House of Commons Hansard #60 of the 42nd Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was medical.

Topics

Questions on the Order PaperRoutine Proceedings

12:10 p.m.

Winnipeg North Manitoba

Liberal

Kevin Lamoureux LiberalParliamentary Secretary to the Leader of the Government in the House of Commons

Mr. Speaker, the following questions will be answered today: Nos. 87 and 88.

Question No. 87Questions on the Order PaperRoutine Proceedings

12:10 p.m.

Conservative

Kellie Leitch Conservative Simcoe—Grey, ON

With regard to the 2016-2017 Main Estimates for the Canadian Institutes of Health Research (CIHR), specifically the 134% increase in proposed spending on “Internal Services” as compared to the 2015-2016 Main Estimates: (a) what Budget line item will these funds be drawn from; (b) how many Full-Time Equivalents (FTEs) will this increase add to the CIHR's payroll; (c) will any added FTEs be permanent employees or contracted for a definite time period, and, if so, how many will there be in each staffing category; and (d) how many additional FTEs will be executive-level?

Question No. 87Questions on the Order PaperRoutine Proceedings

12:10 p.m.

Markham—Stouffville Ontario

Liberal

Jane Philpott LiberalMinister of Health

Mr. Speaker, in response to (a), Treasury Board Secretariat issued a new guideline on how to report internal services on April 1. To be compliant, Canadian Institutes of Health Research, CIHR, changed how it captures and reports internal services. The increase of 134% is a direct result of this change in reporting methodology.

In response to (b), no additional FTEs will be added to CIHR’s payroll.

In response to (c), there will be no additional FTEs.

In response to (d), there will be no additional FTEs.

Question No. 88Questions on the Order PaperRoutine Proceedings

12:10 p.m.

Conservative

Diane Finley Conservative Haldimand—Norfolk, ON

With regard to the government hiring consultants, including an American investment bank, to help analyze the feasibility of a $1 billion (U.S.) aid package to Bombardier Inc.: (a) what was the total cost of all American consultants hired; (b) what were the criteria for hiring these consultants; (c) for each consultation in (a), (i) what organizations and individuals were consulted, (ii) what were the dates, (iii) what was the location; (d) what other consultations has the government conducted with other outside sources on this subject; and (e) for each consultation in (d), (i) what was the total cost of other outside sources hired, (ii) what organizations and individuals were consulted as a result?

Question No. 88Questions on the Order PaperRoutine Proceedings

12:10 p.m.

Mississauga—Malton Ontario

Liberal

Navdeep Bains LiberalMinister of Innovation

Mr. Speaker, the Department of Innovation, Science and Economic Development is aware of media references about specific firms involved in due diligence work related to Bombardier. Canada’s discussions with Bombardier, including related due diligence work, are covered by non-disclosure agreements due to their commercial sensitivity.

Questions Passed as Orders for ReturnsRoutine Proceedings

12:10 p.m.

Winnipeg North Manitoba

Liberal

Kevin Lamoureux LiberalParliamentary Secretary to the Leader of the Government in the House of Commons

Mr. Speaker, if Questions Nos. 94, 95, 102, and 110 could be made orders for return, these returns would be tabled immediately.

Questions Passed as Orders for ReturnsRoutine Proceedings

12:10 p.m.

Liberal

The Assistant Deputy Speaker Liberal Anthony Rota

Is that agreed?

Questions Passed as Orders for ReturnsRoutine Proceedings

12:10 p.m.

Some hon. members

Agreed.

Question No. 94Questions Passed as Orders for ReturnsRoutine Proceedings

12:10 p.m.

Conservative

Andrew Scheer Conservative Regina—Qu'Appelle, SK

With regard to the Finance Minister's trip to New York, Paris, and London: (a) who were all the participants on the trip, including (i) the Minister's staff, (ii) Members of Parliament, (iii) Senators, (iv) departmental employees, (v) other invitees; (b) for each participant identified in (a), what was the cost of the trip broken down by (i) total cost, (ii) accomodations, (iv) travel, (v) meals, (vi) all other expenses; and (c) for all events and hospitality organized during the trip, what are the details including (i) dates, (ii) city, (iii) number of participants, (iv) total cost?

