in a timely manner, because it will save lives. At second reading, we proved to our community of warriors that we stood in solidarity with them. I'm telling you today that this committee and our House collectively have the power to leave an incredible legacy.

With that, I'll end. I just want to say, once again, thank you, and I appreciate and will take your questions.

[The Chair, Liberal, Bill Casey]

Thank you very much.

We appreciate your passion and your concern.

I just have to say that almost every issue we deal with is really important to people, and lives are at stake in almost everything we deal with. I think we do a pretty good job as a non-partisan group of members of Parliament to analyze them, and that's what we're going to do with your bill for sure.

We're going to start questioning with Mr. Ayoub for seven minutes.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

Thank you, Mr. Chair.

I want to thank and congratulate my colleague for tabling his bill.

I'm pleased that you clarified the non-partisan aspect of bills that deal with the health of Canadians. These bills are all important, and we handle them as diligently as possible. We always want to do better. We would like to work faster, but that doesn't always allow us to do better.

Taking the necessary time to conduct a proper study and to do things correctly is part of the process. I don't want to go over the non-partisan and political aspect. You really focused on it. However, this aspect doesn't really concern or interest me when it comes to bills that deal with the health of Canadians.

We can't be against virtue. As you have seen recently by the government's actions, ensuring the mental health of Canadians has been a priority since day one. We've taken measures, as demonstrated by the budget. Significant amounts have been invested across the country. The minister came to talk to us about it. Mental health is a very important issue. Today, we're talking about post-traumatic stress disorder. The disorder represents a significant portion of the impact of mental illness that must be addressed.

Your bill requires that a conference be convened to establish a federal framework for post-traumatic stress disorder. The development of a national action plan on post-traumatic stress disorder was one of the priorities identified in the Minister of Public Safety and Emergency Preparedness's mandate letter.

How is this federal framework different from your bill?

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

I really appreciate your comments.

Every government comes out with a mandate, and they choose to allocate funds and move forward with it. We know from the nature of government and from the nature of the day-to-day that sometimes we fail or we lose sight of our best intentions.

My bill came out before the mandate letters did and we moved forward with those. Bill C-211 calls for a national framework to be developed, working with our provinces, working with legislators, working with industry and academics from across our nation. There are groups that are doing some incredible work. There are provinces that have followed through with different pieces of legislation.

But as we stand today, there are still inconsistencies in what is being delivered from one end of our nation to the other. Leadership needs to be seen. This is calling for a piece of legislation so that irrespective of government, there will be a line item to ensure that the responsibility to our warriors and our front-line workers will be maintained and that as we move forward, we're moving forward in lockstep and taking care of those who serve their communities and their country.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

Have you had the chance to meet with the minister and discuss this federal framework with him?

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Yes. As a matter of fact, we've met with many of our colleagues across all party lines from the very beginning, whether it was the Minister of Health or Minister of Public Safety, and we have continued to dialogue also with the parliamentary secretaries.

Again, as I mentioned, this is a non-partisan issue for me, and in doing our background work we made sure that we were working with colleagues from all sides of the aisle. I have to say that we often get thanks for the work we've done and for being a champion of this issue, but the reality is that we have champions on all sides of our House who have been doing some incredible work in the ridings and in the industry with this.

To sum up my answer for my honourable colleague, I have had meetings with ministers, not formal meetings, but we have had meetings to discuss our bill.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

Your bill was introduced prior to the release of the Standing Committee on Public Safety and National Security's report. Recommendations were made through the committee.

What do you think of the content of this report and of the recommendations? Would you implement any of the recommendations to improve your bill?

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

I had the opportunity to actually sub in on those committees, on that committee work. Because of the work that I've done in this area, my passion, as well as my bill moving forward, I was afforded the opportunity to sit in and participate in that.

There's great work that was done on that report. I actually referenced it in my speech. I think it is something that we can use as a road map moving forward. But as you and I know, Parliament and, indeed, legislative assemblies right across our country are filled with committee reports that sit on shelves and simply collect dust. I think we need to use that report, as well as the one that you're doing, to really lead that legacy of action. That's what I'm calling for.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

Have you identified certain amendments that could be included? Have you reached that step?

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

No. I think we've gone through it. I think number one is looking at a national framework, national strategy on how we move forward. We've received a letter from the Minister of Public Safety on that as well, as they move forward.

Again, we need to be moving forward in a coordinated, cohesive manner nationally. The number one recommendation out of that report says that there is indeed a need and that they recommend that there be a national strategy to fight PTSD.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

Thank you.

[The Chair, Liberal, Bill Casey]

Mr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Mr. Chair.

I want to thank my colleague. Todd, you've been very humble. I know you're giving credit around the table to everyone, and it is true that we have many people taking leadership roles and championing this, but without your leadership and your passion and commitment it certainly wouldn't be where it is today. On behalf of everybody, I thank you for that.

I know you've been very involved and you've had a lot of responses from the public safety community. I was wondering if you could share with us at committee one story that really stands out in your mind. Is there one?

