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Results: 1 - 15 of 47
View Kevin Sorenson Profile
CPC (AB)
Mr. Speaker, this will be the last time I ever present a petition in the House. I want to thank you for your services as Chair.
I rise today to present a number of petitions on behalf of my colleague, my seatmate and my friend, the member for Langley—Aldergrove.
In the first, the petitioners call upon Parliament to enshrine in the Criminal Code the protection of conscience for physicians and health care institutions from coercion or intimidation to provide or refer for assisted suicide or euthanasia.
View Karen McCrimmon Profile
Lib. (ON)
View Karen McCrimmon Profile
2019-06-19 21:47 [p.29444]
Mr. Speaker, Bill C-83 has two main objectives.
First of all, it would allow federal inmates to be separated from the general prison population when necessary for security reasons. Second, it will ensure that inmates have access to the interventions, programs and mental health care they need to safely return to the general prison population and make progress toward successful rehabilitation and reintegration.
The bill would achieve these objectives by replacing the current system of administrative segregation with structured intervention units. In SIUs, inmates would be entitled to twice as much time out of their cells, four hours daily instead of two, and two hours of meaningful human contact every day.
We have allocated $448 million over six years to ensure that the Correctional Service has the resources to provide programs and interventions to inmates in SIUs and to implement this new system safely and effectively. That funding includes $150 million for mental health care, both in SIUs and throughout the federal correction system.
Bill C-83 was introduced last October. It was studied by the public safety committee in November and reported back to the House in December with a number of amendments. There were further amendments at report stage, in February, including one from the member for Oakville North—Burlington that added a system for binding external review.
In recent months, hon. senators have been studying the bill, and they have now sent it back to us with proposed amendments of their own. The high level of interest in Bill C-83 is indicative of the importance of the federal corrections system and of the laws and policies that govern it. Effective and humane corrections are essential to public safety, and they are a statement of who we are as a country. In the words of Dostoyevsky, “the degree of civilization in a society is revealed by entering its prisons.”
I extend my sincere thanks to all the intervenors who provided testimony and written briefs over the course of the last nine months and to parliamentarians in both chambers who examined this legislation and made thoughtful and constructive suggestions.
Since the Senate social affairs committee completed clause-by-clause consideration of the bill a couple of weeks ago, the government has been carefully studying the committee's recommendations, all of which seek to achieve laudable objectives. We are proposing to accept several of the Senate's amendments as is or with small technical modifications.
First, with respect to minor adjustments, we agree with amendments that would require a mental health assessment of all inmates within 30 days of admission into federal custody and within 24 hours of being transferred to an SIU. This fits with the focus on early diagnosis and treatment that will be facilitated by the major investments we are making in mental health care.
We agree with the proposal to rearrange section 29 of the act, which deals with inmate transfers, to emphasize the possibility of transfers to external hospitals. The Correctional Service runs five certified psychiatric hospitals of its own and will now have significant new resources for mental health care. Even so, there may be cases when a transfer to an external facility is appropriate. If the transfer can be done safely, if the hospital has the capacity and if it is in the best interest of the patient, then it should be done. In fact, that is why we allocated funds in budget 2018 for more external mental health beds.
We also agree with an amendment regarding the initial review of SIU transfers. The bill would require a review by the warden in the first five days. This amendment clarifies that the clock on those five days would start ticking as soon as the transfer decision was made, as opposed to the moment the inmate physically arrived in the SIU.
With minor changes, we agree with two amendments to the section of the bill that would require consideration of systemic and background factors in decisions involving indigenous offenders. One of them would provide greater precision by specifying that a person's family and adoption history should be included in the analysis. The other would clarify that these factors may be used to lower the assessment of an inmate's risk level, but not to raise it.
These provisions in themselves would obviously not be enough to solve the problem of indigenous overrepresentation in the corrections system. The upstream socio-economic factors that result in higher rates of indigenous people involved with the criminal justice system must generally be addressed in concert with other departments and agencies, and efforts to that effect are indeed under way. The Correctional Service is charged with ensuring that indigenous people in its custody get a genuine opportunity to turn their lives around, and these amendments should help advance that objective.
There are two other amendments on which we agree with the intent, and we are essentially proposing to meet the Senate halfway.
The first is an amendment that seeks to add certain elements to section 4 of the act, which establishes guiding principles for the Correctional Service. In particular, it puts a focus on alternatives to incarceration, and we agree that those alternatives should be consistently considered and used wherever appropriate.
We are, however, suggesting a few changes to the language drafted in the Senate. For example, the amendment lists sections 29, 81 and 84 of the act as alternatives to incarceration. Section 29 refers to hospital transfers, and section 81 refers to healing lodges, so their inclusion here makes sense. However, section 84 is about community-supported release following incarceration. It is not an alternative; it is the next step, so we are proposing to remove it from this list.
The amendment would also require that preference be given to alternatives to incarceration. Frankly, that is very problematic. Alternatives to incarceration should be used where appropriate, but there are situations when putting someone in prison is a valid and necessary approach. Alternatives should be considered, but not necessarily preferred.
Also, for clarity sake, we are proposing to remove or replace certain terms that do not have established legal meanings, such as “carceral isolations” or “incarcerated persons” or “a broad interpretation informed by human rights”. Certainly, everything government agencies do should be informed by human rights principles, but to be enforceable and actionable, legal terms need to have clear and precise definitions. If we asked everyone in this House to explain what it means to interpret legislation broadly and in a manner informed by human rights, we would probably get 338 different responses.
View Karen McCrimmon Profile
Lib. (ON)
View Karen McCrimmon Profile
2019-06-19 21:58 [p.29446]
Mr. Speaker, that is why we are proposing to remove these terms. Even so, of course, the Charter of Rights and Freedoms will continue to apply to everything the Correctional Service does.
The other amendment that we are proposing to partially retain has to do with strip searches. The Senate is proposing to prohibit any strip searches conducted as a matter of routine and we wholeheartedly endorse that objective. It would not be pleasant for any of us to be strip-searched.
People in prison have often experienced trauma, including sexual abuse. Strip searches can cause them to relive that trauma and can even deter people from participating in programs like work release if they know they will be strip-searched on their way out or on their way back in. The Correctional Service should do everything possible to minimize strip searches.
