Conservative MP Marilyn Gladu knew the odds were stacked against her.
It’s rare, she was told, for any private member’s bill to win approval, let alone one proposed by a rookie opposition MP in a majority Parliament.
But she also saw an opportunity.
Following the contentious debate over medically-assisted dying, Ms. Gladu (Sarnia-Lambton, Ont.) proposed a private member’s bill, C-277, establishing a national framework for palliative care in Canada. It’s now set to go for third reading in the House of Commons on May 8 after winning support from the governing Liberals, NDP MPs, and Ms. Gladu’s colleagues in the Conservative caucus, extremely rare for any piece of legislation, let alone an opposition private member’s bill.
Ms. Gladu said she owes it all to hard work and a co-operative spirit.
“You come and you’re not adversarial, you want to hear people’s input, you’re open to working collaboratively to amend the bill if needed, and you go from there,” she said, in an interview, of how the bill has managed to work its way through Parliament.
The bill calls for the development of a national framework that would provide Canadians with access to palliative care in hospitals, at home, at long-term care facilities, and at residential hospices.
Existing services, Ms. Gladu said, vary among jurisdictions, with 70 per cent of Canadians currently lacking access to palliative care.
It’s a number that shocked her, considering the wealth of palliative care services offered in her southwestern Ontario riding.
Between its hospice and hospital, Sarnia is home to 20 palliative beds, five palliative care specialists, and an integrated network of home care, she said, noting there are only 200 palliative care specialists and 30 hospices in all of Canada.
“Honestly, I thought it was like that everywhere,” she said, calling on Ottawa to use funds from its planned infrastructure spending package to build more hospices, specialized facilities providing end-of-life care that are more comparable to communal homes than hospitals.
The cost of hosting a patient at a hospice, she noted, totals, on average, $200 to $300 per day, compared to $1,200 at a hospital.
If passed, the legislation would give Ottawa one year to come to terms with the provinces on training and education on palliative care for health-care providers, supports for palliative caregivers, and to ensure consistent access to palliative care across the country, among other initiatives.
In drafting the bill, Ms. Gladu said she deliberately sought to win broad support from the major parties in the House, and said she believed the NDP would be in favour of substantive legislation on palliative care after MP and party leadership candidate Charlie Angus (Timmins-James Bay, Ont.) shepherded through a motion on the issue in 2011.
From there, Ms. Gladu said she reached out to the diverse contingent of players in the palliative care space, such as physicians, nurses, hospice operators, home-care providers, and occupational therapists, to “find out what should be in the bill.”
What she heard was clear and resounding: the government needs to clearly lay out what services it plans on funding.
“Right now there’s partial funding in some places for palliative care, and zero funding in other places,” she explained.
“So if they decide, for example, all pain control, spiritual counselling, crisis intervention, home care would be covered, that would be a huge difference from what happens today.”
Noah Shack, director of policy for the Centre for Israel and Jewish Affairs, the advocacy group for Canada’s Jewish federations, praised Ms. Gladu for reaching across the aisle and for working collaboratively with palliative care proponents while drafting her bill.
CIJA is part of an inter-faith coalition that has called for better access to palliative care services, which include religious counselling.
“Ms. Gladu’s success can be attributed to her hard work, and her ability to collaborate with colleagues from all parties who understand the growing importance of the issue,” Mr. Shack told The Hill Times via email.
Although private members’ bills rarely pass, Ms. Gladu’s legislation was able to win broad support because all parties in the House understood that palliative care is a “non-partisan issue” that is “extremely important and deeply personal to many Canadians,” said Mr. Shack.
Ms. Gladu said she had to be careful in crafting her bill to ensure her legislation reflected what the provinces were responsible for, and where the “federal government can lead.”
After the bill was drafted, she said it was reviewed by a number of people, then shunted off to Health Minister Jane Philpott (Markham-Stouffville, Ont.) and her staff.
After being introduced in the House, the bill made it through to the committee stage, where several amendments were added. Most notably, language was altered to make it clear the federal government was playing a supporting role but the provinces would be responsible for actually implementing the measures, as well as restoring the position of the commissioner of palliative care.
Members also wanted to take out the language in the framework related to how the government would implement it, there being several mechanisms at the government’s disposal to implement the measures contained in the legislation, including the Canada Health Act.
When reached for comment, Minister Philpott’s office said the Liberals were in favour of the bill in its current iteration.
“The government supports MP Gladu’s Bill C-277, as amended at committee, and looks forward to the report stage and third reading of the bill,” Andrew MacKendrick, the minister’s press secretary, said in a statement.
“All signals are that it should receive approval at third reading. That said, we take nothing for granted until it does,” Ms. Gladu said.
If the bill passes third reading, it will need to win approval in the fragmented Senate. The Conservatives currently hold the most seats, with 39, while the Independent Senators Group holds 35, the Liberals 18, and other independents seven.
Conservative Senator Yonah Martin (British Columbia) has offered to sponsor the bill when it comes to the Senate, and Ms. Gladu said she’s already been talking to other Senators to explain the legislation in hopes they too will support it.
Although the fragmented nature of the Senate might complicate matters, if the bill receives all-party support in the House, it would send a “very strong message” to the Upper Chamber, said Ms. Gladu.
Ms. Gladu also pointed to the amendments put forward by Senators to the assisted dying legislation as an indication there’s an “appetite” in the Upper Chamber for her bill.
The Hill Times
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