44th Parl. 1st Sess.
May 31, 2023 02:00PM
Does the hon. member have unanimous consent?
Some hon. members: Agreed.
The Assistant Deputy Speaker (Mrs. Carol Hughes): Pursuant to order made on Thursday, June 23, 2022, the division stands deferred until Thursday, June 1, at the expiry of the time provided for Oral Questions.
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Madam Speaker, I am pleased to rise to speak to Bill C‑284. As members know, this enactment provides for the development of a national strategy to support the prevention and treatment of eye disease to ensure better health outcomes for Canadians. It also designates the month of February as age-related macular degeneration month.
The preamble of Bill C‑284 reads as follows, and I quote:
Whereas vision loss in Canada is associated with a number of causes, including macular degeneration, cataracts, glaucoma and diabetic retinopathy;
Whereas millions of [Quebeckers and] Canadians live with eye disease that could lead to vision loss or blindness if not treated;
Whereas it is estimated that vision loss costs [Quebeckers and] Canadians billions of dollars every year, both in financial costs and in loss of well-being;
Whereas the loss of central vision can severely impact a person's independence and quality of life;
Whereas coordination and information sharing between the federal and provincial governments is needed to ensure new treatments are made available, to prevent and treat eye disease and to prevent health inequities among people with vision loss;
It also states, and I quote:
And whereas Parliament considers that it is desirable to be proactive in the fight against vision loss and to implement a national strategy on eye care
In the same vein as many bills introduced over the past few Parliaments calling for autism, cancer or diabetes strategies, this bill calls for a strategy in the form of a report on eye health. Not surprisingly, the bill has the support of the Canadian Ophthalmological Society and the Canadian Association of Optometrists. In the wake of the introduction of the bill and World Sight Day on October 13, these groups published a survey that highlights the lack of understanding among Canadians about this important aspect of our health.
As we know, the strategy proposed in Bill C‑284 is built on four pillars:
identify the training, education and guidance needs of health care practitioners and other professionals related to the prevention and treatment of eye disease, including clinical practice guidelines;
promote research and improve data collection on eye disease prevention and treatment;
promote information and knowledge sharing between the federal and provincial governments in relation to eye disease prevention and treatment; and
ensure that Health Canada is able to rapidly consider new applications for treatments and devices used for macular degeneration, cataracts, glaucoma and diabetic retinopathy.
The Bloc Québécois will vote in favour of the principle of the bill, because eye health is important for people's quality of life.
All in all, the bill itself does nothing. It only forces the government to produce a report that will establish a national strategy for eye care. Furthermore, designating the month of February as age-related macular degeneration month is a symbolic measure.
Although health services, including eye care services, are the jurisdiction of Quebec and the provinces, this bill gives the federal government a role by funding research and approving medications or devices.
The bill overall respects Quebec's and the provinces' jurisdictions. That is why the Bloc Québécois supports it. However, the Bloc will take the time to study the bill to ensure that the federal strategy is complete and complements the actions of the Quebec government.
In Quebec, optometry services are available to people under 18 or over 65, and emergency services are covered for everyone. There is also a visual aid program, which allows any individual with a permanent visual impairment who is covered under Quebec's health insurance plan to obtain visual aids such as magnifiers, an optical system, a calculator, a Braille typewriter, a white cane, an electronic obstacle detector, night vision goggles, and the list goes on.
The program also offers financial help to get a guide dog, as well as resources for students. Speaking of guide dogs, I am going to talk about a fantastic Quebec organization that does remarkable and indispensable work. I am talking about Mira.
In his childhood, founder Éric St-Pierre developed a passion for raising dogs. He trained dogs on the family farm, following his father's advice. His ease and natural talent with the animals led him to undergo professional training in order to have a career training guard dogs and sniffer dogs.
In 1975, Mr. St‑Pierre built a kennel in Sainte‑Madeleine. He spent most of his time training dogs. One day, a friend who worked as an orientation and mobility teacher at the Nazareth and Louis Braille Institute asked Mr. St‑Pierre for advice about the behaviour of a guide dog from the United States. Back then, there were no francophone guide dog schools in Canada. Éric St-Pierre quickly realized that these dogs were not raised or trained in conditions that worked in Quebec. He realized that there was also a language barrier limiting many people's access to the services of these dogs. He therefore promised the institute that he would train dogs for them, and that is how Mira came to be. It was the first francophone centre for guide dogs in Canada.
Mira was founded in 1981. It is a non-profit organization that provides free guide dogs and service dogs to people with visual or mobility impairments, as well as to young people with autism spectrum disorder.
All of Mira's services and activities are based on the principle of body equality, meaning that what is accessible to everyone must also be accessible to people with disabilities. Within this framework, the organization's mission has the following objectives: increase the autonomy and promote the social integration of people with disabilities through the use of guide dogs and service dogs; provide services freely to all beneficiaries, regardless of their income; improve the mobility and orientation of people with disabilities so that they can move about freely in their daily lives; create an individual intervention plan adapted for each beneficiary that takes into account the beneficiary's level of autonomy, social and professional context, and mobility needs; and promote the benefits of service dogs in public places, in schools and on public transport.
Mira is known for its innovative programs, dog training techniques and fundraising activities. Since it was created, Mira has provided more than 3,700 dogs free of charge to people living with one or more disabilities. Much of this success is due to public support and concern. Without this help, Mira would not be what it is today.