(Return tabled)

Question No. 95Questions Passed as Orders for ReturnsRoutine Proceedings

12:10 p.m.

Conservative

Pierre Poilievre Conservative Carleton, ON

With regard to the 2016-2017 budget document tabled before the House of Commons on March 22, 2016 by the Minister of Finance titled “Growing the Middle Class”: what are the yearly income data points that were used to create Chart 1 in that document?

(Return tabled)

Question No. 102Questions Passed as Orders for ReturnsRoutine Proceedings

12:10 p.m.

Conservative

Andrew Scheer Conservative Regina—Qu'Appelle, SK

With regard to public finances: (a) what was the government's monthly surplus or deficit from November 2014 to January 2016, broken down by each month in that period; (b) what was the government's surplus or deficit for the 2014-15 fiscal year; (c) what was the projected surplus or deficit for the 2015-16 fiscal year as published by the Department of Finance as of November 4, 2015; and (d) what definitions does the Department of Finance use in determining whether the government is in a surplus or deficit position, and do these definitions establish that a surplus exists when revenues exceed expenses?

(Return tabled)

Question No. 110Questions Passed as Orders for ReturnsRoutine Proceedings

12:10 p.m.

NDP

Brigitte Sansoucy NDP Saint-Hyacinthe—Bagot, QC

With regard to the mandate letter to the Minister of Families, Children and Social Development, as it pertains to the development of a Canadian poverty reduction strategy: (a) what timelines have been set by (i) the Minister, (ii) the Department; (b) what (i) stakeholders, (ii) organizations, (iii) partners have been identified for consultation purposes; and (c) what amounts have been earmarked for implementing the Canadian poverty reduction strategy?

(Return tabled)

Questions Passed as Orders for ReturnsRoutine Proceedings

12:15 p.m.

Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Mr. Speaker, I would ask that the remaining questions be allowed to stand.

Questions Passed as Orders for ReturnsRoutine Proceedings

12:15 p.m.

Liberal

The Assistant Deputy Speaker Liberal Anthony Rota

Is that agreed?

Questions Passed as Orders for ReturnsRoutine Proceedings

12:15 p.m.

Some hon. members

Agreed.

The House resumed consideration of Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), as reported (with amendment) from the committee, and of the motions in Group No. 1.

Criminal CodeGovernment Orders

May 20th, 2016 / 12:15 p.m.

Brampton West Ontario

Liberal

Kamal Khera LiberalParliamentary Secretary to the Minister of Health

Mr. Speaker, it is an honour for me to rise today to speak in support of Bill C-14, an act to amend the Criminal Code and to make related amendments to other acts (medical assistance in dying).

I would like to start off by first acknowledging that medical assistance in dying is a deeply personal issue for all Canadians, which is tied to both their life experiences and personal beliefs. My background as a registered nurse in an oncology unit helped shape my thoughts and opinions on this matter.

Understanding that this is a very sensitive issue, with proponents on all sides of the debate, within days of this new Parliament, the now-government caucus moved swiftly to strike a joint committee to study the matter and make recommendations, which heard from many Canadians and experts on this issue. After working several days, sometimes well into the evening, the committee made its recommendations to Parliament.

Before I continue, I would like to thank all my hon. colleagues on both sides of the House, and in the Senate, who participated in the special committee and the justice committee for their contributions.

I also know that our minister has worked very hard to craft legislation that would ensure that the priorities of Canadians were met when it came to the issue of medical assistance in dying.

I strongly believe that the proposed legislation finds the perfect balance by reconciling the issue of autonomy of competent adults with the protection of vulnerable people through a thoughtful tailoring of the eligibility criteria and robust safeguards that are essential to preventing error and abuse. It also strikes the right balance by ensuring that conscience rights of physicians and nurse practitioners are protected, and commits to continuing to work with the provinces and territories regarding coordination and jurisdictional issues.

