Amy Amantea tuned in to the English-language federal leaders’ debate with modest hope there would be at least some discussion of issues relevant to disabled Canadians.
The first half of the campaign had passed with barely a reference, even from the party that had delivered a historic achievement in national disability policy. Earlier this year, the Liberals made good on a 2015 campaign promise when the Accessible Canada Act received royal assent, marking the first time any government had enacted accessibility legislation at the federal level.
The government estimates one in five Canadians over the age of 15 is disabled, and Amantea, who is legally blind, hoped leaders would use the Oct. 7 debate to address some of the many issues they face. But those hopes faded as the debate progressed, giving way instead to doubts about how Canada’s disabled residents would fare after the Oct. 21 election.
“We have a lot of very unique needs and circumstances in our community that don’t get addressed,” Amantea said in a telephone interview from Vancouver. “Just a nod, just a mention would have been kind of nice, but it was not to be.”
Amantea said that relative silence has persisted into the final week of the campaign, giving rise to concerns throughout Canada’s disabled community. Many fear that parties who fail to make mention of key issues facing disabled Canadians while courting votes may prove even more dismissive once those votes have been cast.
They point to party platforms and public pledges, most of which make scant mention of either the Accessible Canada Act or disability-specific measures on issues such as infrastructure, health and affordable housing.
The Liberals response to questions on disability policy largely focused on past achievements. Spokesman Joe Pickerill did offer some future plans, including doubling the disability child benefit, establishing a $40-million-per-year national fund meant to help disabled Canadians find work, and simplifying the process veterans use to access disability benefits.
The Green party did not respond to request for comment, and the People’s Party of Canada said its platform contained “no policy related to disabled persons.”
The NDP did not provide comment to The Canadian Press, but made several commitments to strengthen the Accessible Canada Act in a letter sent to an Ontario-based disability advocacy group.
The act, while widely acknowledged as a significant milestone, was also broadly criticized by nearly a hundred grass-roots organizations across the country as too weak to be truly effective. Such critiques continued even after the government agreed to adopt some Senate amendments sought by the disability groups, who hoped future governments would continue to build on the new law.
Only the NDP agreed to do so when approached by the Accessibility for Ontarians with Disabilities Act Alliance, which contacted all major parties in July.
“The Liberals hailed this bill as a historical piece of legislation. But without substantial amendments, it is yet another in a long line of Liberal half-measures,” reads the NDP’s response. “New Democrats are committed to ensuring that C-81 actually lives up to Liberal party rhetoric.”
The Conservatives, too, pledged to “work closely with the disability community to ensure that our laws reflect their lived realities.” Spokesman Simon Jefferies also noted party members pushed to strengthen the act but saw their amendments voted down by the government.
The vagueness of these commitments troubles Gabrielle Peters, a wheelchair-user and writer.
“Canada’s approach to accessibility has been to grant it as a gift they give us rather than a right we deserve,” Peters said. “Now that we have the ACA, the concern is that the broader public and the government think the issue is resolved when this law is, at best, a beginning.”
Other disabled voters expressed concerns about the handful of relevant promises that have been put forward on the campaign trail. In addition to pledging expanded eligibility for the disability tax credit, the Conservatives have said they would implement a $50-million national autism strategy focusing on research and services for children. The NDP and Greens have followed suit with similar proposals and larger pots of cash.
While widely lauded among parent-led advocacy groups, some autistic adults view the proposals with skepticism.
Alex Haagaard, who is autistic and uses a wheelchair, said that while much modern disability policy including the ACA tends to apply a social lens, discussion of autism is still framed through the outmoded medical model that positions the disability as an ailment to be cured rather than a part of a person’s identity.
Haagaard said action is clearly needed to help parents seeking supports for their children and teachers working to integrate autistic students into their classrooms, but said current attitudes at the heart of the campaign rhetoric are troubling.
A national strategy, Haagaard said, also risks undermining the goal of broader inclusion for other disabled populations.
“That is counter to the goals of disability justice to silo autism as this individual condition that warrants this level of attention compared to other disabilities,” Haagaard said.
Like Amantea, Peters felt let down by the leaders debates, citing the prevalence of discussion around medical assistance in dying over other issues that affect disabled people. The subject is polarizing, with many advocacy groups and individuals asserting such legislation devalues the lives of disabled people and places them at greater risk.
Such a narrow focus, Peters said, shows all parties’ failure to reckon with or address the diverse, complex needs of an overlooked demographic.
“What strikes me as missing in policy and in this election is us,” she said. “Disabled people. The not inspirational, not motivational, not middle class, not white, disabled people of this country. In other words — most of us.”
Elizabeth May is surprisingly cheerful for an environmental crusader worried that the civilization may be on the brink of collapse by the time her 43-year-old daughter reaches May’s own age of 65.
It’s because after being a party of one for eight years in Parliament and only graduating to a party of two earlier this year, the Green party leader says this federal election — her fourth — feels different.
Support is coming in unexpected places, she says forcing her to run something closer to a truly national campaign and visit ridings that weren’t previously on her itinerary.
The polls reflect some of that. May has the highest approval rating of the leaders on the CBC’s Leader Meter.
Her party’s support has nearly doubled in the past year to close to 10 per cent, which would translate into anywhere from one to eight seats with four seats being the consensus prediction.
But the Greens have been here before. They polled at close to 10 per cent in 2010 long before the prospect of a dystopian future drove tens of thousands of Canadians into the streets last month.
Many of those marchers, like the climate strike’s founder Greta Thunberg, are too young to vote and are too young to be surveyed about voting intentions in Canada’s upcoming federal election.
As a politician, May laughingly told The Vancouver Sun’s editorial board that she should be talking about measuring for new curtains in the prime minister’s resident in anticipation of moving in.
But she’s a pragmatist and what is within reach in 2019 is holding the balance of power — or the balance of responsibility, as she describes it — in a minority government.
Unlike the B.C. Green party, May would make no deals to support either the Conservatives or the Liberals.
She’d use her few seats as a club to force the prime minister to either bend policies — especially on the environment — to something closer to the Greens’ platform or she’d bring down the government.
For many, the Greens’ plan is scary, requiring radical and fundamental changes to retool the Canadian economy, its social programs and even individuals’ expectations and habits.
May admits that.
By 2030, her plan would cut carbon emissions by 60 per cent from the 2005 levels, limiting temperature rise to 1.5 degrees Celsius above global pre-industrial averages. Within a decade, a Green Canada would be fully powered by renewable energy.
Quoting an October 2018 Intergovernmental Panel on Climate Change report, May says it’s all do-able and that the needed technology already exists to avoid going above 1.5 degrees C.
Citing a National Research Council projection, the Greens’ platform says four million jobs would be created in energy efficiency retrofits compared with the 62,000 Canadians working in oil and gas in 2018.
But May admits some will disappear and talks about a “just transition” for workers that would include more education spending, bridging of some workers to early retirement and a guaranteed livable income, which would replace and build on disability payments, social assistance and income supplements.
“It’s a tough choice and I’m not saying that people will never sacrifice,” May said. “But we’re talking about whether our children are able to have anything above a deteriorating human civilization all around them …
“A functioning human civilization is at risk within the lifetime of my daughter to be able to have basic elements of a functioning human society.”
