Mr. Speaker, I have a lot to say on this issue.
We are talking about Bill C-2 today, safe injection sites, and I want to start with what the bill should be about.
I think the bill should be about saving lives. It should be about reducing disease. It should be about reducing harm. It should be about public health and also public safety.
When we talk about what a bill should be about, quite frankly, very often it is up to the government to decide, and we take our cues from it; however, in this case, the bill is actually a response to a Supreme Court of Canada decision. Therefore, we know ahead of time what the bill should be about because we can look at the Supreme Court decision and the language in it and know what the bill should be about. However, in looking at the bill, we see it is all wrong. It is not a proper response to the Supreme Court of Canada case.
As members probably know, this Supreme Court of Canada case is about a situation in Vancouver around InSite, which is a supervised safe injection site. This facility receives an exemption from section 56 of the Controlled Drugs and Substances Act.
We had a challenge here, and the Supreme Court of Canada was unequivocal in what it said about InSite, which is a model for other safe injection sites. I will read some of the quotes on this case, because they will tell us what Bill should be about. It is fascinating what the court said.
The court did rule that the minister's decision to close InSite violated its patrons' charter rights and that the minister's decision was “...arbitrary, undermining the very purposes of the CDSA, which include public health and safety.”
It is arbitrary, and I will argue in a few minutes that the proposed legislation is an arbitrary response.
Further in the case, the court said that
|| The infringement at stake is serious; it threatens the health, indeed the lives, of the claimants and others like them. The grave consequences that might result from a lapse in the current constitutional exemption for InSite cannot be ignored. These claimants would be cast back into the application process they have tried and failed at, and made to await the Minister’s decision based on a reconsideration of the same facts.
The court talks about this threatening the health and lives of the claimants, so we are talking about health here. We are talking about section 7 rights, which are that everybody has the right to “life, liberty and security of person and the right not to be deprived thereof”.
The court actually sets out who has the onus of responsibility here in proving a case. The court said:
||...the Minister must exercise that discretion within the constraints imposed by the law and the Charter, aiming to strike the appropriate balance between achieving public health and public safety. In accordance with the Charter, the Minister must consider whether denying an exemption would cause deprivations of life and security of the person that are not in accordance with the principles of fundamental justice.
The court continues a little further on,
|| Where, as here, a supervised injection site will decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety, the Minister should generally grant an exemption.
I stress “should”. This is not “may”; it is not permissive language. The court has been very forceful here in saying “should generally grant an exemption”.
However, with the bill before us, the onus is actually being reversed.
The courts have said that it will decrease the risk of death and that there is little or no evidence of a negative impact on public safety. However, what do we have before us? We have a bill that would actually force communities to prove the benefits. It would force communities into an extensive application to prove what the benefits would be, what the impacts would be on the community.
It is actually reversing that onus, when the courts have been very clear that there is no evidence to show that safe-injection sites would have a negative impact on public safety. This bill would force communities to come up with scientific evidence demonstrating that there is a medical benefit. Come on; we know there is a medical benefit. There would be a letter of opinion from the ministers responsible, information about infectious diseases and overdoses, a description of the available drug treatment services, a description of the potential impact of a site on public safety, and the list goes on.
This is not an appropriate response, because this bill should be about health. It should be about preventing death. It should be about preventing the spread of disease.
I believe that a bill like this would actually stymie the process. There is one safe injection site in Canada right now, InSite, but if community members believe that their community needs a safe injection site, they should be able to open one, because harm reduction works and the evidence shows that. Therefore, I want to talk about how this bill, in creating these barriers and these obstacles to harm reduction and the obstacles and barriers to saving lives, could potentially impact a community like Halifax.
Halifax does not have a safe injection site, but I would say that the people of Halifax robustly embrace the concept of harm reduction. We have many different harm reduction facilities of different forms in our community, including a needle exchange, housing first principles, a mobile street health outreach bus, and a travelling methadone clinic. Halifax understands harm reduction.
We do not have a safe injection site and there are no plans for one. However, on the heels of this case there was quite a bit of media discussion about whether Halifax would have a safe injection site and about how this court case would allow that to happen. There are no plans for a program in Nova Scotia, but after the Supreme Court of Canada decision, the chief medical officer came forward and said he was happy to hear the Supreme Court of Canada's decision. In The Chronicle Herald at the time, he said:
|| We're very pleased with this because it leaves the option open down the road. If it's warranted then it's certainly something we may consider in the future.
This is from Dr. Robert Strang. Our chief medical officer has said that the decision was a wise one, and it made him happy to think that we may be able to have a site like this, if needed, in Nova Scotia.
Then what is the problem? Why do we have this reaction in the form of Bill ? Why is it that the Conservatives have brought forward this bill that would actually circumscribe or limit communities' abilities to take action and enact this kind of harm reduction in their community?
Well, at the same time that Bill C-2 came out, we saw a really interesting little fundraising campaign by the Conservative Party of Canada called “keep heroin out of our backyards”. I have the website right here, and under “keep heroin out of our backyards”, it says, “Add your name if you demand a say before a supervised drug consumption site is opened close to your family”.
That, on its face, seems as though it might be reasonable, but then we read further into this campaign and we realize it is all about not just raising money for the Conservative Party but also about fearmongering:
|| Do you want a supervised drug consumption site in your community? These are facilities where drug addicts get to shoot up heroin and other illicit drugs.
|| I don't want one anywhere near my home.
Parenthetically, Mr. Speaker, we are not talking about putting them beside our homes.
|| Yet, as I write this, special interests are trying to open up these supervised drug consumption sites in cities and towns across Canada—over the objections of local residents and law enforcement.