I want to assure members that our government is committed to continued discussions with the provinces and territories on a range of issues, not only related to medical assistance in dying but also to a full range of end-of-life options, including palliative care.

In various testimony given before the House committee, witnesses discussed other regimes where medical assistance in dying has been implemented. In Europe, for example, three countries have legislated access to medical assistance in dying, which is Belgium, the Netherlands, and Luxembourg. In the United States, four states have legislated access.

However, where Canada is unique is in the jurisdictional complexities that we face. In Canada, the federal government has exclusive jurisdiction over criminal law, and health is a shared jurisdiction between the federal, provincial, and territorial governments. Primary responsibility for the provision and delivery of health care services rests with individual jurisdictions. This is why our government has proposed legislation that will be applied across all provinces and territories but at the same time will respect and allow flexibility for jurisdictional roles and responsibilities in the areas of health care.

This brings me to another important issue that cannot be ignored or put aside when talking about enabling access to medical assistance in dying when one is approaching end-of-life care, and that is access to quality palliative care. It is very clear that Canadians are looking to their government for leadership to advance the availability and quality of palliative care within the broader scope of how we address Canadians' needs at the end of their life.

We know that most people at the end of life wish to remain at home as long as possible, as long as they are well supported by the services they need. This is why the federal government is committed to improving palliative care as part of a new health accord, supported by a long-term investment of $3 billion over four years.

Recently, federal, provincial, and territorial ministers of health agreed to work individually and collectively on improving home care to better meet the needs of patients closer to home. However, an agreement must still be reached on how funds will be used to strengthen and transform the health care system. We know that all jurisdictions are working diligently to meet the growing home and palliative care needs of their aging populations. However, we also know that jurisdictions are at different points. Some are well advanced in their efforts, and others are at a more moderate stage. By continuing to work with provinces, territories, and stakeholders, we will bolster each other's efforts for the benefit of all Canadians.

Another aspect that I would like to address when we talk about providing Canadians with that full range of options at the end of life is access. The government is very clear in its commitment to facilitate access to these services and to those providing it. This includes access to this new service of medical assistance in dying.

Our government is committed to respecting the autonomy of Canadians suffering from grievous and irremediable medical conditions. Access to medical assistance in dying would only be available for those who meet the following conditions: be a mentally competent adult who is in an advanced state of irreversible decline in capability; have a serious an incurable illness, disease, or disability, and are experiencing, enduring an intolerable suffering; and whose deaths are reasonably foreseeable.

It will also remain a crime to assist a person either in dying or in causing a person's death in situations other than lawful medical assistance in dying.

With regard to Bill C-14, our government is also committed to protecting the exercise of conscience rights as the proposed legislation also provides exemptions for both physicians and nurse practitioners from having to provide medical assistance in dying. Over the course of this national dialogue, we have seen that the protection of conscience rights for these providers is clearly an issue for many Canadians. Our government has listened and made Bill C-14 more explicit on this issue, and therefore more appropriate for the diversity within Canada.

The bill now reads as follows:

For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying.

We trust that this helps to address the concerns some of members may have either personally and/or on behalf of their constituents on the issue of the protection of conscience rights.

Our government is also proposing to work with provinces and territories to create an end-of-life care coordination system. This would have a dual function. It would respect the conscience rights of health care providers, while facilitating access for Canadians to not only medical assistance in dying but a full range of end-of-life options, including palliative care.

The federal government would be prepared to collaborate on developing such a system should provinces and territories wish to participate, so that all Canadians have access to the care they need and deserve. We could also start on this by reviewing the information that we have on assisted dying regimes in other countries to see what they have done, and assessing their applicability to Canada.

Working in the health care field and especially in oncology, I know that health care is about connecting and helping people during their most vulnerable times. This means that we need accountable and transparent regulations to monitor and instill confidence in the appropriate implementation of medical assistance in dying.

This will protect vulnerable patients when they may not be able to do so themselves and help Canadians understand the number of requests for medical assistance in dying, the types of medical conditions that lead to requests, and whether the procedural safeguards in the law are working as intended. It will also work to ensure that high-quality, comparable Canadian data is generated so that any future discussions about changes to the medical assistance in dying system can be based on the best possible evidence.

