44th Parl. 1st Sess.
October 20, 2023 10:00AM
Uqaqtittiji, before the Indian Act, first nations, Métis and Inuit thrived and passed on intergenerational love from generation to generation. The Indian Act is an attempt to erase indigenous peoples from the lands we now call Canada.
Bill C-38 is about status. It could have been about addressing discrimination to the fullest extent. I struggle to support Bill C-38, an act to amend the Indian Act. I am conflicted and disappointed to witness yet another form of incremental change proposed by the Liberal government.
As the Indian Act Sex Discrimination Working Group have clearly stated, the United Nations Declaration on the Rights of Indigenous Peoples says indigenous peoples have “the right not to be subjected to forced assimilation or destruction of their culture”. This bill does not meet this minimum standard. For decades, first nations have fought for their rights to be upheld. If Bill C-38 is passed as it is, discrimination against first nations women and their families will continue.
There are two reasons I support getting this bill to committee. Number one, while experts say it does not go far enough, this bill is needed, and number two, the failings of this bill to respect the rights of indigenous peoples will show, through public discourse at committee stage, that amendments are necessary.
Bill C-38 was tabled because of a court case, Nicholas v. Canada. It is not because the government is taking a proactive, co-operative approach to reconciliation. Introducing this bill is the minimum requirement set out in that case. After years of discrimination caused by enfranchisement in the Indian Act, 16 courageous plaintiffs sued the Canadian government in June 2021. They agreed to pause proceedings on the condition that legislation be introduced to address this inequity.
The Liberals' commitment to reconciliation with indigenous peoples is abysmal. If their commitment was real, Bill C-38 would be fulsome. It would have addressed all discriminatory provisions of the Indian Act. Incremental changes are not sufficient to ensure the advancement of indigenous peoples' rights.
I acknowledge that the Indian Act must be abolished. It is a complicated assimilative tool going back generations. The Liberal government has shown that it is not ready to abolish the act. Bill C-38, like previous court cases, makes amendments that are narrow in scope. Future court cases will be imminent if amendments are not made to this bill. Discrimination will be allowed to continue without the ability to seek reparations.
The Liberal government has shown that it is not ready to undertake the full-scale reconciliation needed to adhere to international law as the governing party. The following background will be the tip of an iceberg. All parliamentarians must commit to learning more about the Indian Act and how it continues to implement the genocide of indigenous peoples.
The Indian Act was established in 1867. John A. Macdonald understood the strength of first nations, Inuit and Métis as a threat to his causes. He had to find a way to weaken them. The Indian Act was the tool to continue the process of genocide against the first peoples who thrived on the lands we now call Canada. The Indian Act is a long-ago piece of legislation that was introduced in 1867. The act remains today.
Since its inception, the Indian Act has continued to deny equality for first nations. The Indian Act allows discrimination without justification. The Indian Act denies women status and therefore rights by gaining status. The Indian Act introduced residential schools, created reserves and imposed a band council system. The Indian Act also tells first nations who can have status and who cannot.
Before the creation of bands by this act, indigenous peoples had their own forms of governance. I am thankful for the strength of those who maintained their governance. I am thankful to Inuit elders. I am thankful to hereditary chiefs. I am thankful to the Wet'suwet'en. I am thankful to the Tseeweyhum family and the many others who keep indigenous legal orders alive.
The Canadian government has known about sex-based inequities in the Indian Act for decades. Bill C-31 in 1985, Bill C-3 in 2011 and Bill S-3 in 2017 have attempted to eliminate sex-based inequities. None of these bills worked to the fullest extent; what they did was complicate indigenous identity for some and not for others.
The Indian Act continues to divide indigenous peoples against each other. With each amendment, the Indian Act becomes more complex and confusing to navigate for indigenous peoples. Indeed, I am told by many how confusing it is to know if they have status, how to get status and if their children will be able to get it. They ask, “What are the implications of being removed?”
It is a shame that in 2020, the Minister of Indigenous Services tabled one of three reports after Bill S-3 to amend the Indian Act was passed. The final report made recommendations that are not being addressed in Bill C-38 by the Minister of Indigenous Services today.
As of 2020, there were over 12,000 applications for status still needing review. The special Bill S-3 processing units created in 2016, as of February 2023, have 1,770 files in progress and 3,990 files in the queue. The bill before us would do nothing to address this backlog. First nations are waiting up to 18 months for a decision by Indigenous Services Canada. This is unacceptable.
Bill C-38 would address enfranchisement, deregistration, loss of natal band membership and certain offensive language. These are long-awaited amendments that indigenous peoples have demanded for decades.
Enfranchisement is a particular genocidal policy and a clear example of Canada's attempts to assimilate indigenous peoples. Enfranchisement was either voluntary or involuntary. Women were enfranchised when they married a non-indigenous man between the years of 1869 and 1985. Other examples of enfranchisement included going to university, becoming a doctor or lawyer, working as a minister, seeking to vote and if one sought freedom from residential schools. Amendments introduced in 1985 attempted to remove enfranchisement. Obviously this did not work.
Bill C-38 would still discriminate against women and children who were involuntarily enfranchised. Descendants are unable to transmit entitlement to registration to the same extent as families that were never enfranchised. Those who were enfranchised as a band or collective have no entitlement to register under the Indian Act today.
I will now turn to deregistration, which provides for removing status from membership. There can be any number of reasons to deregister. These provisions would keep the safety of not impacting the children of those who may have deregistered.
