OPTOMETRY ACT, 1991 / LOI DE 1991 SUR LES OPTOMÉTRISTES
L'ARTICLE 3, MODIFIÉ, EST ADOPTÉ.
L'ARTICLE 4, MODIFIÉ, EST ADOPTÉ.
CONTENTS
Tuesday 5 November 1991
Regulated Health Professions Act, 1991, and companion legislation / Loi de 1991 sur les professions de la santé réglementées et les projets de loi qui l'accompagnent
Optometry Act, 1991 / Loi de 1991 sur les optométristes
STANDING COMMITTEE ON SOCIAL DEVELOPMENT
Chair: Caplan, Elinor (Oriole L)
Vice-Chair: Cordiano, Joseph (Lawrence L)
Beer, Charles (York North L)
Haeck, Christel (St. Catharines-Brock NDP)
Hope, Randy R. (Chatham-Kent NDP)
Malkowski, Gary (York East NDP)
Martin, Tony (Sault Ste Marie NDP)
McLeod, Lyn (Fort William L)
Owens, Stephen (Scarborough Centre NDP)
Wessenger, Paul (Simcoe Centre NDP)
Wilson, Jim (Simcoe West PC)
Witmer, Elizabeth (Waterloo North PC)
Substitutions:
Callahan, Robert V. (Brampton South L) for Mr Beer
Conway, Sean G. (Renfrew North L) for Mrs McLeod
Ward, Brad (Brantford NDP) for Mr Malkowski
Clerk: Mellor, Lynn
Staff: Spakowski, Mark, Legislative Counsel
The committee met at 1534 in room 151.
REGULATED HEALTH PROFESSIONS ACT, 1991, AND COMPANION LEGISLATION / LOI DE 1991 SUR LES PROFESSIONS DE LA SANTÉ RÉGLEMENTÉES ET LES PROJETS DE LOI QUI L'ACCOMPAGNENT
Resuming consideration of Bill 43, the Regulated Health Professions Act, 1991, and its companion legislation, Bills 44-64.
Suite de l'étude du projet de loi 43, Loi sur les professions de la santé réglementées et les projets de loi, 44 à 64, qui l'accompagnent.
OPTOMETRY ACT, 1991 / LOI DE 1991 SUR LES OPTOMÉTRISTES
The Chair: The standing committee on social development is now in session. We are dealing today with Bill 60, An Act respecting the regulation of the the Profession of Optometry. We have a number of motions which have been circulated today. We have dealt with all parts of this bill, except for the ones that are on the agenda.
Section/article 3:
The Chair: We will begin with section 3. I see first Mr Wessenger and a motion by the government, as well as a motion to be placed by Mr Wilson.
Mr Wessenger: There is a problem. I have not even seen the mendment yet that is proposed by the Conservatives.
The Chair: The clerk is distributing it now.
Mr Wessenger moves that section 3 of the bill be struck out and the following substituted:
"3. The practice of optometry is the assessment of the eye and vision system and the diagnosis, treatment and prevention of,
"(a) disorders of refraction;
"(b) sensory and oculomotor disorders and dysfunctions of the eye and vision system; and
"(c) prescribed diseases."
Mr Wessenger: Before I speak to the amendment, I wonder if there is an existing amendment on section 3.
The Chair: Are you withdrawing the amendment you had placed before?
Mr Wessenger: Yes, I withdraw the one placed before.
The effect of this amendment is to add a new class of authorized practice for the practice of optometry, and that is "prescribed diseases." What that in effect means is that the College of Optometrists of Ontario would have the right to pass regulations pertaining to designating the diseases it could diagnose. Those regulations would then, in the normal course, be circulated among all the health professions. It would then go to the Health Professions Regulatory Advisory Council for approval. If approved, the advisory council would then submit it to the minister for approval in the normal course of regulatory procedure.
The Chair: Mr Wilson, I note you have an amendment which is quite similar. Do you want to amend the government's amendment, or are you placing a whole amendment of your own?
Mr J. Wilson: Yes, I would like to amend the government's amendment, particularly in view of what the parliamentary assistant has just said. My amendment would be that we add two words to the government's amendment in clause 3(c). Where the government's amendment reads "prescribed diseases," I would move that clause 3(c) be amended to read "diseases as prescribed in regulation."
The Chair: That is not just two words. What you will have to write out for us is that you are deleting "prescribed diseases" and inserting in its place under clause 3(c), "diseases as prescribed in regulation." Is that what you are moving?
Mr J. Wilson: Yes.
The Chair: Would you read that into the record and then your motion can be properly placed?
Mr J. Wilson: I move that clause 3(c) of the amendment be struck out and the following substituted:
"(c) diseases as prescribed in regulation."
The Chair: That would achieve your objective, I believe.
Mr J. Wilson: The purpose is to make sure that we are absolutely clear that the list of prescribed diseases will be set out in the regulations and dealt with by the advisory council. I see it as a very friendly amendment, and would hope that the government will support it.
The Chair: I notice there is another amendment to section 3.
Mr J. Wilson: I will be withdrawing our previous amendment.
The Chair: Mr Conway, how would you like to dispose of your amendment to section 3?
Mr Conway: It is Mr Beer's amendment, I believe. This is very confusing. I am just substituting here today. There are amendments being introduced and I am really in your hands. Our amendments have been postponed, I gather?
The Chair: That is correct.
Mr Conway: I am in the committee's hands.
The Chair: On behalf of Mr Beer, you can withdraw your amendment or you can allow the amendment to stand.
Mr Owens: Can we request a recess? We have just had this amendment dropped in front of us.
The Chair: We have had a request to recess for five minutes.
Mr Owens: I would suggest 10.
The Chair: We will recess and reconvene at 3:45 pm. Hopefully by that time you can decide how you are going to proceed on the amendment.
The committee recessed at 1540 pm.
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The Chair: The standing committee on social development is in session. For clarification as to process, we are going to deal with Mr Wilson's amendment to the amendment first; that is, the amendment to the government motion. I believe there was a minor clarification. Do you have it in front of you?
Mr J. Wilson: Yes.
The Chair: Mr Wilson moves that clause 3(c) of the amendment be struck out and the following substituted:
"(c) diseases as prescribed in the regulations."
That is the amendment to the government motion we are voting on now. Is there any discussion?
Mr Wessenger: I would like to oppose the amendment for the simple reason that this does not in any way change the effect from our resolution, which said "prescribed diseases." It makes no change in substance, so it is completely unnecessary to change this language, and also, the language proposed is inconsistent with the language contained elsewhere in the act. We should be consistent in our drafting. I have confidence in the drafting ability of our legal counsel and that they have used the right language. I take that as the proper way we should describe giving the college of optometrists the power to prescribe, by regulation, diseases.
