Subscribe to our Newsletter

Subscribe to our Newsletter

Bill 44 - Pharmacy and Drug Amendment Act, 2008

November 6, 2008 - Second Reading

Ms Blakeman: Thank you very much, Mr. Speaker. I have a huge number of questions about this bill. For those of us that are interested in personal health information, protection of personal information, the increasing insecurity of electronic databases, our inability to control human interference, human will to misbehave, frankly, and having personal health information in the hands of organizations, companies, who can use that information other than for the reason it was collected: what does that mean? Here we have a situation where the College of Pharmacists is supposed to be inspecting, investigating, and auditing pharmacists and clarifying the information to be collected by pharmacists and who this information can be shared with.

Now, I was lucky enough, although at the time I would not have said this, to have been on the review for the Health Information Act. I’m glad I was because I understand how it’s supposed to work and spent a lot of time looking at it clause by clause. I meant to grab that bill and bring it because I need it in this file. But I think the overall concern with what we’re anticipating here is what safeguards are in place and how we control that the information is used for only what it was gathered for and not for marketing purposes.

Let me say: is there anything wrong with marketing? No. The world runs on marketing. That’s the point in a lot of cases: to get consumers to help drive the economy by buying stuff. Well, how do you get people to buy stuff? You tell them that they need stuff so that they’ll go and buy it. I mean, that’s the whole point of advertising around Christmastime to children. They will go to their parents and say: “I must have this for Christmas. Please tell Santa to bring it.”

Marketing has become very sophisticated. I mean, right now we’re watching with some amusement a popular television show called Mad Men, which is centred around a group of advertising executives operating in the ’50s, if I can judge by it the costumes they’re wearing. That was sort of that big breakthrough in the way we advertise things, where you got into subliminal advertising and selling a lifestyle rather than selling an item. So there’s nothing wrong with marketing.

My concern is where people approach the health system with a great deal of trepidation and fear. We have a society where people don’t feel that they’re in control and have all the facts to make decisions about their health, so they are trusting the health professionals around them to give them guidance. It’s very difficult, even for well-educated, well-versed people, to figure out the difference between a health professional who is giving you health information because it’s good for your health and a health professional who’s giving you information because they’re interested in marketing something.

Now, when was the last time I said those words? When was that? Well, that would have been around the Health Protection Act from 2000 because that’s what that bill was all about. In the end, we were able to get the government to add in some protections to make sure that where a member of the medical profession, a doctor or physician specifically, was offering a medical procedure that was not, strictly speaking, medically necessary, they had to fess up and say that right up front. “Yes, you need eye surgery, sir, and here’s the lens that you need to have and that will be covered by health care. But, you know, sir, I can sell you an additional product that you don’t need, but you might like to chose to have it.” That clarification had to go in that act at the time.

My concern around what we’re contemplating here is: how far does the information sharing that is being set out in this act go? What are the safeguards that are in place and the clarity that’s in place for the pharmacists, to make sure that they’re well inside of the guidelines? Frankly, it’s no fun for pharmacists either, to have their customers looking at them going, “You’ve changed because now you can sell me stuff, and I’m not sure where that line is,” and start to question the rest of the information their pharmacist is giving them. Everybody wants clarity here, and I’m not sure that we’re getting it from this bill.

The Alberta College of Pharmacists has certainly done a lot of work over the last number of years. I must say that the pharmacists prescribing had everybody’s knickers in a twist, and with good reason to start off with. I think they ended up making their way through those troubled waters quite well because what we ended up with was very, very specially trained pharmacists in very, very singular circumstances that got the ability to actually prescribe. Ninety-nine per cent of all the rest of the pharmacists are really able to extend a prescription that you’ve already got or modify it to a slightly different dosage. There is good consultation set up between the pharmacist and your regular doctor, who gave the prescription in the first place.

I think it was six pharmacists that were actually granted the ability to prescribe in Alberta, and that was mostly around people working in very specialized clinics like the AIDS hospice and one of the inner-city clinics, I think, where there was a high number of people who were sort of self-medicating and trying to work their way through straightening out that drug cocktail they were in.

That’s the primary issue that I have around this bill. I think we want to be much more innovative in who is allowed to deliver what health service. We’ve already seen some of those changes. We’re going to finally have midwives allowed here in Alberta, which is real nice. They’ve been allowed everywhere else in the world for a long period of time, and we finally agreed…

Mr. Liepert: They’ve always been allowed. They just weren’t funded.

Ms Blakeman: No. Actually, they weren’t allowed. When I first started into this, they weren’t allowed. They weren’t a recognized profession, and you could be taken to court for doing it.

To me the issue that’s at hand here is the access to those databases of information. We’ve got pharmacists involved with electronic health records, and we wanted to do that. Certainly, I have constituents who want that information to be available when they turn up in the Banff hospital with some chest pains. They want access to their health records so that everybody knows what medication they’re on and what surgeries they’ve had and what all is going on. But I have a concern about how we make it clear to the pharmacists and the public what kind of personal health information can be used for what purpose so that everybody knows it and there won’t be any shenanigans.

Having said shenanigans, there will be those people who will decide to break the rules that we set out. How do we catch those people? How do we monitor, and how do we enforce on those individuals who choose to break the rules that we set out there? I have to say, Mr. Speaker, being a nonviolent soul, that enforcement must be swift and fierce – maybe I could throw in, possibly, medieval – in its certainty because as there is more and more medical information available about individuals, that information can have very far-reaching effects on our lives. As we get into genome therapy and start to understand the most intricate parts of how our bodies work and whether we are more susceptible genetically to cancer or to MS or to any number of things, we have gates that exist, access points that exist in our society as to whether you can get travel insurance based on your health, whether you get coverage under government, whether you can live in this particular place, a lot of other decisions based on that. We have to be very careful. To me this starts to move into a civil rights and human rights area very quickly. Frankly, I haven’t been too happy with the protections that I’ve seen exist so far. We have a good Health Information Act here in Alberta, but I’m watching, and as I keep tabs on this around what’s happening in the wider world about access to and protection of personal information in those databases, I’m not happy with it overall. We need to be very, very careful with what we’re anticipating here.

I wanted to set out those concerns now. I’ll be looking forward to reading more background on this bill and also listening to the sponsor, who is able to answer some of the questions that I’ve put on the record. If we’re operating completely under the Health Information Act, fair enough. I know what that gig is. But I have the other issues that I’ve put on the record around wilful disregard and how we would catch them.

I think there are also still problems about Internet pharmacies and ordering prescription drugs over the Internet, which is a whole other world that’s opening up to us now. I remember the joy when somebody e-mailed me that I could order my medication for my pet online, and I could have.

Mr. MacDonald: What kind of medication?

Ms Blakeman: I had a dog that needed anti-inflammatories. [interjections] Internet pharmacies and ordering drugs over the Internet: that’s the connection, Mr. Minister. I think that’s the other piece of this bill that I want to look into further.

Thank you for the opportunity to put some of those concerns on the record in second. I am kind of, sort of supporting it, but I’m reserving final judgment on that. I would like to move to adjourn debate. Thank you very much, Mr. Speaker.