The third component of Bill C-38 is on natal band membership. Bill C-38 would provide a legal mechanism to re-affiliate women to their natal bands. This amendment would serve to allow for membership to be reinstated on a band list based on specific conditions. It would address reinstatement of membership for a group of individuals who were originally prevented from being reinstated based on oversight.
Finally, the bill would amend outdated language, which is a small but important step. The offensive language regarding first nations peoples who require dependency on others would be amended. The offending definition of “mentally incompetent Indian” would be replaced with “dependent person”.
Bill C-38 would address these cases, and it is estimated it would impact around 4,000 people. Many more would remain discriminated against.
The Liberals had a chance to remove discrimination from the Indian Act once and for all. Bill C-15, on the United Nations Declaration on the Rights of Indigenous Peoples, became law in Canada. The Liberals had a chance to introduce that bill so that it would be in alignment with international law. Instead, they are introducing more piecemeal legislation. The past court challenges, Descheneaux v. Canada, McIvor v. Canada, and Matson v. Canada, make it clear. The Senate committee on aboriginal peoples makes it clear. The Indian Act Sex Discrimination Working Group makes it clear. So many more make it clear. The Liberal government's pattern of reluctant piecemeal changes in response to litigation is unjust.
There is no justification for Canada to ignore, and indeed infringe on, indigenous people's rights. Parliaments would debate again after the passage of Bill C-38 why it is not okay to keep disrespecting indigenous peoples and infringing on their rights.
Two other major issues not addressed are the second-generation cut-off and the ability to seek reparations. The second-generation cut-off in section 6(2) is not addressed in Bill C-38. This is shocking, given how much attention has been paid to this section in past works. In its Bill S-3 review, the ministry of Indigenous Services Canada reported on it. The Indian Act Sex Discrimination Working Group in its works reported on it. The Senate committee on indigenous peoples reported on it. They all recommended to remove provisions related to the second-generation cut-off.
If bands reject second-generation cut-off, it is because they are not being properly resourced by Indigenous Services Canada to meet the needs of their increasing membership.
Section 6(2) is sexist, and it is problematic. Who a child's mother is, is usually readily apparent. Who the father is, is not always apparent. Whether the father acknowledges his paternity, and this can be counted as the second-status parent for purposes of eligibility for status, is essentially his decision. The two-parent rule continues Canada's program of forced assimilation. Maintenance of the two-parent rule would fulfill the genocidal intention of the Indian Act, getting rid of “the Indian problem”.
Until this rule is amended, hundreds of thousands of indigenous people, mostly women and their descendants, will be discriminated against.
First nations children were robbed of their mothers. First nations children continue to be robbed of their mothers. The current child welfare system continues to separate indigenous peoples from each other. The Liberals say they will consult on second-generation cut-off. Consultation should not be necessary. Discrimination is discrimination. No amount of consultation will result in the justification of it. The government must interpret the rule of law as adhering to international human rights laws and the charter.
We are told by the Liberals that the public portion of this consultation will not begin until 2024. It will be much longer before legislation is drafted and presented before the House again. This tactic to delay is a denial of the rights of indigenous peoples. We should not have to wait for discriminatory provisions to be removed. There is no justification for discrimination to be allowed to continue.
Another form of oppression is preventing indigenous peoples from seeking reparations. Bill C-38 includes specific clauses that will not allow victims of these policies to seek reparation for the discrimination they have experienced. First nations women and children will continue to be harmed, yet they will not be able to seek reparations, even if discrimination is found.
In past bills, there were related provisions legislating that governments are not liable for harms done under the act. Persons are prevented from seeking claims against the government for discrimination caused by the implementation of the Indian Act.
These injustices remain in Bill C-38. According to human rights laws, Canadians are allowed to seek reparations. Why can first nations not do so?
Bill C-38 is a flawed proposal. While it addresses some injustices in the Indian Act, discrimination against first nations would continue. Bill C-38 continues the Liberal incremental approach to reconciliation.
The Liberals' interpretation of Nicholas v. Canada is about status. Bill C-38 must not just be about status; it must be about addressing discrimination and violations of basic human rights. It must be about reconciliation.
I ask this again: Why is it that when Canadians experience human rights violations, they are allowed to seek reparations, when first nations are not?
I hope that Bill C-38 can be salvaged. I hope that, at committee, we hear from experts explaining why improvements must be sought to ensure that first nations' rights are on par with Canadian human rights.
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Mr. Speaker, I know my hon. colleague from the NDP is very passionate about the issues she speaks of. I serve on the indigenous and northern affairs committee with her and I know that she is very serious about solving these issues.
She spent a fair amount of her time going to great lengths to explain the shortfalls of this bill. She talked about the second-generation cut-off and how much work has already been done on that.
As we have talked about today, since this bill was introduced, it has taken almost a year for us to actually get to debate on this. We have had a lot of time to initiate some of these changes.
With all those frustrations and concerns, has there been any attempt by her or her party to utilize these discussions to leverage their coalition agreement with the Liberals to actually include some of these indigenous issues in their agreement, to get some action?
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Uqaqtittiji, when it comes to the confidence and supply agreement, we have discussed, very clearly, what the conditions are. In terms of indigenous issues, we have been clear about what we need to do, so there would be no surprises.
I shadow the Minister of Indigenous Services, the Minister of Crown-Indigenous Relations and the Minister of Northern Affairs. I continue to work with the ministers that I shadow to make sure that we are going beyond what is said in the confidence and supply agreement, so that indigenous people's rights are being respected.
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Mr. Speaker, I thank my colleague from Nunavut for her speech. She too, like our colleague from Saint-Hyacinthe—Bagot, is very credible. She is very concerned and knowledgeable about the issue, to say the least.
