44th Parl. 1st Sess.
April 25, 2023 10:00AM
Mr. Speaker, I listen intently every time Conservatives stand to speak in the House because I am listening to hear if we are finally going to hear something about the climate crisis and protecting our environment, but yet again, we are not hearing anything about that.
We do, however, hear about carbon capture. That is the push they would like to see, despite the International Panel on Climate Change making it clear that this method of reducing greenhouse gas emissions is unproven, risky and one of the most expensive options.
When will the member and the Conservatives finally acknowledge that we are in a climate crisis and start pushing the government for real solutions for future generations?
117 words
- Hear!
- Rabble!
- add
- star_border
- share
Mr. Speaker, we will continue to push the government for solutions on many issues, including the environment. We have never shied away from that.
I would encourage the member from the NDP to stand by her values and her principles the next time she is blindly supporting the government on these issues.
52 words
- Hear!
- Rabble!
- add
- star_border
- share
Mr. Speaker, this is a question that probably deserves more time than we have, but we are talking about inflation, and a lot of what we are experiencing right now is not typical inflation. It is not a wage-price spiral. It is from events that are making things cost more, such as the impact of Putin's attack on Ukraine and the impact of climate events, which make various foodstuffs cost more.
I wonder if the hon. member has some thoughts on that, about how he distinguishes between inflationary trends the Bank of Canada can affect, for example, and things costing more. How do we alleviate those costs for Canadians?
111 words
- Hear!
- Rabble!
- add
- star_border
- share
Mr. Speaker, I thank the member for her thoughtful introspection on this particularly important issue.
The thrust of my speech was very obvious. It is the failed fiscal policies of this government that have created the financial crisis, the affordability crisis that we find ourselves in.
I am not diminishing world events. I think it has taken root around the world and it has impacted Canada to a certain degree, but as many economists have argued, as many former random Liberals have argued, it is the failed Liberal policies that have contributed to the crisis we are facing.
98 words
- Hear!
- Rabble!
- add
- star_border
- share
Mr. Speaker, as the member for Sackville—Preston—Chezzetcook, I am pleased to rise to speak to Bill C-47, budget implementation act, 2023, No. 1.
I want to start, first, by explaining that Canada has probably been the most successful country coming out of COVID in the last two years. In the last year, we have seen the best and strongest economic growth in the G7, which is quite impressive.
Canadians had created 1.2 million jobs prior to the pandemic. Now we have recaptured that 1.2 million, and Canadians have created another 830,000 jobs. That is over two million jobs in the last five years. I would say that is very impressive.
Yes, we are facing inflation, which is a challenge the world is facing, but in the last month inflation has come down from 8% to 4.2%. The banks and economists are saying we are going to be down to about 3% by September. That is quite impressive as well.
We know there are challenges. We know the banks raised the interest rate, which is putting more pressure on individuals and Canadians, yet the unemployment rate is at a record low, which is extremely important.
What we have seen as well with unemployment is the fact that we brought forward the learning and child care program. We have seen a lot more women joining the workforce, which has shown us at a record high of 85.7% of women between 25 and 55 years of age participating in the workforce.
This budget targets inflation relief, strengthening public health care and dental care, the clean economy, and of course, maintaining our lowest net debt-to-GDP ratio in the G7.
The grocery rebate is directly helping 11 million Canadians. It is extremely important. A family of four is receiving about $467. Single Canadians are receiving about $234, and seniors are receiving $225. That is for low-income Canadians who are receiving the GST, of course.
For students, we are increasing the student grant by 40% and raising the interest-free Canada student loan limit so we can be of help on that end as well.
There have been various programs for seniors. I just mentioned the grocery rebate for those with low incomes. We also increased the OAS and GIS, which will grow by 30% by 2027-28. That is about $20 billion a year in increases, so that is direct support for seniors to ensure they are able to enjoy their retirement.
In the riding of Sackville—Preston—Chezzetcook, there have also been investments, like in the Beaverbank Kinsac Lions Club, which received $25,000 for upgrades. Also, the Sackville Seniors Advisory Council received $25,000 for programming. Those are direct investments into the riding of Sackville—Preston—Chezzetcook.
On the housing front, which is extremely important, for first-time homebuyers, young people, there is a new tax-free savings account, which will allow them to save $40,000 tax-free over, I believe, about seven years. This is tax-free going in and tax-free coming out for first-time homebuyers, which will be a very good investment and definitely a major help to young people.
It is also creating more flexibility around existing mortgages by extending amortization payments, adjusting the payment schedule or even authorizing lump sum payments. In the riding of Sackville—Preston—Chezzetcook, there have been some successful housing projects in the Chezzetcook area, the Lake Echo area and the Preston area.
Under the economy, industry and competitiveness for the green economy, which is a focus of our government, there are tax credits that will entice, invite, encourage and build on green electricity. We will see a 15% tax rebate on clean electricity. We will also see up to 30% in tax credits for machinery or equipment used for manufacturing or processing clean technology. The cleanest, hydrogen, will get up to a 40% rebate, which is encouraging. We know that Canadians will move forward on those major initiatives.
Through the Canada Infrastructure Bank, we have invested up to $20 billion for major projects in electricity and clean growth, and for those in Ontario, we have seen a major project, which is a game-changer, in the Volkswagen battery manufacturing, which will be an asset for the workers and people in Ontario.
