Hon. Marc Gold (Government Representative in the Senate): Honourable senators, I have the honour to table, in both official languages, a Charter Statement prepared by the Minister of Justice in relation to Bill C-32, An Act to implement certain provisions of the fall economic statement tabled in Parliament on November 3, 2022 and certain provisions of the budget tabled in Parliament on April 7, 2022, pursuant to the Department of Justice Act, R.S.C. 1985, c. J-2, sbs. 4.2(1).

Hon. Ratna Omidvar, Chair of the Standing Senate Committee on Social Affairs, Science and Technology, presented the following report:

Thursday, November 24, 2022

The Standing Senate Committee on Social Affairs, Science and Technology has the honour to present its

TENTH REPORT

Your committee, to which was referred Bill S-246, An Act respecting Lebanese Heritage Month, has, in obedience to the order of reference of November 3, 2022, examined the said bill and now reports the same without amendment.

Respectfully submitted,

RATNA OMIDVAR

Chair

Hon. Stan Kutcher: Honourable senators, I rise today to speak in support of Bill S-248, introduced by Senator Wallin in this chamber, a bill that would allow for the provision of advance requests for medical assistance in dying, or MAID, for competent persons who wish to avail themselves of this method of asserting their end-of-life choice.

I will not repeat the well-researched and clearly presented information provided by Senator Wallin on what we know about Canadians’ opinions regarding advance requests or her discussion about Audrey’s Amendment and the details of this bill. I will focus my remarks on a number of key items that I hope will be considered at the committee that studies this important legislation. Before I do that, I want to echo two key points that Senator Wallin addressed in her speech.

First, it is clear that this bill amends the Criminal Code to allow for advance requests. It is permissive, not prescriptive. There is nothing in this bill that compels or directs any person to seek MAID using an advance request.

Second, this bill does not promote MAID as an alternative to palliative care or a remedy for access to needed services and supports. As Senator Wallin put it, “MAID is not an alternative to poverty or treatment or support or family.” I agree with both of these considerations.

That said, let me begin my contribution to this debate by considering what an advance request for MAID is and, equally important, what an advance request for MAID is not.

We can think of an advance request for MAID as a request made by a competent person, for MAID, in advance of a loss of decision-making capacity, to be acted upon under the circumstances outlined in the request after the requester’s loss of decision-making capacity, following the requirements set out in federal legislation.

This consideration has a number of key components that can assist us in thinking critically and compassionately about advance requests for MAID. It can help identify areas that need careful attention as safeguards and standards are constructed to help manage the application of advance requests.

I will focus on four areas:

First, an advance request is not a directive. MAID providers are not obliged to provide MAID simply in response to a request. They must still follow their professional guidelines, best judgment and all legal stipulations in responding to an advance request. Thus, the request itself must be clear, specific and stipulate the conditions under which it is to be considered by the MAID provider.

Second, the request must be made by a competent person, and as such, a clinically and legally defensible determination of competence should accompany an advance request.

Third, the advance request must be made voluntarily and be well considered. That means that the request cannot be the result of undue influence or coercion and that the person making the advance request has demonstrated that they have considered relevant information prior to them making the request.

Fourth, the request has been made in due consideration of the impact of the passage of time. It should be regularly updated so that the MAID provider has reasonable comfort that the request is current.

Before going into these four areas in more detail, I will address what an advance request is not and consider what some kinds of conditions are that we may expect that advanced requests would be made for.

An advance request is different than an advance directive. Advance directives already exist, are well established and are common in many different aspects of medical care. Senator Mégie raised this important issue in a question to Senator Wallin.

While an advance request for the federal regime for MAID would be governed by the Criminal Code, advance directives are governed by provincial/territorial regimes for other types of health care. Most frequently, they are given in the context of a choice or refusal of treatment.

For a personal example, when my elderly mother began to experience numerous and compounding health challenges, my brothers and I had many very emotionally problematic conversations with her about what kinds of treatments she would accept and what kinds of treatments she would not accept. These were difficult.

We wrote down her decisions and we all signed off on them. We made sure that we provided evidence of her cognitive capacity at the time of our discussions. We also all came to an agreement on substitute decision making. When the time came — and it did — we provided her medical team with her directives. They followed them.

