“When the member was health minister, did he talk to the provinces and territories to see if they wanted health systems that can share data? How would sharing this data make health care better in Canada?”

“Mr. Speaker, I want to thank my colleague for his great speech. I know he has previously served as health minister, and I am rather curious to know whether, when he held that position, he had any discussions with provincial and territorial ministers to gauge the level of interest in this interoperability. Could he also talk about how this interoperability might improve the quality of health care services in Canada?”

“I want us to pass this bill. The provinces want to work with the federal government on it. Big tech companies work across the country, so we need to work together to stop them from blocking patient health records.”

“Mr. Speaker, I would also like to point out that my colleague herself has also served as health minister and that she contributed to moving this program forward. I tried, to the best of my ability, to follow her example and continue to push it ahead. Indeed, the bill was nearly finished when I was in the post. Things have changed since then. The good news is that the new Minister of Health is very committed to moving it forward, and rightly so. The provinces and territories have consistently emphasized the importance of working with the Canadian government because big tech operates across several provinces at once. It is easier, as a country, with the provinces and the Canadian government working together, to put enough pressure on those companies to ensure they do not block the data that is important to patients.”

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“We have made progress on sharing health data over the years, but we still need to do more. Every province and territory must be able to use this health data, no matter where Canadians live.”

“Mr. Speaker, since I have to be very brief, I will thank the member for his continuous advocacy. He knows there has been progress over the years, but he also knows really well that we need more progress in order to support all provinces and territories, regardless of where Canadians live, in their ability to access and benefit from the health data that is so important to them.”

“This bill is about putting patients first and improving health technology. Passing it alone is not enough, because we also need provinces and territories to work with us. If all governments agree to put patients first, we can build a better healthcare system.”

“Mr. Speaker, I genuinely believe that Bill S-5, and what the Minister of Health talked about when she introduced the legislation, is all about the patients. It is all about delivering for patients. It recognizes that health information technology has to play a critical role. I agree with the member that there has to be a high sense of co-operation. Passing the legislation would not necessarily make it happen on its own. We would need to have the provinces and territories buy in. We have seen that some provinces are further ahead than others. Would the member not agree that no matter what level of government we talk about, if everyone agrees to the principle of putting the patient first, we should be able to have a better system that would serve those patients?”

“Some companies trap health data in their computer systems so they can make money off it. This bill stops that. I want to know if the member agrees that banning this is a good thing.”

“I want to thank my colleague for his speech, which I listened to with great interest. I would like to commend my colleague, who spoke in both official languages. I want to talk a little about data blocking and ask the member opposite whether he believes the banning of data blocking is a good thing. We have seen some very serious instances, in his province and in mine, of companies refusing to let the data be used and refusing to let it exit the electronic systems because they are hanging onto it to monetize it. I wonder if the member thinks it is a good thing that the Government of Canada would put an end to that with Bill S-5.”

“Health technology must work for patients, not the other way around. I want to know if the member thinks we can pass this bill before Christmas.”

“Mr. Speaker, I wanted to pick up on one of the member’s comments on the whole idea of technology, because I really do agree with it. We have to ensure that technology works for people and not the reverse, in terms of having access. I will get the opportunity to expand upon that shortly, but I wanted to amplify just how important it is, in recognizing Bill S-5, that the primary focus is on patients in using technology. The member seems to imply that he supports the legislation in principle and wants to see it go to committee. Does he believe it is something that could be passed before Christmas?”

“I support this bill. Right now, hospitals, clinics, and doctors use computer systems that cannot talk to each other. Tech companies also block health data from being shared. This bill stops that blocking and makes systems work together so doctors and patients can easily see medical records. It also lets researchers use health data to improve care and build new tools like AI.”

