SoVote

Context: House Hansard - 184 - Apr/25/23

Mr. Gord Johns (Courtenay—Alberni, NDP)

Apr/25/23 5:48:26 p.m.
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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?

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Mr. Stephen Ellis

Apr/25/23 5:49:24 p.m.
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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.

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Mrs. Élisabeth Brière (Parliamentary Secretary to the Minister of Mental Health and Addictions and Associate Minister of Health, Lib.)

Apr/25/23 5:50:37 p.m.
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Re: Bill C-323

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.

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Mrs. Claude DeBellefeuille (Salaberry—Suroît, BQ)

Apr/25/23 6:00:20 p.m.
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Re: Bill C-323

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.

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Mr. Gord Johns (Courtenay—Alberni, NDP)

Apr/25/23 6:09:19 p.m.
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Re: Bill C-323 Bill C-218

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.

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The Deputy Speaker

Apr/25/23 6:19:20 p.m.
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Do not forget that on a bunt one can get an infield home run as well, so it can actually happen.

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Ms. Michelle Ferreri (Peterborough—Kawartha, CPC)

Apr/25/23 6:19:33 p.m.
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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?

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The Deputy Speaker

Apr/25/23 6:24:42 p.m.
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I would ask members to hold conversations outside so we can get through the debate. The hon. member for Peterborough—Kawartha.

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Ms. Michelle Ferreri

Apr/25/23 6:24:51 p.m.
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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—

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The Deputy Speaker

Apr/25/23 6:25:05 p.m.
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We have a point of order from the hon. member for Kingston and the Islands.

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Mr. Mark Gerretsen

Apr/25/23 6:25:08 p.m.
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Mr. Speaker, the member for Winnipeg North and I respect the conversation. I apologize if there was some mistake. We were having a private conversation among ourselves and perhaps we were too loud. I apologize to the member for that. We certainly were not commenting on the content of her speech.

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The Deputy Speaker

Apr/25/23 6:25:22 p.m.
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I thank the member for that clarification. The hon. member for Peterborough—Kawartha.

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Ms. Michelle Ferreri

Apr/25/23 6:25:25 p.m.
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Re: Bill C-323

Thank you, Mr. Speaker. Today feels somewhat exciting because what my colleague has put forth is a simple, tangible action item that will move the needle in opening access to mental health supports. The member for Cumberland—Colchester, who also happens to be a doctor, has put forth a private member's bill, Bill C-323, An Act to amend the Excise Tax Act (mental health services). Currently, many health services, including optometry, chiropractic, physiotherapy, foot care, acupuncture and many other services, are exempt from charging goods and services taxes. That means GST or HST depending on which province someone lives in. However, psychotherapy and mental health counselling are not exempt, meaning the service provider must charge tax. If we remove the tax, that would work out to about every eighth appointment being free. The reality is many Canadians do not have coverage for psychotherapy and mental health counselling. This would make a difference. This would also help alleviate the administrative stress on the providers. As I outlined earlier, these professionals are already managing an incredible workload to meet the demand. This would be a small but important step in making things more manageable. According to the Centre for Addiction and Mental Health, or CAMH, psychotherapy is a general term used to describe a form of treatment that is based on talking work done with a therapist. The aim is to relieve distress by discussing and expressing feelings; to help change attitudes, behaviours and habits that may be unhelpful; and to promote a more constructive and adaptive way of coping. Successful psychotherapy depends on a supportive, comfortable relationship with a trusted therapist. Psychotherapy can be life changing for many people. It can be maintenance of one's mental health, like visiting the gym to keep one's body healthy. One of my favourite sayings is by Fred Rogers, that anything mentionable is manageable. That is exactly what psychotherapy provides: the ability to identify and name behaviours and feelings so people can better manage them. I would love to see everyone have access to psychotherapy. This bill is a great stepping stone to making that happen, by making it more affordable and also highlighting how important and valuable this service is. One of the biggest hurdles in accessing support is asking for help. We have come a long way in how we talk about mental health, but we have a lot farther to go. Acknowledging access to mental health counselling and psychotherapy is a healthy and credible way to take care of oneself and it is wonderful, but now we must ensure people have access when they ask for it and ensure those services are affordable. The president of the Canadian Paediatric Society said that behavioural and psychosocial problems “serious enough to disrupt functioning and development affect approximately 1.2 million youth in Canada” and “fewer than 20%...receive appropriate treatment.” Furthermore, he told the committee that support services can be very difficult to access and that sometimes this lack of access to specialized services results in a doctor prescribing medications. We have an addiction crisis. We should not discount how much this is connected. I want to leave everyone with a message from Dr. Stuart Shanker, another witness from the status of women committee. Dr. Shanker studies neuroscience and is a leader in teaching thousands of people about self-regulation. In his testimony, he said, “You can change every single kid's trajectory”. This goes for adults too. The science shows it takes a lot of different ingredients, but when someone is able to access them, the results can be wonderful and life changing. I would say to everyone at home that wherever they are in their mental health journey, it is not permanent. There are amazing resources and people to help. Their life matters and they matter. Today, I ask every member in this House to support Bill C-323, a private member's bill which says to Canadians that this House cares about mental health, that this House recognizes the value of psychotherapy and mental health counselling, and that this House is making it a priority to make it easier to access and to make it more affordable.

