Justice Committee on Nov. 23rd, 2023

[The Chair, Liberal, Lena Metlege Diab]

Thank you, Mr. Housefather.

We now go to Mr. Fortin for two minutes.

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

Thank you, Madam Chair.

I'm coming back to you, Mr. Roy, not because the other two witnesses aren't important, of course. They raised some very interesting points, but you are here.

You talked about how we should consider expanding the commission's investigative powers to include going to the scene. The commission can compel certain witnesses to appear, if it wishes, including the applicant, who as you pointed out, is the accused. Those are all important considerations, in my view, but something is bothering me.

Let's say we give the commission broader powers, as you recommend. At the end of the day, doesn't that amount to the commission retrying the case? Theoretically, that should not be possible, since the commission's job is simply to determine whether a retrial is warranted.

Aren't you concerned that is a step too far, to some extent?

[Simon Roy]

That's an interesting question.

One of the discussions earlier was about whether the basis for triggering a review should be limited to new evidence. Obviously, if the evidence has already been considered, there could be a duplication of work. However, if someone wants to present new evidence, I think the commission should have the power to assess evidence that wasn't presented during the original proceedings.

Consider the argument that someone else committed the crime. If that argument wasn't presented at trial, I think it's appropriate that the commission would want to hear the witness in order to assess whether a miscarriage of justice occurred. If the witness was already heard at trial, the commission might not gain much from hearing the witness again.

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

It could also increase the wait times.

Thank you, Mr. Roy.

Thank you again to the witnesses for being with us today.

[The Chair, Liberal, Lena Metlege Diab]

Thank you.

Mr. Garrison, go ahead, please.

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

Thank you, Madam Chair.

I'd like to go back to you, Mr. Curtis, and to where we left off.

You said that only 5% of those applicants in the U.K. commission were legally represented. I'm going to ask you the obvious question, and I'm sure you have studied this: Is there any difference in success in having those wrongful convictions reversed? Is there any difference between those who had legal representation at the commission and those who did not?

[John Curtis]

We don't think so. We think the difference is in the time the case takes to review rather than the outcome. Once a case gets back to the court, the court will appoint representation for the actual hearing day.

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

Of course, that would be the same situation here in Canada.

In terms of successful appeals in Britain, have you noticed any difference, let's say perhaps with the social makeup in Britain, in the overrepresentation of Blacks or those who live in poverty? Have you dealt with this question in the U.K. commission?

[John Curtis]

We haven't. I can't give you any data on that, I'm afraid. It might be something we could supply further to the session.

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

It's not something the U.K. commission has been seized with.

[John Curtis]

There is a definite overrepresentation of certain communities within the prison population. We work on our outreach to try to improve our application intake so that it is representative of the prison population. We've had some success with that, but it requires a good investment, as far as the commission is resourced, to do that—to go into prisons and build those relationships with people in prison and build trust within the communities.

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

Thank you very much, Mr. Curtis.

[The Chair, Liberal, Lena Metlege Diab]

Thank you very much to our panellists, both those in person and those online.

Members, we'll suspend for two minutes to allow the next panellists to be set up. My understanding is that there will be one in person and two by video conference.

[The Chair, Liberal, Lena Metlege Diab]

Welcome back, colleagues, for our second panel. We will now resume.

In our second hour, we are proceeding with our study on Bill C-321.

We welcome, as an individual, Elizabeth Donnelly, associate professor, school of social work, University of Windsor, who is joining us by video conference; Linda Silas, president of the Canadian Federation of Nurses Unions; and Danette Thomsen, British Columbia regional council member, northeast region, British Columbia Nurses' Union, also joining us by video conference.

We will start with six minutes each.

Mr. Brock, are you on the list?

Oh, I'm sorry; before that, you each have five minutes for your opening remarks. After that, we will commence with questions.

I will ask Madam Donnelly to please proceed.

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

I want to thank the committee so much for the invitation. I'm delighted. It seems the third time's the charm to be able to present to you today.

My name is Elizabeth Donnelly. I'm an associate professor, but I am here today primarily because I have spent the last decade, and more, of my life focusing on workforce health issues for paramedics. I'm currently a co-investigator with Dr. Mausz in the Violence in Paramedicine Research Group.

