Chandra Arya

[Black History Month, February 16th, 2024]

Mr. Speaker, this Black History Month, I would like to recognize an Ottawa-based organization: AKHRI - Mothers and Daughters Literacy. Its mission is to create lasting, positive, community-based change through basic literacy in rural and underprivileged communities in Somaliland. It empowers girls and women with the power to learn, to be heard, to be seen and to make a difference. I agree that educated, empowered women can change the world.

Successful economic development of a community or a country can be fast-tracked if education is made available to all and, specifically, if girls are educated. I would like to recognize and to thank the team, under the leadership of Anab Mohamed, for its noble and dedicated service to realize AKHRI’s mission.

[Canada Early Learning and Child Care Act, February 16th, 2024]

Madam Speaker, I fully agree with the hon. member that the people who work in child care should be adequately compensated. It is very much a requirement. This is a collaborative program between the federal government and the provinces, and authorities at all levels of government should work hand in hand to find a means of making sure it is implemented well in every single respect.

[Canada Early Learning and Child Care Act, February 16th, 2024]

Madam Speaker, I am glad to note that the member has personally experienced the economic benefits that educating children at a very young age bring, allowing them to grow up educated and allowing parents to contribute to the workforce generally, not only in Quebec, because of course it is something that other provinces and the federal government have learned from. I have seen it happen in other parts of the world that a focus on children's, and especially girls', education has contributed to the economic development of an entire region, entire community and the entire country. Therefore it is very important that through the bill we would be making up for what was lacking in Canada.

Again, I recognize the contributions of Quebec in bringing this forward as a national priority.

[Canada Early Learning and Child Care Act, February 16th, 2024]

Madam Speaker, one thing the families in Nepean are overwhelmingly in support of is this program, because they see the benefit it brings to their family. It allows them the funds required to help children undertake some sports activities. It has helped families, especially mothers, free themselves up so they can go back into the workforce. Some of the mothers I know are using the program to help them get better educated for better-quality jobs.

[Canada Early Learning and Child Care Act, February 16th, 2024]

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

We all know that affordability is a top-of-mind topic, so let us consider early learning and child care through that lens. Before the early learning and child care agreements with all provinces and territories were finalized, daily child care fees ranged from $20 to $48 a day per child. Those dollars could go a long way in a grocery store or to keep children active in sports or other activities. Child care fees have been dropping across Canada, and we are continuing to work hard with our provincial and territorial colleagues to meet our March 2026 goal of a $10-a-day, on average, fee for children under the age of six in licensed child care.

Affordable child care means hundreds of dollars every month in the pockets of Canadians of all income levels. Affordable child care means money for nutritious meals on the table as prices at grocery stores remain high. Affordable child care means money for clothing and other necessities.

Carolyn Ferns, the Ontario Coalition for Better Child Care's public policy coordinator put it perfectly: “Affordable child care is life-changing for families and for our communities. It is great to see the collaboration between the federal and provincial governments making that a reality for Ontario families.” Of course it is a reality not just for Ontario families; it is also a reality for every family in Canada with young children, whoever they are, wherever they live and regardless of their income level.

Let me share just a few of the testimonials parents have taken the trouble to write to members and to the government as they realize the financial relief affordable child care is bringing to them. Most are accompanied by expressions of enthusiasm and emphasis, such as multiple exclamation points or capital letters.

The first one is, “My daughter on Vancouver Island found out yesterday that her daycare will be charging $10/day. This is huge for families! Thank you to the federal and provincial [governments] for collaborating on this excellent legislation. It truly puts families first.” The next is, “Just paid our January day care fees. Under $500! This is a 55% reduction from last year. This is going to make such a huge difference for so many families.” The third one is, “Our infant's day care fees have dropped $500 per month, and on the 26th at her [18-month anniversary], it will drop an additional $200 (two hundred!) per month. Probably one of the largest pieces of legislation to personally affect me in my lifetime.”

Here is another one: “I will not benefit from this as my kids are grown and I remember paying $650/month for child care on a salary of $1,200/month back in the 80s. But I am so very, very happy that young families are benefiting from this.” The last one is, “It was absolutely surreal to see my day care fees drop from a high of $167.25. As of [January], we will be paying less than 50% of that, on a path to $10.” It is clear from these and many other social media posts, interviews and comments that families in Canada are thrilled and, in many cases, astonished that affordable early learning and child care is finally here.

The Government of Canada has made an historic investment of nearly $30 billion over five years to build a Canada-wide early learning and child care system. We have done so in collaboration with provincial, territorial and indigenous partners, all of whom deserve enormous credit for their willingness to work together to give every child in Canada the best possible start in life, and in so doing, to bring financial and emotional relief to millions of families from coast to coast to coast.

