Justice Committee on Oct. 26th, 2023

[James Maloney, Liberal, Etobicoke—Lakeshore, ON]

Mr. Caputo took the words out of my mouth.

I want to get to the first responders—and I appreciate that offer, Mr. Doherty. I've been working with you for eight years and always admire the level of passion you bring to our job, but, more importantly—and reflected today—the amount of compassion you bring to this job.

This bill is another example of that, so thank you.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

I appreciate that.

[James Maloney, Liberal, Etobicoke—Lakeshore, ON]

I agree with you wholeheartedly. We have to not only make people like your daughter want to do this job, but we also need to make people like your daughter understand that we have their backs and we're there for them.

We talked about first responders during the pandemic. Everybody, rightfully, was thanking first responders. You can never thank them enough.

I had a paramedic come to my office one day, and she didn't come out and say it, but she sort of suggested that paramedics were always left off that list. It left a very, very powerful impression on me.

That is my way of saying thank you again for doing this. But I want to get on to the second panel. I know we have some paramedics here, so I will stop there.

You made it very clear that you're willing to accept amendments. There's a consensus around this table. It's readily apparent that we support the bill. We just want to avoid any overlap potential with Bill C-3. I think you've already agreed, as Ms. Brière pointed out, to the amendment that would mirror the language with respect to health care professionals and those providing health care services so that could be accomplished.

You're right. You want to capture everybody, not only people who are on the job, but people who might not be on the job or are providing these types of services in another capacity or at another time.

I will leave it there, so we can move on. I thank you, Mr. Doherty, from the bottom of my heart.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

I appreciate it. Thank you, Mr. Maloney.

[The Vice-Chair (Mr. Rhéal Éloi Fortin), Bloc, Rhéal Fortin]

Thank you, Mr. Doherty, for being with us today.

We're going to take you up on your offer to make yourself available as needed.

Now, we will break for five minutes to bring in our witnesses for the second hour.

Once again, thank you, Mr. Doherty.

[The Vice-Chair (Mr. Rhéal Éloi Fortin), Bloc, Rhéal Fortin]

We are back.

Good afternoon everyone.

There are issues with Ms. Donnelly's connection, so the technicians are working with her to get the problem resolved.

In the meantime, since we're running a bit late—it's already 4:35—and we're supposed to end at 5:30, I suggest we start with Mr. Mausz. If we get Ms. Donnelly's connection sorted out, she can give her opening statement after Mr. Mausz.

Everyone seems to be okay with that.

Welcome, Mr. Mausz.

Justin Mausz is an advanced care paramedic and scientist at Peel Regional Paramedic Services.

Assuming her connection issues are fixed, we will then hear from Elizabeth Donnelly, an associate professor, and she will be appearing as an individual.

Also with us is Paul Hills, president of the Saskatoon Paramedics Association. He is here on behalf of the International Association of Fire Fighters.

Welcome to all of you.

You will each have five minutes for your opening statements.

You have five minutes, Mr. Mausz. Please go ahead.

[Dr. Justin Mausz, Advanced Care Paramedic & Scientist, Peel Regional Paramedic Services]

Thank you very much, Mr. Chair.

Thank you to the committee for this invitation. It is very important, and I am grateful for the opportunity to speak on this issue.

I am an advanced care paramedic with the Region of Peel. I'm also a clinician-scientist, having finished a Ph.D. a little over a year ago. I'm a faculty member in the department of family and community medicine at the University of Toronto. After working clinically as a paramedic for nearly 18 years, I've transitioned primarily into a role now that focuses on applied health research on health and well-being issues that are affecting my colleagues in the paramedic services.

I would say to you that paramedics provide vital care to Canadians. We are an important part of our country's health care and public safety infrastructure. My colleagues provide care from the moment of birth right through to the moment of death. Canadians are coming to rely more and more on paramedics in Canada as we fill gaps in primary health and social care.

However, despite the importance of the services that we provide, in the years leading up to the COVID-19 pandemic, paramedics have been found to have some of the highest rates of work-related mental illness among public safety personnel in Canada. This includes post-traumatic stress disorder, depression, anxiety, disturbed sleep, chronic pain, and alarmingly high rates of suicidality.