In addition to my research, I have maintained certification as an emergency medical technician for over 20 years. I have done a significant amount of frontline work, so this is not theoretical work for me. This is very much about the folks I worked with and about keeping them safe.

Because I was initially supposed to testify last month, I just want to very briefly reiterate the points that my colleague made about our research.

Violence against paramedics is wildly under-reported, primarily due to a culture of a under-reporting and this idea that tolerating violence has become an expected professional competency. These beliefs about violence being unavoidable are changing after the creation of a novel reporting strategy and significant organizational change. Violence reporting is increasing, and while it's still under-reported, our research has found that paramedics are reporting violence every 18 hours, are assaulted every 46 hours and experience violence that results in physical harm every nine days.

The issue of violence against paramedics has been a concern for the paramedic community for years. The Paramedic Chiefs of Canada put out a position paper a number of years ago outlining a host of strategies that needed to be operationalized to keep paramedics safe. These included research to better understand the scope of the problem, evidence-informed strategies to keep our paramedics safe on the front line, increasing public awareness, and—most importantly for the folks on this call today—changes in policy and legislation.

This has been reinforced in the white paper they put out on the future of paramedicine in Canada, where violence was specifically identified as a health issue in the paramedic community. This has also been captured in the report that Mr. Doherty noted, report 29, which recommends amending the Criminal Code.

The paramedic community is doing their part. Many services have deployed this novel reporting tool. Many of them have agreed to share their data with my research group, so we are going to have a better idea of what's going on. It's a huge concern for our community, because we already have significantly higher rates of mental health challenges.

While the evidence base is still emerging within the Canadian context, it has been identified as a correlate to depression, anxiety, stress and burnout in other populations. Also—not specifically with paramedics—exposure to violence has been identified as associated with an intent to leave the profession. Right now, we're struggling to get providers on the roads. We're struggling to staff the trucks. We need to retain every human being that we have to provide the services that Canadians count on.

The paramedic community needs you. It needs the justice system for so many different reasons. Because violence was so long considered unavoidable and because tolerating it was an expected professional competency, we need everyone to say, “No, that's not true.”

Paramedics are helpers. They show up. They train. They prepare. They will be there in the night, upside down, in a ditch. They will show up for you when you need them.

Is it really reasonable that we tell our paramedics that we want them to show up but also to deal with intimidation, racial slurs and sexual harassment? Would you expect that in your workplace? Would that be acceptable for your constituents? I don't think that's true.

Legislation alone isn't going to solve this problem. It's complex. It's going to require comprehensive approaches. Paramedic services can do their part by putting programs together to keep their paramedics safe. Police organizations can get involved by investigating and laying charges. The Canadian government can do its part by amending the Criminal Code.

Amending the Criminal Code will do a lot of different things.

The first thing is it—

[The Chair, Liberal, Lena Metlege Diab]

Thank you very much, Ms. Donnelly. We'll get back to you with questions.

Next is Madam Linda Silas.

[Linda Silas, President, Canadian Federation of Nurses Unions]

Good afternoon.

Sorry, Elizabeth. That bell is the worst part of the job.

Thank you, Madam Chair, and thank you, committee members, for the invitation. It's a privilege to be here.

As you know, I would like to acknowledge that the land that we are sitting on is the unceded, unsurrendered territory of the Algonquin Anishinabe people. I'm a proud New Brunswicker from the beautiful land of the Mi'kmaq people.

I'm here as president of the Canadian Federation of Nurses Unions and on behalf of my 250,000 members. I'm proud that Danette, one of our leaders in British Columbia, will be presenting soon.

We're the working nurses. Like the paramedics, we're there 24-7, taking care of the sick.

Canada's nurses believe that the language in Bill C-321 complements the existing protections and Criminal Code changes outlined in Bill C-3, which is now two years old. I'll get to that soon.

The Criminal Code changes found in Bill C-3 aimed to ensure better safeguards for health care workers, including nurses. Now Bill C-321 proposes expanding the language to include first responders. We welcome this proposed change to the Criminal Code. We recognize that violence against any health worker or first responder when they are performing their duties is an aggravating factor to sentences.

The facts are shocking. You heard Elizabeth talk about the paramedic field. In 2023, a pan-Canadian survey of nurses was done. Two-thirds reported incidents of physical assaults over the past year and 40% of those nurses reported physical abuse more than once a month while engaged in their duties.

