Justice Committee on May 8th, 2023

[The Chair, Liberal, Randeep Sarai]

I call this meeting to order.

Welcome to meeting number 64 of the House of Commons Standing Committee on Justice and Human Rights.

Pursuant to the order adopted in the House on March 8, 2023, the committee is meeting in public to begin its study of Bill C-295, an act to amend the Criminal Code (neglect of vulnerable adults).

Today's meeting is taking place in a hybrid format, pursuant to the House order of June 23, 2022. Members are attending in person in the room and remotely using the Zoom application.

As you're all members, including the panellist, I won't go into how to use Zoom or your interpretation functions.

In the interest of time, I would now like to welcome Dr. Fry to our committee.

Dr. Fry, the floor is yours. You have five minutes. Then we'll have questions and answers right after.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you, Chair, and thank you very much, colleagues, for inviting me here to speak on my bill, Bill C-295.

I think it is an important bill, even though it sounds like a simple bill. It's an important bill, because the issue of long-term care is a provincial jurisdiction. It is not in the Canada Health Act. It's purely provincial jurisdiction. The only way the federal government can have a role is to do something within its jurisdiction, which is the Criminal Code.

What this bill is meant to do is amend sections 214 and 215 of the Criminal Code to protect vulnerable adults. It extends the definition to vulnerable adults. Currently, sections 214 and 215 deal with child abuse and negligence. We are now using it to extend the definition to vulnerable adults.

The bill puts in some specific definitions. It tells us what a vulnerable adult is. A vulnerable adult is a person who, by virtue of age, mental or physical illness, or disability, is frail. That's meant to be a vulnerable adult. The ability to take care of that vulnerable adult follows completely through with sections 214 and 215 of the Criminal Code with regard to children.

Why are we doing this? We're doing this because currently the only national standards that we have for long-term care, which is a provincial jurisdiction—and I want to keep stressing that—is a national voluntary set of standards. Everyone should and could try to...etc. There is no mandate for this. This continued on for a very long time, until COVID-19 exposed the vulnerability of that system.

As we well know, about 54% of all long-term care facilities are run by the private sector. Many of them are not-for-profit. Some are run by the church-based sector, but most of them are just private.

I think, again, it's what we saw after COVID-19. We found that while only 3% of people who got COVID-19 were in long-term care facilities, they made up 43% of those who died. That was really out of whack. It was an overbalance of that.

At the same time, while other countries had 41% of people in long-term care facilities dying from COVID-19, in Canada we actually were the worst. We had about 69% of our seniors getting COVID-19, and dying from it, as we well saw.

I think the reason is that we don't have mandated standards. The federal government cannot stand up and mandate standards. It is something the provincial government's going to have to do.

Currently, what this bill does is it defines who a vulnerable adult is. It expands the duty of care from a child to a vulnerable adult. It actually puts in some other definitions. For instance, it defines what a “long-term care facility” is. A long-term care facility is where three or more people are vulnerable by virtue of—as I said before—age, mental illness, physical illness, disability, etc. They are not related to the caregiver by blood or marriage. That rules out somebody who's looking after grandma or grandpa at home. This is about a facility. There must be three or more people in the facility.

Now, it defines “manager”. What is a manager of a long-term care facility? It defines what a manager is and the duty of that manager. It defines what that duty is. There is “failure to perform”. If that manager fails to perform a duty to provide the necessities of life and the appropriate care to vulnerable adults, then they would be liable, as obviously this bill tells you, to certain penalties—a fine or jail time.

It also talks a little about what was wrong. Why did COVID-19 expose this problem that we didn't know about before? As a physician, I knew. I knew about the problem with long-term care units. I looked after patients in some of these units. We knew what the problems were.

After what happened with COVID-19.... As you know, the armed forces went in to help in some of these facilities. Their report is scathing. It talks about how, in fact, many of the people in these areas.... The cleanliness was lacking; protocols were lacking; most of the aides who were performing the work to take care of seniors had no formal medical education or health care education or training—they were just doing this. They were moving from patient to patient during COVID, using the same gloves and the same protective equipment; they did not often wash their hands, and I think those are the things that we saw.

What this bill is striving to do is.... The Canadian Standards Association has set standards that are very clear for what is required to care for vulnerable adults in these facilities. What this is doing is saying to managers and owners of these facilities, if you don't do it, you're going to be penalized. It brings in teeth and accountability to something. This is the only way that the federal government can intervene.

I'll leave it there, and I'll be happy to answer any of your questions.

Thank you.

[The Chair, Liberal, Randeep Sarai]

Thank you, Dr. Fry.

Before we start this round of questions, we're just going to do a quick sound check with Mr. Caputo. I'll let the clerk do that.

[Frank Caputo, Conservative, Kamloops—Thompson—Cariboo, BC]

Good afternoon, everybody.

I hope that everything's working well now. Thank you for your patience.

[The Clerk of the Committee, Geneviève Desjardins]

Thank you.

I have a thumbs-up for you.

[The Chair, Liberal, Randeep Sarai]

Sounds good.