We know from research that situations that involve threats to physical safety, such as violence, increase the risk of adverse mental health outcomes, including post-traumatic stress disorder. In the wake of the COVID-19 pandemic, we are seeing that reports of violent attacks on health care professionals and public safety personnel, including paramedics, are growing at an alarming rate.

Unfortunately, most of the incidents are never formally reported or tracked. This means that only the most serious incidents tend to capture attention, and the vast majority go unreported. This makes the true scope of the problem hard to measure and hard to grasp.

My colleagues in Peel Region have been researching this topic extensively. In an earlier study of our personnel in Peel Region, one in four of our active-duty paramedics was found to have significant symptoms of either post-traumatic stress disorder, major depressive disorder, or generalized anxiety disorder as recently as February 2020 when we stopped collecting data just before the pandemic.

In a series of studies that we have done internally in Peel Region, we found that despite a majority of our personnel experiencing some form of violence, less than 40% formally reported or documented the incidents to their supervisors.

In partnership with community and industry experts, we've developed a novel reporting process to track this problem. Whenever our paramedics complete their paperwork after being dispatched from a 911 call, they are prompted to complete a new violence report if they experience violence during the interaction. Over a two-year study period, we found that nearly 50% of our active-duty paramedics filed a violence report. Forty per cent of those reports documented a physical or a sexual assault. Twenty-five per cent of the reports that we saw documented some form of verbal abuse on either gender, sexual orientation, race, or ethnicity, and those incidents were associated with an increased risk of emotional and psychological distress. Eighty-one of our paramedics were physically harmed during this two-year period, and that corresponds to 10% of our active-duty workforce.

Expressed as rates, these findings suggest that one of our paramedics was experiencing violence every 18 hours, was physically or sexually assaulted every 46 hours, and was physically harmed as a result of a violent attack every nine days.

In closing, I would suggest that this degree of violence creates the potential for significant physical and psychological harm, and as Canadians come to rely on paramedic care more and more, this creates a significant vulnerability from our health human-resources perspective. In order for Canadians to be able to depend on paramedics to provide skilled, compassionate and high-quality care, paramedics must be protected from acts of violence.

[The Vice-Chair (Mr. Rhéal Éloi Fortin), Bloc, Rhéal Fortin]

Thank you, Mr. Mausz.

We're going to suspend momentarily to test Ms. Donnelly's audio one last time. If everything is working, we will hear from her right away.

Thank you.

[The Vice-Chair (Mr. Rhéal Éloi Fortin), Bloc, Rhéal Fortin]

We'll have to come back to Ms. Donnelly later, once everything is sorted out.

To keep things moving along, we will go right to Mr. Hills' opening remarks. He is the president of the Saskatoon Paramedics Association, and he is representing the International Association of Fire Fighters.

Go ahead, Mr. Hills. You have five minutes.

[Paul Hills, President of the Saskatoon Paramedics Association, International Association of Fire Fighters]

Thank you, Mr. Chair.

Thank you, committee, and fellow witnesses. I appreciate the opportunity to be here today to discuss Bill C-321. As stated before, I am Paul Hills, president of the Saskatoon Paramedics Association. I represent IAFF Local 3270.

On behalf of over 27,000 paramedics and firefighters across Canada who belong to the IAFF, we strongly support Bill C-321. I personally have been coming to the Hill and advocating on this issue for over a decade. I've been a medic for over 25 years and a strong advocate for my profession for over 18. I serve one of the busiest cities per capita in Canada for EMS. I'm here personally because I have been a victim of violence and witnessed external acts of violence in the workplace.

I'll give you just a quick snapshot of what a shift look like for a paramedic. We normally start our 12-hour shift with a team briefing. We check our trucks and then it's go, go, go. We rarely have any breaks. That means no breakfast, no lunch and no supper as compared with the average worker, not to mention all while experiencing some of the most horrific and heart-wrenching situations that exist in society—incidents involving children being stabbed by their parents, or families tragically dying in motor vehicle collisions.

