“Doctors have asked for shared patient records for ten years, and almost all of them say a lack of access hurts their work. The Liberals let a bill to fix this die when they called an election. I want the minister to explain why it took so long to bring it back.”

“Madam Speaker, I was really struck by my colleague’s comment that 92% of practising physicians have been hampered by lack of access to information about their patients. The Canadian Medical Association and other medical organizations have been calling for this for a decade. The Competition Tribunal, in June 2022, identified the behaviour of electronic medical record providers as being anti-competitive, and of course we had Bill C-72 before the previous Parliament. My question for the minister, given that the Liberals let Bill C-72 die on the Order Paper when they called an election last January, is, what took them so long?”

“As a doctor in Ontario, I know our hospitals still cannot easily share patient records with each other. The minister says this bill will not replace Ontario's existing laws. I want to know if this bill will actually change anything in Ontario or not.”

“Madam Speaker, I was interested in the point the minister made about Ontario and Quebec already having legislation that this legislation would not supersede. This interested me in particular because, as a physician practising in Ontario, I know that the clinical notes from one hospital that I worked at over the last few years in Guelph, Ontario, could be viewed in the region west of Toronto, but I also worked in Kingston, Ontario, over that time, and clinical notes from my other work in Guelph could not be viewed in that region. Even Ontario has not resolved this problem within the province. I wonder if we are talking about whether Ontario has legislation that calls for this, or about whether Ontario has a reality of interoperability between all the regions in Ontario. Would Bill S-5 affect Ontario as it stands today or not?”

“I agree with the goal of this bill, but I doubt it will work. Getting different medical computer systems to share information is a very hard technical problem. A similar law in the United States mostly failed, and Ontario tried this without success. The government also has a bad record with technology projects, and it plans to put an agency in charge that wasted hundreds of millions of dollars on a failed digital prescription system. I want this bill sent to committee so we can question experts and hold that agency accountable.”