Earlier, I was talking about consensus-building, which is not the federal government's role within first nations.
Since the beginning of this debate, we have been talking about the Indian Act, about reviewing it, improving it and making changes to it. Basically, my question to my colleague is this: Rather than talking about legislation, should we not start talking about agreements between the federal government and first nations?
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Uqaqtittiji, indeed, nation-to-nation conversations are absolutely important. When it comes to recognizing the right to self-determination and implementing the United Nations Declaration on the Rights of Indigenous Peoples, we must show through our actions what reconciliation actually means. That also means including the use of indigenous legal orders.
I hope that, through our conversations, we will continue to advance the importance of nation-to-nation relationships.
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Mr. Speaker, I thank my colleague for the wisdom and knowledge she has brought to the House on this issue.
Successive Liberal and Conservative governments have failed indigenous, Inuit and Métis people with their incremental approach to reconciliation. In fact, I still remember that the Conservatives under the Harper government said that the missing and murdered indigenous women and girls issue is an Indian issue. Here we are today with this bill, yet another bill with an incremental approach.
Can the member advise the House on what generational damages she sees for the people, the women and families on the ground as a result of Canada's colonial and incremental approach to ensuring indigenous rights are respected.
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Uqaqtittiji, being Inuk, I have grown up in a colonial system, and people do not understand that a lot of the time. All I have to say to better describe it is that my dad committed suicide. I was raised in the foster care system. I have too many families that I have to thank for helping raise me to be who I am.
The unfortunate truth about my story is that it is a common story of indigenous peoples. What I just shared is common to so many first nations, Métis and Inuit. With the ignorance we experienced from regular, mainstream Canadians, we had to start using terms such as “systemic racism” and “genocidal policies”. The terms help explain what the impacts are of these discriminatory policies, discriminatory lies and administrative tactics to not only steal our lands but continue to steal our time and oppress us.
I am so thankful to indigenous peoples who keep our culture alive and who keep our languages alive.
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Mr. Speaker, I must say, at this great distance, that I speak to you acknowledging that I am on the territory of the W̱SÁNEĆ peoples, who held this land on the southern Vancouver Island and the islands I represent, whom I have the honour to work with. I try constantly to remember that I am in a nation-to-nation relationship with five different first nations that are on this territory. Although, as the chiefs will always remind me, they are Indian Act nations and, in reality, we are villages within a much-larger nation of the W̱SÁNEĆ nation.
I am deeply honoured to share a working place with the member of Parliament for Nunavut, and I appreciate her voice and leadership more than she knows. I was so disappointed when I read Bill C-38. She confirmed for me my sense that this is so much less than what one should expect at this point.
I was the first member of Parliament, as far as I know, a number of years ago, to call for the repeal of the Indian Act in the House of Commons. I turned to my colleague at the time, Romeo Saganash, to tell him I was about to call for the repeal of the Indian Act. I asked him if he thought that was okay, because I had not consulted with a lot of first nations before I did that. He said that nobody asked them before they passed the legislation, so he thought it was okay.
We have a long road to go. It is not a slow road, and yet the steps being taken by the government are slow and often completely contradictory in terms of reconciliation.
I wanted to express my deep support and gratitude to the member and let her know that, where I can, I will do what she recommends on Bill C-38. It obviously needs—
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Unfortunately, I must interrupt the hon. member for Saanich—Gulf Islands. I need to allow time for the answer.
The hon. member for Nunavut.
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Uqaqtittiji, solidarity is so important, and in a party system, it is very hard to see solidarity. I do feel the sense of solidarity the member has shared with me, and I think we all need to talk about solidarity more often when it comes to discussing indigenous people's rights.
I started off my conversation about intergenerational love and how we lived with it since time immemorial. Since 1867, all the successive governments stripped us of our intergenerational love. We have shown that, through our strength and our willingness to understand that our culture is too important, it is for us to manage the wildlife and the environment. We are the right people to be the leaders in Canada.
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Mr. Speaker, as a Métis, an indigenous Canadian, I am happy and pleased to see this bill coming in. It has taken a long time.
However, I am concerned about the NDP-Liberals and how they have worked against indigenous people in many respects, such as with natural resources projects. There have been projects, such as northern gateway, that were approved and wanted by indigenous peoples. Why are the NDP and the Liberals working against indigenous peoples?
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Uqaqtittiji, when oppressed people have been led to poverty and have been suppressed for generations, the options they have become fewer.
The industry and the mining companies provide an option that looks attractive because governments are failing indigenous peoples. When indigenous peoples are saying they support it, it is because it is the only option left. I thank the Wet'suwet'en who continue to fight against the LNG project.
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Mr. Speaker, I really have appreciated hearing the debate in the House today. It draws our attention to the fact that this is a very complicated issue that we really need, in the House, to listen to far more than to debate amongst ourselves. I thank the last member for her speech on her concerns about the circumstances that our first nations and our indigenous peoples find themselves in.
Part of the challenge, I do believe, is that indigenous communities are multiple and they come from very different perspectives themselves. I have had conversations with young leaders in the indigenous community who say that their circumstances are so complicated. In their minds, it will take time. What they want to see is something that is really important. I will focus on just this one point and get into the bill more at the next opportunity I have to speak.
The bill would provide strides toward reconciliation and the reversal of discrimination and inequalities within the Indian Act, but it is only a milestone in a long journey of self-determination for first nations across Canada.. What I hear more than anything, over and over again, from indigenous individuals who want to see a good future for themselves and their families is that they do not want to be stakeholders in Canada. They want to be shareholders. I look forward to that day with them.