But if the Greens hold the balance of power in a post-Oct. 21 Parliament, it’s not just the environmental agenda that may influence new legislation.
May frequently references the 1960s minority government of Liberal Prime Minister Lester Pearson that with support of the NDP (then named the Co-operative Commonwealth Federation), which resulted in universal health care, the Canada Pension Plan, unemployment insurance and the flag (which, bizarrely, was the most controversial).
So beyond an improved climate plan, what do the Greens want? Proportional representation rather than a first-past-the-post voting system has always been high on its list both federally and provincially. The Liberals promised it in 2015 and reneged. A Liberal minority government might be willing to rethink that.
The Greens’ platform calls for decriminalization of drug possession and access to “a safe, screened supply.” The Conservatives have resolutely said no, while the Liberals have said no for now.
May is actively supporting Wilson-Raybould’s bid to win re-election as an Independent in Vancouver-Granville. Wilson-Raybould was forced out of the Liberal Party after she publicly accused Justin Trudeau and his staff of inappropriately pressuring her to stop the prosecution of engineering giant SNC-Lavalin.
The only reason there is a Green candidate in that riding is because running the party’s constitution requires one in every federal riding.
But would May be willing to bring down the new government — Liberal or Conservative — if it agreed to negotiate a deferred prosecution agreement?
May could play a pivotal role in forging a better response to the climate emergency and even help return Canada to a leadership role if she can muster the kind of patience, diplomacy and intelligence that NDP leader Tommy Douglas exercised in the 1960s.
And if she can’t? Well, we’ll have another election sooner rather than later and by then, at least some of those climate-striking kids will have reached voting age.
A federal election 2019 platform primer: Brief summaries of where the Liberals, Conservatives, New Democrats and Greens stand on 12 major issues, and highlights of what they are promising Canadians.
Climate change/carbon tax/fossil fuels
The Liberals commit to planting two billion trees in a $3 billion plan to conserve forests, agricultural lands, wetlands and coastal areas. They promise carbon neutrality — balancing emissions against carbon offsets — by 2050 and to halve taxes for companies that develop or manufacture products with zero emissions. They propose interest-free loans of up to $40,000 to make homes more energy efficient and a grant for people who buy carbon neutral homes. They plan to send disadvantaged kids to camp so they’ll learn to love the outdoors.
The Conservatives promise to meet Canada’s Paris commitment to cut emissions by 30 per cent below 2005 levels by 2030, but provide few specifics. They would scrap the carbon tax. They believe Canada would make little impact on climate change by reducing emissions at home, so would make Canadian oil and gas cleaner to replace dirtier products from other countries. The parliamentary budget office says the party’s green homes tax credit for energy-saving renovations would cost $1.8 billion over three years.
The NDP promises to help stabilize the global temperature rise to 1.5 C. It would continue carbon pricing and will clamp down on big polluters. It would move government vehicles to electric by 2025. It would retrofit all housing stock in Canada by 2050, giving low-interest loans to homeowners. It says all new buildings would have net-zero emissions by 2030. It would power Canada with net carbon-free electricity by 2030. To pay for these steps, it would redirect the billions spent on oil and gas subsidies.
The Greens pledge $3.2 billion over five years to help keep the global temperature rise to 1.5 C. They would go beyond the Paris targets, promising a 60 per cent cut in carbon emissions below 2005 levels by 2030, and to set emission limits and penalties for industries. By 2030, all of Canada’s electricity would come from renewable sources. The party would fund building retrofits and ensure new construction meets carbon neutral standards by 2030. It would reduce nitrogen fertilizers and support farmers to shift to regenerative farming.
Trans Mountain pipeline
Leader Justin Trudeau made a bargain on the environment and the economy: Cancel the Northern Gateway oil pipeline, approve the Trans Mountain expansion, create a national carbon tax and get concessions from Alberta, including phasing out coal energy and capping oilsands emissions. In 2018, Trudeau bought Trans Mountain for $4.5 billion. A second approval for pipeline expansion was given in June. Said Trudeau: “We need to create wealth today so we can invest in the future.”
Leader Andrew Scheer supports the Trans Mountain expansion. But more is needed to encourage oil and gas projects, say Conservatives. That includes repealing the carbon tax and Bill C-69, which overhauled federal environmental assessments of major construction projects, and ending the ban on shipping oil on the B.C. north coast. Scheer would use federal powers to declare a major project in the national interest. Criticizing the Liberal approach, Scheer said: “Not a single inch of new pipeline has been laid.”
Leader Jagmeet Singh wants the Trans Mountain expansion abandoned, saying it will undermine efforts to fight climate change. The NDP also worry about ocean spill risks. Approval of the project ignores violations of Indigenous rights, says the party. In criticizing Liberal approval of the project, Singh said: “While they’re great with symbolic gestures like voting for a climate change emergency, they do the opposite of helping the environment the very next day with the approval of this pipeline expansion.”
Green leader Elizabeth May was arrested in Burnaby in 2018 for protesting the Trans Mountain expansion. “The commitment to build a pipeline in 2018, when we are in climate crisis, is a crime against future generations and I will not be part of it,” said May. The Greens would cancel the project. The party would cut subsidies to fossil fuel industries of several billion dollars a year and would redirect the money toward a transition to renewable energy.
The Liberals promise to help people with annual incomes below $120,000 (and up to $150,000 in high-cost areas such as Vancouver) by taking up to 10 per cent off the price of a home with the First-Time Home Buyer Incentive, budgeted at $1.25 billion over three years. This applies to homes up to $789,000 in expensive regions such as Vancouver. The party promises a national anti-speculation tax of one per cent on non-resident, foreign owners; it’s estimated to create revenue of $940 million over four years.
The party promises to change the Liberals’ mortgage stress test to ensure first-time homebuyers aren’t unnecessarily prevented from getting mortgages, and to work toward removing the stress test from mortgage renewals. It would increase amortization periods on insured mortgages to 30 years for first-time homebuyers to lower monthly payments, make surplus federal real estate available for development to increase the supply of housing, and hold a $20-million inquiry into money laundering in the real estate sector.
The NDP promises to create 500,000 units of affordable rental housing in the next 10 years, financed by $5 billion in the first 18 months of government, and also to create “fast-start funds” to help communities build co-ops, social, and non-profit housing. It would waive the federal GST on construction of new rentals; reintroduce 30-year terms to CMHC-insured mortgages on entry-level homes; double the homebuyer’s tax credit to $1,500; put a foreign buyer’s tax on sales to non-Canadians.
The Greens would make housing a fundamental human right, and work with provinces to build 25,000 new rental homes and 15,000 rehabilitated units annually for the next 10 years.They promise to: boost funding for new builds by $750 million and for rent assistance by $750 million to help 125,000 rental households; better support provincial and municipal housing projects; provide financing to non-profits to expand housing for seniors, people with special needs and low-income families; restore tax incentives for building rental housing.
Liberals promise to improve the accessibility to and affordability of before- and after-school care for kids in elementary school. The party says it has created thousands of new preschool child care spaces and would create up to 250,000 more for kids ages five to 10. It would improve child care hours for people who work overtime or late shifts. It promises to reduce fees 10 per cent, which could save a family of four around $800 annually. The party has promised new funding of $535 million a year.