Mr Owens: My question is to legislative counsel. The parliamentary assistant mentioned that it would be the college that would be doing the prescribing of diseases. Is that your interpretation of the language as it currently reads under the government amendment?
Mr Spakowski: The government amendment says "prescribed diseases." In my opinion, yes, "prescribed" there means "prescribed by regulations." The regulations referred to would be regulations made by the council of the college. "Prescribed" is defined in the code as prescribed by the regulations, and the regulation-making power is in the code to prescribe anything that is set out as prescribed.
Mr Owens: So the clause 3(c) currently being moved by Mr Wilson is redundant and serves no particular purpose -- politically maybe it does -- in terms of adding clarity to the language.
Mr Spakowski: I would say it has the same legal effect.
Mr Callahan: I think that is a nice way of phrasing it, but does it have the same practical effect? I would like to ask the parliamentary assistant: With simply putting the words "prescribed diseases" as finally proposed by the government, how does the mechanism start? What input do the professions being affected have to it to get it going? In the Conservative amendment they would have the opportunity to prepare a regulation and submit it to the cabinet regulations committee and would have some input into it. But without that, with just "prescribed diseases" they are left hanging out there. It may have the same legal effect. I certainly would not want to dispute legislative counsel's interpretation, but the practical effect is that they are just hanging out there, and it could be left there for ever. They would be in the position they are in right now without this attempted amendment to mollify the situation.
Mr Wessenger: In my opinion there is no problem. We have the general bill, Bill 43, which all the professions are under. Under Bill 43, of course, we have the advisory council, and the regulation in this case would be made by the college of optometrists. Like other regulations, it must be reviewed by the ministry, and it will be referred by the ministry to the advisory council. These processes ensure that the government has independent policy advice and that optometrists, members of other professions and the public have the opportunity to comment on what is put forward by the college. The regulation is passed by the college and it goes through the process.
Mr Callahan: I understand from speaking with people who are involved in this that the minister has indicated that the way it would be triggered would be that the Ontario Medical Association and the college of optometrists would get together and try to negotiate what the prescribed diseases were. As I understand it, this process has been going on for a considerable period of time and we do not yet see any agreement reached, so how in the world do you expect that simply putting it in that fashion is going to change it? If, as legislative counsel has said, the amendment that has been read in by Mr Wilson has the same legal effect, what is the difference? Why can we not pass that and get on with it and stop squabbling?
Mr Wessenger: First of all, Mr Callahan, there has been a misapprehension with respect to the process by the optometrists. It is not a legal requirement that the optometrists and the OMA sit down and agree on a list. There was a suggestion made to the minister by the representatives of the optometrists, as I understand it, that the minister could assist in the meeting between the optometrists and the OMA. The minister, I understand, agreed to assist in such a meeting, but that has no legal aspect at all. It is purely a meeting at the request, by the way, of the optometrists. It was their request, not the request of the ministry.
Mr Callahan: I do not sit on this committee often, but I was here when the minister made her opening statement. She said she was going to listen to the people who came before her and that she was flexible and wanted the fullest representations from them. If the two of them are exactly the same, according to legislative counsel, in terms of their legal effect, why is it that the government prefers the clause (c) you are presenting, "prescribed diseases," as opposed to the one Mr Wilson has introduced as an amendment?
Mr Wessenger: That is a very easy question. When it comes to the drafting of legal language, I prefer the advice of lawyers to that of optometrists.
Mr Callahan: Just a second. Legislative counsel has told us quite clearly, and you said, and I would reaffirm, that the wording suggested in the government motion in clause (c) and that suggested in Mr Wilson's motion have the same legal effect. Is that correct?
Mr Spakowski: Yes.
Mr Callahan: All right. You have it from legal staff advising the committee that that is the case. Now can you tell me why you prefer one to the other?
Mr Wessenger: I think that is very simple.
Mr Callahan: I am simple, so explain it to me.
Mr Wessenger: The language put in the amendment is inconsistent with the language used elsewhere in the act. We are advised by legal counsel, and I think it only makes sense, to have consistent language throughout the act related to the professions and to the main legislation.
Mr Callahan: Where is it inconsistent?
The Chair: Mr Wilson, you have the floor.
Mr J. Wilson: I really do not have anything to add. I think Mr Callahan has made some excellent arguments and I do not think they have been refuted rationally or properly by the parliamentary assistant. I ask members in their heart of hearts and mind of minds to assess what you have just heard and support this amendment.
Mr Conway: I feel like a late arrival to a Benedictine monastery where I am in the midst of an elaborate vespers that I do not profess to understand in any detail. I am essentially here because a growing number of my constituents are increasingly concerned and have been on my case about this part of this multifaceted bill. I have heard what the minister said and I have heard what the parliamentary assistant said, and I am sure they offer it in good faith. My concern continues to be that the people for whom this is planned, to whom it is directed, have a much higher level of discomfort than apparently a lot of other providers do. I gather as well that there has been a not inconsiderable border clash between the government and the optometrists, about which border clash I pass no judgement. There is clearly some difficulty here.
I join Mr Callahan in making the observation that if people who are going to be affected are not comfortable and we are not going to redo this legislation for at least another generation or a half generation, then why would we not opt for the amendment that has been put by the member for Simcoe West, which appears to be more or less the same thing in terms of what legal counsel has analysed, but more important, gives some greater degree of comfort to a whole group of providers?
As I say, I am here just as the local member for Renfrew North. People in Deep River, Eganville and Pembroke have been phoning me, writing me and visiting me in the last few weeks to a quite considerable extent. They are really unhappy about what they think is going to happen. It is a long way to Ottawa to the neighbourhood ophthalmologist. A 72-year-old woman drove in the other day to tell me her tale and she asked me to come here and speak her piece and concern.
This is like a game of water polo. There is a lot more going on underneath the water line and I was not around for all that elaborate activity underneath the water line.
I think Mr Callahan has made a very good point. There is not a great deal of difference in the language in terms of its effect. If we are trying to assist the community in setting aside whatever tensions have existed between this government, perhaps even a previous government and the optometrists, who I gather played this game rather more creatively than some others, why would we not accept an amendment that provides a greater degree of comfort to those providers, since it is clear that a very substantial number of people in that profession feel very strongly that the government's plan, however well intentioned, is in their minds a restriction on what they have been doing for lo these many years?