I am now going to talk about two people I knew well and who lost their sight because of macular degeneration and diabetes. When I was finishing high school, a friend of mine found out that in a few years she would lose her sight to a genetic disease, early-onset macular degeneration. Diane Lamarche had a bright future ahead of her. She was a serious student who got good grades in high school. She enjoyed walking, basketball and tennis. She was also an avid reader.
We got to know each other better when we worked together as playground monitors in Lebel‑sur‑Quévillon. In our senior year of high school, she told us that she was losing her sight and that she was already learning Braille. The news left us gutted. She was so young, and had such a promising life ahead of her as an adult.
Our eyes and vision are indispensable for acquiring information from our external environment. They make it possible to coordinate all our movements, in particular those of our hands. Vision has three roles: perceptual, sensory and cognitive.
Another person who was even closer to me, my uncle Germain Boyer, lost his vision in his 70th year because of his diabetes. I remember that he enjoyed Yule logs so much that he would stock up every year. He has since passed away, but I will always remember his kindness and cheerfulness. I want to send my love to my aunt Denise and my cousins Sylvain and Mélanie in memory of him.
Ultimately, prevention remains an effective way to avoid vision loss, unless it is caused by macular degeneration, poor health or genetics.
If passed, this bill will help ensure better eye health and better vision for Quebeckers and Canadians.
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Madam Speaker, it is a great honour to stand in this House today and speak in support of Bill C-284, an act to establish a national strategy for eye care. I am proud to say that New Democrats will be supporting this bill and, in fact, as I will point out in my remarks, this is something we have been championing since the 1960s.
This legislation, in general, would provide for “the development of a national strategy to support the prevention and treatment of eye disease to ensure better health outcomes for Canadians.” The bill states:
The national strategy must describe the various forms of eye disease and include measures to
(a) identify the training, education and guidance needs of health care practitioners and other professionals related to the prevention and treatment of eye disease, including clinical practice guidelines;
(b) promote research and improve data collection on eye disease prevention and treatment;
(c) promote information and knowledge sharing between the federal and provincial governments in relation to eye disease prevention and treatment; and
(d) ensure that Health Canada is able to rapidly consider new applications for treatments and devices used for macular degeneration, cataracts, glaucoma and diabetic retinopathy.
This legislation would also designate the month of February as age-related macular degeneration awareness month.
I want to pause and thank my hon. colleague from Humber River—Black Creek, who has been an energetic, spirited and passionate sponsor of this bill. It would not be right to proceed any further without noting her energy and great work in promoting this overdue policy.
Eye health has been underfunded and deprioritized in Canada for too long. As a result, millions of Canadians are being put at unnecessary risk of vision loss because they lack access to eye care. A national strategy on eye care would ensure better access, better outcomes and quality of life for Canadians. It would also support Canadian leadership in vision research that can be exportable to the world.
Canada's New Democrats believe that our public health care system should cover us from head to toe, and that includes comprehensive eye care. Currently, access to eye care varies widely from province to province, resulting in variable health outcomes and exacerbating inequalities in our health care system. Over eight million Canadians are living with an eye condition that puts them at significant risk of blindness. An estimated 1.2 million Canadians are currently living with vision loss, with many facing a lack of investment in services and supports that impacts their living life to its fullest potential. That number is expected to grow to two million people by 2050. It underscores the need and the appropriateness of acting now so that we can arrest that alarming development.
The leading causes of vision loss in Canada are the following: Cataracts affect some 3.5 million people; age-related macular degeneration, 1.5 million people; glaucoma, about 300,000 people; and diabetic retinopathy, almost a million people or some 800,000.
Routine eye exams play a crucial role in the prevention of vision loss. If certain eye diseases are diagnosed early enough, they can be effectively managed through different invasive measures and before expensive and more invasive procedures are required. According to a recent report by Deloitte, the cost of vision loss to our economy, both directly and indirectly, was some $33 billion in 2019. That is projected to grow to some $56 billion by 2050.
If diagnosed early and if people have access to regular screening and treatment, most vision loss can be prevented: in fact, in about 75% of cases. Seventy per cent of existing vision impairment in Canada is estimated to be correctable with prescription glasses. The sizable proportion of correctable vision impairment is related to the barriers to access to vision care in Canada. Most guidelines recommend having an eye exam once a year for people aged six to 18 or 65 and older, as well as for those with diabetes or with an existing eye disease. For healthy people aged 19 to 64, one visit per two years is considered sufficient. However, this very basic diagnostic health need is not being met.
I will give a few examples. Starting September 1, free annual eye exams paid for through the Ontario health insurance plan will no longer be available to seniors. Manitoba and Nova Scotia currently only insure eye exams every 24 months for every senior, which is twice as long as is recommended. Millions of Canadians without extended health benefits do not have their eyes checked or cared for, due to cost.
As I said, the NDP has been advocating for universal public optical treatment since its founding convention in 1961. I am going to quote from that convention, which reads, “Believing that a country's most precious possession is the health of its citizens, the New Party will introduce a National Health Plan, providing benefits to those who need them without regard to their ability to pay. The plan will cover a full range of services: medical, surgical, dental and optical treatment, as well as prescribed drugs and appliances.”