“Mr. Speaker, I will be sharing my time today with the member for Winnipeg North. When I was a health system and academic leader, we used to talk about having two jobs in health care. First was taking care of the patient of today. To do that work, obviously, we need access to the health data across a patient’s journey, no matter where they are in the health care system. We also talked about having a second patient, the patient of tomorrow, and that is the work of supporting research, quality improvement and health system innovation. Bill S-5 is a critical piece of legislation that would allow us to care for both the patient of today and the patient of tomorrow, and that is why I am proud to rise in the House today to speak in support of it. All over Canada today, people are going to visit their family doctors. They are going to be talking about their mental health. They are going to be talking about their diabetes and their blood pressure control. They are going to be talking about their cancer journeys. They are going to be getting immunizations, prescriptions and requisitions for medical imaging. They might be getting a referral to a specialist. They might be referred for counselling or for physiotherapy. In pretty much every one of those family doctor’s offices today, they are going to find their family doctor sitting and typing away on a computer, generating tasks for the physician or the health care worker and for the patient. If a referral is made, the doctor is going to be typing away, generating forms inside that computer, and if that patient then goes to see a specialist, they are going to find the specialist sitting at their desk taking notes on a computer. If they end up in an emergency situation and have to go to the hospital, all the notes, the test results and the imaging results are going to be stored in an electronic record. In my community of downtown Toronto, those places, the family doctor’s office, the hospital, the emergency department and the specialist’s office, might be just a few subway stops away from each other. Sometimes they are even in the same building, so one could forgive a patient for assuming those computers are talking to each other. However, it turns out that all too often, that is not the case. People could be forgiven for asking why, in a set of single-payer health systems across the country in any given province or territory, the data generated in the hospital, the data generated in the doctor’s office and the data generated in the home care interface are sitting in separate silos, not talking to each other. Bill S-5 seeks to remedy that. By requiring the vendors of the electronic systems we use in our health systems every day to meet interoperability standards and putting an end to data blocking, wherein vendors hold onto the data of Canadians under the mistaken view that they own the data about the health of our people, as opposed to the patient and the health system as a public good, we would be putting in place the necessary infrastructure for a modern health care system across the country. It used to be that in order for electronic systems to talk to each other in a health care system, they had to actually be on the same system. I am pleased that this is no longer the case. We do not need all of Canada to be using a single electronic health record for data to flow in the ways that patients need, because technology has leapfrogged that requirement. When vendors meet those interoperability standards referred to in this bill, the data would be able to move in order for us to take better care of people. The hospital and the clinic would be able to securely share information that is relevant to the care of the patient. To emphasize the importance of this bill, one need only quote the preamble: the health information of Canadians is not easily accessible to them or to their health care professionals, which puts the safety of Canadians at risk; There is broad consensus among stakeholders that the interoperability between health technologies and health information systems, as well as a prohibition of data blocking, are necessary to ensure patient health and safety, improve health outcomes and promote equitable care for Canadians. For patients to make informed decisions about their own health, they must have easy, comprehensive and secure access to their health information. Their health care professionals and researchers must also have access to it. Why does this bill matter? Why do we need health records to be interoperable, and why do we need health data to be treated as a public good? I want to speak to primary use and secondary use and begin by talking about the delivery of clinical care and access to one’s own records. We have covered well in the House today in this debate the necessity of interoperability of health records for patient safety in terms of clinicians being able to access critical information when a person comes in for care, so I want to focus my remarks on the two other critical aspects. First is the ability of Canadians to access their own health records. Second is the ability to use the data for research, quality improvement and system oversight. The pan-Canadian OurCare consultations, led by Dr. Tara Kiran and an incredible national team of researchers and experts in public engagement and primary care, had conversations with hundreds of people living across Canada to understand what Canadians wanted from a better primary care system. In their conversations, a core refrain arose again and again: People in Canada are frustrated that they do not have access to their own medical information. People shared how not having access to their own medical records made it challenging to get the care they need when they had an emergency, when they moved to a different province, when their doctor moved or retired, when they did not have a doctor or when they were just trying to advocate for themselves or for their loved ones. Through the OurCare consultations, people in Canada spoke clearly and consistently. They want access to their own health records online in a format they can share with clinicians and loved ones and where they can have confidence that the information will be kept private and secure, which is not a very radical or unusual idea. Countries around the world have already given people access to their own health records through an app, like the Nordic countries, for example, but also Estonia, Spain, Portugal, France, England and Australia, just to name a few. As we look to build national infrastructure and to become more self-reliant as a country and as we look to create the conditions for our country to thrive in the years to come, we need to invest in the most foundational of assets: the health of our people. Bill S-5 would open the door for people being able to access their own health records by ensuring that their data would be liberated from the vendors who may be holding on to it. That brings me to secondary use and the patient of tomorrow. This is an aspect of data interoperability we should not neglect, because beyond the care of individual people, we need health data to do quality improvement, to do groundbreaking research, to engage in health system oversight and to develop artificial intelligence and apply it to the biggest problems facing the health of Canadians. This is what we call secondary use of data, because health data is the raw material for improving care. Research and quality improvement teams use data to track people’s health outcomes over time, to measure the impact of our interventions and to ask important questions that will lead to the next generation of breakthroughs. Health data also contains the stories of important inequities and outcomes across the country. It helps us to understand whether people living in rural communities, people experiencing homelessness, indigenous people, Black Canadians and other groups are getting the care they deserve. This information can then drive our investments and programs as a government, but to understand the story, we need the data. Our superb Canadian researchers and health system leaders cannot do their jobs without it, and if it is being blocked sitting inside a vendor’s records, we are going to be in trouble. Finally, I want to say a few words about artificial intelligence. We are obviously at a new frontier. If we want to use AI to reduce wait times in emergency departments or wait times for specialist care, and if we want to use AI to improve the quality of care being provided to seniors in long-term care, to cancer patients in our cancer centres or to children in our family doctors’ offices, we are going to need data and the data will need to be linked in order for us to do it. Bill S-5 would regulate vendors. It would require them to play ball in ensuring that data can be shared across our health systems. Once the data is unblocked and interoperable, a lot of work still remains to be done. This bill would not replace the work ahead on sovereignty, commercialization, data export approaches and indigenous data sovereignty, all of which have been flagged by our colleagues in the Senate, but it would lay the foundation for all those things. Bill S-5 would lay the foundation for us to care for the patient of today and tomorrow. I am proud to support it.”