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Mr. Speaker, the bill before us seeks to establish a federal eye care policy.
The federal government fails at almost every one of its basic mandates, like having a half-decent foreign policy and a border that is not a firearms drive-through. I will not even mention passports. It is therefore not surprising for the government to try to change the channel by undertaking something outside of its jurisdiction. However, the Bloc Québécois, as always, will participate in good faith in the study of this bill. Even if it is hard to fathom what the federal government has to do with eye care, one cannot be against motherhood and apple pie.
Losing one's eyesight is a curse that affects too many of our constituents. Let us examine the issue together, look at what the government is doing—or rather not doing—and try to find ways to minimize the damage.
As an economist, I will start with some raw numbers. I know the Speaker will like that. Call it occupational conditioning.
It is important to remember the impact that these problems can have on everyday life. When a person experiences sensory loss, it compromises their safety and their relationship with the world. They lose their main connection with the world. That is not something that I would wish on anyone, even my worst enemy.
The population of Quebec is growing older and that is causing an increase in health care needs. The demand for care for eye conditions and diseases is no exception. In fact, there are already huge economic and financial costs associated with that. In 2019, Canadian society paid close to $9.5 billion in direct costs and $4.3 billion in productivity losses directly related to vision loss.
According to the Canadian Council of the Blind, these costs, particularly those related to vision loss in Canada, will only increase and could go from $32.9 billion in 2019 to $56 billion in 2050, which represents an increase of 70% in 30 years.
In addition to this growth in the demand for health care, which is expected to continue, the Canadian health care system has been institutionalizing a fiscal imbalance between the federal and provincial levels of governments since the 1990s. That was when major cuts were made to the Canada health and social transfer. In other words, Quebec has no authority to raise enough taxes to cover the growing costs of health care, while the federal government is collecting far too much considering the services it offers and their dismal quality.
The causes, as we know, are the so-called federal spending power, which allows the government to interfere in areas of provincial jurisdiction, along with inadequate intergovernmental transfers, the most problematic of them being the Canada health transfer.
According to the 2002 report of the commission on fiscal imbalance, this federal transfer not only applies to areas under provincial jurisdiction, it includes terms and conditions that unquestionably limit the provinces' decision-making and fiscal autonomy.
Unless and until health transfers become more generous and more flexible, Quebec's health care system will struggle to provide care to all Quebeckers who need it, including, of course, those having problems as a result of eye disease.
Bill C‑284 certainly is a step in the right direction. Overall, it does respect provincial jurisdictions. However, there is one exception, namely the first of the four pillars of the proposed national strategy, which interferes in an area of provincial jurisdiction. I believe that it is always important to remind the federal government that anything having to do with hospitals or clinical practice is the responsibility of the Government of Quebec and the other provincial governments.
Nevertheless, bringing in a federal strategy for eye care, especially when the time comes to play a role in funding research and approving drugs or devices, was more than necessary for advancing treatment in this field. That is why the Bloc Québécois will join the Canadian Ophthalmological Society and the Canadian Association of Optometrists in supporting Bill C‑284.
Eye disease will become an increasingly bigger problem over the years, as I mentioned earlier. We are pleased that a bill addressing the issue has been introduced to move forward on this important issue, although we will reiterate again and again that provincial jurisdictions must be respected.
Although we do support the bill, it would have been nice if it had been more ambitious, while still respecting provincial jurisdictions. No one can be against developing national strategies and designating certain months to raise awareness, as the bill plans to do with the month of February, but sooner or later, the Quebec health care system will need transfers.
Once this bill passes, it will be high time for the federal government to finally provide the health transfers that will allow for meaningful investments to make concrete improvements to eye care services in Quebec. For example, these transfers could make it possible to adapt online government resources or offer people enhanced coverage under the Quebec health insurance plan, RAMQ.
Quebec's department of health and social services is already doing a lot through RAMQ. Quebec has one of the best provincial eye care plans in Canada, but it costs money. Indeed, on March 9, Quebec increased its coverage for ocular prostheses, something that had not been done in at least 30 years.
The rest of the provinces offer eye care coverage that varies from government to government. The provinces have already done a great deal of work, but there is still a lot to do. Of course, that requires investment. All in all, we agree with the spirit of the bill, and we will ensure that future bills addressing eye care get more and more ambitious, especially when it comes to health transfers.
When examining this bill, the Bloc Québécois will obviously take the time necessary to ensure that provincial jurisdictions are respected, as I mentioned, and that the federal strategy complements what is already being done in Quebec. Doing no harm is the least the federal government can do.
The Bloc Québécois will always be there to support measures that will enable Quebec to take better care of its people. Let us remember that the road to hell is paved with good intentions, and the Liberal government has a lot of good intentions. We will simply ensure that the initiative, which is commendable overall, does not turn into yet another headache for those in Quebec who are actually taking care of our citizens.
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Mr. Speaker, I am very proud to rise on behalf of the New Democratic Party to talk about Bill C-284, an act to establish a national strategy for eye care. I want to thank my colleague, the member for Algoma—Manitoulin—Kapuskasing, who brought forward Motion No. 86 in a previous Parliament to make this a reality.
In 2003, the Government of Canada promised that we would have a national vision health plan. Twenty years have gone by, and nothing has been done. The issue of health and vision care is fundamental to quality of life.