I will quote the Canadian Manufacturers and Exporters: “CME welcomes #Budget2023 and the initial steps it takes to respond to the US Inflation Reduction Act...drive net zero transitions, improve labour shortages, and alleviate and supply chain disruptions.” That will also be an asset.
There are also industry-targeted investments we have for our space industry, our forestry industry and our tourism industry. We know our tourism industry took a major hit during COVID. We need to support our communities, so they can have more ways of attracting more tourists to their communities and also invest in bringing more international investment in conventions and events in our regions.
With that, of course, I cannot go without mentioning the investment in Michelin, the tire plant in Nova Scotia. It has three plants, of course, and the Bridgewater one is where they are going to modernize and also create innovative technology for tires to be more efficient, including the electric vehicle tires. Of course, they will cut on emissions, which will mean more jobs and a reduction to the environmental footprint of our economy.
We have also seen some reductions and savings, of up to $15 billion over five years, by reducing spending on consulting firms. There will be a 3% reduction for each department right across the government and $6 billion in savings over six years through the realignment of former announcements.
I do need to touch on a couple of key things. Health care is extremely important in Nova Scotia. We had been receiving $3.5 billion over 10 years. Now, we will be receiving $5 billion, which is $1.5 million, or a third, more. That would be very helpfully invested in home care, long-term care, dental care, oral health care, major doctors and nurses, and also in promoting initiatives to bring them to rural and remote communities.
Our workers are very important, and one of the things I want to talk about is the doubling of the tradespeople tool deduction from $500 to $1,000. I have heard many tradespeople tell me that was something they wanted. Also, I think a very important initiative is the employer ownership trusts, which mean there would be tax changes to allow private owners to sell to their employees the shares in the business, which would make them directly engaged in the challenges, but also the profits as well.
Our student work placement program is creating quality work-integrated learning opportunities. I will share with members that there is an announcement we had in Nova Scotia not so long ago of the Nova Scotia Apprenticeship Agency's START program, which sees many students who are learning on the ground as well as in their institutions.
There are many other investments, of course. The one I want to talk about is the investment in veterans to reduce backlogs once again. We already reduced the backlogs by 70%. We want to bring that down to 0. Also, we will continue to support our veterans through various services. There are some investments in my riding, of course. The Royal Canadian Legion branch in Waverley would receive $159,000 for a roof replacement, and the one in Eastern Passage would receive over $21,000 for renovations as well.
There is lots of investment, of course, in Atlantic Canada, in the Coast Guard, the ferry services, protecting our fresh waters and the Atlantic loop, which would help Quebec, Nova Scotia, New Brunswick and others.
In closing, very importantly, I want to thank the Minister of Finance and the Prime Minister. I also want to thank all Canadians who contributed to the success of this budget, because it is a budget for Canada.
1347 words
- Hear!
- Rabble!
- add
- star_border
- share
moved that Bill C-323, An Act to amend the Excise Tax Act (mental health services), be read the second time and referred to a committee.
He said: Mr. Speaker, it is a pleasure to be here this evening to introduce this bill, which would exempt psychotherapy and mental health counselling services from the goods and services tax. There is a mental health crisis in Canada. Unfortunately, these problems affect 33% of Canadians, from the youngest to the oldest. This is serious. It is a very serious problem.
This evening I rise to address an extremely troubling issue for Canadians, which is mental health. It is very difficult to capture exactly what we are talking about when we speak of mental health. I will talk a bit about it, as we go forward, in multiple areas, using my experience as a physician over the last 30 years, and about what it means to me and those folks whom I have had the opportunity to treat with respect to their mental health.
Before I start that, though, I want to read a letter I received today:
Good morning Dr. Ellis,
We met in April last year...and had a memorable discussion about the impact of the tax on psychotherapy and counselling therapy services on your constituents. I am now a full-time clinician working with children and youth, and our conversation especially touched on the main barriers to mental health care for these vulnerable young people in Canada.... I have followed this issue closely. I appreciate that you called [the Canadian Counselling and Psychotherapy Association] to speak before HESA, and your commitment to rectifying this issue through your Bill C-323.
As you likely know, our parliamentary petition e-4126 [has] been rejected by the Government due to semantics over the different regulatory titles of our profession in the various regulated provinces. Unfortunately, I now need to increase my fees in order to account for this unfair tax. I am deeply concerned about the financial strain it will have on my clients, and clients of all clinicians across Canada and in your constituency. Inflation has significantly increased the cost of psychotherapy and counselling therapy services.
It causes me considerable discomfort to have to read that here and underscore the importance of the need to change the unfair Excise Tax Act. We know that many therapists who help to look after the mental health of Canadians do not charge tax on their services. For instance, psychologists, psychiatrists and family doctors do not have to charge HST on their services.
The difficulty here is access. We all know that when someone is referred for treatment for mental health issues in Canada, it takes an inordinate amount of time to access those services. That is one of the things I have learned, having been a family doctor. Actually, I graduated from medical school 30 years ago this year, which is shocking since I was 12 when I graduated. Doogie Howser was my name. I am just joking; this is a serious subject.