I am certain that for many in this chamber, this is a situation not unknown to you. It can be very uncomfortable because it deals with the reality of the upcoming death of a loved one. But it is supposed to be uncomfortable because if it were not so, we would not be loving and caring people.

The same discomfort should and does arise in all of our discussions about MAID. Discomfort is a necessary part of this journey.

Advance directives can include preferences for treatment and stipulations for refusal of treatment. As such, they are logical extensions of the doctrine of informed consent for treatment and refusal of treatment.

They can range widely, from accepting palliative sedation while concurrently not accepting antibiotic treatment for a potentially life-ending infection to directing a “do not resuscitate” order, to refusing all foods and fluids administered via a feeding tube or by mouth, known as voluntarily stopping eating and drinking, or VSED, which usually — and we’ve lived through this — results in death in 7 to 10 days.

Thus, while an advance request for MAID is not the same thing as an advance directive, these different concepts share the acceptance of personal autonomy as it pertains to advance decision making, and we are underpinned by the doctrine of informed consent and the right to choose and refuse treatment, even if that choice results in or hastens death.

While it is anticipated that most advance requests will be made in the context of neurodegenerative diseases such as Alzheimer’s disease, other kinds of illnesses may also trigger an advance request. For example, a primary brain tumour, such as glioblastoma multiforme. GBM, as it is known in the medical community, is the most invasive type of brain tumour and is not curable.

People diagnosed with GBM typically live 10 to 22 months from the time of diagnosis. While most people are cognitively intact when diagnosed, decision-making capacity can decline very rapidly. End-stage GBM can include severe headaches, inability to swallow, delirium, hallucinations, delusions, loss of control over bodily functions, seizures and loss of consciousness. Knowing this reality, an individual may consider making an advance request for MAID at the time of diagnosis.

The challenge that this condition illustrates is that it is not possible to predict with any degree of certainty how long a period of decision-making competency will be in place before the changes — which can occur rapidly — happen, leading to an inability to consent to MAID even if that is the person’s end‑of‑life choice.

Incidentally, this uncertainty can lead to a person deciding to access MAID before they want to, a situation that is horribly unsatisfactory, to say the least.

Let us now return to the four points that I made arising from the definition of an advance request.

First, the issue of clarity, so that everyone, including the MAID provider, is certain about what the wishes of the competent person making the request are. It’s the wishes of the competent person.

Here, in my opinion, it is necessary to ensure that the request is made in written form and is specific to what the individual making the request considers to be their threshold that will trigger a MAID request. The request should provide as much information as possible for others to be able to clearly understand the conditions under which MAID can be administered.

Statements such as “when I am no longer able to enjoy life” or “when I am not able to make my own decisions” or “when I can no longer recognize my family” should not be put forward as situations for MAID consideration. Specificity is needed. For example:

I would like to receive MAID under the following conditions, even if I am not in pain and regardless of what others think about how my life is going: if I can no longer recognize any member of my family at any time of their visits for a period of two months; OR if I can no longer toilet myself for a period of one month; OR if I do not know where I am, what day it is and what month of the year it is, daily, for a period of one month.

What is important to stress here is that these conditions are specific and are what the individual considers to be intolerable to them. They will vary from person to person and are not conditions that a third party decides.

Furthermore, if the individual is willing, family members and others can participate in the discussions as to what conditions the individual considers to be the threshold for MAID when the advance request is being developed. With such specificity, fulfilling the advance request for MAID becomes clearer for the patient, clinician and family members alike.

My second consideration was that the request be made by a competent person, and, as such, a clinically and legally defensible determination of competence should accompany an advanced request. This means that the advanced request for MAID should include an assessment of competency provided by a qualified clinician, and a note describing the assessment and its results should be signed, dated and affixed to the written advance request. For example, a clinical interview plus a mini-mental state examination could be considered to fulfill this condition.

That safeguard is useful to avoid later questions as to whether the person making the advanced request was or was not competent to do so at the time the advanced request was made.

Third, the advance request must be made voluntarily and be well considered. That means the request cannot be the result of coercion, and the person making the advance request has demonstrated they have considered relevant information prior to making their request. This issue may be addressed in the legislation or it may be addressed in clinical guidelines that need to be developed to assist patients, their families, clinicians and MAID assessors.

