Welcome to the 125th meeting of the Standing Committee on Health.
This morning we have three sections of our committee meeting. In the first section, we're going to hear from our guest. I think his name is Mr. Webber. He's going to have a 10-minute opening statement, and then we'll have one round of questions. Then, we're going to suspend for a few moments and we're going to bring in the CRA officials. They're going to have a two-minute opening statement, and then we'll have questions. Then, we're going to suspend and do clause-by-clause.
We have quite a bit to do, although I think the amendments are pretty simple and shouldn't take too long.
I want to tell you a little story. Yesterday, I got a call from a man whose son was killed in a car accident in my riding. Because the system didn't work right, he was not able to donate his organs, and he should have been able to. He was 30 years old. He could have saved many lives and improved the lives of many people, but because the donation system didn't work right, nobody responded, and nobody did what they should have done or could have done in order to make good use of those organs from that donor. I just want to put that on the record for his sake. The father feels so bad that the son missed the opportunity to share.
I tell that story as an incentive for us to move forward, and now I turn the floor over to Mr. Webber.
Welcome, and congratulations.
Thank you, Bill. I appreciate it.
I don't know if you recall, but a couple of years ago I was at this committee and I couldn't even speak because I had lost my voice. I'm getting there again, so it's bad timing, but I hope I can get through this.
Colleagues, it is my absolute pleasure to be here today to speak on my private member's bill, Bill Before I begin, I want to thank you all immensely for your unwavering support of this initiative. There is no question that we all share the common goal of improving our organ and tissue donation system here in Canada, so that Canadians no longer have to die awaiting a life-saving transplant.
As I have said before, this is not a political issue; this is a human issue, and our work on this issue is proof that when it really counts, we're able to leave our partisan stripes at the door. I also want to thank those who rose in the House to speak to this bill. I was moved by your kind words and your personal stories, and I think it's fair to say that many people had no idea how passionate we could all be about this issue.
Finally, I want to thank the analysts and the clerk for the work they have done on this issue. Your work on the committee report was excellent. You perfectly captured what we heard and what we want to see done, so I sincerely thank you.
As I mentioned in greater detail in my comments in the House during second reading, this bill would sensibly utilize the annual tax return process to allow Canadians to indicate their intention to consent to be organ donors. I have been afforded the opportunity to discuss my bill in greater detail with the Canada Revenue Agency, and I very much appreciate that collaborative gesture. I thank them for allowing time for me to meet with them.
This bill would enable the CRA to facilitate the registration of individuals with their respective provincial and territorial registries, but it will be the provinces and territories that will ultimately finalize the consent with those who wish to register.
This bill does not specify, at least at this point, the exact nature of the data collection process or the actual content that is to appear on the tax return. This bill is very narrowly focused on giving the CRA the legal exemption it requires to set up agreements with provincial and territorial partners, because existing legislation prohibits the use of tax returns for any purpose other than the collection of taxes, and of course allowing Elections Canada to pass on their information to them.
While I wanted to provide the CRA with a lot of working space and flexibility to implement the will of Parliament, I do have some concerns and I hope that we can put those to rest today when the CRA is up here and we're questioning them. I want to ensure that the CRA hears loud and clear that the expectation of Parliament is to have this addition made on the front page of the T1 tax returns in all provinces and territories. I also want it made clear that we expect people to have the option to tick a box on that front page—a call to action, if you will. We've all filled out forms before, and we know that unless there's a box to tick or a space to fill, we tend not to stop and read the fine print. We need to make sure that we have a front page that calls on tax filers to take a specific action to demonstrate their willingness to register.
I realize that the front page has very limited space, but it does have enough space to do what we all envision. In fact, the options I've offered would take less space than that afforded to Elections Canada on the front page. I think we can all agree that unless this initiative appears on the front page, we will lose a tremendous opportunity and dramatically reduce the impact of our work.
When it comes to the electronic filers, the e-filers, things should be quite simple, and of course the majority of Canadians, probably 90%, e-file. The CRA should make it a requirement of all tax software, which they certify annually, that the offer to consent appear prominently in the filing process. Based on residency, a tax filer should be afforded a secure connection to their own provincial or territorial registry to consent. A tax preparer should also have the option of requesting a consent package for those who are not physically filing their own return. We need to seize every opportunity to register as many as possible.
I should also mention here that I will be moving two minor amendments to my bill. These amendments are friendly amendments. They will simply change “organ donors” to “organ and tissue donors”. I believe, from my earlier discussions with colleagues and the chair, that this is not going to be an issue. We will ensure that we are not limiting ourselves from a legal perspective. I'll bring those motions forward during clause-by-clause.
I don't believe that we are intending any other amendments to the legislation, but I do welcome any that will help ensure we reach our goal to have more registered donors.
Of course, we will be hearing from the CRA officials, and I encourage my colleagues to implore a continued sense of urgency for implementation. It's always been my experience that a deadline focuses everyone and helps get the job done.