That being said, I think it is important to say that, as clinicians, one thing we understand is that when someone comes into our office and has finally made the decision and realized that they are suffering with a mental health problem, they want treatment and they want it now. The sad state of affairs that exists in Canada is that we are not able to provide that. Of course, delays may easily mean someone does not get the treatment they need, only to then slip further into the issues they have. That presents a significant difficulty.
We know there is a significant range of mental health issues we can see from a clinician's perspective. Whether it is an issue with a young person whose relationship is breaking up, more severe depressive type symptoms or generalized anxiety disorder, there is a whole host of issues, all the way to schizophrenia and depression in later years in seniors. All of those things form the basis of what we understand as mental health.
There have been considerable efforts made around the world, and in Canada in particular, to look at mental health issues and make it more acceptable to speak out loud about mental health so that people know speaking about it is what will allow them to seek out the help and services they need. However, those services may not be available. It would be an absolute shame if someone has made that decision and then is unable to receive the services they need.
Mental health, of course, affects our physical health. Often, as a family physician, I would spend a lot of time in the office trying to understand exactly what was wrong with someone. A common presentation, like maybe insomnia, a lack of ability to sleep or feeling tired all the time, requires a significant amount of workup to ensure there is no physical health problem.
Oftentimes, I would go down that road of understanding and try to convince somebody that their problem lies with an illness such as depression. Once they are convinced of that, which is not always the case, then of course the treatment regime is what follows. It could be medications, but counselling is an essential part of treatment to help people begin to undo some of the negative thought processes they have and help them with a more resilient type of thinking for the future.
We know that those two things go hand in hand. They are essential. Again, there is a multitude of ways to receive that type of treatment, but we know that psychotherapy and mental health counselling can be a significant part of it.
With the letter I read, we know very clearly that there is a significant financial burden on folks who are working in this industry and how difficult it is for people who are coming forward. Oftentimes, psychotherapy services and mental health counselling services, for those fortunate enough to have a health care plan, have a limit within a plan. Often there is no coverage, of course, for those not fortunate enough to have a health care plan.
That means, specifically for these two types of services, that people are paying GST or HST on top of a significant amount, perhaps $150, $175, $200 or $250 an hour, to receive those types of services. Of course, as we all know by doing simple math, that can add up fairly quickly, which becomes a disincentive. If we do the math quickly, we can understand that if we remove this tax from these services, almost every eighth visit will be free for a person. To me, that is a significant issue.
Another thing I want to mention is the breadth of Canadians who are affected by mental health issues. I had the opportunity to speak to some international medical graduates this past week in the Toronto area who were in this country from two years to 28 years. Unfortunately, as we know, with the systems that exist, all 15 folks I had the opportunity to speak with were unable to gain licensure here in Canada as physicians. They worked as lab techs, security guards and physician assistants, and some of them had moved on. One guy rose through the ranks to be vice-president of a company. They were all very well-educated and hard-working folks.
The other part of this is that sadly, Canada, in the international medical community, has become known as the graveyard for doctors. That is the term they use. When they come here, they get in an interminable cycle that does not allow them to practise. Why am I talking about this? It is not because we have this great program called the blue seal program, which would eliminate these problems. It is because of the heart-wrenching stories I heard from these international medical graduates, who were very well trained in their own country.
One of the telling stories I heard was of a gentleman who said his children knew that he was a physician, but when he went to work, they asked why he was dressing up in a security guard uniform. When we hear that, we can understand the heart-wrenching nature of the amount of effort that all of these folks put into their work, into their profession, which they are unable to practise here. I could tell that the tears were very close to the surface and ready to flow.
That is an important story because we know, as I said at the beginning, that mental health can affect people of younger ages all the way to the end of life. We know that is a significant issue. We also know that there are other significant groups, such as racialized minorities, immigrants and people who identify as part of the LGBTQ community, that suffer with more mental illness than other portions of the population. We need to understand that mental illness affects everybody across every spectrum of the population in Canada. It is a very important thing we need to underscore.
We also need to understand that the health care system is failing us. We know that in Canada, some services in mental health care are paid for, such as in my province of Nova Scotia, but we also know that for expenses in health care, Canada is ranked first among 30 OECD countries in percentage of health care spending as part of the economy. We know that we are severely lacking in doctors per 1,000 people, in specialist wait times and in access to resources. For this reason, we know that when the government has the opportunity to make changes on some very specific things, that could perhaps cross party lines if there is something we can significantly do about it.
It behooves us to look at a few things regarding the way the pandemic has impacted the mental health of Canadians.
We certainly know that youth have been significantly affected, more so than other segments of the population. Since COVID-19, fewer Canadians report having excellent or very good mental health. It was 68% in 2019 and it was down to 55% in July 2020. Prior to COVID, youth aged 15 to 24 were the least likely to report excellent or very good mental health, a sad state in and of itself, but they reported the greatest decline, a 20 percentage point reduction, from 60% pre-COVID to, sadly, 40% in July 2020. Inexplicably, it appears that seniors age 65 and older have not experienced declines in mental health since the pandemic began. As I mentioned previously, women continue to report lower levels of mental health compared with men, from 52% to 58%.
