Evidence of meeting #67 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was legal.

A video is available from Parliament.

On the agenda

MPs speaking

Also speaking

Lynda Balneaves  Registered Nurse and Medical and Non-Medical Cannabis Researcher, Canadian Nurses Association
Karey Shuhendler  Policy Advisor, Policy, Advocacy and Strategy, Canadian Nurses Association
Serge Melanson  Doctor, New Brunswick Medical Society
Robert Strang  Chief Medical Officer of Health, Nova Scotia Department of Health and Wellness
Michael DeVillaer  Assistant Professor, Policy Analyst, McMaster University, As an Individual
Mark Kleiman  Professor of Public Policy, Marron Institute of Urban Management, New York University, As an Individual
Trina Fraser  Partner, Brazeau Seller LLP
Brenda Baxter  Director General, Workplace Directorate, Labour Program, Department of Employment and Social Development
Norm Keith  Partner, Fasken Martineau DuMoulin LLP
Clara Morin Dal Col  Minister of Health, Métis National Council
Isadore Day  Ontario Regional Chief, Chiefs of Ontario
Wenda Watteyne  Senior Policy Advisor, Métis National Council
David Hammond  Professor, University of Waterloo, School of Public Health and Health Systems, As an Individual
Mike Hammoud  President, Atlantic Convenience Stores Association
Melodie Tilson  Director of Policy, Non-Smokers' Rights Association
Pippa Beck  Senior Policy Analyst, Non-Smokers' Rights Association
Steven Hoffman  Professor, Faculty of Health, Osgoode Hall Law School, York University, As an Individual
Beau Kilmer  Co-Director, RAND Drug Policy Research Center
Kirk Tousaw  Lawyer, Tousaw Law Corporation
Stephen Rolles  Senior Policy Analyst, Transform Drug Policy Foundation

12:30 p.m.

Conservative

Len Webber Conservative Calgary Confederation, AB

Thank you.

12:30 p.m.

Liberal

The Chair Liberal Bill Casey

Mr. Davies.

12:30 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Thank you.

Mr. Keith, do you know what percentage of workplace fatalities annually are due to impairment?

12:30 p.m.

Partner, Fasken Martineau DuMoulin LLP

Norm Keith

No. That's a really good point you raise. The Association of Workers' Compensation Boards across Canada, which collects the most reliable data that covers most, but not all, workplace accidents and fatalities, measures on a number of collection criteria but they don't collect the data on alcohol or drug-related fatalities.

In Ontario, the chief coroner has a policy—it's not legislation or regulation but a policy—that every time a worker dies at work, the worker is tested for drugs or alcohol. That's how we often know what the substance is; otherwise the employers or the public never know.

12:30 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

In that jurisdiction, do we know then? If they are testing after fatality they must know what the percentage is.

12:30 p.m.

Partner, Fasken Martineau DuMoulin LLP

Norm Keith

Yes, absolutely.

12:30 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

So what sort of percentage is there?

12:30 p.m.

Partner, Fasken Martineau DuMoulin LLP

Norm Keith

The coroner has that information and it's estimated between 38% and 40%.

It's sad and tragic.

12:30 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

That would be a correlation that they find the presence of a substance but that's not necessarily a finding of cause of the death, I would take it?

12:30 p.m.

Partner, Fasken Martineau DuMoulin LLP

Norm Keith

Correct.

Causation is always a complex analysis.

12:30 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

I would like to get your views on how we would define safety sensitive positions. Engineers design bridges. A mistake made by an engineer in a critical calculation could cause a bridge to collapse. It is the same thing for architects. A fire in Britain caused 80 deaths. It looks like there was a decision made by someone not to put fireproof cladding inside the building. Doctors make life-and-death decisions; surgeons have people under the knife. Police carry guns.

I'm curious, it strikes me that all those are safety sensitive positions. Would you include those groups in your proposal to randomly test?

Diplomatically, I'm keeping lawyers out.

12:30 p.m.

Partner, Fasken Martineau DuMoulin LLP

Norm Keith

Definitely keep the lawyers out.

Safety sensitive positions are defined in employer policies in industries across Canada and around the world. The problem is that different interest groups and different industries are going to have a different approach to defining “safety sensitive position”.

