Evidence of meeting #64 for Justice and Human Rights in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was facility.
A recording is available from Parliament.
3:55 p.m.
Liberal
The Chair Liberal Randeep Sarai
Thank you, Mr. Van Popta.
Next we'll go to Ms. Brière for five minutes.
3:55 p.m.
Liberal
Élisabeth Brière Liberal Sherbrooke, QC
Thank you very much, Mr. Chair.
Ms. Fry, I will speak in French. I'd like to start by thanking you for joining us today and for introducing this bill. I was fortunate to work with you on the Special Joint Committee on Medical Assistance in Dying, and I think the bill you are introducing today is another high point in our ongoing commitment to the most vulnerable people in our society.
We know that COVID-19 highlighted the concerning living conditions of seniors and other vulnerable people living in long-term care facilities. These situations can occur anywhere in Canada. Last month, in my region, in Sherbrooke, tenants of a residence had to be evacuated due to suspected neglect. Over the past few years, I have heard all sorts of stories, including one about a patient who stayed in the patient lift for the duration of the staff member's break.
Do you believe your bill will be a first step in establishing a stronger legal framework regarding elder and vulnerable persons abuse?
4 p.m.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
Yes, it is a first step—thank you for pointing that out—but it was something that had to happen, because we have no idea if another pandemic will hit us tomorrow, and we don't want to be scrambling around once again. We want to be able to have some protocols and clear guidelines in place, and accountability. Right now, with the national guidelines we have for provinces, those guidelines are voluntary. As the executive director of the Ontario Health Coalition said, nothing was done; no one was charged; no one was held responsible for what went on during COVID-19 in long-term care centres.
This is something that will be a first step, in the meantime, helping people to be accountable. The Canadian Standards Association recently set new guidelines. If we have that kind of body naming guidelines and we know what those guidelines are, if people fail to meet those guidelines and if the provinces don't want to do anything about it, the federal government can hold them responsible in the interim. Hopefully the next step will be to work with provinces to find a way to build in ways of getting provinces to have clear guidelines and enforce those guidelines themselves locally.
4 p.m.
Liberal
Élisabeth Brière Liberal Sherbrooke, QC
Do you believe the bill respects the division of federal and provincial jurisdictions?
4 p.m.
Liberal
Élisabeth Brière Liberal Sherbrooke, QC
Do you believe the bill respects the division of federal and provincial jurisdictions?
4 p.m.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
Yes, I think it does. Everyone talks about the Canada Health Act. Long-term care facilities are not included in the Canada Health Act. They are not part of it, so the federal government cannot use the Canada Health Act to discuss long-term care. They have to do it on a one-on-one negotiating basis with provinces and say, “Here are some of the things that....”
In the interim, what it can do is use the Criminal Code to make people accountable and responsible for lack of duty to care.
4 p.m.
Liberal
Élisabeth Brière Liberal Sherbrooke, QC
In developing the bill, did you meet with various stakeholders and visit long-term care facilities?
4 p.m.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
Yes, I did. I spent a lot of time in long-term care facilities while I was practising medicine for 20 years. I saw it—the heartbreak of patients complaining about the care they got or didn't get, and the abuse they got from a lot of caregivers was something that.... All I could do was complain. I couldn't do anything about it. They also had to be quiet and say nothing, in case they got treated even worse. The people in a position of trust and authority could penalize you if you dared to say something happened there that made you unhappy, or if your family managed to complain about something.
I'm a member of Parliament now, and I could use that ability to deal with something. Dealing with it prior to COVID meant the public would want to know what I was talking about. COVID exposed all of this. As we saw, the armed forces' task force made some very clear reports, which read almost like horror stories, about what was lacking in these long-term care facilities.
4 p.m.
Liberal
The Chair Liberal Randeep Sarai
Thank you, Ms. Brière.
Next, we'll go to Ms. Larouche for five minutes.
4 p.m.
Bloc
Andréanne Larouche Bloc Shefford, QC
Thank you very much, Mr. Chair.
Ms. Fry, thank you very much for joining us and testifying on a bill that I feel very strongly about. You talked about your experience as a physician. For my part, before I was a member of Parliament, I was a project manager on elder abuse and bullying awareness.
In Quebec, the Secrétariat aux aînés has a policy to counter elder abuse, and Quebec has a law to strengthen the fight against elder abuse.
The topic is particularly close to my heart and I have been following the situation closely. I worked in collaboration with various actors, including a collaborative intervention process where we brought together representatives from the health community, the police community and the community, such as the Alternative Justice and Mediation organization, for which I worked. We also developed tools for filing complaints.
Listening to you, I get the impression that the reality in Quebec is different from the rest of Canada, and I'll explain why. We have a fairly comprehensive law in Quebec aimed at addressing elder abuse. We also have a higher rate of public residences for seniors. In fact, in Quebec, 88% of long-term care facilities, or CHSLDs, are public, compared to 46% in the rest of Canada. That's a significant difference.
