Debates of Nov. 5th, 2026

Connected Care for Canadians Act

[Mario Simard, Bloc, Jonquière—Hébertville—Pays-des-Bleuets, QC]

Madam Speaker, before I start my remarks, I would like to note a recurring trend. We are seeing more and more bills here in the House that originated in the Senate. As members know, the time allocated for debate on a bill is not unlimited, so I find it somewhat curious that the government continues to place so many Senate bills on the agenda.

Let me turn now to Bill S-5. As my colleague from Laurentides—Labelle said earlier, its objective is certainly commendable. No one can argue with it. Unfortunately, however, this bill reflects a familiar tendency to believe that Ottawa knows best, that Ottawa knows better than the provinces what is good for them in areas under their jurisdiction, and that Ottawa possesses more expertise when it comes to implementing policies. I must say, it is getting a bit tiresome.

There is a major problem, as my colleagues have pointed out. Despite what the Minister of Health said earlier, nowhere does this bill explicitly recognize Quebec's and the provinces' exclusive jurisdiction over the organization of health care delivery or the fact that Quebec can choose to develop its own digital infrastructure. If the Bloc Québécois is to support such a bill, it must include an explicit recognition.

I would like to point out that, as my colleague from Laurentides—Labelle said earlier, the Government of Quebec has already indicated its intention to deploy its own digital health infrastructure. Unfortunately, this bill in no way reflects the autonomy that Quebec claims with respect to health care. Moreover, to my knowledge, Quebec has not committed to following the pan-Canadian interoperability roadmap. The major stumbling block in Bill S‑5 is that it does not respect jurisdictions.

To convince my colleagues of this, I will reread clause 7(1), which my colleague from Montcalm referred to earlier. I hope the Minister of Health will listen to us.

The Governor in Council may, by order, make any provision of this Act or the regulations applicable in any province or territory if the Governor in Council is satisfied, after applying the criteria and the process provided for in the regulations, that the province or territory does not have requirements that are substantially similar to or exceed those established under this Act.

What does that mean, ultimately? It means that Ottawa is leaving the door wide open to tell the provinces how they should act. That is why I said in my introduction that this is, once again, a form of centralizing federalism. I will not use the term “predatory federalism”, but this is yet another form of federalism that is heavily focused on allowing Ottawa to define what is right and what constitutes good health care within the provinces' areas of jurisdiction.

This is very clear, and I want to make that point clear to the minister. In theory, Bill S-5 might not apply to Quebec, as my colleague said, but we must still speak out against clause 7, which would allow the government, by order, to effectively override provincial laws in areas that fall under provincial jurisdiction.

Unless the government is willing to amend its bill, I do not see how the Bloc Québécois can support it. At the very least, a preamble should be added that clearly specifies that Quebec remains in charge of its health care.

However, today is budget day, and we are always happy on budget day. This bill gives me the opportunity to talk about something that is central to the Canadian federation, and we will see it reflected in the budget: the perennial problem of health transfers. If we want to fix health care, we need to solve the funding problem. Year in and year out, and during every election campaign, when Quebeckers and Canadians are asked what their priorities are, health care is usually one of their top priorities.

I want to go back to the issue of health transfers because, in the great history of Canadian federalism and the injustices and inequities in relations between Quebec and Ottawa, one thing is glaringly obvious. I am talking about the infamous fiscal imbalance.

For those who do not remember what that is, I will explain. The Government of Quebec delivers virtually all social services and, in fact, Ottawa delivers very few services. There is EI, but that is paid for by workers. There is OAS, which is a social program. Ottawa participates very little in terms of social programs, although it takes up 60% of the tax room.

In the end, Ottawa always has much more money than its responsibilities require, while Quebec and the provinces never have enough because they have a smaller tax base. That is the fiscal imbalance in a nutshell.

Instead of piling on more and more health initiatives, encroaching on an area under provincial jurisdiction, Ottawa should focus on making health transfers more predictable and unconditional.