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The Deputy Speaker

Apr/25/23 6:29:54 p.m.
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The time provided for the consideration of Private Members' Business has now expired, and the order is dropped to the bottom of the order of precedence on the Order Paper.

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Mr. Adam van Koeverden (Parliamentary Secretary to the Minister of Health and to the Minister of Sport, Lib.)

Apr/25/23 6:30:30 p.m.
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Re: Bill C-47

Mr. Speaker, it is a privilege to rise this evening to talk about budget 2023 and all of the investments it is going to make in our country and in our communities right across Canada from coast to coast to coast. Since the tabling of budget 2023, I have had the opportunity to spend some time in my riding, as we all did, throughout the Easter break. However, it was more than just Easter break in my riding. There were quite a lot of activities, festivities and things to celebrate, including Sikh Heritage Month, Ramadan, Passover, Easter and many other things. It was good to be back in Milton to engage with industry leaders, families, students, academics and various advocates on budget 2023 and put into context what it means for Milton and Miltonians. Budget 2023 is designed to meet the challenges and opportunities of today by building an economy that works for all Canadians while supporting our communities towards a greener, healthier and more sustainable future. These are really ambitious objectives. We are meeting the moment, and we are going to achieve those objectives by providing targeted relief to help families, seniors, students and workers afford everyday essentials, with some fairly historic investments in health care. We are expanding our dental care rebate and focusing on families and the people who do not currently have access because they do not have any insurance. When I was an athlete competing for Canada, I did not have a dental care plan, so I paid out of pocket for dental. At the time, I thought I was a minority. I thought I might be one of only a few Canadians who do not have access to dental care. However, as it turns out, fully one-third of Canadians do not have access to dental care, and that is too many. It turns out that many seniors in my riding fall just over the income threshold for the provincial program that seeks to provide support and dental care for seniors. One has to have very low income in order to qualify for some of those programs. A lot of self-employed people, and we have plenty of those as we have a lot of entrepreneurs in Milton, do not have access to benefits, and some of their kids will not have access to dental. Friends of mine in Milton, Carley and her husband, have three jobs between the two of them. They work really hard serving our community, yet their three kids do not have dental care insurance, because their jobs do not cover it. However, with these new investments, all three of those kids will be able to visit the dentist, and it will not provide the family with any sort of financial burden, which is great. I would like to take a deeper dive on some local implications of budget 2023, and how it will invest in the clean economy and deliver some great jobs and great careers for now and for generations to come. First and foremost, I would like to focus on how budget 2023 makes life more affordable for Milton families. Too many people in our community and across the country are faced with real, tangible affordability challenges. They are struggling with the effects of higher grocery prices and rising housing costs. Budget 2023 is providing relief with a one-time grocery rebate, which is a $2.5-billion measure targeted on inflation, for the Canadians who need it most. It is a proven method to address these concerns, by using the GST rebate, which a lot of people are familiar with. Over 11 million low- and middle-income Canadians and families will receive the grocery rebate, and that means an extra $467 for families. Canadians without children will receive $234, and seniors will receive up to an additional $225. These measures are means-tested, which means they will be targeted to the families that need it most. I looked into this a little bit and did some research on the rising cost of groceries in Canada, and indeed, in 2023, groceries will cost families, on average, about the same amount. Many families are changing some of their eating habits. My partner, Emily, does not eat meat, and I eat less meat as a result of eating many meals with her and find that eating vegetarian a couple of times a week lowers our total cost. Adding all of those supports and programs that our government has introduced and improved over the last couple of years really puts this into context. I encourage Canadians who are interested in the budget or in any of these cost-savings measures to go to the website and check out how certain families will be implicated with all of these changes. I will post the website when I post this speech. I actually did a bit of research, taking an arbitrary four-person family in Milton with an income of $85,000. I found that, with reduced child care costs, the Canada child benefit, the Canada dental benefit, tax relief from an increased basic personal amount and the increased climate action incentive payments, this family will save over $11,000. I actually went a