It is a little over 60 years since that statement was made, and here we are in a G7 country and we are not making sure every citizen can get their eyes checked every year, never mind have the relatively inexpensive correction done that would prevent them, in many cases, from getting vision loss and even blindness. That is a national shame and it is time it was rectified.
More recently, the NPD's 2019 election platform committed to achieving head-to-toe public health care for all Canadians, and we specifically included eye care. In the 2021 platform, we committed to a long-term path to providing public coverage for eye care, along with other health services. In May 2021, the New Democrat member of Parliament for Algoma—Manitoulin—Kapuskasing, who I note is in the chair today, introduced Motion No. 86. That motion called on the federal government to work toward the creation of a national strategy for action on eye health and vision care. One can see not only that our support for this bill is there because of the need and the overdue nature of this, but that New Democrats have been playing a key role in placing this issue on the national agenda for decades.
I have to point out where the Government of Canada has simply failed to meet its commitments in this regard. In 2003, the Government of Canada made a commitment to the World Health Organization to develop a vision health plan for Canada by 2007 and to implement that plan by 2009. To date, no plan has been developed.
As recently as July 2021, the Government of Canada voted in the UN General Assembly for the first agreement to be adopted at the United Nations designed to tackle preventable sight loss and ensure that eye health is part of the United Nations sustainable development goals. In this resolution, the establishment of a national vision health plan was endorsed again by Canada.
As much as I credit the hon. member for taking this overdue measure, one has to wonder why this had to take the form a private member's bill, why the government is not meeting its own obligations and why it is not actually introducing government legislation using the full force of its control of the Order Paper to meet its own commitments, which it has made not only to Canadians but on the world stage.
It is important to note as well that this legislation has the support of stakeholders across this country. Several organizations, including Fighting Blindness Canada, the Canadian Council of the Blind, the Canadian National Institute for the Blind, Vision Loss Rehabilitation Canada, Diabetes Canada, the Canadian Association of Optometrists, the Canadian Ophthalmological Society and the Canadian Association of Retired Persons, have all advocated for a national eye care strategy for many years.
I want to pause for a moment to talk about the particular impacts this has on marginalized groups, including its gender impacts. When gender differences limit access to proper eye care services, women are at greater risk of developing eye diseases that are otherwise treatable and preventable. Recent studies published in The Lancet Global Health in 2020 revealed that women carry the greater burden of visual impairment globally. More women than men have impaired vision due to cataracts, age-related macular degeneration and dry eye disease. One in four women is at risk of vision impairment, compared to just one in eight men.
I will conclude by thanking the hon. member again for introducing this bill and let her know that the NDP will enthusiastically support it at all stages.
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Madam Speaker, I am happy to rise today to speak in support of Bill C-284, an act to establish a national strategy for eye care, presented by my friend and colleague, the hon. member for Humber River—Black Creek. I know this is something the member has been working on for quite some time and I would like to recognize her extensive work on this issue.
This piece of legislation would not only ensure better health outcomes for Canadians, but also recognize the month of February as Age-Related Macular Degeneration Awareness Month, bringing awareness to the leading cause of vision loss in people 50 years or older.
More than eight million Canadians are presently living with one of the four common eye diseases and more than one in 10 older adults have some degree of vision loss, which places them at serious risk of losing their vision. Vision loss can be harmful to many elements of daily life, impacting the way a person works, participates in activities and interacts with the world around them. That is why it is our duty to take proactive measures to prevent and treat these diseases effectively.
Routine vision care can help to reduce the risks of blindness and vision loss later in life and improve the outcomes associated with eye diseases like cataracts and glaucoma. Unfortunately, the COVID-19 pandemic worsened the issue of vision loss in Canada as eye surgeries were cancelled or delayed and wait times to see vision care providers also increased over the course of the pandemic. That is why a national strategy—
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- May/31/23 5:53:32 p.m.
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The hon. member for Shefford on a point of order.
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Madam Speaker, I have a little reminder. The member's notes are touching the microphone, which is making a noise that interferes with the work of the interpreters. Members just need to be careful.
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- May/31/23 5:53:42 p.m.
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I also noted that.
I would ask the hon. member to ensure that when she is moving her pages, she keeps them away from the microphone because it creates a problem for the interpreters.
The hon. member for Brampton South.
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Madam Speaker, I will be careful of that.
Unfortunately, the COVID-19 pandemic worsened the issue of vision loss in Canada, as eye surgeries were cancelled or delayed. Wait times to see vision care providers also increased over the course of the pandemic. That is why a national strategy for eye care is essential. It would provide a comprehensive road map, laying out a common direction and shared leadership. It would build collaboration among researchers, medical professionals and community organizations to develop innovative approaches to combat eye diseases and preserve sight.
In 2021, the CNIB opened a new centre in Brampton South, providing access to innovative technology and training for Bramptonians with sight loss. It is doing incredible work, and I am confident that Bill C-284 would bring us one step closer to empowering Canadians impacted by blindness with an integrated approach.
As members in this House know, Bill C-237, the National Framework for Diabetes Act, passed unanimously in 2021. I want to touch on how blindness can be a serious complication because of diabetes retinopathy, and I also want to recognize Diabetes Canada's work on this issue as well.