“I want the House to pass this bill. Family doctors spend too much time tracking down hospital records and medication changes for their patients. This bill will not fix everything on its own, but we need it to build a system that lets medical information flow properly.”

“Mr. Speaker, in my colleague’s riding today, as in mine, there are family physicians like my colleagues who are spending an inordinate amount of time chasing results, trying to figure out what happened to their patient when they were admitted to the hospital and what changes were made to their medications, and calling the pharmacy to try to figure out what occurred. This bill would lay a foundation. It would open the door for the kind of information data flow that is truly necessary to fix these problems. A lot of work would have to happen after that. The bill would not magically fix everything, but if we do not pass it, we will not have the infrastructure necessary to address these important issues.”

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“I want my colleague to explain how this bill will make it easier for patients to get care. How will it help patients and cut down on paperwork for healthcare workers?”

“Mr. Speaker, I thank my colleague for her service for two decades. She knows exactly about one patient, one data. Can my colleague tell us how the bill would reduce barriers to care? Also, we heard that there is workforce pressure. How would it be more helpful for the patient and reduce the burden of administrative work?”

“I support this bill. Health workers spend too much time filling out forms and chasing down information. Technology can cut that paperwork so they have more time for patients, but only if companies share health data instead of blocking it. This bill fixes that.”

“Mr. Speaker, I think we all know that the barriers for health care workers in the system today are considerable. There is a lot that artificial intelligence, for example, can do to improve the productivity of our health systems and reduce administrative burdens on our health care providers, whether they are a home care worker in a home, a PSW in long-term care or a nurse practitioner in primary care. AI can help all those people spend their time taking care of patients instead of running around trying to access information. It can reduce the administrative burden, whether it is from filling out forms or getting appointments for patients. However, all of that requires that the data be accessible, that it be linked and interoperable and that it not be blocked by the vendors of electronic medical records and electronic health records. That is why this bill would make a difference for the workers in our health systems across Canada.”

“I want this bill to pass. Health systems need to be able to share patient data across the country. Companies are blocking that data right now. Passing this bill is the first step so we can share information and figure out rules to protect patient privacy.”

“Mr. Speaker, it will be critical, in order to do this work, for the data to flow. The data needs to be linked so that across different parts of the health care system, we can follow a patient’s journey over time. Once that occurs at the technical level, we have to figure out how we will govern the data, how we will make sure that privacy is protected and how we will ensure that the data is available to the people who need to use it and have permission to use it, but not misused by others, whether that would happen through the regulations coming out of this bill or, more likely, at the level of the health systems as people work through this over time. Right now, people across Canada doing health care leadership cannot even begin those conversations because they cannot access the data because it is being blocked. This is a necessary step on the journey to health system transformation across Canada.”

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“I want the House to pass this bill. It stops companies from blocking health records and makes sure different computer systems can share patient information. This will help doctors and nurses give better care, avoid repeat tests, and protect patients.”