Therefore, Bill C-14 creates legal obligations for physicians, nurse practitioners, and pharmacists to report certain information for the purpose of monitoring. Regulations will be put in place to guide the information to be provided, to whom, and within what time frame. In the short term, Health Canada is working with our counterparts in the provinces and territories to establish an interim system should the bill be passed on June 6, until a permanent process is in place.

In closing, I would like to once again reaffirm my support for Bill C-14, which I believe is the right approach for medical assistance in dying. It will support and facilitate access for those seeking it, protect our most vulnerable, and protect conscience rights. We know that no one solution can reconcile the diverse perspectives on medical assistance in dying, but we believe we are moving forward together with a balanced approach that is appropriate for Canada at this time.

I thank the Speaker for giving me the opportunity to speak on this very important piece of legislation.

Criminal CodeGovernment Orders

12:25 p.m.

Conservative

Michael Cooper Conservative St. Albert—Edmonton, AB

Mr. Speaker, I want to ask the member a question about the deadline of June 6.

Right now, it looks like the earliest that the legislation will get to the Senate is mid-week during the week that we return. The expiration of the stay on the declaration of constitutional invalidity expires on the following Monday. It looks like it is now virtually impossible to meet the June 6 deadline.

In the face of that fact, would the hon. member agree that the Minister of Justice should apply to the Supreme Court to ask for a further extension, not a six-month extension, not a four-month extension, perhaps a one month or six-week extension, so that we can get legislation passed without there being a void in which there would be an absence of certainty and an absence of protections for vulnerable Canadians?

Criminal CodeGovernment Orders

12:25 p.m.

Liberal

Kamal Khera Liberal Brampton West, ON

Mr. Speaker, I would like to thank the hon. member for his question and for all his hard work on the special committee and the justice committee.

What he said, again, reinforces how important it is for us to pass the legislation by June 6. As members know, if the legislation is not in place by June 6, the court's ruling would come into effect, meaning that medical assistance in dying would be lawful where it is in accordance with the parameters set by the Carter ruling.

We know if the bill does not pass there will be a vacuum. I know this is something that my hon. colleague has said before in the House as well. People who are suffering incurable and irremediable conditions will be left with no access to medical assistance in dying because no medical practitioner will be at all comfortable assisting anyone in dying without any legal framework.

On the other side, we will be putting our most vulnerable population at risk with absolutely no safeguards, and we know how disastrous that could be.

Again, this just shows how important it is for us, as parliamentarians and as Canadians, to pass the legislation by June 6.

Criminal CodeGovernment Orders

12:25 p.m.

NDP

Randall Garrison NDP Esquimalt—Saanich—Sooke, BC

Mr. Speaker, I, too, would like to thank the Parliamentary Secretary to the Minister of Health for her very thoughtful remarks on the bill.

My question for her is about process. I am one of the people who did not get an opportunity to speak to the bill at second reading. Under the time allocation motion, we now, today, will have 10 amendments on the bill before us and we will have only nine speakers. We actually have more amendments than speakers on the bill.

I wonder how she feels or why she feels the government is unwilling to accept the proposal that was just made that would allow this debate to continue on Monday and allow many more members of Parliament to participate in the debate at report stage, because we are going to have less than 10% of the members of Parliament actually participating at this stage.

Criminal CodeGovernment Orders

12:25 p.m.

Liberal

Kamal Khera Liberal Brampton West, ON

Mr. Speaker, for all Canadians, this is an extremely difficult and deeply personal issue, tied to their life experiences and personal beliefs.

As we know, it is a very diversified situation. For some, medical assistance in dying would be very troubling, and for others, the legislation would not go far enough. We believe that the legislation is the best approach to ensure that dying patients who are suffering unbearable pain have the choice of a peaceful death, and that the vulnerable are protected.

The Supreme Court of Canada decided that Canadians suffering intolerably have the right to request assistance to end their suffering, and we respect that decision.