I reviewed the testimony of the delegation to this committee back in August of this year when those representatives from the college of optometrists were here talking about the capabilities of the men and women they are graduating from that school in Waterloo. As I say, there is a very high degree of concern and anxiety in the profession in my part of the province. It seems to me that if what we are being told is that there is not technically a great deal of difference, why would we not accept Mr Wilson's amendment, which appears to provide, to the profession at least, a higher degree of comfort? They do believe that what this bill will do in practical effect is limit what good works they do for people, in rural communities like mine particularly.
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Mr Owens: With respect to some of the comments Mr Conway has made, first of all, since the delegation appeared in August there have been some changes to the act, understanding that there were some levels of discomfort with respect to the definitions of certain words. The government side on the committee heard their concerns and brought forward changes to that. This is now the third generation of amendments. In terms of your comments around events happening below the water line, then you are correct. As I say, we are now into the third generation of amendments.
I think the operative point you make in your statement is that the optometrists are perhaps thinking what might happen in their own minds if we do not change the legislation to something that better fits their perceptions of what reality should be. I feel quite comfortable with the amendment the government has put forward with respect to prescribed diseases. I think legislative counsel has quite accurately pointed out that it will be the college of optometrists that will be in the business of prescribing which diseases optometrists will be in a position to diagnose.
In terms of some of the comments Mr Callahan made about people being left hanging or whatever the phrases were, the issue is covered quite nicely in the sense that the college is made up of optometrists as well as lay people who will address the concerns of the consumers as well as the professions, so there is going to be that kind of input. It is not going to be just simply an order in council that is passed by the government in terms of which diseases will be prescribed.
In terms of the border clash Mr Conway alludes to, I think the government has been more of a referee rather than an active participant between two parties and has been trying to do the best thing for all parties concerned. The bottom line is to do the best thing for the consumers of the product to ensure the access that you describe your constituent is concerned about, and also to add that measure of protection that we have heard from time to time has been lacking in some of the professions.
Mr Conway: Can I just respond to one point? I may need some guidance in this.
The Chair: Mrs Witmer is next, but I will put you on the list, Mr Conway.
Mrs Witmer: I would agree with Mr Conway that there is a high degree of concern and anxiety about the amendments that are being discussed today. I live in a riding that has the only school of optometry in Ontario. I have been lobbied by the staff, the students and also by the optometrists in my own community. They are quite concerned with the legislation that is before us today. I believe it is extremely important that we consider their very legitimate concerns and provide the amendment they have recommended to us in order that they can feel comfortable.
They are the people who provide the service and I would agree that this amendment would certainly reinforce the purpose of self-regulation. I would hope the government would see fit to support this very friendly amendment.
Mr Conway: I just want to pick up on a point that the two previous speakers have made. The way I read these two propositions is that "diseases as prescribed in the regulations" would trigger a certain kind of procedural activity, whereas "prescribed diseases" refers that to a different kind of mechanism under this health disciplines legislation. If I am wrong in that, then I would be quite happy to be corrected.
Mr Wessenger: Since Mr Conway has asked the question, seeing he does not feel my explanation is clear enough, I will ask counsel to explain the procedure.
Ms Bohnen: "Prescribed" in "prescribed diseases" means exactly the same thing as "as prescribed in the regulations," and the mechanism for proposal and disposition of the regulations is identical. The council of the college of optometrists, after consultation with its members no doubt, will propose regulations listing the diseases. That regulation will come to the Ministry of Health, where it will be considered. It will be referred to the advisory council. Ultimately it will come back to the government for approval. There is no difference. The reason, I believe, that the government prefers the wording "prescribed diseases" is for consistency with how authority has been set out elsewhere in the act.
Mr Conway: I understand that, but I am not so sure you have not made the case again for Mr Wilson's amendment. As one of the members from the government said, you play the role of referee. In a sense that is what we do here. I am hearing one of the parties tell me that they do not view the language with the same degree of equanimity; quite the contrary. If they mean more or less the same thing -- I do not know how many hundreds or thousands of optometrists we have; hundreds, I am sure, not thousands --
Ms Bohnen: Eight hundred.
Mr Callahan: Eight hundred and sixty-five, or something like that.
Mr Conway: Why would we not use language with which they feel more comfortable?
Mr Callahan: I would like to go back to that very point. I am from Missouri; you have to prove it to me. You have told me, parliamentary assistant, that the reason the wording of the government motion is preferred over that of Mr Wilson's motion is that it fits in better with the wording of the act. Perhaps you can be good enough to show me where that is the case so I can make my own determination.
While you are doing that, I would like to address similar things that Mrs Witmer and Mr Conway have addressed. This is the section that perhaps will put this to bed. It is most important. I am new on this committee, but reviewing the Hansards from the past, it becomes quite apparent that if you are taking away something they have had since, I think, 1911, if you are in fact reducing accessibility for these people, you are affecting each and every one of your constituents, particularly in places like Sault Ste Marie and areas in the outlying districts where you will not have access to an ophthalmologist. You may have to travel considerable distances. We have all seen this in terms of delivery of health care to the people in the north. It had to be funded by the government to provide transportation to get people to those areas where they could get treatment.
You have heard it all, or those of you who have been around have heard it all, that you are denying access for your own constituents. Lo and behold, if this bill, when it is finally put to bed with all the appropriate amendments, does in fact do that you can be sure you are going to hear from your constituents.
I might add as well that I do not think it takes a rocket scientist. All you have to do is make an appointment with your local ophthalmologist to have your eyes examined and it can take up to six months. In some areas it is because they are very busy people. There are limited numbers. It also has something to do perhaps with the cap placed on them. I would not suggest that, but I imagine that may have some thrust in some areas.
You have to understand that, and if legislative counsel -- and I do not want to attribute to him what you did, Mr Owens, that he said that would be as good as the other. My reading of it was that the two definitions are identical, that they have the same legal meaning. If that is the case, why are we sitting here splitting hairs? Let's get on with it. Let's make certain our constituents all over this fine province, natives -- they are going to have a real problem. The government has indicated it has a great concern about the native population, and well it should. But if there is not something done to provide the services that can be done by optometrists to the people in the native communities, they are going to have to travel to an ophthalmologist, or they are going to have to do without that service.
They are going to get secondary health care, or it is going to be a question where the government, again, is going to have to provide transportation for these people and that can be difficult even if the funds are made available by your government, which I suggest would be very difficult during this time of recession. But let's talk about the weather of Ontario, where a person cannot be taken a long distance to have that matter dealt with.