Earlier this year, I met an advocate named Ryan and his dog named Joe. Ryan lives with diabetic retinopathy. He told me about the challenges Canadians with vision impairments face using their insulin pumps. He and many other Canadians are experiencing these hardships, so we need to work together to remove those barriers.
Living with blindness, especially as a result of chronic disease, is an experience that is difficult for people without visual impairment to truly understand. This further underscores the need to have a coordinated strategy so that we can work together with provinces and territories, indigenous peoples and other partners to improve health outcomes. Through this approach, we can proactively identify and intervene in cases of diabetic retinopathy, mitigating the risk of vision loss.
We know that with early intervention and coordinated care, vision loss can be preserved. Of vision loss cases, 75% can be prevented if patients are diagnosed early and have access to treatment. We know that providing hope and better health outcomes for individuals affected by eye diseases is transformational. Already, the Government of Canada is leading and supporting a range of activities related to eye disease prevention and treatment.
I would like to talk about the investments announced in budget 2023 to strengthen our public health care system.
Budget 2023 commits $196 billion in funding to support our health work force; reduce backlogs; expand access to family health, mental health and substance use services; and modernize our health system. This is to ensure provinces and territories can provide the high quality and timely health care Canadians expect and deserve.
We see the surgical backlogs and the impacts on our systems, and we are addressing that need. Surgical backlogs, including vision-related surgeries, are a key part of this plan and are a health system priority of this government. Budget 2023 includes a $2-billion one-time top-up to provinces and territories to address urgent pressures in emergency rooms, operating rooms and pediatric hospitals. In addition, Indigenous Services Canada’s non-insured health benefits program also provides vision care to eligible first nations and Inuit beneficiaries where they are not otherwise covered by other plans or programs.
The government has also made significant investments in vision loss prevention and research. Over the last five years, the Canadian Institutes of Health Research has invested approximately $61 million in vision-related research. This research spans the spectrum of prevention, diagnosis, treatment and management of various vision-related conditions.
These investments contribute to the evidence base needed to improve health systems and health outcomes for Canadians experiencing vision loss.
Finally, I wish to highlight that medically necessary vision care services are covered by provincial and territorial health insurance plans. Any vision care service that must be performed in a hospital is covered and supported under Canada’s public health care system. The federal government is committed to continue working with provinces and territories on our shared health priorities, including those related to vision care.
In conclusion, Bill C-284 would allow the Minister of Health to develop a national strategy to support the prevention and treatment of eye disease. It would facilitate engagement with provinces, territories, key stakeholders and partners to ensure that we are all pursuing common objectives in the vision care space, along with sharing best practices. This bill would complement existing work and research efforts, supported by provincial and territorial governments, and the Canadian Institutes for Health Research.
Once again, I wish to thank the hon. member for Humber River—Black Creek for putting forward this important bill. I know that my residents in Brampton South and, indeed, all Canadians are counting on us to act quickly to prevent and treat eye diseases. I encourage members to vote in favour, as we continue to strengthen our efforts on vision care in Canada.
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Madam Speaker, it is an honour to rise today and speak to Bill C-284, put forward by my colleague from Humber River—Black Creek. The question before us today is fundamentally about ensuring that Canadians receive a coordinated response regarding their health care needs, particularly eye care.
The proposed national eye care framework intends to promote information sharing and knowledge sharing between the federal and provincial governments in relation to eye care disease prevention and treatment, all the while ensuring that both levels of government respect their roles within our national health care system. To quote the bill directly, a key component intends to “promote research and improve data collection on eye disease prevention and treatment”. Doing so would enable eye care health providers a centralized resource to access the status of their own patient base and make sure that they share their expertise across the country, all the while ensuring that only the best and newest technologies are used going forward.
According to the Canadian Council of the Blind, due to an increase in surgery wait times caused by the lockdowns during the pandemic, there has been a $1.3-billion increase in the cost of vision health over the past two years. All of this is compounded by the fact that 75% of vision loss cases in Canada can be prevented if patients are diagnosed early and have access to treatment. Furthermore, 70% of existing vision impairment in Canada is estimated to be correctable with prescription glasses.
This proposal from my colleague is not only very commendable, but is being put forward at a very timely moment. A national framework would allow all provinces and the federal government, as well as health care practitioners and researchers, to sit down at one table and jointly develop and implement the measures necessary to make sure that all Canadians from coast to coast have access to eye care and the best practices available in a timely manner.
Developing an effective framework is now more critical for the future of our children due to the prevalence of electronic devices. They release blue light, which can reach the retina, the inner lining of our eyes. Studies have shown that this light can damage cells in the retina, leading in some cases to early age-related macular degeneration, a unique concern of the modern age that is far more likely to impact our children. Children may not even know that their phones could be permanently damaging their eyes due to a lack of educational awareness.
Some might resist getting an eye care exam due to the belief that glasses are not “cool”. I will admit that it was hard for me, some 10-plus years ago, to admit that I needed glasses. This is a pressing challenge, as a long list of diseases and health care problems can only be discovered through a regular eye examination. Many eye diseases do not have any preceding symptoms and cannot be treated without a professional assessment.
The concern of vision loss in Canada requires a coordinated response, in both education and organization, between the provinces and the federal government, especially since there is a high percentage of seniors and school-aged children who have undiagnosed eye care issues. Very few children had their eyes tested during the pandemic, and as previously mentioned, many spend a great deal of time in front of a computer screen.