In parenthesis, I ask, “Really? What objections? Where are they being opened? Where is it that communities are rising up against this? There are no proposals for any of them.
It says, “...as I write this, special interests are trying to open up these [facilities].” Is it a special interest to want to keep Canadians alive? I do not think that is a special interest.
I will keep going:
|| We've had enough—that's why I'm pleased that the [we know who he is] government is acting to put the safety of our communities first.
If members could see this website, they would see that it shows an empty syringe on the sidewalk, instilling fear in all of us.
I biked up to my community office on Monday last week when we were home for our riding week. What did I find in front of my office on the sidewalk? I found an empty syringe. I got some gloves and picked it up. A few doors down is the North End Community Health Centre. It has a sharps disposal container. I dropped it off there.
It is real. The idea that people are using intravenous drugs on our streets is real.
What I actually think is the threat to public safety here is not safe injection sites but the fact that people who have addictions, who may be homeless, who may be struggling with a myriad of other issues, have nowhere to go that is safe and supervised.
I talked to the people at Metro Non-Profit Housing Association, which is down the street from my office. They talk about finding needles in their bathrooms. Why is that? It is because that is where people can go. It is safe and warm, or the safest they can get, and it is warm and private. They can close the door and do their drugs there. Is that appropriate? I think that is more of a threat to safety than safe injection sites.
Behind my office there is a needle drop, a sharps container, that a local community group put in place for people who are doing drugs. It is kind of a dark alley. Stuff goes on there, and we need to acknowledge what is happening in our communities. What happened is that people actually broke into the box to get the needles. That is not harm reduction. Actually creating a supply of dirty needles for people to break into and share is not harm reduction. However, that is the reality of what is happening in our communities.
There was a local cafe maybe four doors down from my office that closed a couple of years ago. It had to put a sharps container in the bathroom. I think having needles in my local cafe is more of a threat to my safety than a safe injection site where the activity is supervised and the needles are clean and disposed of properly. I would much rather have a safe injection site beside my office than know that there are dirty needles behind my office that people are reusing.
This is about safety. This is about public health, and I want to get back to public health for a second, because nowhere in the bill is there even a mention of public health. I find that shocking.
When we are talking about health and what this bill should be about, which is saving lives and stopping the spread of disease, we have stats; we have real, hard evidence from InSite. The rate of overdose deaths in East Vancouver has dropped by 35% since InSite opened. That is pretty good evidence. Something is working.
Harm reduction works. A study over a one-year period showed there had been no fatalities from those injections. In one year, over 2,100 referrals were made to InSite users to addiction counselling or other support services. There is no referral service behind my office.
People who used InSite services at least once a week were 1.7 times more likely to enrol in a detox program than those who visited infrequently and probably a heck of a lot more likely to enrol than the folks behind my office.
There was a significant drop in the number of discarded syringes, injection-related litter, and people injecting in the streets one year after InSite opened.
Injection drug users who use InSite are 70% less likely to share needles. That is a staggering number. Reducing needle sharing has been listed as an international best practice to reduce the rate of HIV and AIDS.
InSite users are more likely to seek medical care through the site. This means fewer trips to the emergency room and an improvement of health outcomes.
There was a pretty big sigh there as I was reading the evidence. The evidence should speak for itself, but it is not, because we have Bill in front of us to actually make it harder for people and communities to have this kind of success story in their community.
It is all about evidence. Evidence shows that harm reduction, like safe injection, works, and I am really proud of the harm reduction initiatives in my community.
We have Mainline Needle Exchange, where folks can actually get clean needles and maybe get referred to some services.
We have Direction 180, which is a methadone clinic. It has recently had huge success buying a mobile bus to get to some of the communities that are not in the north end of Halifax and to ensure people get their methadone. These folks are trying to deal with their addictions. They are trying to better themselves. We need to have these harm reduction programs in place for them so they can succeed. What is the alternative? Death?
We have MOSH, or Mobile Outreach Street Health, which is a van that goes around to where people are, such as under bridges, in fields and at the homeless shelters, to give them the medical treatment they need.
This is what we need, but unfortunately the government is not interested in harm reduction. I have a good quote from Cindy MacIsaac who runs Direction 180, our methadone clinic. She said:
|| Ottawa’s new approach is to criminalize what should still be seen as a health issue...You can’t even use the term harm reduction anymore when applying for federal funding. The taps have been turned off.
This bill is all about creating fear. It is not about health or about helping people get better. Bill is a bill about power, power to the minister and disempowerment to the most vulnerable members of our society.
There is a more powerful argument against the bill. That is the voices of members of my community and communities across the country that recognize the value of safe injection sites as a harm reduction program. They want the ability to set up similar sites where needed.
Safe injection sites are one way we can help save lives, treat people who suffer from a disease, help people reorient their lives, improve the quality of life for community members and make our cities safer for everyone. We need less barriers to programs like the ones this bill would create. The government is getting in the way of caring for those people who need the most help.
I want to emphasize that addiction is not a choice. It is a disease, and those who suffer from it should be treated with the dignity and the respect we give to other people suffering from chronic illness. When we speak about safe injection sites or harm reduction programs, there is very often a human element that gets left behind in these debates. I want to ensure that we talk about that human element in the House. People who suffer from addiction are also suffering from the stigma and discrimination that follow the disease. This bill lacks the understanding of this human element. It makes it more difficult for safe injection sites to be established in our communities and for individuals battling addiction to receive compassionate care.