The party has not made any campaign announcements about child care. It has promised to make maternity benefits tax-free, which could save an average Canadian $4,000 a year. It would reintroduce a children’s fitness tax credit, allowing parents to claim up to $1,000 a child annually for sports, and a children’s arts and learning tax credit, allowing parents to claim up to $500. The budget office says this would cost $616 million in its first year, increasing annually.
The NDP would enshrine in law a commitment to high-quality public child care. The party notes provinces such as Quebec, B.C. and Alberta have made investments in child care and it promises to “build on that work” by investing $1 billion in 2020 and growing that investment annually, in conjunction with provinces and territories. It gave no specifics for the number of spaces planned, but said affordable child care helps the economy by allowing parents to work.
The Greens say universal child care is crucial for women’s equality and promise to increase funding to at least one per cent of GDP annually, adding an additional $1 billion each year until this level is reached. The party did not say the number of new spaces it would create. It would eliminate GST on construction of new child care spaces. The party plans to boost early educator jobs, locate new facilities along transit routes and strengthen parental leave benefits.
In this year’s budget, the Liberals promised $70 million over five years to create a money-laundering task force and support financial intelligence gathering. Another $68.9 million over the next five years was earmarked to strengthen policing. The Liberals also amended the Criminal Code this year to make it easier to prove money laundering. “This is a real problem we are taking seriously,” Trudeau said following a B.C. report that estimated laundering at $46.7 billion in Canada.
Scheer announced that his party would launch a national money-laundering inquiry to “root out” corrupt practices that inflate housing prices. About $20 million would be budgeted for the two-year inquiry, meant to produce recommendations for regulatory and legislative changes and extra enforcement. The inquiry would be able to compel testimony and order disclosure. “We believe this will get to the bottom of the shadowy practices that are going on,” said Scheer.
The NDP announced it would launch a national inquiry to determine why there hasn’t been sufficient investigation into a criminal activity that is “so widespread.” The NDP would create an RCMP anti-money-laundering unit supported with $20 million a year, with $10 million of that earmarked for B.C. The NDP would work with provinces to create a registry to increase transparency about who owns properties. “This is a direct issue the federal government can play a massive role in flagging, identifying and in ending,” said Singh.
The Greens are calling for a public inquiry into what the RCMP and other agencies knew about money laundering in B.C. casinos and why they did not expose the corruption. In the House of Commons this year, May said: “What did the RCMP know, why did they turn a blind eye and are we looking into it?” The party says a crackdown is needed on financial crime, suggesting a special RCMP unit and more resources for investigations and prosecutions.
The Liberals recently named Dominic Barton, a businessman with extensive experience in Asia, as Canada’s ambassador to China. They hope he will reset a relationship that collapsed following Canada’s detaining last December of Huawei executive Meng Wanzhou at the request of the U.S., the arrest of two Canadian citizens in China a few days later and China’s blocking of important Canadian exports. Organizers of an election debate on foreign policy in September cancelled the event after Trudeau dropped out.
In response to China blocking Canadian exports, the Conservatives pledge to pull $250 million in funding from the Asian Infrastructure Investment Bank, which is headquartered in Beijing. Scheer said he is against using Canadian tax dollars to build infrastructure in countries that China influences. He said the focus of the relationship between Canada and China should be on the two Canadians detained there, and that a reset in that relationship begins with a prime minister who stands up to China.
Jagmeet Singh is calling for the focus of the Canada-China relationship to be on the Canadians detained in China. He said trade with China has focused on free trade that doesn’t benefit workers. He described the Chinese ban on canola, pork and beef exports as being “unfairly targeted by China despite a lack of scientific evidence” and said China is punishing Canadian producers over a diplomatic disagreement. He has called for the Liberals to protect Canadian workers.
May has been critical of the Canada-China Investment Treaty brought in by the Conservatives in 2014. She has said it allows discriminatory practices towards Canadian enterprises and allows for “secret” government-to-government wrangling “in which China’s larger economic weight is likely to lead to all manner of concessions by our government.” The relationship “is imperilled by some rather large forces that are outside of our control. Donald Trump is poking China with a stick and creating a trade war. We’re caught in the middle.”
The Liberals promise to spend $6 billion over four years to ensure every Canadian has access to a family doctor or primary health care team. They would also set national standards for access to mental health services, expand access to home care and “take the critical next steps” toward universal pharmacare to include prescription drug coverage. They would increase funding for pediatric cancer research by $30 million in 2020 and create a national Institute for women’s health research to tackle gaps in care.
The Conservatives would continue the health care transfer to provinces and maintain the funding increase of at least three per cent a year. The party would spend $1.5 billion on MRI and CT machines. It would reduce the number of hours required per week on therapy to qualify for the disability tax credit to 10 from 14. The Conservatives have not pledged to introduce universal pharmacare and Scheer has said he doesn’t trust the Liberals to implement it.
The NDP would create a universal pharmacare program starting in late 2020 at a cost of $10 billion. The party would expand public dental care coverage to households making under $70,000, starting in 2020, and copayments for households earning $70,000-$90,000, at a cost of $560 million in the first year, $1.9 billion in the second year and up to $850 million after that. The NDP would fight efforts to privatize health care.
The Greens would change the federal-provincial Health Accord to base health transfer payments on demographics and needs in each province, rather than on GDP growth. The party would Introduce universal pharmacare and free dental care for low-income Canadians and would reduce drug patent protection periods. It would expand mental health and rehabilitation services and access to safe abortion services. It would improve health care for Indigenous Peoples by implementing calls to action from the Truth and Reconciliation Commission.
The Liberal’s platform on job creation focuses on supports to workers and supports for business. The promises to workers include guaranteed training for apprentices and $100 million in funding for skills upgrading, specifically for work in conducting energy audits, building retrofits and carbon-neutral home construction. To business, the party promises to cut in half corporate taxes for businesses in zero-emission industries, including renewable energy and zero-emission vehicles. It also plans to cut the cost of incorporating a small business.
The Conservatives’ platform includes creating a national energy corridor to carry oil, natural gas and electricity as a means to “create wealth, prosperity and opportunity” for Canadians. The party’s platform also plans support for small business by exempting spouses from new taxes on dividend payments from small businesses, reducing “red tape” in federal regulations by 25 per cent, and enforcing a rule to cut two old regulations for every new regulation introduced on business.
The NDP ties its goal to reduce carbon emissions to its promise to create jobs, estimating that clean energy, sustainable infrastructure and energy-efficient buildings will create 300,000 new jobs. Forestry is singled out, both for the role of forests in climate health and the source of jobs that support rural communities. The party promises to support innovation in value-added manufacturing of forest products and reforestation. It would allow workers to qualify for employment insurance after quitting work to return to school.
Acknowledging job losses in oil and gas production while phasing out fossil fuels, the Greens vow a “just transition” for workers from those sectors into renewable energy and in construction for energy-efficiency retrofits of buildings. The plan includes a fund to support training and a community benefit strategy to maximize local hiring and purchasing. May has also proposed a “robot tax” that employers would pay when they replace workers with artificial intelligence, with the revenue used to retrain workers.
Drug policy/opioid overdose epidemic
The Liberals pledge $700 million in additional funding between 2020 and 2014 to expand access to drug treatment and to combat opioid and meth addictions. The party will help provinces expand community-based services, build more in-patient rehab beds, and “scale up the most effective programs” — such as extending hours for Vancouver’s Insite and other safe consumption sites. It will also make drug treatment court the default option for first-time non-violent offenders charged exclusively with simple possession, to help drug users get quick access to treatment.