Referring to Canada as a whole and for a better understanding of the gravity of the situation, here are some of the numbers. Over eight million Canadians, or one in five, have some form of eye disease. Some 1.2 million Canadians live with vision loss or blindness. It is estimated by the Canadian Council of the Blind that vision loss and blindness were likely associated with 1,292 deaths in Canada in 2019. These deaths would have occurred due to factors such as increased risk of falls for the elderly and isolation experienced by those with vision loss.
Vision loss has a profound impact on our society and economy, costing an estimated $32.9 billion a year, $4.2 billion of which is attributed to reduced productivity in the workplace. Over half of the cost, $17.4 billion, is attributed to reduced quality of life, which is primarily due to a loss of independence, especially among seniors.
Many of us have a personal connection to someone experiencing vision loss. My own mother struggles with age-related macular degeneration, or AMD, which is one of the top five causes of blindness. The other four are cataracts, diabetic retinopathy, glaucoma and uncorrected refractive errors. Of these, all but two, AMD and glaucoma, can be prevented through proper care if caught at an early stage, or treated with modern tools such as laser eye surgery and/or prescription glasses.
While glaucoma has no present cure, there are treatment options that, if begun early enough, can prevent an individual’s loss of vision. Even in the case of AMD, a healthy lifestyle and regular eye exams can help delay the loss of vision as one grows older. Also, new recent accredited medical devices provide the hope to even reverse AMD, at least temporarily. In the case of cataracts, we have been able to treat this condition, I am told, as far back as the time of ancient Egypt.
There should be no excuse in the modern world to fail to provide Canadians with the knowledge about what treatments they can access in our provincial health care systems. Losing one's vision increases mental, financial and social hardships on an individual. It can lead to a loss of mobility and an inability to live independently, to drive, to read or to participate in physical activity. It can result in a loss of social interaction or even lead to social isolation, which can often lead to depression and other mental illnesses.
Through being proactive and taking preventative measures now, we can not only save individuals and families from a great deal of grief, but also help maintain the solvency of our health care system by helping provinces avoid spending even greater resources down the road in both treatment time and costs. Through proper education and awareness campaigns, Canadians can potentially save themselves from great heartache and financial costs by reducing smoking, having a healthy diet, getting regular eye exams and being informed of family genetics.
It must be stressed, however, that a health care strategy and delivery remain in provincial jurisdiction. The intent behind this national framework is for the federal government to serve as a centralized communication hub between eye health care providers in different provinces and federal regulators, allowing them to share their expertise and knowledge with each other. The requirement of regular reporting should also spur faster responses from Health Canada in reviewing and approving new technologies for the benefit of all.
This program must be a team effort led by professionals, in conjunction with the provinces, with the federal government keeping its involvement in proper scope, namely participating in this national framework. As long as these concerns are respected and decisions on strategies and spending priorities remain within provincial jurisdiction, as stipulated in the Canada Health Act, I can support this bill and look forward to doing so.
By passing Bill C-284, not only can we help millions of Canadians struggling with vision loss, but we can also be proactive and reduce the number of children who could face vision loss in the future. Eye care is but one part of our comprehensive health care strategy in Canada.
In my remaining time, I wish to speak more personally. At some point, I believe we will need a larger discussion on how health care is funded and how accountability in that funding is measured. Both levels of government provide dollars to health care, and it is clear that, while partially federally funded, health care is delivered provincially. The topic of health care funding and delivery comes up often when I hold round tables and town halls in Chatham-Kent—Leamington, where constituents often blame one or the other or both levels of government for the inadequacies in the system they experience.
I am reminded of Saturday mornings two decades ago in my own household. During the week, we had four daughters, but on Saturday mornings, when it came time to take out the garbage, we had five: Alyssa, Carina, Brenna, Kiana and “Not Me”. It was always Not Me's turn to take out the garbage. Health care accountability often reminds me of those Saturday morning discussions when people point at two levels of government and both levels of government point at each other.
Former provincial treasurer Darcy McKeough, who is in his nineties and still lives in my riding, mused in a biography that the level of government that does the spending should do the taxing so as to be held accountable. That will be an interesting discussion one day, but it is not for today.
Today, I encourage all members of this House to support this legislation put before us by my hon. colleague.
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Madam Speaker, I am pleased to rise to speak to Bill C-284. As my colleague from Abitibi—Baie-James—Nunavik—Eeyou said so brilliantly earlier, the Bloc Québécois will be voting in favour of this bill.
I see no reason why we would oppose a national strategy to support the prevention and treatment of eye diseases, just as I see no reason why we would oppose an age-related macular degeneration awareness month.
The Bloc Québécois will be voting in favour of this bill because, and I mean no offence, it is, in my view, an apple pie bill. Indeed, no one could oppose such a strategy, especially since the health services outlined in the bill—as we will perhaps see when it is studied in committee—are more the responsibility of the federal government. Research funding and the approval of certain drugs and medical devices fall under federal jurisdiction. I do not see any problems with jurisdiction either, but we do reserve the right to take a closer look at the ins and outs of this bill in committee.
