Laurie in Debate
Bill 41: Health Professions Statutes Amendment Act, 2007
Bill 41: Health Professions Statutes Amendment Act, 2007 debate in the 26th Legislature of Alberta, 3rd Session by Ms. Laurie Blakeman, MLA Edmonton-Centre
Alberta Hansard – December 04, 2007
Ms Blakeman: Thank you very much, Mr. Chairman. A bit of housekeeping to begin with. I would ask that the amendments be severed so they can be voted separately, but at the same time, I will also acknowledge that I have allowed a grouping together of various amendments. We can’t group them together unless we sever them, so the severing comes first. Then I have suggested that we vote on them in packages or groups, and those groups would be sections A, D, F, and G, which primarily cover the consultation powers or consultations sections that have been added in; a second vote for what I’ll call the ethics section, which the minister has just referred to, specific to sections B and E; and finally, a third vote, on C, which covers some of the powers.
Now, to anyone who follows along with this at home, some of those powers that have been granted to the minister are mixed into some of those other sections, but this was the best severing and regrouping that I could do to allow us to vote appropriately. Thank you for the chair’s co-operation in that severing and regrouping.
The minister is correct. The colleges are not happy. They feel that there are still a number of things that were not addressed that they continue to be concerned about. Just so that we have a sense of the scope of who’s being affected here, we are looking at the College of Combined Laboratory and X-ray Technologists, College of Alberta Dental Assistants, Alberta Dental Association and College, the College of Registered Dental Hygienists of Alberta, the College of Dieticians of Alberta, the College of Licensed Practical Nurses, Alberta College of Medical Diagnostic and Therapeutic Technologists, the College of Medical Laboratory Technologists, Association of Naturopathic Practitioners, and the Opticians Association. The College of Optometrists has now opted out of the rest of this group and said they’re okay with the bill. But I’ll continue with the list of others who are not: the College of Pharmacists . . .
Mr. Hancock: Who was that?
Ms Blakeman: The College of Optometrists. [interjection] Yeah. It’s a letter that was sent to you on December 3.
Continuing with a list of that grouping: The College of Physical Therapists of Alberta, the College of Physicians and Surgeons, the College of Alberta Psychologists, the College and Association of Registered Nurses of Alberta, also known as CARNA, the College of Registered Psychiatric Nurses of Alberta, the College of Social Workers, the College of Speech-Language Pathologists and Audiologists, and the College and Association of Chiropractors. So a significant body of our health professionals have joined together in their opposition to this bill. But I do acknowledge that the Alberta College of Optometrists did send a letter on the 3rd of December to the minister indicating that they were now willing to support Bill 41, given the amendments.
Some of the concerns that remain. They are pleased to see that the consultation has been included here, but their point is, as ours often is here in the opposition, that the devil is in the detail. Without seeing the regs that go along with this act, we don’t really have a good sense of how this act will in fact play. It’s very important that the regs are able to be debated openly, and in particular is the ability for the colleges to be able to present their position on a given desire of the ministry to make changes if we have a situation again like we had in Lloydminster, for example, which is what gave us – this is sort of the Lloydminster memorial bill. This is why we ended up with this bill: because of the situation that happened there last spring and everything that’s fallen out from it.
On the one hand, I agreed that the situation that was brought to light in Lloydminster needed to be addressed through legislation. What the government did in response is they addressed it and then went far beyond it. That is my issue with this bill and the issue of the organizations that I just read into the record. They feel very strongly that under this act they need to be able to present their position about why they made a certain choice, and they need to be involved and have the ability to appeal. They are truly offended by having the minister give himself or herself powers to come in and dictate things like bylaws or standards – I will note here that previously it also included a code of ethics, which has now been removed – and they really feel that that’s wrong. It does go into that watershed; it goes down that slippery slope; it steps over that crack. Whatever metaphor you want to use, it crosses that line about self-regulating professions.
We do have a set-up that we’ve worked with, in some cases for over a hundred years, with various professions in the province where we give them rights and privileges and also expect responsibilities from them. We delegate that to them and say: “You set this up yourself. You have a college. You have an association. You self-regulate. You set the standards, and you make sure that your members adhere to that. You go and do that.” We’ve delegated it to them. Now we have an act that comes in and goes: well, just a second; as the minister I’m going to be able to come in and change your bylaws of your college or change your standards or change your code of ethics. That is deeply offensive to these groups, and it is also marking a real change. It is a watershed in how we deal with self-regulated professions, which is why you’re also getting a slop over, a flooding over of concern that is starting to be brought forward by other self-regulated professions outside of the health professions. Now we’re starting to hear from lawyers who have concerns, accountants that have concerns, and other professions that are self-regulated going: boy, if that happened to health professions, it could happen to us next. So they all have a vested interest in this act.