“Madam Speaker, the minister’s enthusiasm for the bill is very well appreciated. The issue of health information technology is very near and dear to my heart, and not always in a happy way. Without naming any names of any particular institutions, one of the hospitals that I worked at for a long time foisted on physicians a health information technology solution without asking the physicians, the pharmacists or the nurses if they should do this or whether it was a good idea. They spent millions of dollars on it, and it frankly ruined our professional lives when it did not work at all. It is important to have good intentions. It is important to be enthusiastic about those intentions, but it is really important that the solutions that end up hitting the ground actually work for the people who use them and for the people those professionals serve. We have to be really careful about a bill like this. The possibility of causing more problems than it solves is a real and present danger. It is always a great honour to be in the chamber. It is always a great honour to speak on behalf of the people of Kitchener South—Hespeler. It is a great honour to give the Conservative response to the minister’s speech. This is, I believe, the first piece of legislation pertaining to health care in the 45th Parliament. It has been a long time coming. It has been a year and a half. I am a bit sad to say this is a bill that is warmed over from the last Parliament, when it somehow did not make it through. It has been years coming, and for that reason I would hold it to an even higher standard than if it were invented de novo. The bill before us today, Bill S-5, has the admittedly laudable goal of making it illegal for health information technology companies to engage in what the bill defines as data blocking, that is, stopping the exchange, or impeding the exchange, of personal health information between authorized health information technologies. In sharp contradistinction to many of the government bills that we have been debating over this past month, or even this past week, this is a very short bill. I commend it for that reason. It is perhaps only five pages long, in one language. Even though it is easy to read the bill, which I am grateful for, it is very difficult for me to understand how it could, in fact, work. I spent 95% of my clinical career in hospitals. There are three electronic medical record vendors that hospitals in Canada use very commonly: Epic, Cerner and Meditech. All three, I am sorry to say, are American companies. All three are subject to a 2016 law passed by the Obama administration called the Cures Act. My understanding is that the Cures Act is very similar, both in its intent and its operations, to the bill before us today, Bill S-5. Of course, it would be ideal, internationally, that all three of these systems be able to transmit patient health information between each other, obviously with the consent of the patient involved, but it is a really hard problem. This morning, for instance, my office printer was on the fritz. I was unable to send data, this speech, from my computer to the printer in my office. I had to get a friend in the lobby to print it for me, and that is a much simpler problem than all of the health information in all of Canada. Software vendors and Bill S-5 can have the best of intentions, but the problem of data interoperability is just a hard problem. Let us take, for instance, Meditech. Currently, Meditech has multiple products, multiple product families and different versions of each currently operating in the wild. There is Meditech 6.0, Meditech 6.1, Meditech Expanse, Meditech Expanse 2.1, Meditech Expanse 2.2. Different hospitals may choose to invest more or less money, or use one product family over another. They may choose to update whichever product family they are using often or not, depending on their own IT and human resources. I imagine it is a full-time job, nay several full-time jobs, at Meditech headquarters just to make sure that its own systems can communicate with each other in an interoperable fashion. That is not for a lack of trying. How much work, how many people and how much money will it take to make the Meditech system talk to the Epic system, to make both talk to Cerner and to make all three talk to the 10 to 15 major players in the European market? How much of a barrier of entry to one day starting a Canadian competitor would all of this entail? Let us drill down on a small part of the problem to understand the full scale of the problem. In my work as an ICU physician, any individual patient might have literally tens of thousands of data points stored in the EMR from just one day. Just their vital signs, such as heart rate, oxygen saturation, respiratory rate, body temperature and blood pressure, might be recorded and time-stamped continuously, providing thousands of data points before we even speak of medications, diagnostic imaging, clinical notes, blood work, etc. Each of these data points has to be filed or coded in some agreed upon, legible way in order to be interoperable. Even to zero in on just blood pressure, there are multiple numbers that go into a blood pressure reading and different numbers one might want to store, such as the systolic, the diastolic and the mean arterial pressure. There are different ways of measuring a blood pressure, namely a sphygmomanometer or a blood pressure cuff, or invasive arterial monitoring. Sometimes we are measuring both continuously throughout the day. One system might store, code and display the cuff systolic and the intra-arterial map every 15 minutes. My system might store, code and display only the cuff three times a day, or when an intra-arterial pressure is available, it might store that, superseding the other. It seems almost impossible to have a government regulatory body come in and say which one is correct. The sphygmomanometer, the intra-arterial blood pressure monitor, the EKG and the pulse oximeter all measure a patient’s heart rate, and three of the four measure it continuously. How do we impose a system that ensures that each health vendor will store those in mutually comprehensible ways? Let us consider a patient on continuous EKG monitoring. Literally every beat of their heart comes with multiple measurable waveforms depending on which EKG is looked at. Each monitoring system will come with different alarms and different ways of storing who responded to each alarm, how long the alarm went off, who turned it off and why they turned it off. I cannot imagine setting one standard for how all of this ought to be captured. This is not like saying all smart phones have to use a USB-C plug. There are so many more inputs and outputs to a human body that constitute health information. When I speak of monitoring vital signs, I am speaking of a fraction of a fraction of all the forms of data that go into health and health care. I have just now been speaking about electronic medical records, only one of the types of software we would find in a hospital. There are also prescription management systems, diagnostic imaging systems and scheduling systems, all of which contain personal health information. By the way, health care centres like hospitals are just one sort of organization that uses some classes of devices and some sorts of information technology on those devices. Bill S-5 seems to seek to regulate all sorts of other devices. For instance, I am wearing an Apple Watch. It went off, and the Speaker got mad at me. It also stores personal health information of mine on it, such as my heart rate. If someone has a CPAP machine at home or a blood sugar monitor, the bill would seem to make demands on those device manufacturers as well. This is just the present state of things. Health information technology is changing now at a faster and faster rate. A friend of mine runs an AI-powered ultrasound diagnostics start-up company for use by combat medics to see if a soldier in the field has a pneumothorax in real time. It is a pocket-sized device. It is an amazing invention. He worked so hard on it. He employs so many fantastic Canadian scientists who are designing it and making it better every day. I understand that he spends about 0% of his time making sure that whatever data is stored on that device in a battlefield somewhere can talk to Cerner, Epic and Meditech. He is trying to save lives by making something that has never existed before. How can he expect that whatever data his invention ends up outputting 10 years from now will be legible by these legacy systems? I am hoping that this House will take seriously the scale of the problem that Bill S-5 is trying to make go away. As I said earlier in my speech, the bill closely follows the approach that the Obama