Debates of March 22nd, 2021

Opposition Motion—Long-Term Care

[The Assistant Deputy Speaker, NDP, Carol Hughes]

There is no consent. Therefore, pursuant to Standing Order 85 the amendment cannot be moved at this time.

Questions and comments, the hon. member for Vancouver East.

[Jenny Kwan, NDP, Vancouver East, BC]

Madam Speaker, fundamental to this motion and the issue we have seen with the pandemic is that for-profit long-term care facilities have resulted in a much higher rate of COVID infections and deaths of seniors.

Does the member support taking profit out of care for seniors?

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Madam Speaker, one of the things that makes Canada great is our strong and robust publicly funded health care system, which I strongly support.

For profit or not, if it is government owned we need to have guidelines and best practices to ensure quality of care. I do not think a governance model, in and of itself, without those standards can guarantee anything. That said, I do think, given everything that I outlined in the speech, particularly the sale of many long-term care facilities to Anbang and the disastrous results of that, we need to have a strong discussion in this country about how we are treating our country's seniors in these facilities.

[Jennifer O'Connell, Liberal, Parliamentary Secretary to the Minister of Health]

Madam Speaker, I am disappointed that the NDP did not allow the amendment because the proposed amendment spoke to precisely the areas that our government had invested in from the first wave to the second wave, including in PPE and infrastructure to improve long-term care facilities, funding for staffing, and support for provinces and territories. With that said, I do agree with the member opposite's comments that every senior needs to live in dignity. It is precisely why the Prime Minister made long-term care national standards a priority in the Speech from the Throne as well as in the fall economic statement.

If the member is looking for solutions and her party supports solutions, why, on February 9 did her leader comment publicly that he does not support national standards and took that off the table for her and her party to work with us to establish long-term care national standards? Why does her leader not support those standards?

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Madam Speaker, I have three points. Point number one, if somebody, over and over again, talks about how much money they spent and do not get results, we should not trust them to spend our money. That is the hallmark of the Liberal government, which should be ashamed for trying to say that. It has spent its way into a worse situation for seniors.

Number two, on the issue of moving forward and standards, the Liberal government has done nothing. It has said that it wants to deliver on guidelines. It has not done anything. The Minister of Health has not put anything forward on this. It is not a priority of the government, and she should be ashamed for raising this as a talking point. She should update her book.

Number three, with regard to my leader, the leader said that he, as much as everybody else has said in this debate today, that Ottawa has to respect jurisdiction, but at the same time there is room for guidelines and best practices for how to move forward.

I would encourage the member, in her new role, to encourage her ministers to deliver some action so that she does not have to keep having this debate with me, over and over again, in the House in the future.

[Claude DeBellefeuille, Bloc, Salaberry—Suroît, QC]

Madam Speaker, the member surely knows that the three or four long-term care homes in Quebec that experienced serious problems have now been placed in trusteeship. Analyses have been conducted and investigations are under way, by the coroner, among others.

Does the member not think that the Government of Quebec is in the best position to find solutions and fix the serious mistakes that were made in long-term care homes in Quebec? Is it not up to the Quebec National Assembly to make these decisions and not the federal government, which is interfering in provincial jurisdictions?

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Madam Speaker, we need change. Canadian seniors in any part of this country cannot be expected to live under the circumstances they have been put over the last year.

Provinces have an important role to play and their autonomy needs to be underscored, but the federal government has a duty to work collaboratively with provinces on coming up with a solution. That is where our discussion should be squarely focused.

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker, I will be sharing my time with the member for Montcalm.

As I rise to speak to this motion, which calls for national standards and the nationalization of long-term care homes, or CHSLDs, as we know them, I feel a sense of exasperation. As everyone might expect, we vehemently oppose the motion because it proposes outright interference in an area under the jurisdiction of Quebec and the provinces, which want nothing to do with federal standards.

It is up to Quebeckers to choose the care model they want, be that public or private. The COVID-19 pandemic did expose the weaknesses in our long-term care homes, but Quebec is perfectly capable of improving its own system without handing over the reins.

A public investigation by the coroner's office and an investigation by the ombudsperson are under way. Quebec does not need federal standards to improve the situation, nor does it need Ottawa to tell it how to solve its problems.

I will focus on three points. I will explain our position as it aligns with that of Quebec and a number of seniors' organizations in Quebec.

