Justice Committee on Oct. 26th, 2023

[Paul Hills]

Thank you for your question. It is one tool in the tool box. We do have to work on reporting. We do not need to reinvent the wheel. We need to learn from better practice around the country and share information on what is working.

Research is coming out of Peel. They are leaders in the industry as far as mental health research goes, and we need to learn from the chiefs and disseminate that information down to the front line. As far as reporting goes, we need to get better at that, educate our members and make it easier for them to do it.

In regard to other mechanisms, we have staging policies for violent acts. We have the ability to call police if necessary in significant situations, but that also depends on whether our radios work. That also depends on their not being busy. That also depends on.... I don't know that someone's going to pull a knife on me. I don't know that there's a gun beside someone, because they're calling me because they have a sore back and then they have mental health issues.

There are a lot of things in place. It's not to say that this is the be-all and end-all. This is just a major foundational piece, I think, moving forward, that will assist cultural change in industries that aren't a Peel, aren't a Medavie, aren't Saskatoon small mom-and-pop shops that say, “We have someone else doing what they need to do to take care of us in multiple areas” and to put it all together.

[Rhéal Fortin, Bloc, Rivière-du-Nord, QC]

Thank you.

My question is for both witnesses.

I realize that not all assaults are reported, but I want to talk about when they are. Let's say a first responder is injured or assaulted, or a death threat is made against them, and they report the incident. When these cases go to court, how do judges deal with them, in your experience? Do they take the matter seriously? Conversely, do you feel they aren't dealt with appropriately?

[Dr. Justin Mausz]

Thank you for your question. It's an important one.

A number of things need to line up in order for a violent act to escalate to the level where the legislation would take effect. We need to remember that the incident needs to be reported. It needs to be reported to the police. The police need to investigate. The threshold of criminality needs to be met, and then the case needs to be brought before a judge. Therefore, there are multiple points along this journey where that system and that chain, I think, can falter.

What we do see in the data is that a large portion of the incidents are not felt to meet that threshold that warrants reporting it to the police or at which the police feel it warrants being brought for criminal prosecution. I think it is illustrating the harms that this sort of exposure has for our colleagues. I think it is illustrating the importance on a societal level of protecting our members to make sure we can provide life-saving care. I think with those things we'll see meaningful change.

[Rhéal Fortin, Bloc, Rivière-du-Nord, QC]

The idea behind Bill C‑321 is that these situations would lead to harsher sentences or have to be considered an aggravating circumstance. However, the bill would not do anything to change the degree or threshold of proof required in cases involving assaults or threats. How will the provision in Bill C‑321 help you? What will change for you, your members and your co‑workers if the bill is passed?

[Paul Hills]

It's a recognition that we're putting ourselves in situations that normal people don't put themselves into. My back is turned to gang members when I'm walking into houses where there are weapons. I have people with needles and guns who are protecting themselves and they turn on me. It's just a recognition again that we're doing what most people are not doing. That's the best I can do.

[Rhéal Fortin, Bloc, Rivière-du-Nord, QC]

Thank you.

[The Chair, Liberal, Lena Metlege Diab]

Thank you, Mr. Fortin.

Mr. Garrison, go ahead.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Thank you very much, Madam Chair.

Thanks very much to both witnesses for being here today. My sympathies to Ms. Donnelly, whom I very much would like to have heard from in this session.

Obviously, I'm in support of this bill, but I have a concern that this bill is not enough. We have heard very moving testimony about the impacts on individual paramedics—

[Rhéal Fortin, Bloc, Rivière-du-Nord, QC]

Madam Chair, there's no interpretation.

[The Chair, Liberal, Lena Metlege Diab]

Mr. Garrison, can you speak a bit more? They're saying the sound is not good enough to interpret.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

It's difficult for me to say anything that will not be extremely frustrated.

I am in my constituency office, on the House of Commons desktop computer. If the system can't accommodate this, we have a serious problem.

[The Chair, Liberal, Lena Metlege Diab]

We're going to suspend for a minute or two.

[The Chair, Liberal, Lena Metlege Diab]

I call the meeting back to order.

Mr. Garrison, thank you. You've sent me the questions to ask on your behalf, because it's not an option not to have interpretation and their being unable to interpret.

We're going to continue, and I'm going to ask the questions on behalf of Mr. Garrison.

Can the witnesses tell us a bit more about the costs to the system resulting from this situation in terms of things like sick leave, stress leave and the retention of those with valuable training and experience in the profession?

Thank you.

[Paul Hills]

Again, I'm a data guy and a story guy.

People get assaulted and they decide not to come to work tomorrow. I don't get lunch for 12 hours. I decide not to come to work tomorrow. There are so many stressors on a paramedic specifically that I can speak to that it is unfathomable why they decide to keep coming to work, honestly.