I suggest we had best get on with it. Let's stop splitting hairs. If they are the same legal component, the government's and Mr Wilson's amendment, be magnanimous. Recognize that this is an important issue to your constituents and all of our constituents. It is not a partisan issue; it is a matter of getting this very fine piece of legislation finalized, and we can do it in such a way that we hurt the fewest number of people and aid the most people. I urge the government members not to be straitjacketed by terminology when legislative counsel, who is paid an extraordinary fee to advise us in this regard --
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The Chair: I think legislative counsel is about ready to object.
Mr Callahan: -- has told us there is absolutely no difference. That is why I say I am from Missouri, because I cannot believe the government would hold up this very important piece of legislation if they are, as legislative counsel said, identical in their legal meaning, unless there was some other purpose, and I want to know what that purpose is.
The Chair: I believe you almost provoked legislative counsel to take issue with the notion of exorbitant fees, Mr Callahan.
Mr Martin: I am not from Missouri; I am from Sault Ste Marie. I have been sitting in on these discussions since the beginning of this round and listened to all the folks who came forward and presented. We heard the same speech you just gave from the optometrists in August. We are very aware of all the things you have raised. We have raised them ourselves here and in other settings concerning access to service and all those kinds of things.
The present activity we are involved in is trying to find a place where we can all to some degree be comfortable, and I think we have. Indeed, when you talk about splitting hairs here, and that seems to be the issue at the moment, it seems to me the government brought forth an amendment that answered all the questions you raised a few minutes ago. The Conservative caucus has brought today to the table an amendment that begins the splitting-hair process. If "prescribed diseases" is consistent with what is in the bill already, why do we not just do that and get on with it if it means the same thing?
I would also like to suggest -- or present, because I guess I feel like it -- to you that all of this legislation is under debate by various professionals as we in Ontario try to sort out who can do what for whom, and it has been described by the minister in starting out this session as "living legislation." It is legislation that will be established today and changed in time to reflect reality and the delivery of health as it evolves in our province.
What we have here particularly, it seems to me, is a difference of opinion between two professional groups, and what we are doing here today is setting up an opportunity for those groups to come to terms ultimately with who does what. I am more than happy to put this issue to bed.
This government is not in any way getting in the way of this legislation moving forward. As a matter of fact we have been magnanimous, if that is the word the people are using, in bringing amendments to the bill and agreeing with amendments made by the Liberal Party. In this instance, I think it makes more sense to be consistent with what we have already done than to introduce a new twist that means the same thing and is causing us to spend a whole lot of time this afternoon.
Mr Owens: With respect to the comments made by Mr Callahan, I am going to first of all take gentle exception with respect to native health care. This committee, this minister, the parliamentary assistant and all the folks who have been involved in the negotiation of this act and many other issues around this very important issue have dealt with this group with care, sensitivity and respect for their cultural needs.
If you had tuned in to the hearings yesterday, you would have noted that we passed an aboriginal midwifery section to the Midwifery Act which addresses the issue of aboriginal concerns. So I take exception to the comments with respect to natives. Coming from Scarborough, but having the same sense of scepticism a person coming from Missouri may have, you have made the -- maybe allegation is too strong a word and if the chairperson thinks I should withdraw it, I will. However, you have said that --
The Chair: I have often cautioned members about the language they use, and if you feel that word may be provocative, you might choose another word.
Mr Owens: You have said that this bill, if passed as the government has proposed, will take away and reduce services to the communities. We have heard that, and when we have questioned how -- even now in its third generation we come down to the "prescribed diseases" and "diseases prescribed in the regulations," I am asking, in a rhetorical sense of course, how the phrasing of "prescribed diseases" will reduce services to people in Ontario, your constituents and my constituents. The services will continue as they are now.
The issue of underserviced areas within Ontario is a very serious issue and we understand that. It was a serious issue under your government and it was a serious issue under the government of the third party. We intend to take steps to address that issue. But launching into conversations that using the words "prescribed" and "regulations" will somehow address that issue is not appropriate. I hear what you are saying around let's move this on, and if you agree with the opinion of legislative counsel that there is no difference, then I suggest we move on and get this act passed.
Mr Callahan: First of all, I did not think I offended the native community. In fact, I was pleading their cause.
The Chair: Mr Callahan --
Mr Callahan: All right. I am not going to get into that, but I did want to find out something from the member for Sault Ste Marie. He said something very interesting: "This is a competition between two groups." I get the feeling that maybe he has more information than I do. But more important, I would like to know whether the trigger mechanism for setting up the prescribed diseases is identical under both wordings, and if that is the case then I await from counsel the reason, the rationale, the section by section, as to why the wording of the government's amendment is preferable for consistency purposes than that of Mr Wilson. I await that.
Mr Wessenger: I will have counsel enlighten you, Mr Callahan.
Ms Bohnen: I would like to begin by explaining to you why it is that we say "prescribed diseases" means diseases prescribed in regulations made by the College of Optometrists of Ontario. The word "prescribed" is defined in section 1 of the health professions procedural code to mean "prescribed in the regulations." "Regulations" is defined in subsection 2(2) of the Optometry Act to mean "the regulations under this act," the Optometry Act. Therefore, "prescribed" means diseases prescribed in the regulations under the Optometry Act. The process is, as you said, that the council of the college of optometrists initiates the process for these regulations.
Mr Callahan: Yes, but again, you indicated the government's wording is preferable to that of Mr Wilson because it is more consistent with the wording of Bill 60, and that is what I am asking you, to show me where it is inconsistent.
Ms Bohnen: Okay. The legislative package is dotted with references to things that will be done in the regulations and I tried, as I have been sitting here listening, to pick out a few of them. One example is an amended section to the Medicine Act dealing with the composition of the council of the College of Physicians and Surgeons. It is done in like manner throughout the other acts, and it says, "One person for each faculty of a university in Ontario selected in the prescribed manner." "Prescribed" means in the manner prescribed in the regulations. So we have tried to be consistent throughout all the bills, when we need to refer to something that will be prescribed in the regulations, to say "prescribed."
Mr Callahan: I am sorry. I am still at a loss to understand why the words "prescribed diseases" -- I am a firm believer that you are going to make the legal profession rich and somebody is going to have to finally litigate, perhaps, the question of prescribed diseases. It is better to put it in there and be clear and say "diseases as prescribed in the regulations," then we all know what we are talking about.
The Chair: Are we ready for the vote on the amendment to the amendment? All those in favour of Mr Wilson's amendment to the amendment? Those opposed?
Motion negatived.
Mr Conway: What we will want to do, then, just for the sake of technical clarity, is that the Liberal amendments that were put by my colleague from York East, that deferred amendment on section 3, I would like to move that --
The Chair: I believe you have requested the clerk to frame that as an amendment to the amendment.