In my own professional experience in conducting numerous patient decision-making assessments, the issue of clarifying that there is no undue coercion is always part of how such assessments are done. If the clinician is not certain about coercion, the usual practice is to seek a second opinion from a colleague. If there continues to be uncertainty, further investigation may be required to clarify the situation.

Perhaps this is the issue that Senator Batters was trying to address with her questions to Senator Wallin about two independent witnesses whose purpose was to confirm that the advanced request was made voluntarily.

Senator Klyne: Honourable senators, I rise to speak to the inquiry commenced by Senator Harder on December 2, 2021, regarding the future of the Royal Canadian Mounted Police. It’s an important discussion, and, by many accounts, one that is long overdue. I hope it’s a discussion that leads to a clear and realistic picture of our RCMP and a bright future for the organization.

The RCMP is the most unique police force in the world. It’s our national police force; it’s our federal police force; and in some jurisdictions, it’s the provincial or territorial police force, or the municipal police. It is also an international police force through its involvement in INTERPOL.

Depot Division, the RCMP Academy, is considered one of the most elite police training academies in the world. From 1885 to 1920, Depot was the headquarters of the North-West Mounted Police and then the Royal Northwest Mounted Police. Not only has every member of our national police been trained at Depot since the inception of the North-West Mounted Police in 1873, Depot has also trained police and investigators of many stripes from around the world.

Mounties in their dress uniform are collectively one of the most recognized symbols in the world, dressed in the red serge, Stetson hats, Strathcona boots with spurs and midnight blue stirrup overalls with a yellow stripe down the legs. Like Canada’s multiculturalism, two official languages, the maple leaf, our Parliament buildings, maple syrup and the Rockies, the RCMP is a symbol of national identity.

We also know that those who serve in our national police force act with courage every time they put on the uniform, sometimes making the ultimate sacrifice in the line of duty. Last month, the death of Constable Shaelyn Yang in Burnaby, B.C., was a tragic reminder.

Suffice it to say the RCMP has an important place in our country’s complex history and in our national culture, as well as in keeping us safe. However, there are concerns with our RCMP. There are questions about its mandate, its focus and its conviction to uphold the RCMP’s core values. All of this lends itself to a question around the RCMP work environment, the influence of systemic racism, numerous cases of failure to adhere to proper protocols and decades of physical and sexual harassment, not to mention the difficulty in recruiting applicants and cadets. These concerns give rise to an overarching question centring on the culture and organizational structure of the RCMP and whether the organization’s mandate and core values will support its desired strategic direction and goals.

The RCMP must also demonstrate that it will proceed with values and actions of reconciliation with Indigenous peoples, with an acknowledgement and understanding of the truth of Canada’s history. I fully believe that this undertaking is not a quantum leap. The time has come to take a closer look at the issues that have been plaguing the RCMP for many years while building on its best attributes. That’s what I will be speaking to today.

The problems with the RCMP are well documented. As Senator Harder noted last year in his speech, the RCMP was the subject of a heart-wrenching report in 2020 by the Honourable Michel Bastarache, a former justice of the Supreme Court of Canada. The report was titled Broken Lives, Broken Dreams, and it was written following Justice Bastarache’s review of more than 3,000 claims of sexual harassment and sexual assault submitted by female RCMP staff members under the Merlo Davidson Settlement Agreement. The results of his report were clear. It revealed toxic behaviour within the ranks of the police force and a broken culture that has permeated every level of its ranks. The problems were clear, systemic and irrefutable, and they continue to trouble the RCMP to this day.

Compensation was given to 2,304 women following the settlement of the Merlo Davidson class action lawsuit. More than $125 million was paid out to female RCMP staff members who suffered gender-based abuse, harassment and discrimination.

The need for transformation lingers. Just this past June, another report was issued by three former federal judges following the settlement of the Tiller lawsuit, filed on behalf of women who worked in a close capacity with the RCMP and who had suffered abuse. In this case, 417 women were awarded close to $20 million in damages for behaviour they were subjected to by RCMP staff members.