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

There are many. I get emotional when we.... As I said, there's a heavy burden when you're listening to these stories. You have people you consider heroes who are pinning their hopes on what we're doing. I used to think that I handled stress very well, but I think the weight of the world has been placed on our shoulders, and that speaks volumes to the issue and the need for us to do something.

I will answer the question. I developed a challenge coin with respect to my bill. I don't know if anybody has seen it. Mr. Chair, if it's okay.... On one side it has my parliamentary crest. On the other side it has the shields of first responders and our troops.

At Christmastime we were back in our ridings, and I was walking through a lobby. As you know, our days are fairly busy. Our schedules are not ours anymore. I saw a friend of mine who is in the RCMP and whom I've known for a very long time. As I was going by, I patted him on the shoulder and said, “Thanks for everything you're doing.” I kept going, but I was drawn back. I don't know why. I went back and said, “I'm really sorry to bother you.” He was meeting with his team at that time. I said, “I don't know if you know, but I have a private member's bill with respect to PTSD. It's called Bill C-211. I have a challenge coin that I want to give you, and I just want to say thank you for everything you're doing.” Then I left and went on my way.

We went away for Christmas. When I came back, there were emails, voice mails, and messages from this gentleman. Finally I phoned him and I said, “What's up?” He said, “I just have to tell you. I don't know if you believe that things happen for a reason.” This is very altruistic, for those who are here. He said, “I want to ask you if you remember when we saw each other before Christmas.” I said, “Of course I do.” He said, “Something drew you back to see me, and you gave me your challenge coin. Nobody knows this, but I was at my darkest point. I was essentially saying goodbye. Nobody knows this. Since getting that coin, I've come out to my wife, and I've sought treatment. I want to be the face of your bill, because you are saving lives and that day you saved my life.”

You can see how emotional it is. That's just one. We had a gallery filled with people. Every day they send us the same. There are so many. We can save lives.

Sorry. I'm a big baby, but this is real. It's not made up. A simple pat....

When 284 members of Parliament stood unanimously on March 8, 56 days ago, there was a giant of a firefighter suffering from PTSD who was emotional and was crying. He said, “For the first time, I have hope.” To me, that's shocking. I'm sorry, but that's unacceptable for us as leaders within our country. We have to do better, and we have to be better.

Is there one story? There are many stories. That's one. His story.... It was released that day. His name is Kent MacNeill, staff sergeant for the RCMP. Every day, I'm inundated with the same. We have thousands of stories that are the same, whether it's a survivor or a wife, as I read earlier. It's crazy.

[Colin Carrie, Conservative, Oshawa, ON]

Thanks for sharing that. Do not apologize for getting emotional. I think all of us around the table here have either friends or family who put their lives on the line for us. All of us owe those individuals more than can ever be paid.

I'm so impressed with what you have done here. It is so rare that a private member's bill receives unanimous consent like this at any stage of the legislative process.

Can you take a moment and explain to those who are listening why you think Bill C-211 received support from all sides of the House?

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Yes. It's because we all know somebody who this has impacted. We're inundated with media about another first responder or veteran who has committed suicide. I think we're just now understanding the challenges associated with mental health injuries.

We have groups that are doing some incredible work. As we sit here today, it's Mental Health Week. I'd like to say that I think there is indeed a genuine willingness to get this going and get moving. We need to do it.

We need to put a piece of legislation in place. The question earlier was, why do we need a piece of legislation to have this take place? I get that all the time. We need a piece of legislation because it mandates us to move forward, whether it's this government or the next government. If the next government chooses not to do it, then they have to come before the House and tell us why they won't. They have to answer to Canadians. They have to answer to those who sign up, wear our maple leaf on their shoulders, and put their lives in danger so that you and I and our families can sleep soundly at night.

That's why this bill is so important. That's why I think we're seeing unanimous support along the way. We can't lose another life this way. It's so important for us to keep this momentum going.

[The Chair, Liberal, Bill Casey]

Thank you.

Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

Thank you, Mr. Doherty, for being here.

Mental illness affects some 6.7 million Canadians. That's about 20% of the population. It costs our economy an estimated $51 billion each year. That's a bigger burden than is caused by cancer or infectious disease, yet only about 7% of public health care spending in Canada goes to mental illness. Nearly one in 10 of the Canadian military personnel who took part in the mission in Afghanistan are now collecting disability benefits for post-traumatic stress disorder. Experts say the prevalence of that disease is likely much higher among Canada's combat troops.

Overall, 17% of Canadians aged 15 or older reported having a mental health care need in the past year, but one-third of those individuals reported that their needs were not fully met. We all know that most mental health remedies and therapies are actually not even covered by our health care system, such as access to counselling.

Mr. Doherty, you mentioned that maybe we've only recently come to terms with PTSD, and I think that's partially true. But in 2008, almost 10 years ago, researchers at McMaster University released a study that found the prevalence rate of lifetime PTSD in Canada was an estimated 9.2%. Furthermore, the researchers estimated that at any given time, 2.4% of the population is experiencing the disorder. A study by the U.S. Department of Veterans Affairs found that Canada had the highest prevalence of PTSD of the 24 countries included in the study. They found that 9.2% of Canadians, almost one in 10, will suffer from PTSD in their lifetime.