The IAFF supports this bill because we believe that this legislation and the tougher penalties it proposes will build a strong foundation to address the growing trend of violence towards first responders and health care workers across Canada. The Criminal Code rightly addresses acts of violence against peace officers. This is now an opportunity to address acts of violence against paramedics and firefighters, almost a daily occurrence.

As a paramedic, I've seen many new pieces of safety equipment added to our ensemble over the years. The one piece of equipment coming out of school that I never thought I would be issued is that of a bulletproof vest. We've been wearing them in Saskatoon for over 15 years. This is not a piece of equipment that I as a paramedic should be issued. Last I checked, it's for military and police officers, not frontline health care workers.

An IAFF survey has shown that 13% of departments experienced at least one act of violence toward on-duty personnel at structure fires in the past five years, while 40% reported acts of violence toward personnel during medical calls in that same time period. I know first-hand that violence and threats against us are on the rise. There is no shortage of examples.

Personally, I've had my life and those of my family threatened by gang members. I've had machetes and knives pulled on me. I've removed guns from patients while attending to their medical needs. My best friend was in a house and had a patient with a nine-millimetre beside him in the chair. He had to choose: Possibly get shot in the face and have a chance to fight back, or run away and get shot in the back. Luckily, things turned out safely.

In Toronto just two weeks ago, a firefighter attempting to put out a fire in an encampment was attacked with a six-foot piece of PVC piping and hit in the face for no reason whatsoever.

In British Columbia, interactions with overdose patients have become violent or aggressive once we've rendered medical care to save their lives.

In Winnipeg, a firefighter got stabbed in the back while attending to a patient on a sidewalk.

I could spend the rest of the hour sharing real-life events—my partner here could as well—of violent acts or near misses, but the takeaway is that it's real. It's happening right now.

We must acknowledge that the consequences of violent calls aren't just physical injuries. There may be long-lasting mental health injuries. In Montreal, for example, a Local 125 member was chased by a man with a large knife. He had to barricade himself in a room. Although he was not physically injured, he was never able to return to work after 10 years of disability.

The IAFF understands and supports the overarching need to address root causes behind violent acts towards paramedics, firefighters and health care workers. These may stem from societal issues, such as economic inequality, addictions and mental health. In the meantime, we agree that there is a role for the federal government to play in protecting paramedics and firefighters and health care workers from the real threat of workplace violence in the form of tougher Criminal Code penalties.

To me, it isn't just about accountability for those who perpetrate violence against us or other health care workers. To me, it's about closure for the victim. The closure comes from a recognition of decision-makers that we deserve better by caring for those who care for all of us in our time of need. We need to use all the tools in the tool box, as we've discussed, whether it be Bill C-3, Bill C-321 or Bill C-324, to help deter the violence and help the helpers.

Bill C-321 will definitely help in this mission. We urge the committee members to support this bill going forward, with any amendments that are necessary.

Thank you for this opportunity. I look forward to answering any questions.

[The Vice-Chair (Mr. Rhéal Éloi Fortin), Bloc, Rhéal Fortin]

You still have 30 seconds.

[Paul Hills]

I can ad lib.

[The Vice-Chair (Mr. Rhéal Éloi Fortin), Bloc, Rhéal Fortin]

Very good. Thank you.

As I understand it, there's still an issue with Ms. Donnelly's connection.

We can try one last time.

[The Clerk of the Committee, Ms. Sophia Nickel]

Hello, Ms. Donnelly. If you can, give us just one more sentence.

[Dr. Elizabeth Donnelly, Associate Professor, School of Social Work, University of Windsor, As an Individual]

For sure. Hopefully it works this time.

[The Vice-Chair (Mr. Rhéal Éloi Fortin), Bloc, Rhéal Fortin]

Please ask her to speak a little longer.

[Dr. Elizabeth Donnelly]

I would really love the opportunity to address this committee. I am deeply distressed at the possibility that I may not be able to share. I submitted comments, but I would love to tell you more, if we can make it happen.

