Tuesday, November 18, 2003 ó 1:00 p.m.
Speaker: I will now call the House to order. We will proceed at this time with prayers.
Speaker:We will proceed at this time with the Order Paper.
Introduction of visitors.
INTRODUCTION OF VISITORS
Mrs. Peter: Mr. Speaker, I encourage all members of the Legislature to please help me make welcome my sisters who join us in the gallery today, Helen Charlie and Dorothy Rispin.
Speaker: Are there any returns or documents for tabling?
Are there any reports of committees?
Are there any petitions?
Are there any bills to be introduced?
Are there any notices of motion?
NOTICES OF MOTION
Ms. Duncan: Mr. Speaker, I give notice of the following motion:
THAT this House supports the Close to Our Heart campaign in its efforts to raise $600,000 to replace the ageing cardiac monitoring equipment at the Whitehorse General Hospital; and
THAT this House urges the Yukon Party government to use a portion of its $61-million surplus to make a substantial contribution toward the campaign.
Thank you, Mr. Speaker.
Mr. Cathers: Mr. Speaker, I give notice of the following motion:
THAT this House urges the Yukon government to continue its efforts with First Nation governments, municipalities, non-governmental organizations, business and labour organizations to improve the investment climate within the Yukon.
Mr. McRobb: Mr. Speaker, I give notice of the following motion:
THAT this House urges the government to adopt the spirit and intent of Motion No. 130, standing in the name of the Member for Whitehorse Centre, and to table a similarly worded motion respecting the repayment of outstanding loans and to call it as the lead motion for debate during government private membersí motion day scheduled for November 26, 2003.
Speaker: Are there any further notices of motion?
Are there any statements by ministers?
This then brings us to Question Period.
Question re: Taxpayer Protection Act amendment
Mr. Hardy:Page 47 of the public accounts makes it clear that the Government of the Yukon is already doing what the Auditor General and the Canadian Institute of Chartered Accountants want it to do. It already prepares its financial statements on a consolidated basis and on a non-consolidated basis. That page also explains that the non-consolidated statements are prepared "for the purpose of determining if financial resources are realistically available to the government to meet its program responsibilities."
Why is the Premier asking the House to approve a change that is completely unnecessary, that will present an unrealistic picture of the governmentís cash position and that removes the protection from the Taxpayer Protection Act?
Hon. Mr. Fentie: I appreciate the member oppositeís foray into accounting practices. Unfortunately, the memberís assessment of what he just relayed to the House is completely incorrect. What we are doing with this amendment is maintaining the intent and the integrity of the Taxpayer Protection Act. The Yukon Territory cannot go into an accumulated deficit.
The important factor here is that we are opening up options to be able to partner with the private sector for investment into this territory to grow our economy. Thatís what this is about. This has nothing to do with how the member tries to portray this governmentís amendment to the Taxpayer Protection Act.
I would really like to get into a constructive debate on what we can do with this very benign amendment and the positives it will bring this territory. We all know that government spending has not been successful in creating an economy in this territory. We have known that for the last decade. Our dependence on government must be reduced. Our involvement with the private sector must be increased. Thatís what weíre doing.
Mr. Hardy: Well, itís interesting, Mr. Speaker, when the Premier says that government spending isnít going to stimulate the economy the way he wants, yet heís actually recommending and embarking on a $300-million spending spree.
Mr. Speaker, you donít need a crystal ball or a degree in rocket science to see what the Premierís real agenda is. The Premier is using this so-called benign change to pave the way for a major shift in how public infrastructure will be financed, built, managed and even owned. In his quest for private sector investment, he has put a huge dollar sign on the territory, and Yukon people donít even have a say in the matter.
Why did the Premier embark on this course of action without first asking Yukon people if they want their territory sold off to the highest bidder?
Hon. Mr. Fentie: Well, I will agree with the member on one statement: "a major shift". This territory is taking a major shift a shift in direction toward prosperity. Thatís what this is about, Mr. Speaker. This is not selling off the territory; this is creating a future for the territory. This is ensuring that we have private sector investment in the Yukon; this is ensuring that we diminish our dependence on the southern taxpayer. And this is ensuring that this territory will become a net contributor to Canada. Thatís what this is about, and itís for the benefit of Yukoners and Canadians.
Mr. Hardy: This Premier is shifting our dependence onto multinationals, and thatís far more risky than where we are right now.
The Premier talks about involving First Nation governments in the territoryís economy. Heís even willing to cut side deals to make that happen. The Premier is also obliged, under First Nation final agreements, to uphold a certain standard of consultation with First Nation governments before making any major changes in how things are done in the Yukon. The Premier has signed consultation protocols with First Nation governments reinforcing that obligation.
Did the Premier consult with Yukon First Nation governments before deciding to put the public infrastructure for sale to private investigators?
Hon. Mr. Fentie: Iím sure the member meant "investors", not "investigators".
Mr. Speaker, we as a government recognize the jurisdiction and responsibilities that self-governing First Nations have taken on as they recognize our jurisdiction and responsibilities.
The memberís innuendo and conjecture has nothing to do with the facts. The facts are that the Taxpayer Protection Act is maintained as it was intended. The government cannot go into an accumulated deficit. Thatís important, but now the government can partner not only with the private sector but with other governments like First Nations to build a future of this territory in partnership, together, so that our children and the Yukoners of today have a more prosperous and brighter future. Thatís what we were elected to do. Thatís what weíre doing with this amendment.
Question re: Wildlife management consultation process
Mrs. Peter:I have a question for the Premier.
Over the last several months we have seen the Minister of Environment bungle the captive wildlife file by not respecting the consultation process. The Premier says that he is committed to strong, respectful relationships with Yukon First Nations and involving First Nation governments in the economy. Why has the Premier allowed the Environment minister to damage those relationships by failing to conduct meaningful consultations with First Nation governments and mandated bodies such as the renewable resource councils and the Yukon Fish and Wildlife Management Board?
Hon. Mr. Edzerza: I stand here today to inform the member opposite that this government has gone the extra mile to make good relationships with First Nation people. In fact, I feel quite comfortable in stating in the House today that itís probably the best I have seen over the last four or five different leading parties in this territory.
Mrs. Peter: My question was for the Premier of the Yukon.
First Nations do not want to see the Yukon animals treated like a commodity ó to be bought and sold or held captive for commercial purposes. Yet the Minister of Environment seems determined to allow private ownership of Yukon game animals.
I would like to quote from a brochure put out by the Yukon Game Growers Association: "Elk bulls have always been some of the most prize trophies for keen hunters. Few opportunities are available in the wild to harvest such a trophy. Now our industry can supply them."
Can the Premier tell us how he can reconcile that position by the Yukon Game Growers Association with the position of Yukon First Nations?
Hon. Mr. Edzerza: Again I will remind the member opposite that game farming has been in the Yukon for a great number of years. In fact, I remember seeing these animals for probably the last 10 or 15 years Iíve been around and out to the different farms. I know that First Nations may have issues with this; however, this has been a way of life for several people in the Yukon Territory, and I think the First Nations people really donít have as much of an issue with it as the member opposite would like to believe.
Mrs. Peter: This Premier has shown his willingness to put the Yukon up for sale. Thatís why heís changing the Taxpayer Protection Act. Letís get out and sell the Yukon to the highest bidder. Well, thatís not what the Yukon people want, Mr. Speaker. Itís certainly not what the Yukon First Nations want.
Will the Premier make a commitment that he will not allow his Minister of Environment to treat Yukon game animals like one more Yukon-brand product that can be marketed to even people who sell canned hunts in other jurisdictions?
Hon. Mr. Edzerza: Mr. Speaker, Iíd like to remind the member opposite that this government does not support hunt farms, but it does support game farming. This government recognizes the importance of the environment, fish and wildlife, and that all Yukoners want these resources to be properly cared for. The environment also contributes to the economy in many ways, including trapping, aquaculture, guided outfitting, wildlife viewing and tourism. Many hardworking men and women run businesses in these areas. We recognize their contribution to the Yukon Territory, and we do support them.
Question re: Business loans, outstanding
Ms. Duncan: Mr. Speaker, my question is for the Minister of Finance.
Itís well known, and itís well known publicly that two members of the Yukon Party government owe taxpayers hundreds of thousands of dollars. Itís also well known publicly that the Member for Porter Creek Centre has made instalments; however, he has also made some capital improvements. The MLA for Klondike has not paid back his loan; however, he does have money for capital improvements such as a telephone system and carpeting in the hotel.
Since the government came to office a year ago, the amount of interest alone on the MLA for Klondikeís loan has increased by $15,000. The bill to taxpayers is now $274,000. This government has promised to bring forward a new policy on these loans.
Will the Finance minister commit that the policy will be brought forward this session and that it will not allow ministers with outstanding loans to not pay the interest?
Hon. Mr. Fentie: Mr. Speaker, I would offer the member a chance to ask another question. Iíve already answered this question a number of times, and surely the member opposite, as a former Minister of Finance, would understand that there is already a policy in place. What weíre bringing forward is a solution ó a solution because government should not be in the loans business, a solution because weíre dealing with a vast amount of variables on these loans under previous governmentsí commitments, Mr. Speaker. We are doing our work. In this sitting, before it ends, weíll bring forward a solution.
Ms. Duncan: Itís interesting. The Premier also promised in this House on April 8 that he wouldnít amend the Taxpayer Protection Act, and yet thatís exactly what he has done.
A minister owes taxpayers $116,000 on three outstanding loans to the Member for Porter Creek Centre. Itís no wonder we donít want the government amending the Taxpayer Protection Act so it can borrow money. If the loans policy forgives the interest that has built up over a number of years, it will be quite a windfall.
The MLA for Klondike would save $150,000. This would be completely unfair to the people who have paid back their loans with interest.
Will the Premier, the Finance minister, confirm today that the new policy will not allow the ministers to skip out on interest payments?
Hon. Mr. Fentie: This member is becoming quite infamous for her personal attacks, but in this case we have maintained all along that we will bring forward a solution. There already is a policy in place. Obviously it hasnít worked. Some of these delinquencies go back past a decade, and weíre serious about bringing a solution to this issue ó period.
This issue has been a long-standing one. Government, I will reiterate, should not be in the loans business. This particular issue is proof positive. We will, at the end of this sitting, bring forward a solution. And I want to talk about what really is a debt in this Legislature, and that would be two and a half years of wasted government headed by the member for the third party. Thatís a huge debt owed to this territory.
Ms. Duncan: He has been watching football too long; he thinks that the best defence is a good offence.
The fact is that the MLA for Klondike owes $150,000 in interest on a loan from Yukon taxpayers. Judging by the Finance ministerís very careful answers today, it appears that this government is set to forgive that amount of money. In other words, itís a $150,000 gift for the MLA for Klondike. The MLA for Porter Creek Centre would also save hundreds of thousands of dollars. If you donít like the rules, just change them.
Allowing ministers to skip out on interest payments while others have paid back their loans with interest is a double standard. Itís another one from the Yukon Party government. Will the Finance minister absolutely, unequivocally, confirm today that any policy brought forward by this government will not allow ministers to skip out on interest payments on overdue loans?
Hon. Mr. Fentie: This government is committed to bringing forward a solution ó period. Thatís what we are doing. We are doing our work. This is a long-standing issue. That member opposite was in government a short time ago and could have done the same thing.
The member is obviously very exercised about this issue. My answer would be in the form of a question: if the member is so concerned about this, why, then, in the two and half years of government, did that member, as Minister of Finance, not bring forward a solution? I ask you that, Mr. Speaker.
Question re: Economic strategy
Mr. McRobb:After only a year in government, the Premier is finally getting around to engaging various stakeholders in the process of developing a Yukon economic strategy. This is interesting to watch since most of what the Premier has done so far on the economy has been based on watered-down versions of stuff that was already on the shelf.
At the same time, he is changing the Yukon Taxpayer Protection Act so he can steam ahead on the public/private partnerships that could put much of our public infrastructure into private-for-profit hands.
Can the Premier tell this House why he decided to pre-empt the consultation process by taking this drastic step before developing this Yukon economic strategy with stakeholders?
Hon. Mr. Fentie: I think the member is somewhat confused. Heís either asking a question about the Department of Economic Development and the strategic economic direction itís taking, and/or heís asking a question about this drastic step in the Taxpayer Protection Act, which, by the way, is a simple and benign amendment of a mechanical nature.
So if the memberís asking about the Department of Economic Development, we are taking a very positive and constructive step with stakeholders to plan the strategic direction for the new Department of Economic Development. Thatís what weíre doing.
I can tell you, Mr. Speaker, that we are progressing nicely. The Department of Economic Development is up and running, and this supplementary budget is something the members opposite may want to debate in depth when it comes to this department. There are a lot of good things in it, and this territory is on the move.
Mr. McRobb: Well, Mr. Speaker, the Premier did not answer the question, but he did admit it was a drastic step, and we will agree with him on that point. The Premier has already decided what his economic strategy will be: letís package up the Yukon, slap a brand on it and sell it to the highest bidder. Thatís his economic strategy, and he wants the members of this House to go along with it by passing his changes to the Taxpayer Protection Act. The problem is he hasnít asked Yukon people if thatís what they want. He hasnít asked them whether they want private corporations to own bridges, schools and roads. Would the Premier now set aside his amendments to the Taxpayer Protection Act until he gives stakeholders involved in the Yukon economic strategy adequate opportunity to assess its implications and provide him with their advice?
Hon. Mr. Fentie: Now that weíre talking about drastic steps and measures, letís talk about the former NDP government and the drastic step and measure they took to get around the Taxpayer Protection Act. Letís talk about borrowing from the immigrant investment fund. Letís talk about setting up a numbered company to get around the Taxpayer Protection Act and putting Yukoners into debt, Mr. Speaker.
Our amendment does none of these things. Our amendment provides full disclosure to the Yukon public: the exact and correct surplus of this territory. Our amendment does not allow this territory to get around the Taxpayer Protection Act. In fact, it ensures that we work within the Taxpayer Protection Act, and it provides advantages for us to partner with the private sector to invest in this territory as they should. Itís a very big problem, considering the dependence of this territory on government expenditure. Thatís whatís wrong; thatís what weíre changing. That is how weíre turning this territory around. And it was a commitment to the Yukon public to ensure that the private sector becomes more involved in the territoryís future, especially in its economic development.
Mr. McRobb: The Premier did not answer the question whether he would give an opportunity to the stakeholders to give their input before he plunged ahead.
Furthermore, Mr. Speaker, the Premierís memory is very short and itís very convenient. He was a member of that previous NDP government; he was part of the decisions it made. Like so many other things this government does, what weíre told one day doesnít hold true the next. The sand is always shifting but the patterns are becoming clear.
The Premier wants permission to go on a spending spree with our dollars but he wonít ask the taxpayers for their permission. Heíll just use his majority in the House to push it through.
Before amending the Taxpayer Protection Act, will the Premier at least ask participants in the Yukon economic strategy for their advice about putting public infrastructure into the hands of developers and investors? Will he do that?
Hon. Mr. Fentie: The memberís comment is important. The member said I was a member of the NDP. That is correct, I was. Mr. Speaker, Iíve seen the light. We were going nowhere in the territory, nowhere under the NDP. That is why I left.