To give you a sense of the severity of the problem, I’d like to share a quote from Justice Bastarache’s report which says:

 . . . the culture of the RCMP is toxic and tolerates misogyny and homophobia at all ranks and in all provinces and territories. This culture does not reflect the stated values of the RCMP, and it is found throughout the organization. RCMP members and officers are forced to accept that they must function in the context of this culture to succeed. RCMP employees appear to blame the “bad apples” without recognizing the systemic and internal origins of this conduct.

Colleagues, the inability to address serious systemic issues must be addressed. This matter needs action, and the Senate is in a good position to assist on the issues that Justice Bastarache identified. It’s not enough for the federal government to acknowledge the report and move on. To be clear, like many others, I want the RCMP to be the pride of Canada and I want other countries to be inspired by our national police force. This will require deep, transformational change — perhaps radical surgery — without losing the patient on the operating table.

As senators, we are in a strong position to help bring about that change. We should use that position to consider a review of the role and mandate of the RCMP, as suggested by Senator Harder’s inquiry. Furthermore, to take that to another level, we can influence the creation of a positive, clear and realistic picture of the RCMP’s future and contribute to resetting the RCMP’s strategic direction, its mission, its vision and its culture and organizational structure and review and reaffirm its renewed core values of June 2022.

Despite the serious work that needs to be done, I want to highlight some of the positive contributions that the RCMP has made to Canada. Their presence in the Prairies is important, and my province of Saskatchewan has a long and celebrated history with the organization. I’ve seen it first-hand as the chief executive officer of the RCMP Heritage Centre, which is under consideration for national museum status, a proposal I strongly support.

The RCMP Heritage Centre is a magnificent building that is an incredible museum, exhibiting the long and storied history of the RCMP. The site tells the story of the organization’s contribution to Canadian history and the development of Canada. It’s a time capsule, and when you see people visiting the museum, it becomes clear just how much pride and regard Canadians have for the organization and how international visitors are inspired by the storied Mounties.

One of the great privileges of my life has been attending graduation ceremonies for RCMP candidates who have completed the training and are ready to become RCMP officers. Seeing the emotional reactions of parents, friends and family members as they watch graduates in the dress uniform that symbolizes the RCMP and all it stands for being sworn in to uphold their duties is something I’ll never forget. Even more moving and unforgettable at a graduation ceremony is an active or retired member of the force presenting a badge to their adult‑age son or daughter. Those ceremonies always remind me of the importance of this historic institution. It’s a ceremony that I’m sure emphasizes the honour and responsibility being bestowed upon the graduate.

The RCMP Heritage Centre has also embarked on the path of reconciliation, collaborating with Indigenous leaders, elders and educators to build its truth and reconciliation strategy. The organization is committed to helping answer the Truth and Reconciliation Commission’s Calls to Action as well as the Calls for Justice of the National Inquiry into Missing and Murdered Indigenous Women and Girls — with specific calls identified for the Centre’s focus from both guiding reports.

The RCMP Heritage Centre is also working with Depot Division to develop specialized Indigenous-led cultural teaching and education for cadets about the communities where they will be posted. This is promising.

Unfortunately, not all members of the RCMP have lived up to the RCMP’s core values, honour and code of conduct. This leads me back to my main point: The time is now for transformational change. My belief, like Senator Harder’s, is that we should take what we have learned from previous studies and testimony and help set our national police force on a new path: a path that acknowledges, honours and respects its legacy — the good, the bad and the difficult; a path that restores the RCMP pride and reputation for being a national police force that operates with the utmost level of honour and respect for everyone — a police force that acts with integrity, shows respect, demonstrates compassion, takes responsibility and serves with excellence; a path in which Canadians’ pride is unwavering and other countries are inspired.

I’m encouraged by the federal government taking some important steps. They’ve introduced Bill C-20, which, if passed, would establish a public complaints and review commission to replace the insufficient Civilian Review and Complaints Commission. This bill follows the 2021 report by the House Standing Committee on Public Safety and National Security entitled Systemic Racism in Policing in Canada. An enhanced independent review and complaints body is one important step toward restoring public confidence in the RCMP. It’s a good place to start, but more work needs to be done.