All workers deserve a workplace free of violence and abuse. It should not be tolerated. Sadly, nurses and health care workers experience it routinely. We have to look at these. We have to bring in new measures, such as changing the Criminal Code, but we will also talk about prevention modes.

Many people in Canada are aware that public safety personnel—peace officers, police officers, firefighters and corrections officers—have high-risk jobs and often face violence. Most would be surprised that the same ratios exist in the health care field. Our health care facilities and our health care system are not safe places to work.

In addition to physical injury, workplace violence is strongly correlated with negative impacts on workers' mental health and has been seen as an issue facing nurses for many years. Exposure to violence predicts negative mental health outcomes, including PTSD. From our survey of working nurses, three in four, or 78.5%, report symptoms of burnout. Similar data is seen with public safety personnel.

A similar study was done by CFNU in 2019. Nearly one in four nurses screened positive for PTSD symptoms. MP Doherty will remember all the work we did in 2019 on a federal framework on PTSD, which included health care workers, such as nurses and paramedics.

Sadly, violence and abuse are normal in the health care system. Such a high rate of violence would be unthinkable in any other profession. It needs to be stopped. The health care risks are often accepted.

The House of Commons committee on health, HESA, tackled the challenge of rampant violence against nurses for the first time in a 2019 study. Bill C-3 came out of this and came into law in 2021, as one of HESA's recommendations. Bill C-321 will expand these protections.

Nurses are in solidarity with paramedics on this, but we need to go further than this. We need to be clear that this is not enough. We have to make the public and lawmakers aware of the changes in the Criminal Code and work on better protection for our health care workforce in order to work safely in our health care facilities and in our community. Thank you so much.

While we're encouraged by all this work, we know that many more recommendations of the HESA committee have to be done there.

We support this piece of legislation, but we encourage all MPs and all committees to look further to make our health care and our community safer for those who take care of the sick and the injured in their work.

Thank you, Madam Chair.

I'll answer your questions.

[The Chair, Liberal, Lena Metlege Diab]

Thank you very much.

Next we have Madame Thomsen.

[Danette Thomsen, British Columbia Regional Council Member, North East Region, British Columbia Nurses' Union]

Good afternoon.

I'd like to acknowledge that I personally live on the unceded territories of the Lheidli T'enneh, where MP Doherty is from. Today I join you from the lands of the Coast Salish peoples—the Musqueam, Squamish and Tsleil-Waututh.

It is an absolute privilege to be here with you today speaking on behalf of our members.

When you consider acts of violence as a cause of workers from all occupations taking time away from work, nurses represent 30% of total claims, the second-highest occupation behind nurse aides, orderlies and patient service associates. Between 2018 and 2022, nurses reported an average of 51 injuries per month caused by acts of violence in B.C. alone. The number of injuries reported over a four-year period between 2013 and 2017 rose by 49%, from 1,653 to 2,458. It's unacceptable.

BCNU represents approximately 48,000 members in the province of B.C.

You just have to turn on the news to see the increase in aggression in our society. Wait times in health care facilities due to circumstances outside of nurses' control are increasing, and incidents of violence are increasing along with them. Nurses working short-staffed, trying diligently to give the best care to their patients, are being targeted. They need to be protected. That is our job—your job and my job. We need to do this today.

Their families need them to return home safe. Can you imagine going home and not being able to hold your young child due to having been assaulted at work? Can you imagine a patient in a waiting room calling 911 to warn that a health care worker is about to get seriously injured, if not killed? This patient then proceeded to attack one of our male nurses and attempted to choke him out. The nurse who was attacked was working a shift his wife was supposed to work. Had he not been there, his month-long recovery could have looked so much different for somebody else.

What about the nurse in rural B.C. who, last January, entered a female patient's room and was attacked? Can you imagine being held over a chair, receiving punch after punch, with handfuls of your hair being pulled out, while waiting frantically for help to come from the RCMP? In many rural communities at night, there's only one RCMP officer on duty. That nurse was freed by another male patient, who assisted.

We hear horrifying stories. Many are so horrifying that I can't even tell them. The psychological impacts on our nurse victims and the colleagues who try to assist them last far beyond the physical trauma. This is costing our already crumbling health care system, as nurses are now dealing with their own mental health injuries and time off work, trying to heal. We are losing nurses from our system. This is the first time ever that B.C. is reporting empty seats in nursing programs. There's normally a wait-list to get into our programs, and we're not even filling our seats.