Another very important thing to note is that there are groups in Canada doing very good work. I will give a shout-out to my daughter, Allison Fitzgerald, who was on TV this morning talking about Kids Help Phone, which has done excellent work. It has some shocking numbers, though, when we think about it. Since the pandemic began, it has had 14 million interactions with youth in Canada. We know that is a significant issue that continues to come forward.
The Canadian Paediatric Society put out policy briefs with respect to child and youth mental health, recognizing the significant issues associated with it. It said, “Accessible, evidence-based treatments can help mitigate long-term disabilities and support academic and occupational success.” It also said, which we again need to underscore, “Those under the age of 25 have been uniquely impacted by the pandemic.” They have had stress, anxiety, disrupted access to learning and identity-affirming activities, and reduced academic and economic opportunities.
In conclusion, what can we do to help support all Canadians? We can modify the Excise Tax Act and eliminate the taxes on psychotherapy services and mental health counsellors. Even though we may say this is not a huge issue, we have an opportunity to do something. The government needs to look at opportunities so we can stop talking, make a difference and do something to help the health of Canadians.
2035 words
- Hear!
- Rabble!
- add
- star_border
- share
Mr. Speaker, I thank my colleague for his speech and for introducing Bill C-323.
The basic objective of the bill is to expand access to mental health services, and we agree with that. However, given that the majority of provinces do not yet have a definition for psychotherapy and mental health counselling services, how can we ensure that the bill will be applied in the same way in every province?
72 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/25/23 5:46:08 p.m.
- Watch
Mr. Speaker, I think that it is important to find a way to address the problem. We can find proper titles for professions such as psychotherapist and mental health counsellor. I think that it is possible, then, to group together all professions offering the same services even if they have different names.
I think that this is a way to find the process that will be best for all Canadians.
71 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/25/23 5:47:03 p.m.
- Watch
Mr. Speaker, can my colleague tell us whether each province has its own criteria for officially recognizing the profession of psychotherapy? Are the criteria consistent? I would like him to tell me more about this subject.
37 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/25/23 5:47:25 p.m.
- Watch
Mr. Speaker, I think I have used up all my French today, and I apologize to my colleagues. It is hard to speak and think at the same time in a different language, so maybe I used it all up.
As I said previously, there are some different definitions, but if we look at this as a broad definition in a different basket to be able to say that these are the types of services that are provided by these individuals, then I think we have a pathway forward to begin to say that we need to provide help for these services. The other way to look at it is from the opposite point of view. The mental health counselling services that are required to charge GST or HST are the folks we want to be exempted from this.
I do not think the nomenclature needs to allow us to not be able to move forward and cause us to have paralysis on this. We need to move forward for the betterment of all Canadians.
175 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/25/23 5:48:26 p.m.
- Watch
Mr. Speaker, first, I want to thank my colleague for Cumberland—Colchester, because he did draw pretty high in the order of precedence to move forward with a bill that is going to remove barriers for people to get access to mental health care and psychotherapy, which is very important. My colleague from London—Fanshawe had a bill that was very similar, as he is well aware.
We believe, as New Democrats, that there should not be tax on health care, and I think most of us agree. We need to do better to make sure there is access. Does my colleague agree that we need to go much further, that there needs to be true parity between physical and mental health in our country, that it should be universal and everybody should have access?
We know this will increase access, but many are still going to have to pay out of pocket in a two-tiered mental health care system, and they cannot afford it. Does my colleague agree that we need to create a pathway to get to a truly universal mental health care system in this country?
192 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/25/23 5:49:24 p.m.
- Watch
Mr. Speaker, one of the things we often find here in the chamber and in the federal government, or at least I have found since I have been here in the last 18 to 20 months, is that sometimes we try to swing for a home run, but we strike out. I think this is something we can start with and actually make a difference in the lives of many Canadians in an area of health care that we know is in significant crisis. If we start saying, “Hey, we're going to do this, or let's add that, or something else,” then we are not actually going to accomplish anything, which is my fear in saying, “Yes, we should aspire to greatness.”
Of course, everyone in their own life should aspire to greatness, but I think we should aspire to things that we can actually do so that we can make a difference in the lives of Canadians, and then we are moving things forward here. Again, when the Conservatives have the ability to form government, we will attempt to do great things, hopefully with the support of all of our colleagues, and then we can see Canada move forward as a greater country.
210 words
- Hear!
- Rabble!
- add
- star_border
- share
Mr. Speaker, I am pleased to be able to take part in today's debate on Bill C‑323, an act to amend the Excise Tax Act with regard to mental health services.
I want to thank the member for Cumberland—Colchester for bringing forward this important subject. The MP for London—Fanshawe also introduced a bill on this subject.
The bill would exempt psychotherapy and mental health counselling services from the goods and services tax and the harmonized sales tax.
I would begin by pointing out that our government has been taking meaningful action to support mental health care services for Canadians since 2015.
These investments include $5 billion over 10 years to provinces and territories starting in 2017 to improve and increase the availability of mental health and addiction services.
The toxic drug and overdose crisis claims the lives of 20 Canadians a day, on average. Many of them are homeless and have mental health problems. That has a major impact on our communities, our health care systems and our social services.
