Health Committee on Dec. 8th, 2022

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Garon.

We have Mr. Davies, please, for two and a half minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

Sherry, I'm really glad that you mentioned the national building code. I know it's outside of the purview of your legislation, but I've been here for 14 years, and firefighters have been lobbying on this Hill every year for the last 14 years—and probably before that—for enforceable national building standards.

Again, it's a preventative measure. When we're building skyscrapers and homes, it has to be part of our structure and culture that we design and use materials that have firefighters' safety in mind. I think we still have a long way to go in that regard.

I want to speak for a minute about presumptive cancers and get your feeling of where we're at on that. I know that in B.C. we cover, under the Workers Compensation Act, presumptive cancers for brain, bladder, colorectal, kidney, ureter, testicular, lung, esophageal, non-Hodgkin's lymphoma and leukemia. I think it's been extended a bit. It's been extended, as you point out, to heart disease and certain mental health disorders.

I'm just wondering if you can give us a bit of a flavour nationally. Who has the best list in the country? Do you know? Do you see a role for the federal government in working with the provinces and territories to make sure that the best standard in this country becomes the floor standard in this country?

[Sherry Romanado, Liberal, Longueuil—Charles-LeMoyne, QC]

As an MP from Quebec, it's hard for me to choose any province other than my own.

[Some hon. members]

Oh, oh!

[Sherry Romanado, Liberal, Longueuil—Charles-LeMoyne, QC]

That's part of this bill. Look, it's about who has what information. Can we bring everybody to the table and say that are there are 19 and we think that now it's 20...? We know that Quebec has cancers linked that are not linked anywhere else in the country.

It's about bringing that information together and letting provinces decide what they would like to do in their own respective provinces. It's about making sure they have the information. We all know it's there. Let's not redouble our efforts or redo the work. We know that the information is there and the research is there.

As much as I'd like to give B.C., which I think is at 18 now...but they're also one of the provinces that recognizes female cancers. I can't emphasize that enough. This is something that's very emerging.

[Don Davies, NDP, Vancouver Kingsway, BC]

I'm glad you mentioned the gendered aspect. I think that's an important part of it as well.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Davies.

Next is Dr. Ellis, please, for five minutes.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much, Mr. Chair.

Thank you, Sherry, for being here. As we get closer to Christmas, maybe we'll have something to celebrate. I think that's important.

I don't know about other regions, but in Nova Scotia at this time of year there's a multitude of events at local fire halls. It's always great to get out and see the local firefighters.

I want you to know that across my riding in Nova Scotia the firefighters are very thankful for and very aware of what's going on with this bill. I think it means a lot to them, and I think it has been pointed out very clearly to their families, which we can never forget.

The other thing that I think is very clear across the country, which is heartwarming, is that we do know that fire halls are at the centre of communities, and not just when things go sour. We know that's an important thing. We saw that during hurricane Fiona in Nova Scotia. Many fire halls were comfort centres even if they weren't a designated comfort centre. The style and the quality of a person who we attract to be a firefighter in a small community means that even if they're not designated as a comfort centre, they're there anyway.

They know that they have a great presence in the community. They're givers to all communities. I think it's important to highlight that. They're there whether they're formally asked to be or not. I think that to highlight this is also very important. I've had a long association with the Village of Bible Hill fire department. That's been a great thing for me. It's always a pleasure to serve them.

I've gone to each of the fire halls over this season just before Christmas, and one of the things that I do want to highlight is the number of medical first responder calls for firefighters. It would appear that—certainly in my area of Nova Scotia—it's taking up almost 50% of the call time for firefighters these days.

I'm very happy that we have this bill and that we're talking about prevention. I would like to hear your opinion with respect to medical first responder calls and the potential for prevention there. In my mind, we originally weren't asking firefighters to do that type of work, so the preparation that might be required and the treatment for symptoms related to coming upon incredibly horrific scenes are perhaps not there. Could you comment on that? I know it's not totally related, but I know that it's part of your heart.

Thank you.

[Sherry Romanado, Liberal, Longueuil—Charles-LeMoyne, QC]

Thank you so much.

Please thank your local firefighters for me.

A few of you mentioned the important community service that firefighters and fire halls play all over this country. Whether it be volunteering for Christmas basket donations or local funding and food drives and so on, firefighters do more than just put out fires, as you said.

There's a changing face of firefighting in Canada where we're now actually seeing that putting what they call “water on fire” is less and less of what they do. When it comes to the changing face of firefighting, this bill and Todd Doherty's bill—I don't want to say Todd Doherty's bill, because it's a law—are a bit of a blessing and a curse, because with the increased awareness of PTSD and cancers in firefighting also comes the difficulty in recruitment and retention.