“Mr. Speaker, it is a pleasure to rise and speak to Bill S-5 today. If we take a look at information nowadays, it has never been easier to access. It has become critically important that when we take a look at our health care system, we look at ways in which we can improve upon it. I want to reflect on some of the days, going as far back as when I was the health care critic in the province of Manitoba, when I was meeting with patients and stakeholders. Even back then, they were talking about information gathered on behalf of clients or patients and how that information is retained and ultimately shared. I remember that when I had to change my family doctor, as my first one made the decision to retire, I was given a yellow envelope to bring to my new doctor. A year ago or so, when I was with my family doctor inside the checkup room, he was sitting at a computer, which I could watch. It was truly amazing how he was able to connect my health care needs through the computer. I did not have to get a prescription issued from the doctor or a piece of paper. Rather, he told me that I could go to X place and that my prescription would be ready. When I take a look at what Bill S-5 is all about, it is all about patients, whether directly or indirectly. That is why I would like to think that all members of the House will see the value of supporting the legislation. I have listened to members opposite all morning talk about the concerns they have, and I am not going to marginalize their concerns. I suspect that all members have some concerns as we move into this area. It is a very challenging area; there is no doubt about it. Someone mentioned that while we could bring in legislation, it would not guarantee that the system is going to work and the patient is going to benefit. There are jurisdictional issues. To individuals who are genuinely concerned about the issue of which level of government is responsible for what, I will say that instead of that being the primary concern, the primary concern should be the patient. If we view this through that lens, I believe we will see more co-operation taking place among institutions, private companies, non-profit companies and the different levels of government, if we are prepared to do what the minister has made very clear. In her statement, she talked about working with provincial and territorial jurisdictions and indigenous communities. At the end of the day, information does matter. What takes place in our doctors’ offices, our hospitals, our care facilities and our pharmacies really does matter, as does a person’s ability to go into a facility, whatever type of facility it might be, and have a sense that a health care provider has access to the information that is so very important for that patient. If that were to be done right, where we get collaboration and get all systems onside moving in one direction, with the priority being the patient, we would see less duplication. People would understand the differences in medications that might be being taken at one end versus at the other end. Some testing may not have to take place, or in some cases testing would take place, such as an x-ray, a lab test or whatever it might be. The different types of medications an individual takes throughout the year would be known. These are all important pieces of information. In working collaboratively with other jurisdictions, I would argue, as I said at the outset, and putting the lens on the patient, it is the patient who would benefit with the passage of Bill S-5. I had the opportunity to ask members opposite some questions regarding the principle of the legislation. I am encouraged by the Minister of Health and the government’s agenda to get this legislation through with fantastic support from the Senate of Canada. I am pleased with the general approach of the opposition, as the principle of the legislation appears to have been accepted. That being said, I suspect there might be a number of issues, based on what I have heard, that would come up at the committee stage. I am sure there would be representation at the committee stage about issues related to things such as data blocking, which has been talked about a great deal. Data blocking is done far too often. Because of a vested interest, information is being retained by one vendor for reasons I will not go into today, but much of it would be driven by the dollar. Data blocking would be directly dealt with in this legislation, which is a very good thing. Then there are interoperable issues. For example, in the province of Manitoba, there might be a care facility using a different technology system from what is being used at the Health Sciences Centre. Because of that, it is the patient who loses the most. That is one of the reasons the compatibility of technologies is so important in the legislation. The data would be able to be transferred. We hear a great deal about data, records and so forth, and it is important for us to recognize that with regard to data and technology, the government is very concerned with ensuring that privacy is respected. As we know, Canadians are very concerned about the issue of privacy, and understandably so. Some provinces are further advanced than others, and I recognize that, but as we roll this out, what would end up happening is that the quality of health care services would improve for all Canadians. The health care worker, be it a nurse or a doctor, would have better opportunity to provide bedside care or to provide consultation, as a direct result of moving forward with Bill S-5. That is not to mention, as some have already pointed out, that it would also save lives. Someone asked why it is taking us as long as it is. I think it is important to recognize that we have a very substantial legislative agenda. In the last 18 months, we have been pushing forward on a series of legislative initiatives. This bill is an important piece to it, because our health care matters in Canada. Canadians want us—”

“We should all focus on what is best for the patient as we debate this bill here and in committee. I believe every member of Parliament wants to protect people's private data.”

“Mr. Speaker, the member, in posing the questions, highlighted something I had indicated. If everyone would do exactly what she did with respect to her question, which is to put the patient first and look at it through that lens, I suspect that the debate would be well served not only on the floor of the House of Commons but also in committee. I can assure the member that it does not matter what side of the House one looks at. I believe every member wants to ensure the privacy and protection of data. There is no doubt whatsoever in my mind on that.”

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“The federal government must protect our health rules and keep sending health money to the provinces. Our government has committed to that. We also created a $5-billion fund for health buildings, and I look forward to that money being spent across Canada.”

“Mr. Speaker, there is a long story with respect to health care transfers. We could go back many decades to when the provinces and the federal government made the decision that they wanted some change in tax points to the provinces in favour of having direct cash going to them. I was never a big fan of that. I believe that the federal government needs to not only have a strong, healthy Canada Health Act but also to maintain a basic level of health transfers. That is something the government, under the Prime Minister, has committed to do. In addition to that, I would recognize that the Prime Minister came up with a $5-billion fund to build Canada’s capital health infrastructure. I look forward to those health care dollars’ being spent across the country.”

“I want the member to explain more about companies blocking health data and protecting their own interests. Why is data blocking such an important issue?”

“Mr. Speaker, I just learned that the member for Winnipeg North is a former Manitoba health critic. His comments on a stronger collaboration are well noted. However, I wonder if my colleague can elaborate a bit more on data blocking and vested interests. Why is data blocking important?”

“Companies block health data to make money, not to help patients. We must put patients first to make our health care system better.”

“Mr. Speaker, the simple reason is that often data blocking is not done in the interests of the patient but in the interests of some vendor that has a vested interest, and often that vested interest is driven by money. Whether it is the Prime Minister or any member of the Liberal caucus, what we are saying is that we need to put the patient first. If we put the patient first, we will have a better, stronger and healthier health care system.”