When I was getting ready to speak to the bill, I spoke to people at the Brunswick Street Mission and the Mainline Needle Exchange. They said that the people who needed help in my community were increasingly younger people living in shelters, that they were inadequately housed and suffered from severe health issues, including mental health issues and mental illness. The problems face people who suffer from addictions cannot be isolated from housing, health, poverty, education, or addiction. They are all inseparable problems that can overwhelm anyone.
Safe injection sites are an important part of dealing with these issues holistically. At InSite in Vancouver, it is not just a program about drugs. Safe injection sites are about helping people through providing a safe space, peer support services, and health services. Unfortunately, this bill does not look at the whole picture. It makes safe injection sites harder to establish across the country and makes it harder for our community to want to tackle these and other connected issues.
With no safe injection sites and no safe spaces for people fighting addiction, we are pushing those people to the very margins of society, which exacerbates poverty, homelessness, and health and safety issues for our communities.
Mr. Speaker, I have a few thoughts to share with members on Bill . We could start by asking about the message of the Conservatives with regard to drug usage, on Bill C-2, and what ultimate impression they are trying to give Canadians.
The Conservatives do not believe in facts and science, and they are more concerned about how they can portray the image of being the party that is tough on all aspects of crime. Whether it is justified or not is completely irrelevant.
Bill somewhat exemplifies why the government is so focused on things that are not necessarily in the best interests of Canadians but rather on sending a very strong message, which is ultimately, I would argue, to the detriment of all Canadians. First I would emphasize my disappointment with the , who is responsible for the public health and well-being of Canadians, for bringing forward legislation that will not put our individuals or communities in a healthier position going forward.
The disappoints me most because Canadians from coast to coast to coast are concerned about health care, and she is doing nothing to come up with a provincial agreement for a health care accord that expires in 2014. This is an issue about which people across this land are concerned. We love and care about our health care services, and the Conservatives have completely ignored it. They have not even met with ministers to discuss it. This issue touches each and every one of us in a very real and tangible way, and the Conservatives choose not to deal with it. They want to focus on their message, whether it is in the best interests of Canadians or not.
The should be ashamed of herself for bringing forward a bill such as this, while ignoring an issue that is of critical importance to each and every Canadian across this land. We challenge the Minister of Health to reflect upon the damage she is proposing by introducing Bill . She should get to work on the health care accord, which is a very important issue.
Therein lies the difference between a Liberal government and a Conservative-Reform government. We believe in working with the different stakeholders. When the injection site was put in place in British Columbia, the Liberal administration in Ottawa worked closely with the different stakeholders. The Liberals expressed interest in helping communities in which discarded needles, pipes, and other paraphernalia were left lying on our streets. We expressed interest in how we could help to deal with the lives that were being destroyed, the suicides that were being committed, and the heroin overdoses and so forth.
It was not the Liberal administration alone doing that. The police force, the British Columbia government, and many other stakeholders expressed concern. They all came to the table and came to an agreement that having InSite would help; it would make the community a healthier place.
The national Liberal government did not make that determination alone. We recognized and worked with the other stakeholders, and the key is that we did work with the other stakeholders. Through that work we were able to support InSite, which has been very successful. We only have to look at it.
The has not even visited the site in question, from what I understand. Why? If she visits the place and starts talking to the staff, she might actually find that it is working. She could talk to the local Vancouver police, whom I understand are in support of it. The minister does not want to talk about the evidence.
The does not want to understand the true value of having this safe injection site because it does not fit the ideological agenda that the Conservatives want to espouse. They do not let the facts or science deter them from doing the wrong thing. This is most unfortunate. One would think that the would have gone to the site and worked with, or at least talked to, people to find out what they actually had to say about it. From what I understand, that is not the case.
When we look at the local leadership, the province supports it and the police support it, and many different health care professionals recognize the benefits and support it. We can look at the users who need the site and support it.
We can talk about the facts, about how individuals' lives have been saved. We could go to the community to see different facilities, community centres, schools, or back lanes, and we would find that those areas are healthier environments as a direct result of it.
These are the types of things that are important for us to recognize. However, the Conservative Reform government does not recognize that because it does not fit its political agenda.
We know how much it relies on that political agenda. Within hours of the minister introducing the bill, the Conservatives started a fundraising campaign. They said that the Liberals and New Democrats want to have injection houses throughout Canada, implying that they would go into all these different communities and that the only way to prevent that was to donate money to the Conservative Party.
The Conservatives are using Bill as a fundraising tool. Here we have a newly minted being manipulated and used as a fundraising tool, when in fact she should be dealing with the issues that Canadians truly want her to deal with.
An hon. member: Get a life over there.
Mr. Speaker, I am pleased to speak to the bill, but I think this is a sorry debate. This debate is clearly demonstrating that ideology conflicts with the facts.
Bill before us would amend the Controlled Drugs and Substances Act, which would prevent groups from setting up supervised injection sites and offering those services across the country.
I would like to talk about this issue in relation to what is currently going on in Quebec. I have here with me a report by the Agence de la santé et des services sociaux de Montréal. Quebec began addressing this issue over 13 years ago. For more than 13 years, health and social services professionals have been working on this, studying the issue, conducting pilot projects and consulting agencies to see how Quebec may or may not want to integrate services such as supervised injection sites. Quebec has been working hard on this and I am sure other parts of the country have as well.
In 2000, at the request of the department of health and social services, Quebec formed a cocaine addicts intervention committee. The committee's mandate was to come up with strategies to improve the quality of life of cocaine addicts. One year later, the committee recommended setting up a pilot project. As you can see, these consultations started quite some time ago.