I was talking to the Canadian Association of Fire Chiefs about the reality that people may not consider a career in firefighting because they don't want to get cancer or PTSD. Bringing out this awareness also brings out some challenges. We can also say with those challenges that we're doing something about them. Whether it be the road to mental readiness resiliency training that we see in the Canadian Armed Forces—which many firefighters and first responders are now following—or saying that we recognize cancer in firefighting and we're doing something about it with this national framework to bring people together around the table to figure out how we prevent it, I think will alleviate some of people's fears in considering a career in firefighting.

As our previous colleague had mentioned, growing up everyone wanted to be a firefighter or a police officer. Fortunately nobody ever said, “I want to be a politician.”

[Some hon. members]

Oh, oh!

[Sherry Romanado, Liberal, Longueuil—Charles-LeMoyne, QC]

Often, firefighters are given a lot of respect in their communities. Going through this bill, I have not had one person say to me that they don't think this is the right thing to do.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Chair, perhaps I might get one more plug in.

We might think about the nomenclature around paid and volunteer firefighters, because, let's be honest: They're all professionals.

Thank you for the indulgence, Chair.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Ellis.

The last round of questions is for Mr. Jowhari, please.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you, Mr. Chair.

As you said, I'm the last person, and I'm going to ask for your and my colleagues' indulgence. Today is a very special day for me. We'll get to that shortly.

I want to start by congratulating and thanking Sherry. Often, we say we are honoured and privileged to represent our riding, but through this bill and through your advocacy, we—as the 338 members of this House—are truly honoured and privileged to be able to represent 126,000 firefighters and their families and, on that note, most probably the whole of Canada. Thank you very much.

I'm quickly acknowledging the 189 members of the Richmond Hill Professional Fire Fighters Association, local 1957, led by fire chief, Bryan Burbidge, and Tim Sparks and Jeff Voisin who are the secretary and president of the IAFF local 1957.

Every night or early morning when I arrive in Richmond Hill on my drive from Ottawa, as I turn from Highway 404 to Highway 16, one of the very few lights that is on is at my local firefighters' station. Every Monday morning when I leave, at 2 or 3 in the morning—to make sure that I'm here for 9 in the morning on Mondays—one of the few lights that is always on is at the firefighters' station. I want to thank them. Indeed, they are in the heart of our community.

My experience with the firefighters is a bit different from dealing with fire itself, but indeed has to do with cancer and with the support that I received. It's a funny thing; today, it is 19 years since I lost my father who was in palliative care and didn't survive his cancer. It was around 9:30 at night, when I was sitting beside him, that he fell to a heart attack. We called 911, and guess who was the first one at our door? The firefighters were the first ones who came to our door.

At that time, they immediately proceeded to start with the resuscitation process. I later on noticed they were in full contact with the paramedics who were driving to our house, who arrived probably five minutes after them. The firefighters were there within a minute. Then, we had the police come—because there was a death, and it was in the home—probably about a half an hour later. When the paramedics arrived, the resuscitation process was handed to the paramedics, but the firefighters did everything they could.

I can tell you that later on they provided all of the supporting information on the circumstances of the passing of my father to the police, and they were very supportive. I can tell you this: I'll never forget that. They were the first ones in my house helping me, and they were the last ones who left my house. For that, I'm indebted to all firefighters, especially those firefighters who were there with me and with my family on that day. I salute their families for supporting them every day and every night.

As I'm celebrating the memory of my father, I would like to ask you if you can talk about the memorial grant program that has been rolled out since 2018, and the impact that it has on this bill?

Thank you.

[Sherry Romanado, Liberal, Longueuil—Charles-LeMoyne, QC]

Thank you, Majid, for sharing your story. Sharing is exactly what makes this so special for me. I'm probably the luckiest MP in the House right now. I have colleagues like you. All of you have supported me in this, and it's not about me. You can imagine what that says to the 126,000 firefighters across Canada. They are seeing politicians come together, regardless of political stripe, and we're all fighting for them. They are the first ones in the house and the last ones to leave. They're asking us to be there for them, and that's what this is about.

I love the fact that you brought up the memorial grant program established in 2018. It provides families of first responders, including firefighters, who die as a result of their duties, with a one-time lump sum, tax-free direct payment of $300,000. The purpose of this grant.... The program includes the loss of life resulting from occupational illness attributable to employment.

How it works in terms of its criteria is that a presumptive list of occupational illnesses and related years of service, based on established provincial and territorial practices, is maintained. In terms of eligibility, the grant will look at the province of practice for firefighters. Depending on which cancers are part of the presumptive list, they would be eligible for this program.