Child care fees have been reduced across the country, and by 2025-26, the average fee for regulated child care spaces across Canada would be $10 a day. As families across the country are realizing, there are no losers here. It is a financial win for families regardless of their income level. Since 2015, the Government of Canada has delivered real improvements to make life more affordable for Canadians. There is no better example than the progress we have made on the new ELCC system. As of 2025-26, a minimum of $9.2 billion would be provided every year, on an ongoing basis, for affordable early learning and child care, and indigenous early learning and child care.

The return on this investment for families with young children is obvious and is supported by evidence. Of course, we can look to the overwhelming success of the Quebec early learning and child care system, which is now ingrained in the social fabric of that province. When we speak about affordability, it is perfectly appropriate to ask whether the country as a whole can afford it. The answer is a resounding yes. This is a plan to drive economic growth, to increase participation in the workforce, especially among mothers who want to pursue professional ambitions or further their education to get better-paying jobs.

It is one of the many investments the Government of Canada remains committed to, investments that increase our economic growth and Canadians’ quality of life. Independent studies show that our early learning and child care system could raise real GDP by as much as 1.2% over the next two decades. Further, a range of studies have shown that for every dollar spent on early childhood education, the broader economy receives between $1.50 and $2.80 in return. That would be a huge return on our early learning and child care investment.

We are hearing loud and clear how thrilled families are that their governments have joined together to bring them significant financial relief. Doubtless, many are beginning to wonder why we waited so long. It is a fair question. As other colleagues have said, in passing this legislation, we would be promising the best possible start in life to future generations of children in Canada. We are on the brink of making history, of cementing together these wonderful provincial and territorial agreements into an enduring testament to our commitment and caring. When we eventually leave office, we can do so with the pride and satisfaction of knowing that we were all part of this great, lasting achievement.

I urge colleagues to give quick passage to Bill C-35.

[Criminal Code, February 15th, 2024]

Mr. Speaker, in his speech, the hon. member mentioned the 31% increase in the number of Canadians using the assistance of this MAID legislation.

I know this number of a 31% jump, when seen in isolation, is big. However, does the member agree that, because the legislation is fairly new, all the people who had been waiting and suffering for such a long time started utilizing these MAID legislation provisions? Does he agree that, going forward, when these MAID provisions are normalized, the rate of growth he quoted will not be so huge in the future?

[Criminal Code, February 15th, 2024]

Madam Speaker, the short answer would be what I always say, which is that whenever we bring in legislation that fundamentally affects all Canadians, especially the kind of legislation that has never been thought of during the last 155 years, we need to take a real look at it, modify it and change it if required. I am sure there will be a time in the future when we can have a real look at the whole MAID legislation to see whether we can tweak it to better serve Canadians.

[Criminal Code, February 15th, 2024]

Madam Speaker, especially on issues on which highly qualified experts and professionals are giving their opinions, sometimes it may not be possible for everyone in the room to agree on the right answer. That is why the government has invested in consultation. The bill did not come up on its own. It is not just an outcome of the thought process of some bureaucrats sitting in a government building here; it also includes a lot of consultations with Canadians, health care professionals and other experts. Their inputs have also been taken into consideration when formulating the legislation.

[Criminal Code, February 15th, 2024]

Madam Speaker, I agree with the hon. member that rural and remote communities, including indigenous peoples, have difficulty accessing the quality health care that many of us in urban centres take for granted.

I also agree with the member that we need to look beyond the formal structure that is currently available in identifying the people with knowledge who can provide health care services. We should see whether we can bring people with the knowledge and expertise in traditional medicine or the various other knowledge systems available around the world into the system, where their knowledge and experience would be available not only to indigenous peoples but to all Canadians.

[Criminal Code, February 15th, 2024]

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

I am pleased to have the opportunity to speak in the House today in support of Bill C-62, the bill that proposes to extend the temporary exclusion of mental illness as an eligible condition for medical assistance in dying by three years, until March 17, 2027. I will speak today about the importance of a delay before lifting this exclusion to provide more time for the provinces, territories and their health care partners to prepare for this critical juncture in the evolution of medical assistance in dying, which we refer to as MAID in Canada.

The legal framework for MAID is set out in the federal Criminal Code. However, it is the provinces and territories who have the responsibility for health care delivery, including MAID implementation. We have been working in close collaboration with the provinces and territories to support the safe implementation of MAID since before the original legislation permitting MAID was enacted in the Criminal Code in 2016. This is an important relationship built on the mutual goal of ensuring quality health care for the people of Canada.