In 2003, the same department mandated the Agence de la santé et des services sociaux de Montréal to conduct a feasibility study for setting up injection sites. The advisory committee made two proposals: first, a pilot project to create a drop-in centre and social integration services for injection drug users; and, second, consider adding a supervised injection site to existing services.
Experiments and consultations followed. It would be a shame if all this work of the past 13 years became increasingly difficult or was even tossed aside because of a bill that came out of nowhere and is based on Conservative ideology.
Institutions such as the Institut national de santé publique du Québec or the Coalition réduction des méfaits, which is made up of 32 community organizations, are involved in the process. The process takes into account expert opinions and what is happening in Quebec and the City of Montreal.
This is not a situation where you can barge in and do something on an impulse or because it is what a voter base is suggesting. This is serious. Here is how it works: there is a consultation and pilot projects are set up. That is a very important step. I think the Conservatives' approach should be modelled on this sort of process, which takes facts and expert opinions into account, shows compassion and reflects the differences in the communities affected.
This very important step could become obsolete, meaning that it could end up being pointless. The Conservatives' bill is undermining 13 years of consultations and meaningful work. It is unfortunate, and it is not something we should accept.
Le Devoir recently published an article about the reaction of stakeholders in Quebec to Bill . I would like to share a quote from the article:
|| Cactus Montréal and public health director Dr. Richard Massé are concerned that their jobs will become more difficult. [Dr. Massé wondered] how much of a say minority groups will have in this bill. These services save lives. It is too early to say what will happen, but this appears to create some significant barriers, even though the Supreme Court clearly said that not providing these services was a violation of human rights.
Those involved in the process are concerned and are wondering whether this will make their jobs harder, and understandably so.
I am only naming those ones. However, all the experts who appeared before the committee spoke against this bill. There is no reason to believe that this bill would be beneficial for people's health. It is completely ironic that the would defend such a bill. Indeed, the should be rising to defend his tough on crime agenda.
Frankly, the connection between Bill and health is not trivial; it is actually significant. For that reason we should vote against Bill C-2. If we really care about the health of Canadians, then, well, this bill is just plain wrong.
There is a supervised injection site in Vancouver and it is obviously effective. The evidence is there. There has been a 35% decrease in overdose deaths in Vancouver since this site opened. Furthermore, InSite has been shown to decrease crime, communicable disease infection rates and relapse rates for drug users.
This is what I am talking about. If we truly care about the health of Canadians, we must understand that this bill does not make any sense in terms of improving people's health. If the government really wants to help people stay healthy, it will make resources available to respond to their needs and to prevent crime, death and disease. It is high time we trusted the experts working on the ground when they speak in favour of or against such a bill.
I would like to draw the members' attention to a very concrete example involving another bill that I considered. This bill had a nice title and promised to fight elder abuse. In fact, it made only a small amendment to the Criminal Code, which might result in harsher sentences for crimes of elder abuse, although that is not a given. The NDP voted in favour of this bill and supported it.
However, we have to really look at the facts here. Temporary committees were created as part of the federal parliamentary process, and an all-party committee proposed some possible solutions, saying that intervention and prevention programs were needed to combat elder abuse. That is what we need to focus on if we really want to combat elder abuse. The bill was supposed to address elder abuse, and yet it made only one small amendment that would not really change anything in order to address this issue.
The same thing is happening here. An issue has been put on the table. However, if we really want to improve people's health, that is not the right direction to take.
I would like to talk about AJOI, an organization created on the West Island in Montreal to help at-risk street youth. First of all, people did not think that problem existed on the West Island. It took a long time for street youth at risk of becoming involved in crime to have access to this service. The project was created thanks to exceptional stakeholders, like Mr. Langevin, who believed in such projects. A number of stakeholders are now involved in the centre, which is well known in the community. This is the kind of project that really helps people.
Furthermore, the Centre Bienvenue provides supervised apartments for people with intellectual disabilities. That centre had to fight to exist. The neighbours did not want it in their community because they said it would increase crime and reduce property values. Ultimately, after speaking with and consulting their neighbours, the Centre Bienvenue officials convinced them and informed them of the reality of the situation. Thanks to that work in the community, people now have such a centre to turn to.
Here is what the Conservatives should do: instead of responding to people's fears and spreading false information, they should educate people about the benefits of supervised injection sites and forge ahead by reassuring Canadians. That would be the right thing to do for Canadians.
Mr. Speaker, it is no secret: the Conservatives' Bill is the product of this government's opposition to the decision by the Supreme Court, which found that the government should uphold the exemption that allows Vancouver's supervised injection site, InSite, to remain open.
InSite is North America's first and only legal supervised injection site. It seems obvious that despite the many people speaking in favour of opening at least three more sites elsewhere in Canada—in Toronto and Ottawa in particular—Bill is simply meant to create obstacles for anyone wishing to undertake such initiatives.
Even the Canadian Medical Association said in its press release that it “is deeply concerned that the proposed legislation may be creating unnecessary obstacles and burdens that could ultimately deter creation of more injection sites”.
The Supreme Court, medical community experts and street workers all agree that this type of approach “is a central pillar in a comprehensive public health approach to disease prevention and health promotion”.
In its decision, the Supreme Court ruled that the evidence indicated that a supervised injection site will decrease the risk of death and disease, and where there is little or no evidence that it will have a negative impact on public safety, the minister should generally grant an exemption.
The Conservatives have managed to inflate statistics on crime, repeat offenders and abortion, and are simply continuing to impose their political and moral agenda and ignoring all the evidence and trends before them.