A spokeswoman said the party has not yet released its policy, but will “in the coming weeks.” On the campaign trail, leader Andrew Scheer has criticized the Liberals for expanding supervised-injection sites without properly consulting communities. He has told reporters that a Conservative drug policy would focus on getting people off drugs, not “maintaining” a life of addiction. The former Conservative government tried unsuccessfully to have Vancouver’s Insite shut down.
The NDP promises to declare the opioid crisis a public health emergency and to work with governments and experts to end “the criminalization and stigma of drug addiction” so people can get help without fear of arrest. The party supports overdose-prevention sites. It would expand access to treatment on demand, launch an investigation into the role of drug companies in opioid overdoses and seek financial compensation for the public costs of the crisis, and “get tough” on traffickers. The platform provides no cost estimates.
The Greens promise $100 million annually to respond to the opioid crisis, plus $1 billion annually for treatment that includes mental health and addictions. The party’s platform promises to declare a national health emergency, plus “Recognize that fentanyl contamination is why deaths are more accurately described as poisonings than overdoses. Drug possession should be decriminalized, ensuring people have access to a screened supply and the medical support they need. … Increase funding to community-based organizations to test drugs and make naloxone kits widely available.”
The Liberals say they will create a national infrastructure fund to support yet-to-be-determined “major nation-building projects.” They would make permanent the federal commitment to fund public transit, and put in an additional $3 billion a year in stable funding on top of gas tax transfers, and require that new federal investments in public transit are used to support zero-emission buses and rail starting in 2023. They would also support the transition to zero-emission fleets for school and transit buses, and encourage businesses to convert their fleets.
The Conservatives have committed to ensuring promised infrastructure projects will proceed, with top priority to infrastructure projects that shorten commute times, like the George Massey Tunnel replacement. They would scrap the $35-billion Canada Infrastructure Bank. They would reintroduce a transit tax credit similar to the one ended in 2017, which will apply to monthly and weekly passes, and some electronic fare cards. It’s estimated that over 10 years, the tax credit will cost the government $2.2 billion.
The NDP would introduce a permanent funding mechanism for public transit. It wants to electrify transit and municipal vehicles by 2030, expand rail service, work with provinces and municipalities toward “fare-free transit” and re-establish rural bus routes formerly covered by Greyhound and expand bus service in rural regions. It would use community benefit agreements for infrastructure projects. To encourage zero-emission vehicle adoption, it would extend federal incentives for vehicles and chargers, waive federal taxes on purchases and expand charging networks.
The Greens would develop a national transportation strategy with the goal of reaching zero-carbon public transportation — rail, light rail and electric buses — across Canada by 2040, and revamp the Canada Infrastructure Bank. They would ban the sale of internal combustion engine passenger vehicles by 2030, require all passenger ferries to convert to electric or hybrid by 2030, exempt new and used zero-emission vehicles from federal sales tax, expand charging stations, implement a passenger rail transportation policy, create a cycling and walking infrastructure fund, and develop “green freight transport program.”
Cost of living
The Liberal plan is to reduce personal income taxes by raising the personal exemption to $15,000 from $12,069, saving the average Canadian $292 and the average middle-class family $585. The party takes aim at cellphone bills, promising that increased competition would reduce them 25 per cent and threatening regulation if that doesn’t happen. The party would increase student grants by $1,200, to reach $4,200 a year. The party’s promises to seniors include increasing old-age-security payments by 10 per cent.
The Conservatives’ tax plan aims straight at cutting the lowest-bracket tax rate to 13.75 per cent from 15 per cent, which the party bills as its “universal tax cut,” saying it will save as much as $440 for individuals or $850 for a two-income family. The party’s plan also includes increasing Registered Education Savings Plan grants to $750 a year from $500 and reviving tax credits for expenses on children’s arts and sports programs and commuter transit passes.
The NDP platform doesn’t include promises to cut taxes but it does seek to reduce cellphone and internet bills and to make post-secondary education more affordable. The party would require carriers to introduce basic internet and cellphone plans, and would order caps on phone and internet bills. The NDP would cap and reduce post-secondary tuition and would eliminate interest on student loans and increase access to student grants. It would work toward making post-secondary education part of the public system.
The Greens call for a $15-an-hour minimum wage and a “guaranteed livable income” to replace supports such as disability and social assistance payments. The party’s affordability plan also promises universal access to post-secondary education. That means free tuition for Canadian students and forgiving existing student debts held by the federal government. For seniors, the party would increase the Canada Pension Plan’s target for income replacement to 50 per cent of pre-retirement income from 25 per cent.
The Liberals would work with the U.S. to “modernize” the Safe Third Country Agreement. They would increase immigration to 350,000 a year by 2021 — up from 310,000 in 2018 — and would create a program to allow communities, chambers of commerce and labour councils to directly sponsor immigrants, with a minimum of 5,000 spaces. The party would make applying for Canadian citizenship free for permanent residents.
The Conservatives would renegotiate the Canada-U.S. Safe Third Country Agreement, which requires refugee claimants to request protection in the first safe country where they arrive. They would stop border crossings at unofficial points of entry. The Conservatives would improve language training and credential recognition so it is easier for immigrants to use their skills in Canada. The party would promote private sponsorships of refugees and prioritize “people facing true persecution.” They would set immigration levels “consistent with what is in Canada’s best interests.”
The NDP would suspend the Safe Third Country Agreement. It would work with provinces to address gaps in settlement services and improve foreign credentials recognition. The NDP would end the cap on applications to sponsor parents and grandparents, and address backlogs that delay reunification. The party would regulate immigration consultants, give status to caregivers brought to Canada and expedite their reuniting with families. They would set immigration levels to “meet Canada’s labour force needs and recognize people’s experiences, contributions and ties to Canada.”
The Greens would terminate the Safe Third Country Agreement. The party would include “environmental refugee” as a refugee category. It would create a system to evaluate immigrants’ education to help them get accreditation and jobs. It would also eliminate the temporary foreign workers program, increase immigration to address labour shortages, process the estimated 200,000 people in Canada who don’t have official status, and regulate immigration consultants. The Greens have not announced immigration levels but would “attract immigrants and establish a system that is fair.”
VICTORIA — The number of doctors in Canada is growing at a rate more than double that of the population, says a report by the Canadian Institute of Health Information.
Canada’s population increased by 4.6 per cent between 2014 and 2018, while the number of physicians grew by 12.5 per cent over the same time period, says the report released Thursday.
Manitoba and British Columbia registered the largest increases in doctors at more than 17 per cent each while Quebec had the lowest level of physician growth at 5.9 per cent, just below the 6.5 per cent growth in Nova Scotia.
While the supply of doctors has grown faster than the population over the past dozen years, many Canadians continue to report difficulties finding a family physician, said Geoff Ballinger, the institute’s physician information manager.
“The big question is why does there seem to be this disconnect between the growing numbers of physicians and the fact that around the same proportion of Canadians are still having a challenge accessing physicians,” he said.
The Canadian Institute of Health Information is an independent, not-for-profit organization that works with governments and stakeholders to gather and provide information on policy, management, care and research.