I know that the RCMP can become the paragon of excellence in policing. Of that, I have no doubt. There really is a solid foundation to build upon, and much off-balance-sheet equity in the symbol. However, as time marches by without transformational change, that off-balance-sheet equity diminishes.

I urge colleagues to support Senator Harder’s suggestion to create a special Senate committee to study the future of the RCMP. This committee would be an important tool in helping to address past injustices and assist the RCMP in making a much‑needed transformational change and better define its role in a 21st century Canada. We could draw from this chamber’s experience and expertise in many relevant subjects, including law enforcement. As well, many of the legislators in this chamber have direct experience in making transformational change and collaborating with other leaders. I know that this is a challenging subject and would not be an easy task, but “hard” or “easy” has nothing to do with it.

I’d like to close with a recent and unforgettable moment for the RCMP on the world stage. As we all know, on September 8, Queen Elizabeth II passed away. Her death was mourned around the world. In the days that followed, tributes, memories and stories were shared, all celebrating the life of a remarkable woman and renowned monarch. Millions — perhaps billions — of people witnessed the state funeral.

For many Canadians watching from home, one moment stood out: As the funeral procession began, it was led by the Royal Canadian Mounted Police — Canada’s national police — in their dress uniform, mounted on their magnificent black steeds. In that moment, I believe Canada swelled with pride. That moment of pride represents everything the RCMP is, but it is not all that it can be. I hope we have the courage to help guide it back to a new path.

Thank you, hiy kitatamihin.

Senator Batters: Thank you very much for mentioning in your speech the RCMP Heritage Centre in our hometown of Regina. A year ago, during the last election campaign, the federal government promised to make that centre a national museum. That is something I know you briefly mentioned in your speech. I wonder if you have any update on how that is proceeding. Certainly, that’s something that should be happening. The promise was made a year ago, and we would like to see it happen as soon as possible.

The Hon. the Speaker: Is leave granted, honourable senators?

The Hon. the Speaker informed the Senate that a message had been received from the House of Commons with Bill C-228, An Act to amend the Bankruptcy and Insolvency Act, the Companies’ Creditors Arrangement Act and the Pension Benefits Standards Act, 1985.

(Bill read first time.)

(Pursuant to the order adopted by the Senate on December 7, 2021, to receive a Minister of the Crown, the Honourable Patty Hajdu, P.C., M.P., Minister of Indigenous Services and Minister responsible for the Federal Economic Development Agency for Northern Ontario, appeared before honourable senators during Question Period.)

Senator Plett: Well, minister your government reaffirms its commitment to reconciliation, and I think we can both agree that ensuring clean tap water for every First Nation is a very crucial part of achieving just that. Yet your government’s verbal affirmations contradict its failure to meet the 2021 deadline. I appreciate what you are saying about your commitments, but these commitments don’t seem to take effect. Has your government now put a firm deadline on its commitment to end these drinking water advisories? If so, when is it? I’m sure that most chiefs and councils would be happy to assist you in getting this done.

I can also tell you that the government is confident that we have enough money to be able to complete this work, and that the money is there and accessible as we continue this work.

I believe — in fact, I am profoundly certain — that no community wants to be, as the honourable senator has said, under a boil water advisory. However, I will also reflect on the comments of leaders who have said that they do not want to prematurely lift boil water advisories — in fact, the chief in Neskantaga told me this just a couple of days ago — if they don’t have confidence that the system will continue to deliver water. It is because of the lack of confidence that their community members have.

This is an exercise in true self-determination, working with communities at the speed that they determine, which is why it makes it difficult to set another deadline.

Hon. Marie-Françoise Mégie: Welcome to the Senate, minister.

As I’m sure you know, diabetes has a significant and disproportionate impact on Indigenous and Inuit communities. Currently, access to continuous glucose monitoring systems is limited under the Non-Insured Health Benefits program for First Nations and Inuit in Canada.

Given the current drug benefit list, when will you be able to change your policy to make sure Indigenous children get the care and services they need to effectively treat and prevent diabetes?

Hon. Patty Hajdu, P.C., M.P., Minister of Indigenous Services and Minister responsible for the Federal Economic Development Agency for Northern Ontario: Thank you, senator. That is a very important question.