I believe that we could have this in place for the 2019 tax returns, but that would require everyone to continue pushing all involved in the process. This committee has shown its willingness to move quickly on the legislation, and I hope that those after us, meaning the CRA and of course the , are just as motivated to make this happen quickly, because once it leaves here, it's out of our hands.
We know that a Canadian dies almost every day awaiting a life-saving transplant. Every day sooner that we get this done means that we literally could save a life.
A while ago, the elections commissioner indicated to Parliament that if Parliament wanted to implement changes in time for the 2019 election, then legislation would have to be passed by a certain date. That was for changes to the elections laws. I would like to see the CRA provide a similar breakdown on their timelines to give us a sense of what needs to be done, and by when, for this to happen in 2019. This would be helpful for everyone in the process to have. It gives us a target to focus on.
Finally, I would like to thank the government. That doesn't happen too often. I would like to thank the government for committing the funding to this initiative in the fall economic update just last week. Governments don't often commit funding ahead of legislation passing, especially when it's from a private member's bill and, for that matter, an opposition private member's bill. The fact that this funding has been committed is very much appreciated by me, and it signifies an impressive willingness from the government to see this happen.
I have referred to this bill several times as “my bill”, as it stands in my name, but I do want to say that this is really our bill. This is our committee's bill, because we all worked together as a single team to make this a reality. We found a shared goal and a sensible solution, and we all worked together to make this happen.
I'm very proud of all of you who were here along this process with me. We are getting closer every day, but there still remains a lot of work ahead. I must be honest in saying that I am a bit concerned that we don't yet have a clear, unambiguous commitment on some important implementation aspects. Hopefully, we will deal with that today with the CRA. Nonetheless, we've gone a long way in a short amount of time, and I'm very proud of all you guys. I have to thank you all for the work you've done on this.
I also want to thank my colleague, Mr. Webber. I would like to echo the positive comments regarding this bill, which, as has been said, transcends partisanship.
Mr. Webber, even though the bill hasn't been implemented yet, it's undoubtedly helping to save lives simply by encouraging discussion on organ and tissue donation. By discussing and promoting these issues, we're saving lives by providing information to people, who can then decide to register as organ donors. I would like to congratulate you once again. We now need to work hard to ensure that the bill is passed before the next general election.
I have before me an income tax form. My questions are relatively simple. If I understand correctly, and I would like you to confirm this, the Canada Revenue Agency will give the province the names of citizens who wish to become organ and tissue donors only if the province asks that the information be included in the federal income tax return. Is that the case?
In addition, since Quebec has two income tax returns, we must ask the province which of the two forms will be chosen. Have you had these types of discussions with the officials? What's the current situation?
Absolutely. This has been a big passion of mine for many years, developed from life experiences. As part of the work I did, first of all I pursued a provincial registry in Alberta to get it onto the driver's licence.
There was frustration there, because only 20% of Albertans were registering, so we built up this new registry. We got it on the driver's licence, yet only 20% of Albertans were registering, and it was disappointing. I had to think of a way to get all Albertans—and now all Canadians, because I'm on the federal level—to tap into a product, the tax return. This would enable every Canadian to be approached—or at least every Canadian who does their taxes. I think that it would significantly increase the number of registrations on registries throughout the country.
It has to be put in front of Canadians. It has to be asked when they're there. For example, I went to renew my driver's licence. Of course, I've already registered, but there were others up ahead of me, and the registry agent would get them their new licence and ask if they would like to be an organ donor, if they would be willing to consent. When I was there that day, there were three people, out of maybe four or five, who said yes. The registry agent then went through the process of signing them up to the registry, which took maybe five minutes.
We just need to have people in place to be able to ask the question of Canadians.
Good morning, everyone.
Thank you for the invitation to appear here before this committee and respond to your questions about Bill , an act to amend the Canada Revenue Agency Act regarding organ donations.
I'm Frank Vermaeten. I'm the assistant commissioner of the assessment, benefit and service branch of the Canada Revenue Agency.
My branch is responsible for administering key services on behalf of the CRA in support of tax and revenue generation programs. I'm accompanied today by my colleagues Sheila Barnard and Randy Hewlett.
Sheila Barnard is the manager of the legislation section in the individual returns directorate in my branch. Sheila is responsible for coordinating the implementation of the legislative changes affecting T1 returns.
Randy Hewlett is the director general of the legislative policy directorate, whose mandate is to manage the legislative and regulatory process within the agency. Randy's team also works with the provinces and territories to implement and administer provincial and territorial tax legislation.
Bill would enact a provision that would authorize the CRA to enter into an agreement with a provincial or territorial government to collect any information required for establishing or maintaining an organ donor registry in the province or territory.
Specifically, the CRA would collect and share personal information for individuals who wish to receive information from their provincial or territorial government on becoming an organ donor. The individual authorization to share personal information for this purpose would be collected with the income tax return.
Mr. Chair, we would now be pleased to answer the committee's questions regarding the implementation of Bill .
First, I want to express, on behalf of the New Democratic Party, our congratulations to Mr. Webber, not only for his initiative but also for his tenacity in seeing this through. It takes a lot of energy. I don't know if Canadians realize how much energy it takes to conceive of a bill and then work not only to get it drafted and thought through but also to get it to this stage. I congratulate you on that.