administration took in 2016, 10 years ago. Did this approach work in that milieu? If it pleases the House, I would love to table at some point a paper from November 2025 published in the Journal of the American Medical Association and written by Everson et al., entitled “EHR Interoperability Experiences Reported by Family Physicians”. The scientists surveyed more than 8,000 family doctors, asking them what their experience with health information interoperability has been like eight years after the Cures Act. I am sorry to say that despite the best of intentions, the results in this paper are dismal. Only 8% of the family doctors surveyed reported ideal interoperability. From my reading of the paper, it seemed that a majority of the doctors went so far as to give up on accessing outside clinical documentation. I hope we can talk more about this study at committee. Perhaps we could invite the authors of it to committee, should the bill succeed at second reading. If it is the case that the U.S. administration, after eight years of trying, largely failed to regulate the big American health information technology vendors I mentioned, Cerner, Meditech and Epic, how can we expect that the Canadian federal government would succeed in regulating those same American health information technology vendors into making their systems interoperable? As I said, most Canadian hospitals use information technology from these American providers. Many of the Canadian hospitals I have personally worked at, however, cannot afford to use the latest systems or subscribe to the most up-to-date features from each of these vendors. Is it really possible that Canadian regulators will be able to bully these gigantic corporations? Cerner is, in fact, by the way, the health information branch of Oracle, one of the largest tech companies in the world. Are we going to be able to demand that Oracle change what it is doing into solving what I fear may be an unsolvable problem when we are currently shopping in its bargain bin? Is it the case that the federal government has a good track record generally in the field of IT systems management? Who among us here could forget the $2.6-billion boondoggle that we now call the Phoenix pay system? Who could forget the $60-million arrive scam scandal? Who could forget the most recent scandal of all, the $300 million blown on the unworkable PrescribeIT program? I, for one, am not going to forget the PrescribeIT scandal. I think anyone who is familiar with my parliamentary work knows about PrescribeIT by now, because it has been the biggest part of what I have been working on over the last year. In brief, not to belabour the point, as I know the health minister is very familiar with it, it was a 10-year-long attempt by an organization called Canada Health Infoway, which receives funding both from provinces and from the federal government, to solve a simple problem. Ten years ago, when she introduced the legislation that gave the money for PrescribeIT, the minister of health at the time, Jane Philpott, called it the axe the fax program. Members are aware, of course, how much Liberals like rhyming three-word slogans such as axe the fax. Right now, in our country, physicians fax prescriptions to pharmacies. That was the case in 2016 when Jane Philpott introduced the legislation. Canada Health Infoway spent $300 million and took 10 years to make just this small class of health information transfer digitally between a doctor’s office or hospital and a pharmacy. We have investigated this matter at committee in some detail. To this day, I do not understand how it is that Canada Health Infoway invented something other than a digital fax, which has existed since 1998. Indeed, by its own admission, it invented nothing. It gave Telus $80 million to provide and manage the software platform, which already existed. That was a good deal for Telus. To this day, our study of this matter at committee having been truncated, I still have no idea what became of the other $220 million. It had a $300-million budget. It bought the software and had Telus managing it for $80 million. I do not know where the $220 million went. After all of that money and all of that time, physicians and pharmacists in our country, by and large, refused to use the solution. Canada Health Infoway seems to have spent a decade designing, or not designing but ordering, a software solution from Telus, without bothering to check in with frontline workers whether they liked the product or whether they would agree to use the product. The product was free, and still over 95% of physicians in our country declined to use the product. That is really bad and frankly activates my PTSD from my home hospital, which had foisted an information management system on us all those years ago. Of all the dogs that have never hunted, the PrescribeIT dog really did not hunt. It was a free solution that 95% of physicians and pharmacists declined to take up. With Phoenix, arrive scam and PrescribeIT, there is not a good track record. Maybe the federal government is about to turn over a new leaf and provide IT systems that work and that people want to use. I wish I could believe that, but do members know who it plans to put in charge of Bill S-5? Can anyone in the House guess? It is Canada Health Infoway, the totally corrupt organization that just blew $300 million on a failed solution. I know this is the Liberals’ plan by word of mouth, but I also know it from Senate testimony. This bill is called Bill S-5 because it came from the Senate. It has already gone through Senate committee hearings, and that has been the clear message. They had the now interim CEO of Canada Health Infoway give testimony. It is their intention to oversee the regulation of this perhaps unsolvable problem. For those who have not heard, Canada Health Infoway just fired its CEO because he came to the health committee to answer questions about PrescribeIT. He refused to answer the most basic questions about what he accomplished with his nearly $1-million salary. He would not even answer what his salary was. We had to get that information by other means. Its current CEO is the former vice-president, whom he hired. The $300-million PrescribeIT boondoggle is not even Canada Health Infoway’s total spend over the last decade. I believe the organization was in receipt of $1 billion of public money over this time, yet when we had the chair of the board at the health committee and I asked him what it accomplished with the other $700 million, he was unable to describe a single tangible achievement. This is a big problem. Even acknowledging that PrescribeIT did not work, acknowledging that the CEO of Canada Health Infoway was a big problem and acknowledging the extent to which the health minister took credit or did not for his dismissal, even after all that occurred, she planned to reward Canada Health Infoway with another $50 million of funding this year. I came to question period week after week and asked why she would give it this money. To her credit, the minister halted that funding, acknowledging that this organization is in a serious state of disrepair. This is a big problem when we talk about Bill S-5. It is, to my understanding, still the Liberals’ intention to have Canada Health Infoway lead the charge on regulating into existence a solution that is maybe not even possible when they have not accounted for the last $1 billion they spent. Do I support Bill S-5 in principle? Of course I do. Of course health information technology should be interoperable. Of course no patient should ever have their care suffer because data transfer between institutions is hard. Do I believe that the government, with its track record of IT boondoggles and its track record with Canada Health Infoway, will succeed in getting this job done with this piece of very short legislation? I fear I do not. I want to hear more about it at committee. I certainly want to hear more from Canada Health Infoway on what its plan was, but I cannot say that I have great faith that it will work out. Solving a problem like the one I have described is not a matter of intention. For instance, I do not want anyone in this country to be sad. If we were to make a law that no one is allowed to be sad anymore, it would not work. That was the question I asked the minister. She said it seemed to be the case that Bill S-5 would not even apply to Ontario because Ontario already has legislation with this intention. However, the reality in Ontario, as I described in my question, is not that health information technologies are interoperable. In the discussion and debate we have in this House, I would love for the government to explain why it will succeed where Ontario has failed if it already has similar legislation.”