We have an obligation to protect those who are protecting others. We have an obligation to care for the caregivers.

I'm excited to be a part of this today. Thank you for having us here as the B.C. Nurses' Union. I look forward to answering any of your questions.

We fully support Bill C-321.

[The Chair, Liberal, Lena Metlege Diab]

Thank you very much.

We will now begin our round of questioning for six minutes each. We'll start with Mr. Brock.

[Larry Brock, Conservative, Brantford—Brant, ON]

Thank you, Madam Chair.

Thank you, ladies, for your attendance virtually and in person, and for your advocacy in this particular area.

I'm going to turn matters over to you, Ms. Donnelly.

Unfortunately, you ran out of time. Five minutes goes by very quickly, so I'll give you an opportunity to finish your thoughts.

[Dr. Elizabeth Donnelly]

Thank you so, so much.

One question that was asked when my colleague was testifying was, why does this matter and what is this going to change?

It's going to change a ton, because it's going to communicate to paramedics that they're valued and that the Government of Canada supports them. It's going to raise public awareness and say, “Hey, this issue of assault against our helpers is unacceptable. It's a serious offence and will be treated as such.” It's going to communicate to law enforcement and to the Crown that these assaults aren't just assaults; they are threats to public safety because we are losing our helpers. When we lose our helpers, we're going to lose safety for our whole community.

I think the other thing that's really important to understand is that just because the criminal justice system gets involved doesn't necessarily mean that everything is going to result in conviction. There are lots of avenues—diversion, mental health court—that can be used to get folks who may have health concerns the right kinds of support. The goal of this is restorative justice, not necessarily punishment.

Thank you so much for the extra few minutes to get my final thoughts out. I appreciate it.

[Larry Brock, Conservative, Brantford—Brant, ON]

You're welcome.

The next question can be answered by anyone on the panel.

I'd like to make an observation that it's probably no small wonder that we have a crisis in the nursing profession in light of everything you shared with us in terms of the historical nature of the profession and the abuse that the profession receives. This is nursing, and this is also first-line responders as well.

I understand that under-reporting is commonplace in the nursing industry and in the paramedic and first responders field. I am married to a nurse. You represent my wife. For the last 20 years, I have heard example after example of how she has been personally tormented, that the administration is not doing anything about it, that there is a lack of security within the hospital setting itself and that the security is not acting as a deterrent.

The question I am bringing to your attention right now is on the whole issue of public knowledge, information sharing and making sure that the police understand they have tools available to them to charge.

The concern I have is on deterrence. One of the central features of sentencing on any particular case, from shoplifting all the way to murder, is that there is an element of deterrence—personal, specific deterrence to the offender to learn that there are consequences for their behaviour, and general deterrence to the community to learn that if one engages in similar behaviour, there are going to be consequences.

I am hearing from all of you that is the message you want to share.

We know that for many, many decades, there have been numerous cases of offences in the Criminal Code that have had aggravating features attached to them. When you have committed an offence against a certain individual in certain circumstances, it is an aggravating feature in sentencing.

In light of that, do you have any evidence to suggest that the Criminal Code will have some impact on the community at large, and on your profession, by making this an aggravating feature when you assault a health care worker or a first responder?

That is to anyone on the panel, please.

[Linda Silas]

I'll start. Thank your wife and give her hope, because I do have hope.

I've been on many committees, on either violence or the nursing shortage, and we have a crisis in this country. The crisis goes further than nursing. It goes in all respects to our other health care workers.

On why it's important to change a criminal act, Elizabeth said it: It's a question of respect. It's a question of acknowledging that there is a problem.

As citizens, if we get stopped by the police and we spit on the police officer, we know exactly where we're going. In health care, patients, the community and parents do not understand that. We have to change the culture. Changing the culture starts with laws and prevention programs. It starts by MPs like you talking about it and saying that this is not okay.

My occupational health and safety experts from Alberta are going to Windsor the week of the 5th to look at the metal detectors at the Windsor hospital. That is discouraging. Health care dollars should be going to provide more nurses, more doctors, more health care professionals and workers, not metal detectors—but that's where we're going, and you're going to see it across the country.

[Larry Brock, Conservative, Brantford—Brant, ON]

Does anyone else on the panel wish to respond?