The report found that in 2018 there were almost 90,000 physicians in Canada, which is equivalent to 241 physicians per 100,000 population, the highest number per capita ever, said Ballinger.
Statistics Canada figures from 2016 show 15.8 per cent of Canadians aged 12 and older, or about 4.8 million people, reported they didn’t have a regular health care provider.
The figures show Quebec, at 25.6 per cent, had the highest proportion of residents who were without a regular doctor, followed by Saskatchewan at 18.7 per cent and Alberta at 18 per cent.
Liberal Leader Justin Trudeau made an election promise earlier this week to ensure all Canadians have access to a family doctor.
Ballinger said the higher figures were encouraging for patients looking for a regular physician.
“The issue that we don’t have a handle on yet is whether those increased numbers of physicians are perhaps in parts of the province where the greatest need is,” he said. “We are seeing across the country that patients do have an issue trying to get access to a physician, particularly patients more in rural and remote areas.”
The report also reveals a changing demographic trend among the physician population, citing more female doctors in Canada than ever before.
Since 2014, the number of female doctors increased by 21 per cent, while male doctors rose seven per cent, Ballinger said.
The report tracked doctor incomes and found total gross clinical payments through medical plans was $27.4 billion in 2017-2018, an increase of 3.9 per cent over the previous year, Ballinger said.
It concludes average annual gross clinical payment for a doctor in Canada was $345,000, ranging from $267,000 in Nova Scotia to $385,000 in Alberta.
Cyclists ride across a trestle bridge, part of the Columbia and Western Rail Trail. Handout/Trails Society / PNG
A historic rail trail that was donated to the province by the Trans Canada Trail society could be opened to logging trucks if a government proposal to cancel its trail designation gets the green light, say trail advocates.
The Ministry of Forests is seeking to transfer management of a 67-kilometre portion of the Columbia and Western Rail Trail to unspecified agencies to reflect local interests and support “access for industrial activity,” according to a letter sent to stakeholders soliciting feedback on the plan.
A major logging company holds tenure for several cut blocks near the trail, which runs from Castlegar to Fife, east of Christina Lake.
“It’s mind-boggling that they’re even considering this,” said Ciel Sander, president of Trails Society of B.C. “The trail is a government asset. It should be protected as a linear park, not an access road for logging trucks.”
The Columbia and Western Rail Trail was donated to the Trans Canada Trail decades ago by the Canadian Pacific Railway for inclusion in the The Great Trail, previously known as the Trans Canada Trail, a national trail network stretching 24,000 kilometres across the country.
In 2004, the committee transferred the trail to the B.C. government with the “expressed intention that it would be used and managed as a recreational trail,” said Trans Canada Trail vice-president Jérémie Gabourg.
While the government’s proposal is clear that recreational access will remain, it marks the first time a group has sought to convert a portion of The Great Trail from a trail to a road in any province or territory.
“Sections of The Great Trail of Canada are on roadways, and we strive to move these sections of the trail to greenways, where possible,” said Gabourg. “To see a trail go from greenway to roadway is disheartening … It could set a dangerous precedent.”
The Columbia and Western Rail Trail connects with the popular Kettle Valley Rail Trail, a route that attracts cyclists from around the world. In accepting the trail from the Trans Canada Trail in 2004, the government made a commitment to preserve and protect it from motorized use, said Léon Lebrun, who was involved in the process as past president of Trails Society of B.C.
“We have a government who has not taken real responsibility,” he said. Officials have “turned a blind eye” to motorized users who have graded parts of the trail and removed several bollards designed to prevent access. “They had no permit and no permission, and the government did nothing.”
In its letter to stakeholders, the Ministry of Forests recognized vehicles are already accessing the trail, explaining the proposed administration change would ensure it was being maintained for that use.
“This portion of rail corridor contains engineered structures including steel trestles, hard rock tunnels, major culverts and retaining walls atypical of recreation trails and requiring management beyond typical trail standards,” said the letter by John Hawkins, director of Recreation Sites and Trails B.C.
But Rossland Mayor Kathy Moore said that allowing motorized vehicles would be rewarding people who broke the law.
“While we acknowledge that this change reflects current use, this is clearly the result of years of mismanagement of what was intended as, and should have remained, a high-profile recreation and tourism amenity,” she replied to Hawkins in a letter that was shared with Postmedia.
“Those who have consistently flaunted trail use regulations are now being rewarded … We expect (Recreation Sites and Trails B.C.) to acknowledge this as a tragic failure, and ensure that resources and strategies are in place to prevent further losses of our valued trails.”
Stakeholders were given one month to register their feedback with the Ministry of Forests, ending Aug. 26.
In a statement, the Ministry of Forests said the process is ongoing to receive more information from regional districts. A decision is expected before the end of the year.
As of today, Karly has been clean and sober for 30 days after four years of battling addiction.
Addiction made the 17-year-old from Chiliwack vulnerable to exploitation and bullying. It disrupted her schooling, left her psychotic, suicidal, near death and unable to care for her year-old baby.
“In addiction, I never thought I could be this happy without drugs,” she said earlier this week.
“There’s obviously times when I’m feeling like I don’t want to live any more. But I realize a lot of people do care for me, and it would hurt a lot of people if I did leave.”
Up until now, Karly didn’t worry that fentanyl laced in the cocaine, crystal meth and other street drugs she’s used might kill her, as it has more than 4,000 other British Columbians in the past four years.
“Honestly, I just thought I wasn’t going to get that wrong batch. I thought I could trust my dealers. Now, I’m starting to realize the risk. I was using alone. It’s pretty scary now that I think about it.
“I could have overdosed, my poor son he would have had no mom.”
But Karly’s recovery is at risk because the B.C. government is refusing to pay for her treatment. The question of why was bounced from the Ministry of Mental Health and Addictions to the Ministry of Children and Family Development, back to addictions, then back to MCFD, and finally to Fraser Health over two days.
Friday afternoon, MCFD responded that due to privacy concerns it could not discuss the specifics of the case.
The spokesperson did confirm that the government pays for youth residential treatment. Funds are allocated by the health ministry to regional health authorities. MCFD social workers are supposed to refer youth and families to the health authority, which is supposed to do the assessments and placements.
Reached late Friday afternoon, Fraser Health said that it does not have provincial funding for youth beds at Westminster House, where Karly is getting treatment, only adult beds.
Postmedia editors and I are also concerned about Karly’s privacy and vulnerability. For that reason, we are not using her real name, or that of her mother.
On July 10, her mother Krista found Karly white-faced and barely breathing on the floor. It was a moment she had been bracing for since 2015.
Krista, who is a nurse, didn’t need the naloxone kit that she keeps at the ready. She shook Karly awake and got her into the car to take her to Surrey Creekside Withdrawal Management Centre.
En route, Karly flailed about, kicking in the glove box, banging her head against the window and screaming.
“She was in psychosis. She was not my child,” Krista said. “It took six nurses and two doctors to get her inside.”
At 9 p.m, Karly called her mom to say that if they didn’t let her out, she was going to escape, prostitute myself and get enough money to kill herself.
“I felt in my heart that she was really going to do it.”
Panicked, Krista called Susan Hogarth, Westminster House’s executive director, and begged for help. Westminster House is a residential treatment centre for women, with four designated youth beds in New Westminster.