I will say at the beginning that I have had bad eyes my whole life. I have had to wear glasses. When I realized I had a cataract, I was shocked. The effect it had on my ability to work was dramatic. I could not read reports. I was stunned at how quickly my vision deteriorated, yet in the midst of the height of the COVID crisis, I was able to get into a public hospital in Canada to get treated. My quality of life turned around immediately. I know it was much to the chagrin of Conservatives that I was back at work the next day, holding both the Conservatives and the Liberals to account.
Issues of health care and vision care are fundamental. We see that cataracts, for example, affect 3.5 million people. Age-related macular degeneration affects 1.5 million people, and glaucoma affects 294,000 people. Diabetic retinopathy affects 749,800 people. This is affecting people in Canada, so to have a strategy to make sure we are including vision care in the overall understanding of health care is very important.
Certainly at the heart of the New Democratic Party's vision of health care, from 1961 with Tommy Douglas, is the belief that we need head-to-toe health coverage for everyone in Canada. It is not just about quality of life; it is also about the impact on our economy. It is about those we love being able to live lives of dignity. Deloitte just put the cost at $33 billion in 2019, from a lack of proper eye care for people.
If it is diagnosed early and people have access to treatment, vision loss can be prevented in 75% of cases. How do we make sure that happens? It is about having timely access. It is about being able to go to an eye doctor. I mention this because in Ontario, the government of Doug Ford, the man who promised the people of Ontario that he would give them buck-a-beer, targeted eye care against seniors. As of September 1, once-a-year eye coverage that had been available has now been moved to once every 18 months. The Conservatives say that this is not a problem and that it is saving us some money, but here is the kicker: When someone is 84 years old, suddenly has a worsening eye condition and is told that they are not allowed follow-up eye coverage and will have to wait another 18 months to be seen, this is the difference between being able to see and going blind. However, Doug Ford said that seniors are no longer eligible for that care.
Adults with lazy eye are also no longer covered in Ontario. I talked about cataracts and having lived through the frightening impact of suffering a cataract. People are no longer eligible to have cataract surgery in the Ontario of Doug Ford unless they can prove that their condition would cause significantly decreased vision. It is up to the person who is not able to see to prove to the Conservative bureaucrats in Ontario that they are eligible and that they deserve cataract surgery.
Doug Ford also does not think retinal disease is an issue that should be looked after. Corneal disease is no longer a priority for Doug Ford. Optic pathway disease is no longer a priority for Doug Ford. In each case, the person must prove they are suffering significant impacts before they are eligible for treatment. Otherwise, they pay out of pocket. For people who cannot pay out of pocket, particularly in times of high inflation, the impact is the potential of going blind.
I think that any ordinary, decent human being would realize and agree that that is a real misuse of public trust, but then this also is the government that decided that, instead of favouring seniors with eye care, it would look after Mr. X in the Greenbelt.
Who was his other friend, the guy who calls himself the Phoenix Kiss? Is this like an episode of the Sopranos? Mr. Phoenix Kiss says, “Meet the fixer.” He really fixed Doug Ford, with this bogus transfer of public land so that insiders could make money. Then, of course, there were the gifts at Doug Ford's family wedding. There were developers showing up to give money.
Members do not want to stand up and defend Doug Ford? Okay, I will continue.
One could hear the music playing as if it were right out of The Godfather. That was criminal, corporate, Conservative culture to a T. Those are the same people who say, “You know, when we get into power we're going to do nothing for people except sell off a whole bunch of public buildings paid for by the taxpayer to our friends”. I wonder if Mr. Phoenix Kiss and Mr. X will be invited. Actually, Mr. X does know the member for Carleton who lives in the mansion at Stornoway.
I raise these issues because this is about issues of priority. In Ontario, senior citizens have a right and should be able to know that if they have problems with cataracts, or a degenerative visual disease for which they can get treatment, without regard to whether they are an insider developer who hangs out with the Ford family at their weddings. That is what public health care is about. Public health care is about the obligation of federal and provincial officials to put in policies that make sure that we develop the long-term benefits for the people of our country.
The New Democratic Party thinks this issue of a vision care strategy is really important. We are going to need to see, of course, some standards that we put in place to ensure that across Canada we are addressing the serious issues concerning lack of service for those who are suffering from visual impairment. For people who are blind, there is a real lack of services. We have seen in indigenous communities a lack of ability to access proper treatment, especially at a young age. When the inability of a child to see properly at a young age is identified, we are able to rectify problems that will affect their learning from the get-go. I certainly remember back in grade 3 when the nuns were yelling at me because I was heckling, it was also because I could not see the board. Then they gave me glasses and I became a much more focused heckler.
I know that my laser eye now has caused a lot of problems for both Liberals and Conservatives because I stay focused on the issues and it is not just the blur that it used to be. I can actually identify the differences between these parties and where they are both bloodily similar. That requires really good political eye progress.
I would stay all day talking about the issue of proper eye care coverage and the need for us to take responsibility on this issue, but I want to say that New Democrats support this bill. We think it is a good initiative. It is a bill that we have supported in the past. We supported it when it was sponsored by the member for Algoma—Manitoulin—Kapuskasing. We have waited 20 long years to have a national vision care strategy and we need to get it implemented.
We need to also start talking about a long-term path to providing public coverage for all forms of eye care. This kind of care is fundamental to the value and quality of life and it is fundamental to the value and quality of our society. We will certainly be supporting this bill.
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Mr. Speaker, I am thankful for the opportunity to speak to Bill C-284. I will only take a few minutes to express my support for it.
I want to congratulate the member for Humber River—Black Creek for bringing the bill forward. She has championed it at every stage. I know she has been here in the House to listen to the debate and has heard what members have had to say as it made its way through committee and back to us now for its final hour of debate.