That is why Bill C-83 would allow for the use of body scanners similar to what exists in airports as recommended by the United Nations. Rather than a blanket prohibition though, the government is proposing that the law require that Correctional Service use a body scanner instead of a strip search whenever one is available. That accounts for the fact that it will take some time for body scanners to be installed in every institution and it recognizes that sometimes machines break down. In those situations, correctional staff still need to be confident that inmates are not smuggling drugs, weapons or other contraband. That is important not only for staff safety but for the safety of other inmates as well. As body scanners become more available in federal institutions, strip searches should become increasingly rare.
I will now turn to the proposals from the Senate with which we respectfully disagree.
To begin with, there are two relatively similar ones that would take existing concepts used for indigenous corrections and expand them to other unspecified groups. This would apply to section 81 of the act, which allows for community-run healing lodges and section 84, which allows for community-supported release. Both of these concepts have proven valuable and successful in an indigenous context and the idea of expanding them is indeed worthy of serious consideration.
Certainly, there are other overrepresented groups in federal custody, particularly Canadians of African descent. Our government is wholly in favour of examining whether strategies that have worked for indigenous corrections can be successfully applied in other contexts and with other communities. We are opposing this amendment not because we disagree with the principle but because the serious consideration and examination I mentioned has not happened yet.
Before moving forward with something like this, there should be extensive consultations to determine which groups would be interested. Where does the capacity exist? And how the experience of the relatively few indigenous communities and organizations that run section 81 facilities is or is not applicable more broadly.
It would be a major policy change and potentially a positive one, but the study and analysis should come before we change the law, not after.
We also respectfully disagree with an amendment that would require the Correctional Service to approve the transfer to a provincial hospital of any inmate with a disabling mental health issue. As I mentioned earlier, in the 2018 budget, our government increased funding for external mental health beds. The use of provincial hospitals may be appropriate in some circumstances. The fact is, though, that it can be very difficult to find provincial hospitals willing and able to house and treat federal inmates. If we want to change the law without the aim of bringing about the transfer of a significant number of people from federal correctional institutions to provincial hospitals, it is imperative that we consult the provinces first.
It is also important for the sake of preserving the clinical independence of the health care providers who work in corrections that the law not pre-empt their professional judgment. The law already allows for these kinds of transfers where possible and appropriate and where recommended by medical professionals. At the same time, we are dramatically bolstering mental health resources within the federal correctional service so that inmates receive high-quality mental health care wherever they serve their sentence. We are also proposing not to accept an amendment that would allow sentences to be shortened on application to a court, due to acts or omissions by correctional personnel deemed to constitute unfairness in the administration of a sentence.
Once again, the goal of deterring improper conduct by correctional staff is commendable. There are a great many people working in federal corrections who are committed professionals doing excellent work. Anything less should be deterred, denounced and the persons potentially disciplined or dismissed. Inmates who are negatively impacted by inappropriate conduct on the part of correctional staff already have recourse, in the form of grievances or lawsuits, for example. The idea of retroactively shortening court-imposed sentences in these circumstances would be a major policy change. Before enacting this kind of provision, there should be consultations with stakeholders, including victims groups as well as provincial partners and other actors in the justice system. Parliamentarians in both chambers should have the opportunity to study it at length. It is not something that should be tacked on at the end of a legislative process that did not contemplate this kind of approach.
We also respectfully disagree with the recommendation to have the new system reviewed by parliamentary committees after two years rather than five. This House added a five-year review to the bill, and that is a reasonable time frame. It gives the new system time to get off the ground and be fully implemented and that will actually make Parliament's review more meaningful and impactful when it happens. In the interim, the minister will soon be appointing an advisory panel to monitor implementation of the SIUs as they roll out. That panel will be able to visit sites, meet with inmates and staff, provide feedback to the commissioner and sound the alarm if something is really not working out as it should. Of course, parliamentary committees do not need legislation to tell them what to study. Even without a legal requirement, if committees of this House or of the other place want to review the SIU system two years from now, they are perfectly free to do so.
Finally, the government respectfully disagrees with the proposal to institute judicial review of all SIU placements after 48 hours. Bill C-83 already has a strong system of binding external oversight.
Independent external decision-makers appointed by the minister will review any case where someone in an SIU has not received the minimum hours out of cell or minimum hours of meaningful human contact for five days in a row, or 15 days out of 30. They will also review cases where the Correctional Service is not following the advice of a health care professional to remove an inmate from an SIU or change their conditions. They will review all SIU placements at 90 days and every 60 days thereafter for any inmate still in the SIU at that point. That is in addition to regular and robust internal review at five, 30 and 60 days.
Simply put, judicial review of SIU placements is unnecessary. Colleagues do not have to take my word for it. At the public safety committee, the correctional investigator supported using the independent chairperson model to oversee SIUs. That is a model that uses ministerial appointees, not judges.
Plus, while no court has considered the new SIU system proposed by this bill, courts in Ontario and B.C. have rendered decisions about the kind of oversight they deem necessary for the current system of administrative segregation. In B.C., the court found that oversight of administrative segregation must be external to the Correctional Service but did not say that judicial review was required. In Ontario, the court actually found that internal review was preferable, saying, “The reviewing tribunal can have adequate independence without having all the attributes of a judge.”
Beyond being unnecessary, requiring judicial review of all SIU placements longer than 48 hours would have considerable impacts on provincial superior courts. There would need to be new judges appointed to handle the caseload. Those judges would be paid for out of federal funds and they would require support staff paid for by the provinces. There would also be changes required to the Judges Act, as well as to corresponding provincial legislation. In other words, accepting this amendment would mean imposing legislative and financial requirements on the provinces without so much as a phone call to check and see if they are on board.
If judicial review were the only way to ensure that this new system works properly and to provide the procedural safeguards required, then one could make an argument that all of these complications, making legislative amendments across the country, finding the money in federal and provincial coffers, and fast-tracking the appointment of a bunch of new judges would just have to somehow get done. However, judicial review is far from the only option. There must absolutely be robust oversight of the new system proposed by Bill C-83 and review by independent external decision-makers meets that need.
I thank all hon. senators for their efforts and their contributions. At this point, the bill truly is the product of the Parliament of Canada as a whole.
If the version we are sending back to the Senate receives royal assent, it will be a piece of legislation drafted by the government, amended by Liberal, Conservative, NDP and Green Party members, and amended by our colleagues in the Senate, as well.
For all of our frequent disagreements, this bill is a good example of the strength of the legislative process in our parliamentary democracy. Most importantly, it will significantly improve Canada's correctional system, enhancing the safety of the people who work and live in federal institutions and improving the system's effectiveness when it comes to rehabilitation and safe, successful reintegration.