To address this crisis and save lives, we have invested more than $800 million since 2017. We have restored harm reduction as an essential pillar of our strategy and work to support a compassionate and evidence-based response to the overdose crisis and the stigma associated with it.
Since 2020, we have also invested over $270 million in the Wellness Together Canada portal, which gives Canadians free tools and support for their health and well-being.
Starting in 2021, we began delivering $100 million over three years to support projects for innovative mental health interventions for populations disproportionately impacted by COVID, including health care workers, frontline workers, youth, seniors, persons with disabilities, indigenous people and racialized communities.
Since last year, we have begun investing $1.5 billion over six years to support trauma-informed, culturally appropriate, indigenous-led services to improve mental wellness, including over $825 million through budget 2021 and budget 2022 to support distinctions-based mental health and wellness strategies with first nations, Inuit, and Métis peoples.
Building on these historic investments, budget 2023 proposes significant new funding to build upon and complement the substantial existing investments for mental health and substance use supports for Canadians.
On February 7, we announced an investment of nearly $200 billion over 10 years to improve health care services for Canadians, including mental health care services. This commitment includes billions of dollars in additional federal funding transferred to the provinces and territories to improve health and mental health care over the coming years through a combination of an increase in the Canada health transfer and an additional $25 billion over 10 years to support bilateral agreements with the provinces and territories.
The new FPT bilateral agreements include an integrated inclusive approach to mental health in family health services, the health workforce, as well as data and digital tools. These investments will support the health and mental health needs of Canadians and will require provinces and territories to produce detailed action plans.
This approach is the most effective way to integrate mental health and substance use services into the health care system, including primary care, and to ensure transparency and accountability on the part of the provinces and territories as to how this funding is spent and where it is spent.
In addition, budget 2023 proposes to provide a total of $359.2 million over five years starting in 2023-24 to support a renewed Canadian drugs and substances strategy.
Budget 2023 also proposes providing $158.4 million over three years, starting in 2023‑24, to support the implementation and operation of the new national suicide prevention line, 988.
We have partnered with CAMH to oversee the implementation of this new crisis line and we are working closely with our U.S. counterparts to learn from their four-year implementation process for the similar service they launched last year.
We know that the fundamental principle of Bill C‑323 is to make mental health services more accessible and that is a principle we support.
However, our government also appreciates that tax changes, like those proposed in Bill C-323, should ideally be undertaken through the budget process, extensive debate and in discussion with provinces and territories. This enables us to fully consider trade-offs, balance priorities, close potential loopholes and undertake new fiscal commitments only to the extent that they are fair and affordable.
In short, this approach ensures consistency with the tax framework and the uniformity of the entire tax system. Making a tax exemption through the ad hoc passage of a private member's bill such as Bill C-323 has the potential to undermine this process.
Viewed through this lens, this bill raises a number of issues.
Because health care is essentially a provincial responsibility, the federal government uses provincial funding and regulatory practices as criteria to determine which services should be considered basic health care services for taxation purposes.
In this regard, if a service is covered by the health care plan of two or more provinces, it may be considered basic health care and exempted from the GST/HST in all provinces. Likewise, if a profession is regulated as a health care profession by at least five provinces, the services of that profession may be exempted from the GST/HST in all provinces.
However, psychotherapy and mental health counselling are not currently covered by the public health system in any province and are not regulated in at least five provinces.
This means that exempting the GST/HST on psychotherapy and mental health counselling services as proposed by Bill C-323 could undermine the long-standing criteria established for determining the GST/HST status of health care services.
Consequently, this could make it more difficult to make objective decisions about any possible future efforts to exempt other services.
While psychotherapy and mental health counselling services do not currently meet any of the long-standing criteria that were established to determine which health care services supplied by health care practitioners should be exempt, psychotherapy services provided by a psychologist or other regulated health professional such as a physician, nurse or social worker do meet the criteria and are already exempt if the services are within the scope of practice of their profession.
We look forward to exploring these issues through the legislative process. In particular, whether the bill would apply in the same way in each province is an important issue to be explored through debate. This is a basic question of fairness for Canadians.
We look forward to exploring these issues through the legislative process and, in particular, whether the bill would apply in the same way in each province. That is an important issue that should be discussed in this debate.
Canadians deserve to have access to the mental health services they need.
Canadians deserve to have access to the mental health services they need. That is why our government is committed to ensuring that mental health care is treated as an equal and integral part of Canada's universal health care system.
While we do support removing barriers to Canadians' access to mental health support, it is my hope that the considerations that I noted earlier will be addressed through parliamentary debate and review.
1231 words
- Hear!
- Rabble!
- add
- star_border
- share
Mr. Speaker, I am very pleased to rise in the House this evening to speak to Bill C-323, which was introduced by the member for Cumberland—Colchester. I know that my Conservative colleague is a physician and, quite honestly, he is to be commended for introducing this bill. Sometimes we wonder whether we can really make a difference in people's lives as members of Parliament. This evening, I get the feeling that, yes, by supporting this bill, the Bloc Québécois will be helping improve the lives of people who need it.
First of all, it is important to point out that, right now, only physicians and psychologists have the right to GST exemptions. That does not make any sense, because we know that psychotherapy is now carefully regulated in Quebec and that there are professional bodies that have the right to regulate the professional service of psychotherapy using very strict criteria.