What concerns me a bit more about having a better strategy to support the prevention and treatment of eye disease is how to do it. A strategy is fine, but it needs to be accompanied by action. That is what I want to focus on as I discuss this topic.
The essential point here is that there is still a lot of work to be done. The work to improve the eye health of Quebecers and Canadians will require more services. For me, first and foremost, the best solution for more services is to have coverage under the Régie de l’assurance-maladie du Québec, which means an increase in health transfers. If we want better services, we need more resources.
Let us look, for example, at new treatments like the Luxturna gene therapy, a treatment that makes it possible to treat Leber congenital amaurosis. That is a significant and very costly illness, with just one treatment costing $1 million. That is an enormous cost.
In that regard, on March 23, the federal government announced $1.3 billion over three years to help the provinces cover those treatment costs. We know that gene therapies are treatments that herald small revolutions in medicine and health, but they are very costly treatments. If the past is any indication, we know that the federal government is not always there for health funding.
Now it is clear where I am going. The best way to have the best health care and to fight against eye disease is to combat one of the problems that plague the Canadian federation: I am talking about the fiscal imbalance. I would note that, last week, the mischievous member for Mirabel held a symposium here in Ottawa on the fiscal imbalance to study the phenomenon in depth. It was a non-partisan symposium attended by the Parliamentary Budget Officer—I do not think the Parliamentary Budget Officer is partisan—and Mr. Benoît Pelletier, a former Liberal minister from Quebec, who is not a Bloc supporter, but who came to speak to us about the fiscal imbalance.
Why am I talking about the fiscal imbalance? It is to remind members of the demands made by Quebec and the provinces on health care funding. Quebec and the provinces estimated their health funding shortfall at $28 billion per year. The goal was to increase Ottawa’s health transfers from 22% to 35%.
What did the federal government offer? Members will recall that it was far less than $28 billion. What the federal government offered was $4.16 billion. The difference between the provinces' demand for $28 billion and the federal offer of $4.6 billion is not just about money. The difference between the two means that vision care will never be provided for lack of resources. There is no doubt about that.
For example, in Quebec, year after year, health resources generally represent approximately 42% of Quebec's total budget. That means that there is 58% left for all of the government's other responsibilities such as education, fighting poverty, child care—Quebec was a pioneer in this field, as it created the child care model—infrastructure, roads, public transportation and bridges. There is 58% left for that, for funding municipalities and also for supporting Quebec businesses. If we wait for the federal government to support Quebec businesses, we will be waiting a long time, as we saw again with the announcement that Volkswagen is building in Ontario. Therefore, 42% of the Quebec government's budget goes directly to health care. That considerably reduces its budgetary margin. That is known as the fiscal imbalance.
I can give a very simple definition. It is a definition that everyone agrees on, the definition from the Séguin report. I am talking here about Yves Séguin, the former Liberal minister, not the guy who had a goat. Yves Séguin said that the provinces' spending structure is such that expenditures grow faster than the economy, while those of the federal government grow at roughly the same pace. Furthermore, when the federal government wants to adjust its spending, it can just unilaterally cut transfers to the provinces, without any political fallout.
That is the fiscal imbalance rule.
That means that the federal government can make promises like it did in March when it said that it was going to inject $1.3 billion over three years to help the provinces with new gene therapy treatments. However, nothing prevents the government from eliminating that funding down the road. In so doing, the government strangles the provinces and the provinces are then stuck having to deliver services that they do not necessarily have the funding for. That is completely objective, ideologically neutral information. Take, for example, the Conference Board, which published a report showing that the Canadian federation is not viable in the long term and that the provincial economies are not viable in the Canadian federation, given the fiscal imbalance. That is also a recurring theme in the Parliamentary Budget Officer's reports, which document how the fiscal imbalance is wreaking havoc, particularly when it comes to health care.
I am saying all of this because, if we want a strategy that will really give us a robust health care system that can provide treatment for eye disease, then the we need more funding for health care.
I want to make my colleagues aware of something that happened this week.
On Tuesday, Liberal and NDP members once again joined forces to remove an additional $2 billion for health care from Bill C-47, an act to implement certain provisions of the budget tabled in Parliament on March 28, 2023. The NDP and Liberals got together to ensure that $2 billion was cut from health care funding. The Liberal-NDP coalition had an opportunity to partially correct the federal government's lack of investment in health care and to take concrete action, which is what people are calling for, to relieve the overburdened and exhausted health care system. They also had an opportunity to offer treatments for eye diseases that met Quebeckers' expectations, but they decided otherwise. All they have managed to do is disappoint people.
Liberal and NDP members voted in favour of an amendment to remove $2 billion in additional health provisions for Quebec and the provinces when Bill C-47 was studied in committee. The amendment was proposed by the Liberal Party and removes additional support for health care in Quebec.
I think we should forget all the fine words and promises made by Liberal and NDP members who claim to be concerned about the state of our health care system. Indeed, when it comes time to invest more, they are nowhere to be found. Worse, they are actually cutting billions of dollars from health care, even when those billions were invested unintentionally.
I repeat, the best way to have better eye care is to have a robust health care system and health care funding that lives up to the expectations of Quebeckers and Canadians.
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- May/31/23 6:20:50 p.m.
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The hon. member for Humber River—Black Creek has five minutes for her right of reply.