I thought it would be important to point out some striking statistics that relate to the eye health of Canadians. In 2019, the year for which we have data, $38.2 billion was lost in the Canadian economy, 1.2 million Canadians were blind or partially sighted, eight million Canadians were at risk of blindness and 1,292 deaths were associated with vision loss.
About 75% of individuals can be prevented from going blind if diagnosed early. Unfortunately, we all take our eyesight for granted until it is often too late. Bill C-284 attempts to raise awareness of the impacts of vision loss and blindness, improve eye health care and support, and foster innovative research to advance new therapies for vision loss.
It is important to try to put ourselves in the shoes of others. A close friend of mine, whom of course I will not name as I do not want to embarrass him, is slowly starting to lose his vision as a result of a genetic problem with his eyes. He is an individual who works in a technical field that requires him to always look at what he is doing and use his hands, sometimes on very small instruments. I think quite often about what will happen when he gets to the point his father did and he does not have the vision he requires to do his job.
Let us for a second think of the impact that has on people, not just from an economic perspective, because obviously they would be at a disadvantage, but also from the perspective of how it affects them psychologically. Having a strategy for how we will address issues like this, how we will support Canadians like this and how we can do more research and education around strategies related to the vision of individuals and the deterioration of it is incredibly important.
I want to again congratulate the member for Humber River—Black Creek for bringing forward this very important piece of legislation. I express my support for it and have heard around the House of others who support it. I really hope it will pass and make its way over to the Senate, where it can be adopted and then become law.
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Mr. Speaker, I rise today to speak on an important matter, the future of eye care in Canada, Bill C-284, which was presented by the hon. member for Humber River—Black Creek and addresses a matter of national concern and would ensure Canadians have access to a coordinated and comprehensive eye care response.
I thank the member opposite for bringing this bill forward. I am happy we have had some productive discussions over its content. One of my first concerns when I heard about the bill was the possible overreaching of power between the federal and the provincial government, because this does end up in the hands of health care, which is the responsibility of provinces, but I am so glad this bill would not do this. It is more about collaboration and what we can do to make sure we have national eye care and health for all Canadians.
I am surprised by one of the statistics I found, which is that 75% of Canadians have some type of vision loss or eye impediment. I am a prime example; I wear glasses. It is no surprise that a lot of us, as we get a bit more mature, start having eye difficulties. The other side of this is the fact there are a lot of diseases, such as macular degeneration, which are very hard to deal with. Any time one has loss of vision, it becomes quite incapacitating.
I will go off topic a little. I was at a conference a couple of years ago, and one of the guest speakers was a motivational speaker. He was a thalidomide baby and was born without arms. He said that every time he went to a classroom, the first question people always asked was how he lived without arms and whether he missed them. He would reply that he never had them so never missed them.
For most Canadians, it is the exact opposite when it comes to eyesight. Most of us are born with healthy eyesight and we take for granted the fact that we have good eyesight and we never think about losing it. We do not wake up and say, “Wow, I can see this morning.” It is not until one has a disease or injury and loses their eyesight, or until one has an impediment to their eyesight, that people think about it.
I think it is very important we bring recognition to this. We also want to make sure there is a good strategy in place for Canadians and that we do not go after any vulnerable or marginalized communities. We need to ensure every Canadian, regardless of their social or economic background, has equal access to quality eye care. One's eyesight is very important. It is the number one sense that people are most afraid of losing. However, like I say, every day we take it for granted.
My grandfather had macular degeneration, and he told me an interesting story. He was not fully blind, but he was legally blind, and he could still see out of the corners of his eyes. He was legally blind and hard of hearing in his early 90s, and he said it made for a very long day. He still lived on a farm and he looked forward to cutting the grass in the summer, but he would cut the grass every day. I asked him how he saw to cut the grass, and he said that he could still see out of the corners of his eyes. He figured that if he cut it every day, he would cut every piece of grass at least once in a week, because he did not think he would miss the exact same piece of grass seven days in a row. This was something he did to keep his mind active and keep busy throughout the whole summer. This was one of the things he lived for. Unfortunately, he passed away a number of years ago, but that is life. At least he tried to live his life as best as he could with the impairment he had.
The big challenge when one has an eye impacted, whether it is through disease or injury, is to try to make the best of the situation. It is so easy to get down and ask what we can do now and think that because we cannot see then we cannot do anything. However, as we have seen through many different types of programs for Canadians, such as service dogs for the blind, Canadians can lead a functioning life.
We know that on every street corner, there are beepers to make sure they know when to cross the street. There are many things we try to do, but the main thing is hoping that Canadians do not have to go through this type of situation of losing their vision. A very important thing about this situation is that we want to make sure Canadians have a great eye care service.
Something else I found out are the studies on exposure to blue light. One might think, “What is a blue light?” Every one of us looks at our cell phone at least once or twice a day, or we look at computer screens. This is actually starting to have an impact on our vision. It is quite a horrible thing, when we start thinking that it could cause earlier macular degeneration in our children or our young adults. We need to start looking at what kinds of opportunities there are so we do not have these kinds of things affecting our eyesight.
For myself, the glasses I have right now do have a blue light filter on them so that it is not as hard for me to look at computer screens. People are already starting to use technology in place to offset some of the things that are affecting our eyesight.
I have to admit that, even growing up, I was one of those people who probably did not take care of my eyes as well as I could have, because, being on a farm, it is quite easy to be in dusty conditions. When someone is using a grinder and not using goggles, they might even get a bit of a grinding file in their eyes. I have experienced a few horrible situations, yet one does not think about it and how it could impact one's life later on. As with any injury, all of the issues that could potentially happen seem to materialize the most later in one's life.