At the beginning of the pandemic, it is true that Quebec made the decision to transfer patients to long-term care facilities, or CHSLDs, to free up hospital beds, believing that the entire hospital system would be overwhelmed by the pandemic. We also recognize that COVID-19 mainly affects seniors. This, combined with ongoing deficiencies in our CHSLD system, including a lack of staff, poor administration, and the movement of staff between care centres, has led to the devastation that we are seeing today, with just under half of the 10,087 COVID-19-related deaths in Quebec having occurred in long-term care homes.

Let us not forget that, last May, negotiations between Premier Legault and the Liberal government were particularly tense because the federal government refused to extend the military assistance in Quebec. The federal government then used Quebec's need for military assistance to announce its intention to impose Canadian standards in CHSLDs in the throne speech. This was a way for the federal government to impose its requirements when faced with the provinces joining forces and calling for a 35% increase in health care transfers.

Since then, the federal government has brought up this idea again in last fall's economic update and at the 20th first ministers' conference with the support of the NDP, of course. In all likelihood, the federal standards will be based on the guidelines for long-term care facilities, which were issued by Health Canada in April 2020 and updated on February 26, 2021. This document sets out the procedures to be followed in long-term care facilities to combat COVID-19.

I want to point out that Quebec is already debating the nationalisation of its long-term care facilities, with the debate being led by Premier Legault and his minister responsible for seniors and caregivers, Marguerite Blais. Let us allow them to discuss and debate that.

The Bloc Québécois wants to reiterate that health falls under the exclusive jurisdiction of Quebec and the provinces. Sections 91 and 92 of the Constitution Act, 1867, set out how jurisdictions are shared between the federal government and Quebec and the provinces. It is clear.

Health is the exclusive jurisdiction of Quebec, except when it comes to the health of indigenous peoples, military hospitals, Health Canada drug certification and quarantine. The federal government has failed when it comes to indigenous health, vaccine nationalism and quarantines.

The Liberal Party of Canada and the NDP are always trying to interfere in the jurisdictions of Quebec and the provinces, especially in the area of health care, because it is close to the people and therefore seems like the right thing to do. However, federalism, which they champion, requires each level of government to respect its exclusive jurisdictions. Both parties are giving in to the temptation to get out of this crisis any way they can, including centralization and austerity through cuts, and this is obviously a direct affront to Quebec and the provinces. I will have a bit more to say on that later, when I talk about health transfers.

Federalists sometimes argue that health transfers must have conditions attached, otherwise provinces take advantage of them to lower taxes rather than provide better services to their people.

Our response to that argument is that it is not the federal government's job to lecture the provincial and Quebec governments. This paternalism must stop. In a democracy, it is up to voters to sanction their government. A unanimous motion adopted by the Quebec National Assembly condemned the pan-Canadian standards for long-term care and demanded an increase in transfers.

On December 2, Marguerite Blais, the minister responsible for seniors and informal caregivers, moved a motion to condemn the Liberals' desire to impose these Canadian standards :

That the National Assembly reject the Government of Canada's desire to impose Canadian standards in Québec CHSLDs and long-term care facilities for the elderly, as this falls under exclusive Québec jurisdiction;

That it express its disappointment that the federal government did not include an increase in health transfer payments in its last economic update, while the provinces must cover significant health spending costs in the context of the COVID-19 pandemic;

That it call on the federal government to commit to not imposing Canadian standards in Québec CHSLDs and long-term care facilities for the elderly and to increasing health transfer payments to the tune of 35% of healthcare network costs.

The Bloc Québécois obviously supports the unanimous opinion of the Quebec National Assembly and denounces the centralizing vision espoused by the NDP and the Liberals.

Quebec already has standards. Long-term care homes are regulated by Quebec's Act Respecting Health Services and Social Services. Furthermore, I remind members that the majority of long-term care homes in Quebec, 86% of them, are publicly run, while the Canadian average is 46%.

Let me be clear: The provinces and Quebec have the expertise and experience to manage long-term care homes. The federal government does not. The provinces and Quebec are also the ones paying for the vast majority of these services. In 2014, the Canadian Institute for Health Information estimated that 73% of long-term care home costs in Canada were covered by provincial, territorial and municipal plans and agencies, whereas 23% of costs were covered by residents or through their private insurance.