When it comes to consultation, it happened during the election. We committed to maintain the Taxpayer Protection Act; we are maintaining it, its intent, its integrity. But we also committed to utilize government budgets and policies to restore investor confidence and create a responsible, sustainable economy. Thatís what our amendment does. Thatís why we are proceeding. We have consulted and itís called the Yukon Party platform.
Question re: Taxpayer Protection Act amendment
Mr. Hardy:Well, we are finally starting to see the governmentís real colours, and we are actually starting to see, when they see the light, what they are actually going to do.
The Premier has admitted that his changes to the Taxpayer Protection Act are about private/public partnerships ó P3s. He has even admitted that P3s can increase the cost of a project, but thatís the way he wants to go ó higher costs. He wants investment; he wants money to play with.
For starters, the Member for Klondike spelled it out quite clearly yesterday: P3s ó a bridge in Dawson City will be built that way. Will the Premier tell us what negotiations have already taken place between this government and the private sector regarding the construction of a bridge in Dawson City?
Hon. Mr. Fentie: The only real discussion on a bridge in Dawson City has happened pretty much in the public forum. Thatís the fact of the matter.
The other point is that the NDP do not support the Taxpayer Protection Act. They voted against it. They called it a shoddy piece of legislation. This side of the House would like to hear from the members opposite what their real position is now. If they are supporting the Taxpayer Protection Act today, then they are supporting an act that they opposed when it was tabled. Nothing has changed, Mr. Speaker. What has changed is that there is a government in place today that recognizes the importance of the private sector in building a future and an economy.
This amendment ensures that that private sector involvement is guaranteed.
Mr. Hardy: Well, even a secret government canít keep everything secret forever.
As for the Premierís budget tour, he let the cat out of the bag. The Yukon has a great big dollar sign on it. The Yukon is not just open for business, the Yukon is for sale under this leadership. No wonder a local cartoonist shows these Cabinet ministers with dollar signs on their ties.
Well, Yukon people donít want to be bought and sold. They donít want to be sold off, sold out or sold down the river, Mr. Speaker.
What discussions or negotiations are already underway with private sector companies regarding Yukon public infrastructure ó specifically, a Dawson bridge, the Whitehorse jail replacement and any resource corridors in southeast Yukon?
Hon. Mr. Fentie: The discussions are happening right here in the House. Itís the member opposite who is bringing up all these wonderful projects ó great ideas. Now we have the NDP being a little more constructive. Theyíre talking infrastructure ó very important. Public/private partnerships have been used in other jurisdictions when it comes to infrastructure that helps lay the groundwork for sustainable, long-term economic development. Thatís a good thing.
We havenít had any in-depth or detailed discussions with any firm. All weíre doing here today, Mr. Speaker, is making a benign amendment to the Taxpayer Protection Act to ensure that, at some point, those discussions can start to take place so we can garner private sector investment in this territory. Thatís a good thing.
Mr. Hardy: Iíd recommend the Premier get his language correct. One moment itís a drastic change; next thing, itís a benign change. The Premier has been very candid about why he wants the Taxpayer Protection Act changed. He wants a $70-million surplus to look like a $300-million surplus. Thatís not benign. He wants $300 million of taxpayersí money to play with, as if he were a CEO and weíre just the shareholders ó Government of the Yukon Incorporated: weíll sell anything to anybody if thereís a buck in it.
For shame, Mr. Speaker.
What companies inside or outside the territory has the Premier, or any of his Cabinet ministers, had discussions with about the future development of the Yukon infrastructure, such as roads, bridges, jails, schools or hospitals?
Hon. Mr. Fentie: Iíve already answered that question, Mr. Speaker, but letís talk about a drastic change. Itís the NDPís position on the Taxpayer Protection Act. Thatís a 180-degree change; thatís drastic.
What weíre doing is making a positive change for this territoryís future. Thatís what this benign amendment does. This amendment will allow us more options and more opportunities to turn the Yukon Territoryís economy around, to build a better and more prosperous future for our citizens. That is what we are doing. We will not deviate; we will not be deflected; we are going to build an economy for this territory.
Question re: Taxpayer Protection Act amendment
Mr. Hardy: Mr. Speaker, itís not going to be an economy that the Yukon people own. What a difference a few years and a change in scenery can make, though. Back in 1998, this Premier sat in the back row on that side of the House, and hereís what he had to say about P3s: "I agree that governments have to look for innovative ways of creating jobs and stimulating the economy, but I'm not convinced that this one particular way, public-private partnerships, is the be-all and end-all," April 8, 1998. Itís right there in Hansard, Mr. Speaker, and I have a very simple question for the Premier: Who got to him? Who has been whispering in his ear that public/private partnerships now are the be-all and end-all, Mr. Speaker?
Hon. Mr. Fentie: Well, the fortunate thing for me is the time I got to spend observing government from the backbenches, and that time of observation taught me something. It taught me that the way governments in this territory were proceeding, in terms of the direction of the Yukon, was not the right way. When I talked about P3s back then, I said, "Iím not so sureÖ" Iíve done the research. I see now in my position here, as the Minister of Finance and the Premier of this territory that we should not ignore opportunity and options such as public/private partnerships. They work. There are many cases where these types of partnerships have created benefits for the jurisdictions that they have been implemented in. Thatís why weíre making this change; thatís why this territory is going to engage with the private sector. Government cannot build an economy. Itís the private sector that builds an economy. Government must lay the groundwork and create the environment for the private sector to invest in. Thatís essentially what this small, benign amendment will allow us to do.
Mr. Hardy: We had a Premier who originally wasnít going to change the Taxpayer Protection Act; he was in support of it. Now we have a CEO of the Government of the Yukon Inc. who is going to change it.
We had a Premier who said, in 1998, that no matter how you disguise it, how you label it, whatever the case may be, the common denominator is we must pay back the debt whether it be now in the short term or whether it be deferred for the long term.
Now we have the CEO of the Government of the Yukon Inc. who is quite happy to borrow on margin and stick future generations with the debts he runs up by going on a big capital spending spree.
Who are the secret directors that are influencing the Premierís conversion from fiscal prudence to fiscal recklessness, Mr. Speaker?
Speaker:Before the Premier answers, I discussed this issue in the House yesterday about putting adjectives in front of membersí names, and I would ask the leader of the official opposition not to do that, please.
Hon. Mr. Fentie: I am being very open and accountable to the Yukon public. Iím saying to the Yukon public that there was a time during my involvement with the former government that I recognized that that was not the correct direction to go, that there has to be a change in this territory. That is why I made the decisions I did, that is why I joined the Yukon Party, that is why we ran for election and that is why we made the commitments we did to the Yukon public. They, the Yukon public, are the ones that elected this party as a government.
Now we are delivering. We are delivering on the commitment to turn this territory around and build an economy. Thatís what we are doing. This amendment does not commit the Yukon to debt at all. This amendment allows private sector investment. Itís the NDP, as a government, that committed the territory to debt through the immigrant investment fund ó millions of dollars ó and that is something the member opposite should stand up and be accountable to the Yukon public for.
Also, the member should be clear with the public. Does the NDP now support the Taxpayer Protection Act or do they not support the Taxpayer Protection Act? Thatís a decision they have to make.
Mr. Hardy: Well, well, well, Mr. Speaker, isnít the Premier getting a little upset. He is on a dangerous course here, though. Many, many people have tried to point this out, even in his own party. But the Premier is determined. He is here to wheel and deal. Send us your cash and weíll sell you this sucker.
Well, Yukoners have a right to know who is calling the shots ó enough hokey pokey, Mr. Speaker.
Has the Premier, or any member of his Cabinet or caucus, accepted gifts or hospitality from any private sector companies involved in the business of infrastructure development in the Yukon? Will the Premier provide details of any such transactions?
Hon. Mr. Fentie: This is becoming ridiculous. The member opposite should be ashamed of even trying to make those points on the floor of this House. The member knows that there is a standard process and procedure when it comes to ministerial travel and what gifts may be received. Thatís all duly noted and itís public information. Itís logged and documented. This debate is becoming silly.
The members opposite have to come to terms with their position. Do they support the Taxpayer Protection Act or do they not support it? Do they support economic development in this territory or do they not support economic development? And most importantly, what is the NDPís position on the private sector? Do they support the involvement of the private sector in the development of Yukonís economy or do they not?
From what weíre hearing today, obviously they have no intention of supporting the private sector in the Yukon. In other words, they would relegate this territory to being wards of the federal government. Thatís not what weíre all about as a government. We are going to become net contributors to this country by making the moves we are to engage the private sector.
Speaker: The time for Question Period has now elapsed.
Notice of opposition private membersí business
Ms. Duncan: Pursuant to Standing Order 14.2(3), Iíd like to identify the items standing in the name of the third party to be called on Wednesday, November 19, 2003. They are Bill No. 101 and Bill No. 102.
Mr. McRobb: Pursuant to Standing Order 14.2(3), I would like to identify the following item, standing in the name of the Member for Whitehorse Centre, to be called on Wednesday, November 19. It is Motion No. 103.
Speaker: We will now proceed to Orders of the Day.
ORDERS OF THE DAY
Bill No. 41: Second Reading
Clerk:Second reading, Bill No. 41, standing in the name of the hon. Mr. Hart.
Hon. Mr. Jenkins: I move that Bill No. 41, entitled Health Professions Act, be now read a second time.
Speaker: It has been moved by the Minister of Health and Social Services that Bill No. 41, entitled Health Professions Act, be now read a second time.
Hon. Mr. Jenkins: Iím pleased today to introduce Bill No. 41, the Health Professions Act. The development of this bill has been a joint effort between the Minister of Community Services and me, and itís one that has been and will continue to be a close partnership between our respective departments.
This bill addresses a long-outstanding issue in the Yukon that affects both health professionals and the public consumers of health care services. Iíd like to first recognize and acknowledge the critical and fundamental contributions of our health care professionals to the health care system here in the Yukon.
Some Hon. Member: Point of order.
Point of order
Speaker:Member for Kluane, on a point of order.
Mr. McRobb: I believe we may have some procedural difficulty here, because the Order Paper has this bill, Bill No. 41, Health Professions Act, listed in the name of the hon. Mr. Hart, yet we see someone else going with this bill. I would like to ask for your direction.
Speaker:There is no point of order, in that Cabinet as a whole is responsible for government bills. Thus, any member of the government ó Cabinet ó can stand up and speak to those. Please continue.
Hon. Mr. Jenkins: Let me go back to the beginning, given that we had a miscommunication and the official opposition didnít quite understand the Standing Orders and the rules of debate here in the Legislature.
I am pleased to introduce today Bill No. 41, the Health Professions Act. The development of this bill has been a joint effort between the Minister of Community Services and me and is one that has, and will continue to have, a close partnership between our departments.
This bill addresses a long outstanding issue in the Yukon that affects both health professionals and the public consumers of health care services.
I would like to first recognize and acknowledge the critical and fundamental contribution of our health care professionals to the health care system here in the Yukon. We are extremely fortunate to have a large number of dedicated and hard-working professionals whose primary interest is the well-being of the members of our community. This bill is being brought forward with the support of these professionals, many of whom see this step as being long overdue.
Currently there are only 10 regulated health professions and more than 20 unregulated professions in the Yukon providing health services to the general public. Many of these unregulated health professions are normally regulated in other Canadian jurisdictions because it is seen to be in the public interest to do so.
When a health profession is regulated, then there are some assurances to the public and other health professionals that certain educational and training standards have been met and the scope of practice and services they are qualified to offer is clearly laid out.
This is important for a number of reasons. First, it ensures an acceptable standard of practice that minimizes any risk to public health and safety. This helps to protect the consumers of a health service provided by a health professional.
Secondly, it protects the integrity of that health profession. It means that the profession itself has recognized certain qualifications and standards that define what they do, and it is only people who have reached that standard who are entitled to hold themselves out as that health professional.
Thirdly, it allows for a common and fair complaint investigation hearing and discipline process that protect both the public and the health professional.
This bill before us takes an omnibus act approach, which provides a general framework for governing health professionals. This approach allows for common provisions to be continued in the legislation and for the details related to the specific health profession to be included in regulations. By taking this approach we can set up the governance structure for a large number of health professions within one piece of legislation.
Using this approach allows the government and health professionals to easily update and keep current with changes in their professional field. It is also a more efficient, cost-effective and timely approach as it allows the government to move fairly quickly in regulating health professions rather than taking years to develop separate pieces of legislation for each area.
The approach we have chosen is the approach that has been adopted in British Columbia, Alberta, Ontario and Quebec, as well as being considered by many other Canadian jurisdictions. The flexibility and adaptability of this legislation is one of its attractive features.
This act does not define up front who will be regulated under it. There is no predetermined list of groups the government has already decided will be regulated. What it does, Mr. Speaker, is create a process whereby a decision is made on whether it is in the public interest for a health profession to be regulated here in the Yukon.
This approach ensures that the decision to designate a health profession is well considered, inclusive and is made early, based on the consideration of all the important information and issues. Health professionals will be directly involved in the process that leads to the decision of whether or not to designate their field under this act, and they will be directly involved in the development of their regulations, if they are to be regulated. Other health professions, interested and affected groups and the general public will also be involved in this process.
The flexibility of this act not only allows unregulated health professions to come under it, but it also allows for those health professions that are currently regulated to come under it at some point in the future. Some of these health professions have expressed preliminary interest in coming under this new structure rather than continuing with their own separate and, in some cases, much outdated legislation.
In other Canadian jurisdictions, the regulation of health disciplines is normally done through professional colleges. In the Yukon, the only fully self-regulated health profession is the registered nurses. Other than for nurses, the self-regulating approach does not work in the north because the number of practitioners in any single health profession is far too small in numbers. Because of this, the act envisions the function of the registrar and administrative support structures being provided within government, specifically within the Department of Community Services. This is the current arrangement for all regulated health professionals other than for registered nurses.
The department recognizes, however, that a registrar overseeing a number of different health professions cannot be familiar with the details that relate to the professional practice issues of those professions. To ensure input from the profession, the act authorizes the minister to appoint advisory committees for the various health disciplines to advise the minister and the registrarís office on important issues affecting that health profession.
The flexibility of the act also allows the registrar to appoint inspectors and for the minister to appoint disciplinary and review committees with membership that includes professionals from other jurisdictions who are proficient in that discipline.
In this way, the Yukon will be able to benefit from the expertise of the professional colleges and to merge that knowledge with the local knowledge and special circumstances of our Yukon content.
As I mentioned earlier, the act empowers Cabinet to make regulations specific to a health profession that is designated under it. The regulations will address, for example, details such as education, training, qualifications, scope of practice standards, professional codes of conduct, continuing competency and education, classes of licences and supervision, health records and more. The act itself focuses primarily on establishing the process for recognition and designation of a health profession, the role of the registrar, the procedures to deal with complaints, inspections and discipline, and the requirement to establish and operate health profession corporations.
The act before our Legislature is the result of a lot of time, effort and hard work by government officials and a large number of regulated and unregulated health care professionals.
Mr. Speaker, Iíd like to take this opportunity to thank those professional representatives who were involved in the reference group discussions that reviewed the details of this legislation and those who gave freely of their time to attend information and briefing sessions. Their positive contribution has made a difference and their work on this is very much appreciated.