The consultation is critical and is an improvement. I will indeed note that this was something that I had in an amendment in front of this House barely a week ago, I think. This was around the Lobbyists Act, Bill 1, and I was asking that the NGO sector be consulted about the regulations before they were implemented, and I was tut-tutted and oh, no, no’d by the minister. This wasn’t possible. Well, gee, what a difference a week makes. Maybe what a difference the health profession makes over the not-for-profit sector. I’m not sure if that’s a deciding factor, but here we are on a different bill, and now consultation written into legislation about consulting with a group before regulations are put out is before us in the House. I have enjoyed watching the minister eat a little crow. I’m not going to make him eat the whole thing, but that is worth noting.
The second issue is around that code of ethics section, which is regarded as deeply intrusive by the groups. They believe that the bylaws and standards section should also be removed, not just the ethics section. The Health Professions Act describes bylaws as internal, and they would argue that this should not be open for the minister to be able to interfere with.
There was also an issue raised with me about standards of practice, and in particular nurses were mentioned because their standards are very high. In fact, they are nationally set. So for a provincial minister to be coming in on a national set of standards is inappropriate – that is the argument – and should not be happening. That’s a perfect example of why we’ve crossed a line here in what the minister is contemplating in Bill 41.
One of the last issues that is being raised is around liability protection. This is a point that I’ve often made with this government, and it’s the reverse of it today. Usually I’m saying that if the government is going to delegate the responsibility for accomplishing a task, they must also delegate the authority to be able to accomplish it. That argument is usually around delegated administrative organizations and their ability to have proper funding or around municipalities and corresponding funding. But we have a different situation here, where we’ve got an administrator that’s appointed to be taking over. That’s in section (c), that I’m calling powers, extra powers, which in the original act appears on page 13.
If the administrator is appointed to take over, if they, then, have the authority to do something, they also, the colleges believe, must be held responsible. They must be liable for anything that goes wrong. Referenced for me was the Finney decision in Quebec about good-faith clauses. That decision in Quebec basically said that good-faith clauses aren’t holding up anymore. I think I agree. I think that there is an issue there, and those two things have to go together. This government is particularly bad about splitting them, but authority and responsibility do go together. If you’re going to delegate that responsibility, the authority to do it has to go along with it, and they’re liable, they’re responsible, and they’re account-able for it. I think that has to be part of it. What the group is demanding is that if an administrator is put in place over their heads, that administrator should also be liable for the consequences of the decisions they make, and that reflects directly upon the minister. Again, those were issues that were raised in my consultations with some of those colleges, particularly the College of Physicians and Surgeons. I will note that with the government majority I am expecting that these amendments will pass, Mr. Chairman, and in doing so, they will then rule amendments I was going to bring in out of order. I was going to bring forward amendments that would have in fact struck a number of the sections that the groups felt were most offensive to them, in particular the whole 135 section: 135.1, 135.2, 135.3, et cetera. I was going to go through and methodically bring forward amendments to strike those sections in their entirety. Once this government amendment passes, of course – with their majority I expect it to – that then rules my amendments out of order because the decision has been made by the Assembly, and I cannot then, in essence, challenge a decision made by the Assembly. The decision has been made, so I have lost my ability to bring in those amendments, and that’s just the luck of the draw in being the shadow minister, I’m afraid.
Those are the issues that I had wanted to raise as part of the debate in Committee of the Whole on Bill 41. Again, overall I think this bill started out with one small right idea, a correct idea, and morphed into some sort of health-profession-eating dragon that should not have been allowed to escape from its egg. It was hatched and birthed under Bill 41, and now we have to deal with this fire-breathing monster that’s put out there. Even given the amendments that the minister has been willing to bring in, it diminishes the amount of fire that is coming out of the mouth of that dragon, but it does not extinguish it. It’s still fire, and it’s still a dragon, and this bill is still a problem even with those amendments.
I’m certainly willing to support the amendment group around the establishment of consultation. I will certainly support taking ethics out, but the section that I’m pinpointing as a power section, which is emblematic more than anything – there are a number of sections that are mixed into the other ones that are also power giving – is where I think we all really have the trouble here with this act. The amendments did not address it sufficiently in that the minister gave that position very far-reaching powers to affect the way self-regulatory health professions go about their business and how the minister can come in on them because he deems it in the public interest. There are no criteria set out. The minister himself or herself is not held responsible or accountable. There are no report-back provisions in this. There are no accountability provisions for the very person who most needs to be held accountable with this change. So there will be long-lasting effects of this bill and not positive ones, I suspect.
I regret that the minister felt that he had to go this far. I think that merely settling the issue around the College of Physicians and Surgeons’ requirement to report to public health that something had gone wrong would have been sufficient. We didn’t need the rest of what happened with this bill, and that, I believe, is unfortunate. I have spoken to the groupings of the amendments here, and I will cede the floor to those others who wish to comment.
Thank you.
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