You talked about respect for jurisdictions in your speech. How could we ensure that this bill respects them? Putting the issue of abuse in the Criminal Code—we would be willing to do that—is a federal issue, but I would add a caveat to that. I would like your views on the issue of respecting jurisdictions because, in the case of Quebec, 88% of CHSLDs are public and under the jurisdiction of the Ministry of Health and Social Services.
4:05 p.m.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
I think that's an important question. Thank you for it.
One thing we saw was that during COVID, there were 13 different jurisdictions with regard to public health, protocols and everything. The federal government did not have the ability to say to everyone, “Let's play by one plan and do it one way, so that everyone is following the same rules.” The federal government couldn't do that. What we saw was that, because of the spottiness in different provinces regarding the way things were run....
The Criminal Code applies to individuals, persons and facilities. If Quebec has great laws, protocols and legislation, it is purely for Quebec. We are talking about across the country. Pandemics don't respect provincial jurisdictions. Pandemics happen, and our duty is to protect people.
4:05 p.m.
Bloc
Andréanne Larouche Bloc Shefford, QC
Of course, we want to protect people. Since protecting people is the responsibility of the health and social services network, there are already standards in place. You said that.
In no way do I want to trivialize what happened, but I just want to remind you that it was the Canadian Armed Forces that, in their report, pointed out what people needed. You talk about the labour shortage, but we still need to implement these standards and to implement them we need the resources and the personnel to take care of the people. So we also need bigger health budgets. I am not the one who highlighted the importance of financial transfers; it is the Canadian Armed Forces themselves who mention it in their report.
I would like to end with two small caveats, which we can come back to later.
We are willing to discuss your bill and find ways to improve it. For example, the definition of “long-term care facility” proposed in the bill does not specify that these facilities, such as long-term care homes, are under provincial jurisdiction. This is something we will have to look at. In addition, this definition is very prescriptive and excludes, among others, older people who are able to decide, voluntarily, to reside in one of these facilities but who do not necessarily have disabilities. So those things should be added. Are you willing and open to talking about that in your bill?
4:05 p.m.
Liberal
The Chair Liberal Randeep Sarai
Thank you, Ms. Larouche.
Dr. Fry, very briefly, you have 10 seconds.
4:05 p.m.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
I don't think I understood your question very well, but perhaps we can get to it in another round.
Thank you.
4:05 p.m.
Liberal
May 8th, 2023 / 4:05 p.m.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Thank you very much, Mr. Chair, and thank you very much, Dr. Fry, for being here with us today and for introducing this bill.
I think the members of the committee all understand that the Criminal Code is a blunt instrument and a limited instrument, but it is an instrument for getting at the crisis that we saw during COVID.
With respect to my colleague from the Bloc, though, I think we saw a problem different from a jurisdictional problem, and that was the ownership—
4:10 p.m.
Bloc
Andréanne Larouche Bloc Shefford, QC
Mr. Chair, I'm sorry, there is a problem with the interpretation.
4:10 p.m.
Liberal
The Chair Liberal Randeep Sarai
There's a translation problem. We'll pause for a second.
Say a few words and see if....
4:10 p.m.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
The translation is malfunctioning. Is it okay?
I'll back up just slightly.
With respect to my Bloc colleague, who talked about jurisdiction as the difference, what I saw was something different. In the first 15 months of COVID, we had 56,000 residents in long-term care in Canada who got COVID, and 22,000 staff who got it. There were around 14,000 deaths among the residents. That's a rate of about 20% of those who were infected.
However, the record for private, non-profit facilities was much worse. There were three times as many infections and two times as many staff infections per bed, and the resident deaths were at a significantly higher rate. Sometimes it was between 30% and 40% of those who were infected, when the general rate was somewhere around 20%.
It seems to me that the distinction here, which the facts support, is not about whose jurisdiction it was, but who owned those facilities. I wonder whether you would agree with me that it's a significant problem.
4:10 p.m.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
Absolutely, I agree with you. Yes. I think it's a very important distinction that you are making.
If you look at Ontario, for example, people who were in a long-term care facility during COVID were 13 times more likely to get infected and die than people who were the same age and living in the community. I think we saw that the problem was with the long-term care facilities, and not necessarily with the age alone.
4:10 p.m.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Also, the difference between the public, the not-for-profit and the for-profit facilities was quite significant.
4:10 p.m.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
We know that in some provinces, there's a huge number of not-for-profits. That's what we're trying to say. It's different in every province, and we're using this blunt instrument to make people accountable and responsible.
4:10 p.m.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
As a New Democrat, I'm one of those who thinks we should try to eliminate for-profit long-term care. That's why, in our agreement with the government, we got a commitment for the introduction of a safe long-term care act, which would correct that omission from the Canada Health Act.
What would you think of a separate, stand-alone, safe long-term care act?