So, once again, Mr. Speaker, to all those involved, thank you.
Work on this act has been underway in various forms under three successive administrations, and I am pleased to be the minister to see the final product before this Legislature today, along with my colleague, the Minister of Community Services.
This act is something that has been needed in the Yukon for some time and is supported by both regulated and unregulated health professionals, groups, associations and interested stakeholders. I am sure the opposition members will be fully supportive of this bill, as both parties have previously endorsed the health professions act approach and initiated preliminary work when they were in government.
Again, I look forward to the support of the opposition on this piece of legislation before us and I look forward to discussing in general debate the main aspects of it with the opposition.
Thank you very much, Mr. Speaker.
Mr. Cardiff: It gives me great pleasure today to rise to speak to the Health Professions Act. I agree that itís something that is long overdue. Itís something that is needed and something that I think all health care workers, professionals, have been wanting for a long time. I think that the public also wants to be assured that the standards of service, complaints processes ó that they can be assured and be confident in the health care system and how those services are delivered here in the Yukon, that they can rest assured that everything is in good stead.
I would also like to take this opportunity as well to thank the people in the department and the health care professionals who worked long and hard toward the development of this act.
That doesnít mean that everything, however, is perfect. I think that this process has been rushed to some extent in the past three or four months and that a little more time could have been taken. I will look forward to discussing that with the minister when we get into Committee.
Just a little bit about health professions acts in Canada ó in all jurisdictions in Canada there is, for the most part, a self-governing model of professional regulation. According to this model, responsibility for setting and enforcing standards of practice is delegated by the government to regulatory bodies or colleges.
That isnít the case in this act. The colleges are accountable to both the government and the public for performing these functions and regulating the health professions in the public interest. Here we have the government, to a large degree, fulfilling that role. And the minister can say health professions will be involved, the public will be involved and there will be consultation, but itís not a "must" situation, itís a "may" situation. The government may do that. Thereís nothing that says the government must do that. I think that that is something that needs to be noted, and that is something that people have raised questions about.
The specialized practice of health professions ó and there are many of them. The minister said there were 30 of them or so, and Iím sure that there may even be more. The specialized practice makes direct regulation by the government difficult. The self-governing model relies on the expertise of practitioners and recognizes the value of peer review to establish and monitor standards of practice and ethics and to promote quality assurance. I think that is something that the public would demand ó quality assurance ó and I think that itís important. People want to know that theyíre going to get quality and that there are going to be some standards of practice when they go to visit a health care professional.
The self-governing model also maximizes the autonomy of health professions but requires them to act in the public interest and to regulate professional practice. Self-governance is a privilege conferred by society, and it is the responsibility of the profession to ensure that it acts at all times to serve and protect the public.
What we see in this act, or in the short time that weíve had it ó we had a briefing yesterday morning and today we get to debate the bill on the floor of the House. Luckily weíve had concerned citizens come and pose some questions about the process for developing this piece of legislation and some concerns they have with it. So weíll definitely have some things to talk about when we get to Committee.
Just to list some of those concerns: the process that was used to consult in the development; whether or not there was public consultation. We know that there was lots of consultation with health care professions over the years, and recently there was a consultation process with health care professionals, but weíre uncertain as to the extent that the government consulted with the public, which is paramount, because it is the public that receives the services and the public wants to be assured that whatís in this act is going to protect their interest.
There are also some concerns around enforcement, the complaint process and the privacy of client information in the complaint process and the enforcement. And there are some concerns about the powers of the registrar and the fact that it rests in government. The fact that the registrar is in government is of concern, I think, to a lot of people, given the publicís trust of government, I guess.
A lot of people feel that the registrar function would be better housed at armís length from government rather than housed right in the government, so we would like to explore that a little bit as well when we get to Committee.
That outlines briefly our concerns at this time. I look forward to discussing this further when we get into Committee of the Whole.
Ms. Duncan: I rise to address the Health Professions Act brought forward this afternoon. The development of this bill has been somewhat discussed by the current Minister of Health. The issue that has come before other governments has been: do we regulate health professions individually, such as we have already done with some 10 health professions. Those 10, for the record, include physicians, registered nurses, licensed practical nurses, dentists, dental hygienists, dental therapists, denturists, pharmacists, chiropractors and optometrists. So those 10 professions have their own act, their own piece of legislation. There are a number of existing and emerging health professionals who have come to governments of a variety of parties and said that they would like to be regulated too, or that they would like to have a professional designation.
One of the key ones that comes to mind ó again, itís to the credit of my former colleague ó is the issue of midwifery in the Yukon.
We have asked the Health minister many times to deliver on that legislation, and the delivery is in this Health Professions Act, because the health profession of being a midwife can now be regulated once this act is passed.
So it makes sense, in part, to do an omnibus bill, and I appreciate that, although it was started by the government I led and, much like the Decision Making, Support and Protection to Adults Act, the credit for it largely belongs with my former colleague, the former Member for Riverdale South, it is the current government that has brought this bill forward. The face-to-face consultation actually started under our watch.
So the government has elected to do the omnibus bill ó fair enough. They brought it forward. There are some issues with it, not the least of which is that over-arching issue we face as members of the Legislature, in that legislation that has far-reaching consequences can be passed very quickly through this very small Legislature. Members will recall in our discussions around devolution and the five pieces of mirror legislation, industry had expressed the concern to all governments that changes be given full and careful consideration, not be tabled one day, discussed the next and passed on the third. Thatís an issue for individuals when it comes to legislation that has far-reaching impacts. Nonetheless, that is the way the government intends to proceed.
On the whole, I appreciate that the act has had substantial consultation with members of the profession. I do believe that the public needs to be heard from on this ó the public at large. According to the minutes Iíve seen, there are 200-odd letters that have been sent out and 120 was the number used in terms of response, but the public as a whole should give some consideration to the legislation.
I support the concept of a health professions act, an omnibus bill. I do, however, have three difficulties: one, the speed with which itís intended by the government that it be passed and thus the difficulty that the public may have in giving this full and thorough consideration such as a period of time would allow them. The second concern I have is, fundamentally, the government has professed that they are going to rid the Yukon of red tape and do a red-tape reduction type of exercise. Mr. Speaker, Iíd like to file with the Clerk, because weíre not allowed props in the House, the complaint, inspections and discipline flow chart that we have been provided with in the briefing.
In the seven-plus years Iíve been in the Legislature, Iíve never seen anything this complex and convoluted and incomprehensible. And itís designed for the general public, who just wants to be able to come to an agency and say, "I have an issue with the way this herbalist, this particular professional, has dealt with me." That process, as outlined by the government, is incomprehensible. It should be the very first project for the governmentís red-tape reduction committee, whatever they call it. The current name escapes me. The issue is that this is for use by the general public. If we who deal with government legislation and government all the time have difficulty with this, how is the general public going to feel about it? Itís regulated in this act, and thatís one particular section where I would strongly suggest that the government slow down a little bit, take another look at that, and do the job right, because itís not right the way it is.
The Member for Mount Lorne has pointed out there is an incredible amount of power and authority invested in the registrar who cannot, in all reasonableness, be expected to be a member of all of these professions ó certainly not. There has to be a greater role for the college of professionals: not just advisory, but in examining the very issue.
Weíve said many times this is an extremely small jurisdiction and itís hard to go anywhere and not bump into an individual who doesnít have some relationship with somebody else. The potential for conflict is great. For example, in the discipline committee of the Law Society in the Yukon, there are lay members available because, quite often, other members of the bar will say, "I have a conflict." We need to have a similar sort of situation in place for the health professions. We need to not only have some lay people but we also need to have professionals from outside the territory who can look at particular issues, particularly professional standards.
How could a public servant reasonably be expected to know that these are the standards agreed upon by professionals in this particular field, whatever it is? So, I have an issue with the way the government proposes the complaint process and the registrar work. It needs more work before it comes before this House and, in Committee, I would strongly suggest to the minister, whoís not fond of my suggestions, that this particular section of the act be set aside and the professionals have a greater degree of satisfaction with it.
In speaking of the professionals, the minister has indicated that there has been a great deal of consultation with the professionals and, from the minutes, it would appear to be that as well.
Does he have any letters of support for this legislation and support for its proposed method of implementation? Perhaps he could address that at second reading, or certainly in Committee.
Finally with respect to this bill, there is also a great deal of power solely resting with the Cabinet and with the minister. In other words, if a health profession wishes to be regulated, they approach the minister. The minister makes a decision. If the minister decides against designation, the process ends. There is no route of appeal spelled out. That strikes me as not recognizing the role of the Legislature itself.
I can envision a scenario where a minister of whatever stripe could say no, make the decision, then that health profession logically could lobby members of the Legislature to bring forward motions and it would become a public debate.
If that is the route, then I think that perhaps the role of the Legislature should be recognized. If the minister makes a decision and there is no route of appeal, then it should be spelled out that the route of appeal is through either the ministerís Cabinet colleagues and/or members of the Legislature. It may be commonly understood but maybe it should be spelled out. If we are going to do the legislation, letís do it well. There is a lot of power and authority that is vested solely in the Minister of Health in this case.
The other point I would like to make is just with respect to the health professions overall. As I said, there are 10 that are regulated and some 20-plus that would envision being regulated. Publicly, other speakers before me have recognized ó and I would also like to recognize ó the tremendous contribution these individuals make to the health and well-being of the territory.
Thank you, Mr. Speaker. I look forward to a more thorough debate of this bill in Committee of the Whole.
Speaker: If the member now speaks, he will close debate. Does any other member wish to be heard?
Hon. Mr. Jenkins: Mr. Speaker, this omnibus bill is done in exactly that manner so the opposition ó who are the critique of the government and hold us accountable ó can fully understand whatís going on. Weíve taken the KISS approach in this area for the exclusive benefit of the third party and the official opposition.
This bill vests a lot of authority in the Cabinet, and Cabinet currently holds that authority because, for any of the health professions that choose to be regulated or are currently regulated, itís basically a ministerial and Cabinet decision. A lot of areas have been encompassed and given their own piece of legislation, but most of the major jurisdictions in Canada have recognized the area and have chosen to go the route of an omnibus bill ó British Columbia, Alberta, Ontario and Quebec.
A number of other Canadian jurisdictions are choosing to examine this option and, in all probability, will be going this route, Mr. Speaker.
Now, I have some difficulties in the Department of Health and Social Services having developed this whole bill, and it basically crosses over into Community Services under the Liberal governmentís renewal process, which housed the registrar over in Community Services. So there was quite a lot of work done by Community Services. But itís kind of a disjointed approach to things that was put in place by the Liberals under their renewal that weíre having to live with. Weíve witnessed that with the flawed process that the previous Liberal administration used for the devolution transfer agreement, but weíre having to deal with these areas as a government and go one by one and recognize the issues and be up front and move forward.
Now, Mr. Speaker, on this act there was a lot of consultation. Over 200 letters were sent out. The briefings and the meetings that were held leading up to the conclusion of this piece of legislation were provided to the official opposition and the third party so that they could understand how thorough a process was gone through by the officials to bring this forward to a conclusion.
Mr. Speaker, there is always the exercise of the opposition to make the claim that not enough consultation has taken place. Well, Mr. Speaker, in this situation, you can always make that accusation, but the background research and all the documentation has been supplied to the official opposition and the third party so they could understand and they could come to an understanding of what has been gone through in the process.
The issue of public trust is an important and critical component to this whole situation. The only way of ensuring that public trust is maintained is to have in place regulation of the various categories of health professionals who provide services to the general public. We recognize fully that we are a very small jurisdiction. We do not have the numbers here and we are going to have to rely on outside expertise from British Columbia and Alberta for a lot of the disciplines that are considered for regulation.
Yes, those regulations will flow through and they will be ratified by Cabinet, but they wonít be at that Cabinet table until thorough consultation has taken place with the health profession indicated and an open dialogue with the general public. There may currently be 20 unregulated areas. I hope that no one envisions that all 20 categories will be regulated in the next three, four or five years, because it will probably take that long or longer to deal with the ones that have asked for regulation up front. It is going to be an ongoing and continuous process, and this omnibus bill allows for that process to continue. It allows new and emerging health care categories of professionals to be included.
If you look at any of the health care categories or health-providing categories and the professionals in that group, it could take ó and it does take ó a considerably long time to have a stand-alone piece of legislation developed and the regulations developed going along for that health care group.
That is witnessed by the one group that lobbied the previous administration and put a new act in place to encompass their health care field.
The regulations are still in the process of being developed, Mr. Speaker, so it is a long process to develop the regulations, especially the discipline area, and thatís where the leader of the third party got into the situation where she mentioned the flow chart. Yes, it is a difficult flow chart for the discipline area. Itís difficult to follow, but it has to flow outside the Yukon to other jurisdictions for their expertise, given the small numbers that we will have in certain categories. We have to allow for that eventuality. That will be developed in the regulations, but weíll have to allow the flexibility in the legislation to use outside expertise for discipline matters. Thatís the only way we can be successful in this piece of legislation.
Mr. Speaker, I did sense a degree of support for this omnibus bill from the official opposition. I couldnít get my head around where the leader of the third party was coming from, whether there was support or whether there wasnít support, but the support should go to her previous colleague who worked on this. Our side will acknowledge that a lot of work has gone into this legislation by previous administrations and by health care professionals. We want to commend all those who have been involved in the developing of this piece of legislation. Without their capable assistance this would not have come to fruition at this time.
That said, the decision had to be made as to how to proceed ó whether we go with a stand-alone piece of legislation for each of the health profession groups or an omnibus bill encompassing potentially all health care providers. That election was made and we are moving forward.
I am sure that there will be some interesting components in line-by-line on this bill, and I will look forward to that taking place.
Motion for second reading of Bill No. 41 agreed to
Hon. Mr. Jenkins: I move that the Speaker do now leave the Chair and that the House resolve into Committee of the Whole.
Speaker: It has been moved by the government House leader that the Speaker do now leave the Chair and that the House resolve into Committee of the Whole.
Motion agreed to
Speaker leaves the Chair
COMMITTEE OF THE WHOLE
Chair:Order, please. Committee of the Whole will now come to order. The matter before the Committee is Bill No. 41, Health Professions Act.
Before we begin, do members wish a recess?
Some Hon. Members: Agreed.
Chair: We will stand in recess for 15 minutes.
Chair: Committee of the Whole will now come to order. The matter before the Committee is Bill No. 41, Health Professions Act.
Bill No. 41 ó Health Professions Act
Chair:Weíll proceed with general debate. Is there any general debate?
Mr. Cardiff: Well, there are many questions. I guess itís a matter of where to start.
One of the concerns that we have is how much power there is that rests with the Cabinet in the process for designation of professions and a lot of the requirements and standards that are covered under this act.
There is also another issue. The minister this afternoon, when he was giving his closing remarks, talked about information, the sharing of information, the KISS approach, and how they shared information with the opposition. The act was tabled in the House a little more than a week ago. We got the briefing yesterday morning. We received a 24-page document at 10:30 this morning that was much appreciated. One of the issues that Iíd like to raise, just right off the top, is that there is an appearance of a conflict, maybe, in that the government is probably one of the largest employers of health care professionals.