We will see whether there is any good news in the budget and whether health care transfers will live up to the expectations of Quebec and the provinces. Right now, if we look at the big picture, Quebec is spending about 42% of its total budget on health care. Back in the 1960s, when the public health care system was first established, 50¢ of every dollar invested in health care came from the federal government and 50¢ came from the provincial government. Today, the federal government's share is estimated at barely 22%. That means that, for every dollar invested, 22¢ comes from the federal government. Quebec has to cover the rest, and the infamous fiscal imbalance comes into play, as I mentioned earlier.

That said, 42% of the Government of Quebec's budget is a huge share. That means that Quebec has only about 58% of its total fiscal capacity left to address essential priorities, such as education, poverty, infrastructure, municipalities and support for Quebec businesses. We have been fighting long and hard over health care transfers in Canada. In 1980, the Mulroney government made the first drastic cuts to health transfers.

Then came the famous Liberal era, when there were budget surpluses. Where did those budget surpluses come from? They came from the recurring cuts Paul Martin made to health care. In the wake of the 1997-98 referendum, $2 billion in recurring funding was cut from the provinces. Jean Chrétien boasted to the G7 that he had balanced the budget, which is pretty cynical, really, because he got his surpluses by cutting transfer payments to the provinces. He added that he would not have to pay the political price for this, because the public believed—members may recall Lucien Bouchard's shift toward outpatient care—that the governments of Quebec and the other provinces were to blame for the shortcomings in health care services. However, it was the federal government that had just insidiously cut transfer payments and that was not shouldering its share of responsibility for health care.

It is budget day. I hope the federal government will see the light. It needs to put an end to the predatory federalism and accept its share of responsibility for health transfers.

[Guillaume Deschênes-Thériault, Liberal, Madawaska—Restigouche, NB]

Madam Speaker, better data collection and interoperability, and therefore better dialogue between systems, will ultimately benefit the health of Canadians, including Quebeckers.

As we know, these things do not happen in a vacuum. Some Quebeckers might have consultations in Ontario or New Brunswick, just as people from other provinces might have consultations in Quebec. I welcome the idea of having a health care system that is more connected in terms of data sharing, because it represents progress. In fact, if we look at the Quebec model for data management, it is already pretty much in line with what is set out in Bill S-5, and it will ensure greater consistency, and therefore comparability, of data right across the country.

I wish I could understand why my colleague appears to oppose improved data collection, which will benefit the entire population.

[Mario Simard, Bloc, Jonquière—Hébertville—Pays-des-Bleuets, QC]

Madam Speaker, if somebody is getting their arm taken off, they are not going to worry about the pimple on their nose. In health care, having better data sharing is worthwhile. However, what people want is access to services.

Unfortunately, what we have been seeing within the federation for far too long are cuts to health care transfers. This makes it more difficult to access care, and it makes it harder for the provinces to manage other areas under their jurisdiction.

If my colleague wants to see results in health care, he should convince his government to invest as it should and to increase its participation through transfers. That is the best solution.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, my colleague was right to raise the whole issue of chronic underfunding in health care, the lack of federal funding, and the federal government's fundamental inability to shoulder its fair share.

Going back to the bill, under clause 7, which my colleague mentioned, the bill would apply, by order, to a province such as Quebec if the minister determines that Quebec's existing measures do not meet the criteria. Whatever she wants to do, she will do by enforcing regulations that we have not seen, that we will never see, and that she can also amend at her discretion, by order.

The minister told us that she respects the way things are being done in Quebec. My colleague argued that the preamble should explicitly state that the minister intends to respect Quebec's constitutional jurisdiction. Can he tell us whether he is convinced that the minister's commitment will lead to a willingness to accept an amendment proposed by the Bloc Québécois?

[Mario Simard, Bloc, Jonquière—Hébertville—Pays-des-Bleuets, QC]

Madam Speaker, a little while ago, I was listening to the Minister of Health, who said, in response to a question from the member for Montcalm, that she would table the clause demonstrating that the provinces' areas of jurisdiction will be respected.

After a close reading of the bill, it quickly becomes apparent that, and I can see that my colleague from Québec Centre agrees with me on this, the federal government is leaving the door open to the possibility of assessing the Quebec government's IT policies and deciding whether they are valid. That is completely unacceptable.