The devil is sometimes in the details, so I'm just going to focus a bit on the details of the legislation. It's really a simple bill. It's a powerful concept but a simple bill, made up by adding two new subsections, 63.1(1) and 63.1(2).
Proposed subsection 63.1(1) says, “The Agency [meaning the Canada Revenue Agency] may enter into an agreement with a provincial or territorial government to collect [using income tax returns] any information that the province or territory requires for the purpose of establishing or maintaining an organ donor registry in the province or territory.”
To either Mr. Webber or anybody from CRA, do we know what information they will require in order to maintain the registry?
Congratulations for doing this. In my opinion, this is a very elegant solution to a problem. There have been some suggestions that there be more consent, and this sort of thing, put in on this. Having worked in the medical system, I know different portions of it. They worry about mission creep. When they say that there is some portion of it.... I'll give you an example. It's sometimes thought that because the emergency department is always open and it's always there, you could also use it as a central area for people to come and get their immunizations. It's not an emergency, but it's always open, so you can always do it.
They want to make sure that's not adding to the workload for doing something that's not part of their mandate.
Would you not agree that adding all these extra things—asking for the consent and all these things that are normally done by the province—would add to mission creep, whereas simply sending this to the provinces, which is what you have here, would avoid that? Would that make sense?
I should just clarify what that is. It's jargon that we have used in my profession for years. I forget that it's not used a lot outside my previous bubble. For instance, you would have an organization that, because of its placement, is a good conduit or vehicle for something, like using the emergency department for immunizations or as a conduit for someone to access social work, because it's always open. That actually happens.
They find that by not pushing back on that, departments get overloaded with work that wasn't part of their original mandate. It gets established and you're having to expend resources on things that you weren't created to do. This is what we mean by mission creep.
That was my thought when I heard.... I didn't really think there was much of that in this. You're just ticking yes or no boxes and sending it to the provinces, whereas putting all these extra things—getting consent and having your lawyers do it.... Someone might say, “If we can do this for organ donation, let's do it for something else. Let's do it for registering kids for vaccinations” and this sort of thing.
That's what I meant by it. I'm satisfied by the answers given that it tends to avoid that with this rather simple and elegant solution to this. It seems very straightforward. I don't have any further questions on this.
Thank you. I'll be brief.
I just want to state once again for the record how important it is to recognize that Canada is doing a very poor job in terms of making sure that Canadians are registered for organ and tissue donation, and that compared to other countries we are really falling behind.
I want to state for the record as well that the New Democrats support a presumed consent system where every Canadian is presumed to be an organ and tissue donor unless they specifically elect not to be. Of course, we have seen the figures from Spain and other European countries that saw a 30% to 40% or 50% increase in their organs and tissues available for donation by moving to a presumed consent system.
That's the gold standard that I would like to see our government working towards. That in no way takes away from Mr. Webber's excellent initiative here. As long as we have an opt-in system, searching for as many portals and entries as possible to put in front of Canadians the opportunity to be an organ donor, I think is commendable. That's why the New Democrats will offer their full support to this.
I'm happy to move to clause-by-clause so that we can do everything we can to expedite this fine initiative, and I hope that it can be made law as soon as possible.
If I may, I'll move to a different order of business. I served notice last week of the following motion:
That, pursuant to Standing Order 108(2), the Committee invite the Minister of Health to provide a briefing, at the earliest opportunity, on the forced sterilization of Indigenous women in Canada.
I would like to move that motion today and speak to it, if I may, briefly.
I think all members of this committee are well aware of the very disturbing news that women in this country have, as recently as 2017, been compelled to be sterilized or have been sterilized without their consent or knowledge. This has been particularly prevalent among indigenous women. We know that there's not a person in this room or in the House who would not express complete abhorrence of that practice.
I'm informed that, internationally, forced sterilization falls squarely within the definition of torture. This is a very serious issue, and I think that it's also pressing, because it's alarming that it has happened so recently. I know I was very surprised to hear that it was done as recently as 2017.
I do think the should come before this committee and give us a briefing on this. Now, I understand this is an issue that probably crosses over multiple ministries. Obviously, these are medical procedures that are being administered in health facilities, and primarily to indigenous women, which is a core responsibility of the federal government. There's no question that this falls under the jurisdiction of the health committee.
I think that it would also be of interest to the indigenous affairs committee, but of course we have to remember that not all women who have undergone this procedure are indigenous, so this is not only an indigenous women's issue. It is purely a health issue, and also I think it's a women's issue, so probably the committee responsible for the status of women and women's issues would be interested.
My understanding is that in the committee responsible for women's issues and the committee responsible for indigenous health—I think under —there have been motions that either have been tabled or will be tabled at those committees, but they're not to call the . They are to call the respective ministers responsible to those committees. This is the only motion in Parliament that is before any committee that will ask for the Minister of Health to come and provide a briefing.
I would move that motion today, if I may, and ask for my colleagues' support so that this committee can at least have an opportunity to inquire of the into this very pressing, urgent and important matter.