All long-term care homes must meet certain safety and quality of care standards to receive a permit to operate. They need to renew that permit every four or five years, depending on what category they belong to, by once again demonstrating that they meet the minimum standards. The government even conducts occasional site visits to verify the quality of the services provided. Every long-term care home also needs to set up a users' committee that is responsible for informing residents of their rights, defending their interests and trying to improve the quality of services. I saw this myself when I was managing a project to increase awareness of elder abuse.

Given the situation, the Government of Quebec has already announced that it wants to standardize the regulations governing long-term care homes and staff working conditions. This is clearly not a federal responsibility, since the federal government has neither the experience nor the expertise required to set standards for long-term care facilities in the place of the provinces and Quebec. Instead, the federal government should focus on doing what is expected of it properly and live up to its responsibilities. My colleague from Salaberry—Suroît, who was a manager in the health care system, could also talk about that. The Premier of Quebec even said that it was a mistake for the Liberal government to propose centralizing measures in an area of provincial jurisdiction like health.

Last spring's report from the Canadian Armed Forces on their experience in Quebec long-term care homes was clear: There are already plenty of standards and rules governing PPE usage and infection control and prevention. Those rules were not enough to stop the virus, though, because long-term care homes had a hard time complying with the standards and rules. The reason for that was clearly a staff shortage. According to the report, long-term care homes are in dire need of medically trained staff.

If the federal government really wants to help the provinces and Quebec get through the pandemic and provide better care to our seniors, it should stop being so paternalistic. It should forget about imposing national standards that are not a good fit for a range of social and institutional contexts. Instead, it should increase health transfers, which would enable Quebec and the provinces to attract and retain more health care workers.

For my third point, let us look at where other seniors' organizations in Quebec stand on this. Representatives from the FADOQ network, the Quebec seniors' federation, reiterated to the Standing Committee on the Status of Women what they have long been saying in their pre-budget briefs to the finance committee: Quebec does not need standards, it needs financial resources to be able to take care of people.

It all boils down to health care funding. Health transfers have been slashed by successive Liberal and Conservative governments since the 1990s. Countless other organizations in Quebec agree, including the Association féminine d'éducation et d'action sociale, which advocates for women's rights and recognizes that underfunding has a direct impact on health care. Even Daniel Béland, the director of the McGill Institute for the Study of Canada, felt that the idea of imposing national standards was just a way to make the Prime Minister look good. Some people might see it as a good idea.

However, the provinces and Quebec should really be in charge of this, and they need more money. The solution is simple: increase federal health transfers. The government's refusal to provide ongoing funding for health care is not unrelated to the difficulties that the provinces and Quebec are having in providing proper care for their residents.

It is inconceivable that health care professionals have had to prop up our health care system over the past year as we have combatted this pandemic. In the meantime, the federal government has stubbornly continued to tell us that it will wait until after the crisis to increase funding, even though increasing funding is the most obvious way to permanently overcome this crisis and to predict, plan for and respond to the next one.

The Canadian government needs to realize that Quebec and the provinces are not making a frivolous request. This funding is required immediately so that Canadians and Quebeckers can receive the care they deserve and so that seniors can be treated with the respect they are owed for their contributions to our society.

Madam—

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I apologize for interrupting, but your time is up.

Questions and comments, the hon. member for Salaberry—Suroît.

[Claude DeBellefeuille, Bloc, Salaberry—Suroît, QC]

Madam Speaker, I want to sincerely congratulate my colleague from Shefford for the professionalism she showed in her speech. She is a wonderful critic for seniors, and it is clear that she is well equipped to represent and reflect the needs of Quebec's seniors.

Can she reiterate for the members opposite and for the NDP how important it is that the government respect Quebec and its decisions in the National Assembly with respect to managing all health care services for seniors?

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker, I thank my colleague from Salaberry—Suroît for her excellent question.

I did not have time to do so during my speech, but I had planned to give some examples of times when the federal government tried to interfere in matters in Quebec by asking the province to take action in the area of health. Every time, the action the federal government asked Quebec to take was not in line with its reality or that of the other provinces. For example, when it comes to drugs, injection drugs and marijuana were issues that caused conflict.

Quebec is clearly in the best position to understand the interests of seniors and the hard-working staff in its health care system.

I worked in the community sector. I worked with organizations and the health care system. What people repeatedly told me was that they needed funding.

[Matthew Green, NDP, Hamilton Centre, ON]

Madam Speaker, time and again we have heard the Bloc members passionately arguing on behalf of their province, yet I would like to think that all members in the House would want to ensure that all people across the country would have a standard through which we could protect our seniors.