These situations show the problems associated with cuts to statistical and psychosocial studies, the collection and analysis of information and the social sciences in general. This results in decisions being made solely on the basis of beliefs and prejudices, not facts.
A number of groups believe that this bill is irresponsible. The Canadian HIV/AIDS Legal Network and the Canadian Drug Policy Coalition issued a joint news release, and had this to say about Bill :
|| The bill is an irresponsible initiative that ignores both the extensive evidence that such health services are needed and effective, and the human rights of Canadians with addictions. In essence, the bill seeks to create multiple additional hurdles that providers of health services must overcome.
The bill imposes about twenty conditions that must be met in order to obtain an exemption under the Controlled Drugs and Substances Act, especially with respect to the consultation of experts and groups. Proponents of the project would be solely responsible for fulfilling the requirements for consultations with government and community stakeholders.
The irony is that when InSite was being established in 2003, the Mayor of Vancouver claimed the following:
|| [It] was launched after extensive dialogue in the local area, and with thorough city-wide debate, and its programming continues to be shaped with ongoing input from nearby residents, businesses, and service organizations.
This bill is based entirely on bad faith and stereotypes and has been promoted through a fearmongering campaign. The very day the previous bill, Bill , was introduced, the government began a shock advertising campaign entitled “Keep heroin out of our backyards”. The campaign speaks out against supervised injection sites in utter disregard for all the scientific arguments, statistics and research that managed to convince every judge who sits on the highest court in the country.
On the campaign site, it reads:
|| Yet, as I write this, special interests are trying to open up these supervised drug consumption sites in cities and towns across Canada—over the objections of local residents and law enforcement....Add your name if you demand a say before a supervised drug consumption site is opened close to your family.
The government did a good job of scaring people.
This campaign was strongly criticized by organizations including the Canadian Drug Policy Coalition, which felt that the Conservatives' initiative was clearly:
||...an attempt to stir up opposition to these life-saving services and to the people who use these services.
The coalition also criticized the language used in the campaign, which directly targets families by calling into question the safety of their loved ones.
That is irresponsible and dishonest. InSite is not located in a residential neighbourhood right next door to an elementary school. It is located in one of the poorest and most violent neighbourhoods in Canada, Vancouver's Downtown Eastside.
Many experts testified in committee about the benefits this centre has brought into the lives of those who use it and the positive impact it has had on their environment. I would like to quote Ahmed Bayoumi, a doctor and researcher who continues to fight for the establishment of other supervised injection sites. He had this to say about InSite:
|| [InSite] has been associated with a reduction in public injecting, no increase in drug-related loitering or drug dealing, no changes in crime rates, no evidence of increased relapse among people who had stopped injecting drugs, and decreased fatal overdose in neighbourhoods near Insite. Among people who used the facility, there was an observed increased rate of referrals for drug treatment and a decreased rate of sharing of injection equipment.
Needless to say, there was no shortage of reactions when this bill was introduced, and those reactions were not really complimentary to the government.
Let us begin with the Supreme Court, which in its September 29, 2011 ruling basically accused the government of acting in an arbitrary manner and overestimating the risk associated with these types of facilities as compared to the positive effects they can have. According to the Supreme Court:
According to the Supreme Court, applying the Controlled Drugs and Substances Act to InSite was:
||...arbitrary, undermining the very purposes of the CDSA, which include public health and safety. It is also grossly disproportionate: the potential denial of health services and the correlative increase in the risk of death and disease to injection drug users outweigh any benefit that might be derived from maintaining an absolute prohibition on possession of illegal drugs on Insite’s premises.
Along the same lines, Dr. Bayoumi had this to say about Bill :
||...sets up barriers and puts in place opaque mechanisms that could lead to narrow perspectives dominating the decision. It is a step backwards for informed health policy decision making.
In a press release issued in response to Bill , which was Bill at the time, the Canadian Medical Association stated that this bill:
||...is founded upon ideology that seeks to hinder initiatives to mitigate the very real challenges and great personal harm caused by drug abuse.
In fact, even Vancouver's Mayor Robertson defended the centre, saying he considers it a key resource and part of any good public health policy. He concluded his press release by saying:
||Especially in light of the Supreme Court’s affirmation of the program’s proven ability to prevent overdose deaths and the spread of disease, I am strongly opposed to any legislative or regulatory changes which would impede Insite’s successful operations.
In the way it has managed this issue, the Conservative government has demonstrated its utter contempt for the Supreme Court, which had to act as a counterbalance to the government's ideological policies.
The Conservatives never hesitate to lower the standard of debate around real arguments in order to spew rhetoric or propose strategies simply to achieve their own ends.
This is not only appalling, but unworthy of someone who is supposed to carry the responsibilities of the Minister of Health.
This government is ignoring the Supreme Court's clear, unanimous decision by introducing a bill that distorts the nature of the rationale given by the judges.
Using our role as legislators in this way is unacceptable and proves only one thing: the Conservatives will do anything to achieve their own ends.
In his book on the and his model of governance, author Christian Nadeau said something that rang very true and still holds true today: the Prime Minister is giving himself four years to:
||...overhaul the country's institutions so that the Conservatives have the maximum possible room to manoeuvre in terms of citizens’ rights and security, freedom of conscience and social justice...
When we are dealing with supervised injection sites, we should be listening to and supporting the experts and the people on the front lines, the people who work with drug addicts every day. We should take their advice.
The government has no scientific studies to back its claims. Sites like these are not there to encourage drug use. Far from it. It has been proven that these kinds of sites can help decrease drug use and addiction. If we keep these people underground, how will street outreach workers and health care experts be able to help the addicts who want help?