“The federal government cannot solve this health data problem. Canada is too big, and provinces are closer to the issue. If a single province cannot fix this at home, no federal government can either. We should not spend money on a project that is doomed to fail.”

“Madam Speaker, I think this is becoming a bit of a running gag. After literally every speech I give in this House, the member for Winnipeg North stands and says, “but Stephen Harper”. I suspect that he checks under his bed for Stephen Harper before he goes to sleep at night. In general, I criticized the federal government trying to do things that cannot be done. This is a vast country. If this problem were solvable, it would be solvable close to home at a low level. If a single province cannot get this done within its borders, I do not understand how any federal government, Stephen Harper’s or otherwise, would be able to achieve that. Is it still a good idea to do something that is well-intentioned but doomed to failure? Part of the answer to that is how much money the Liberals plan to spend on their well-intentioned, doomed project.”

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“I think this bill is dangerous. A new regulator could make rules that hurt small inventors and protect big medical tech companies. Health care also belongs to the provinces under the Constitution, not the federal government.”

“Madam Speaker, I think it is dangerous. There are two major dangers that I see. One is to free enterprise. If we have some giant regulator, unaccountable to the House, making decisions about what constitutes interoperability, how is that going to affect my friend? He is a professor of medicine. He is, frankly, a genius. He is trying to develop this ultrasound AI-powered technology. It would be easy for the regulator to put restrictions on him that would make it almost impossible for him to enter the market unless he lives up to the standard that the fat cats like Cerner and Meditech get the regulator to adopt. There is a real risk of protectionism and the choking out of health care innovation. I have read the Canadian Constitution front to back a few times. It talks about hospitals being under provincial jurisdiction. We have the Public Health Agency, we have Health Canada, and we have the Canada Health Act. It seems that in many ways in this country, health care currently comes under federal jurisdiction, and the words “health care” do not appear in Canada’s written constitution, at least.”

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“Canadians should be able to access their health records anywhere. Different health systems have trouble sharing this data, and we need to fix that. I want my colleague to say more about how we can make these data systems work together.”