Even though it was past midnight, Hogarth agreed to take Karly.
“We can’t not put a child somewhere,” Hogarth said this week.
The cost for treatment at Westminster House is $9,000 a month, meaning Krista needs $27,000 to pay for the three months of treatment that counsellors say Karly needs to be stabilized enough to go into second-stage care.
The crucial first month of treatment was covered using donations from individuals, and Hockey for the Homeless.
Now there are bills to be paid.
Krista’s only contact with the government has been through MCFD. A social worker helped Karly get mental health services, pre- and post-natal care and helped Krista gain guardianship of her year-old grandson last month.
It’s the social worker who told the family that the government would pay for a 10-week, co-ed live-in treatment program at Vancouver’s Peak House, but not Westminster House.
But Krista and Westminster House’s director believe a co-ed program that has no trauma counselling is not a good fit for Karly.
The only other option suggested was outpatient treatment. But Karly’s already tried and failed at that. Besides, her dealer lives two blocks from their home.
If Karly was an adult on welfare, the Ministry of Social Development and Poverty Reduction would pay $30.90 a day for her room and board in residential care.
Bizarrely, Krista said the social worker suggested maybe Karly could just wait a year and then her treatment would be fully covered.
“This is f–ing BS. I can’t wait until she’s older. She’ll be dead,” said Krista, who has had her own problems with addiction. An alumni of Westminster House, she is four years into recovery.
Concerns about how to pay for Karly’s treatment in addition to caring for Karly’s baby and Karly’s younger sister are wearing heavily on Krista. She’s had to take a medical leave from her job, and is worried about how she will pay her rent.
She’s already spent four years in a constant state of readiness in case Karly overdoses. There’s naloxone in the house. The razors are hidden because “Karly cuts, cuts.” Every time Karly took a bath, Krista stood apprehensively by the door because her daughter had threatened to drown herself.
“She is doing amazing,” Krista said. “The first time I saw her was 15 to 16 days in, and she had colour in her cheeks and they were my kid’s eyes, beautiful brown . . .
“When I brought her son to see her, her smile so genuine. I had not seen it in so many years. The smile was what I remember of her as a kid.”
Hogarth wonders why the government can’t look at the bigger picture of what Karly’s untreated addiction might cost — from more overdoses to her mother’s fragile state to the fate of her son.
Everybody, Hogarth said, deserves a chance at recovery and not just harm reduction interventions.
“Karly is not the easiest client in the world,” she said with a laugh. “But she’s worth it because we want her to go home to her son and to be able to raise him.”
For now, the non-profit Westminster House is covering Karly’s costs with donations augmented by a GoFundMe campaign organized by Krista’s friends.
But it can’t do that forever, or without more donations.
As for Karly, for the first time in years she’s thinking about a future. She won’t be ready to start school in September, but plans to go back as soon as she can for Grade 12 and then go on to study so that she can work in health care.
Nearly a year before two young man died of fentanyl overdoses in houses operated by the Step by Step Recovery Home Society, the B.C. Health Ministry had investigated and substantiated complaints that it was failing to meet the most basic standards.
Within nine days of each other in December 2018, 21-one-year-old Zachary Plett and an unnamed,35-year-old died in different houses operated by the non-profit society that has a total of five houses in Surrey.
A month earlier, inspectors had substantiated complaints at all five houses. According to the ministry’s assisted living registry website, none met the most basic standard of providing residents with safe and nutritious food.
None had staff and volunteers with the skills or qualifications needed to do their jobs. There was no counselling support for residents at any of the houses or any transitional help for those who were leaving.
Late last week, Step by Step closed its house at 132nd Street where Zach died. In a brief conversation Thursday, director Deborah Johnson said it was done “voluntarily.” She promised to call back after speaking to the other directors and staff. But that call didn’t come.
Late Thursday, a spokesperson for the Addictions Ministry said the assisted living registrar was aware that two Step by Step houses had been voluntarily closed, but was still attempting to confirm the closures.
Up until May, Step by Step had taken action on only one of the 65 substantiated complaints. It got rid of the mice at its house at 8058-138A Street in November. But it took 18 days from the time the inspectors were there before the exterminators arrived.
Despite all that, all five houses have maintained their spots on the government’s registry.
What that means is that the social development ministry has continued paying $30.90 a day for each of the 45 residents who are on welfare.
It also means that anyone ordered by the court to go to an addictions recovery house as part of their probation can be sent there.
In late May, Plett’s mother and others filed more complaints about Step by Step that have yet to be posted. But a spokesperson for the mental health and addictions ministry confirmed that they are being investigated.
Plett is incredulous. “My son died there and nothing’s been done,” she said this week.
In an email, the ministry spokesperson confirmed that no enforcement action has been taken and that there is no specific timeline for the investigation to be completed.
“The review of complaints is a complex issue that can often involve a number of agencies conducting their own investigations (which can also require a staged process),” she wrote.
“Each case is different and requires appropriate due diligence. Throughout the process of addressing non-compliance, as operators shift and improve the way they provide service, new assessments are conducted and status is updated online within 30 days.”
A senseless death
Two days after Zach Plett arrived at 9310-132nd Street in Surrey, he was dead. According to the coroner, he died between 9 a.m. and noon on Dec. 15, 2018. But his body wasn’t discovered until 4 p.m.
Plett described what she saw when went to collect Zach’s belongings.
“The house was horrible. The walls were dirty. The ceiling was stained. My son’s bed sheets were mouldy.
“His body was already taken. But the bed was soaking wet with his bodily fluids. There was graffiti on the furniture. The drape was just a hanging blanket. It was filthy.”
To add insult to grief and despair, Plett noticed that his roommate was wearing Zach’s shoes.
Worse than the state of house is the fact that Zach died in the daytime and it was at least four hours before anybody noticed.
Plett wants to know why nobody had checked on Zach? Were there no structured programs where his absence would have been noticed? Didn’t anyone wonder why he missed breakfast and lunch?
“I had no idea what it was like or I would never have sent him,” said Plett.
After battling addiction for seven years, Zach had spent the previous three months in Gimli, Man. and what Plett describes as an excellent facility that cost $40,000.
But Zach wanted to come home, despite Plett’s concerns about omnipresent fentanyl in Metro Vancouver. They agreed that he couldn’t live with her.
A trusted friend gave Plett the name of a recovery house and within a week of returning to British Columbia, Zach went to Into Action’s house in Surrey. It is a government-registered facility that has never had a substantiated complaint against it.
Because he wasn’t on welfare, his mother E-transferred $950 to Into Action to cover his first month’s stay. She was told that the staff would help Zach do the paperwork to get him on the welfare roll.
Later that day, Zach called his mother, asking her to bring him a clean blanket and pillow because the house was dirty.
Because family members aren’t allowed into the house, Plett met him at the end of the driveway to hand over the bedding. It was the last time she saw Zach.
The next day, Dec. 13, he called to say that he had been “kicked out” for “causing problems.” He told Plett that it was because he’d complained about the house and asked to see the consent form that he’d signed.
Later that day, someone from Into Action drove Zach to Step by Step’s house on 132nd Street. Two days later, he was dead.
Because of the confidentiality clause in the informed consent forms signed by all residents, Into Action executive director Chris Burwash would not even confirm that Zach had been a resident.