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Madam Speaker, I want to sincerely thank all of my colleagues in the House. All of their comments were so sincerely delivered and so accurate on all of the issues that matter to us in this particular issue that we are trying to move forward.
My colleagues mentioned that our colleague from Algoma—Manitoulin—Kapuskasing introduced Motion No. 86 some years back, trying to move this issue, trying to get vision onto the radar screen here at the federal level. Countless times, whether it was 2007 and 2009, we have talked about it, but nothing has been done about it. I can say that I think the closest we have come to it is where we are tonight.
We have reached this point here tonight because of all of the members who are here. From last June, when I introduced the bill, the Conservatives, the Bloc and the NDP were right there, standing together with Liberal colleagues to support something that we knew was important.
One of the things that we heard about tonight was the number of organizations and the number of people who were anxiously waiting for this to happen. Some of them have said that they have been waiting since 2003 for the federal government to take some sort of leadership on this issue. I am glad to have had the opportunity to be able to get it this far.
There are so many organizations that are watching this discussion tonight, including the Canadian Council of the Blind, the Canadian Association of Retired Persons, the Canadian Association of Optometrists, the Canadian Ophthalmological Society and Waterloo University, which is doing outstanding work in the area of eye care.
There is a lot of emphasis on what we are doing, and there is a lot of hope. The millions of people who are suffering from various categories of vision loss are counting on us tonight to send this bill off to committee so that the health committee can have a look at it. They are counting on us to ensure that it is not going to end up as just a whole lot of talk by elected officials, as happened before, with nothing delivered.
I think it is imperative that we move the bill over to the committee so that we can truly get some serious work done on something that is way overdue. We all know someone who is suffering from macular degeneration or blindness or various other eye diseases. I, for one, do not want to see them disappointed, and I know none of the members want to see them disappointed either.
The earlier we get the bill to committee and move it along there, the better. Listening to the excellent comments that were made tonight and the speeches from members, who all spoke so well, there is no need for me to reiterate anything. It has all been said.
The question becomes, what do we do with it? Do we waste another two weeks or so? I do not think we need to do that. Time is too valuable in the House. We only have three weeks left. If we could get the bill moved to committee this evening, we could get started doing that work. It would be a sign of hope and of sincerity from all of the members in this House.
I hope members will appreciate the urgency of the need to move the bill along. We do not have six months ahead of us; we have three weeks. It would really be a great bonus to all of those in the vision loss community if we could simply move it over with a voice vote and not have to waste another two weeks of House time, which is very valuable, especially at this particular time.
I thank all of my colleagues who spoke so very well. I appreciate their support. More importantly, the vision community appreciates their support immensely.
I look forward to our finishing off this discussion this evening.
Madam Speaker, I thank you for being the one who introduced this initially, and I thank you for all of your assistance in moving it forward, along with my other colleagues.
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- May/31/23 6:25:13 p.m.
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The question is on the motion.
If a member of a recognized party present in the House wishes that the motion be carried or carried on division or wishes to request a recorded division, I would invite them to rise and indicate it to the Chair.
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- May/31/23 6:25:48 p.m.
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Madam Speaker, I look forward to every member having the opportunity to support this bill and would request a recorded division.
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Pursuant to order made on Thursday, June 23, 2022, the division stands deferred until Wednesday, June 7, at the expiry of the time provided for Oral Questions.
The hon. parliamentary secretary to the government House leader.
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- May/31/23 6:26:12 p.m.
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Madam Speaker, I suspect if you were to canvass the House, you would find unanimous consent at this time to see the clock at 6:30 p.m. so that we can begin Government Orders with Bill C-35 at report stage.
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- May/31/23 6:26:22 p.m.
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Do we have unanimous consent to see the clock at 6:30 p.m.?
It is agreed.
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There is one motion in amendment standing on the Notice Paper for the report stage of Bill C-35. Motion No. 1 will be debated and voted upon.
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She said: Madam Speaker, I am going to start by reading what Melissa wrote to me: “I'm a healthcare worker who works long hours, currently have been trying to find childcare since I found out I was pregnant with no such luck. My son is 12 months July 1st, and I am set to return work July 4th, but no luck with childcare so not sure if I'm going to be able to return.” This is the reality of thousands of emails and messages I have read about Canadians struggling to access child care.
Tonight, we are here to discuss Bill C-35, or the universal child care plan, as the Liberals love to call it. In particular, we are speaking to the report put forth by the HUMA committee that studied this legislation. Conservatives are here, in particular, to ensure the voices of parents are heard.
This Liberal-NDP government loves to tell Canadians that it is feminist. In fact, the preamble of the bill specifically says “gender equality, on the rights of women and their economic participation and prosperity”. How does that help Melissa, the health care worker, in improving her rights, economic participation and prosperity when the choice to go to work is taken from her?
Erin Cullen, who speaks on behalf of ECEs and ABCs in Newfoundland and Labrador, said that there is no choice for families when it comes to child care because there is none available. Erin compared the $10-a-day child care slogan to the government telling people that they get free groceries, but when they go to the grocery store, there is nothing on the shelves.