These kinds of sites bring addicts out of hiding so that we can make contact with them, provide support and eventually help them rebuild their lives.
I urge the government to rethink its approach. I urge them to withdraw Bill because the official opposition will clearly be voting against this bill at all stages.
In my opinion, this bill will do some very serious damage to the fight against drug addiction.
Mr. Speaker, I am pleased to rise today to speak to the bill, which was formerly Bill and is now Bill .
The bill is on something about respect for communities, but that is not really what is going on here. It is an attempt to undermine a Supreme Court decision by putting in rules and regulations, which the Supreme Court has asked the government to do, that would make it virtually impossible to actually abide by the Supreme Court decision, which says that these places should be permitted to exist.
Once again, we have a government that ignores facts, statistics, and evidence. This is a government, do not forget, that wanted to eliminate evidence by closing down such things as the long form census and the Experimental Lakes Area. The Conservatives do want there to be evidence. They do not want Canadians to know what they are up to by there being evidence of what might happen.
We have a government that acts, time and again, in opposition to evidence-based decision-making. It acts in opposition to science-based decision-making. It acts in opposition to decision-making that is for the public good. Instead, its actions seem to be knee-jerk reactions that give the Conservatives opportunities to raise money to get elected and to continue this practice of doing things that are not in the interest of the public.
This is yet another example of an action by a government that is attempting to raise alarm bells for citizens about what might or might not happen in their neighbourhoods.
So far, only three communities I am aware of have actually asked for the authority the bill would grant, albeit without going through some pretty steep hoops. They are Toronto, Vancouver, and Ottawa.
My riding is in Toronto, in one of the most disadvantaged neighbourhoods in Ontario. It is against that context that I want to talk about why it is the NDP believes that the bill is completely wrong-headed. In fact, the bill would be defying the Supreme Court ruling.
The Supreme Court ruling directed the government to come up with mechanisms to allow these things to happen. Instead, we are getting a bill that would make it well-nigh impossible for a community, a public health agency, doctors, and respected members of a community to actually put in place a safe injection site where public harm and harm to individuals would be reduced.
If the Conservatives are opposed to reducing harm, why are they in government? The whole point of us being here is to try to reduce harm. However, the bill would actually increase it in places where we should be trying to reduce it.
The government has taken its cue, based on the questions I have been hearing so far today, from the notion that people do not want one of those things in their neighbourhood. Well, I walk in the park in my neighbourhood. It is a big, beautiful park on the banks of the Humber River, and there are needles in that park from drug users who have not had a safe place to inject, and therefore they litter the ground. One cannot walk safely in my little park, because there is no place for harm reduction in my neighbourhood. There is no harm reduction place where people can go to inject the drugs safely.
An addiction is recognized by medical authorities, the public, insurance companies, and even the reputable sources of disability recognition as, in fact, a disability, not a crime. It is not something to be looked down upon. We need to find ways to help individuals who have addictions.
One way to help these individuals, which has been successfully promoted in Vancouver, is a safe injection site. It is a place where it has been found that harm is reduced for the public, both the individuals who are addicted and the public at large, by providing them with a place they can go to safely inject themselves with what we otherwise understand are dangerous drugs.
We would all love it if these things did not exist, but they do exist. They exist in a manner in which the outcome of the use of these drugs in unsupervised ways, in unsafe ways, has led to significant increases in other diseases, such as HIV and hepatitis C. Who is going to look after those individuals when those diseases get the better of them? Those diseases will eventually get the better of those individuals, and it is the public, not the individuals themselves, that will pay for their health care.
We are dealing with a government that is preaching about the government having to watch every penny. Here is a situation in which the taxpayer, which Conservatives claim to be on the side of, will end up paying more because of this shortsighted bill. The taxpayer will have to look after the individuals who eventually come to hospitals and medical facilities as a result of diseases we could have prevented and limited had we been dealing with them in a more proactive way early on, when these individuals started to inject themselves unsafely.
We should be doing more to try to deal with the addictions themselves. As we have seen in the press very recently, in a big and public way, addictions are a real problem for individuals in my city. One of the first things that happens to addicts is that they deny it. They do not have a problem.
I was a union representative for many years, and many were the individuals who claimed they had no problem. Some we were able to help. Some got treatment. Others did not, and unfortunately, they became a burden to the health system first, and then, in some cases, they passed away. Those individuals were a burden on society, not because they were not able to get the help they needed but because they denied that they had that problem in the first place.
The same is going to be true of individuals who are seeking help at the safe injection sites. Some of them do not believe they have a problem. How are we going to convince them to get help unless we lead them to the help? That is part of what the safe injection sites do. They provide a safe place where addicts can get counselling and where they can get attention from nurses and doctors. They can therefore be exposed to the help to get them free from their addictions.
That kind of thing is being asked for by the City of Toronto as part of its request to the federal government. In fact, the City of Toronto will be speaking on this matter when the bill goes to committee, because it has recommended that the Board of Health make a submission to the federal government to register its opposition to Bill . This is a recommendation from the medical officer of health of Toronto, by the way. It will also recommend the development of a more feasible CDSA exemption application process for supervised injection services, in consultation with relevant provincial public health, public safety, and community stakeholders, including people who use drugs.
The Board of Health urges the provincial government to fund the integration of supervised injection services on a pilot basis, but they cannot do that if the federal government will not give its permission. That is what we are up against. We are up against a government that, as evidenced by the questions I have been hearing so far, is fundamentally opposed to the existence of these things anywhere. It has put into the bill such blockades or walls to get over that it will be virtually impossible for any of the cities in our country to create a supervised injection site with permission from the government.