step lower on the income scale. I applied the same income that my family would have had when I was growing up, with two kids under six and a combined income of around $60,000, which is probably more than my mom made back in the day, but obviously times have changed a bit. With the grocery rebate, the increase in the Canada child benefit, the climate action incentive results and reduced child care costs, for a family that earns $60,000, that would result in a net savings of over $21,000. These are real, tangible impacts the budget would have on chequebooks. I was knocking on doors throughout January. Families in Milton were saying that times are tough, but they recognize the measures we have brought forward as a government, which are really helping their families. That was good to hear, and it makes me want to come back to work to keep working hard on these things. I have stood in this House before to talk about the $198.6-billion investments in health care that this budget formally introduces, but I would like to focus on one aspect that impacts many of our neighbours, and that is the health care human resource crisis. My mom is at an age now when she is looking to have a few procedures done. One of those is a cataract surgery. She also needed a new knee, and she has been waiting a long time. That knee was ready to get fixed during the pandemic. She went on a couple of lists, and that was delayed, obviously. Many of those challenges are worsened by the health care human resources crisis. Canada needs more doctors and nurses, and we need them now. We are addressing this need with a number of priorities outlined in bilateral agreements with the provinces and territories. Namely, we are streamlining foreign credential recognition, so that internationally trained medical professionals in Canada can get working in their fields of expertise more quickly. We are investing in wages for PSWs and other workers to encourage retention, and we are also investing in education for better recruitment to the sector. We want young people to know that if they are considering a job in health care, we are here to support that ambition every single step of the way. For students, the budget is really extraordinary. Over 750,000 post-secondary students rely on federal assistance each year to help them cover the cost of tuition, housing and everyday essentials. We want to make those expenditures more affordable, so budget 2023 seeks to do this by improving financial assistance for students with a 40% increase to Canada student grants. That is $4,200 for full-time students. We are also raising the total federal aid available to full-time students by over $1,000, up to $14,400 for 2023. In all of that, we would also eliminate all of the interest on Canada student loans and Canada apprenticeship loans forever. There will be no more interest on those loans. I think this is an incredible measure. The next generation of students will never know the additional burden of that financial hardship going into their working years. I was really glad to hear that. Two weeks ago, two of the awesome co-op students working in my constituency office in Milton organized a day when I went into their schools, Milton District High School and St. Francis Xavier, and I spoke to teachers and students about the impact this would have. The majority of those teachers have experienced student debt. I asked the students who was planning on going to university or college next year, and everybody put up their hand. I asked the teachers who had student loans when they were in school, and every teacher there put up their hand, obviously. I asked them how long it took to pay off that debt. It took a while. It took a couple of years; there is no question. It is important to note that this is not just for college and university; it is also for trades and apprenticeship graduates, so that those students would never have to experience that same financial burden. I would like to skip forward a bit to some of the measures in this budget that would support seniors, specifically. In budget 2023, we are strengthening pensions by providing $76 billion in support to over seven million seniors through critical programs like the guaranteed income supplement and old age security. Really importantly, these benefits would continue to be adjusted to keep up with inflation, and we would also expand dental care to seniors and redouble our efforts to support local seniors through programs like the New Horizons for Seniors. I recently announced over $100,000 in funding for seven local senior-serving community organizations, groups like Ontario Seniors' Forum and many others, which are hosting events in the library and at the arts centre to combat loneliness and isolation and serve our seniors. This budget would do so much for Milton. I had a chance to visit local small businesses to talk about the fact that we are going to work with credit card companies to reduce the costs of constantly swiping our phones or our cards on small purchases. I am guilty of buying at least one coffee a day with my telephone, and I know those costs get downloaded right to the small businesses. These are just some of the ways the lives of Miltonians would see positive change with the passing of this budget, and I am glad I had the opportunity to engage with some of my local members and stakeholders. Now, I would like to engage with some of my fellow members here in the House of Commons.