The courts and arbitrators keep crying out for legislation, and for legislative and parliamentary leadership on defining a framework for that term. It may not be a definitive or an exhaustive term. It may or may not include engineers who are designing safety sensitive, public safety-related cladding in buildings.

I think without any legal definition or attempt to define it as part of a framework, and that being of course the basis upon which you then can test people.... We're not suggesting that everybody get tested. The thing is that this be a rational process. Otherwise, what you're doing is saying, it's all up for grabs, and it will be litigated to death.

My interests really are against the interests of lawyers. You're going to reduce the amount of litigation, which is not a bad thing in society, I think I would suggest.

12:35 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Ms. Baxter, did you want to say something?

12:35 p.m.

Director General, Workplace Directorate, Labour Program, Department of Employment and Social Development

Brenda Baxter

I did want to say that through the jurisprudence they actually have somewhat defined what a safety sensitive position is. It's:

A safety-sensitive job can be characterized as one in which incapacity due to drug or alcohol impairment could result in direct and significant risk of injury to the employee, others or the environment.

You have to consider that in workplaces, you have large workplaces, small workplaces, medium-sized workplaces, unionized and non-unionized ones. I think what's at the core of this, in determining what is a safety sensitive position, is really the tenet of the occupational health and safety regimes in Canada, which is that dialogue between the employer and employees to be able to determine what the hazards are in the workplace. In doing so, you would be defining what some of those safety sensitive positions are and what measures need to be taken to reduce and mitigate those risks in the workplace.

Having a definition that runs across all workplaces doesn't work. You need to have some ability, some flexibility, to respond to the variety of different types of work, workplaces, and sizes of workplaces.

12:35 p.m.

Liberal

The Chair Liberal Bill Casey

Thanks very much.

Mr. Oliver.

12:35 p.m.

Liberal

John Oliver Liberal Oakville, ON

I just wanted to correct the record a little bit here with respect to some comments made by my colleague, Dr. Carrie.

The task force on legalization of marijuana travelled across Canada. I think they were five or six months on the job. They had 20,000 submissions from all walks of life, all professions, all areas. Under this section, on what we heard, they dealt specifically with people working in safety sensitive positions, such as health care workers, law enforcement personnel, and employees in transportation, construction, and resource extraction industries. They heard about the challenges associated with providing reasonable accommodation of employees who use cannabis for medical purposes. Employer groups were in to see them calling for more guidance from federal, provincial, and territorial governments about appropriate workplace drug use and drug testing.

So I think there was extensive consultation by the government through the task force in the area of testimony that Mr. Keith is bringing to us and others have today.

Again, we are dealing with implementation at this point.

I guess that's my question to you, Mr. Keith. With concerns being heard by the task force, the concerns you bring forward.... As I've already told you, there is already case law, and there seem to be permissions in place for employers for safety sensitive positions to advise in advance that someone will be tested and to implement those. You said we're partially there.

In terms of implementation, I heard you suggest we should more comprehensively address the issue in the Labour Code. Is there anything more you would add to those five recommendations?

12:35 p.m.

Partner, Fasken Martineau DuMoulin LLP

Norm Keith

In the McLennan report, on page 29, it reads, “Employer groups called for more guidance from federal, provincial and territorial governments about appropriate workplace, drug use and drug testing policies.”

I think the request has been out there for awhile.

12:35 p.m.

Liberal

John Oliver Liberal Oakville, ON

Right.

12:35 p.m.

Partner, Fasken Martineau DuMoulin LLP

Norm Keith

It's not just so that employers can find out who's using drugs or drinking on the job; it's to make sure that workers are safe at work. With the absence of any federal or provincial definition of a safety sensitive position, it's left to workplace parties to work it out and, ultimately, to litigate this. There are literally hundreds of cases every year fighting about whether a particular position is safety sensitive or not. The statutory definition wouldn't answer everything, but it would give guidance, and that's what needed.

September 14th, 2017 / 12:35 p.m.

Liberal

John Oliver Liberal Oakville, ON

Would your advice to this committee, as part of our clause-by-clause review of Bill C-45 and any amendments or attachments we decide to put with it, then be to address those five principles that you brought forward?