Obviously, as you saw from the map, there is no consistency among the provinces as to which cancers are recognized or linked to firefighting, so the program is currently applied unevenly across the country. The research doesn't change, Majid, when we cross the border into a different province. Hopefully, as part of this, we'll be looking at the memorial grant to see if it could be applied more evenly across the country.

[The Chair, Liberal, Sean Casey]

Thank you, Mrs. Romanado.

Thank you, Mr. Jowhari.

That takes us to the top of the hour.

Mrs. Romanado, thank you so much for being with us. It's evident that you've put your heart and soul, and all of your professional talent in preparing and bringing this forward. You've also succeeded in doing something that only a few people can, and that is uniting people on all sides of the House. Congratulations and thank you.

We will suspend for four minutes to allow Mrs. Romanado to take her leave, and Mr. Lake to get himself set up.

Thank you.

[The Chair, Liberal, Sean Casey]

We are back in session.

I'd like to welcome Mr. Lake, who has joined us today to talk about the Senate public bill which he is sponsoring in the House, namely Bill S-203, an act respecting a federal framework on autism spectrum disorder.

Mr. Lake, thank you so much for being with us. I know that it was on short notice, but I also know this is your life's work and you probably didn't need much notice. It's a pleasure and honour to have you here.

You may take up to five minutes for your opening statement.

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

Thank you, Mr. Chair.

I appreciate the committee. For those of you who weren't here the other day, I subbed in on Tuesday and wound up presenting on Thursday. I was asked if I was ready, and after 15 years, yes, I'm ready.

It's kind of a metaphor, because I probably could have been more ready. I probably could have prepared more for two months before a committee hearing, but that's kind of the nature of where we're at with the national autism strategy, too. There's been a lot of conversation over years and years. We're never going to have unanimity on every single aspect of what would go into a national autism strategy. At some point you have to move forward with the knowledge that you have based on the shared wisdom that we have across the country. You move forward in a way that, hopefully, organic. We're learning more every day through the process and hearing from more people, and just getting better and better.

That's the spirit with which I come here.

I'll touch on the technical details of the bill quickly for a second. Largely, what I am looking forward to today is just a conversation that we can all have. I've had a couple of conversations on the side. I want people to feel comfortable just asking anything they want. I'm good with that. I'm not an expert. I'm not a scientist. I'm not autistic myself. There are folks who are scientists and folks who are autistic themselves who will share their stories over time. I would encourage you to reach out and have those conversations. But I am the parent of a 27-year-old son with autism who was 10 when I was first elected. I learn from him every single day.

I will talk about the technical details before I get into talking about Jaden, because I'll talk about my son a lot over the next 50 minutes or so.

Technically, this is a bill that's a federal framework. It's called “An Act respecting a federal framework on autism spectrum disorder”. Really the bill itself is about accountability and timelines. The bill doesn't lay out a national strategy; it is just putting forward some accountability.

We've been having this conversation about a national strategy for years and years. Senators Housakos and Boehm really got together in a non-partisan, cross-partisan way and put forward an idea to put a framework around a timeline for establishing a national strategy, some basics around how we could get there, and then also an accountability framework for how we could evaluate how that strategy is working once we have it. It charges the minister with some responsibility to meet the timelines.

The government at this point in time has signalled that we're going to have a national strategy within.... I believe and am hoping that by 2023 we'll have a national strategy in this country. Really this is pushing to build some accountability around that.

Lots of times people will ask this: What would be part of a strategy? Why has it taken so long? This will be probably a large part of the conversation as we move forward.

I think part of the challenge is finding that common ground. We've had this seemingly interminable conversation over all of the different aspects. You have some pretty strong opinions on some things. Where I've found the common ground in 15 years as we've gone around and had conversations—and really this is common almost around the world—is the need for diagnosis, an early diagnosis, and the need for early help. They call it “therapy treatment intervention”. There's always debate over terminology, and all the words seem to be subject to some debate. I like to think of it as just the “help” that's needed.

Then there's education, and what the education system looks like for autistic Canadians.

After their early education, as someone moves into adult years, what do their employment prospects look like? What does housing look like?

The sixth area that I always reference in finding common ground as family members when we're talking about autism is what happens when we're gone as parents? I guarantee you that we as family members are all seized with this. What happens when we're not there? Who is going to care for our loved one the way we cared for and supported our loved one?

I think a national strategy.... As we move forward we're trying to get to a point where we have a society that is loving and caring and helping in whatever way it can, in whatever way the evidence base shows to get us to where we need to be.

I have so many more notes here that I could reference. I'm a politician. Whatever you ask, I'm going to work what I want to say into the answers anyway.