Both the expert panel on MAID and mental illness and the Special Joint Committee on Medical Assistance in Dying emphasized the importance of clear practice standards and consistent implementation of guidelines across the country, training for physicians and nurse practitioners, and case review and oversight to support best practices and trust in the appropriate application of the law.

Provincial and territorial governments and their stakeholders, such as health care professional organizations, regulatory bodies and practitioners, have been actively planning for eligibility for MAID for persons whose sole medical condition is a mental illness. As has been recognized across the board, critical progress has been made in this regard. However, the provinces and territories face different challenges within their jurisdictions and are at varying stages of work in implementing these key elements and consequently their readiness for the lifting of the exclusion.

For example, a model practice standard for MAID was developed by an independent task force group made up of clinical, regulatory and legal experts as a resource for physician and nursing regulatory authorities to adopt or adapt in their development or ongoing revision of MAID standards. In addition to the model standard, the task group also released a companion document entitled “Advice to the Profession”.

Practice standards are developed and adopted by regulatory bodies responsible for ensuring that specific groups of health professionals operate within the highest standard of clinical practice and medical ethics. While some provincial and territorial regulatory bodies have successfully implemented MAID practice standards into their guidance documents for clinicians, others are still in the process of reviewing and updating their existing standards. To support the safe implementation of the MAID framework, health Canada supported the development of a nationally accredited bilingual MAID curriculum to support a standardized approach to care across the country. The Canadian Association of MAiD Assessors and Providers has created and is now delivering a training program that has been recognized and accredited by the appropriate professional bodies.

The MAID curriculum includes a series of training modules to advise and support clinicians in assessing persons who request MAID, including those with mental illness and complex chronic conditions, or who are impacted by structural vulnerability, as well as help with the practical application of the MAID legislative framework. The curriculum will help achieve a safe and consistent approach to care across Canada and ensure access to high-quality MAID training for health practitioners. So far, more than 1,100 clinicians have registered for the training, which is impressive given the curriculum was just launched in August 2023. This is only a portion of the workforce. More time would allow additional physicians and nurse practitioners to register and participate in the training, and to internalize these learnings and put them into professional practice.

Now let me turn to case review and oversight of MAID. In Canada there is a process of self-regulation within the medical and nursing professions. The provincial and territorial regulatory bodies, which I spoke of earlier, have a mandate to protect the public for all health care, and MAID is no exception. In addition to the presence of health professional regulatory bodies, several provinces have implemented formal oversight mechanisms specific to MAID. For example, in Ontario, the Chief Coroner reviews every MAID provision, as does Quebec’s end-of-life commission. Both of these bodies have strict policies regarding the timing and type of information to be reported by clinicians, and the Quebec commission issues annual reports.

While the provinces with formal MAID oversight processes represent over 90% of all MAID provisions in Canada, other provinces do not have formal MAID quality assurance and oversight processes in place to complement existing complaint-based oversight processes undertaken by professional regulatory bodies. Work is being planned to explore case review and oversight models, and best practices, through a federal-provincial-territorial working group, with a view to supporting consistency across jurisdictions.

All provinces and territories were united in their request to delay the lifting of the exclusion in order to have more time to prepare their clinicians and health care systems to manage requests where mental illness is the sole underlying condition, and to put the necessary supports in place. Provincial and territorial governments must ensure not only that practitioners are trained to provide MAID safely but also that the necessary supports are available to clinicians and their patients through the assessment process.

Both the expert panel and the special joint committee on MAID emphasized the importance of interdisciplinary engagement and the knowledge of available resources and treatments. Experts and practitioner communities have also expressed the need for support mechanisms to be in place for providers undertaking assessments and persons who request MAID, irrespective of their eligibility.

While some jurisdictions have robust coordination services to manage requests and provide ancillary services, other jurisdictions take a decentralized approach, which can result in less coordination across services and disciplines. The availability of necessary support services for both practitioners and patients is also variable, depending on the region. For example, we have heard about the challenges of accessing health care services generally in rural and remote areas of the country. Additional time would allow more work to be done to support patients and clinicians involved in MAID.

The Liberal government is committed to supporting and protecting Canadians with a mental illness who may be vulnerable, while respecting personal autonomy and choice. The provinces and territories are ultimately responsible for the organization and delivery of MAID and supporting health services. Given their responsibility for how MAID is delivered, moving forward before provinces and territories are ready would not be the responsible course of action.

We believe that the extension of three years proposed in Bill C-62 would provide the time necessary to work on these important elements for the safe and consistent application of MAID for persons suffering solely from a mental illness.