[English]

It is actually related to the previous question, which is about flipping from treatment — often very expensive treatment — to prevention. I see those glucose monitors you’re speaking of as an important prevention tool to help people control their diabetes and get better outcomes that reduce the need for more extreme interventions.

I had an Indigenous pharmacist actually teach me about this type of glucose monitor. So I’m working now with the department to understand how we can add that type of glucose monitor to the formulary so that more Indigenous people can have access to that particular tool. That will, indeed, eventually alleviate costs on the treatment of severe diabetes and diabetes‑related complications.

Hon. Paula Simons: Minister, Call to Action 11 from the Truth and Reconciliation Commission report calls for adequate federal funding support for Indigenous students seeking a post-secondary education, but according to the Canadian Alliance of Student Associations, only 19% of about 25,000 eligible Indigenous learners received funding from the Post-Secondary Student Support Program each year.

Can you tell us what your government is planning to do to increase funding for Indigenous students? Can you also tell us whether you would be open to expanding the terms of the ISET Program — the Indigenous Skills and Employment Training Program — so it is less strictly tied to labour market outcomes?

Hon. Patty Hajdu, P.C., M.P., Minister of Indigenous Services and Minister responsible for the Federal Economic Development Agency for Northern Ontario: Thank you very much.

I was proud to be the minister of the former Department of Employment, Workforce Development and Labour when the ISET Program received a historic increase — 58% more funding and a 10-year commitment — that allows adult education and ISET’s programs, which is Indigenous secondary education training programs, to have a longer runway to help people achieve their education and training goals.

I’m interested to hear more about the flexibilities the honourable member is talking about, and she can certainly share them with the current minister under whose portfolio that falls.

In terms of the shortfall for post-secondary education supports, our government has taken historic measures to make post‑secondary education more affordable. Often, First Nations and Indigenous students still have barriers to attending because of lives, quite frankly, that include poverty. That makes going to school and staying in school very challenging.

So I share her ambition around increasing access to post‑secondary education for First Nations students. I think every student who has the capacity, an acceptance letter and an ability to attend post-secondary should have a smooth passage to those studies and that training. Not only is that good for the individual, but it is good for communities. It certainly is good for Canada. We need every ounce of talent as we face these enormous challenges together.

So I will be focused on working with my colleagues, the Minister of Finance and others, to ensure that the department has better capacity.

Hon. Brian Francis: Hello, Minister Hajdu.

Last week in The Globe and Mail, Tanya Talaga reported that last September, an Ontario regional pharmacist for the First Nations and Inuit Health Branch, which is a part of Indigenous Services Canada, sent a memo asking nursing staff to save expired children’s pain and fever medication due to ongoing shortages.

Not only is there no evidence of a similar directive being made in other jurisdictions, but Health Canada has advised against doing so since safety and effectiveness are not guaranteed. This is yet another unacceptable example of First Nations children being provided with a different standard of care than their peers.

Could you confirm whether the directive to stockpile expired medication for First Nations children remains in effect in Ontario or elsewhere? Could you also tell us what percentage of the foreign supply of medication recently secured by Canada will be allocated to Indigenous children, including those in rural and northern communities, where the need is greater?

Hon. Patty Hajdu, P.C., M.P., Minister of Indigenous Services and Minister responsible for the Federal Economic Development Agency for Northern Ontario: Thank you very much, senator. I asked that question myself of the department when I read Ms. Talaga’s report.

I will start by first reassuring people that we do not have a shortage of children’s medication in First Nations. It’s very important that we understand that is not the case, and that community health centres not only have children’s pain medication in stock, but we also have many of the compounds needed should we get to a place where we need to compound those medications, obviously with professionals at hand.

In terms of the report, what I understood from the department’s briefing to me was that the information that Ms. Talaga had was incorrect. There was that directive by other provincial health authorities to save medications that were out of date for potential use. Again, we are not there by any stretch of the imagination, and I am glad for that. We have a very sophisticated team at the First Nations and Inuit Health Branch that regularly monitors medication shortages and works closely with the Public Health Agency of Canada, Health Canada and provincial partners to make sure that we will have the supplies we need.

As of today, we are certain we do.

Hon. Dennis Glen Patterson: Thank you, and welcome, minister.