“Madam Speaker, it is important to hear from somebody like my colleague, who has the medical professional background that he does. He has very eloquently expressed a lot of the problems that currently exist. It is very reasonable for Canadians to expect that their data and their information would be available to them wherever they may be, and I think this is a problem that needs to be addressed. It has been a problem in Saskatchewan. It has been a problem in Ontario, as he has highlighted very well. I passed a bill on the copyright side for interoperability, so I appreciate his talking about the need for data interoperability. I am just wondering, on that very specific point, if he has a little more to add to the remarks he made earlier.”

“I want to change this bill to focus more on patients. It should give people control of their own health records so they can choose who to share them with.”

“Madam Speaker, something the member was driving at that I think is really important is the lens I would want this sort of bill to take. In medicine in general, we have struggled over the last several decades to be more patient-centred and less institutionally centred in our approach. I would love it if this health information technology bill put health information technology more in the hands of patients, if it adopted the patient-centred approach. Instead of a bill telling Epic and Cerner that they have to fulfill Canada Health Infoway’s requirements on interoperability, I would love to see a bill that asks Cerner and Epic to put the health information in the hands of the patient to whom the information pertains, and then that patient could choose to hand it over to Epic or to Meditech if and when they see fit.”

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“The Liberals have enough votes to pass this bill if they want to. I do not know why the government cares how we will vote. I cannot speak for my party, and I have not decided how I will vote yet.”

“Madam Speaker, my understanding is that the Liberal government has a majority in the House. The legislation will pass if the Liberal Party wants to pass it. I am honestly befuddled as to why the parliamentary secretary to the government House leader is so interested in whether we support the legislation. I am not in a position to speak for the Conservative Party today. For myself, I can say I have not made up my mind.”

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“I want to know what extra data the member needs from the government. We need proof that this health care law will work well and that health systems will be able to share data easily.”

“Madam Speaker, I am wondering what additional data the hon. member is looking for, in terms of what the government needs to provide in order to give not just Conservatives but Canadians comfort that the legislation would be implemented well and would provide for good, truly interoperable portable systems.”

“I do not trust Canada Health Infoway to lead this work. Setting these rules is very hard, and many of the experts work for the big tech companies. I want to know who will write the rules, how they will do it, and how much it will cost.”

“Madam Speaker, it comes down to trust. It is my understanding, based on the Senate testimony, that the intent is for Canada Health Infoway to lead this effort. I do not trust Canada Health Infoway. It is a really, really difficult technical problem. I understand some things about health care. I understand not a lot of things about information technology. There are very few people, I think, who actually could make regulations that make sense. Unfortunately, I feel that many of them are currently in the employ of Cerner, Meditech and Epic. If more meat could be put on the bones regarding who would actually be doing the regulations, thinking about the regulations, and how much money it would cost to get those people to do it, then perhaps I would have some more trust in this approach overall.”

“Provinces need more federal money to provide good health care. I want to know what the member thinks about Canada spending more money paying interest on the debt than on health care transfers.”

“Madam Speaker, I appreciate my colleague’s speech on this important issue today. I was particularly interested in the part about health care transfers. It is not a big ask for the provinces in order to provide the health care that Canadians deserve. It does fall under provincial jurisdiction, but they are asking the federal government for health transfers. I would like to know the member’s opinion on the fact that we are spending more taxpayer dollars on servicing our debt than we are on health care transfers in this country.”

“I want to know why the government waited so long to fix our health records system. Doctors have asked for these changes for ten years, but the Liberals let an earlier version of this bill die.”

“Madam Speaker, my colleague gave a good description of how the Liberals have allowed our health care system to fall behind. Medical associations have been calling for these changes for 10 years. In 2022, Canada’s Competition Bureau also highlighted the problems associated with electronic health records. However, the Liberals let Bill C‑72 die on the Order Paper when they called the election last year. I am glad they are finally taking action, but why did they wait so long?”

“Canadians should be able to access their health records anywhere in the country. People, not companies or regional authorities, should decide who gets to see their health data. How does this bill make sure individuals have that control?”

“Madam Speaker, I think there is a reasonable expectation among Canadians that their health data should move with them. I am from Saskatchewan. If I had a health incident here in Ontario, I would want to know that it would be very easy for my health data to be readily available to whoever is providing the service that I needed in that particular moment. I think it is important that it be up to the individual, in a sense, to decide where that data is available, so I wonder if the member has any ideas, with the bill, on how to make the individual, not so much a company and maybe not even a regional authority, the ultimate person to say that, yes, they want their health data to be available, either across the country or in certain provinces.”