The thing with vision loss is that it is not just about how it impedes a person's life. It is also about their abilities, their mental health and the social integration and productivity they have. I talked about how one can have service dogs for the blind. Someone can have a cane to monitor where they are, but we want to make sure that people do not get to that stage. That is the one thing about this whole bill: making sure we have a structure in place between national and provincial jurisdictions to make sure that Canadians are taken care of the best they can be.
I did talk a little bit about how modern technology, such as the blue light filter, can help with eyesight, but there is also laser eye surgery. I know that the first time I heard about this, I was quite young, and I was wondering why anyone would want to cut the cornea of their eye to shape it so that they do not have to wear glasses. However, if someone wore glasses with very thick lenses, it was actually quite liberating to not have a heavy pair of glasses on their eyes. People were always concerned, wondering whether the scar tissue would be as strong as the original skin cells themselves. I think, as time has progressed, laser surgery has really materialized into a safe procedure.
Another thing is cataracts. People did not think about them. In the past, cataracts would go across one's eyes, basically like wax paper, and there was not much that could be done. Now, however, not only can doctors reverse that process, but they can also actually, when the lens is changed, get people back to 20/20 eyesight.
There are a lot of technologies out there that are helping with eye research and how it can advance Canadians, to make sure that they do not lose their vision. Technology is one of the biggest ways through which I am hoping we can solve a lot of our problems around the world, but more so with eye care, so it is very important that we have brought this forward.
In many cases, we can talk about how good technology is. At the same time, there are always limitations. One of the limitations I learned about regarding macular degeneration is that there is some new technology that was proposed that it is still in the final testing phases with Health Canada. How can that be rectified? I think, bureaucratically, there are some opportunities that need to be looked at so we can address that. That is something we need to start looking forward to. What kind of new technologies are out there that can save our vision?
I think it is very good that the member did bring this bill forward. Hopefully, we can actually get a better case for our health care for our eyes, and in the future, work collaboratively with the Government of Canada as well as with all the provinces.
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Mr. Speaker, it is not easy to speak after everyone else. I will be repeating things that others have already said. At least it shows that we are sometimes capable of sharing the same vision and seeing eye to eye—no pun intended.
Every time a bill introduced in the House of Commons has any direct or indirect bearing on health, we are forced to point out that health is the jurisdiction of Quebec and the provinces and that Quebec already has a number of programs specifically addressing eye health. My colleague from Terrebonne discussed this matter at length just now. I will use different words, but essentially, we are saying the same thing. Naturally, there is always room for improvement.
All we can do is once again point out that the funding from Ottawa is not meeting the needs and that the health care transfer agreement that was signed in March 2023 was very far from meeting the real needs of our health care systems. That is an obvious sign that the provinces were forced to sign the transfer agreement. The federal government twisted their arm to get them to sign it. It is so easy for the federal government to achieve its ends, given the ongoing fiscal imbalance between the federal government and the provinces. That is exactly what my colleague from Terrebonne was saying.
I would like to remind the House of certain facts. This is too good an opportunity to pass up. Ottawa offered only one-sixth of what the provinces were calling for, or $46.2 billion over 10 years. In Quebec, three ministers pointed out that the federal funding was far below what Quebeckers expected.
Let us not forget that the federal government continues to withhold Quebec's share of the $25 billion that it had promised in the bilateral health agreements. Again, instead of sending that money to Quebec, which already knows its needs in health, the federal government is withholding the money to try to impose its priorities. I want to take advantage of the time I have left to call on the federal government to sign an agreement with Quebec that recognizes asymmetrical federalism and respects Quebec's jurisdictions.
That being said, I will come back to Bill C‑284, which seeks to raise public awareness of eye disease and its treatment, as well as prevention, in order to improve health outcomes for Canadians. The Bloc Québécois voted in favour of the bill at second reading and we will also vote to pass the bill at third reading. Amendments were made that confirm our position.
In its initial version, the bill called for the Canadian strategy to impose clinical practice guidelines on the provinces. Here again, the federal government wants to lecture us and argues that it can do better. However, it is the professional associations that govern these professions, and they fall under provincial jurisdiction. In Quebec, the Ordre des optométristes du Québec was established under the province's professional code and the Optometry Act. In addition to regulating the profession, the order ensures the quality, practice and continuing education of its members. It stands to reason that clinical practice guidelines cannot be imposed by the federal government. The government acknowledged its mistake and removed that aspect from the bill, thus limiting its jurisdictional encroachments.
The fact remains that item (a) of the content of the strategy remains an irritant, because, as mentioned, training and guidance do not fall under its jurisdiction. I would remind the House of the wording of item (a):
(a) identify the needs of health care professionals for training and guidance on the prevention and treatment of eye disease [including clinical practice guidelines].
This is another attempt to intrude. The training of health care professionals is a matter for Quebec and the provinces. Despite that, and since the term “identify” is not prescriptive and the bill contains some good elements, such as improving the examination of drugs and devices related to eye disease, as well as developing research, we will vote in favour of the bill.
I would like to highlight an important beneficial element of the bill. Point (b) of the eye care strategy mentions promoting research. Quebec is actively involved in ophthalmology research through its universities and hospital network. For example, the Vision Health Research Network, which brings together the Maisonneuve‑Rosemont hospital research centre, the Université de Montréal hospital research centre, as well as seven Quebec universities and several integrated health and social services centres, conducts basic, evaluative and clinical research on eye health.