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Mr. Robert Kitchen (Souris—Moose Mountain, CPC)

Apr/25/23 6:40:46 p.m.
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Re: Bill C-47

Mr. Speaker, the member for Milton talked a lot about local implications and being back in his riding. I, too, was back in my riding over the last couple of weeks. When I was there, I heard a totally different scenario from my constituents. They were talking about the huge inflationary cost of everything that is impacting them. In fact, they talked an awful lot about the servicing of the debt, which is going to be $42.9 billion, and who will pay for that. Those were concerns they had. One of the big things in my riding was a concern about the fact that there was not a single mention of the coal transition or, using the new wording that Liberals like to use, sustainable jobs. The reality is that none of that was there to try to help the people who are going to be losing their jobs. Jobs are not being created in the riding. I do recognize that the member has been involved with health care. He and I both met yesterday with the Canadian Chiropractic Association. In his speech, he talked about student debt and its impact. Does he recognize that the chiropractic students who are paying back student loans are not actually included in this? Would he agree to adding them to this?

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Mr. Adam van Koeverden

Apr/25/23 6:41:59 p.m.
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Re: Bill C-47

Mr. Speaker, it was nice to see my colleague at the Canadian Chiropractic Association's meeting yesterday. I had a chance to give a speech as the parliamentary secretary for health. I had a chance to acknowledge that the doctor opposite is in fact a chiropractor. I know that he was well received by many of those constituents. Indeed, when we frame the conversation around what one likes about the budget or what one does not like about the budget, we are very likely to receive different feedback. However, it is undeniable that the measures in this budget that I went through, measures for seniors, to tackle the climate crisis and to invest in jobs, will have an impact in Saskatchewan. My dad used to live in Regina, and I have a lot of great friends there. I saw my former teammate Kia Byers just a couple of days ago, and she was talking about the need of Saskatchewan to get off coal and join the green revolution and to invest in more sustainable practices going forward. I could not agree more. There are enough people in Saskatchewan that I think they deserve their own nuclear power plant and they should start using some of that great uranium they take out of the ground in that fine province to fuel their province rather than burning coal.

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Ms. Andréanne Larouche (Shefford, BQ)

Apr/25/23 6:43:12 p.m.
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Re: Bill C-47

Mr. Speaker, to hear my Liberal colleagues today, I really get the impression that everything is just fine and dandy. I thank my colleague for his speech, but there were many things that piqued my attention. I could ask tons of questions, but I will try to be brief. An annual income of $85,000 for a family is good, but my colleague said that his government was helping seniors. What is it doing for seniors whose annual income is $20,000? Does he really think it is possible to live with dignity on that amount? I just reread a press release by FADOQ because I too have been consulting the people back home. In fact, I organized a conference on seniors' health. FADOQ says that the only thing for seniors in this budget is the one-time help for groceries, a single cheque that seniors will receive once. That is not going to help in the long term. FADOQ is critical of the fact that the guaranteed income supplement was not increased. As far as old age security is concerned, I would remind my colleague that, currently, every senior under 75 is still not getting help from their government, and those 75 and older got an increase of only 10%. Those 75 and under got absolutely nothing. My colleague just spoke about nuclear energy. I cannot believe how much greenwashing there is in this budget. As I said, I could go on at length about that, but his government is putting the same spin on its approach to seniors.

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Mr. Adam van Koeverden

Apr/25/23 6:44:38 p.m.
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Re: Bill C-47

Mr. Speaker, I thank my colleague for her comments and mini-speech. There were a lot of questions in there. This government has done some amazing things over the past seven years. I am going to speak in English so that I can get my idea out because I have never actually said this in French before. There is no government in history that has done more to solve seniors poverty. When we took power in 2015, seniors poverty was at a totally unacceptable rate, something around 9% or 10%. Seniors as a cohort in Canada are now the least impoverished group socio-demographically. That is not to suggest that we ought not to do even more to support seniors, but we have done more than just cut seniors poverty in half in this country by investing in old age security, which my colleague erroneously pointed out has not been reinvested in. We have increased all sorts of funding to seniors-serving organizations, and seniors poverty is now at an all-time low. That does not mean that we should not continue to invest, but to suggest we have done nothing is false.

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The Deputy Speaker

Apr/25/23 6:46:04 p.m.
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All right, here is my reminder of the evening: I really do not want to interrupt people's thoughts or to limit the time that people ask questions or answer questions, but we just asked two questions and other parties are not going to get an opportunity to answer. Try to keep the questions short and try to keep the answers short so everybody can participate in this debate. Continuing debate, the hon. member for Beauport—Côte-de-Beaupré—Île d'Orléans—Charlevoix.

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