I look forward to the passage and the implementation of Bill C-83.
View Jim Eglinski Profile
CPC (AB)
View Jim Eglinski Profile
2019-06-19 22:46 [p.29452]
Mr. Speaker, it is my last speech, and I do apologize. It was just the terminology that slipped out.
Years ago we learned that we had to give respect to the prisoners. They had to be treated properly. That is no different today. I realize that Bill C-83 is trying to do that in a number of areas. As our colleagues in the Senate have said, there are some things that need to be corrected. I hate to say it, but the Liberals are not listening again.
My primary purpose in getting up today is to say that the women and men who work in our institutions do a great job for our country. They are a fantastic group of people. In many cases, maybe even more than police officers who are out on the street or our military who might be defending some country somewhere, these guys are right on the front lines.
A lot of our prisoners are everyday common people. We do not need to worry too much about them. They are civil. We can have great conversations with them. We can joke around with them. However, we do have some real bad apples there. Some have mental health problems. Some are just downright mean. Some can be rehabilitated. Some, and I am going back to 50 years of experience, cannot be rehabilitated or do not want to be rehabilitated, and that is where the problem comes with segregation.
I know that the Supreme Court has ruled that we need to change our policies. We need to give prisoners more rights, but that will come at a cost to the country. I guess we will have to accept that, because that is what it has ruled.
However, the primary thing is that I want my friends and my constituents who work at Grande Cache Institution to be safe. I want the average prisoner who is there, who maybe was picked up for impaired driving or maybe something minor, who is not really a bad person, to be very safe in our institutions. That is my primary concern.
My colleagues across have been given a number of recommendations from the Senate that I think need to be addressed and cannot be ignored. I did not pick up on all of them, and I am not going to deal with all of them. However there is one I thought I would spend a little time talking about.
The Senate said that the authority should be left with the institutions as to the movement of a prisoner to a provincial institution. That is only rational, good, common sense. I am not knocking professional health people. They do a great job for us, but we have some great con artists in our jails who could sweet talk the Speaker into letting them sit up there while the Speaker took their place. That is how good they are. I know that the Speaker would never be conned. However, that is where my fear comes in. The institution staff know these people. They are dealing with them 24 hours a day, seven days a week. They know how slick the prisoners can be.
A medical professional coming in, maybe for an hour or two or maybe three hours a week, could be baffled. That is why I think it was a very wise decision that came back from the Senate. It was a common-sense correction, yet it is being ignored.
I appreciate being given the time to stand up here to defend the institutional guards at Grande Cache and others across the country. They are doing a great job for us.
Get rid of the needles. I am not going any further with that. It is the biggest mistake we ever made.
View Robert Nault Profile
Lib. (ON)
View Robert Nault Profile
2019-06-05 17:32 [p.28602]
moved:
That the House: (a) call on the Standing Committee on Health to undertake a study and report its findings to determine (i) the factors that contribute to significant disparities in the health outcomes of rural Canadians, compared to those in urban centres, (ii) strategies, including the use of modern and rapidly improving communications technologies, to improve health care delivery to rural Canadians; and (b) call on the government to work with the provinces and territories, and relevant stakeholders, to further address and improve health care delivery in rural Canada.
He said: Mr. Speaker, it is an honour and a pleasure to get the chance to speak to my private member's motion, Motion No. 226, which relates to health care delivery in rural Canada.
As a representative of the Kenora riding, one of the largest rural ridings in Canada, which stretches from almost the American border all the way to Hudson Bay, I know this is probably one of the easiest ridings to use to explain what it means for an area to be remote and inaccessible, or accessible only by plane or a winter road when the lakes freeze over.
This is an important subject matter for all rural Canadians, because it is one of those issues all Canadians think about, which is their health care, the health care delivery and the ability of government to deliver health care products to all Canadians, particularly in the north. For these reasons, northwestern Ontario presents a unique case study in many ways. From infrastructure to environment, transportation and employment, the north forces us to think outside the box.
Health care can be approached from many different angles, including mental health treatment, health care providers and availability, prescription drug coverage and culturally appropriate care, just to name a few.
The 2016 Statistics Canada census data indicates that Canada's population was over 35 million individuals, of whom 16.8% live in rural Canada. The 2006 report by the Canadian Institute for Health Information entitled “How Healthy are Rural Canadians? An Assessment of Their Health Status and Health Determinants” found that rural Canadians have higher death rates, higher infant mortality rates and shorter life expectancies than their urban counterparts.
Health-related factors such as a higher proportion of smokers, lower consumption of fruit and vegetables, and obesity disproportionately affect rural residents. Additionally, the population in rural areas tends to be older than in urban areas.
The recruitment and retention of physicians and health care professionals are also a significant challenge. Throughout the years that I have been involved in this, it has never been easy to find enough professionals to work in rural Canada. According to 2016 data from the Canadian Institute for Health Information, there were approximately 84,000 physicians in Canada, of whom only 6,790, or 8% , practised in rural settings.
In 2006, the Canadian Institute for Health Information issued a report that found that populations living in rural areas had a shorter average life expectancy by almost three years for men, as well as higher smoking rates compared to their urban counterparts. These numbers are statistically significant, according to the report.
Mortality risk for diseases such as heart disease and heart attacks, as well as respiratory diseases like influenza and pneumonia, were also significantly higher in rural versus large urban areas. There is a variation in the levels of services available, as rural areas lack the population base to warrant the construction of extensive health infrastructure.
In addition, rural and remote communities face challenges in recruiting and retaining health care professionals. I will keep repeating that, because it is something we talk about in my riding almost weekly.
On the youth side, there is no process for measuring health disparities in Canada. If we look at the experience of rural children and youth in the health care system, we get a good idea of what is happening. Indigenous populations, particularly those that are rural and remote, are the most underserved communities in all of Canada.
I would like to take a minute to provide an example of health care delivery in the north so that we can see how different it is from the urban experience.
In September 2018, the Sioux Lookout First Nations Health Authority released “Our Children and Youth Health Report”, which represents the experiences of 31 first nations communities in the Sioux Lookout area.