Yet the government is also the one that is going to regulate it, so youíre going to be hearing complaints about your own employees.
The separation between Health and Social Services and the registration and regulation being in Community Services ó is that the purpose of that separation? Is it the fact that youíre employing health care professionals but you are also regulating them?
Hon. Mr. Jenkins: The registrar authority is contained with Community Services. That was determined under government renewal, which was a process set up by the Liberal administration. There was so much turmoil and turbulence surrounding government renewal that we are still feeling the aftershocks today, so we are not going to go there and disrupt what is currently in place.
There was probably a much better way of organizing things than was done by the Liberals but we will deal with it and, like a number of other situations, we are having to put the wheels back on the cart and the cart back on the road to get things moving along.
Mr. Cardiff: I sense the minister is not comfortable with this. Theyíve been in government for a year. Iím wondering why he hasnít done anything to address this ó or maybe the minister is comfortable with it, but I sense heís not comfortable with the registration of health professionals and the regulation of health professionals being in the Department of Community Services.
I donít know whether he agrees with that and, if he doesnít agree with it, why hasnít there been some move to correct that?
Hon. Mr. Jenkins: Let me make it abundantly clear to the member opposite that the minister is completely comfortable with this bill that has been presented and how it flows and the various components of it and the fit it has into government. Otherwise I wouldnít have supported my colleague, the Minister of Community Services, who tabled this bill.
Weíve worked together on developing this bill. Our department officials have worked diligently for the past number of months. One only has to point out the documentation that was supplied to the members opposite ó the official opposition and the third party ó the minutes of the Health Professions Act reference group and the various meetings that have taken place, and you can see from the list of those from the various departments who attended the meeting that there was a thorough and complete level of cooperation between the Department of Health and Social Services and Community Services. So thatís not an issue here. What weíre looking for is the most cost-effective, simple and expeditious way to regulate a discipline thatís going to serve the needs of Yukon in the most appropriate manner.
Mr. Cardiff: Thatís the document I got at 10:30 this morning. Itís 24 pages and I agree, there are a lot of people who attended these meetings. Thereís no doubt in my mind, and they all come with great credentials, Iím sure, and Iím sure that we all know some of these people.
One of the concerns that was raised ó Iíll just quote from the document ó the question raised was, "Will the final legislative draft act be in the public domain for a significant period of time?" It says that the act will not be available to the public until itís tabled in the Legislature, likely in the first week of November.
Well, thatís what weíve seen. So, whereís the publicís opportunity to comment on this? They are the ones who are concerned about regulation, quality assurance and standards of practice, and the public has not been consulted on this. The act has been in this House for less than two weeks and the public has not seen it or had an opportunity to comment on it. So what would the minister say to that?
Hon. Mr. Jenkins: Thatís the same process that any other piece of legislation in the Yukon follows. Itís not a public document until it is tabled in this Legislature. Thatís a given, and it doesnít matter what piece of legislation you refer to, save and except when our party took the unprecedented step of providing embargoed copies of two supplementaries to the official opposition and the third party on the first sitting day. Those were supplementary bills, and yes, they were provided embargoed. And we provided briefings.
So, Mr. Chair, weíve gone the extra mile as a government to provide open and complete disclosure of as much information as we can at the earliest possible opportunity. Thatís a given. We agreed to do that and we have done that, and we will continue to do whatever we can to follow suit in that manner.
Now, to suggest that there wasnít public consultation ó I donít know what the member opposite is trying to get his head around. It will probably, in all likelihood, take a great deal of time to implement the provisions of this piece of legislation in regulation. It is envisioned that each group that is being looked at for regulation will go through an extensive consultation process ó both publicly and with the specific members of that professional group ó before regulation is sanctioned by Cabinet. So there is quite a thorough and complete process that is envisioned.
Even if we were to bring forward ó in the manner that the previous Liberal administration brought forward ó a health professions bill, the majority of the work is done via regulations. We already have one piece of legislation where the regulations are being worked on but they are not completed as yet.
This goes back quite a period of time. The other option is to bring forward a bill for each specific discipline and pass that bill, then subsequently go in to developing the regulations. Most political jurisdictions in Canada ó B.C. and Alberta are where we focused our attention, but also Quebec and Ontario ó have opted to go for the omnibus bill approach and develop the regulations after. Thatís the approach weíre taking. The regulations will be developed in complete consultation with the discipline we are looking at regulating, as well as the general public.
Mr. Cardiff: One of the other things the minister mentioned this morning was the fact that there were about 10 professions that are already regulated, and there are about 20 that are unregulated. Maybe the minister could provide, by legislative return, a list of those that are regulated and those that are unregulated, and whether or not that list would also include alternative health professions such as massage, acupuncture, reiki and things like that ó whether or not those professions would also fall under this piece of legislation.
What the minister said, my understanding of what he said, is that the ones that are regulated and the ones that arenít regulated will be regulated under an existing piece of legislation if theyíre regulated already, but they may fall under this piece of legislation, and the ones that are unregulated can apply or ask to be regulated under this piece of legislation. Iím just wondering what happens in the event ó when these requests are made, I can understand it if one or two ask to be regulated, and there would be processes that go into place to develop those regulations so that they would fall under the health professions omnibus bill, but what happens if half of them, 15 of them, the day after we pass this and itís given assent ó that would be December 15, I would assume ó you have 15 requests? Whoís going to decide who receives the priority? Is there a method? Who is going to decide the priority that each profession receives and what kind of pressure would the minister think that puts on government and on the finances of government to do something like that?
Hon. Mr. Jenkins: Mr. Chair, thatís a completely hypothetical question. But let me share with the member opposite the regulated professions currently in the Yukon and the unregulated professions.
The regulated professions are chiropractors, dental hygienists, dental therapists, dentists, denturists, optometrists, pharmacists, physicians ó they are in the YMC and YMA, the registered nurses and registered practical nurses. Theyíre the categories that are currently regulated.
The unregulated professions are audiologists, counsellors, dieticians, emergency medical assistants, hearing aid specialists, massage therapists, medical imaging technologists, medical laboratory technologists, midwifery planning association, midwives, occupational therapists, osteopaths, psychiatric nurses, physiotherapists, psychologists, social workers, speech and language pathologists, Whitehorse General Hospital management staff, Yukon Holistic Health Network, and there are probably a number in that category ó acupuncture, herbalists, reflexologists and naturopaths ó and itís a growing area.
Thereís a whole series of categories, but the question of what would happen if 15 of these groups walked in the door tomorrow and wanted to be regulated is very hypothetical. Weíll proceed in a manner that is appropriate. Where the demand generates, itself we will move forward.
We only have so much capacity if thatís what the member opposite is identifying, and we can only take on so many at one time. Thatís a given. I wouldnít envision being able to regulate all this in probably the next four or five years, and we donít know how many other fields are coming forward. There are changes all the time.
Mr. Cardiff: I can understand that. The question that I was trying to ask was whether or not there would be resources added to government to implement this act.
Another question that might be asked as well is ó itís my understanding that itís a profession that requests designation and regulation to fall under this act. I guess, what Iím asking is: could a request come from somewhere other than a profession? If there was a public body that decided that they wanted a certain group of professionals regulated to ensure standards of practice and public safety, is that in this act somewhere?
Hon. Mr. Jenkins: Yes, Mr. Chair.
Mr. Cardiff: Could the minister maybe tell us where we could find it?
Hon. Mr. Jenkins: I am aware that the member opposite wasnít at the briefing, and if we could just have a couple moments, weíll find out where this is spelled out.
I refer the member opposite to clause 4 and would encourage him to become familiar with that section.
Mr. Cardiff: I heard the minister make reference to the fact that I didnít make it to the briefing, and he is quite correct. The briefing came on very short notice as well, just like the document we received today.
But thatís pretty standard operating procedure for the House leader on that side.
I would like to know a little bit more about the consultation process in drafting this legislation, and Iíd like to know: was the legislation prepared and then consulted on, or was it ongoing?
Hon. Mr. Jenkins: The concept of the omnibus bill was determined by Cabinet, Mr. Chair. That was accepted, rather than regulating each health care category. Thatís a given. And the consultation process that ensued was surrounding how this process would flow under an omnibus bill and then, subsequent to that, when a discipline was determined to become encompassed and put under this legislation, how the regulations would be developed and how the registration would flow and how the discipline would flow. All of that is spelled out.
Mr. Cardiff: In the briefing notes, it mentions that letters were sent to First Nations and to First Nation leaders, to Council of Yukon First Nations. There were representatives of Council of Yukon First Nations. Iím just wondering what the level of support ó and maybe even the minister has letters of support from First Nations when they engaged in this consultation process with First Nations about this legislation. Maybe he could tell us about those letters of support that he received from First Nations or health professionals with regard to the consultation that we conducted on that.
Hon. Mr. Jenkins: The overall support from those with whom this was discussed was approximately 90 percent. I am given to understand that that was the figure that was determined by the officials dealing with this matter. There were over 200 letters sent out by the department. There are minutes of a number of meetings that were held, starting in September this year up until currently. The leader of the third party alluded that this has been a long-standing development process and praised one of her colleagues. I thoroughly concur that there was some work done by the previous two administrations, going back some five, six, seven years before this was brought forward. When our government moved forward on it, we made the determination that we were going to move forward on the basis of an omnibus bill. There was a 90-percent acceptance of that fact, and what you have before you is a product of a lot of hard work by a lot of dedicated members of the Yukon government with input from the various discipline categories.
Mr. Cardiff: Well, I am not saying that there wasnít a lot of hard work put into this. I agree. There is a lot in this to get hold of. Thatís probably one of the concerns I have: the shortness of notice of having to deal with this.
The minister said that they sent out 200 letters of consultation to First Nations, health care professionals and groups and that there was 90-percent acceptance. That would tell me that there should be 180 letters of support that this minister could provide to this House. Can he do that?
Hon. Mr. Jenkins: Iím not going back to the department to dig up the letters of support, but the general acceptance of the approach our government took, and the general acceptance of all categories, was 90 percent. Thatís an in-house estimate of the level of support. There was very good support for the approach our government took.
Thatís where weíre at; thatís why weíre here today. It has been requested by a number of categories and disciplines, and they have asked for this bill and we have agreed and moved forward.
Mr. Cardiff: Iím pretty sure I heard the minister say this earlier, but Iíd just like to clarify it one more time before I move on, and that is about further consultation ó Iím pretty sure I heard him say this and Iíd just like to make sure I have the minister on record as supporting this, that this is the course of action that theyíll be taking on further consultation. There will be further consultation with health care professionals on the designation and in the writing of regulations governing them ó there will be.
Hon. Mr. Jenkins: Thatís where most of the consultation will take place, but itíll be with the specific professional group and it will also encompass the general public, but where most of the emphasis and thrust will be is on the health care provider and their specific membership in that category. Then there will be a wider consultation on the regulations. It will be open. I suspect the most appetite to deal with the actual regulations will come from the category or discipline we are regulating. But yes, I can assure the member there will be ongoing dialogue and there will be a complete consultation process before the regulations are developed and put in place.
Mr. Cardiff: It is specified in the act that that will be there?
My understanding, and a concern that was raised is that the registrar may consult with a professional advisory body at various points in the process. It makes more sense to me. I know the minister is going to get up and say, "Well, you know, we want flexibility and we can go for that fine detail in the regulation," but if itís not in the legislation that the registrar, the ministerís agent ó and thereís a problem with that probably too ó but what it says in the legislation is that the registrar or Cabinet "may" consult. It doesnít say it "must" or that it "will". It says it "may". Thatís a concern.
Hon. Mr. Jenkins: Iím sorry that the member has a concern of that nature.
Yesterday in the bill we were debating, I explained the difference between putting something into the act itself and then dealing with something by regulations. In this case, what we have is enabling legislation. The regulations will flow from it. Iím sure the member opposite will drive that wind turbine to the degree that is necessary to produce lots of electricity. Weíre on a different wavelength.
This is enabling legislation; the regulations will flow from it. Yesterday we had an example of legislation that was restricted and, unless provided for in the regulations, this would be the case; this would apply. In some legislation you move one way; in another piece of legislation you move the other. This is enabling legislation. Any government would be remiss in its duty if it did not fully consult with a category of health care providers that it was going to regulate.
Our assurance as a government that we will be consulting with the category that weíre going to be regulating is a given. That will be done, Mr. Chair.
Mr. Cardiff: But itís not spelled out in the legislation that theyíll do that.
Weíll move on here in a little different direction here, maybe. Under the act there is a section ó the complaint process. My understanding is that complaints would be made to the registrar. Maybe we should start there.
Hon. Mr. Jenkins: The member opposite is actually very correct. The complaints are submitted to the registrar, and the registrar must investigate all matters raised by a complainant. You have to give your complaint in writing to the registrar, and the registrar may also initiate the inspection/investigation process without a formal complaint being submitted. An example would be that an individual may feel that their friend has not received appropriate treatment by a regulated health professional. No written complaint is submitted, but the individual wants to alert the registrar that there may be concerns with the way that a health professional is carrying out their profession. The registrar must notify the health professional that they are the subject of investigation and ask them to provide any information regarding the matter to the registrar. Thatís part of the formal complaint process.
We tried to keep it simple; we tried to look at how to flow it as simply as possible. And the flow chart that the leader of the third party held up and waved around is ó you might want to have a look at it, because there are seven different categories in there. If you took all seven different categories and took them in their own context, the process would be very simple.
But if you put it all on one page, it looks somewhat complicated. It is actually a very simplified process.
Mr. Cardiff: One of the concerns, I guess, is the nature of a complaint. Who decides if a complaint is frivolous and what if there is a disagreement with the complainant or someone else in the process on whether or not it is frivolous?
Hon. Mr. Jenkins: It would be the registrar or the registrar in consultation with that health care professionalís committee.
Mr. Cardiff: By that I would take it that there will be committees with respect to each health care profession and that they will be set up. Am I correct in that assumption?
Hon. Mr. Jenkins: Not in all cases. For some we will rely on expertise from other jurisdictions. Thatís what is contemplated. We do not have enough health care professionals in a number of these categories here in the Yukon. So if they are eventually regulated, for the whole investigation and regulatory end of it and disciplinary end of it we would probably have to use outside expertise. That is envisioned and provided for in this legislation.
Mr. Cardiff: So I am hearing the minister say that they are going to go outside to ó one of the things I talked about in second reading, in my opening comments, was about the use of colleges in other jurisdictions. I recognize that we are a small jurisdiction and we donít have the resources in a lot of these professions to have a body such as a college, but we could have linkages with colleges in other jurisdictions that would support various things.
They would support ethical standards, professional practices, the standards of practice and things of that nature. Would they be involved in any monitoring of the profession?
Maybe the minister could tell us a little bit about the role he sees those outside bodies ó colleges ó playing in the regulation of health professions in the Yukon.
Hon. Mr. Jenkins: The outside colleges could be part of the investigation, the discipline and consultation process. They could be used in many manners, but that primarily would be where their utilization would be envisioned.