When a person in Quebec has a problem, their first instinct is not necessarily to call the federal mental health help line. If a person needs help in Quebec, they will first turn to their local community service centre, or CLSC, which helps people with anxiety, or they will turn to a support group. I am lucky because there are three great mental health support groups in my riding, namely Psycohésion, Ancres et Ailes and Le Dahlia. These groups help people every day and welcome them into their organizations to give them support and foster a feeling of solidarity with others in the group. These services are provided by community groups specializing in mental health, which, by the way, are not funded by Ottawa. They are entirely funded by Quebec.
As far as psychotherapy services are concerned, it may be worth repeating that Quebec passed legislation in 2009 that very clearly regulates psychotherapy. First, psychotherapists are required to be members of a professional association. Having spoken to osteopaths in Quebec, I can say that obtaining a professional designation is an exceedingly long and demanding process. Osteopaths are required to charge GST because their services are not considered psychotherapy. What is more, since they are not yet members of a professional body, they cannot make representations or participate in negotiations. It is very hard to become a member of a professional body. Professional designations are very strictly regulated.
Furthermore, to practise psychotherapy, a person needs to have a master's degree. That means doing an undergraduate degree first and then a master's in a very specific field related to psychotherapy. The person also needs to have 765 hours of training in psychotherapy at the university level. That is a lot, because added to that is 600 hours of a work placement, where the student provides psychotherapy consultation services under the supervision of a psychologist or a member of another professional body that is eligible to provide psychotherapy. In Quebec, it is very strictly regulated. The member introducing this bill is right to introduce it, because the current situation is unfair. It is not right.
As I often mention, I am a social worker and a member of my professional association. If I were to take all the required courses and complete a work placement, I could become a psychotherapist, but my clients would pay the GST. However, if they go see the psychologist in the office next door, they would not pay the GST. That is completely unfair and unjust.
I have a great deal of respect for my colleague, because, as a physician, he has the humility to say that other professionals besides doctors and psychologists have the ability, the intelligence, the competence and the knowledge required to support people through psychotherapy, and he agrees that these people should have the same privilege as he does of not having to charge the GST.
It is very difficult to access mental health services. If these services were provided only by psychologists and doctors, many people in Quebec would not get help. That is why it is a shared responsibility.
Social workers and psychologists may take different therapeutic approaches, but both are equally effective for supporting someone who has a problem or who wants to be supported in a certain decision in his or her life plan, someone who is experiencing upheaval, shock or trauma and who wants to be supported and treated by professionals. The bill recognizes that this professional association has the right to provide psychotherapy based on the criteria I mentioned earlier.
We hear a lot about mental health. I heard the member for Sherbrooke praising her government, but one thing is certain. Our support for this bill is meant as a concrete gesture to make a difference for people who seek help from various professionals who are able to support them in their psychotherapy. It is also our way of telling people that if they need help, there are many professions that can help them and that are all equally professional.
Mental health is a professional field, an action, that belongs to the provinces. Local community service centres and community groups are in the best position to lend support to people in distress. Having a federal crisis line that competes with the Quebec crisis line will not provide better support. It is just confusing.
Go to our ridings and ask anyone who is depressed and thinking about ending their life who they will call first. If they need help, their thoughts will turn to crisis lines like Tel-Aide, Kids Help Phone, or other community agencies in their riding. They will think about the social worker they visited at the local community service centre or the psychoeducator at their community support group who talked to them and treated them like someone who is different, but who has problems.
If a person is really in a bind and really in distress, they would never think to call a federal help line. I have looked at the federal portal that my colleague from Sherbrooke was talking about. It is true that there is a lot of information available there, but Quebec already has a help line. I do not know whether the other provinces do or not, but we have many different help lines for all sorts of people.
I am sure members will understand that I am not thrilled to see the federal government infringing on Quebec's jurisdiction when it comes to mental health, because all that is going to do is cause confusion in Quebec. When someone is not doing well, they do not need a whole bunch of telephone numbers and a big directory to know who to call. They really need to be connected to their community. The best place to be and the best support a person can get in their community is from their family, friends, local community service centre and community groups. Those are the people who will help the individual move forward and get through difficult times.
The Bloc Québécois is really pleased to support Bill C‑323 to make a real difference in the lives of those who need help and to offer them a GST exemption.
1205 words
- Hear!
- Rabble!
- add
- star_border
- share
Mr. Speaker, before I get started, I want to spend a minute thanking my colleague from Cumberland—Colchester for tabling this important bill, Bill C-323, an act to amend the Excise Tax Act for mental health services. As we know, this bill would expand the category of health care services exempt from point-of-sale taxes to include psychotherapy and mental health services. As I stated earlier, my colleague from London—Fanshawe tabled a very similar bill a while ago, and I was glad to see that my Conservative colleague stepped forward and moved forward with this bill, because he is much higher in the order of precedence.
We know that physical health services such as optometric, chiropractic and physiotherapy services are already exempt from federal sales taxes. Eliminating federal sales taxes from psychotherapy and mental health services would be a step forward, but, really and truly, there should be no taxes on any health care in this country. A tax exemption would reduce the cost of these services directly, by increasing access to them, but it is not the complete solution, as I stated earlier. Taxes are certainly a barrier, and it would help with that, but many Canadians still cannot afford these services, which are critical, especially in the crisis that we are seeing right now with mental health. In terms of increasing the availabilityof these services, it does not do that, but it does reduce barriers for those who can afford, or barely afford, to access these services.