Does the previous speaker not acknowledge the failures of long-term care within her province, given the death rates in Quebec? Would this member ever consider the possibility that Quebec might actually have lower standards than the national comparators across the country, or is its national assembly so perfect that it will always far exceed the rest of Canada?

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker, I thank my colleague for his comment.

I would once again invite him to reconsider the attack that the Liberals and the NDP are making on the jurisdictions of Quebec and the provinces.

As I mentioned at the beginning of my speech, Quebec is already looking into solutions. It is looking at what happened during the crisis in order to come up with real solutions.

Long-term care homes were already a point of debate during Quebec's most recent elections. Since then, the minister responsible for seniors, the health minister and the premier have been looking into the issue. We need to recognize their expertise, not tell them that we are going to impose standards on them. That is paternalism and a slap in the face. That is telling them that they are unable to manage their health care system, and I think that is unacceptable.

[Dan Mazier, Conservative, Dauphin—Swan River—Neepawa, MB]

Madam Speaker, I was wondering if the member could offer some comments on why the Liberal government chose to take no action in Quebec in particular.

Was there a particular instance when the Liberal government could have acted better in Quebec?

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker, as I said, there are some things that the federal government could have acted on much more quickly by looking after its own affairs.

I am thinking of the issue of border security. FADOQ told me that many seniors wondered why the federal government did not act sooner.

It also could have been transparent about vaccines. Seniors were first on the vaccination list, but there was a lack of transparency, which led to delays. People finally started getting vaccinated, but there were delays. Seniors wondered and are still wondering about this lack of transparency.

There was also not enough PPE. The government could have provided more.

Coming back to vaccines, we must develop a system to produce vaccines. The issue of vaccine nationalism was abandoned by the Liberals and the Conservatives.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, what more can I say, after my colleague's magnificent speech? She really is an excellent critic for seniors.

She went over all the aspects of the NDP motion that are problematic. This motion presupposes that national standards are needed. I see that assumption as a contemptuous premise, not contemptuous of seniors but of those who provide care for them.

By moving this motion, which imposes national standards without having to debate them, the NDP is claiming that it would have done better. On what basis can they say they would have done better in these circumstances?

Obviously, what happened in long-term care facilities was catastrophic. At the beginning of the pandemic, Quebec made the decision to transfer patients to long-term care facilities to free up hospital beds, because many believed the pandemic would overwhelm the hospital system. Many believed that hospitals would become hot spots or red zones. Since some people were waiting for spots in long-term care facilities, Quebec thought it was a good idea to free up hospital beds so that the system would be able to respond to and withstand the first wave of the pandemic.

The decision was made in good faith. No one wanted what happened in the long-term care facilities. Investigations by the coroner and the ombudsperson might provide more information on what was done well and what could have been done better.

It is a disaster, and it is unprecedented. Where was the personal protective equipment? Why was the national stockpile depleted? Why did we send PPE to mainland China when our stockpile was depleted? Why did we not protect those who infected the residents at the long-term care facilities? Why has the government failed to increase health transfers for the past 30 years, something that would have prevented PSWs from needing to work at two or three facilities just to make ends meet?

This pandemic has shed light on the weaknesses in the network. Every expert that testified at the Standing Committee on Health told us that the pandemic has laid bare the weak links in the system and that this is the result of chronic underfunding in health.

The government turning around and telling the provinces and Quebec what they must do, claiming they could have done better, is nothing short of contempt. I am a bit surprised because Quebec does not need national standards to take care of its people and re-evaluate itself. Investigations are under way and there will likely be others. The debate on nationalization has already started, but it is worth noting that in politics, universal standards are never very good.

In Quebec, 86% of long-term care homes are public. In Canada, the average is 46%.

The Canadian Institute for Health Information estimated in a report that 73% of long-term care home costs in Canada were covered by provincial, territorial and municipal systems and agencies, whereas 23% of costs were covered by residents or through their private insurance.

I want to get back to the notion of jurisdictions. Lucien Bouchard, who was the leader of the official opposition in the House and served as premier of Quebec, said that successive governments in Quebec have always set out to reaffirm Quebec's jurisdictions, to ensure that the people of Quebec retain control over their economic, social and cultural development. In response to my New Democrat colleague's claim earlier that our only concern was the Quebec nation, I want to point out that this objective is not in any way connected to a government's position on the status of Quebec.