I therefore hold out little hope that the minister will see the light and amend the preamble to this bill to clearly affirm that health care falls within provincial jurisdiction and that the federal government should not interfere.

[Jean-Yves Duclos, Liberal, Québec Centre, QC]

Madam Speaker, there seems to be some confusion in the remarks made by my colleague, for whom I have a great deal of respect. This has nothing to do with the decisions made by the Government of Quebec. What this bill aims to do is regulate the activities of organizations, including multinationals, that are unfortunately restricting access to data needed by patients and health care professionals.

Does my colleague acknowledge that there is some confusion in what he said? The Quebec government is not the target here; technology companies are.

[Mario Simard, Bloc, Jonquière—Hébertville—Pays-des-Bleuets, QC]

Madam Speaker, I admit that I get confused sometimes, but as for this bill, I would invite my colleague from Québec Centre to reread clause 7. He will learn that the government is giving itself the option of enforcing a law in an area of jurisdiction that is not its responsibility.

[Maggie Chi, Liberal, Parliamentary Secretary to the Minister of Health]

Madam Speaker, it is great to see you here today. I will be sharing my time with the member for Bourassa.

I rise today to support Bill S-5, the connected care for Canadians act, which is crucial to establishing a connected health care system in Canada.

In Canada, health information is fragmented and is scattered among hundreds of health information systems across family doctor offices, hospitals, walk-in clinics and pharmacies. Bill S-5 would break down these digital barriers so a patient's health information could move securely and seamlessly wherever they receive care. It means that patients would no longer have to physically carry medical records from one doctor's appointment to another or repeatedly explain their medical history every time they seek care.

Bill S-5 is also about making the health care system work better for Canadians. It would unlock the potential of standardized and anonymized health data to accelerate medical breakthroughs and improve health outcomes for all Canadians. Health information in Canada is often stuck in separate digital systems that cannot be easily shared, first, because of data blocking, a practice that prevents authorized users from accessing health data even when privacy legislation allows it, and, second, because of a lack of common standards. For example, one hospital's database could record a patient's blood type using a numeric code, another could use an alphanumeric code, and a third hospital might use a written description. All three could mean exactly the same thing, but without common standards, their computer systems might not recognize each other's blood type entries.

To address this, Bill S-5 would require health information vendors in Canada to adopt common standards and would prohibit vendors from data blocking. These standards would be set out and maintained through regulations, with requirements that would ensure secure access for patients within the protection of existing security law. This is the approach used in other jurisdictions as well, such as Australia, the United States and the European Union.

Bill S-5 would build on the shared pan-Canadian interoperability road map, already endorsed by provinces and territories, and on the working together to improve health care for Canadians plan, which committed nearly $200 billion over 10 years, with modernizing health data as one of four shared priorities.

When somebody sees a new doctor, they are asked for their medical history. Bill S-5 would enable patients and their doctors to access health records electronically, no matter where in Canada patients receive care. This is connected care. Doctors' being able to access electronic health records is critical to the continuity of care. Without a seamless exchange of information between systems and providers, the burden of health information falls to patients and their families. Moreover, the lack of access to a patient's medical records increases the risks of misdiagnoses, medication errors, duplicate testing and treatment delays.

Take, for example, patients in rural and remote communities or patients with very complex conditions who are referred to hospitals in major urban centres for advanced diagnostic procedures, complex treatments and highly specialized medical care. Oftentimes these patients arrive in serious condition, usually with photocopies of their health records, and the information is often incomplete. Patients with a language barrier or limited medical familiarity shoulder the burden of coordinating their own care because there is no digital connection between our health information systems. In all these cases, important health information is often missing or inaccessible. Unfortunately, this happens very often.

Bill S-5 would help support these patients with a more coordinated and integrated health care system, with accurate and accessible data so doctors can make clinical decisions with complete information and provide the health care Canadians deserve. In today's rapidly evolving world of medical research and innovation, large, high-quality data sets are the foundation of medical breakthroughs such as accelerating drug discoveries and enabling earlier disease detection. For example, the quality, quantity and representativeness of the data sets largely determines how accurately a health AI model performs in real-world settings.