As we know, right now in Canada, provinces are spending about 5% to 7% of their budget on mental health. Actually, some are even lower. Ontario is at 3%, under its Conservative government. OECD countries are at 12% to 14%. The U.K. is at the higher end of that.
We know we have to do more to create parity between mental and physical health in this country. We have a two-tiered health care system when it comes to mental health in this country; we truly do. We know that Conservatives believe that we should have a two-tiered health care system when it comes to our physical health in this country. As New Democrats, we believe that everybody should have access to mental health supports, including psychotherapy, and we believe that everybody deserves timely access to a full range of a mental health treatments and services regardless of their ability to pay. We talked about the need for parity between physical and mental health in our country and the importance of that.
Like I said, my colleague from London—Fanshawe tabled Bill C-218 to take a step forward and to remove barriers. According to a report by the Mental Health Commission of Canada, almost 35% of respondents report moderate to severe mental health concerns. Fewer than one in three people with current mental health concerns are accessing mental health services. A key barrier to accessing services includes financial constraints and long wait-lists, so this does move a few people along. It is really important that we move forward. We know that counselling and psychotherapy are the most unmet needs of Canadians seeking help with mental health care. We are very appreciative of this bill.
My colleague highlighted earlier, and I really appreciate his doing this, that Canadians' mental health concerns have worsened throughout the pandemic. We have seen that. Again, Canadians are experiencing more and more difficulty making ends meet as they deal with increased inflation, a cost of living crisis and stagnating wages, so reducing the cost of access to services and, of course, treatment is important. Increasing the access to treatment for all Canadians who need it, by reducing financial barriers, is critical. We just want to highlight that one in four Canadians cannot pay right now for a $500 emergency. Mental health treatment can easily far exceed this cost.
I want to talk a bit about our party's history on this. A 2017 NDP-sponsored bill would have removed GST from psychotherapy services. Bill C-218, sponsored by my colleague from London—Fanshawe, would also have removed GST from psychotherapy services. It is currently out of the order of precedence, so, again, we commend our colleague for moving this forward. The same colleague from London—Fanshawe presented a petition to the House of Commons to remove GST from counselling therapy and psychotherapy services. That petition received over 14,000 signatures.
When the Conservatives' order of precedence comes forward, we do like it when they take NDP bills. This is something we are just starting to get used to.
Members will recall that Scott Duvall, my friend from Hamilton, a former MP for Hamilton Mountain, brought forward a bill on pension theft to protect pensioners and their pensions from corporations that were going after their pensions. We were glad to see that a Conservative colleague took his bill and advanced it. The Conservatives had voted against a very similar bill when they were in government before the current Liberal government.
Also the small business transfer really started with the late Jack Layton. He brought that idea forward. It was carried by Guy Caron. We were glad to see the Conservatives advance another NDP bill.
These are important bills. I really think that is the spirit of Private Members' Business, members working collectively together trying to find pathways to support Canadians. This is another example of that.
A 2023 finance committee report included the following recommendation:
Recommendation 32
Exempt counselling therapy and psychotherapy from the application of GST/HST.
This is something that was supported at finance committee and now is being advanced here in the House. This is great news.
We hear from stakeholders who are concerned about the lack of access to mental health services and the lack of availability. As New Democrats, we want to increase both. I stated that this bill might not increase availability, but it will certainly increase access to services by reducing costs.
Almost all Canadians support publicly funding mental health care, making it the same as physical health care, creating parity. Ninety-four per cent of Canadians think that provincial and territorial government health plans should cover mental health care. This was according to a study done as recently as 2019.
My colleague talked about New Democrats always going for the home run. If we want to talk in baseball terms, I would say this is a bunt. It is getting some people to first base. We actually could go for the home run. As New Democrats, we have proven that with our dental care plan to make sure that children under 12 get access to dental care. We hit second base this year with seniors and people living with disabilities. Next year we hit third base with all families that earn $90,000 or less.
We are going to hit a home run. Some day I hope that everybody in this country has access to dental care. If we brought forward a bill saying that we were going to remove GST from teeth cleaning, I do not think many kids would get their teeth cleaned. I will be really honest, it might be a step forward, and maybe a few might get their teeth cleaned, but we believe, as New Democrats, that we actually can hit some home runs in here.
I want to work with my colleague, and I hope he wants to work with me too, to hit a home run when it comes to mental health and making sure that people get access to treatment. I believe we can do it. I think we can do better than a bunt. We can get to first base, second base, third base and a home run, if we set out a plan and if we work together, which is really important.
One thing I was really disappointed about, and I have heard this from my colleagues on this side, is that the Liberal government is trying to find barriers to supporting this bill on a definition, on terms of what identifies psychotherapy and mental health. We have some really well-paid public servants who I am sure could make some recommendations at committee. Let us get the bill to committee. Let us do the right thing and work collectively.