Mr Conway: That is correct.
The Chair: Would you like to take a five-minute recess so that can be framed?
Mr Conway: I think we are going to have to do it. Am I correct? Is that the way that would be done?
The Chair: You would withdraw this one and place your new amendment as an amendment to the government's motion.
Mr Conway: To the new government motion, yes.
Mr Hope: What are you amending?
Mr Conway: It is just that my colleague put a couple of motions down. The new government motion --
The Chair: Perhaps I can be helpful. Because the government's amendments, Mr Hope, were just received today, the amendments that had been proposed by Mr Beer and also by Mr Wilson before him, which were framed to fit with the government's amendments, now require some changes in light of the government's new amendments that have been tabled today. We have had requests from both Mr Wilson and Mr Conway to allow some time for reframing their amendments to the government's new motions. That is what has been requested. I think if we take five minutes, that can be resolved amicably.
Mr Hope: Whatever you think.
The Chair: The committee is in recess for five minutes.
The committee recessed at 1623.
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The Chair: We are dealing with section 3 of Bill 60.
Mr Conway moves that the amendment be amended by striking all the words after "prevention of" and substituting the following:
"(a) diseases and disorders of the eye; and,
"(b) sensory and oculomotor disorders and dysfunctions of the eye and vision system."
Mr Conway: I would simply like to reiterate some of what I have said earlier. My colleague Mr Beer had put this amendment earlier. It was set aside pending ongoing discussions. The argument I make in support of this is that there are a surprising number of optometrists with whom I have discussed this matter in recent weeks, albeit largely in my part of rural eastern Ontario, who, while they appreciate what the government is saying, feel that the government's intentions are not somehow going to be lived out in quite the way they are offered, and that this in fact is a restriction. It is a restriction that is going to compromise the self-regulatory aspect of their profession in a way that will provide a real difficulty to people living in rural Renfrew county who have, I think, only one ophthalmologist at their service and several optometrists who provide a front-line kind of care in all kinds of rural communities, some of which I have mentioned earlier. In my discussions with them, they felt that their interest and the public interest would be best served by the language that is before you in this amendment.
Mr Callahan: I would like to support the motion, and I presume the reason (c) has disappeared is that it is encompassed in (a), just for clarification purposes.
I want to go back to something that struck my eye when I was reading the Hansards. It was the question of the representative you had appear before you from Shibley, Righton in terms of having clear definitive terms of reference of what the optometrist could do and could not do. It was essential for a number of reasons. First of all, for disciplinary proceedings the parameters should be very clear. The secondary function was for legal liability, albeit, as I read the Hansards, there has not been an optometrist who has been called on the civil carpet over its lengthy years as a profession.
That was the thing that really attracted me, because in a very real sense this legislation, the entirety of it, was commenced with a view to being consumer legislation which was to define the product the public could expect to receive, and at the same time ensure the product was being provided in a sensitive and professional way. If that is the case, and I believe that to be the case, then it is absolutely essential that the governing body has the clarity of definition to be able to determine whether or not an individual practising in this field is doing it in such a way that he deserves not to be sanctioned, and in addition to that, that it be available to the public, that they can prove in a very definite way that this person has exceeded or gone beyond the bounds of his capability.
Of course leaving it the way it is proposed by the government, changing the parameters as suggested by the optometrists, really places those two issues in some lack of clarity. To go back to what I said before, if the purpose of this legislation was consumer-oriented, to try to define more clearly the parameters, then it has to be done in a much more significant way. I suggest that the motion that has been moved by my colleague from Renfrew North on behalf of Mr Beer goes a long way towards doing that. Again, not wanting to deprive any of my colleagues in the profession I belong to from being able to eke out a livelihood in terms of interpreting these things, I advance it notwithstanding.
The Chair: Is "eke out a livelihood" the opposite of exorbitant fees?
Mr Callahan: I said "eke out a livelihood" just like the Attorney General up there. He used to eke out a livelihood too.
The Chair: Sorry about that, Mr Callahan. I could not resist.
Mr Callahan: You say this is living legislation and that changes can be made. For heaven's sake, let's do it now at a time when we can benefit all those people out there in Ontario who are going to be denied accessibility to the person on whom you are granting a bequest of the full service of being able to have these people come to him for anything other than the fitting of lenses. I suggest these two sections here go a long way towards creating clarity, and the law should always be clear. I know the government members probably received some instruction on this and you do not want to interfere with that advice, nor would I try to persuade you to, but in the interest of all your constituents who are obviously watching this and who somewhere down the line -- maybe not tomorrow, maybe not the next day, but next year, when seniors find they cannot get service promptly, when native populations find they cannot get service promptly, when a whole host of people throughout the province find they cannot get service promptly, they are going to be knocking on your door. If that happens in four years, you are safe, but if it happens before that, you are going to have grave difficulty, because you are going to have to answer those problems. I urge you to support this amendment to the amendment.
Mr Wessenger: I would like to speak against the amendment, because what the amendment does is allow optometrists to diagnose all diseases and disorders of the eye. In fact, optometrists do not diagnose all diseases and disorders of the eye. They will admit that. In effect they do admit it by accepting the "disorders of refraction."
If we look at what they were willing to accept, they were willing to accept basically the government amendment. We had a slight disagreement with respect to the matter of "prescribed diseases" or "diseases as set out in the regulations." However, that was just a misunderstanding on their part with respect to the meaning of the language and I understand they have now accepted that.
This would leave it wide open, and in fact optometrists do not do that and the intent of this legislation is to give to optometrists what they actually do.
As far as the whole question of clarity goes, the term "disorders of refraction" is a term that is set out to describe eye disorders by the World Health Organization in the Manual of International Statistic Classification of Diseases, Injuries and Causes of Death. Under "disorders of refraction" they list certain types of disorders; that is, hypermetropia, myopia, astigmatism, anisometropia and aniseikonia, presbyopia and disorders of accommodation. I understand this is basically one of the disorders that optometrists identify from their examinations.
I might add that the government amendment recognizes optometrists as diagnosing considerably more than was recognized by the Health Professions Legislation Review. If we look at the description of the practice of optometry contained in legislation in other provinces, the scope of practice described here is basically broader than that in other provinces, which do not give the wide-open power of diagnosis to the optometrists.
In addition to diagnosing specified diseases, disorders and dysfunctions, which they will be doing, optometrists are recognized as assessing the whole eye and vision system. Therefore, limitations on what they may diagnose in no way prevents them from recognizing or detecting the signs of other conditions, monitoring their patients and making referrals when necessary.