Our government's national AI strategy, AI for all, recognizes data as a strategic national asset that must be responsibly stewarded and mobilized to support innovation and productivity across the economy. Our health care system generates a vast amount of health data, spanning diverse populations, medical conditions and care settings.

By leveraging our standardized and anonymized health data, Canadian researchers have an opportunity to become global leaders in medical research and health innovation, driving medical breakthroughs and improving health outcomes for all Canadians. Currently, much of this data remains fragmented in disconnected systems. By securely unlocking its potential by applying common standards, our medical researchers can drive breakthroughs in disease detection, treatment and improved hospital efficiency.

For example, in my riding of Don Valley North, we are fortunate to have North York General Hospital, Canada's top-ranked community academic hospital. It partnered with a Canadian health AI company, and by leveraging the data it has collected from the emergency department, it has trained an AI model that analyzes real-time patient vitals, waiting times, triage assessments and hospital capacity to identify where patients can receive care sooner. This has cut the average emergency wait time by nearly 28%.

Data can save lives. The knowledge that can be unlocked from our health data sets has the power to transform our health care system. Better health data means a more accessible and innovative health care system. That is why Bill S-5 is such a consequential piece of legislation, and I believe it is a practical path forward that would serve the best interests of all Canadians.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, setting aside the fact that, as we mentioned earlier, as soon as the pan-Canadian interoperability roadmap was announced, Quebec made it clear that it did not want any part of it, though it was open to data sharing, there is one issue that piques my curiosity from a purely technological standpoint.

This bill is about connecting all health care data from coast to coast to coast. Does my colleague have any technological opinions on how vulnerable this kind of system might be to cyber-attacks, like the one that hit sites like Hugging Face not so long ago?

[Maggie Chi, Liberal, Don Valley North, ON]

Madam Speaker, that is an excellent question. As I mentioned in my speech, in a rapidly evolving world with a lot of cybersecurity threats, and with the development of AI, security is definitely top of mind for all of us. The legislation, at the core of it, would block the ability of vendors to block data, while respecting provinces' and territories' ability to also operate within their privacy laws and acts. We are very mindful of that. We will continue to work with the provinces and territories as we write out the regulations, while respecting the provincial and territorial jurisdictions.

[Eric St-Pierre, Liberal, Honoré-Mercier, QC]

Madam Speaker, I am curious as to whether the member for Don Valley North can comment on how a more connected health care system, through Bill S-5, could help Canadians facing barriers to care, especially those living in rural and remote communities across Canada.

[Maggie Chi, Liberal, Don Valley North, ON]

Madam Speaker, I mentioned a few examples in my speech of frustration with always having to remember one's medical care record or the history of one's procedures. We have all experienced that. Sometimes we forget, sometimes we may have remembered things wrong, and it proves a hindrance to our care. Sometimes it causes delays, really dangerous delays. We heard the minister mention the example of Theresa and her family. We want to avoid that.

As we continue to have discussions with providers, doctors and clinicians are telling us about the importance of having the legislation passed because it would enable data sharing. It would enable more connected care. It would help them facilitate care that is more beneficial to the health outcomes of patients. We are very optimistic about the future of more connected care in Canada that the bill would enable.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, I believe it is important that we advance the legislation. Back in the nineties, I was the health care critic in the province of Manitoba. Even back then, we were talking about having better access and about patients being able to see their records. I see the legislation as modernizing something that is long overdue. It is in the patient's best interest. Could my colleague provide her thoughts on the patient's best interest and how the bill would support that?

[Maggie Chi, Liberal, Don Valley North, ON]

Madam Speaker, I want to thank my friend and colleague for his long-time advocacy for creating this future of connected care in Canada.

Absolutely, that is the goal for all of us, to provide the reality of more connected care in our communities. For far too long, and far too often, we have heard frustrations about remembering one's medical records, having misdiagnoses, having mistreatments or delays. We all want that to improve. This bill would not only provide a path to that for clinicians and health authorities. It would also provide patients with the autonomy of having their personal data and more connected care for everybody .