Incidentally, it is shocking and rather odd to see the NDP, which rightly and aggressively advocates for indigenous peoples to gain control over their social, economic and cultural development, trying to diminish the Quebec nation's control over health care.

When I spoke about my colleague's bill to establish a Canadian pharmacare program, I said that he had ignored Quebec. Today, that seems very obvious to me in this motion. However, what is needed is an increase in health transfers. If there is anything we can learn from this pandemic, it is that Quebec and the provinces must be able to plan for the future and rebuild their health networks.

Is the federal government's priority to give care providers the means to take care of our people? After 30 years of neglect, will it finally contribute its fair share once and for all in order to rebuild our health care systems and properly take care of our citizens? Have we ever seen a federal government lose an election on the issue of health? I have been interested in politics for quite some time and have never seen that. However, I have seen it at the provincial level and with a Quebec government. Why would a provincial government lose an election on the issue of health? Because that is a provincial jurisdiction.

All the federal government has to do is provide its share. Those with the expertise will provide the care. Claiming that they would have done better and that standards are going to solve the problems is just wishful thinking. Yes, there must be discussions, but Quebec is capable of having them and taking corrective action. Standards for Quebec's long-term care facilities, the CHSLDs, already exist, namely in the the act respecting health services and social services. This legislation can be improved and it will definitely be improved as a result of the investigations under way.

The Bloc Québécois is here to apprise the House of Commons of the unanimous motions and the consensus of the National Assembly. The National Assembly unanimously adopted a motion condemning the idea of national standards for CHSLDs and demanding an increase in health transfers.

Madam Speaker, how much time do I have left?

[The Assistant Deputy Speaker, NDP, Carol Hughes]

You have 20 seconds left.

[Luc Thériault, Bloc, Montcalm, QC]

I will continue by answering questions, then.

In closing, this motion says that health transfers must be increased to 35%. Quebec and the provinces are united. Thinking that this debate can wait until after the pandemic is a fundamental mistake that must be avoided.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Madam Speaker, I was really saddened by my colleague's speech, even though he is a great orator, because he failed to acknowledge the crisis in long-term care facilities. This network was particularly hard hit in Quebec, where thousands died.

Today's proposal from the NDP is about incorporating long-term care facilities into the Canada Health Act and increasing funding for long-term care. Over 75% of Quebeckers support this initiative, so what the NDP is proposing today is certainly supported by public opinion in Quebec.

I do not understand why the Bloc Québécois—

[The Assistant Deputy Speaker, NDP, Carol Hughes]

Order. Other members also want to ask questions. The hon. member for Montcalm.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I am surprised that the member for New Westminster—Burnaby is saying the motion passed unanimously by Quebec's National Assembly is in conflict with what Quebeckers as a whole think. That is out of line. Not only is the member dismissing Quebec's jurisdiction and its ability to manage its own affairs, but he is also accusing the Government of Quebec of being out of touch with Quebeckers. That is really something.

I am just saying that there was a catastrophe in long-term care facilities, but we are capable of managing it with the federal government's collaboration. Quebec and the provinces are currently demanding $28 billion in health care funding so they can take care of their own.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the President of the Queen’s Privy Council for Canada and Minister of Intergovernmental Affairs and to the Leader of the Government in the House of Commons]

Madam Speaker, Liberal members of Parliament in all areas of Canada recognize that what happened in long-term care homes through the pandemic is a good example of building back better, something the Prime Minister talks about. We need national standards that obligate us to continue to work with provinces and territories to deliver what Canadians want us to deliver.

Will the member not recognize that the federal government is at times called upon by citizens in all of our provinces to take specific action to protect the interests of seniors?

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, as we all know, the Liberal federal government and the NDP have a centralist agenda, and they often try to leverage the crisis in long-term care homes to further impose their will on Quebec and the provinces. It is deplorable.

I cannot figure out why they do not understand that health transfers have to go up now to give the people in charge of care some room to manoeuver so they can rebuild their networks and take care of seniors.

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker, one aspect I was not able to touch on in my speech was union leaders' support for the National Assembly of Quebec's demand for increased health transfers, which would help resolve the crisis. What are my colleague's thoughts on that?

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, my colleague is absolutely right. As recently as March 1, 2021, the FTQ, the CSN, the CSQ an the CSD all stressed the importance of increasing health transfers to deal with the public service crisis brought on by the pandemic. Long-term care homes have certainly been affected by the crisis.