I would like to refer to a couple of instances that have been raised as of some concern by the optometrists. In submissions to the committee, the association said it would be prevented from diagnosis of cataract, monitoring its development, providing for changes in the patient's visual needs, counselling and referring patients when necessary. Not so. Optometrists may lawfully continue to assess eyes, detect symptoms of cataract, monitor the patient and make referrals when necessary.
Also, with respect to the whole question of glaucoma testing, under the legislation the optometrists will continue to be able to do glaucoma testing, to communicate the results of those tests to the patient and, where the tests show the glaucoma situation, to refer them to ophthalmologists, which they presently do.
Mr J. Wilson: Just very briefly, because I have to go in the House -- I am the next speaker up, I believe, after Mrs Sullivan.
Mr Owens: Trashing medicare.
Mr J. Wilson: It is a very important bill.
We will be supporting the Liberal amendment for the simple reason that, since our amendment has just been defeated, we think this is the second-best option. The word "refraction" is something that very much disturbs us in the government's amendment in the final analysis, and something we have heard from optometrists disturbs them also. So we will be supporting the Liberal amendment. I think it is the second-best option, given that ours has already been defeated, and I congratulate the Liberal members for coming forward with it and putting forward what I think to date has been a very good argument in support of the amendment.
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Mr Callahan: I want to clear something up the parliamentary assistant said. He said that optometrists will now, if they see something in the eye -- which is the window of your soul, by the way, if you did not know that -- be able to refer it to an ophthalmologist. It is my understanding from reading through the Hansards that if they see something, they cannot tell the person he has it. They can simply refer them to an ophthalmologist, at the expense of OHIP, at a time, or prematurely perhaps, in the case of cataracts, where before they could have watched it, kept an eye on it -- I am not attempting to be funny there -- and then at the appropriate time referred it to the medical profession, the ophthalmologist, for treatment.
I thought I heard you say they could deal with all these things you listed. I am not going to attempt to even put my mouth around them because they are as bad as some legal phrases, but that is not until the prescribed diseases are triggered by whatever the mechanism is that triggers them. Between now and the time they are triggered, in fact what the optometrists have to do is look into a person's eye and say: "There's something wrong there, but I can't tell you because that's outside the scope of my authority under this act presented by the government. I'll refer you to ophthalmologist A. You can get an appointment with him six months from now and he can tell you. If I'm wrong, then come back and we'll continue the procedure."
If I am wrong in that regard, please tell me, because if prescribed diseases have already been catalogued in some government regulation, I would like to know what it is. I think the optometrists would like to know that too.
Mr Wessenger: The diseases I listed are described as "disorders of refraction," and those types of diseases will not have to be mentioned as "prescribed diseases" because they are already covered under the definition "disorders of refraction," so it will be completely unnecessary for those to be set out under "prescribed diseases." It would only be diseases or disorders that do not fall under the category "disorders of refraction" that would have to be set out under "prescribed diseases." So "prescribed diseases" is an addition, not an inclusive situation. It is in addition to what is set out in "disorders of refraction," as well as an addition to what was set out in clause (b) as well, "sensory and oculomotor disorders and dysfunctions of the eye and vision system."
Mr Callahan: Where is that prescribed? Where is that set out in law?
Mr Wessenger: It is set out in section 3, "The practice of optometry is the assessment of the eye and vision system and the diagnosis, treatment and" --
Mr Callahan: I can read that, but where are those listed?
Mr Wessenger: Those are listed under the list of diseases by the World Health Organization.
Mr Callahan: What has that got to do with the legislation in Ontario?
Mr Wessenger: It is recognized by the World Health Organization as being a disorder of refraction. I am sure the court would accept what the World Health Organization defines as a disorder of refraction.
The Chair: Perhaps I could be a little helpful. What the parliamentary assistant has pointed out is that in the government's amendment under clause (a), "disorders of refraction" means -- he has listed what that actually means. As I understand it, that is accepted practice, because it is a definition from the World Health Organization. Is that correct, Mr Wessenger?
Mr Wessenger: That is correct. Thank you, Madam Chair.
Mr Callahan: So these people can use this Hansard some day if they are prosecuted for that and say, "That's what we were told by the parliamentary assistant, that the World Health Organization's definition should be used." I would find that little comfort, but thank you.
The Chair: We are ready for the vote.
Mr Conway: A recorded vote.
The committee divided on Mr Conway's motion, which was negatived on the following vote:
Ayes -- 3
Callahan, Conway, Witmer.
Nays -- 6
Haeck, Hope, Martin, Owens, Ward, Wessenger.
The Chair: We now move to Mr Wessenger's amendment. This is the government amendment, the main amendment as moved by Mr Wessenger. Are we ready for the vote?
Mr Conway: I would like to make a comment on that very briefly. I cannot see myself supporting this, simply because while I recognize that the government has moved, I continue to be troubled by the fact that the people who are expected to deliver this service that it is almost a wilful restriction of what they have been doing. As a referee, that gives me a great deal of discomfort. While I appreciate what the government has done, I do not think it is clear enough and I do not think it is satisfying enough and I --
Mr Callahan: I also share your concern.
Mr Conway: My colleague the member for Brampton South tells me he shares my concern as well. It is for that reason I cannot support the main motion which will be put presently.
Mr Wessenger: If I might put it on the record, I have something here that is written from the optometrists. It says, "In response to the government's proposed amendment of November 4, 1991, the Ontario Association of Optometrists, representing the profession of optometry, proposes the following amendments to the government amendments." It says:
"Scope of practice and authorized acts: Scope of practice:
"3. The practice of optometry is the assessment of the eye and vision system and the diagnosis, treatment and prevention of,
"(a) disorders of refraction;
"(b) sensory and oculomotor disorders and dysfunctions of the eye and vision system; and
"(c) diseases as prescribed in the regulations."
This is exactly the same as the government motion except for using "prescribed diseases," which means the same thing as "diseases as prescribed in the regulations." This is what has been requested by the OAO. That is all I would like to put on the record.
Mr Conway: I would just respond to that by saying I think that is disingenuous.
The Chair: I will put you on the list, Mr Conway. Mr Martin.
Mr Martin: I have heard the member for Renfrew North today speak very seriously and sincerely about his concern re his constituents and the folks who came to his office. I heard Mr Callahan as well speak rather eloquently about his concern re the delivery of service. I assure you that having sat on this committee from the beginning of this go-round, I also -- actually all of us on this side -- have listened to a lot of our constituents and we have listened to the optometrists as they have come. We listened to them seriously and many times over the last number of weeks, and particularly in the last week or two.