I commend my staff every day when they come to work, because it is awful right now. When I hear on the weekend that multiple more paramedics have been assaulted and they still show up to work the next day, it just baffles me. The only time they take time off work is if they are injured to the point where they can't show up to work after medical attention.

One of my members took multiple months off after their vehicle was surrounded by multiple assailants threatening to kill them inside the vehicle. It's time lost.

We cannot sacrifice a single paramedic on the street these days. That is how short we are. We are running short every single day. One person leaving is detrimental to our system and to the health and wellness of the rest of our paramedics trying to do what we do every day.

[The Chair, Liberal, Lena Metlege Diab]

Thank you very much.

I am now going to the final round. It's 5:19. My understanding is that we agreed to leave at 5:30, so I am going to shorten the rounds.

We'll go to Mr. Van Popta for maybe three minutes.

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

Okay. I can do something worthwhile in three minutes with these competent witnesses.

Dr. Mausz, I'll focus on an article that you had published in the International Journal of Environmental Research and Public Health just recently, with a shout-out to Professor Donnelly as well, who was a contributor to that.

I would put the question to you, Professor, but you're not here, so the question goes to Dr. Mausz.

I appreciate the empirical approach to collecting data. In the study, you noted the lack of data due to under-reporting. You talked about it in your testimony as well, about leveraging a novel reporting process embedded within the electronic patient record. You said that from that you were getting more reliable data.

I would ask this question: What are you going to do with that data? I ask that in the context of the evidence from the storyteller Paul Hills, who said that even those reported cases aren't being dealt with by law enforcement people.

What difference is your data going to make?

Thank you.

[Dr. Justin Mausz]

That's a very important question. Thank you very much.

We can do more things with this data than I can tell you about in three minutes, but I'll do my very best to be succinct. Beyond the prospect of criminal prosecution, we use this data as actionable risk intelligence within our service. We're able to identify patterns of behaviour among the people we serve in the community. We develop customized response plans so that we are balancing a provider's safety with the needs that might be expressed by the patient so that they are continuing to get skilled and high-quality pre-hospital care.

We use this to improve dispatch processes. We use this to put flags on patients who have a known history of violence. We use this to develop business cases for new equipment, for new training and for new procedures. We use this to promote interprofessional collaboration with our colleagues and police and our colleagues at allied health, including community crisis workers.

[The Chair, Liberal, Lena Metlege Diab]

You have time for another question.

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

Okay.

What we're studying here today is Bill C-321, a private member's bill from our colleague Mr. Doherty. It would make assaulting a health care worker an aggravating circumstance in sentencing. With this additional data, what difference will that make in sentencing? What we're really after is to keep our health care workers safer through law enforcement.

[Dr. Justin Mausz]

One thing I would say with respect to the bill specifically is this: The degree to which the violence we're seeing among our members rises to the level of criminal remains to be determined. I don't know. I don't have a number for that. But even in the absence of criminal assault on our people, there are tangible things we can do to strengthen the safety of our members as well as the safety of the communities that we are responsible to serve.

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

Thank you.

I will cede my time.

[The Chair, Liberal, Lena Metlege Diab]

Thank you very much. I was going to give you three and a half minutes.

Go ahead, Ms. Damoff.

[Pam Damoff, Liberal, Oakville North—Burlington, ON]

Thanks, Chair.

Thanks to our witnesses for being here.

Before I start, I want to give a shout-out to Carmen Santoro, who is here with the IAFF. He proudly served the Town of Oakville for many years with the fire service. It's really nice to have him here and to know that he's still continuing to do that good work.

Mr. Hills, you graciously took me on a ride-along with you in Saskatoon this summer. We had an opportunity to talk to people at the hospital and to some of your co-workers about this issue. One thing I'm thinking about is this: Can you choose not to attend an emergency when you know that there's a good chance that you'll be physically assaulted?

[Paul Hills]

That is a very, very good question. Our right to refuse unsafe work has an extremely high threshold.

Now, obviously we have the ability through 911 and flagged addresses...or whether it be the police notifying us that there are weapons involved. We will typically stage in those situations and not go there until police are there and clear the scene. But once we're in a situation where it's unsafe, it's no holds barred. How do you get out of that situation? How do you deter the situation from getting worse? How do you de-escalate the situation?

Those are all skills and abilities that come with either experience or that are just situational. We don't know. That's where this comes into play. It's hard for me in the moment to just call up and say, “Hey, I'm done; I'm going to tap out of here”, or “Just please don't stab me; I'm going to go over here”. It's just not possible sometimes.

Yes, if my life is under threat and they're telling me to go into that place where someone is holding a gun, then I have the ability to say no, but often we don't know that situation is there until we get in there.

[Pam Damoff, Liberal, Oakville North—Burlington, ON]

Yes, and you have a job where you're already putting your life at risk just by the profession you've chosen, right?