I believe you are aware that in the community of Pangnirtung in Nunavut, there are active cases of tuberculosis, or TB; there are 35 active and 126 latent cases that could become active. A lack of screening facilities means the accurate number could be much higher.

We know that a study published by the Canadian Medical Association found that Nunavut Inuit transferred to Ottawa from my home region have a 25% higher chance of dying after surgery due to what the authors note as systemic barriers in accessing timely and culturally appropriate care.

However, federal monies granted through ICPC — the Inuit‑Crown Partnership Committee — meant to aid in the screening and treatment of TB are not being spent due to a dispute between NTI — Nunavut Tunngavik Inc. — and the Government of Nunavut.

Are you willing to take direct action, minister — this is your money — to ensure the money that was allocated to eliminate TB in Inuit Nunangat is spent?

Hon. Patty Hajdu, P.C., M.P., Minister of Indigenous Services and Minister responsible for the Federal Economic Development Agency for Northern Ontario: Thank you very much. It’s an excellent question.

I have been taking direct action. In fact, all summer and into this fall, I’ve been speaking with both parties. I’m pleased to say that they have signed their letter of agreement on how to move forward. That is a very positive step.

But I will also say that you’re right: The Government of Canada has invested millions of dollars to combat and treat tuberculosis. Obviously, on the medical side, we do need provincial and territorial partners to do that work, in large part because they are the health care delivery providers.

But in addition to that, in Budget 2022, the historic investment of $845 million for Inuit housing allows us to build on some of the progress we have made. There still is a gap. It’s important when we are talking about tuberculosis that we don’t forget about the social determinants of health like housing and access to things like education and information that is culturally appropriate and in languages that people can understand.

We’ll continue to work with our partners to deliver these funds and the supports that are needed so that this extremely urgent work can get done.

[Translation]

Hon. Patty Hajdu, P.C., M.P., Minister of Indigenous Services and Minister responsible for the Federal Economic Development Agency for Northern Ontario: Thank you very much. I’m pleased to hear this question because, in fact, it was one of the first pieces of work I did as a minister for this government, launching the National Inquiry into Missing and Murdered Indigenous Women and Girls. I will note that there are senators in this room who were very active in that work as well.

Of course, it is difficult work. It is a multi-sectoral work. We need partners at the municipal level, the provincial level and the federal level.

The federal government, I often say, is very good at giving money. We don’t necessarily know exactly what to do. Communities do, municipalities do, provinces do, and I see our role as an enabling partner.

We certainly do now have a national action plan that, as I said, partners have fed into. That is a plan for how we get to this place together. There are billions of dollars committed and invested. The national action plan is also what is considered an evergreen document, so it will be updated as we learn more, as we see what works and what doesn’t work.

I will say, it is also something that the work that we’re doing on housing, on homelessness, on supports for Indigenous people in urban settings is critically attached to. Just a few weeks ago, I was in Manitoba, announcing funding for a women’s shelter to be able to have core permanent funding and additional space, dignified space, for Indigenous women who find themselves engaged in the streets, in violent situations, in risky situations. I spoke to some of the women in the shelter.

The federal government is increasingly becoming a very strong partner with municipalities, organizations, Indigenous-led organizations, friendship centres. It’s an all-hands-on-deck piece of work, and I’m honoured to be able to do that with partners.

Hon. Donald Neil Plett (Leader of the Opposition): Minister, as a senator from Manitoba, let me thank you for what you have done in helping that women’s shelter. As you know, you and I were on a flight coming back from Winnipeg the day that you came back from there, so thank you.

Minister, in the spring of this year, the Parliamentary Budget Officer published a report which analyzed the government’s expenditures and results for Indigenous peoples through the creation of a second department. The report found the government was failing Indigenous peoples in a multitude of ways, noting a significant increase in expenditures, which is estimated to be several billions of dollars, and a “significant decline” in the results for Indigenous communities. The report concluded, “All organizations examined performed poorly in their ability to consistently maintain a target and date to achieve it . . . .”

Minister, how do you justify another report that your government is spending more and achieving less? In the six months since the report was tabled, what concrete steps have you taken to reroute the bulk of these expenditures from the Ottawa bureaucracy to Indigenous peoples directly?