[Voices]

Oh, oh!

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

Let's just have a conversation and hopefully....

I love the conversations we've had so far. I love the conversation that happened before this one, where we're able to get around a table like this as members of Parliament from all parties, and more importantly, we get beyond our parties as human beings. We're almost, in a sense, setting aside political labels to have a conversation as human beings who are trying to make our country a better place...and not only for people who need help.

I'll close my comments with this: We get so focused on the help that we fail to realize that when we put the right system in place, there are unbelievable skills, abilities, talents and potential that we're going to unlock as we move forward, which is going to make life better for all of us in this country.

With that, I look forward to your questions.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Lake.

The conversation is going to begin with Dr. Ellis for five minutes, please.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you, Chair, and through you to Mike, I really appreciate you being here. I know this is obviously very personal, but it has become very public and is now a national strategy. I thank you for that.

Very clearly, we know that we have these significant differences across our great nation. I think of a story from Nova Scotia where a plastic surgeon who had a child with autism spectrum disorder chose to leave our province and actually go to Alberta because there were more supports and a more well-defined framework there. I think that's tragic. It's tragic for families to have to consider doing those things, so thank you for doing this work.

One thing I think about is that obviously there are a multitude of people with disabilities who exist in Canada. To expand a bit on that, is it possible that a framework such as this...? In my mind, the six points you touched on would also be a useful framework for anybody who struggles with a disability.

Maybe you can talk about the specifics of autism spectrum disorder. Is this actually an idea around people with disabilities and the families who support them in general?

Thank you.

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

I have two comments.

First of all, I'll point out that one thing the legislation we're discussing right now, Bill S-203, does is lay out some measures to be provided. It says, “The framework must identify measures to provide” and it has a list. It's different from the list that I said. I explained my list based on my experiences. One thing I like about it is that while they went through the Senate process, they moved amendments to add at the end, “anything else that the Minister considers appropriate in relation to autism spectrum disorder.” It's really important to do that.

On the stakeholder side, they added a similar clause about consultations that says, “anyone else that the Minister considers appropriate”. It's so important that this is organic and that we move forward, in a way. We've constantly learned over the decades and we're going to be continuing to learn how to have these conversations.

Jaden was two and a half years old when he started his autism program in 1998. In Alberta, one of the real strengths of the program—it's different from other places—is that it's family support for children with disabilities broadly. It's not an autism-specific program in Alberta.

In Alberta, Jaden went through a multidisciplinary team review. Back then, they determined what his needs were, set a budget for that and then we worked to find service providers who could meet his needs as assessed. It was a fantastic situation. You rightly point out that people move from across the country to Alberta to access that level of support.

I think a national strategy takes a look at the Alberta situation and every other jurisdiction in the country, the evidence about what works and doesn't work, and brings that knowledge base, that evidence.... There are things that other places do better than Alberta was doing. Other countries will do things better than we might be doing in any jurisdiction in Canada.

You want a strategy. You want a system that is gathering the very best evidence from around the world, bringing it to Canada and then sharing it with the autism community and the disability community across the country, so governments in their jurisdiction can make the very best decisions that they can based on the best evidence of the day as we're constantly learning.

The beautiful part about that is that as we do that and establish a world-class national autism strategy, we'll also be able to share with the world what we're learning in Canada as we move forward.

One point I'll make in closing this answer is that while we have a long way to go in Canada, we are a long way ahead of where many places in the world are, as well.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much for that, Mike. I appreciate it.

Again, through you, Chair, we realize that this is about individuals and families.

However, it's illustrative for folks if you have some numbers, Mike, to talk about the costs associated with getting a child assessed who may have autism spectrum disorder, as well as the care costs, etc. I think it's important that Canadians understand how difficult this can become for families in terms of the financial difficulties experienced, not to mention the other struggles that are associated.

If you have some of those, Mike, that you might share, I would appreciate it.

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

It's interesting, because I can share a bit about what the circumstance was for us. In every province, it's a bit different right now.

Back then, we were able to get a diagnosis within, I believe, a couple of months. That's not the case right now in most places in Canada. We were able to get Jaden the help that he needed within a month or two. That's not the case right now in most places in this country. That time frame is so important.

Jaden's program back then, in 1998 dollars, I believe was in the neighbourhood of about $70,000 a year. If you're going to be making the types of investments that we need to make in this area, you have to make sure that you're leaning on the very best evidence that we have available to us now.

In 2022, with this circumstance, the program in Alberta would be different from how it was in 1998. We've learned a lot of things about how we help people. I'm sure that in the rest of the conversation, I can get to some of those points.