Mr. Speaker, as always it is a great honour to rise in the House and represent the people of Timmins—James Bay. I am honoured to rise following my colleague from Vancouver East who has done so much work on health care and end-of-life issues.

I have been meeting across the country with people who are very concerned about the need for a national palliative care strategy. I just met with medical doctors, nurses, and people involved in the palliative care movement in Toronto, and there is a real deep concern following the Supreme Court decision and what it will mean for families and medical practitioners. These are very deep issues that we need to deal with. I think the concern is about a vacuum, a lack of leadership by Parliament to define these issues, that will very much put the medical community in a compromised position that it does not want to be in. Therefore, it is incumbent upon us to address this.

First, I would like to thank the province of Quebec for its fair and balanced consultation process.

The government of the day held a fair consultation process with the various interested parties, and it led to a plan regarding the standards for end-of-life care everywhere in the province and a definition of the process surrounding the issue of euthanasia.

Therefore, it is possible to find a solution to this issue, and Quebec is a model.

What concerns me is that the government knew that the Carter decision was coming. The people in the end-of-life care movement knew that something was happening. I heard all the time, “What is the government going to do?”

In court, one has to mitigate one's damages. One has to be able to show the court that action is being taken. If one does not take action, the court will.

What has come out of the unanimous Carter decision is that the court, rather than defining the issue, has opened it up in a way that will probably make it much broader, probably broader than Quebec has gone, and probably much broader than Parliament would have gone. If we do not act in response, the courts will be expected to intervene again. There will be other challenges and we as a society will be put in a position of dealing with it, and who knows where we will end up in the process. Therefore, it is incumbent upon us to deal with this.

The frustration is also that Parliament had a chance to act. We established in the House a commitment to a national palliative care and end-of-life strategy to work in consultation with the provinces and territories, recognizing their jurisdictions, and to work with the medical community, because there are models of good, quality palliative care out there. When Canadians know what is available, many of these fears about end of life become very different. However, the reality is that across the country there is a patchwork of services. Seventy per cent of Canadians do not have access to quality palliative care. Therefore, the other issue, the issue of assisted suicide and euthanasia, draws a lot of attention in the media.

My concern about my Conservative colleagues is that if they do not act within this year, this issue could become much broader and much more difficult for parliamentarians to respond to. We have an opportunity.

I listened to the hon. members from the Liberal Party. I agree with them: Parliament can act and should act. We have a year. We knew this was coming. We can do this. My concern with the Liberal motion is that it is focused strictly on the Supreme Court ruling and not on the larger end-of-life issues that have to be part of the package.

Harvey Max Chochinov just wrote an excellent op-ed on this. He is an expert on palliative care. He is concerned that they will define through this, through Parliament, or through the courts the right to die but not the right to have access to quality palliative care. It would be a very unjust situation if we simply respond to the court ruling, which might affect 0.2% of the population. I am not diminishing those people, but 70% of the population does not have access to quality end-of-life care.

We have an opportunity right now. The Supreme Court has ruled that this has to be dealt with.

Let us put aside the usual bickering that goes on. We have a period where we can sit down, look at how to do this in a way that is just, that works with the provinces, and realizes that with the vast majority of our population aging, the issue of palliative, home care and hospice care is vitally important.

From a jurisdictional issue and from a planning issue, it is very important as 1% of Canadians use 30% of the health care budget. Many of those in that 1% are people in their final months of life. We are spending enormous amounts of money on end-of-life care, but it is being delivered in a patchwork of services. The stress on patients is enormous, the stress on families can be traumatic and there is the stress on the medical system.

If we talk to people involved in quality palliative care, they will say that once a person is identified in a palliative program, there are no more midnight trips to the emergency ward with a loved one, trying to find a bed, not knowing what to do. It is an incredible stress on families. We have seen really good models in Brantford, Sudbury and Saskatoon. Those models can be replicated in other parts of the country.

I am very concerned that we are standing between a political vacuum on one hand and a committee motion on the other. Again, I commend my colleagues for bringing it forward, but if the motion does not address the issue of palliative care, then I have a problem. I have a problem saying that we are simply going to address the Supreme Court decision and we are walking away on the rest of it. That is problematic for Canadian society.

Some of my colleagues from other parties have said that Canadians are out on this issue. They expect us to show leadership on it. They expect us to show a level of maturity in recognizing that as parliamentarians we are entrusted with certain things. If we do not live up to that standard, the Supreme Court will act for us. I believe the Supreme Court has a fundamental role to play.

The Supreme Court has told Parliament to get its act together, to do it within the course of this year or it will be devolved either to the provinces or we will see further court challenges. Once the courts recognize that Parliament is not willing to act, I think they will start to interpret this ruling in a much broader fashion. I am not sure that is where the Canadian public wants us to go with this.

We have an opportunity right now, and it is an important opportunity, on the issue of end-of-life care. We stood in the House just five months ago, talked about palliative care and we committed to it. Since then, there has been zero action from the federal government. How does that look when the Supreme Court sees that the federal government has done nothing on this?

We have an opportunity. The federal government is mandated by Parliament to start that process with the provinces and territories to establish quality palliative care. The federal government also has a massive role to play in the delivery of health care in first nation communities, which have very little access to quality palliative care, in the military with our veterans, and in the prisons.

The federal government also has a national role to play in health care, to say that we can establish funding that the provinces can access for training. One of the big concerns that has been raised in the palliative care community is that if this moves within a year, the decisions on life and death will be handed over general practitioners who do not have the expertise in palliative and end-of-life issues. We will have to deal with very complex issues in a vacuum, without the support.

The federal government could work with the provinces and establish those norms, those standards and establish training so we could do this in a just and fair way. We could do this in a way that all Canadians would recognize, regardless of their beliefs on this issue. We all share very complicated beliefs. The quality of the lives of citizens, regardless of their station in life and as they face their final few months, has to be considered, a total value that we as Canadians and parliamentarians are willing to embrace.

Charlie Angus

$576,683.00