This is a step. I support the bunt all the way. Let us get to first base. Let us get this to committee. Let us move this forward. However, the government has to get behind this. It always tries to find a barrier. I do not know what it is about Private Members' Business. Maybe the government feels like it is not going to get credit for it and it just wants to go out and oppose it. There are a lot of really smart people in this House. I want to thank my colleague, because he is one of them. He is a physician. He has experience in this, and he is trying to move things forward.
I want to support him. My team wants to support him. This is supported by a tax-free therapy campaign. This is really important. It is supported by mental health providers.
Also, when it comes to gender parity, women and gender-diverse people are disproportionately impacted by the costs of and barriers to health care. They would benefit from this bill. It is really important that we support the bill.
In closing, I want to thank my colleague. I hope all members in this House will get behind this bill, a bill that we clearly support. We tabled a bill almost identical to it earlier in this Parliament. Let us start removing more barriers from people getting access to mental health care in this country.
1635 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/25/23 6:19:20 p.m.
- Watch
Do not forget that on a bunt one can get an infield home run as well, so it can actually happen.
21 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/25/23 6:19:33 p.m.
- Watch
Mr. Speaker, it is always an honour and privilege to stand in the House of Commons on behalf of my community of Peterborough—Kawartha. It is an even bigger honour when I am able to speak to the issue which I believe is the biggest crisis facing our nation: mental health.
There is not a person in this House or watching at home who has not been impacted by mental health. According to a 2020 UNICEF report, Canada ranks 31 out of 38 in children's mental health and happiness and 35 out of 38 in teen suicide. Approximately 12 people die every single day by suicide. That is 4,500 deaths a year that we know about. Suicide rates are approximately three times higher among men compared to women. Suicide is the second-leading cause of death among youth aged 15 to 34 years.
I should have put a trigger warning at the beginning of this speech in the event this bothers anyone watching, as we are talking about mental health and suicide.
Self-reported suicidal thoughts, and I would make note of the language “self-reported”, and attempts are higher for people earning lower incomes. As we know, in this cost of living crisis, financial anxiety is impacting more and more people. What used to be considered good money is barely enough today. I am not going to get into the debate on carbon tax and the Liberals' failure on cost of living. I really want to focus on what we can do today.
I have some stats that put this crisis into perspective. Incidences of suicide are higher in rural settings. Adults with mental disorders, such as major depressive disorder, generalized anxiety disorder and PTSD were more likely to report suicidal ideation. Adults who experienced pandemic-related impacts of isolation and loneliness were more at risk of suicidal thoughts.
In fact, today I met with the Retired Teachers of Ontario, who shared with me that mental health among its 83,000 members is a major concern. Many seniors do not have access to a doctor, and it is deeply impacting their mental and physical health.
Almost every single day I hear from a parent or caregiver who shares their despair, their fear, about the mental health of their child. One gentleman started to talk to me one day and he broke down in tears because his teenage son would not come out of his room. He said, “The son I had before the pandemic and the son I have now is not the same, and I am so worried for his future and his health.” One parent shared with me that she waited eight hours in an emergency room with her teenage daughter because she was having a mental health crisis.
We have not even begun to understand the impact of the pandemic on our children. Their developing brains were exposed to trauma and isolation, and it will take years to get the data to understand the full magnitude of how our children have been impacted.
I sit on the Standing Committee on the Status of Women, and we recently completed a study. The report is titled “A Step-by-Step Approach to Supporting the Mental Health of Young Women and Girls in Canada". The study brought forth many witnesses and a list of recommendations tabled with this House, some of which included education in schools, including self-regulation and empathy; mental health first aid; supports in rural and remote communities, including clinical and virtual care; access to housing; access to virtual mental health care; providing transitional services for individuals who are discharged from addictions and mental health-related hospital programs; youth who are aging out of foster care and individuals who are leaving emergency situations such as violence.
Another recommendation that came out included increased resources for health care practitioners. The reality is our frontline health care workers are suffering from compassion fatigue and burnout. As the old saying goes, the caretaker must first put on their oxygen mask if they are to help those who need it.
Dr. Rakesh Jetly was one of many witnesses who testified in the study. It was this quote that jumped out at me: “It's a year and a half wait for a psychiatrist for a teenager.... A year and a half is a lifetime at that age.”
All that information I just provided seems overwhelming and a huge task to try to change the course we are on, but we cannot give up. How does one climb a mountain? One step at a time.
For many people watching from home, this place of debate can be extremely frustrating and painfully slow. Trust me, I know how they feel.
If the member from Kingston wants to continue to talk while I do my speech, I would ask that he respectfully leave. It is rude.
Mr. Speaker, would you please address that?
830 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/25/23 6:24:42 p.m.
- Watch
I would ask members to hold conversations outside so we can get through the debate.
The hon. member for Peterborough—Kawartha.
22 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/25/23 6:24:51 p.m.
- Watch
Thank you, Mr. Speaker. This topic is extremely serious. If he did not intend it to be rude, I do take that back, but this is really serious for his constituents and my constituents.
Today feels somewhat exciting—
39 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/25/23 6:25:05 p.m.
- Watch
We have a point of order from the hon. member for Kingston and the Islands.
15 words
- Hear!
- Rabble!
- add
- star_border
- share
- menumenu
- notificationsnotifications
- home
- mailmail
- searchsearch