[Abdelhaq Sari, Liberal, Bourassa, QC]

Madam Speaker, I am pleased to have the opportunity to speak to Bill S-5.

I want to begin by having members imagine the following scene: A mother from Montreal North arrives at the emergency room with her son in the middle of the night. She knows his allergies, medications and most recent visits by heart, but the doctor on duty does not see any of that information on the patient's record. His record exists, but it is somewhere else, in another system, not in the system of this clinic, this CLSC or this hospital. It is in a different software program or sitting on a fax machine somewhere. As a result, his mother has to repeat the information over and over again. While she is doing that, time is being wasted, and sometimes much more than just time is lost.

Today, information can travel around the globe in a second, but it is still difficult for a patient's health records to make it across the street. Bill S-5 seeks to remedy that issue. We are talking here about what I would describe as the cost of working in silos, which can be explained in numbers, and those numbers speak for themselves. Four out of five patients want to be able to access their health care records digitally online. However, only 39% are able to do that, and often they can access only some of the information. In 2023, 42% of Canadians reported gaps in the coordination of their care because of systems that do not communicate with one another. Behind those numbers are tests that had to be redone, delayed diagnoses and doctors who are searching for information instead of providing care. There are also families that carry their own health records around in an envelope or even a plastic bag—I have seen it happen—because the systems do not communicate or share data.

Consider the people who provide care. Our doctors, nurses and pharmacists already work under tremendous pressure. Every hour spent filling out forms, waiting for a fax—yes, I did say a fax—or calling another clinic is an hour less spent with a patient. That is really the important thing. That is the service that we want to provide to our citizens. In a system low on resources, unnecessary paperwork is not just a detail; it is health care time wasted.

I would also call this compartmentalization an “opportunity cost”. It is a collective cost. It prevents us from fully understanding which policies work and which performance indicators are best for the work at hand. It prevents us from knowing where shortfalls exist, where to look for the best impact indicator, or how to locate the best efficiency indicator, simply because the systems do not communicate; they exist in silos, with less integration. When systems operate in silos, information is not only less integrated, but the lack of interoperability prevents us from attaining the global perspective we need to measure them properly. Without seeing a situation clearly, it cannot be corrected. Without a global view, improvement is impossible. What cannot be measured is difficult to quantify or even to improve.

Of course, inequalities still remain. Bill S‑5 does two simple but essential things.

First, it requires interoperability. Health information technology vendors will need to ensure that the systems they sell, license or supply as a service can talk to each other and communicate according to common Canada-wide standards, including information security standards.

Second, it prohibits data blocking. A vendor will no longer be able to lock a patient's information to keep its clients captive. Health data belongs to a patient's continuum of care, not to a vendor's business model.

Let us consider a simple example. When people switch phone providers, they get to keep their phone number. No one would consider that revolutionary today. It is taken for granted. It is simply the way things work. Why, then, should we accept that a person's medical history remains trapped in a particular software platform or IT solution? If we demand number portability for our phone service, then we certainly can, and should, demand the same for the health of our families.

I have spent a good deal of my career in IT governance and in business and corporate architecture. To be honest, technology is rarely the problem. More often than not, the problem and the challenge are cultural, including the absence of common rules. People build islands and then act surprised when there are no bridges connecting them. Bill S-5 represents an obligation and an opportunity to build those bridges.

Building bridges involves creating connections. However, connecting systems does not mean we want to expose our data. Some people will ask where Bill S‑5 stands on privacy. The answer is clear: It makes no amendment to any federal, provincial or territorial privacy law. The current rules on the collection, use and disclosure of data continue to apply as they always have. Only authorized users will have access to records. Bill S‑5 does not mandate the sharing of data. It allows for the secure transfer of information where such transfers are already permitted by law.

To reiterate, connecting systems does not mean data will be exposed. On the contrary, data will be better protected. Experts also see data integration as a way to enhance data security. When data is distributed, or even scattered, across multiple siloed systems, redundancy can result in inaccurate information being shared without the knowledge of the individual concerned.