But he said before signing those forms, residents are given “a clear outline of the expectations of them” and “a clear description of what the rules are.”
They are told that there are no second chances if they break the rules.
“If they outright refuse to participate or outright breach our zero tolerance policies — violence or threats of violence, using illicit substances, intentional damage to facility, etc. — we are put in a position where it is impossible for us to allow them to stay. We have to ask them to leave,” he said.
Staff provide them with a list of other government-registered recovery houses and sit with them while they make their choice without any advice or interference, Burwash said. Once a place is found, Into Action staff will take them there.
Burwash emphasized that only registered recovery houses are on the list, which speaks to the importance of the governments registry. But he said it’s frustrating that operators don’t comply with registry standards since their failures reflects badly on all recovery houses.
“We absolutely support the media shining a light on the facilities that are operating below the standards that they agreed to abide by,” he said. “We are certainly not one of them.”
He invited me to visit any time.
On Dec. 14, Zach and his roommate went to an evening Narcotics Anonymous meeting. Plett found the sign-in sheet from the meeting when she collecting his belongings the following day.
“What he and Billy (his roommate) did between then and early morning, I don’t know,” she said. But another resident told her that she thought they were “using” until around 5 a.m.
The toxicology report from the coroner indicated that the amount of fentanyl found in his system was no more than what is given cancer patients for pain control. But because Zach hadn’t taken opioids for six months, his tolerance for fentanyl was minimal.
“Had he died in the middle of the night, I would never have gone public with his story. But he died in the daytime. If they’d woken him up for breakfast or tried … ” said Plett, leaving the rest unspoken.
“He wasn’t monitored. He wasn’t watched … If I had known I would never have sent him there.”
Last week, Plett had an hour-long meeting with Addictions Minister Judy Darcy and the mother of the other young man who overdosed. He died Christmas Eve at another Step by Step. His body was only discovered on Dec. 26 after other residents kicked in the door of the bathroom where he was locked inside.
“She (Darcy) was very genuine and sympathetic,” Plett said. “I don’t think she realized how bad the situation is.”
Problems left unresolved
Step by Step’s first non-compliance reports date back to an inspection done Jan. 23, 2018 at its house at 11854-97A Street in Surrey.
Inspectors found that meals were neither safely prepared nor nutritious. Staffing didn’t meet the residents’ needs. Staff and volunteers weren’t qualified, capable or knowledgeable.
On Nov. 2, they returned. Nothing had changed and more problems were found.
The house didn’t safely accommodate the needs of residents and staff. Site management wasn’t adequate. There was no support for people transitioning out of the residence.
Critically, there were no psychosocial supports to assist individuals to work toward long-term recovery, maximized self-sufficiency, enhanced quality of life and reintegration into the community. Those supports include things like counselling, education, group therapy and individual sessions with psychologists, social workers, peer-support counsellors or others with specialized training.
On Feb. 4 and March 27, inspectors went back again because of a fresh set of complaints. As of May 8, none of the substantiated complaints had been addressed.
On the same day in November that inspectors were at the 97A Street house, they also went to Step by Step’s other four houses in Surrey — 132nd Street where Zach Plett died, 78A Avenue where the other man died, 13210-89th Avenue and 8058 138A Street. Step by Step doesn’t own any of the houses, but one of it directors, Deborah Johnson, is listed as the owner of 138A Street.
Not every house had the same complaints. But all of the complaints were substantiated and there were commonalities.
None had provided properly prepared nutritious food. None had adequate, knowledgeable or capable staff. Not one house was suitable for its use.
None supported residents’ transition to other accommodation or provided psychosocial support.
Since then, there have been repeated inspectors’ visits but the last posted reports indicate that nothing has change.
The first of five guiding principles for the province’s assisted living registry is protecting the health and safety of residents. Promoting client-centred services is also on the list. But then it gets a bit fuzzy.
Others are to “investigate complaints using an incremental, remedial approach” and to “value the perspectives of stakeholders — i.e. residents and their families/caregivers, community advocates for seniors and people with mental health and substance use problems, residents, operators, health authorities and other agencies.”
But as a result of this incremental, remedial approach and seeking of stakeholders’ perspectives, there were two preventable deaths.
What more do inspectors need before the registration for these five houses is cancelled? How much more time will the province give Step by Step to bring them into compliance?
And, how much longer will the ministry of social development continue writing cheques of close to $42,000 each month to an organization that can’t even comply with the most basic standards?
British Columbia is four years into a public health emergencies that has cost 4,483 lives since a public health emergency was declared in 2016.
More than a year ago, a coroner’s death review urged better regulation, evaluation and monitoring of both public and private treatment facilities following the 2016 overdose death of a 20-year-old in a Powell River recovery house.
It’s unconscionable that the government continues to waste precious resources on substandard recovery houses, while doing so little to force bad operators into compliance. At a time when good quality services are more desperately needed than ever, the registry ought to be the place that vulnerable addicts and their loved ones can find those.
Until this is fixed, Maggie Plett is likely right to believe that Zach would have been better off homeless. At least on the street, someone might have noticed him and done something to help.
The B.C. Government’s defence in the landmark three-year-old Medicare constitutional trial in B. C. Supreme Court is ending not with a bang but a testy, two-day courtroom sparring match involving one of its experts.
Dr. Gordon Guyatt gave as good as he got, repulsing a prolonged assault on his objectivity and left the stand Thursday having provided some last-minute fireworks but seemingly little insight on the key issue — wait-lists and the effects of constraints on access to private care in the provincial Medicare Protection Act.
“My perception is that there’s been a fluctuation of concerns with waiting lists and that governments have, to an extent, addressed things,” he said.
“Things can always get better … you have tensions — constant tensions — in every health care system in the world, and problems will never be solved.”
A specialist in internal medicine and, for almost 35 years, a health researcher at McMaster University, the argumentative Guyatt was assailed as more of an ideological warrior than a disinterested expert.
Robert Grant, lawyer for the two clinics and handful of patients behind the legal challenge over barriers to access to private care, portrayed Guyatt as a virulent opponent of the private clinics and Dr. Brian Day, the driving force behind the decade-old litigation.
Noting he had a duty to be impartial, Guyatt bristled at the broadsides aimed at impeaching his credibility.
“Given my, given that commitment, I do not see personally as relevant further pursuit of my opinions about issues beyond the issues that I’ve been asked to comment on in my deposition,” he complained.
“Thank you for that,” Justice John Steeves said. “In the meantime, just answer his questions.”
Government lawyers vainly tried to halt the brutal cross-examination that battered Guyatt’s neutrality.
A self-described left winger who ran repeatedly as an NDP candidate, Guyatt has been a social activist for 40 years.
In 1979 he co-founded the Ontario-based Medical Reform Group, which disbanded in 2014 and was replaced by the Canadian Doctors for Medicare, which he joined.
He was also a director of the Ontario Health Coalition, an activist network, that along with its sister group the B.C. Health Coalition, is a member of the Canadian Health Coalition.
Doctors for Medicare and the B.C. coalition, under the banner of B.C. Friends of Medicare Society, have intervened in the challenge to support the government case.
Grant accused the groups of wrongly asserting Day seeks “U.S.-style health care for Canada, where people go bankrupt, lose their homes and life savings, or worse, because they can’t afford treatment when they need it.”