We have indeed had instruction -- instruction from them, instruction from legal counsel that is made available to us, instruction from each other as we have discussed this -- and we tried to come up with something that would reflect a genuine concern by us about those very things you across the room spoke of so eloquently today. In my heart of hearts, I think we have come up with what at this point in time we think is the best amendment. As I said before, this is not perfect. None of this legislation is what you would call perfect, but it is a good beginning. It is living legislation and it will evolve.
The delivery of health care in this province at this point in time is certainly not perfect, but I think in time, with the kind of discussion we have had here at this table and the discussion that will go on across the province, we will arrive at a place where it will be a little more perfect than it is today. I support the amendment today re this act, and support it having had instruction by many people around it. I know that at this point in time it is the best thing we can do.
Mr Owens: I think the OAO has spoken quite eloquently to my point with respect to the kinds of amendments it would like to see in this piece of legislation. I agree with the point Mr Martin has made, that we have listened quite closely and quite considerably to a number of deputations, whether it has been on the committee or in our constituency offices or in the hallways of the House. It is not without some difficulty that we have come to this resolution, but it has been done in partnership with the optometrists and their associations.
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There have been comments around when prosecution of optometrists for doing as they have done for many years will take place. I am not sure who is going to launch those prosecutions and why optometrists feel they are going to be prosecuted for doing the good work, the excellent work they have done for many generations. There is no dispute that this legislation does not prohibit that fine work from continuing.
Mr Callahan: Finally, it is my understanding -- I may be incorrect -- that there has been a more recent release than that which is being read by the parliamentary assistant, or a more recent feeling than what has been read by the parliamentary assistant, and our rules, because of this being clause-by-clause, do not allow those people to come forward and perhaps correct that record. To the member for Sault Ste Marie, I hope you are right. I somehow have doubts, but I hope you are right. If you are not, I am sure the people of this province will be back to tell us that you were not right and that in fact they are being denied access to services that heretofore, since 1911 or whenever, 1919, they had been receiving.
The committee divided on Mr Wessenger's motion, which was agreed to on the following vote:
Ayes -- 6
Haeck, Hope, Martin, Owens, Ward, Wessenger.
Nays -- 3
Callahan, Conway, Witmer.
Section/article 4:
The Chair: We are now on section 4. We have a government motion first. We have an amendment by Mr Wilson. Are you going to be moving it, Mrs Witmer?
Mrs Witmer: I will be.
The Chair: There is a further amendment by Mr Conway. The clerk has advised me that the order of procedure is that Mr Wessenger's motion should be placed first, Mr Conway's would be an amendment to the government's motion, then Mrs Witmer or Mr Wilson's motion would go next.
Mr Wessenger moves that paragraph 1 of section 4 of the bill be struck out and the following substituted:
"1. Communicating a diagnosis identifying, as the cause of a person's symptoms, a disorder of refraction, a sensory or oculomotor disorder of the eye or vision system or a prescribed disease."
He further moves that section 4 of the bill be amended by adding the following paragraph:
"1.1. Applying or ordering the application of a prescribed form of energy."
Mr Conway's amendment is next.
Mr Conway moves that the government motion amending section 4 of the bill be amended by striking out paragraph 1 set out in the motion and substituting the following:
"1. Communicating a diagnosis identifying, as the cause of a person's symptoms, a disease or disorder of the eye or a sensory or oculomotor disorder of the eye or vision system."
You have withdrawn on behalf of Mr Beer's previous motion. We are speaking first to Mr Conway's amendment to the amendment. All those in favour of Mr Conway's amendment to the amendment? Those opposed?
Motion negatived.
The Chair: Mrs Witmer moves that section 4 of the bill be struck out and the following substituted:
"4. In the course of engaging in the practice of optometry, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to perform the following:
"1. Communicating a diagnosis identifying, as the cause of a person's symptoms, a disorder of refraction or a sensory or oculomotor disorder of the eye or vision system or a disease as prescribed in the regulations.
"2. Prescribing or dispensing, for vision or eye problems, subnormal vision devices, contact lenses or eye glasses.
"3. Performing a procedure in the surface of the cornea.
"4. Applying a prescribed form of energy.
"5. Allergy challenge testing of a kind in which a positive result of the test is a significant allergic response."
Mr Wessenger: I would like to speak against certain provisions of the amendment. First, in paragraph 1, it is the same language as our provisions except it refers to "prescribed by the College of Optometry of Ontario." It is unnecessary to have that language in. It is inconsistent and also it is incorrect, as it is the College of Optometrists of Ontario rather than the College of Optometry of Ontario.
Second, with respect to paragraph 3, we would oppose that because that would authorize optometrists to perform surgery on the eye, and they certainly are not qualified to do that.
With respect to paragraph 4, I have no particular objection to it. If they want to change their amendment to do that, we could certainly accept paragraph 4.
On paragraph 5, again we are in opposition to that because the optometrists are not involved in allergy testing, but they are involved in the care of contact lens patients. They deal with the question of products which may induce allergic responses, but they do not do allergy testing.
Mrs Witmer: I would like to respond to Mr Wessenger and also make a correction. In my amendment I did not say "as prescribed by the College of Optometry of Ontario." I said "as prescribed in the regulations."
Mr Wessenger: Oh, you changed that part.
Mrs Witmer: That was changed, Mr Wessenger.
Mr Wessenger: Okay. The draft I had -- I am sorry.
Mrs Witmer: That is fine. I just wanted to correct the record, and I would like to speak to the amendment as well.
Mr Conway: On a point of order, Madam Chair: I have to leave to go upstairs to join the other health debate. I just want the record to show that I left not because I was not enjoying this debate and did not want to cast a final vote, but I cannot miss this --
Interjections.
Mr Conway: Bill 135 calls. I apologize.
Mrs Witmer: I have visited the school of optometry and had many discussions with the professionals there and with the other professionals in my community. After much discussion, we put forward this amendment because we feel it more appropriately describes the scope of practice for the optometrists and more accurately reflects the work they do. I also think we have to keep in mind that there has not been, in the past 10 years, any real proof of harm to patients from optometrists, and there is certainly no evidence that would support the restriction of the optometrists' scope of practice or performing any of these acts.
I also think we have to remember -- certainly my visit to the school of optometry at the University of Waterloo bore this out -- that optometrists today are very highly educated and trained. In fact, the senate committee at the University of Waterloo reported that the training program "is taught at levels of sophistication that are comparable to science and medical students."