The numbers tell the story. A report from the Canadian Centre for Policy Alternatives, or CCPA, highlights the child care crisis. Of nearly two million kids under the age of six eligible for the program, 950,000 are living in child care deserts. That means that there are at least three children competing for one spot. Ninety-two per cent of families in Saskatchewan are living in a child care desert. Seventy-nine per cent in Newfoundland and Labrador are living in a child care desert. Seventy-six per cent in Manitoba do not have access to child care. It is 64% in British Columbia. The numbers do not lie, and the reality is that these numbers are, in fact, real people, real families and real children who are being left behind.
There is nothing more stressful for a parent than finding quality, reliable, safe child care for their child. Affordability is important, but the reality is that this Liberal-NDP government is failing in all areas to deliver.
I will read some of the testimony we heard in committee about the outrageous wait lists. I asked Sheila Olan-MacLean:
Sheila, could you clarify those numbers you said earlier? I asked about wait-lists. You said that there were 300 per program, but there are 40 programs. That's 12,000. That seems outrageous when you only have 3,300 spaces.
Am I doing the math wrong?
Ms. Olan-MacLean replied, “When you think of a program that may have possibly 100 spaces, or less than 100 spaces, and it has 300 to 400 people—some have 600 people—on the wait-list, yes, that's probably pretty accurate.”
This is the reality of what families are experiencing, and it is destroying their mental health. The reality is that parents can expect years on wait-lists, and there is nothing in the bill to correct it.
The Conservatives put forth multiple amendments calling for choice, inclusivity, access, data and accountability, and members of the Liberal-NDP coalition voted them down. They say they care about access and inclusivity, but their actions speak louder on what they really care about, which is pushing an ideology that will decide what is best for people's children. They believe that the government should decide how people's children are cared for.
Members can listen to this story from Alberta, which was shared by Krystal Churcher, chair of the Association of Alberta Childcare Entrepreneurs, in committee. She said:
I have one child care operator in a rural, under-serviced area of Alberta who has proudly operated a high-quality day care centre for 17 years. She has invested in creating 194 child care spaces for her community. When [she was] asked how she felt [about the program, which is called] CWELCC...she said that she was excited for families to finally have access to more affordable child care and optimistic that it would bring relief to families sitting on wait-lists.
Yesterday she sent a letter to all of her 194 families in her centre, plus 563 families on her wait-list, to notify them that she was closing her centre. After 17 years of successful operation, the viability of her business is gone. With high inflation, fee caps and expansion restrictions on private centres, her centre is financially [blocked]. She has had to make the heartbreaking decision to close a business that she built, because she can't take the financial risk of signing a new lease or investing further into expanding her centre with the unknown of a cost control framework looming. She writes that she is worried that the $10-a-day goal will be at the cost of quality care for children.
These are the decisions facing operators on the ground right now, who are deciding to walk away from something they have proudly created because they can no longer carry the financial burden or because they simply can't agree with the reduced quality of care to bring the costs down.
Where is the gender parity in this story?
Krystal went on to say:
The bill was introduced without adequate consultation with all industry stakeholders and without respecting how the child care sector has evolved in provincial jurisdictions across the country. What we're seeing is a program that has created a demand without the infrastructure to support it, which is causing wait-lists, a two-tiered system and undue stress to families and operators. Women entrepreneurs are facing bankruptcy and closure of businesses that have now lost all their value. The system is, frankly, not equitably accessible and is failing to meet the promises to parents and families. Operators are asking what the real cost is of meeting this $10-a-day goal. Parents are losing choice; the quality of programming is at risk; educators are burned out; and women are losing their businesses.
The Liberal government is the first to tell us that it does not support two-tiered systems, yet this bill would do exactly that.
Ms. Maureen Farris, director of Strath-MacLean Child Care Centre, testified in committee and said:
As I've mentioned, there are so many children who sit on the wait-list and do not have a space, and there are operators who have chosen not to opt into CWELCC and can therefore provide or offer spaces to those families. Yes, that would absolutely create a two-tiered system. Families who could afford to pay for more expensive care would be able to do so, and families who can't may get substandard care, unfortunately.
Nothing addresses the labour shortage, frontline staff burnout and mass exodus from this profession. Again the Conservatives put forth an amendment to fix this, which stated that annual reporting must include “a national labour strategy to recruit and retain a qualified early childhood education workforce”, but, surprise, surprise, it was turned down by the coalition.
This bill is supposed to be composed of five pillars: quality, availability, affordability, accessibility and inclusiveness. However, yet again we have proof that the Liberals want to score political points and are more concerned with marketing a sellable plan than actually offering what it is they are selling. The Liberals moved a subamendment in committee that removed the words “availability” and “accessibility”, which are the biggest issues in child care in this country. Why? Why would they do this? The reality is that Bill C-35 is about as likely to help the child care crisis as it is to win the lottery, because that is exactly what the child care system in Canada is like. Getting a spot is like winning the lottery.
The heartbreaking messages shared in Facebook groups, in the media and to us as parliamentarians need to be heard and they need to be addressed. The Liberal government needs to stop promising what it cannot deliver. It has put the cart before the horse, and the reality is it has failed at affordability, the highest use of food banks. It has failed in accessing housing. Nobody can afford a house. It has also failed in public safety. Therefore, why would Canadians trust it with their children?
Conservatives will continue to fight for those left behind and will not stop fighting for freedom and choice for families to choose what is best for their children.
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moved:
That Bill C-35 be amended by deleting the short title.
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