Yes, first responders who are military personnel, as well as firefighters and corrections officers....
We've also heard evidence, of course, that PTSD can occur from episodic exposure: a woman who was exposed to a vicious sexual assault; refugees who are fleeing war zones and conflict zones and have come to Canada scarred and traumatized by that experience; or first nations, indigenous people. I think we can agree that those people are experiencing PTSD in much the same way as anybody else, but they didn't get that exposure through their workplace.
We heard very trenchant and powerful testimony from every witness, but in particular from our last panel, which told us about the delay that's happened in this area and how important it is to act quickly and in a timely manner for these people. We heard that it's extremely important for these victims to be heard and to be represented. If we take an approach of passing a framework on workplace PTSD, as laudable as that is, what would we be saying to those other groups—indigenous people, women, refugees, and others—who are not included in this federal framework? We would be sending one message to them, that they must wait.
I've heard a couple of arguments that it's better to get this going and not delay. With the greatest respect, Mr. Chair, that is a complete red herring, because nobody is asking for any delay. The amendments that would make this bill comprehensive won't cause any delay or difficulty whatsoever.
This bill essentially calls for the Minister of Health to convene a conference—within a year, I think—and spells out who should be around the table at that conference to begin the process of developing a framework on PTSD. The only question is who is at the table. This bill calls for the Minister of Health, the Minister of National Defence, and the Minister of Veterans Affairs to be present at that table. If we broaden that to include three other ministries, as you'll see later in my amendments, that does not delay anything. It just adds three seats to the table to develop the framework.
It's a chimera and a complete red herring for anybody to argue that broadening this bill at this point slows down anything. It does not. On the contrary, broadening this bill at this point is this committee's opportunity—right now, when the bill is in front of us—to give Canadians the comprehensive PTSD framework that all Canadians have been waiting for. I would argue that not adding these other groups now is actually playing right into the exact trauma that we're warned against. We're warned against not representing people, telling some groups they have to wait while we develop a PTSD framework for others.
Mr. Chairman, I am not going to repeat this argument at each of the different opportunities the committee will have to make this choice, but I will ask every member of this committee to remember that we sit on the committee for health. This bill came to the health committee. It didn't go to public safety; it didn't go to veterans affairs. It didn't go to the committees that one would think are charged with dealing with certain occupations. It came to the health committee, where we are entrusted to make policy for the health of all Canadians.
I would urge my colleagues here and say that, right now, we have a chance—brought by the wonderful work of Mr. Doherty, who has flagged an issue that has been ignored too long, an issue that has devastating impacts on people's lives—to make sure all these voices are heard.
I, for one, am going to very strongly urge that the health committee have this bill leave committee by saying that we have improved the bill by enlarging it slightly to make sure we develop a comprehensive federal framework for PTSD not only for these vital groups that have to deal with trauma every day, but also the three other major groups that have been identified by witnesses at this committee.
It's not a floodgate. We're not talking about 10 or 20 different groups. We're talking about three major groups—women, indigenous people, and refugees—and bringing those voices to the table when we have developed the framework.
I've also heard people say, “Let's just get this done and then we can deal with the rest of the groups later. This will be a framework. Let's just get this framework done.” Do you know what message that sends to the other groups? It tells the other groups that they can wait. That's the message it sends: “We could have dealt with you right here, but we deliberately decided that you can wait.” If I heard one message from these witnesses in this hearing, it's that we cannot wait.
Waiting costs lives. PTSD sufferers commit suicide. They attempt suicide. They lose jobs. They lose family. We heard the devastating testimony. I, for one, don't want to be a member of a committee who says to any of those groups that they have to wait, all because we didn't take the time to add a few words to this bill. Also, remember, just make sure those voices are at the table when the conference is convened.
I am going to raise this now, and I invite my colleagues' comments and look forward to your thoughts on this. If we don't broaden this framework now, if we do decide we're not going to add these other large demographic groups that are cited as suffering from PTSD, then I submit that we do have to put the word “workplace” in here, because that will then be consistent with what this bill is about. I'll point out for a moment that we heard testimony that women have PTSD at double the rate of men—double the rate—so we're not talking about marginal groups; we're actually talking about the main sufferers of PTSD.
I'm going to pause for a moment and just briefly make a case for the workplace aspect. Don't mistake my remarks for minimizing the importance of having a federal framework for workplace PTSD. That's a laudable goal. I'm going to let Mr. Doherty speak for himself later on if he wishes to, but I kind of think, after listening to everything and judging what I heard from speakers, that this is what he intended. I think maybe he intended his bill to be a bill that creates a federal framework for workplace PTSD, specifically for those people in uniform, in particular, or front-line health professionals, those people who deal with it every day in an ongoing way.
I also want to state, for the record, that I understand that there may be some differences in that PTSD, as these people are exposed to PTSD as a routine and regular part of their job. I'm not sure, at the end of the day, that the symptoms that any person with PTSD suffers with are any different, or that the treatment is any different, or that they need to be recognized any differently, but there is that one occupational difference.