Since 1991, the population of the Sioux Lookout area first nations has grown by 74%. The primary point of care for the majority of these communities is the local nursing station, and in many cases, emergency services are available only by plane. For example, women from Sioux Lookout first nations leave their homes and families and travel hundreds of kilometres to give birth at a hospital. Can members imagine being put in a situation like that? In these communities, basically for all the births, families have to fly out, leave for weeks when it is close to the due date, and then be prepared to spend weeks waiting for the child to be born.
The primary point of care for the majority of these communities is their local nursing station, and in many cases, emergency services are available only by plane. For example, women from Sioux Lookout area first nations leave their homes, as I said, and if infants need emergency care, they are transported out by medevac, because there are no emergency departments in these communities. Since 2012, there has been an 11% increase in the rate of emergency room visits for infants.
In the Sioux Lookout area, first nations youth attend the emergency room department for mental health reasons at a rate five times greater than the Ontario average. Between 2012 and 2016, the rate of emergency department visits for mental health increased by 123%.
These are examples of just some of the issues faced by rural and remote communities when it comes to health care delivery. I am here to talk about how we can find a way to deal with the challenges that rural communities face in making sure that their health care and their standards are equal to the health care standards of urban centres.
Jurisdictional issues pose one of the largest roadblocks to providing quality health care in the north. What is the role of our levels of government in this game of what I would call jurisdictional football? The federal government is responsible for the delivery of health care to certain population groups. Of course, the provinces are responsible for the general population of the province.
Section 10 of the Canada Health Act stipulates that each province's health insurance scheme must be universal, which means that it “must entitle one hundred per cent of the insured persons of the province to the insured health services provided for by the plan”. What does this mean? It boils down to the need for a collaborative approach. Rather than working from the top down, we need to approach these communities and regions to establish their unique needs and find those solutions.
Simply put, there is no cookie-cutter answer, and what works for one community may not work for another. The bottom line is that we need to listen to those who live and work within the system every day to make sure that we understand how to deliver health care in rural Canada.
When we have these discussions, sometimes it is hard for people to compare apples and apples or oranges and oranges, so I spent some time doing some comparisons between Canada and Australia. Like most developed countries, Canada and Australia have publicly funded, universal health care coverage. The two countries have similar population densities and geographic areas. As of June 2018, just under 25 million people resided in Australia, and 11.4% resided in remote or rural locations. The Australian federal government is playing an active role in addressing health disparities between urban and rural or remote populations.
The Australian government provides funding to incentivize physicians to work in rural or remote areas and to encourage the uptake of telemedicine technology in those areas. Like rural Canada, rural Australia is under-serviced with respect to the number of physicians. However, the Australian government also realizes that to change that, it needs to have a solution. This is what Australia is doing, and it is something that I think Canada should consider.
Like rural Canada, rural Australia is under-serviced, so in 2009, the Rural Health Standing Committee of the Australian Health Ministers’ Advisory Council was asked to develop a national strategic framework for rural and remote health. It was published in 2011, and then updated in 2016.
In 2014, the Australian government implemented the indigenous Australians' health programme to improve access to health services that are culturally appropriate, throughout Australia.
In June 2017, the Government of Australia passed legislation to establish a national rural health commissioner, as part of the government's efforts to reform health care in rural and remote Australia. As in Canada, the indigenous population in Australia is more likely than non-indigenous Australians to have respiratory diseases, mental health problems, cardiovascular disease, diabetes and chronic kidney disease, as well as reduced life expectancy.
In the private members' business we are in, it is always good to try to do this from the perspective of making sure that it is non-partisan and that it crosses party lines. Last month, I was pleased to second Bill C-451, an act to establish a children’s health commissioner of Canada, which was put forward by the member for Simcoe—Grey. Bill C-451 puts priority on the well-being, health, security and education of children and youth by recognizing that every child has the right to enjoy a standard of living that allows for the child's physical, mental and social development to flourish. To help see these measures through, the bill seeks to establish an independent commissioner to report, advise and provide recommendations to Parliament.
To complement Bill C-451, my motion seeks to shed further light on the health care delivery gaps between rural and urban Canadians. This area needs to be studied, because current evaluations of the health status of rural Canadians are very limited. Because we do not have the population density to build some of the health infrastructure necessary to deliver adequate services, we must look at existing, new and emerging technologies to address this service gap. This particular type of study has never been undertaken in Canada, so I look forward to working with all parties to see that it takes place.
In my riding, we are working on an all nations hospital. We are looking at health care delivery in our region from the perspective of an all nations hospital health care system, to include everyone in the region. We have included all governments and the local communities to look at how best to deliver those kinds of services. This is a potential way forward.
I think that working together, as we did last week with the Minister of Indigenous Services when we announced our government's support for the all nations hospital health care system, we can find ways to better deliver health care in rural communities.
In conclusion, no matter whether a person is rich or poor, young or old, living in a rural or urban setting, Canada's public health care system must provide equal access and care to all. I believe very much that this government and this Parliament have a role to play in making sure that we do the right assessments and find the right structures to put in place good health care.
My last point is that if people are to be allowed to live their lives in rural Canada, including as seniors throughout their retirement years, we are going to have to find the right health care system to make sure that this takes place. Otherwise, as I hear from all my colleagues, a lot of seniors move to urban centres because they have few choices for places to live in rural Canada.
I thank the House for the opportunity to say a few words about this motion.
View Marilyn Gladu Profile
CPC (ON)
View Marilyn Gladu Profile
2019-06-05 17:53 [p.28605]
Mr. Speaker, I am pleased to rise today to speak to Motion No. 226. which seeks to give instructions to the Standing Committee on Health regarding health care delivery in rural Canada.
There is an extremely concerning shortage of family doctors and nurses in Canada, particularly in rural areas. The lack of broadband Internet also prevents rural communities from accessing online health services. The committee should also consider the worrisome deterioration of rural hospitals in its study.
I want to thank the member for Kenora for bringing the motion before the House. My daughter was a nurse in his lovely riding, so she is well acquainted with its hospital and the health care services that are available there.
As the member for Sarnia—Lambton, I note that Sarnia is a mixture of urban and rural, so there are also quite a number of parts of my riding where services and transportation are not available.
I would like to start by talking about the current situation in health care in general in Canada.
We know there is already a shortage of doctors and nurses across the country. I have travelled from coast to coast to coast and spoken with people in various ridings. I would like to give members a few examples of the shortage, starting with what I think is one of the worst cases I have heard, which is Cape Breton.
Cape Breton was missing 52 emergency room physicians and a vascular surgeon. People who cut an artery in Cape Breton would lose a limb or die because they would not be able to get to Halifax in time to get the services.