Mr. Cardiff: Is that in any way indicated in the legislation, that there is a role? Because I think that is one of the areas of concern of some of the people who have been talking to me about this act. Some of the concerns they have are that the registrar seems to be sitting out there all by himself, and heís expected to know everything about everything about 30 different health care professions. What the minister is saying is that heís going to have access to a lot of information, and heís going to get a lot of help from people here in the territory who are involved in these professions, and that there will be a role for those professionals to play in the development of regulations and the development of standards ó the list goes on: ethics, standards for education, the requirements for continuing education of registrants.
There are requirements for maintenance and professional liability insurance coverage by registrants, but they are not specified. That is what my problem is; I donít see anywhere where these people can take comfort, because I donít see where itís specified that the registrar or the Cabinet is obligated to avail themselves of these professional organizations. I know the minister is going to say that weíd be remiss if we didnít, but youíre not obligated in any way under this legislation to do this. Am I correct?
Hon. Mr. Jenkins: This legislation is enabling legislation. These areas that the member opposite refers to will be provided for and dealt with via regulations.
Mr. Cardiff: I hope that when health care professionals read Hansard ó and Iím sure that there will be some reading it ó theyíll get some comfort from the ministerís comments.
What provisions are made to protect the confidentiality of the health care information in the event of an investigation or complaint?
Hon. Mr. Jenkins: I would refer the member opposite to clause 44 and ask the member to read that section of the act.
Mr. Cardiff: If a consent to release private information is signed by the complainant, what guarantees are there against coercion?
Hon. Mr. Jenkins: Clause 44, Mr. Chair.
Mr. Cardiff: Can a complaint under this act be laid by someone who is not a client or a patient of a profession?
Hon. Mr. Jenkins: That question has been asked and that question has been answered. I would refer the member back to the Blues.
Mr. Cardiff: One of the concerns, I think, is with respect to confidentiality of health information ó I guess the concentration. Where will these complaints and the information that flows out of these investigations be kept?
We live in a pretty small jurisdiction. Itís a small community. Weíve seen, in the past nine or 10 months, confidentiality breached with respect to employees.
And I think the public would like to know with some confidence that there will be some confidentiality around their health records. So I would like to know whether or not the public can rest assured that there will be confidentiality around medical information thatís obtained during the course of an investigation.
Hon. Mr. Jenkins: I take the member back to clause 44 and confirm that any information would be housed in the registrarís office.
Mr. Cardiff: So weíve got 30 health care professions potentially being regulated, and all of this information is going to be housed in the registrarís office. So the government is going to look after all this information, and I think that there is a concern about that, given the way that the government handled the confidentiality around things like computer use investigations.
With regard to enforcement and the powers of the registrar, can the minister tell me ó itís my understanding that this act allows for entry to a professional business without a court order. Can the minister tell me if thatís correct?
Hon. Mr. Jenkins: Thatís correct.
Mr. Cardiff: So, in the course of an investigation, the registrar can basically go and kick the door down to the business without a court order. How is the health care professional whose business this is supposed to protect the confidentiality of other patients who may not be the subject of an investigation? Is there something that protects the other clients who may not be part of an investigation, and the sharing of their information?
Hon. Mr. Jenkins: Mr. Chair, I resent the implication being presented by the member opposite that the people undertaking an investigation through the registrarís office are not professional in the conduct of their business. Thatís simply not the case.
Under this piece of legislation, the intention is for the powers to be as broad as possible for the inspectors to fulfill their role in protecting the public interest in the most difficult or problematic of times. These are normal powers that are provided to inspectors in other health profession legislation, and theyíre required for them to do their jobs in protecting both the public interest and the interest of the health professional.
The full extent of these powers would not normally be used but must be provided for in cases where they may be needed. Normally the least intrusive approach to the premises and the full cooperation of the proponent is used first and, in most cases, this results in obtaining the information necessary for the investigation and a resolution of the matter.
The inspector may be someone from another jurisdiction who normally fulfills this function under the auspices of a professional college and may be a health professional from the discipline being investigated. If there is a problem there, the courts can also be used and they can be turned to for a ruling on a court order application if there are questions around the legitimate actions of an inspector.
A health professional who is concerned about the actions of an inspector can refuse to provide the information requested, and the registrarís office would then need to seek a court order. There are checks and balances against the misuse of power, including the courts and ministers. There are checks and balances there, Mr. Chair. Itís a de facto way of undertaking this type of legislation. Itís very enabling, very comprehensive, but it does protect both the health care provider and the client.
Mr. Cardiff: I just have a few more questions under general debate with regard to this area.
Regarding the premises that are being investigated, does the professional or the proprietor have to be present during the investigation? The investigator would go there without a court order to obtain information. Do they have to be present?
Hon. Mr. Jenkins: Normally, yes.
Mr. Cardiff: Normally yes, but not normally, I guess, would be the question.
Another question, I guess, is: would it be possible for the professional to refuse entry to those premises for investigation without a court order, and what happens then?
Hon. Mr. Jenkins: I just went over that and I will repeat what I said earlier, Mr. Chair, and ask the member to pay attention this time.
What I said before is that the powers of the inspector are to be as broad as possible in order for the inspector to fulfill their role in protecting the public interest in the most difficult or problematic situations. These are normal powers that are provided to inspectors in other health professions legislations as they are required for them to do their jobs in protecting both the public interest and the interest of the health professional.
The full extent of these powers would not normally be used but must be provided for in cases where they may be needed. Normally the least intrusive approach on the premises is based on cooperation. It is used first and in most cases this results in obtaining the information necessary for the investigation and a resolution of the matter. The inspector may be someone from another jurisdiction who normally fulfills this function under the auspices of a professional college and may be a health professional from the discipline being investigated.
Ask the member opposite to pay careful attention to the next two categories.
The courts can always be turned to for a ruling on a court order application if there are questions around the legitimate actions of an inspector. A health professional who is concerned about the actions of an inspector can refuse to provide the information requested and the registrarís office would then need to seek a court order.
Now that I have repeated twice, I hope the member is comfortable that he has now received an answer to the same question for the second time. Mr. Chair, there are checks and balances against the misuse of power, including the courts and the minister. The minister is ultimately responsible for the action of the registrarís office.
Mr. Cardiff: Iíd like to thank the minister for making that clearer this time around.
Would these investigations ever be public at any stage, or would they always be an in-house matter?
Hon. Mr. Jenkins: There can be an application to have the hearing component of the disciplinary action in private, yes.
Mr. Cardiff: How will it be ensured that discipline that is set down in one of these investigations ó if there is discipline required ó is carried out, and who is responsible for that?
Hon. Mr. Jenkins: Mr. Chair, that will be done through the registrarís office.
Mr. Cardiff: I think that pretty much answers most of the questions that I had for general debate. I thank the minister for answers and look forward to debating this a little more in line-by-line.
Ms. Duncan: As expressed in the opening discussions of second reading of this act, I have concerns with the role of the registrar and the designation process, and in particular the complaint inspection discipline process for registrants.
So, I would like to go back to the very beginning with the minister. The minister said that the other provinces were going to this omnibus type of bill. In fact, I believe ó and Iíll check the Blues for this, but I believe the minister said that British Columbia and Alberta were going to this method.
Some Hon. Member: (Inaudible)
Ms. Duncan: Heís saying that thatís not the case.
I believe the minister wants to speak.
The fact is that British Columbia has a Health Professions Act, which Iíve had the opportunity to review.
Rather than go with this omnipotent registrar in charge of all things and designations, British Columbia has gone with a model of a health council.
The Yukon has gone with a similar model in other situations. For example, I reference again the legal profession. The Law Society registers individuals. The Law Society collects the dues. The Law Society deals with the complaints.
We already have in place a Yukon Medical Council. I donít have the legislation right in front of me. In the discussion of this legislation, was a health council put to Cabinet as an option in drafting the legislation?
Hon. Mr. Jenkins: For the member oppositeís information, what I stated at the beginning was that B.C., Alberta, Ontario and Quebec have this type of legislation. Other Canadian jurisdictions are looking at it and will probably adopt it. I hope that clarifies the position.
If the member would care to either listen or review the Blues, sheíll find out, Mr. Chair, that that is what was stated.
Our jurisdiction doesnít have the number of individuals to justify such an undertaking as the B.C. model has in place. We will have to rely on Outside expertise for a number of the disciplines that could potentially be covered under this omnibus bill.
Ms. Duncan: The Blues will reflect the fact that the minister didnít answer the question of whether or not the health council model was considered by Cabinet. Nonetheless, Iíll ask again.
The minister said in his view that it was not the route to follow, given we are too small a jurisdiction. How does he explain, then, that the model has worked, does work and is very effective ó the model such as is used with the Law Society, similar to the health council model, as outlined in the B.C. legislation? Why does this independent group work for one set of professionals in our society? Why wouldnít it work for the health professions? Why wouldnít that model work? Was it considered? And why, in the ministerís view, was it rejected or would it not work?
Hon. Mr. Jenkins: Given the number of people who would be in a lot of these disciplines, this was the prime reason this was discounted. Thatís a good suggestion, but given the number of lawyers we have in the Yukon and given the number of registered massage therapists, they donít equate, if you want to use that as an example on a comparison basis. So the example that the member opposite is touting is simply too complicated for the Yukon. We need something very simple, and we have to rely upon expertise from Outside jurisdictions for a number of these areas.
Ms. Duncan: Mr. Chair, I completely disagree with the member opposite. The memberís saying that we have to have a society or a council for each one of the medical professions. Thatís not the suggestion. The 600-plus lawyers who are registered with the Yukon bar all practice in wide and varied parts of the legal profession. B.C. has a health professions council.
The member across the floor asks how big it is. Well, the health professions council consists of three or more members. The Law Society has existed for many years in the Yukon. They have held discipline hearings. They have censured those against whom there is a complaint. There is a degree of confidentiality. They collect the registration fees. They have a standard code of conduct and a standard of discipline. Why did this small-c supposedly conservative government, who ó and the member opposite railed against previous governments for growth in government and government interference with the individual, and now the member is doing exactly that: growing government, making them all-powerful and taking the authority away from the professionals to regulate themselves and to deal with a professional council, such as we have already seen good examples of.
The Legal Profession Act talks about discipline of members. Why wouldnít the model work? The model works for the Law Society. Had we been given more notice and information that this debate was coming forward, I could have determined what similar discussions have been held around accountants.
There are other professions in the Yukon Territory where we are able to register, discipline and deal with public complaints, but we didnít have to grow government to do it. Why would the government, the current Health minister, not examine that model? I donít buy the argument that the Yukon is too small. And is that the only argument he has to offer against a health council ó that weíre too small? Is that the only argument?
Hon. Mr. Jenkins: For the record, Iíll provide the member opposite with a summary of the B.C. model. You have the minister; you have a council; you have a college; you have a board and the health professional association; you have a registrar; you have a registrarís commission; you have another board under that; you have an inquiries commission; you have a complaints commission; you have an appeals commission; you have a discipline commission; you have a hearing commission, and it flows from there.
We just do not have the capacity to model after British Columbia. Weíre growing; our population is growing, thanks to the efforts of the Yukon Party government, and weíre seeing an upwards swing in our population through sound fiscal management, through a very capable leadership. Weíre restoring investor confidence, weíre going to get the economy rolling today; but, the suggestion by the leader of the third party that we go and model ourselves after the B.C. model simply is folly. Itís a figment of her imagination. It would be an impossible task to formulate a model after the B.C. model that would work here. We just do not have the people.
The member opposite alluded to the Law Society. With a population of 30 thousand-odd, weíve got 600 lawyers practising at the bar here. That should tell the member opposite something. There is the ability to conduct and provide for a Law Society and their own formula with that number of members, but if you look at the doctors, the number of doctors here in the Yukon and with the Yukon Medical Council, there are difficulties dealing with issues also.
I would encourage the member to not go off on a tangent and to examine the B.C. model before she endeavours to provide information that will take us down a path of no understanding.
Ms. Duncan: Itís amazing. There is one set of rules when the member is over there and one set of rules when the member is in opposition.
This isnít a tangent, and no, itís not a folly. Just because it wasnít the Minister of Healthís idea doesnít mean that it doesnít hold merit.
Now, we are all used to the ministerís ó now he is imitating playing a fiddle. Is that the constructive debate that the leader promised us? Isnít that constructive.
The fact is that the health profession council ó yes, the model has a registrar and discipline associated with the colleges. But overall there is a health professions council. I donít believe that the minister has given full and fair consideration to that model, as evidenced by the Law Society, or a serious look at the health professions council in British Columbia and how it might work with the Yukon.
Maybe we donít have to go with ó and I will go so far as to say the registrar and the colleges, et cetera, et cetera. But we have very good arrangements with the medical community in British Columbia and Alberta ó very good arrangements ó because the Yukon pays their bills, among other reasons. We have very good arrangements with them. Why couldnít we have a health professions council and use the registrar and use the discipline committee of the colleges as British Columbia does? I am sure, given British Columbiaís financial state, they may want to charge us a nominal fee for such. But why we couldnít have a health professions council, the minister has not fully explained. He has not given a good reason why that idea was rejected.
And he has not given a good reason as to why the Yukon Party, of all parties, would sanction the growth of government and all-powerful public servants as opposed to the people involved in the profession. There isnít a good reason. The only good reason is that that particular Health minister didnít think of it and doesnít believe in constructive debate in this Legislature. And just for the record, Mr. Chair, the population report is that the population of the Yukon, according to the Yukon Bureau of Statistics, has dropped since the Yukon Party took office.
Hon. Mr. Jenkins: Once again, Mr. Chair, the premise of the member oppositeís arguments are incorrect.
Ms. Duncan: The premise of the memberís arguments is not incorrect. The premise of the memberís arguments ó this member is suggesting giving some consideration or explaining to the public why an alternative method, rather than the all-powerful registrar, was not considered in this legislation? Why? If the member truly believes that this is constructive debate and that there should be constructive debate on the floor of this Legislature, then why not? I havenít heard a good reason why the health professions council has not been considered. What I have heard from the health professionals is that they have grave concerns about the registrar and the registrarís role as envisioned by this legislation ó grave concerns.
We have, as the Member for Mount Lorne has pointed out to the member opposite, a proposal that someone without medical training whatsoever be appointed to be all-powerful over possibly 30 different health professions.
The problem is that there are other ó I believe better ómethods of regulating and better methods of dealing with this. Other jurisdictions have them.
So the minister wonít agree or see a point of view other than his own.
How about Alberta? The Alberta legislation in dealing with one of the medical professions ó for example, again, the registrar in that case is a qualified member of the profession. Thereís a problem with the health omnibus bill as presented by the minister, and I would ask that the minister give some realistic consideration to an alternative method of dealing with this, such as what weíve seen in other Yukon legislation. There are Yukon-made solutions here. Why hasnít the minister examined them?
Hon. Mr. Jenkins: Well, once again, I tend to disagree with the member opposite, Mr. Chair, and thatís probably not unusual, but what we have here is a made-in-Yukon solution that relies to a great extent, for the purpose of discipline, on British Columbia and Alberta.
Now, thatís where weíre going to go for this expertise. Our population base, although itís increasing now under the Yukon Party leadership, is still very small to support the model the member opposite is suggesting. Yes, we have looked at it, but we had to come up with a made-in-Yukon solution, as the member suggests we do. Yes, we have done exactly that, Mr. Chair, and this is it before the member now and before this Legislature. I commend this legislation to the House and encourage the member opposite to look at it.