I'm going to congratulate you as a private member for bringing this important issue forward, but I want to put on the record that I don't believe that a federal framework for PTSD should have been left to the efforts of a private member. I believe it is the responsibility of the government of the day to bring that framework forward, and the government has failed to do so over the last 10 years. I want to put that on the record.

Mr. Doherty, I think your bill is an excellent start. It mentions first responders and military. First responders are twice as likely as the average Canadian to suffer from PTSD. Every day they selflessly brave horrific circumstances that greatly increase their susceptibility to operational stress injuries. They have our backs, and I think it's time we had theirs.

In terms of the military, we must honour the incredible sacrifices made by our courageous women and men in uniform every single day. We have to remember that these heroes are human, too, and we need to give them the respect and the services they deserve.

Having said that, as I study your bill, I'm concerned about the scope of the bill being too narrow. In your preamble, you specifically mention first responders, firefighters, military personnel, corrections officers, and members of the RCMP. Those are the only groups that are specifically mentioned. Your bill calls for the convening of a conference, no later than 12 months after the day on which the act comes into force, with the Minister of National Defence, the Minister of Veterans Affairs, and then provincial and territorial government representatives. Of course, that conference will be convened by the Minister of Health.

My questions to you are going to be about whether you would be amenable, Mr. Doherty, to broadening this. Let me go through the broadening that I suggest would make your bill even better.

We know there are gender differences in the prevalence, comorbidity, presentation, and treatment of PTSD. Women are twice as likely as men to be diagnosed with PTSD. The reasons are a little bit unclear. Some think it could be linked to sexual assault, because women are of course much more likely to experience sexual assault than are men. Mr. Doherty, would you be amenable to us amending your bill to include the Minister of Status of Women, as a ministry, to join the Ministers of Veterans Affairs and National Defence in this conference?

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Thank you for that question.

I want to first talk about the statement that you read.

[Don Davies, NDP, Vancouver Kingsway, BC]

I don't have much time, Mr. Doherty, so I'd like you to answer my question if you could.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

I think you'll be happy with what my statement is going to be.

I would agree. I think it's shameful, whether it's this government, previous governments, or what have you, that certain provinces are still fighting to get some form of legislation in place. Legislation and leadership need to be done at the federal level. That's why I'm saying now is the time.

In terms of the Minister of Status of Women, I'm amenable to any recommendations that this group has. My challenge is with you, and one that was left off of that is the Minister of Public Safety. It has been noted, and we've had that discussion.

I think it's very important that we are mindful that every day we delay getting the ministers around the table, whether it's the three that you've mentioned, the public safety minister, or the minister of women.... That's what our bill does. It legislates getting the ministers around the table with their provincial colleagues, with industry, and academics to start working on this framework. At that point, who's involved in that, I think that's up to the—

[Don Davies, NDP, Vancouver Kingsway, BC]

That's exactly my question.

First, in no way am I talking about delay. I'm honouring the convening of the conference within 12 months. The questions I'm going to ask you are to make sure we have the proper people around that table.

Your bill, Mr. Doherty, has specifically indicated certain ministries that you want around that table, and I think you're quite right to have required the Minister of National Defence and the Minister of Veterans Affairs. Of course, I think it is an omission that you don't have the Minister of Public Safety, which, of course, we will propose amending, because you make reference to the RCMP, and the Minister of Public Safety is, of course, the minister responsible for public safety. I'm going to be moving an amendment to add the Minister of Public Safety at this conference for sure. I'm also going to be moving that we add the ministry responsible for women.

I want to talk about indigenous people, because we know with the residential schools issue that probably, outside of military and first responders, the largest incidence of PTSD in the country is in our indigenous population. Research has been conducted that shows there are wide variations, but a 2003 study on B.C. residential school survivors put PTSD rates as high as 64%. Michael Pond, who has worked with first nations communities for 40 years, estimates PTSD rates could be as high as 90% in some communities.

I'm also going to ask if you would be amenable to our adding the minister responsible for indigenous affairs to this conference to make sure that PTSD, as it affects our indigenous population, is also heard in the development of a national framework.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

I'm going to offer that I'm amenable to any changes or recommendations that are moving forward. I will offer this. My bill was developed to look at the overwhelming issue and epidemic that we have with respect to our first responders, our veterans, and the military, and I'm very well aware of the mental health statistics right across the board.

Our challenge is this, and we met with a number of different groups as well as we moved forward. Today, as it sits—and you mentioned it in your opening preamble—we do not have a piece of legislation. We have not seen any action by government, and sometimes as we move forward in government, with best interests intended, we make something so onerous that we cannot wrap our heads around it and we will then fail at a later date.

I would offer to you that the way our bill was drafted was that it would be the best way moving forward so that we had a piece of legislation that then could be used as a template to make sure that we're looking after our other—

[Don Davies, NDP, Vancouver Kingsway, BC]

Can I ask—