12:40 p.m.

Partner, Fasken Martineau DuMoulin LLP

Norm Keith

Yes, that would be the bottom line in my recommendation.

Thank you.

12:40 p.m.

Liberal

John Oliver Liberal Oakville, ON

Thank you very much.

12:40 p.m.

Liberal

The Chair Liberal Bill Casey

That brings to a close our panel on workplace safety of the justice committee; at last it feels like a justice committee meeting.

This afternoon will will return to our health committee, and we'll have a panel on indigenous communities.

I want to thank our panellists very much. We've all learned a lot from you, and we appreciate you taking the time to share your knowledge and experience with us.

I suspend the meeting until 1:45 pm.

1:50 p.m.

Liberal

The Chair Liberal Bill Casey

We will reconvene our 67th meeting of the Standing Committee on Health with our third panel today. Our third panel is on indigenous communities.

I'm looking forward to this. I'm sure it's going to be an interesting presentation, and I'm sure we'll learn a lot.

Our guests today are, presenting for the Métis National Council, Clara Morin Dal Col, minister of health. Also we have Wenda Watteyne, senior policy advisor, and Eduardo Vides, senior health policy adviser.

On behalf of the Chiefs of Ontario, we have Isadore Day, Ontario regional chief.

We'll ask the Métis National Council to make a 10-minute opening statement. Then we'll have Chief Day make an opening statement, and then we'll have questions after that.

Ms. Dal Col.

1:50 p.m.

Clara Morin Dal Col Minister of Health, Métis National Council

Thank you.

Mr. Chair and committee members, thank you for the opportunity to participate in your hearing today. I am here in the capacity of minister of health of the Métis National Council. I am also the president of Métis Nation British Columbia. I'm pleased to be here to provide the Métis nation perspective on Bill C-45.

To provide some background, the Métis are a distinct aboriginal people as defined in section 35 of the Constitution. The Métis nation emerged with its own collective identity, language, culture, way of life, and self-government in the historic northwest prior to Canada's westward expansion following Confederation. The Métis nation continues to exist as a distinct aboriginal people and seeks to advance its right to self-determination, including self-government within Canada.

The Métis National Council is governed by five members. These governing members are Métis Nation British Columbia, Métis Nation of Alberta, Métis Nation of Saskatchewan, Manitoba Métis Federation, and the Métis Nation of Ontario. MNC governing members, through their registries and democratically elected governance structures at the local, regional, and provincial levels, are mandated and authorized to represent the citizens who comprise the Métis nation.

About one-third of all indigenous people in Canada identify as Métis. According to the 2011 census, more than 450,000 people reported they were Métis, with almost 85% located in the western provinces and Ontario. More than 70% of Métis live in urban centres, the largest concentrations being in Winnipeg, Edmonton, Vancouver, Calgary, Saskatoon, and Toronto.

I'd like to talk a bit about the overall health status of Métis people. In the Métis context, we take a “social determinants to health” approach. Everything is interrelated; what happens in one area impacts upon another.

Such historical and current events as residential and day schools, the sixties scoop, racism, loss of family unit security, loss of community wellness and unity, and loss of culture and language have had a lasting impact upon Métis health and wellness.

Métis are vulnerable to chronic diseases such as mental health disorders. These disorders include depression, anxiety, substance use, and chronic pain, including emotional pain. For example, we know from the Métis health status and health care utilization study done in Manitoba in 2010 that Métis had statistically higher rates of depression, anxiety, and substance use than the general population.

The federal task force on cannabis legalization and regulation spoke to the risks of vulnerable populations. The Métis are a vulnerable population in terms of overall health status. It is therefore important that we be involved as equal partners in the work ahead.

I would like to take this opportunity to commend the Prime Minister and Government of Canada for entering into the Canada-Métis Nation Accord in April of this year. This commitment sets out a nation-to-nation, government-to-government relationship between Canada and the Métis nation. Under this accord, we have co-committed to advancing a range of priorities, including Métis health and wellness.