We need to stop relying on a patchwork of systems that, in Quebec and elsewhere, are unfortunately quite outdated. The government is not trying to take control; it is proposing a partnership.

I want to speak directly to my colleagues from Quebec: Health care falls under provincial and territorial jurisdiction, and this bill respects that. It acts as a safety net where similar legislative measures do not exist. Quebec already has a well-developed interoperability regime, and common standards will be clarified in consultation with the provinces and territories.

We are not starting from scratch on this. Federal, provincial and territorial governments are already working together to develop a pan-Canadian interoperability road map, and Bill S‑5 does not seek to supplant that. Its purpose is to support, assist and accelerate the process.

There is also a real economic benefit. Adopting common standards reduces barriers to entry and enables Canadian digital health companies to grow, innovate and compete. Greater competition can foster more modern and potentially less costly solutions for our public health systems.

As for my Conservative colleagues, I know they share our commitment to improving the quality of data in order to make better-informed decisions. Bill S-5 is an essential step toward that objective. Let us be clear: The bill does not require anyone to adopt a single system, nor does it replace the tools that are already in use. It requires them to communicate and exchange information with one another. That approach is simpler, more flexible and more respectful of what each province has already built.

For me, this is a matter of fairness, first and foremost. When information does not follow the patient, it is always the same people who bear the consequences: seniors who are seeing multiple specialists; families living in rural and remote communities; and newcomers, including many in my own community. For a family in a rural or remote community, an electronic prescription, a referral to a specialist sent in a matter of seconds or a remote consultation with the correct medical records to hand can save them hours of driving, days of waiting and a great deal of worry.

In closing, let me go back to the mother from Montreal North who went to the emergency room in the middle of the night. Thanks to Bill S‑5, she will no longer have to be the system's memory. The doctor will have the information they need and her son will receive safer, faster and better coordinated care. Data saves lives and so does integration.

The Senate has carefully studied this bill. In the House, all the parties are saying that they want modern care. We need to ensure that we have the means to achieve our ambitions. Let us work together to pass Bill S‑5 quickly.

[Tamara Kronis, Conservative, Nanaimo—Ladysmith, BC]

Madam Speaker, my colleague gave a good description of how the Liberals have allowed our health care system to fall behind.

Medical associations have been calling for these changes for 10 years. In 2022, Canada's Competition Bureau also highlighted the problems associated with electronic health records. However, the Liberals let Bill C‑72 die on the Order Paper when they called the election last year.

I am glad they are finally taking action, but why did they wait so long?

[Abdelhaq Sari, Liberal, Bourassa, QC]

Madam Speaker, I would like to thank my colleague for her very pertinent question. I am also very enthusiastic about this bill and am delighted to hear that she supports it.

To answer her question, I would simply say that we no longer want medical records to be sent by fax. We want to modernize. We share the same objectives.

As for the delays, whether they were caused by an election or by other circumstances, we share her frustration and want to see this work advance. As I said earlier, there are several provincial or territorial laws and regulations. As my colleague mentioned, Bill S-5 seeks to speed up the process. That is our government's intention.

[Maggie Chi, Liberal, Parliamentary Secretary to the Minister of Health]

Madam Speaker, what really resonated with me is what my colleague and friend said about breaking down silos and creating the condition for connected care. That is exactly what this bill is aiming to do.

My colleague mentioned that in Quebec, there is already a system in place for that, so I want to ask him to describe the benefits he is already seeing in his community and the benefits he wishes to see once we have a connected system across the country.

[Abdelhaq Sari, Liberal, Bourassa, QC]

Madam Speaker, I would like to begin by thanking the parliamentary secretary for her question and for her work both in government and in her wonderful riding.

The first thing I can say about Quebec is that it has already proven itself. It has done its job. Bill S‑5 takes nothing away from Quebec. As I said earlier, its purpose is to assist, support and accelerate the work.