Itís very enabling; yes, it does vest a lot of power in the position of the registrar, but the registrar has access to health professionals and to advisory committees at any point they may require. Many of the complaints to the registrarís office do not deal with health practice issues but relate to other concerns that do not require a health professional.
An example would be administrative issues such as records, communication concerns; it might be just a personality clash. There are checks and balances at each stage of major decision making by the registrar. There are appeal processes in place to respond to any major decisions. The powers of the registrar are normally those used by a registrar in any health profession legislation. Thatís where we are at right now. The registrarís expertise must be in managing responsibilities under the act and seeking professional health practice advice where it is needed. Itís not being an expert in any specific health discipline.
I would encourage the member to review the Blues and have a look at what was mentioned here today, because really what we have is a made-in-Yukon solution for Yukoners, and we will be relying on expertise from neighbouring jurisdictions where they have a larger population base and where they have a larger pool of expertise.
Ms. Duncan: I would encourage the member opposite, the minister responsible, to review the Blues and recognize that there is an opinion on this legislation in the Yukon other than his own, and that opinion among some health professionals is that the act has been set up with one all-powerful registrar.
There is concern out there. Not everyone is entirely comfortable going into a government office, surrounded by a number of individuals, and laying a complaint or expressing a concern.
Some Hon. Member: (Inaudible)
Ms. Duncan: Yes, they do it all the time ó usually downstairs to the opposition offices as opposed to the government offices, because they like to deal with people who listen.
The issue for the professionals ó and professionals in other fields have other methods of registering, other methods of paying professional fees, other methods of dealing with discipline. They exist in the Yukon; theyíve worked well in the Yukon. For some reason, the minister is refusing to examine those. What is the role then? How does the Yukon Medical Council tie in with this? Whatís the future role envisioned for them under this legislation?
Hon. Mr. Jenkins: It is not.
Ms. Duncan: So in other words, then, we have one body of the health professionals that deals with the Yukon Medical Council ó the physicians ó correct?
Hon. Mr. Jenkins: The common bond is that they use the same registrar, and that would continue to be the case. But, Mr. Chair, letís set the record straight. If someone has a complaint under the B.C. model or if someone has a complaint under the Alberta model, they go and register their complaint at a government office. They go to register their complaint at a government office in those cases. In some outlying areas there are other facilities that they go into, but in most cases they go into a government office. Thatís a given. And itís the same registrar who would handle it in B.C.; in Alberta that would handle it; in the Yukon that would handle it. From there, Mr. Chair, weíve set up a made-in-Yukon solution. We do not have the population base to support the exercise that the member opposite is suggesting. And, yes, weíve examined the models in other jurisdictions.
Weíve examined, Mr. Chair, but itís most interesting when you get right down to it. What I hear the member suggesting is that by the time we put this all together, if we model it after the B.C. model, we would need hundreds of people in the system. We donít have the liberty of having that number of people in the system given that we would probably end up regulating a discipline where there might only be two or three or four individuals here in Yukon in that specific field.
Weíve taken that KISS approach and Iíd encourage the members opposite to grasp the fundamentals of that approach. Itís a made-in-Yukon solution that is very, very simple. It accesses other jurisdictions for the discipline exercise should it be required.
Ms. Duncan: First of all, let me correct the member opposite. Yes, I am advocating examining other models. Yes, I like the British Columbia idea of a health professions council. Iím not saying that the council, which in turn ó the council in British Columbia relies upon the registrars of individual colleges such as the College of Psychiatry and other colleges as the ó The minister apparently doesnít want to listen or hear any of the arguments given his body language, so when heís prepared to listen Iíll continue.
The issue is that there is opportunity for professionals to be involved in the establishment of a health council.
Itís interesting that there is a book that was put out, and I often find it relates to discussions in this Legislature. Itís by Barbara Coloroso and is called The Bully, the Bullied, and the Bystander. It often relates to discussions in this Legislature, which is unfortunate.
The health professions council, by and in itself, makes reference to three or more members. Three or more members, individuals or members of the medical profession are certainly available. We have well-established societies that deal with professions. Again I mention law and the Judicial Council. It can review appointments to the bar.
Why we canít go with that type of establishment of a council, and then make use ó for payment of a fee perhaps ó of the registrars of the individual colleges and the discipline committees and the number of committees that the member has articulated. There are a number of them. Iím not advocating establishing all those, but thereís no reason why, rather than establish this omnipotent registrar, the government couldnít have examined the establishment of a health council and the use of British Columbiaís existing councils. Thereís no reason why it couldnít have been examined.
The minister has not given a satisfactory reason, and what Iíve articulated on the floor, and what the Member for Mount Lorne has articulated, to the back of the minister, has been that over ó
Some Hon. Members: (Inaudible)
Chair: Order please.
Ms. Duncan: What I have tried to articulate is that there are other methods that work. The minister has not given any reason why the concerns of the health professions themselves about this all-empowering registrar cannot be met. The concerns could be met with the use of an alternative method. That could be done. The government has given no reason why these Yukonersí views couldnít be considered. Why couldnít they?
Could we stand aside the clauses that make reference to the registrar and consider an alternative method? Itís going to take a great deal of time to develop the regulations. I note that other provincial legislation indicates that regulations are not passed without the input from the profession itself, and itís not a "may" consult, itís a "must" consult.
Some Hon. Member: (Inaudible)
Ms. Duncan: Well, read the acts. Yes, it is "must" consult.
Would the member please indicate, for the Yukon public who do not want to see this registrar established, why this part of the act couldnít be set aside and we look at other methods of regulating the health professions in the territory?
Why couldnít it be set aside? Itís going to take a long time for regulations to be developed. Why not set that part of the act aside? Would the member even consider that suggestion?
Hon. Mr. Jenkins: Once more for the record, let me share with the House that our side has considered the B.C. model; we have considered the Alberta model; we have looked at the best of both. What was determined would be best for the Yukon is a made-in-Yukon solution, which was a premise of the member oppositeís first approach to this situation until it was pointed out clearly that that is what we have done. We have a made-in-Yukon solution.
And it relies on the expertise in our neighbouring jurisdictions on the discipline side of it. We just do not have the population base to support what the member opposite is advocating. Thatís the bottom line.
Chair: Order please. The time being 4:00, do members wish a recess?
Some Hon. Members: Agreed.
Chair: Committee will stand in recess for 15 minutes.
Chair: Committee of the Whole will now come to order. The matter before Committee is Bill No. 41, the Health Professions Act. Weíll continue on with general debate. Ms. Duncan.
Ms. Duncan: Mr. Chair, weíve established that the Minister of Health is not prepared to give consideration to any other opinion with respect to how this Health Professions Act will be regulated other than his own, which is unfortunate, as there are a number of professionals who have grave concerns regarding the expanded powers of the registrar in the way that this legislation is proposed. The minister has indicated he is not prepared to set it aside.
For the record, I would also note, in British Columbiaís act, with respect to regulations, notice of a proposal to make, amend or repeal a regulation must be given to the college of each health profession. This is a very clear indication that the health profession would have input into any regulations.
And also that particular section of the act allows for a time period of three months. The minister has said that of course there would be consultation, but I canít see anywhere where it is spelled out that the health profession must be consulted prior to the regulations being developed. Is the minister prepared to examine a possible amendment to require, absolutely, the consultation of the health profession, or not?
Hon. Mr. Jenkins: Letís look at the B.C. model that is being advocated by the member opposite. In British Columbia every health discipline has its own registrar. What weíre proposing here in the Yukon is one registrar for all health disciplines. In British Columbia the council that the member opposite so firmly believes in only advises the minister on designation of anyone into the health category. And that council can also advise on other matters on which the minister requests input.
Here in the Yukon, the minister does not designate that. It is a decision of Cabinet. Itís at a much higher level.
We have spent a lot of time examining this area, Mr. Chair. The department has put a lot of effort into this initiative and has determined that the best way to proceed was with a made-in-Yukon solution with only one registrar for all the health disciplines. And the registrar only has the power to investigate. When it comes to disciplinary action, we have to rely, in all probability, on other jurisdictions ó British Columbia and Alberta primarily ó for their expertise.
Our population base is not able to support what the member opposite is advocating. We have some disciplines where there might only be three or four members in that discipline.
So, Mr. Chair, Iíd encourage the member opposite to think this through and support the made-in-Yukon solution we have put forward. Now I know she might be uncomfortable undertaking that kind of an approach, but this was determined after careful consideration of what is in place in other Canadian jurisdictions and how we can proceed here within our population size, given the number of health care providers in the various disciplines.
I believe that there is some suggestion by the leader of the third party that we should have this big council. I would encourage the member to look at the B.C. model, to look at what they have in place.
If we look at the health profession council in British Columbia, it consists of three or more members appointed by the Lieutenant Governor in Council ó by OIC here in the Yukon. An appointment under subsection (1) must be a term not exceeding three years. A member of the council may be reappointed to the council. The Lieutenant Governor in Council may designate a chair and one or more vice chairs of the council from among the council members. A member of council who resigns or whose appointment term has ended may continue to serve until a successor is appointed and even if a successor is appointed, continue an investigation commenced under section 8 before the resignation or end of term, to serve as a member of the council for the purposes of sections 9 and 10.
The responsibilities of council ó the council must consider applications for designation of a health professional received under clause 7 and investigate regarding designation of a health professional made under clause 8 in accordance with clauses 9 and 10, consider matters referred to it by the minister under clause 25 in accordance with that clause and carry out other duties that the minister or the lieutenant government or council may by order direct.
The member is suggesting we need another council in the Yukon, Mr. Chair. I disagree.
Ms. Duncan: The member opposite is saying that the proposal I am advocating is simply unworkable, and itís not a made-in-Yukon solution that he has proposed.
I believe the member said earlier in debate this afternoon that other members should try listening. Perhaps the minister should try listening.
What I am advocating is that this all-powerful registrar ó in other jurisdictions, it is outside of government. I am concerned that there is an all-powerful registrar in this act, that it is not a truly made-in-Yukon solution, that there are other made-in-Yukon solutions that the minister has given no defence for not examining. The other point I would make is: why couldnít we have a registrar outside of government? If we could have one registrar for all the health professions in the Yukon inside of government, why canít they be a body ó the registrar ó provided with the resources but outside of the employ of the Government of Yukon ó have them as the Law Society does. Thereís a registrar; thereís a full-time employee who deals with these issues.
The minister has read into the record that the council must consider applications. Thereís a role for the council, and itís not an all-powerful, huge council. Itís three or more members of the public, of the health profession. Why couldnít we have that and use the registrars from B.C.?
The minister is just simply not interested in solutions other than the one he has proposed in the act. Heís not interested, and itís not only my read of this legislation and the briefing that outlines the power of the registrar and the difficulty that people have with it. Other members of the health profession in the Yukon have expressed the same concern. Theyíve expressed this concern as well. The logical question is: why isnít the government hearing that?
The government will have to answer for themselves at the doors.
There is no point in trying to suggest to the minister any further that there are opinions other than his own, because heís not interested in hearing them. The other point I would like to address ó and he didnít answer it ó is in terms of regulations of the health professions. There are a number who have asked if there is any idea on the part of the government of which profession they might begin regulating first? Is there any idea at this point in time, presuming the act passes?
The Member for Mount Lorne asked that question and it was not answered by the minister.
Hon. Mr. Jenkins: Physiotherapists and psychiatric nurses are interested.
Ms. Duncan: Would those regulations be developed concurrently? Would we try to do two at once or would one of them be first?
Hon. Mr. Jenkins: I can advise the House that my officials have informed me that physiotherapist regulations are being worked on now.
Ms. Duncan: My understanding of the legislation ó and I would like to be corrected by the minister opposite ó is that there is no "must" consult, there is no notwithstanding clause for the professions. So if the government develops the regulations and the physiotherapists say, "Weíre not happy with them", thereís no recourse for them. Other than the moral requirement, there is no absolute requirement in legislation for government to consult and there is no absolute requirement whereby members of the profession could say they disagree with these regulations. Is that correct? Itís simply the ministerís public commitment that the medical professions have to go on. Is that correct?
Hon. Mr. Jenkins: The member opposite has the ability to stretch things beyond comprehension. Itís unbelievable. If youíre looking at developing regulations, you have to develop those regulations in consultation with that discipline. Thatís a given. Thatís the way it is and thatís the way we are proceeding. We will develop the regulations in consultation with that health care discipline thatís being encompassed in those regulations. It would be foolhardy to proceed any other way.
Ms. Duncan: It would be very foolish for government to proceed without public consultation; however, weíve seen the government do it before. And the question I asked was: is there any legal requirement in this legislation for the consultation with the medical profession? It was a straightforward yes or no. As I understood the minister ó no, there is no legal requirement. Is that correct?
Hon. Mr. Jenkins: There is no legal requirement for me to carry on a needless, repetitive debate with the member opposite. Thatís a given too.
The commitment has been made. It has been past practice, and it will continue to be the practice of this government to consult with those involved and the general public for the discipline weíre going to be regulating. For that matter, Iím advised by the officials that the physiotherapists are quite pleased with the process theyíre currently going through. And weíd utilize the same process ó engage the professionals in that discipline to develop the regulations.
So I donít know how many more assurances I can provide the member opposite. As minister, itís well known and well recognized that consultation is part of any of the processes, and weíve clearly demonstrated that as a government. The only areas we appear not to have demonstrated it to the satisfaction of the members opposite are those areas on which the members opposite want to focus. Thatís just not an accurate reflection of what we do as a government.
Chair: Is there any further general debate?
Hearing none, we will then continue on with line-by-line debate.
On Clause 1
Clause 1 agreed to
On Clause 2
Clause 2 agreed to
On Clause 3
Mr. Cardiff: Kind of continuing in the same vein that the leader of the third party just finished up with, but in the interest of trying to move things forward here and coming up with, as the minister said earlier, a made-in-the-Yukon solution, we did have some consultations with health care professionals to whom the minister failed to listen, and I have an amendment that Iíd like to move. And I wonít read the whole thing, maybe, in the interest of time and moving this forward ó
Chair: The member has to read the whole amendment.
Mr. Cardiff: THAT Bill No. 41, entitled Health Professions Act be amended at clause 3 at pages 2, 3 and 4 by deleting clause 3 and substituting for it the following:
3(1) The Commissioner in Executive Council may make regulations respecting
(a) the process for the minister to investigate and consider the designation of health professions under this act;
(b) the name of the profession;
(c) one or more titles to be used only by registrants of the profession;
(d) services that may be performed by the registrants of the profession;
(e) limits or conditions on the services that may be performed by registrants of the profession;
(f) services that may be performed only by registrants of that profession; and
(g) services that may be performed by a person who is not a registrant if they perform the service under supervision by a registrant of the profession.