“I support sending this bill to committee to fix it. Patients in my area must travel to get care, and different health systems cannot share their medical records. That puts lives at risk. The government took far too long to bring this bill in, and we need to make sure the software does not fail. The committee needs to fix the rules around privacy, punish hospitals that block data, and make sure new companies can still compete.”

“Madam Speaker, I will be splitting my time. This bill is very easy for the people of Nanaimo—Ladysmith to associate with. To be diagnosed with a chronic illness in Nanaimo—Ladysmith really is to find out how transportation works in British Columbia, because we inevitably need to receive treatment not only in Nanaimo but also in Victoria, in Vancouver or sometimes in other places on the island. We know very well what the consequences are of medical information not being available where we receive our medical care. Those consequences include misdiagnoses, non-diagnoses, wrong medication and lower quality of care as a result. The reason we need to receive health care all over the island and the mainland, and in some cases why we need to go to other places in our community, is that the Nanaimo Regional General Hospital, which is the main hospital in Nanaimo and the area, has about 345 hospital beds. However, I cannot remember a day when the number of patients in the hospital, when I have been there either visiting someone or for another reason, has been below 400. This means that we travel for health care, and we know what happens when our medical records are not available. We understand the problems that come with needing to stop, find information and have it faxed over from one place to another. In B.C., in fact, we have more than 40 different electronic medical record systems, which are used across health authorities, specialists and family practices. We understand the consequences when those systems do not talk to each other. The BC College of Family Physicians reports that more than 78% of doctors use between two and five systems. Believe it or not, that is actually by design, and it puts our lives in danger. What this bill deals with is a phenomenon known in the health care world as “data blocking”. The minister admitted and said in her speech this morning that 92% of doctors in Canada have said that a lack of access to patient medical records hampers their ability to provide care. Health Canada has reported that only 29% of primary care providers share patient information electronically outside of their practice. That is one of the reasons the Canadian Medical Association and other medical health organizations have been calling for a decade or more for electronic medical records to be available where and when health care providers need them. Dr. Margot Burnell, who is a previous Canadian Medical Association president, has described this as doctors facing “an uphill battle trying to provide timely patient care when they are routinely dealing with health systems that cannot communicate with each other”. That makes this bill a very long time coming. In fact, it is not the government’s first attempt to bring this forward. Bill C-72 died on the Order Paper in the last Parliament because the Liberals decided that it was more important for them to go to an election. We ask two questions on this side of the House. The first question is, what took the government so long? Why has it taken this long to bring in a bill that Canadians so badly need and that has been called for by patient advocates, by medical professionals and by patients? The other question is, why did it take the government 18 months to introduce this bill in the House when this bill so clearly needs to be implemented to save lives? The next question we need to ask about a bill like this when it is being brought forward by the government is, what do we need to do to make sure it will get this right? We cannot afford another software debacle or failure in this particular case. We cannot afford for Canadians’ medical records to become unavailable or get scrambled the way we have seen with so many other programs the government has tried to implement in the software space. Whether it is PrescribeIT, Cúram, or some of the other problems that we have had, we cannot afford to see that happen in this space. In that context, it is distressing to have learned from the Senate’s testimony here, and I believe my colleague recounted this earlier, that the government is considering hiring Canada Health InfoWay to administer this particular program. That is a situation where, given the management issues and health care issues with that organization, specifically those related to health care software in the past, Canadians may have some very reasonable concerns. A second issue that I really believe we need to deal with at committee is a number of definitional concerns. The idea of contextual interoperability can mean different things in different circumstances. We must ensure that the data that travels in between systems, when the software interoperability is implemented, is seamless, is not another data dump, is readable on the other end and is usable. Similarly, we need to ensure that there are clear definitions for terms such as “data blocking”, “good enforcement mechanisms”, and “real remedies for failure”. The Competition Bureau pointed out in 2022, which is another reason why we are asking why this is taking so long, that electronic medical record vendors were, in fact, blocking data deliberately. This bill is now targeting those problems, including vendor lock-in, data blocking and the unreadable data dumps I just discussed, so it is very important that the bill expand the information-blocking penalties to include hospital networks and authorities that sit outside of these systems and may further hamper interoperability. The Senate committee on this bill recognized that vendors are only one part of a wider health data system and recommended that the government consider extending responsibility as I have described. I would recommend that the House committee that examines this bill take a look at that gap, because software can only make the record available. Someone still has to complete the referral, the transfer, and get it to the clinician who is taking over care. Privacy is also something that needs a very precise answer with respect to this bill. Section 5 of the bill says that the interoperability duty does not require access, use or exchange where privacy law prohibits it, but clause 6’s data-blocking prohibition has no equivalent expressed privacy law exception. I would note here that the Office of the Privacy Commissioner supports interoperability, but recommends that the ban be subject to privacy law. Therefore, the committee should examine and close that gap where appropriate so that a vendor is not treated as blocking information for refusing an exchange the law, in fact, forbids. There is also a need to ensure that compliance costs are not so high as to prevent entry by new providers. What I would say in closing, is that Bill S-5 would not build the tower that Nanaimo needs. It would not add the staff beds or the cath lab we need north of the Malahat. I will continue to advocate for those things both here in Ottawa and with provincial decision-makers in Victoria. However, this is a good start. I hope we will see the committee do good things with this bill and that it will come back to the House in a format we can support.”