I will urge the committee, though, that if we do seek to narrow this bill to this, that we make the necessary changes to insert the word “workplace” where it's necessary and to eliminate the phrasing in this bill that suggests that it's comprehensive, because that is not only incorrect, it's misleading.
I'm going to refer my colleagues to the summary of the bill. This was the start of some of my confusion. It says:
This enactment requires the Minister of Health to convene a conference with the Minister of National Defence, the Minister of Veterans Affairs, provincial and territorial government representatives responsible for health and representatives of the medical community and patients' groups
—note the reference to “patients' groups”—
for the purpose of developing a comprehensive federal framework
—here I'm going to underline the word “comprehensive”—
to address the challenges of recognizing the symptoms and providing timely diagnosis and treatment of post-traumatic stress disorder.
When you read that, it leads the reader to suggest that we're creating a federal framework on PTSD, period, comprehensively.
I want to refer my colleagues briefly to the preamble.
Whereas post-traumatic stress disorder (PTSD) is a condition that is characterized by persistent emotional distress occurring as a result of physical injury or severe psychological shock and typically involves disturbance of sleep and constant vivid recall of the traumatic experience, with dulled responses to others and to the outside world.
That, my colleagues, is the comprehensive definition of PTSD. That applies to everybody—a first nations victim of residential schools, a woman who has been raped, a refugee, or our first responders.
But then it starts narrowing the scope:
Whereas there is a clear need for persons who have served as first responders, firefighters, military personnel, corrections officers and members of the RCMP to receive direct and timely access to PTSD support;
Well, now we start grappling with this. Is there not a clear need for first nations women and refugees to receive direct and timely access to PTSD support? I don't think anybody at this table would suggest that there isn't, but now we start seeing the bill start to narrow.
I won't go through the third paragraph. It just talks about the need for resources. Then the last paragraph is confusing, because I think it attempts to do both, to be comprehensive and specific.
And whereas many Canadians, in particular persons who have served as first responders, firefighters, military personnel, corrections officers and members of the RCMP, suffer from PTSD and would greatly benefit from the development and implementation of a federal framework....
So there it's suggesting that many Canadians would benefit, including these people, suggesting that there are people who would benefit that aren't included.
By the way, I'm only going to make this speech once, because once we get the issues out and we talk about them, I think we'll get the committee's desire and then we'll make the amendments quickly. I don't plan on speaking to each one of them, but it's the same theme throughout.
Colleagues, we're going to have to change the preamble one way or the other, and I have amendments to do that. I have amendments that will clear this up so that it will deal with workplace PTSD, or provide the opportunity to broaden it to the other groups.
It's unfortunate that I have to bring it up right now in kind of an odd place, but we have to deal with it in the order that we deal with clauses. So, colleagues, with clause 2, I'm going to move, for the purposes of debate, that we include the word “workplace” before “post-traumatic stress disorder.”
We'll begin the process by suggesting that the word “workplace” be included within the following definition:
federal framework means a framework to address the challenges of recognizing the symptoms and providing timely diagnosis and treatment of workplace post-traumatic stress disorder.
As you can tell, I don't support that addition, but now is the time to have that discussion, because if it is the will of the committee to narrow this to the workplace setting, then we should start there and put the word “workplace” in. If so, I will live with and respect the will of the majority of the committee.
I hope that we don't add the word “workplace” there, because I hope we can keep the bill comprehensive. Later on I'll be moving a couple of narrow amendments to add the ministry of women, Indigenous and Northern Affairs, and Citizenship and Immigration to the bill, then clearing up the preamble to be comprehensive, unless the committee at this stage decides to add the word “workplace.” If at this point we decide to add “workplace,” I will move those amendments, but I won't speak to them because I'll understand the direction of the committee at this point.
I will end by saying this, Mr. Chair. Once again, we have an opportunity right now to pass a comprehensive federal framework on PTSD. We have an ability to recognize that this affects a number of major groups and populations in Canada outside of those who wear the uniform, or suffer PTSD as a result of their work.
We have an opportunity to stop the delay. We have an opportunity to represent the major groups. We all know that this has taken too long. As Mr. Doherty and others testified in a very impactful way, time matters in this case. We don't want to have to come back in two, three, four, five, or ten years and then pass a PTSD framework for groups that we know from the testimony in this committee are suffering today.
I will conclude by saying that it's not a big deal to add a few ministers to this. I know I'm going to be hearing from some colleagues that this will complicate matters. It will not. Having the Minister of Veterans Affairs sitting beside the Minister of National Defence.... And by the way, we're going to have to add the Minister of Public Safety to this. I think that's an omission in this bill, because RCMP officers are mentioned, and they fall under the ministry of public safety and national security. We're already going to be adding another chair. We're talking about making sure that, as a committee, the right people are around that table. Whether there are three ministries represented or six, it will not make a difference other than to improve the process to make sure that we're comprehensive.
With that, Mr. Chair, I'll move the motion to add the word “workplace”, and I urge my colleagues to defeat it—