Here is an example: A mother in my riding, Bourassa, goes in with an envelope or a bag containing information that she cannot make sense of. Imagine what it must be like for a doctor to go through that information compared to looking at a file that is available directly to them. Obviously, reading it that way is not the same; the jargon is not the same. We want to make that information accessible. The goal is to save time and provide more direct services to people, to patients, because most of the time should be spent with them, and that is where the greatest impact can be made.

[Jeremy Patzer, Conservative, Swift Current—Grasslands—Kindersley, SK]

Madam Speaker, I think there is a reasonable expectation among Canadians that their health data should move with them. I am from Saskatchewan. If I had a health incident here in Ontario, I would want to know that it would be very easy for my health data to be readily available to whoever is providing the service that I needed in that particular moment.

I think it is important that it be up to the individual, in a sense, to decide where that data is available, so I wonder if the member has any ideas, with the bill, on how to make the individual, not so much a company and maybe not even a regional authority, the ultimate person to say that, yes, they want their health data to be available, either across the country or in certain provinces.

[Abdelhaq Sari, Liberal, Bourassa, QC]

Madam Speaker, what I am hearing is that we share the same objectives. That is really very important.

Health data belong to the patient's own continuum of care. They should not belong to a vendor or to anyone else. This is what we are trying to do, and it is very important that my colleagues opposite know about it. If health care professionals have less paperwork to do, then they will have more time to spend caring for their patients. That is very important.

There may be criticisms from certain organizations. That is normal. It is part of our job to listen to them, but this should not in any way interfere with measures that we want to put in place. This is the solution that we have all agreed on to give everyone access to this data. This is really about integrating health data.

[Tamara Kronis, Conservative, Nanaimo—Ladysmith, BC]

Madam Speaker, I will be splitting my time.

This bill is very easy for the people of Nanaimo—Ladysmith to associate with. To be diagnosed with a chronic illness in Nanaimo—Ladysmith really is to find out how transportation works in British Columbia, because we inevitably need to receive treatment not only in Nanaimo but also in Victoria, in Vancouver or sometimes in other places on the island. We know very well what the consequences are of medical information not being available where we receive our medical care. Those consequences include misdiagnoses, non-diagnoses, wrong medication and lower quality of care as a result.

The reason we need to receive health care all over the island and the mainland, and in some cases why we need to go to other places in our community, is that the Nanaimo Regional General Hospital, which is the main hospital in Nanaimo and the area, has about 345 hospital beds. However, I cannot remember a day when the number of patients in the hospital, when I have been there either visiting someone or for another reason, has been below 400.

This means that we travel for health care, and we know what happens when our medical records are not available. We understand the problems that come with needing to stop, find information and have it faxed over from one place to another. In B.C., in fact, we have more than 40 different electronic medical record systems, which are used across health authorities, specialists and family practices. We understand the consequences when those systems do not talk to each other.

The BC College of Family Physicians reports that more than 78% of doctors use between two and five systems. Believe it or not, that is actually by design, and it puts our lives in danger.

What this bill deals with is a phenomenon known in the health care world as “data blocking”. The minister admitted and said in her speech this morning that 92% of doctors in Canada have said that a lack of access to patient medical records hampers their ability to provide care. Health Canada has reported that only 29% of primary care providers share patient information electronically outside of their practice. That is one of the reasons the Canadian Medical Association and other medical health organizations have been calling for a decade or more for electronic medical records to be available where and when health care providers need them.

Dr. Margot Burnell, who is a previous Canadian Medical Association president, has described this as doctors facing “an uphill battle trying to provide timely patient care when they are routinely dealing with health systems that cannot communicate with each other”. That makes this bill a very long time coming. In fact, it is not the government's first attempt to bring this forward. Bill C-72 died on the Order Paper in the last Parliament because the Liberals decided that it was more important for them to go to an election.

We ask two questions on this side of the House. The first question is, what took the government so long? Why has it taken this long to bring in a bill that Canadians so badly need and that has been called for by patient advocates, by medical professionals and by patients? The other question is, why did it take the government 18 months to introduce this bill in the House when this bill so clearly needs to be implemented to save lives?