Mr. Speaker, before I begin my speech, I would like to set the record straight. Are the Conservatives aware that, in September 2011, the Supreme Court ruled in favour of InSite? The court noted the effectiveness of the site and the very need for it in Vancouver's east side. I do not understand why we are still debating a law that will ensure that these kinds of organizations will not be able to exist in Canada.
Let us put this in context. We should begin by talking about what is happening in that Vancouver neighbourhood—and many other Canadian cities, I might add—and then try to understand why a place such as InSite is critical to the safety of the neighbourhood and why it is beneficial.
Vancouver's downtown east side is home to some of the poorest and most vulnerable people in our country. There are nearly 4,600 intravenous drug users there, which represents approximately half of the entire city's intravenous drug users. That is significant. That proportion is not at all reflective of the actual size of the neighbourhood, which is very small and has few houses. There are various factors that contribute to the high concentration of drug users in that area of the city. We could talk about the numerous rooming houses, the deinstitutionalization of people with mental health issues, the effects of drug policies throughout the years and, of course, the availability of illicit drugs on the street.
Before InSite came about, the things you could see on the streets were mind-blowing: people sitting on the ground or sitting on steps, putting on a tourniquet and shooting up. That was a common occurrence in this neighbourhood. Drug addicts come from all kinds of backgrounds, but the one thing they have in common is that they all had difficult childhoods or experiences that led them to drugs. Anyone walking through that neighbourhood, including children, would come across dirty needles.
The researchers who came up with the idea of InSite thought long and hard about how to create a site that would address all of these problems. InSite was developed as part of a public health project by the Vancouver Coastal Health Authority and its community partners, in response to a twelve-fold increase in overdose-related deaths in Vancouver between 1987 and 1993. At the time, the Vancouver area was seeing huge increases in the rates of communicable diseases, such as hepatitis A, B and C, and HIV, among injection drug users.
InSite first received an exemption in 2003 for conducting activities for a medical and scientific purpose, under the Controlled Drugs and Substances Act, so it could provide services and conduct research on the effectiveness of supervised injection sites. Section 56 of this act gives the minister the authority to approve facilities that use drugs for a medical and scientific purpose or for a law enforcement purpose. In 2007, the drug treatment centre OnSite was added to the facility.
In 2008, InSite's exemption under section 56 expired, and the rejected InSite's renewal request. This decision sparked a string of legal challenges leading to the Supreme Court of British Columbia ruling that InSite should be granted a new exemption. The federal government brought the matter to the B.C. Court of Appeal, which also ruled that InSite should remain open. Finally, in 2011, the Supreme Court of Canada ruled that the minister's decision to close InSite violated the charter rights of its clients and was “arbitrary, undermining the very purposes of the CDSA, which include public health and safety”.
The court based its decision on section 7 of the charter, which states: “Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice”. The court stated:
|| The infringement at stake is serious; it threatens the health, indeed the lives, of the claimants and others like them. The grave consequences that might result from a lapse in the current constitutional exemption for Insite cannot be ignored. These claimants would be cast back into the application process they have tried and failed at, and made to await the Minister’s decision based on a reconsideration of the same facts.
The Supreme Court ruled that InSite and other supervised injection sites must be granted a section 56 exemption when the opening of such sites “will decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety”. After this decision was handed down, public health authorities and agencies in Toronto, Ottawa and Montreal began planning to open supervised injection sites.
Why are we here debating this issue when we clearly did not need to come back to it? We are doing so because once again the Conservatives decided to change a law so that it reflects their ideology. They came up with a deeply flawed bill that is based on an anti-drug ideology and false fears for public safety. This is another attempt to rally the Conservative base, as evidenced by their “Keep heroin out of our backyards” campaign that started mere hours after Bill was introduced in Parliament. This bill will make it almost impossible to open safe injection sites and will put heroin back in our neighbourhoods.
The NDP feels that decisions about programs that could benefit public safety should be based on fact and not ideology. Evidence has shown that supervised injection sites effectively reduce the risk of contracting and spreading blood-borne diseases, such as HIV and hepatitis C, and reduce deaths from overdoses. Evidence has also shown that these sites do not negatively affect public safety and that, in certain cases, they promote it by reducing the injection of drugs in public, the violence associated with such behaviour, and drug-related waste. Safe injection sites make it possible to strike the appropriate balance between public health and public safety. They also connect people in urgent need of health care with the services they need, such as primary health care and drug treatment services.
This bill imposes a far too heavy burden on communities, which would have to prove what the benefits of such a site would be and could then still be denied an exemption. As the Supreme Court pointed out, this bill brings us back to the arbitrary decision made by the minister against InSite in 2008.
The NDP believes that any legislation introduced by the Conservative government must respect the Supreme Court ruling and strike a balance between health and public safety.
This bill flies in the face of the 2011 decision, which ordered the minister to consider granting exemptions for supervised injection sites in order to strike a balance between public health and public safety. That decision ordered the minister to examine all the evidence in light of the advantages of supervised injection sites, rather than coming up with a long list of principles on which to base decisions.
In closing, I would like to add that the NDP believes that any new legislation regarding supervised injection sites must respect the spirit of the Supreme Court ruling, which this bill does not do. We believe that harm reduction programs, including supervised injection sites, should be granted exemptions based on evidence that they will improve public health and save lives, not on ideology.
Mr. Speaker, I am happy today to talk about Bill , formerly known as Bill C-65.