I am pleased to hear that the strategy will aim to enhance research ecosystems and that Quebec will be able to contribute its talents to tomorrow's advances in eye health, because research is definitely expensive.
In his speech, my colleague from Mirabel talked about how important eye health is. According to the statistics that he quoted from 2019, 1.2 million Canadians suffer from diseases that could lead to vision loss, and 4.1% of those people could become blind. He also pointed out that eight million Canadians suffer from an eye disease that may lead to blindness, and that, for some of these diseases, blindness is preventable. What is more, the health care costs related to these diseases can reach up to $9.5 billion. Let us not forget the social and human costs, either. I could once again talk about the importance of increasing health transfers, but my colleague from Terrebonne gave such a good speech about that and I already spoke about it briefly.
The federal government has a role to play in funding research and approving drugs and devices, for instance. The bill is now generally more respectful of the jurisdiction of Quebec and the provinces.
I salute my colleague from Humber River—Black Creek and congratulate her on her bill, because eye care is never a priority. Because it is never a priority, people lose their eyesight. Highlighting this neglected health issue is a major part of this bill and is part of the reason it is so relevant. We have to keep talking about it. As my Conservative colleague mentioned earlier, we live in the screen age. In Quebec, a coalition of experts that created an initiative called Pause Your Screen explains the following on its website:
Prolonged screen use can cause dry eyes (because we blink five times less when looking at a screen), eye strain, blurred vision, headaches, burning, itchy eyes as well as a loss of attention or focus. In the long term, screen use can lead to ocular dryness, fluctuating vision, and photophobia (extreme sensitivity to light), cause or aggravate eye coordination problems, and foster the progression of near-sightedness.
That is a serious problem.
We will now turn our attention to pollution and its effects on eye health. I like to make the necessary connections between pollution and health. A 2021 study reported that researchers had conducted a large-scale project to better understand the development of eye diseases. They found that air pollution can have serious consequences for eye health, especially in terms of age-related macular degeneration. The study was published in the British Journal of Ophthalmology. With tens of thousands of study subjects, it showed that people with higher exposure to air pollution presented higher rates of age-related macular degeneration. We know that air pollution has a significant impact on health. This is yet another reason to reduce CO2 levels and transition to renewable energy sources as quickly as possible.
The bill also designates February as age-related macular degeneration awareness month. That is the name of the disease. As the population ages, the frequency of this disease will increase. Now, we also know that high levels of air pollution will also increase the frequency of this disease.
I will close by saying that if some people remain blind to environmental problems and pollution, then there is a good chance that they will go blind from the CO2 pollution in the air.
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- Oct/20/23 2:11:08 p.m.
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The hon. member for Humber River—Black Creek for her right of reply.
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Mr. Speaker, it is an exciting day for me, as the presenter for this bill. From the beginning, I dedicated this bill to my grandmother, who was blind when she passed away; to my aunt, who had macular degeneration and was blind when she passed away a few weeks ago; and to my mentor, Paul Valenti. All suffered from blindness through various diseases.
As we celebrate October as Vision Month and Children's Vision Month, I am honoured that I got our bill moved forward this fast, even though it seemed like ages to me. However, at least it moved forward and is here at the last hour. I want to thank my fellow MPs for their support, especially the member for South Okanagan—West Kootenay; the member for Scarborough North; and the Assistant Deputy Speaker, the member for Algoma—Manitoulin—Kapuskasing. All were very helpful in helping to trade up the system that we work in, in order to get this moved forward with their additional support. I also want to thank the Hon. Don Boudria, a former colleague whom we all know and a good friend to many of us in the House, for his continued support and invaluable advice at each stage of this bill as to how one gets a private member's bill through the system faster than the regular system.
I thank the countless organizations that have been calling for an eye strategy for Canada since 2003, including the Canadian Council of the Blind and Michael Bergeron, Dr. Keith Gordon and Jim Tokos; Fighting Blindness Canada and Dr. Marie Simonese; the CNIB and Thomas Simpson; Canadian Association of Optometrists and Laura Laurin and François Couillard; the Canadian Ophthalmological Society and Dr. Phil Hooper; and the University of Waterloo, with Dr. Stan Woo. There were so many who were helpful in moving this forward.
Members have heard from many of my colleagues that probably one in five Canadians has an eye disease, and some of them are unaware of that. A big part of what I want the eye strategy to do is to raise that awareness of how important one's eyes are. There are many children under 18 and seniors over 65 who are still not getting eye exams. By the time they get an eye exam, especially for a senior, they may quite possibly have developed glaucoma, retinopathy or many of these other eye diseases.
Seventy-five per cent of eye diseases are preventable, but in order to prevent them, people have to know they have the problem. We all neglect it, me included, usually until it is too late. We have an aging population. The pandemic also delayed paying attention to what was happening among a lot of people.
I am pleased to see that we have gotten this far on the bill. I look forward to working with the Senate as soon as possible. The Senate is very aware that the bill is coming, and senators have been asking when the bill would finally get through the House. I will now turn my time and effort over to working with the Senate to get it through as quickly as possible.
Canada has waited for a long time. The vision community has been waiting for years for us to live up to a commitment that not only our government but also other governments have made. We have made a commitment to the United Nations as well that we would have an eye strategy. As a result of the upcoming vote, hopefully this coming Wednesday, we will get a vote from the House of Commons and move the bill off to finalize the work in the Senate.
Again, I thank all my colleagues for their encouragement and support. I look forward to next Wednesday, having this vote here in the House and really moving it forward. I thank everyone who is here in the House very much.
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