3(2) A designated health profession in regard to registrants in that designated health profession may make regulations respecting
(a) services that may be performed by a registrant of the profession, despite a limitation or prohibition under another enactment;
(b) classes of registrants;
(c) requirements for the registration of persons practising a designated health profession;
(d) standards, limits or conditions for the practice of a designated health profession by registrants;
(e) standards of professional ethics for registrants;
(f) standards of education for registrants;
(g) requirements for continuing education of registrants and for ensuring continuing quality of practice and ability to practice;
(h) requirements for maintenance of professional liability insurance coverage by registrants;
(i) fees payable by registrants;
(j) requirements for issuing, renewing, suspending, cancelling and reinstating the registration or licence of registrants, including providing for
(i) periodic licences that a registrant must hold, and
(ii) suspending or cancelling the registration or licence
for late payment or nonpayment of fees;
(k) advertising or types of advertising by registrants;
(l) advisory committees representing one or more designated health professions to advise the registrar or the minister on matters pertaining to the practice of that profession;
(m) the maximum fine that a discipline committee may impose;
(n) guidelines and educational requirements for registrants respecting their relations with patients;
(o) rules concerning access to health care records held by registrants; and
(p) membership of and procedures to be followed by discipline committees.
Hon. Mr. Jenkins: Mr. Chair, given the nature of the amendment, I would suggest we call for a brief recess while we examine this with our officials and determine whether itís a meaningful amendment that is being proposed or not.
Chair: A brief recess has been called for ó
Some Hon. Member: (Inaudible)
Chair: We will stand in recess for 10 minutes.
Chair: Order please. Committee of the Whole will come to order. The matter before the Committee is Bill No. 41, the Health Professions Act.
The Member for Mount Lorne has proposed an amendment. Do you wish me to read the amendment, or is it clear?
Hon. Mr. Jenkins: Iíd like to thank the Member for Mount Lorne for proposing the amendment. We have had a look at what is being proposed, and we have some serious concerns as to what is being proposed in this amendment. If the health profession group were to make regulations, they would be, by and large, contravening the whole purpose and intent of this piece of legislation.
They could make bylaws for their group, but they could not make regulations. What is being proposed in Bill No. 41, under this Health Professions Act, is one registrar in the whole Yukon for all the various disciplines.
In British Columbia, the model that the leader of the third party has proposed, they have a registrar for each discipline, and they have a health council. They have a whole series of other boards and committees that surrounds this group. The order of magnitude of cost to a discipline would be in the neighbourhood, if we had three members and we chose to regulate outside the Yukon and subject ourselves to such a system, of about $6,000 to $8,000 and as high as $12,000 for one discipline. Thatís why we have chosen to go the route of one registrar for all the disciplines.
Itís a made-in-Yukon solution. It is efficient. It is effective. Yes, the registrar is the investigator, but the registrar is not the discipline board; thatís another body. There are safeguards in the role of the registrar that are clearly defined.
We cannot support this proposed amendment to this Legislature, and we will be voting against it.
Mr. Cardiff: Mr. Chair, the intent of the motion is to allow health care professionals a role in the regulation of their profession. Itís about self-regulation, as it is in other jurisdictions. This is basically directly from other jurisdictions.
I heard the minister say earlier today that you have to develop regulations in consultation with the profession. You would be foolhardy not to do so. Those were his words. You can read them in the Blues tomorrow morning. And thatís what this allows. This allows a designated health professional to play a role in the development of regulations in their specific profession. This is what theyíve asked for.
I donít want to go on and belabour this. I think thatís enough said.
The minister obviously hasnít listened to health care professionals, because this is what theyíve been asking for. I think that if the minister is not prepared to support this, then maybe he should stand down the clause and go out and consult and find out what health care professionals really want.
This is not unlike, as the leader of the third party said, the legal profession and how it regulates itself and develops rules around practising law.
The way I see it, the minister has two options: if heís not going to support this, then my recommendation is that we stand down this clause until such time as the minister can go out and do an adequate consultation on what it is that health care professionals really want.
Chair: Is there any further debate on the amendment?
Mr. Fairclough: I would also like to add a couple of words in regard to this amendment.
Iím in full support of my colleague from Mount Lorne in bringing forward these amendments. Itís not our intention to change the intent of the act or the proposal that has been put forward. Our amendment is directly related to direction and concerns that have been given to us by some health care professionals. Weíre taking their concerns and giving them as a friendly amendment to the minister.
I would like to again ask if the minister could take a little more than 10 minutes to consider this. Weíve heard itís illegal, or that the amendments may be illegal. Weíd like to hear a bit more of it. We donít see a difference in how it is even right now, where they go through the B.C. college route rather than going through a decision that could be made by the Executive Council in respect to regulations.
I would think ó and I am sure that the minister would agree ó that health care professions, whether itís dental therapists or whatnot, know best and have a lot more information about how they would like to see their industry regulated than, I would say, the Minister of Community Services, whom this bills falls under. It is a bit misleading to the public, I would think, to have this fall under that minister.
All we are asking is if the minister can take this and review it more with the department and come back with a bit more explanation ó perhaps an amendment of their own for us to look at and how they could take care of that issue that has been brought forward by the Member for Mount Lorne. That one line in clause 3(2), "A designated health profession, in regard to registrants in that designated health profession, may make regulations respecting Ö"
If they can do that, we will consider pulling our amendment off the table and, I guess, taking the message back to those who have concerns that their issues are met.
So if the minister could do that, we would be in favour of that also.
Ms. Duncan: I would like to address the amendment that has been put forward by the Member for Mount Lorne. I would like to express my appreciation that there has been an attempt made to try to deal with the issue, that those currently in the unregulated health professions feel that there is a problem with the act. I share their concern. This is an attempt ó an amendment brought forward by the Member for Mount Lorne ó to try to go part way to deal with those concerns.
They clearly have not been heard or registered with the government. Itís unfortunate that the government wonít give this full and thorough consideration. Why not ó to use the colloquialism ó sleep on it? Why not have a look at it for 24 hours? We can stand aside one clause of the bill, with the proposed amendment, take a thorough look at it, and the government could come back. Out of respect, it deserves far more than simply a 10-minute, cursory consideration.
The member has brought forward legitimate concerns, tried to address them in the legislation thatís before us, in the appropriate manner, and it deserves more than a 10-minute consideration. So I would ask that the minister, in the spirit of respect that was promised voters, and improving the conduct of the Legislature, to consider giving it full consideration. Stand aside one clause of this act, consider the amendment overnight, and we can discuss it again tomorrow and make an informed decision.
Hon. Mr. Jenkins: I find this quite interesting. When we initially saw this amendment tabled by the Member for Mount Lorne, I asked for a recess so we could examine it with our officials and that was hard to obtain. In fact, I suggested 10 minutes and was told no, and no for a recess. Now weíre to look at it overnight.
We have looked at it, examined it, see the downstream implications of what is being proposed and the additional cost implications for the profession that would be regulated. We want a made-in-Yukon solution, and we have that made-in-Yukon solution here, Mr. Chair. This is not going to change the way weíre proceeding.
Chair: Is there any further debate on the amendment?
An amendment has been proposed by Mr. Cardiff, the Member for Mount Lorne. Are you prepared for the question?
Some Hon. Members: Division.
Chair:Division has been called.
Chair: Order please. Committee of the Whole will now come to order. The matter before the Committee is a proposed amendment to the bill. Mr. Cardiff has proposed an amendment. A count has been called for. All those in favour please rise.
All those opposed please rise.
Chair: The results are five yea and nine nay.
Amendment to Clause 3 negatived
Chair: We will now continue on with debate on clause 3.
Mr. Fairclough: I would like to ask the minister: how does he propose, now that they have voted against the amendments, to address the health professionsí concern if we do not have ó how else is he going to address their concerns?
Hon. Mr. Jenkins: Clause 3 is very specific in that it says: "The Commissioner in Executive Council may make regulations respecting
(a) the process for the minister to investigate and consider the designation of health professions under this act."
Mr. Chair, these regulations would outline procedures to be followed when considering the question of whether or not it is in the public interest to designate a specific health profession. This cross-references clause 4 which authorizes the minister to carry out the process.
Clause 3 states: "(b) the name of the profession;
(c) One or more titles to be used only by registrants of the profession;
(d) services that may be performed by the registrants of the profession;
(e) limits or conditions on the services that may be performed by registrants of the profession;
(f) services that may be performed only by registrants of the profession;
(g) services that may be performed by a person who is not a registrant if they perform the service under supervision by a registrant of the profession;
(h) services that may be performed by a registrant of the profession despite a limitation or prohibition under another enactment;
(i) classes of registrants;
(j) requirements for the registration of persons practising a designated health profession by registrants;
(k) standards, limits, or conditions for the practice of a designated health profession by registrants;
(l) standards of professional ethics for registrants;
(m) standards of education for registrants;
(n) requirements for continuing education for registrants and for ensuring continuing quality of practice and ability to practice;
(o) requirements for maintenance of professional liability and insurance coverage by registrants;
(p) fees payable by registrants;
(q) requirements for issuing, renewing, suspending, cancelling, and reinstating the registration or licence of registrants, including providing for
(i) periodic licences that a registrant must hold, and
(ii) suspending or cancelling the registration of licence for late payment or non-payment of fees;
(r) advertising or types of advertising by registrants;
(s) advisory committees representing one or more designated health professions to advise the registrar or the minister on matters pertaining to the practice of that profession;
(t) the maximum fine that the discipline committee may impose;
(u) guidelines on educational requirements for registrants respecting their relations with patients;
(v) rules concerning access to health care records held by the registrants, and
(w) membership of, and procedures to be followed by, discipline committees."
Mr. Chair, what we have here is a made-in-Yukon solution. What is being advocated by the members opposite is a system whereby we would drive health care providers out of the Yukon Territory given the cost of their registration under the system being proposed. Currently the cost for the registration, save and except a nominal fee, is being borne by the registrarís office. Thatís a given.
If you start to look at, letís say, using an offshore registration body, that cost, as I said earlier, could be of the order for a health profession discipline that had three or four members ó it could be $6,000, $8,000, $10,000, $12,000.
What the members opposite have failed to get from the British Columbia system is the total cost of the whole system they have in place. It ainít cheap, Mr. Chair. Weíre talking about a minimum of a couple hundred thousand dollars to set up something similar here in the Yukon. This omnibus bill was designed to keep costs to a minimum, to keep governmentís intrusiveness to a minimum, yet fulfill the responsibilities we would have.
We currently have a liability that could be argued ó because we arenít regulating this field, weíre sanctioning it, and if something goes wrong, Yukon may be held liable. We donít want to go there, Mr. Chair. We donít want to go there at all. We want to provide for good legislation that is enabling, that allows the profession we are looking at and examining to develop the regulations in full consultation with the government, and then move forward.
The interests the member is referring to are well protected, and they have been, and that has been demonstrated by the past practices of the department in areas where they are involved in developing current regulations. We intend to follow those same practices, and we intend to keep the cost to a very minimum amount.
Our aim is to provide the highest consistent level of health care for Yukoners that we possibly can, and also to keep our costs within checks and within reason. Thatís the exercise. Iíd encourage the members opposite to look at it from a realistic point of view.
Now, I know itís the role of the opposition to keep the government accountable, but I know I spent a number of years in opposition, and it was always my position, when in opposition, if I criticized something the government was doing, to offer a bona fide, legitimate example of how they could proceed in a cost-effective manner in another direction.
Unfortunately, there were very few occasions when I was taken up on the offer, but there were a number of them, and I can think through a number of debates when I was in opposition when amendments were made to legislation as a consequence of suggestions I brought forward.
That said, thatís why I took the time with the officials to seriously examine the proposed change being put forward by the Member for Mount Lorne. It was treated or taken lightly, but it would probably be ultra vires at the least, if not downright illegal, to proceed in the direction that was being suggested.
Mr. Chair, this area is completely taken care of. We can debate it from now until the close of the session, if the members opposite wish. Itís not a problem for this side.
Mr. Fairclough: Well, itís a problem for our side. We want to get on with business. We put together an amendment; we thought it through; weíve taken concerns of members of the health care profession, and we offered a possible solution to the minister and to this House. That side of the House ó the government side ó voted against it.
I asked if there was something else the minister can do, and he read through clause 3 of this act, but really did not answer the question about what else they could do to take care of their problems. Health care professionals know their profession better than the minister or the Minister of Community Services, who will ultimately be making recommendations on the regulations to Cabinet.
One of the other things that could be considered in this ó and thatís why we asked the minister to go back and look at it ó is to drop everything below 3(g) from this act ó make that amendment; drop it. That would partially take care of the consideration and concerns that were raised by the health care professionals. Would the minister consider that, take that and look at it? We want to go on with this. We donít want to debate this too long, but we donít want to leave it alone. We want some serious consideration given to this. Can it be looked at overnight while we move on to other clauses in the act?
Hon. Mr. Jenkins: Mr. Chair, the member opposite asked how we were going to protect the rights of the disciplines weíre going to regulate, and I read clause 3 verbatim. Thatís how weíre going to do it.
Mr. Fairclough: That wasnít what I asked, Mr. Chair. I asked if the minister would consider taking everything under subclause (g) and deleting that. Weíre not going to bring an amendment here. We want the minister to go back and talk with his officials and see. Maybe this can be done, and itís very simple. The minister can propose that amendment himself, perhaps another day. Weíre getting close to the end of the day, and weíre not going to move too much further in this bill. We could possibly pass it, but would the minister consider doing that and coming up maybe with some suggestions or a better explanation? Weíre not satisfied with that explanation that took 10 minutes to put together about it being illegal. We donít even know what part of it ó itís not illegal today, so why would it be illegal if the amendment went into clause 3 of this act? So would the minister please consider taking it back, having the officials look at dropping everything below (g)?
Ms. Duncan: In the absence of the minister responding to that particular point by the Member for Mayo-Tatchun, I would like to outline an additional perspective. The health professions have expressed concern about the way these regulations are going to be developed and about who is in charge ó the registrar. They have expressed serious concerns, to the point where these individuals ó the minister said that if we were to do any method other than what he has proposed, we would drive the health professionals out of the territory because of the cost. Well, what is proposed also will drive health professionals out of the territory, because theyíre saying to us ó the opposition parties ó that they are not comfortable with the way this legislation is being proposed. The comfort level the minister says is there, weíre hearing the opposite from other health professionals. Theyíre Yukoners and theyíre concerned.
There has been an amendment put forward. The minister doesnít support that amendment. It has been defeated. The minister has said in the past, however, that heís prepared to consider amendments and that he has brought them forward.
The minister has also said it is not contained in legislation that there must be a consultation with the health professionals prior to the regulations being developed.
I have a constructive suggestion for the minister: clause 3(1) ó I have noted an amendment using the other legislation but I would like to ask the minister ó so heís comfortable with it ó to consider drafting this and bringing it forward.
Notice of a proposal to make, amend or repeal a regulation under this section must be given to the college of each health profession prescribed for the purpose of this subsection at least 3 months before the regulation, amendment or repeal comes into force.
Under section 12(3) of the B.C. Health Professions Act, it says: "Notice of a proposal to make, amend or repeal a regulation must be given Ö" ó it says to the college of each health profession, and we havenít adopted that model ó "Ö to the Ö health profession prescribed for the purpose of this subsection at least 3 months before the regulation, amendment or repeal comes into force." There is no reason why that could not be added as an amendment at clause 3(1) in this act.