For our first round, we'll begin with Mr. Van Popta and we'll go with five minutes because of votes.

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

Thank you, Chair.

Thank you, Ms. Fry, for being here. Thank you for your private member's bill. We're generally supportive, but it's here at committee so that we can work together to make it stronger.

Before I get into that, I have a question more generally.

In the 2020 Speech from the Throne, the federal government made commitments to work with Parliament on Criminal Code amendments, explicitly to penalize those who neglect seniors, and now here it is in a private member's bill that is being presented. It's also in Mr. Lametti's mandate letter that he should continue to work with the Minister of Seniors to strengthen Canada's approach to elder abuse by finalizing some legislation.

Why has it been left up to a private member's bill to bring this important legislation forward?

[Hedy Fry, Liberal, Vancouver Centre, BC]

Somebody had to do it. As a physician, I saw what happened. Many of us know that so many very...and I use the word “vulnerable” as meaning they cannot speak out. They have no one to go to bat for them; they weren't allowed to have their family visiting them, etc. It was needless.

What we see in terms of these long-term care facilities is a great deal of negligence and abuse, actual abuse.

Somebody had to bring something forward that would get some teeth in why things are being done, negotiating various things with provinces, etc.

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

I think we agree that this is important legislation, an important initiative, but why isn't the government taking the lead on this? Why isn't the Attorney General-Minister of Justice doing this?

[Hedy Fry, Liberal, Vancouver Centre, BC]

When I brought this bill forward, I went to him and I said, I'm bringing this bill forward; do you have a problem with it? He said, no, in fact, we think it's a good idea. Would you do this? Go ahead and do it.

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

Why isn't he leading the charge?

I'll note that we all voted in favour at second reading to bring it to committee, but Mr. Lametti did not vote. Presumably he wasn't in the House that day, but he chose not to vote remotely either.

[Hedy Fry, Liberal, Vancouver Centre, BC]

I can't answer for Mr. Lametti. I'm sorry.

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

That's fair enough.

You highlighted that there's a new definition for “long-term care facility” and a definition for “manager”, but there's no definition in Bill C-295 for owner, yet owners—whatever or whoever that might be—could be criminally charged.

Wouldn't your legislation be improved by having a clear and concise definition of who an owner of a care facility is?

[Hedy Fry, Liberal, Vancouver Centre, BC]

If you look at the definition in the bill, it says that a

manager, in respect of a long-term care facility, means any person who is responsible for

(a) hiring or scheduling staff who provide care to residents,

(b) purchasing or directing the purchase of medical and other supplies that are used in providing necessaries of life to residents,

(c) directing the daily operations of the facility, including planning and coordinating the provision of care....

It gives an extensive list of supervising all the care, monitoring the implementation of policies and protocols—

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

I'm sorry, I have only five minutes and—

[Hedy Fry, Liberal, Vancouver Centre, BC]

The owner usually hires a manager to do this day-to-day work.

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

You're reciting the definition of “manager” but what is the definition of an owner, particularly in a privately owned setting—whether it's for profit or not for profit? Sometimes corporate structures are complex, where one company owns the building but contracts it out to another to operate it, who then might have subcontracts with other private companies that operate some part of it.

Who's the owner in that example?

[Hedy Fry, Liberal, Vancouver Centre, BC]

In that instance it may be the company; it may be an individual person who owns it. The point is that if that person also happens to be doing these duties, managing the care, then that person is defined as a manager as well as an owner.

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

Then that person—

[Hedy Fry, Liberal, Vancouver Centre, BC]

They may be owners at arm's length; they may not know what the managers are doing.

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

That person would then fall within the definition of a manager. My question is, why isn't there a definition of owner, when an owner, whoever that might be, could be charged criminally under this act? We're trying to improve the legislation. Where's the definition of owner?

[Hedy Fry, Liberal, Vancouver Centre, BC]

I think that what we didn't want to do was to say an owner.... Let's say that the owner is a company, and they just hire people to do the work. They have clear guidelines, but they don't do the day-to-day care, and this person who is managing it is falling by the wayside. We didn't want to reach out and say, just because you own it, you're responsible; it would have to be the person doing the work and the day-to-day care and management who we're trying to get after.

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

We'll just leave it at that. I would note only, for the record, that there is no definition of “owner”, so I don't know how somebody could be charged as an owner.

I want to now reflect on the definition of manager. It, on the other hand, is very, very broad, and it includes even the person who is doing the scheduling of the workers. I've spoken to a scheduler at a care facility, and this is a big, stressful job, particularly when there's a shortage of skilled workers.

Would that person, who's doing his or her best to make sure there's full staffing for every shift, be criminally negligent if something tragic were to happen on the floor that day?

[The Chair, Liberal, Randeep Sarai]

Be very quick, Dr. Fry.

[Hedy Fry, Liberal, Vancouver Centre, BC]

I think the bottom line is that when something tragic happens, one would go back, and one would find out why. If the person were taken to court, they would have to say that they just couldn't find staff, or whatever the extenuating circumstances are. They would be able to use that as a reason. Hospitals lack staff all the time.