Let us look across the country. Given the wait times in Ottawa, it takes six years to get a family doctor. The former member for Nanaimo—Ladysmith ran provincially, and one of the priority issues she brought up was the shortage of doctors in B.C. Truly, there is a shortage of health care workers.
This is particularly disturbing, as we have an aging population. Right now, one in six people is a senior, and that will be one in four in the next six to 10 years. With that comes a need for a number of different services.
First of all, we are seeing a movement toward more chronic disease, in part due to rising obesity rates, smoking issues and so on. Also, as people are living longer, we are seeing an increase in dementia, and there is a need for palliative care. Of course, I have been a strong advocate for palliative care during my time in the House. About 70% of Canadians do not have any access to palliative care, and this is especially true in rural and remote places. It is a pressing problem.
As I look to the government that has been in power for four years, I see absolutely no plan to address the gaps that exist regarding the resources for health care workers and all the infrastructure needed in places like Petrolia, which is one of the hamlets within my riding. Right now, the electrical and mechanical systems in place at the Charlotte Eleanor Englehart Hospital are so obsolete and so likely to fail that Petrolia is planning how it will shut down the hospital when the systems fail. All of the patients will have to be moved to the nearby high school. Petrolia needs $5 million to repair that infrastructure.
I could tell members similar stories, from across the nation, of hospitals that have not received any funding for infrastructure. Clearly the provinces do not have money for that. One solution the government could bring forward in that light is a program that would specify rural hospitals and their infrastructure needs, which would address some of the outstanding issues there.
Another need in many rural and remote places is broadband Internet. As we move increasingly to using virtual services, such as virtual palliative care and virtual consultations, communities need broadband Internet to receive them. There is a huge need for this in the north. My riding has several places without good access to the Internet. I think it will be incredibly important to address this need.
One of the other problems with the rural and remote health care system is just accessing the services. Transportation can be very costly and, as the member for Kenora has mentioned, it can take a really long time. In Kenora, people transit by airplane. In my riding, even though there are many services, a lot of people have to go to nearby London, which is an hour away. For low-income people and those who do not have transportation, there is no service to take them for weekly cancer treatments or other procedures. Transportation is a big barrier, and we need to find solutions to address that.
There have been some really innovative solutions that I discovered when I was working on the palliative care private member's bill. One of them was the use of paramedics to deliver palliative care. Trained paramedics, during the hours they are not taking care of emergencies, would distribute pain medications and perform procedures that patients need. This is really cost-efficient, because they are already on the payroll, and it is a great service for people who have trouble accessing services and cannot get the transportation they need. It is those kinds of innovations that will be really important as we move forward.
Another issue in my riding—and I heard it is also an issue in Kenora—has to do with how to attract doctors, nurses and health care workers to go to rural places. There has to be some kind of incentive. One of the great innovations, also in Petrolia, was a clinic that was put together with multiple family physicians and nurse practitioners providing various services. Because the doctors did not have to be sole family physicians working umpteen hours in practice and then being on call for emergencies, the balance of life and work was much better. There was a real effort made to attract doctors to that practice. They are doing a fine job and making services very accessible to people who live nearby. In fact, because of the quality, in some cases people are even coming from Sarnia to Petrolia to access services.
We need to come up with solutions on how to provide health care and work with the provinces and territories. Every region is different. We talked about some of the barriers, such as travel during bad weather, for accessing services, but in some places, the problems are different. Some places have an aging population. In my riding, 50% of people are over the age of 57, so care for seniors is a key issue, and I know that is true as well in Nova Scotia and a number of places across the country.
At the end of the day, I would be happy to have the health committee study this issue. I wish we had time in this parliamentary session, but, as has already been pointed out, it is unlikely that a study could be taken up at this point in time. Perhaps it will happen in a future Parliament.
This is an urgent need and something we need to consider. We need to put together a plan that will identify the health care workers required and how to get them. In some cases, there are enough workers in Canada; in some cases, we will have to change how we train doctors, for example. There was a very innovative example in New Brunswick, where, although there is no teaching hospital or university for residencies, the province partnered with Dalhousie University and Sherbrooke for a residency program that would provide medical services in New Brunswick and allow doctors to be certified. That kind of innovation is needed to address the health care worker issue.
In addition, there is a need for an infrastructure plan, as I have mentioned, for broadband Internet and hospital care and other services. For example, we see an increasing need for home care. Home care in rural and remote situations is increasingly difficult because of the amount of travel time and, in some cases, the weather, etc.
When we get this plan together with the resources and infrastructure and decide which services we will need as we move toward more chronic disease and an aging population with more dementia, thus requiring more palliative care, then we can start to execute that plan. It could not happen soon enough because, as I have said, one person in six being a senior now will be one in four within six to 10 years.
It is an urgent issue, and I am happy to support this motion.
View Ben Lobb Profile
CPC (ON)
View Ben Lobb Profile
2019-06-05 18:22 [p.28609]
Mr. Speaker, it is a pleasure to rise in the House of Commons today. As a lifetime resident of a rural community, it is a pleasure to talk about rural health care and rural issues.
Just talking with different health care providers in the riding, talking to farmers in our communities and what we see in the news, mental health issues in our rural communities are probably the most significant we have ever seen. I do not mean to point farmers out, but people in the agriculture sector feel this due to the stresses of finances, crop prices, trade, last year's harvest and this year's spring planting. Therefore, when we look at the entire package of health care, mental health needs to be a priority. Of course, the proposed study will not happen in this Parliament, but hopefully it will in the 43rd parliament.
Youth suicide is another issue. The youth suicide rate in rural communities is higher than anywhere else. Any information or strategies we can put together to dovetail mental health and youth suicide rates would be very important.
Another topic is addiction. There is an opioid addiction crisis from coast to coast in our small communities. Opioids are a big issue as is crystal meth. It does not really matter what part of the country we are in at this point in time, it is in every one of our communities. Therefore, addiction and mental health treatment and having facilities that are world class and state of the art would help people of all ages deal with these issues, but primarily in a rural area where one has to go so far. People cannot just go down the street for their treatment; it could be several hours away.
Another issue is the number of health care providers who provide a certain service. If we look at mental health, people may require treatment, but they might be told it could take three months to get an appointment. When people are at the point where they have come forward and have asked for help, to tell them that can get that help in three months is not a solution to the problem. Getting hard data to put into this report would be fantastic and would build out these action plans. I know there is lot of it out there, but we need to hammer this home.