The B.C. coalition, he said, incorrectly claimed Day wanted a system where “international private insurance corporations run the show and patients foot the bill.”
Grant said the groups were fearmongering.
“It is an overstatement that this case could bring down single-tier Medicare,” Guyatt agreed, adding he also did not endorse the portrayal of Day and his supporters as “greedy, awful people.”
He maintained he was too busy to keep up with everything the groups did, and distanced himself from the inflammatory rhetoric.
“The way I would put it is that we were advocates for equitable high-quality health care accessible to people without financial obstacles,” he said.
“So, specifically, as I have said previously, I believe that it is more appropriate to base care on the need — the medical need than on ability to pay — and I would like to work, continue to work, in a system where the patients I treat are treated on the basis of need rather than ability to pay. ”
“I understand,” Grant replied.
“But the point (of the trial) isn’t about what you want to do in your own practice; it’s whether or not increased private health care, and specifically private-pay surgeries, will be permitted or not. And you are opposed to increased private-pay surgeries. Isn’t that right? ”
“Yes,” Guyatt confirmed.
Grant insisted Guyatt was a vocal opponent of Day within the Canadian Medical Association, seeing him as a “tragic choice” and “a complete disaster” as the organization’s president.
“I don’t recall active involvement in that matter,” Guyatt said, but again added such comments would be “hyperbolic.”
The Ontario specialist attacked the concept of using “benchmarks” to measure surgical waiting times — saying “not much” research has been conducted to establish what is acceptable and he suggested they were undependable tools set by “good old boys sitting around the table.”
But Guyatt has long minimized waiting lists and their ill effects — calling them “a problem that may be much smaller than we imagine” in 2004.
And he acknowledged he was not familiar with the circumstances in B.C.
“Certainly not in detail …. I do not know the details of the extent of waiting lists currently. I am sure that waiting lists remain a problem. … and that they’re not optimal … I do not know well enough to know whether it would be appropriate to characterize them as a serious problem or not. ”
The final witness John Frank, an expert on social determinants of health, took the stand later on July 18 and was to finish July 19 — day 179 of the proceedings.
“When this trial began I thought it would last up to 18 weeks (three times longer than the similar Chaoulli case in Que.),” said Day, founder of the private Cambie Surgery Centre.
“I am happy that — almost 3 years later — the witness phase is over. I am confident that the justice system will eventually grant all Canadians the same rights to protect their health that the Supreme Court of Canada granted to citizens of Que., and that the citizens of every other country in the world enjoy.”
Justice Steeves plans to hear final arguments this fall and begin deliberations in December.
“Scientists say that’s exactly what’s needed,” Carr said Thursday. “The world’s leading scientists issued a report in the fall of 2018 that implored governments to act with urgency. The climate is changing faster than they earlier predicted.”
Cutting GHGs by 100 per cent in Metro Vancouver requires updating the Climate 2050 Strategic Framework, which calls for an 80-per-cent reduction.
The panel’s report said if global warming is not kept to 1.5 degrees C, it could lead to more periods of drought, increased wildfires, and place entire ecosystems at risk.
To reach the 1.5-degree target, it would require “rapid, far-reaching and unprecedented changes in all aspects of society,” the panel’s report stated.
Carr admits that becoming carbon-neutral requires systemic change in Metro Vancouver.
“The first step is reaching out to the public in the development of roadmaps to get to these kind of reductions,” she said. “I’m counting on the public and stakeholders to get us to where we’re aiming to keep global warming at a level that avoids catastrophe.”
Carr pointed out that the 100-per-cent net reduction in GHG emissions recognizes that not all fossil fuels will be eliminated by 2050. What it means is that any GHG emissions by then will be offset by methods such as sequestration, a form of long-term storage of carbon dioxide by reforestation and wetland restoration.
The 2030 target of 45 per cent is important, Carr said, because it’s an interim measure which allows public bodies to assess how they’re doing over time.
Vancouver set a goal in 2010 of a 33-per-cent drop in GHGs by 2020. Part of the reason why Vancouver is now only at seven per cent, she said, is because there were no interim targets.
“As one example, the region has been impacted by smoke from unprecedented wildfire activity in western North America in three of the past four summers,” it said. “Expected future climate impacts include more wildfire smoke, an increase in rainfall intensity by 20-45 per cent by 2050 and 40-75 per cent by 2100, and at least one metre of sea level rise.”
The report goes to say that achieving carbon neutrality requires Metro Vancouver to not only reduce GHG emissions as much as possible, but also to commit to using “100 per cent renewable fossil fuel-free energy by 2050.”
Across the country, more than 250 local governments have declared climate emergencies.
Dr. Kim Ch, who led a clinical trial which found that over half of patients who used a new type of hormone-reducing medication saw a reduction in their risk of cancer progression and a 33% improvement in overall survival, in Vancouver BC., June 10, 2019. NICK PROCAYLO / PNG
A new drug has helped reduce the risk of death by 33 per cent in men with prostate cancer that has spread, according to the results of an international trial led by the B.C. Cancer Agency’s Dr. Kim Chi.
The double-blind study on the androgen receptor inhibitor drug called apalutamide was conducted in 23 countries at 260 cancer centres. It involved 1,052 men whose median age was 68. The study was sponsored by Janssen, the drug company who makes apalutamide.
At two years, those taking the treatment drug in addition to their standard treatment had a 52 per cent lower risk of cancer spread or death.
Chi, an oncologist, said overall survival rate is only about five years once prostate cancer has spread beyond the prostate so new treatments are desperately needed. The percentage of patients who took the drug whose cancer did not spread was 68.2 per cent, but in the placebo group the proportion was 47.5 per cent. There was a 33 per cent reduction in the risk of death for those who took the drug.
After about two years, 82 per cent of men in the investigational drug group were alive compared to 74 per cent on placebo. Men in both groups also took standard male hormone deprivation therapy showing that combination therapy helps to improve survival. Male hormones (androgens) like testosterone feed prostate tumours and currently, men with metastatic cancer are put on hormone deprivation treatment that has been the standard of care for many decades. Apalutamide, also called Erleada, is said to more completely block male hormones.
Chi said the drug is “not toxic” and there were no significant differences in the proportion of study participants in the intervention or placebo groups who experienced side effects, but skin rashes were just over three times more common in the drug group.
The drug has already been approved in Canada for certain patients with hormone-resistant, non-metastatic cancer but Chi said now that it is showing benefit for patients whose cancer has spread, he expects the drug will be approved by Health Canada for those patients as well, perhaps later this year. After that approval, provinces will have to decide on whether to expand funding for the drug, which costs about $3,000 a month. Chi said he expects more Canadian patients will have access to it next year.
“This is a next generation, better-designed androgen inhibitor and we really need better drugs for those with metastatic prostate cancer,” Chi said.
“There’s a critical need to improve outcomes for these patients and this study suggests this treatment can prolong survival and delay the spread of the disease.”
Chi was also a co-author on another drug trial, the results of which were published in the same issue of the NEJM medical journal. The ENZAMET trial, as it was called, is on a drug called enzalutamide (Xtandi). The results of that trial were similarly favourable.
About 2,700 men will be newly diagnosed with prostate cancer in B.C. this year. More than 600 men will die from it.
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