I am pleased to have an opportunity to denounce this bill, which is intended to terminate the operation of supervised injection sites: nothing more, nothing less. It is in direct opposition to a decision the Supreme Court handed down in 2011.
This is a bill that betrays the irrational ideology of the Conservatives, who believe that repression is the only way to deal with this scourge.
We are not the only people in the world to have considered this issue. There are more than 70 cities worldwide that have supervised injection sites. They are found mainly in Europe and Australia. In Canada, there is but one supervised injection site: InSite, which opened in 2003.
In order to use the services of InSite in Vancouver, users must be at least 16, sign a user agreement, comply with a code of conduct and not be accompanied by children. Users bring their own substances, and the staff provide clean injection equipment. Emergency medical aid is available if required, and expert staff are on site to provide health and social service support.
In addition to providing services to drug users in order to minimize the impact on their health and on public health, InSite conducts research on the effectiveness of supervised injection facilities.
This injection site has already demonstrated its effectiveness by significantly reducing deaths by overdose. It is estimated that overdose deaths in Vancouver have decreased by 35% since the site opened. In addition to reducing overdoses, the facility helps to reduce the rates of communicable diseases among injection drug users. I am referring to hepatitis A, B and C and HIV/AIDS, for example.
Ever since it was established by the Vancouver Coastal Health Authority and its community partners, this public health project has generated controversy. Those who believe only in repression saw it as an encouragement to use drugs.
At first, the site was able to open because it was given an exemption under the Controlled Drugs and Substances Act to operate for medical and scientific purposes. In 2008, the exemption for InSite expired and the health minister denied InSite's application to renew it. This decision triggered a series of court cases, which led to the B.C. Supreme Court decision that InSite should be granted a new exemption. The federal government then appealed this decision. One after the other, the B.C. Court of Appeal and the Supreme Court of Canada ruled that the closure of InSite violated the rights of its patrons under section 7 of the Charter of Rights and Freedoms, which provides that everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.
I would like to quote from the 2011 Supreme Court decision effectively demonstrating the Conservatives' bad faith in this case, as follows:
|| [The minister's decision to close InSite] is arbitrary...because it undermines the very purposes of the CDSA—the protection of health and public safety.
I would also like to quote another excerpt from that decision:
|| The infringement at stake is serious; it threatens the health, indeed the lives, of the claimants and others like them. The grave consequences that might result from a lapse in the current constitutional exemption for Insite cannot be ignored.
Furthermore, the Supreme Court decision does not just concern InSite. It opens the door to new similar sites, and I quote:
|| On future applications, the Minister must exercise that discretion within the constraints imposed by the law and the Charter, aiming to strike the appropriate balance between achieving public health and public safety. In accordance with the Charter, the Minister must consider whether denying an exemption would cause deprivations of life and security of the person that are not in accordance with the principles of fundamental justice. Where, as here, a supervised injection site will decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety, the Minister should generally grant an exemption.
This ruling by Canada’s highest court has led public health agencies throughout the country, including the Agence de la santé et des services sociaux de Montréal, to consider opening supervised injection facilities.
After being turned down twice by the courts, the Conservatives are now trying to get around the Canadian Charter of Rights and Freedoms, as well as the Supreme Court judges, by using Bill to amend the act.
The Conservatives are acting in a way that is just as reprehensible as the bill itself. Some people go so far as to say that this is hypocritical.
As we saw in this House during the previous session of Parliament, the Conservatives’ strategy is plain: to increase the number of requirements that supervised injection sites will have to meet before the department will grant an exemption. These many requirements will make it much more difficult for agencies to open supervised injection facilities in Canada. The Conservatives are so ideologically pigheaded that it is pathetic.
In this House, my colleagues have often heard me say how important it is to base political decisions on fact. Unlike the Conservatives, I have looked at the facts. I have found that 80% of the people questioned, who live or work in Vancouver’s Downtown Eastside, support InSite, primarily because there has been a significant drop in the number of needles discarded and the number of people injecting drugs on the street.
I can cite other figures and percentages. The rate of overdose deaths in East Vancouver has fallen by 35% since InSite opened. It has also been noted that injection drug users who go to lnSite are 70% less likely to share needles. In one year, 2,171 Insite users were referred to addiction counselling or other support services. Unlike repression, lnSite does not marginalize drug users and does not force them into isolation. These are figures that I think are pretty convincing.
There are more than 30 peer-reviewed studies, published in major scientific journals such as the New England Journal of Medicine, The Lancet and the British Medical Journal, that describe the benefits of InSite. Furthermore, there are other studies that show the positive impacts of more than 70 supervised injection sites that are similar to Insite.
In summary, I think that the science and the evidence are quite clear: supervised injection sites promote public health because they reach vulnerable groups and are accepted by the community. They make it possible to improve the health of their users and reduce high-risk behaviour, in addition to lowering the number of overdose deaths and reducing drug use in public places.
Above all, I believe that safe injection sites make it possible to strike the appropriate balance between public health and public safety. Furthermore, the sites give people who need help access to the necessary health services, such as primary health care and drug treatment services.
Front line workers have been clear: supervised injection sites are necessary. Pivot Legal Society, the Canadian HIV/AIDS Legal Network and the Canadian Drug Policy Coalition issued a joint statement about the bill, which reads:
|| This bill is an irresponsible initiative that ignores both the extensive evidence that such health services are needed and effective, and the human rights of Canadians with addictions.
|| It is unethical, unconstitutional and damaging to both public health and the public purse to block access to supervised consumption services...