In rural Ontario, where I am from, there have been higher rates of diabetes, heart disease and obesity for years and decades. Numerous strategies have been put together with respect to this, but we need proactive health care in our rural communities. We need facilities that will promote a healthy lifestyle and get people out exercising.
COPD are is unique to communities as are some forms of cancer. We need further information on that moving forward.
Baby boomers are getting to the age where they have a different set of health care requirements than they once had. In my community, there is now a geriatrician, which is a vital specialist, to provide help to our aging population. I am from a rural community, Huron County and Bruce County, which is on Ontario's west coast. It is a favourite destination for retirees to head to when they are of that age. We have a higher proportion of seniors than other communities. Therefore, a geriatrician is a vital physician.
A couple of weeks ago, one of our beloved members from British Columbia talked about the issue of palliative care doctors. We could use a lot of palliative care doctors in our rural communities, which would help provide a fitting tribute to some of our hard-working Canadians.
Doctor attraction and retention has been an issue in our rural communities. Going back 20 years ago, for example, Goderich, with a population of over 10,000 people, needed doctors. It put together a great doctor attraction and retention program.
Many may know of Gwen Devereaux from Seaforth, Ontario. From coast to coast, she has been educating and informing Canadians on how to attract doctors to rural communities. She has been on CBC and different radio stations, talking about what she has done.
Someone else mentioned that having a beautiful state-of-the-art clinic would attract physicians to the area. Spouses having meaningful employment would go a long way in attracting a physician to a certain community. The provision of services, which can be as basic as broadband Internet or a community centre with a fitness centre, would also help. All of these things contribute to attracting well-educated physicians, nurses, radiologists or whatever position to go into communities, plant roots and live there.
When most doctors and other health practitioners make a commitment to rural communities, they love it and want to stay, and people are happy to have them.
There has been a lot of improvement with e-health records from coast to coast. It defies logic to look at our phones and see what the technology sector can do, yet health continues to lag behind. It is making innovations, but it is lagging behind. Another good innovation is the Ontario Telehealth Network, which we are happy to have. It is changing outcomes in people's lives.
I think we can all agree that we need hard infrastructure. For example, communities need CT scanners. For people who have strokes or heart attacks, scanners can make a difference in their lives. However, does it make sense that a community has to fundraise to have a CT scanner in its hospital? It defies logic. When we talk about ways the federal government can work with all jurisdictions, why make a community pay for that? There may be strategic ways to provide funding for CT scanners.
Something else communities desire are hospices. They are few and far between. Communities have to fundraise to build them. In Ontario, where I am from, if communities are fortunate enough to have funding for the land, which is only 60%, they have to continue to fundraise in perpetuity for the other 40%. The federal government could play a role in working on a national plan to change this and be a little more fair to communities.
It is the same thing for long-term care. Many long-term care facilities are way out of date and need serious upgrades. There are no addiction treatment centres in my area. They are regional, yes, but there is a whole pile of changes we could make to that.
Last, and probably most important, if we do this study in the 43rd Parliament, the Gateway Centre of Excellence in Rural Health should be invited. It is in my riding and it is the only research facility like this in Canada. It was modelled on a U.S. idea. It does rural health research in partnership with universities. The best and brightest minds come to my community every year to do rural health research, and people are so happy for it. Again, they do it on their own dime. It would great if the federal government and the provinces could come together and provide operational funding to different research facilities like this, which provide great research to rural Canada and, in some cases, encourage these bright, young minds to stay in the area.
I look forward to coming back in the 43rd Parliament. I am sure my colleagues across the way would like otherwise. Regardless of the outcome, it would be great if the health committee would do this study and look at moving beyond jurisdictions.
National defence provides health care and we provide all sorts of health care to indigenous Canadians. There is a role for us. If we all work together, we could rise above the partisan lines.
I wish all my colleagues the very best this summer and in the election in October.
View Dave Van Kesteren Profile
CPC (ON)
Mr. Speaker, I have a number of petitions to present.
The first one is a petition asking that the Parliament of Canada enshrine in the Criminal Code the protection of conscience for physicians and health care institutions from coercion or intimidation to provide or refer for assisted suicide or euthanasia.
View Geng Tan Profile
Lib. (ON)
View Geng Tan Profile
2018-11-19 14:06 [p.23525]
Mr. Speaker, in 1960, North York residents came together to build a local hospital, supported by Friends of North York General Hospital, the IODE, Missionary Health Institute and volunteer services. Three thousand volunteers raised over $3 million dollars.
On March 15, 1968, an $8.6 million, 70-bed community hospital opened at the corner of Leslie and Sheppard. Fifty years later, North York General Hospital remains one of Canada's leading community academic hospitals. Its emergency department had over 100,000 visits in 2016-17.
I congratulate the North York General Hospital community for having made a world of difference since 1968.
View Robert Oliphant Profile
Lib. (ON)
View Robert Oliphant Profile
2018-06-12 14:03 [p.20727]
Mr. Speaker, I rise in the House today to mark the 70th anniversary of Toronto's Sunnybrook Health Sciences Centre.
Founded in Don Valley West in 1948 as a hospital for veterans, Sunnybrook has a proud history and a distinguished legacy of caring for Canada's war heroes. Affiliated with the University of Toronto, it continues to stand as a symbol of our nation's gratitude to our armed forces. Over the past 70 years, Sunnybrook has grown into one of Canada's largest and most dynamic health care facilities and has become a leader in patient care, education, and research.
Sunnybrook's veterans centre, working in close partnership with Veterans Affairs Canada, remains the largest veterans care facility in the country. Today, it is home to some 475 veterans from World War II, the Korean War, and modern conflicts who receive state-of-the-art, specialized care.
We look forward to Sunnybrook's next 70 years and the lasting impact the hospital will continue to have on Canadian veterans, their families, as well as the wider community.
View Chandra Arya Profile
Lib. (ON)
View Chandra Arya Profile
2017-11-02 12:35 [p.14867]
Madam Speaker, I listened to my learned friend from the other side, and there were some inaccuracies in what he said. He mentioned that the Conservatives introduced the child benefit during their regime, but that was taxable. Under the Canada child benefit, we are giving more tax-free money to nine out of 10 families than the previous government did. The member also mentioned that we had not considered inflation. Probably the member forgot that we are now two years into our governance and we are linking the Canada child benefit to the cost of living increases.