“People often tell us about problems getting medical care, like hospitals not having records for sick children or seniors. I hope this bill helps fix these gaps.”

“Mr. Speaker, as the member knows, one of the things that happens in our offices on a regular basis is that people contact us with the experiences they have had with the health care system. As MPs, it is very frustrating for us, because we want to help, but health care delivery is something that is up to the provinces. Like my colleague, I have heard many stories of parents taking kids to hospitals and finding out that nobody can remember what the medication is and the records are not available. There are also circumstances where seniors who may have dementia or other issues are taken to the hospital by care providers and are not able to provide a full medical health record. Hopefully, this is something this bill would work to address using a federal power in the background.”

“I support this bill. People in my area must travel to get health care, and they need their medical records to follow them. The government took too long to do this. A committee must study the details carefully so this software project does not become a costly mess.”

“Mr. Speaker, I think I explained in some detail in my speech why I do support the objectives of this legislation and why it is particularly important in communities like ours, where the federal government has not provided enough health care infrastructure and health care support to be able to have access to those records when we have to travel between cities to receive care. On the principle side of things, I wonder what took the government so long. In terms of the operation, it is really important that, in committee, we make sure to get the provisions right so we do not have another Liberal health software boondoggle on our hands.”

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“The government is slow to listen to people in British Columbia. I want health records to be easily shared because doing this right will save lives.”

“Mr. Speaker, I think we all know that sound travels more slowly than light, so sometimes it takes Ottawa longer to hear the needs of British Columbians. We are looking forward to seeing a time when those records are portable. I cannot say it more clearly than that. Let us get this right, though. Let us get it right, because it would save lives.”

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“I support the idea behind this bill. Different health record systems should be able to share patient files easily, and companies should not be allowed to block data. Poor communication hurts patients and wastes doctors' time on paperwork. But this bill will not create more doctors or fix long wait times on its own. The government needs to talk to frontline workers, set strong security rules to protect patient privacy, and explain how the new rules will actually work.”