[The Vice-Chair (Mr. Rhéal Éloi Fortin), Bloc, Rhéal Fortin]

Sorry, Ms. Donnelly, but it's no better for the interpreters. We can hear you, but the audio quality isn't good enough for the interpreters to do their job. We have to make sure that the audio is acceptable for them so they can interpret your remarks.

Unfortunately, we won't be able to hear from you, but we would appreciate it if you could send us your notes, if you wouldn't mind. Ideally, we would like to have them by the end of the day tomorrow, so the committee members can review and consider them.

Thank you.

We will now start the first round.

Mr. Garrison has a point of order.

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

Thank you, Mr. Chair.

We have repeatedly had this problem, and it would be an extreme coincidence if it is always the fault of the person presenting. I had this problem in our last meeting, when I was appearing virtually.

It is clear, when you're appearing virtually, that others who are appearing virtually can hear the person just fine and the sound quality is just fine.

I want to assure Ms. Donnelly that it's nothing she's doing; we have some problem in the programming or in the interface, either between those online and those in the room, or between the room and the interpretation booths.

I have raised this repeatedly over the last year, and we continue to call people who are testifying and say, “Move closer to your router. Move your microphone.” That's clearly not the problem. We need to get to the root of this problem so that this does not continue to happen.

I would ask that we ask the technical staff to look into this problem, rather than assume in each case that, by complete chance, every one of the witnesses or the people appearing virtually are doing something wrong. There's clearly something wrong with the system.

Thank you, Mr. Chair.

[The Vice-Chair (Mr. Rhéal Éloi Fortin), Bloc, Rhéal Fortin]

Thank you, Mr. Garrison.

Go ahead, Mr. Caputo.

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

Following up on Mr. Garrison's point of order, Professor Donnelly is coming through very clearly to us. That is why I am puzzled. We hear her fine. Are the interpreters getting a different feed? She's coming through as clear as day to us here.

Is everybody else hearing her clearly? I am, so I am puzzled as to why we're not hearing her evidence—especially when she's somebody who has taken the time. It is really tragic.

[The Vice-Chair (Mr. Rhéal Éloi Fortin), Bloc, Rhéal Fortin]

Thank you, Mr. Caputo. I agree with you. I, too, could hear Ms. Donnelly clearly.

As you know, only the interpreters can determine whether the audio quality is acceptable, not you or I. We have to trust what they say, since they are the ones who have to work from the audio.

Mr. Garrison rightly pointed out that Ms. Donnelly did nothing wrong. The problem isn't on her end. The problem is with the transmission of the sound from her mike to the interpreters booth.

We apologize, Ms. Donnelly. Again, if you can send us your notes, we will make sure the committee takes them into account.

Mr. Moore had something to say.

Go ahead, Mr. Moore.

[Rob Moore, Conservative, Fundy Royal, NB]

Thank you, Mr. Chair.

My point has just been made by Mr. Garrison and Mr. Caputo. The witnesses, from what I could hear, couldn't be more clear. It's just as clear as what I'm hearing from you and just as clear as what I'm hearing from Mr. Garrison. It really is quite unacceptable that we can't hear from these witnesses. This has happened a number of times.

It's perfectly clear on my end as well, and I look forward to reading your presentation, Ms. Donnelly, if it's unable to work today.

[The Vice-Chair (Mr. Rhéal Éloi Fortin), Bloc, Rhéal Fortin]

Thank you, Mr. Moore.

Does anyone else want to comment?

Mr. Garrison, do you still have your hand up from earlier, or do you have something else to say?

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

No, Mr. Chair, but I do have something to say that this point.

I want to say again that no one around the table is suggesting that we do harm to the interpreters. Everyone understands that the problem is also not with the interpreters. The problem is a technical problem that we've failed to solve here somehow.

I participated using the very same equipment from the very same spot yesterday in the House of Commons as a whole and in my caucus meetings without any problem. The only problem was when I tried to do so in this room, so today I came to the constituency office to do so. I am not asking in my request that we do any harm to the interpreters, just to be clear, or that we ignore the concerns about the health and safety of interpreters. My problem is that we have not addressed this technical problem, which has occurred multiple times.