I did not hear the member talk about affordable housing for seniors. In the riding of Nepean in Ottawa, 10,000 people were on the waiting list for affordable housing. We have made a great many investments for seniors. A few years back, a report stated that in Ottawa and the eastern Ontario region, 2.5% of patients accounted for 35% of hospital expenses. Fifty per cent of that 2.5% were seniors. Therefore, we have transferred more funds to the provinces with the condition they be used for senior care and mental illness.
Finally, does the member recognize that the increase in our GDP growth is the best among the G7 countries due to the investments we have made.
View Rob Nicholson Profile
CPC (ON)
View Rob Nicholson Profile
2017-05-30 13:02 [p.11643]
Mr. Speaker, I am pleased to rise in the House today to share some thoughts regarding Bill C-45, an act respecting cannabis and to amend the Controlled Drugs and Substances Act, the Criminal Code and other acts.
Essentially the bill proposes to regulate and legalize the production, possession, use, and distribution of marijuana across Canada. The government is on record saying it wants to implement this by July of next year. The government's decision to move hastily on such an important piece of legislation concerns me.
Let me be clear, this marijuana bill will have far-reaching impacts on every part of our society. It is imperative that before proceeding with the significant changes to the Criminal Code, a thorough debate takes place in the House for all members who wish to speak.
I would like to take a minute to outline some of the areas of concern that I have with the legislation. One of the major issues I have with the legislation is the fact that it will be putting children at risk of having much greater access to marijuana. I am sure this concern resonates with parents of young children and teenagers. While the government has consistently touted that one of its objectives is to prevent young people from accessing cannabis, in reality the bill does just the opposite.
Clauses 8 and 9 of the legislation are a perfect example. These provisions state that it is prohibited for an individual to possess or distribute more than four cannabis plants that are not budding or flowering. This means that it will be legal for people to grow at least four marijuana plants inside their homes. I do not know of any easier way, and I said that in my question, for children to access marijuana than in that way.
Unlike prescription pills, which people can put away, marijuana plants, by definition, have to be out in the open. I cannot imagine any easier way for children to get hold of marijuana than when their parents are starting to grow it in the kitchen.
My concerns for children and teenagers do not end there. Let us consider the dangers for young people who may come in contact with marijuana edibles. This is an issue that is not properly addressed in Bill C-45. I have seen photographs, as I am sure other members have, of these edibles. They are indistinguishable from candy treats or baked goods that are often found on the kitchen counter, in the kitchen cupboard, or even in a cookie jar, enticing prizes for young children. They are so convincing that an adult could mistake a pot edible for the real thing.
The possible health risks for children ingesting these kinds of edibles cannot be underestimated. According to health care professionals, such as Dr. Robert Glatter, the consumption of multiple servings of edibles at one time, for any age group, results in various potential psychological effects, not to mention the possibility of over-sedation, anxiety, or psychosis. Ingesting multiple servings in a short time span can also produce intense anxiety, paranoia, and even psychosis. These adverse side effects are more frequent among first-time users.
If these are the health risks that affect adults ingesting edibles, one can only imagine the danger they pose to children who are almost certainly going to be first-time users. In fact, experts from the Department of Justice have attested that edibles pose significant risks to the health of children. Clearly, the entirely plausible chance that children may accidentally ingest these edibles deserves a more careful examination by the members of the House.
Another illogical aspect of the legislation that the government must address is the ambiguous rules regarding the quantity of marijuana that children may legally possess. As we have heard, according to Bill C-45, paragraph 8(1)(c), children under the age of 18 are prohibited from possessing the equivalent of five grams of marijuana or more.
What happens when a 12-year-old uses or distributes cannabis to his peers on the playgrounds, every day, with no questions asked? This is a lax approach. How can the government ensure that children and teenagers will not be recruited by organized crime? I can see that is what is going to happen. On a simpler front, is it safer to be in possession of four grams of cannabis or five, or is the safest quantity the possession and distribution of zero grams? That is what our party would support.
The Liberals will tell Canadians that four grams is okay but the Conservatives, on the other hand, are firm in our conviction that zero grams is the only safe amount for our children.
The cannabis act is replete with arbitrary cut-offs that do nothing to protect our children from the dangers of marijuana. In fact, we believe they expose them to greater risk. Canadians deserve clarity when it comes to legislation that will significantly affect so many aspects of our justice, health, and public safety systems, and more important, their daily lives and families. It is not enough, I would like to point out, to say we are going to shove all these things over to the province and let them figure it out. There is a responsibility for the federal government to get it right.
If all these problems with accessibility alone were not sufficient to highlight the shortcomings of Bill C-45, please note that the Prime Minister and his government proposed that the legal age to purchase marijuana be 18 years of age. For a government that claims to espouse and produce evidence-based policy, this provision is clearly off the mark. All we have to do is ask any doctor, health organization, or health expert. For one, the scientific evidence overwhelmingly confirms that the human brain does not fully develop until individuals reach their mid-twenties.
The Canadian Medical Association, as I have pointed out, has already warned the government that the use of cannabis may have significant psychological impacts on brain development up to the age of 25, and recommends that 21 be the youngest acceptable age to legalize the purchase of marijuana. Indeed, the position of the Canadian Paediatric Society likewise urges the government to consider the dangers of so young an age to purchase marijuana. Again, the government keeps talking about protecting children but it completely ignores the evidence. Indeed, the co-author of that position paper, Dr. Christina Grant, has stated, at the very least, the levels of THC must be limited until after the age of 25 to be considered safe for brain health.
Once again, Bill C-45 lacks crucial information. Why are the Liberals ignoring this crucial scientific information, information that has a tangible impact on the health and best interests of Canadians? It is not enough to say we are ignoring all the evidence and let the provinces figure this out. That is not good enough.
Further, while drafting the legislation, the Liberal government had plenty of time to study the impact of marijuana legalization in several jurisdictions in the United States. Instead of learning from the mistakes and challenges that have befallen these states, the government decided to ram the legislation through. Again, this will be a complete detriment to Canadians.
I will give members a couple of examples of what we are talking about.
First is the fact that our American counterparts have found an increase in impaired driving following the legalization of marijuana in certain jurisdictions. In fact, the U.S. Department of Justice found that on Colorado roads, during the year following legalization of marijuana, there has been a 32% increase in deaths related to marijuana-impaired driving. That is completely unacceptable.