“Mr. Speaker, today, I rise on behalf of the great people of Edmonton Southeast to discuss Bill S-5, the connected care for Canadians act. No Canadian needs reminding of the challenges facing our health care system. On this side of the House, we believe Canadians deserve timely, world-class health care when they need it, regardless of their financial circumstances, yet too many Canadians are waiting for a family doctor, a specialist appointment or a procedure that would allow them to return to work and live without pain. Canadians need better care. In many cases, their lives depend on it. While provinces and territories are responsible for delivering health care, the federal government has a responsibility to work constructively with them to improve access and support better outcomes. Bill S-5 presents an opportunity to address one part of this challenge, the difficulty of sharing health information between the professionals responsible for a patient’s care. The principle of this legislation is common sense. However, much more work is needed to ensure that this bill would deliver meaningful improvements for patients. In Alberta, we know that a gap in communication can have serious consequences. In 2012, Greg Price died at just 31 years of age. A subsequent inquiry found that poor communication between providers and breaks in the continuity of care contributed to his death. His family has since worked to ensure that others learn from their tragic experience. More recently, tragedy struck closer to home. Last December, Prashant Sreekumar, a 44-year-old father of three, died at Grey Nuns Community Hospital in Edmonton Southeast after he waited nearly eight hours to see a doctor for chest pain. These cases involved different circumstances, and we should be careful not to suggest that one piece of legislation could have prevented everything that went wrong, but these stories demonstrate why this issue is important. When patients are referred to specialists, they should know whether their referral has been received and who is responsible for following up. When important test results become available, those results must reach the right professionals and therefore be acted upon. A patient dealing with a serious illness should not have to chase records and coordinate communication between medical offices. That responsibility should not fall on a family already worried about the health of someone they love. Bill S-5 would require health information technology vendors to ensure their systems can communicate with one another. It would also prohibit data blocking, subject to regulations. Put simply, a patient’s information should be able to follow them securely through their care. A commercial interest in keeping customers tied to one software system should not prevent the appropriate sharing of information needed to treat a patient. It is a practical goal that Conservatives support. According to the Canadian Institute for Health Information, in 2024, only 68% of hip replacement and 61% of knee replacements were completed within the recommended six-month benchmark. Median waits for MRI scans were also 15 days longer than they were in 2019. These delays have consequences. For a person waiting for knee replacement, it may mean months of difficulty in walking, working or caring for their family. For someone waiting for a scan, it can mean prolonged uncertainty about a potentially serious condition. Better information sharing can help prevent unnecessary repeat tests and the delay caused by missing records, but connecting computer systems will not on its own add more doctors or create additional surgical capacity. Canadians need a broader effort to improve access. The government must explain how this legislation will contribute to that work and how its results will be measured. We must also consider the people delivering care. Doctors enter medicine to help patients, yet too much of their working time is consumed by unnecessary administrative tasks. A joint survey by the Canadian Medical Association and the Canadian Federation of Independent Business estimated that physicians in Canada spend nearly 20 million hours each year on unnecessary administrative work. Disconnected records are only one part of that burden, but that is a part we should address. When clinic staff repeatedly request the same records or a physician must enter information already held in another system, valuable time is lost. That time could be used to see patients. The question is whether Bill S-5 would make that work easier. Would referrals become simpler to track? Would doctors spend less time searching for results? Would small clinics receive the training and support needed to adopt new systems? We cannot promise less paperwork while creating another complicated process for doctors to manage. Frontline professionals must be involved in developing these requirements. Furthermore, Canadians must have confidence that their personal health information is protected. Health records contains some of the most sensitive details of a person’s life, including their mental health history, prescriptions and diagnoses. Patients share that information because they trust their health care providers. That trust must be maintained. Protecting confidential information must not be confused with improperly withholding it for commercial reasons. During the Senate committee review, stakeholders recommended baseline security requirements for vendors, including encryption, strong authentication and records of who accesses information. These recommendations deserve serious consideration. Doctors should not be expected to become cybersecurity experts to determine whether a vendor’s product is adequately protected. Vendors must have clear responsibilities for maintaining safeguards, and patients need clear answers about how their information can be used and what happens if it is compromised. Finally, much of this legislation would depend on regulations developed after it were passed. These regulations would address standards, enforcement and the legislation’s application within provinces and territories, which may also require careful examination. Provinces, health care professionals and patients deserve clarity about what would be required, what it would cost and who would be accountable. Conservatives believe in health care that delivers for its patients, but ultimately what Canadians need are shorter wait times, reliable follow-ups, seamless information transfers, and doctors who have more time to practise medicine rather than working on endless paperwork.”

• Echo ×5

  A repeated line

  “While provinces and territories are responsible for delivering health care.”

  Said 5 times by 4 members since September 23.

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“I want this bill sent to committee. It is short, but it still has loopholes. The committee needs to make it clearer, cut paperwork, and make the process simpler.”

“Mr. Speaker, one thing I appreciate about the bill is that it is not too lengthy, but that does not mean it answers all the questions. We want to send it to committee for review so additional loopholes can be looked at. As recommended by the Senate review committee, more work can be done on it so clarity can be found, the paperwork can be reduced and the process can be streamlined.”

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“The government wasted 300 million dollars on a past digital health project. Does my colleague really think this new bill will give taxpayers their money's worth?”

“Mr. Speaker, it is always a pleasure to rise on behalf of Windsor West. Given boondoggles such as the $300-million PrescribeIT scandal that we have faced, how much confidence does my colleague have that this legislation would be able to deliver anything of value to the Canadian taxpayer?”