Now, the other members of the opposition have brought forward amendments that have not been successful. The minister has said that he has, as a member of the opposition, brought forward amendments. I canít think of any off the top of my head, but he said that, therefore it must be so.
Would the minister consider having his officials draft the amendment based on the B.C. legislation that requires the public notice and consultation with the health professions prior to the regulations being proclaimed? All it does is give the "must" requirement, which the minister has said is not in the legislation right now ó why not put it in? That way, we could go partway to meeting the concerns expressed by the health professions.
Will the minister give that suggestion some consideration and, in so doing, stand aside this clause? We can deal with the remainder of the bill, and he can come back with his own amendment drafted by the legal experts.
Is the minister going to respond to that suggestion?
Mr. Fairclough: Itís very interesting to see the minister sit back and not listen to the public again; weíve seen it so many times in this House. Weíve seen the government do it with the Taxpayer Protection Act and it has been demonstrated right here, right now.
This is a voice from the public, from the professions, and theyíre saying thereís something wrong with this bill, it needs to be changed. And the minister even asks for a constructive debate. This is one of them. Weíre making suggestions. Weíre not even making the amendments. Weíre asking the minister to consider a couple of different options. The minister wouldnít even do that. Is that how business is run in that department with this minister? Itís a simple request.
We only have half an hour left in the day. We can debate the rest of the bill, so will the minister do that instead of reading the newspaper?
Mr. Cardiff: The minister is obviously entrenched in his position and, on the one hand, he talks about looking for solutions, Yukon solutions. He tells us about how he has amended legislation but heís not willing to listen to good ideas and the concerns of health professionals who have come and talked to us in good faith and asked us to bring forward ideas to make this better for Yukoners.
As the minister said earlier, he pointed out that maybe I wasnít listening when we were in general debate, and I hope that the minister is listening now. Maybe he would consider ó hereís another possible solution. Weíve been standing here now proposing solutions for quite some time to address concerns that health care professionals have about how theyíre regulated and who regulates them.
You might as well have a mechanic developing the regulations for dentists or maybe an electrician developing regulations for psychiatrists ó I donít know. But hereís another solution, or at least an idea. The minister can go away and sleep on this. He can consult with his department and with his staff about this. Maybe he would consider adding language after (g) in clause 3 ó just take this and consider it ó stating that the minister may enact regulations for the remainder of these items, (h) to (w), I believe it is, only on the direct advice and with the direct approval of designated health professions. That could be done at a fairly low cost. Basically, they still have the control. All they have to do ó it guarantees that health care professions are going to be consulted and listened to. So it could be done at a low cost, possibly through a health professions council, as the leader of the third party has suggested or maybe by a letter of agreement following a meaningful consultation, to which the Yukon Party committed. The Yukon Party committed to meaningful consultation matters that were important to Yukoners.
I would say that this is important to Yukoners, and this would be a true made-in-Yukon solution. Itís not made in the department; itís not made in the Cabinet office. Just take that under consideration, go away, sleep on it, and letís maybe try that. With any luck, the minister will get up this time and give us his opinion.
Hon. Mr. Jenkins: The question has been asked three different times. The question has been answered once. Thatís all that needs to be answered.
Mr. Fairclough: Mr. Chair, the question hasnít been asked. Weíve given suggestions to the minister, and we asked that the minister have a look at the suggestions that were made by the opposition parties and come back with an explanation. That is what has been asked. The minister refused to answer the questions.
We understand what has been written here. We looked at it, and weíve made suggestions. I would think we made a positive change or suggestions to the minister, who could make the change and bring it forward. I guess the simple question is, with all the suggestions that have been made by this side of the House, would the minister take it back and consider it, and have a discussion with the department on this?
If thereís no change in the position, thereís no change, but we would like them to at least have a debate on this internally in the department. It may be that the minister could bring something back thatís worded better than what weíve proposed. Would he do that?
Hon. Mr. Jenkins: An examination of the B.C. methodology of regulating the disciplines has been conducted. There was an examination of the Alberta model and the way they proceeded.
We do not have the population base to support what is being suggested here. We do not have the number in the majority of these disciplines for them to be self-regulating. The consultation process to develop the regulations will include the members from that profession that has elected to be regulated. Thatís where we are at.
We have a made-in-Yukon solution. Itís extremely viable. Itís cost-effective and it will serve all Yukoners. I am sure that after itís in place, the members of the official opposition and the third party will laud and welcome this new bill and what it does for Yukoners.
Ms. Duncan: The minister has just said that the consultation on regulations will include members of the health profession. We have his verbal commitment. Unfortunately for members of the health profession, thatís all they have. That verbal commitment has not held up in other situations.
If the minister is saying that the minister will include them, I donít understand what the harm is in including that in part of the act and making it law ó that notice about developing these regulations must include discussions with the health professions. If itís going to happen, why is the minister reluctant to accept the constructive suggestion, have it drafted by his department so that there are no questions about its legality or whether or not itís ultra vires? Why wonít the minister take that constructive suggestion? If itís going to happen, whatís the harm in putting it in law?
Mr. Fairclough: I donít know how many more times weíre going to try this, but my colleague from Mount Lorne has made a suggestion that is low cost, is definitely a made-in-Yukon suggestion, and itís a small change to the wording. We can settle for this. It goes partway, and it also takes care of the ministerís argument ó that if the minister would consider adding language after (g) to state that the minister may enact regulations for the remainder ó which I believe go from (h) to (w) ó only on the direct advice with the direct approval of a designated health profession. If that were added in there, it would take care of the ministerís argument and concerns and also take care of the concerns raised by health professions that have asked us to come forward and speak on this section of the act.
Would the minister take that into consideration? We donít have much time here. We can talk it out and let the minister go back and make these decisions, and then see if he has made any changes. Or will the minister just stand up and say that heíll have the department consider it and come back with some advice for us in this House?
If only the minister would hear whatís being said on this side of the House instead of reading the newspaper. Iím sure this must bug the backbenchers ó that we canít proceed with the debate because the minister is more interested in the cartoons of himself in the paper than addressing the serious issues that have been raised by the Yukon public on this.
So I ask again: would he consider reading the Blues, because he hasnít heard it here, taking those suggestions back to his department, and considering them and coming back with some explanation on it? The minister might be surprised what else his department can come up with in taking care of this issue? Would he do that?
Ms. Duncan: Mr. Chair, may I suggest that, as I understand it, a motion to adjourn is always in order. May I suggest we adjourn Committee of the Whole debate for the minister to give this suggestion full and thorough consideration. He apparently does not appear willing to verbally respond and hear what we have to say on behalf of the health professionals who have made their concerns known to us or to respond in any manner. Perhaps he may wish to review them in written form and advise accordingly tomorrow. At our House leadersí meeting, he can advise whether or not an amendment is going to be considered.
MOTION TO REPORT PROGRESS
Chair:Does the member wish to put forward a motion that we report progress?
Ms. Duncan: This clause not having been cleared, yes, I do.
Chair: It has been moved by Ms. Duncan that Committee of the Whole report progress on Bill No. 41, Health Professions Act. Are you agreed?
Some Hon. Members: Disagree.
Chair: I believe the nays have it. We will continue on with the debate.
Ms. Duncan: Would the minister indicate whether or not he is prepared to give the constructive suggestions put forward by ó there has been a suggestion put forward by the Member for Mount Lorne and the Member for Mayo-Tatchun. I have put forward an alternative suggestion as well. Will those suggestions be given consideration and could we stand aside clause 3 and move on to part 2? Will those suggestions be given consideration and this clause stood aside?
Would it help debate if I put that in a form of a motion that we stand aside clause 3?
Chair: Standing aside a clause is not a matter for a motion, as thatís a matter for the government to make that decision. We will continue on with debate on clause 3.
Mr. Fairclough: Does the minister not consider this to be a serious matter?
Hon. Mr. Jenkins: This is a very serious bill. This has very extensive implications for Yukoners. Our government has built a made-in-Yukon solution to this issue. This made-in-Yukon solution obviously is not palatable to the opposition and the official opposition and the third party. That in itself is not surprising but itís not going to ruin the day.
The suggestions for an amendment were not taken lightly. They were carefully considered. The implications were carefully considered and they were subsequently rejected.
We donít take lightly the suggestion of that order or that magnitude. But, that said, we believe we have a very good piece of legislation here in this bill.
I read out the clauses that pertain to the protection and to the areas that will be regulated so that everyone had a clear understanding of them and a thorough knowledge. I guess that on this area, the opposition and this side are going to have to agree that we have disagreed, and move forward.
Mr. Fairclough: Well, the ministerís serious consideration to our recommendations and changes was to not answer the question. He sat there reading a newspaper and didnít take these suggestions that were made on this side of the House seriously.
I asked if it was a serious matter and he said yes. I canít see why the minister would not do a simple thing and put this section aside and consider what was suggested by the Member for Mount Lorne and change some of the wording ó itís simple wording. I asked the minister ó on our side, we feel that it would partially take care of the concerns that were raised by the health profession, and it would still not jeopardize what the minister has suggested. So, whatís wrong with having a friendly amendment to this clause and satisfying some of the concerns that have been raised out there? Itís a serious matter. Why canít it be given a serious consideration?
Hon. Mr. Jenkins: Iím sure that the opposition doesnít have anything in writing from any of these health groups that indicates opposition to this piece of legislation. That said, by the time we get back into debate on this bill, several days hence ó next week, perhaps ó Iím sure theyíll have a whole bunch of correspondence that will be drafted by the official opposition and the third party and plunked in front of us as the objections.
Weíre aware that there is about 90-percent acceptance of how we are proceeding with this piece of legislation. Given the fields that weíre encompassing ó the health disciplines ó that is extremely good. There is always going to be some disagreement with how one proceeds on any piece of legislation put forward by any government. There is not always going to be unanimous agreement. That would be very, very rare.
One only has to look at the piece of legislation where the official opposition and the third party are hammering home the fact that weíre altering the Taxpayer Protection Act completely. Nothing could be further from reality.
But this bill before us, the Health Professions Act, is one that is going to serve the common good of all Yukoners.
Itís a good piece of legislation.
Mr. Chair, if the members opposite wish, I can go back and read for the record once again, if they didnít get it the first time or the second time, the provisions of clause 3, of how the Commissioner and Executive Council may make regulations. Itís a very straightforward process, and it will be all-encompassing. It will include the public and the health profession that is involved in being regulated, and some of these groups are very, very small. I believe some of the smaller groups are three, four members. There is a desire on the part of the majority of these groups to move forward and become regulated and to provide some legal certainty surrounding their practice. Thatís what our government undertook, and thatís what weíre endeavouring to accomplish.
We, the Yukon Party, ran on a platform, Mr. Chair, of providing good governance, providing sound fiscal management, reviving the Yukon economy, getting things going here again in the Yukon that were destroyed by the previous two administrations. Mr. Chair, we also identified the social agenda as being highly important, and we identified with addressing the needs on the social agenda. To that end, this Health Professions Act was identified as a piece of legislation that was needed. And we agreed to move forward on it ó my colleague, the Minister of Community Services, and I, who have kind of a co-jurisdiction in this piece of legislation.
Itís quite interesting that the office of the registrar for health is housed in Community Service, but thatís where the registrarís office was housed under the wonderful Liberal government renewal that took place a few years ago. They couldnít run the economy ó actually, I have to give credit to the NDP. They put the economy in the toilet and the Liberals flushed it. It was an excellent exercise in cooperation between the members of the opposition.
We know that we were elected on a platform of sound fiscal management, and we will do just that. Weíre very, very hopeful that we can see the conclusion of this bill in due course, but weíll probably run out of time today to complete this bill. Itís amazing; the adult support and decision-making legislation cleared the House very quickly. It was much more encompassing and extremely technical in nature, and yet, the scrutiny was just not there.
Perhaps because this is a much simpler bill in nature, there was more of an appetite by the opposition to grasp the fundamentals and stall it in general debate or Committee of the Whole debate and not proceed.
We have identified the area; clause 3(1) is where we have stopped. We have looked at the change that is being proposed by the Member for Mount Lorne. We cannot concur with that and have voted it down.
I would encourage the opposition: letís move forward. Letís move forward and letís clear section 3 and letís get into some debate ó meaningful debate ó on some of the other sections of this piece of legislation.
This bill has 49 clauses in it, and I guess the areas of concern are the investigation powers of the registrar, the inspectors, patient confidentiality, the registrar not being a health professional but a position within government ó when we examined all of these areas ó
Some Hon. Member: Point of order, Mr. Chair.
Point of order
Chair:Mr. Fairclough, on a point of order.
Mr. Fairclough: Mr. Chair, I believe the minister is violating our Standing Order 19(b) or (c) with persistent and needless repetition. Heís not even speaking to the question that has been given to him. He is so busy and determined to stonewall and push his own approach through that he already has his company car warming up in the parking lot for the last half hour, Mr. Speaker.
Chair:There is no point of order.
Hon. Mr. Jenkins: Before I was rudely interrupted, Mr. Chair, I was dealing with the various issues surrounding this bill and the areas where concerns had been raised, but we have set up one registrar for all of the health professions.
Some Hon. Member: (Inaudible)
Chair: Order. Please continue, Mr. Jenkins.
Hon. Mr. Jenkins: Thank you, Mr. Chair. We have set up one registrar for all of the health professions. It is set up, and itís in operation. It currently encompasses a number of fields, and the registrar will be used for all health professions, Mr. Chair.
British Columbia has one registrar for each area, for each health profession. We cannot afford what the members opposite are suggesting: to set up another great big bureaucracy. We know the members opposite are great at it. The model that was being proposed was the B.C. model, and they went on ad infinitum about this B.C. model being the sun, the stars and the moon.
Well, we have to be down to earth in what we deal with in these pieces of legislation, and we are. We have to be realistic and cost effective.
Mr. Chair, seeing the time, I move we report progress.
Some Hon. Member: Mr. Chair ó
Chair:Mr. Fairclough, there is a motion on the floor. Is this pertaining to the motion? Itís not a debatable motion.
Pursuant to our Standing Orders 43(2), if such motion is rejected ó the motion in question being a motion that the Speaker do now resume the Chair ó it shall not be moved again until after some intermediate proceeding has taken place. As no such intermediate proceeding has taken place, we will continue on.
Hon. Mr. Jenkins: The issue before us is Bill No. 41. We dealt with the proposed amendment to the bill. That has been rejected. I understand there is not an appetite in the official opposition to move forward concerning clause 3.
Chair: The time being 6:00 p.m., we shall report progress.
Speaker resumes the Chair
Speaker: I will now call the House to order.
May the House have a report from the Chair of Committee of the Whole?
Mr. Rouble:Mr. Speaker, Committee of the Whole has considered Bill No. 41, Health Professions Act, and ordered me to report progress on it.
Speaker: Youíve heard the report from the Chair of Committee of the Whole. Are you agreed?
Some Hon. Members: Agreed.
Speaker: I declare the report carried.
The time being 6:00 p.m., the House now stands adjourned until 1:00 p.m. tomorrow.
The House adjourned at 6:01 p.m.
The following document was filed November 18, 2003:
Complaint process chart related to Bill No. 41, Health Professions Act (Duncan)