There is little doubt that Canadians will see a similar increase of drug-impaired driving if marijuana is legalized. In fact, statistics have already shown that this is a serious problem. According to the Canadian student tobacco, alcohol and drugs survey, nearly one in five Canadian high school students have been a passenger in a car whose driver had recently smoked marijuana.
Canadians of all ages are very confused about the many existing myths regarding smoking and driving. For example, in a 2014 poll, 32% of Canadian teens believed that driving high is less dangerous than driving drunk. The perpetuation of this kind of thinking will have serious consequences. A report prepared by the Canadian Centre on Substance Abuse states that Canadians 16 to 19 years of age are more likely to drive two hours after ingesting marijuana than they would be two hours after drinking.
The World Health Organization, on the other hand, has been clear in debunking this myth. It has stated:
Evidence suggests that recent cannabis smoking is associated with substantial driving impairment, particularly in occasional smokers, with implications for work in safety-sensitive positions or when operating a means of transportation, including aircraft.... Complex human/machine performance can be impaired as long as 24 hours after smoking a moderate dose of cannabis and the user may be unaware of the drug's influence....
In light of this information, Bill C-45 does not provide sufficient avenues to educate young people about the undeniable danger of driving high. Should the government insist on ramming this legislation through, it should seriously take into account the importance of public awareness campaigns in protecting young people.
Ultimately, actions speak louder than words, and legalizing marijuana sends the wrong message to young Canadians that pot is a benign drug, that it is not a cause for concern. In reality, the government cannot guarantee that more children and teenagers will not be injured in motor vehicle accidents, if not worse, as a result of increased access to marijuana. This, beyond doubt, is something the government should have considered seriously before trying to ram this bill through Parliament in an attempt to live up to a campaign promise.
Another important and threatening problem facing jurisdictions that have legalized marijuana is the increase in cannabis-related hospitalizations. We have already established the research that proves marijuana can have dangerous effects on children's brain development and overall health.
In Colorado, these studies have had far-reaching and tangible consequences. According to a recent report by the Colorado Department of Health, hospitalization involving patients with marijuana exposure and diagnosis tripled from around 803 per 100,000 between 2001 and 2009 to 2,413 per 100,000 after marijuana was legalized. That is about three times as many people who were hospitalized. This serves as a cautionary guideline for how children will be impacted by easy access and exposure to pot.
A report by the Rocky Mountain HIDTA states, “the number of Colorado children who’ve been reported to a poison control center or examined at a hospital for unintentional marijuana exposure annually has spiked since the state legalized recreational cannabis...”
These statistics are not inconsequential. Once again, why has the government ignored the lessons our peers have faced after legalizing marijuana? Answers to these challenges are certainly not found in Bill C-45.
The gaping holes in the legislation are indisputable. If homegrown marijuana plants are permitted, coupled with alarming and unanswered questions related to marijuana edibles, children will clearly have easier access to the substance. Given the bill's ambiguity on how much cannabis constitutes an offence, children and teenagers may possess and distribute up to four grams of marijuana with no clear recourse to protect them. Setting the age of majority for marijuana use at 18 promotes a lax approach to brain development and public safety.
Finally, the government's unwillingness to acknowledge the fact that comparable jurisdictions have faced critical health and safety challenges as a result of their similar legalization processes is not only reckless but unfair to Canadians who put their trust in their members of Parliament.
While the risks to children constitute my greatest concern with Bill C-45, there are numerous other problems that go unaddressed in the legislation. One of these is the fact that the bill provides little to no clarity on the degree of flexibility that the government will allocate to provincial governments and municipal law enforcement to implement this. Additionally, the bill does not sufficiently address the costs for retraining officers given the changes to the Criminal Code.
Moreover, the questions surrounding Canada-U.S. border crossings should legalization take place is particularly worrisome to me, as my constituents in Niagara Falls live right across from our American neighbours and often have the occasion to travel to the United States. Taking note of the fact that most American border states have not legalized recreational marijuana, the discrepancy in policy could greatly impact, among other things, the waiting time to cross the border.
The former U.S. ambassador to Canada, Bruce Heyman, has expressed his doubts regarding efficiency at the border and the legalization of marijuana. His primary concern is the fact that border patrol dogs are not trained to distinguish marijuana scents from other prohibited items.
He stated:
The dogs are trained to have reactions to certain scents. Some of those scents start with marijuana. Others are something that are significantly more challenging for the border. But the dog doesn't tell you this is marijuana and this is an explosive...
The dog reacts, and these border guards are going to have to appropriately do an investigation. That could slow the border down.
My constituents, and all of the 400,000 Canadians who travel to the United States every day, are deeply concerned about the waiting times and they want them to be as expeditious as possible. How can the government ensure that these delays will not affect Canadian business people, families visiting loved ones or even Canada-U.S. relations writ large? Bill C-45 is silent on yet another consideration for Canadians.
It is evident that the government has been too hasty in its attempt to push through this legislation without consideration of all the risks to children, confusion surrounding implementation, and delays in border crossings. This complex issue could result in insurmountable health and safety burdens in the years to come.
As such, I urge my fellow members to take the significant problems with the legislation into consideration.
To conclude, I move that the motion be amended by deleting all of the words after the word “That” and substituting the following:
this House declines to give second reading to Bill C-45, An Act respecting cannabis and to amend the Controlled Drugs and Substances Act, the Criminal Code and other Acts, since the bill makes homegrown marijuana more accessible to children.
View Brian Masse Profile
NDP (ON)
View Brian Masse Profile
2017-02-21 16:31 [p.9173]
Madam Speaker, one of the concerns I have with the bill is the continuation of integration with the United States on programs where previous programs have been disavowed, or have not ensured that the current agreements are kept in good faith. An example is NEXUS. I have written the minister about this.
I will be very specific with another issue, so hopefully people at home can really realize the significance of this. Our hospitals used to have prior arrangements with the United States so that preborn children and their mothers, as well as newborn babies, could get access to American hospitals for high-risk pregnancies and births, as well as after-birth emergencies. They could get into Detroit, for example, within minutes versus going to London. It is a life and death situation. We have yet to hear back from the minister about this. It was proved null and void under the Trump administration. Why would we want to go further when we still do not have clarity about our current rules and agreements and what they are supposed to be?
If there are no known entities for doing that, simply leaving it to people to figure out in life and death situations is just not good enough, so why would we go deeper when we cannot even get basic answers on past practices with agreements?
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