Now I will speak more directly to the proposed legislation. The Métis National Council supports the stated purpose of Bill C-45, including its intent to protect the health of young persons by restricting their access to cannabis, to protect young persons and others from inducements to use cannabis, to reduce the burden on the criminal justice system, and to enhance public awareness of the health risks associated with cannabis use.

Unfortunately, we have not had the opportunity to engage with or consult our citizens and communities on the proposed bill or its regulatory framework. There are indeed a number of matters of importance to the Métis nation, including the potential impacts that legalizing marijuana will have on health and wellness, justice and corrections, and economic development.

The Métis National Council proposes four key recommendations to ensure that there are opportunities for more adequate engagement with the Métis nation in implementation matters.

Recommendation number one is that the Government of Canada ensure meaningful engagement of the Métis nation in the development and implementation of a regulatory framework for cannabis.

The task force advised the Government of Canada that successful implementation of a regulatory framework will take time and will require that governments meet a number of challenges with respect to capacity and infrastructure, oversight, coordination, and communications. It indicated that federal, provincial, municipal, and indigenous governments will need to work together on information and data sharing in coordination of efforts to set up and monitor new systems. Organizations that have appeared before the committee recognize the importance of consultations with indigenous communities on legislation, preventive measures, and interventions to meet local conditions and cultural requirements. We support these recommendations.

Recommendation number two is that the Government of Canada provide the Métis nation with resources to minimize the harms of cannabis use in the Métis population.

The Métis National Council agrees with the task force on cannabis legalization and regulations advice that a public health approach should be taken to promote health and reduce harm. This approach considers the risks associated with cannabis use, including the risks of developmental harms to youth. It is imperative that resources be provided to Métis governments to mitigate harms associated with cannabis use. The Métis nation is prepared to work with all levels of government to undertake health promotion activities and to develop approaches to minimize harms in the Métis population. Funding supports should be provided by the federal government to Métis governments to undertake this work.

Recommendation number three is that funding be provided by the Government of Canada to support prevention, education, and treatment supports, especially for Métis youth. Of particular concern to the Métis nation is the health and wellness of Métis youth.

We understand that legalizing cannabis will have impacts upon the Métis, particularly Métis youth. The Métis population is young. According to Statistics Canada, 41% of the Métis population is under 25, compared with 30% of the non-indigenous population. Many of our Métis youth are already dealing with issues surrounding drug use and addiction issues. We know from a Métis study by McCreary Centre Society in B.C. in 2013 that around half, 48%, of Métis youth had tried marijuana. Among those who had tried it, 23% had used marijuana on six or more days in the preceding month, 30% of males and 18% of females.

We want to ensure that Métis, including Métis children and youth, have access to information to enable them to make informed decisions. We also want to ensure that Métis children and youth have access to Métis-specific prevention, education, and treatment supports. On that front, we agree with the task force that governments should commit to using revenue from cannabis regulation as a source of funding for prevention. Funding should be provided to Métis governments to address these needs.

To minimize harms, we would like to see the minimum legal age set at 19 years. The age of 19 is consistent with the legal age of drinking in most provinces.

Recommendation number four is that the Government of Canada work with the Métis nation in enforcing public safety and protection. The Métis nation supports the task force's recommendations that the federal government take a leadership role to ensure that capacity is developed among all levels of government, including Métis governments, prior to the start of the regulatory regime; that it develop and coordinate national research and surveillance activities, including Métis population-specific research and surveillance; that it establish a surveillance and monitoring system inclusive of Métis; that it engage with indigenous governments, including Métis governments, to explore opportunities for their participation in the cannabis market; and that it engage with indigenous communities, including Métis communities, to develop targeted and culturally appropriate communications.

In particular, resources should be provided to implement an evidence-informed public education campaign targeting the Métis population. Métis are the experts in relation to their own health and health needs and can play a meaningful role in public education.

The Métis nation seeks to work as an equal partner in the development and implementation of regulatory matters and in optimizing help for Métis people in Canada. The Métis nation is committed to working with all levels of government to ensure that the task of legalizing and regulating cannabis is done carefully and safely. Métis governments have the ability to effectively reach Métis people and communities in ways no other government can do. We look forward to contributing to the work ahead.

Thank you again for the opportunity to participate in this panel. We welcome any questions you may have.

Marsi.