The next question we need to ask about a bill like this when it is being brought forward by the government is, what do we need to do to make sure it will get this right? We cannot afford another software debacle or failure in this particular case. We cannot afford for Canadians' medical records to become unavailable or get scrambled the way we have seen with so many other programs the government has tried to implement in the software space. Whether it is PrescribeIT, Cúram, or some of the other problems that we have had, we cannot afford to see that happen in this space.

In that context, it is distressing to have learned from the Senate's testimony here, and I believe my colleague recounted this earlier, that the government is considering hiring Canada Health InfoWay to administer this particular program. That is a situation where, given the management issues and health care issues with that organization, specifically those related to health care software in the past, Canadians may have some very reasonable concerns.

A second issue that I really believe we need to deal with at committee is a number of definitional concerns. The idea of contextual interoperability can mean different things in different circumstances. We must ensure that the data that travels in between systems, when the software interoperability is implemented, is seamless, is not another data dump, is readable on the other end and is usable.

Similarly, we need to ensure that there are clear definitions for terms such as “data blocking”, “good enforcement mechanisms”, and “real remedies for failure”. The Competition Bureau pointed out in 2022, which is another reason why we are asking why this is taking so long, that electronic medical record vendors were, in fact, blocking data deliberately. This bill is now targeting those problems, including vendor lock-in, data blocking and the unreadable data dumps I just discussed, so it is very important that the bill expand the information-blocking penalties to include hospital networks and authorities that sit outside of these systems and may further hamper interoperability.

The Senate committee on this bill recognized that vendors are only one part of a wider health data system and recommended that the government consider extending responsibility as I have described. I would recommend that the House committee that examines this bill take a look at that gap, because software can only make the record available. Someone still has to complete the referral, the transfer, and get it to the clinician who is taking over care.

Privacy is also something that needs a very precise answer with respect to this bill. Section 5 of the bill says that the interoperability duty does not require access, use or exchange where privacy law prohibits it, but clause 6's data-blocking prohibition has no equivalent expressed privacy law exception. I would note here that the Office of the Privacy Commissioner supports interoperability, but recommends that the ban be subject to privacy law. Therefore, the committee should examine and close that gap where appropriate so that a vendor is not treated as blocking information for refusing an exchange the law, in fact, forbids.

There is also a need to ensure that compliance costs are not so high as to prevent entry by new providers.

What I would say in closing, is that Bill S-5 would not build the tower that Nanaimo needs. It would not add the staff beds or the cath lab we need north of the Malahat. I will continue to advocate for those things both here in Ottawa and with provincial decision-makers in Victoria. However, this is a good start. I hope we will see the committee do good things with this bill and that it will come back to the House in a format we can support.

[Jean-Yves Duclos, Liberal, Québec Centre, QC]

Mr. Speaker, I want to commend our colleague for her speech. She obviously demonstrated her deep experience and knowledge of how a modern health care system should work, including in her community. It is very clear from what she has said that she really believes in the value of health data to provide better services to Canadians in her community in particular.

Does she have practical experience with respect to the ways in which access to data can improve quality of care and perhaps even save lives?

[Tamara Kronis, Conservative, Nanaimo—Ladysmith, BC]

Mr. Speaker, as the member knows, one of the things that happens in our offices on a regular basis is that people contact us with the experiences they have had with the health care system. As MPs, it is very frustrating for us, because we want to help, but health care delivery is something that is up to the provinces.

Like my colleague, I have heard many stories of parents taking kids to hospitals and finding out that nobody can remember what the medication is and the records are not available. There are also circumstances where seniors who may have dementia or other issues are taken to the hospital by care providers and are not able to provide a full medical health record. Hopefully, this is something this bill would work to address using a federal power in the background.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Mr. Speaker, I think it is important to recognize that health information technology is all about the patient. For many years, we talked about information from patients and how it contributes to the betterment of health conditions. This legislation would actually save lives. It would improve the conditions.

I am wondering if the member can provide her thoughts on the principle of the legislation. I understand there are some concerns with it, but does she support the principle of the legislation to the degree that she would vote in favour of it going to committee?