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I would also like to point out to you that full eligibility has been accorded to the school of optometry by the Medical Research Council in 1991. I would like to quote again where it says: "We recommend that schools of optometry be recognized as science-based health professional schools with a proven place in research in the science of vision, and that they be accorded full eligibility for the programs of the Medical Research Council."
There have been changes in the past few years, and I would like to stress again that these people are highly educated and trained professionals. I think we have to recognize the scope of practice and the actual work they are doing at the present time because of the training they are receiving. I have been most impressed with what is going on.
Mr Callahan: We will be supporting this amendment. I think it passing strange, in my reading of the Hansards, that in the United States -- the country we all seem to emulate and think is so progressive and far ahead of us -- they go even further than this. They must trust their professional people in optometry down there to a much larger degree because, as I recall, they allow them to administer medication.
When you look at the ever-increasing costs to our health care and the magnificent health care we have, and wanting to maintain it and not get into the US scenario where to become ill could result in your becoming a section 11 or a bankrupt, we are moving -- hopefully not, but it looks like we will be moving -- in that direction of adding a further burden to our health care costs. At the same time we will be depriving the community of those services my colleague has just indicated have never resulted in any type of action for inappropriate steps. Apparently it is very well governed by its governing body. I would imagine that is the case. The people are highly professional. One year of science training along with four years, which is an honours degree in university, certainly makes me feel comfortable with the fact that these people are highly professional.
I suggest that the motion moved by my colleague is one that not only will assist the people of Ontario in terms of having accessibility to services they will need -- particularly seniors as they get older; this is a very important service to them -- but I would certainly hope we would become progressive, perhaps not to the extent of the United States, because we really do not know what their qualifications are down there or whether they are at the high standards our people in this province are at.
I think the amendment that has been put forward is like a vote of confidence in these people who have served this province well since 1919 and who since 1960 been governed by a body, which has resulted in no inappropriate actions to any member of the public. I think the public considers them to be highly trained and highly professional. I urge the members of the government to support this and to ensure that all those things I have addressed do not come to pass.
Mr Wessenger: I would like to respond by saying this legislation in no way restricts what optometrists now do. It does not restrict them in their existing scope of practice. It will still be in the title to do exactly everything they do now. It will not in any way reduce accessibility.
With respect to the whole question of cost, it is kind of interesting. I have the fees in front of me with respect to ophthalmologists and optometrists. For an assessment, the fee paid to an optometrist is $39.15. The fee paid to an ophthalmologist is $38.40, which is less than that paid to an optometrist. For a reassessment by an optometrist it is $19.25, and for a partial assessment by an ophthalmologist it is $19. The interesting aspect is that although the fees are supposed to be relatively the same, at the moment the optometry fees are higher than the ophthalmology fees.
Mr Callahan: I am sorry; I missed that. What do you mean by that?
Mr Wessenger: The allegation has been made that it is going to increase the cost.
Mr Callahan: Well, it is if you have to refer them to --
The Chair: Mr Callahan, you do not have the floor.
Mr Callahan: All right; I was just going to say --
The Chair: You do not have the floor. Mr Wessenger?
Mr Wessenger: With that I will conclude my remarks.
The Chair: Are we ready for the motion? Any further amendments? All those in favour of Mrs Witmer's amendment to the amendment?
The committee divided on Mrs Witmer's motion, which was negatived on the following vote:
Ayes -- 2
Callahan, Witmer.
Nays -- 5
Haeck, Martin, Owens, Ward, Wessenger.
Mr Wessenger: With the consent of the committee, I wonder if it might be possible, with respect to paragraph 4 moved by the Conservatives, to substitute that for paragraph 1.1. I know it will require unanimous consent.
The Chair: Do do you want to withdraw your amendment and read in to the record what you would like to do?
Mr Wessenger: Yes, if that would be satisfactory.
Mr Callahan: On a point of order, Madam Chair: That has already been defeated.
The Chair: No, that is permitted. Mr Wessenger's motion is now on the table. Mr Wessenger is withdrawing his amendment and will read in his new amendment and provide it in writing.
Mr Callahan: But Madam Chair, the paragraph he is trying to impose has already been defeated.
The Chair: What Mr Wessenger is doing, Mr Callahan, is making a change to the amendment he has tabled, using some of the wording that was in Mrs Witmer's amendment.
Mr Callahan: He is not using the exact wording?
The Chair: He will read it into the record and it will be clear.
Mr Wessenger: I move that paragraph 1 of section 4 of the bill be struck out and the following substituted:
"1. Communicating a diagnosis identifying, as the cause of a person's symptoms, a disorder of refraction, a sensory or oculomotor disorder of the eye or vision system or a prescribed disease."
I further move that section 4 of the bill be amended by adding the following paragraph:
"1.1 Applying a prescribed form of energy."
Mr Callahan: Where does that change it?
The Chair: Mr Wessenger's original amendment, stated under 1.1 and written before you, reads: "Applying or ordering the application of a prescribed form of energy." With the change he has just made to his amendment, 1.1 now reads, "Applying a prescribed form of energy." That is his new motion. All right? Clear?
Mr Callahan: That is my point of order. That has already been voted on and defeated.
The Chair: That is not correct. Mrs Witmer's entire amendment was defeated. Mr Wessenger is placing his amendment and it is in order. Are there any speakers to Mr Wessenger's amendment? Are we ready for the vote? All those in favour of the amendment? Any opposed?
Motion agreed to.
The Chair: What I would like to do now, on both section 3 and section 4, is to call for the sections. Shall section 3, as amended, carry? All those in favour? Any opposed?
Section 3, as amended, agreed to.
L'ARTICLE 3, MODIFIÉ, EST ADOPTÉ.
The Chair: Shall section 4, as amended, carry? All those in favour? Any opposed?
Section 4, as amended, agreed to.
L'ARTICLE 4, MODIFIÉ, EST ADOPTÉ.
Title agreed to.
LE TITRE EST ADOPTÉ.
The Chair: Shall the bill, as amended, carry? All those in favour? Any opposed? Carried.
Now we have to order all of the bills. Shall I report Bills 43 to 64, inclusive, as amended, on Thursday, November 7, 1991, to the Legislature? All those in favour? Any opposed?
Mr Callahan: I was going to ask, to be consistent, in light of the fact that we voted against Bill 60, that we have that extracted for purposes of reporting.
The Chair: All right. Shall bills 43, 44, 45, 46 --
Mr Callahan: You do not have to do that.
The Chair: How else do you want to do it?
Mr Callahan: You can simply say Bill 43 through Bill 64, with the exception of Bill 60, shall be reported to the House. That would be an easy way of doing it.
The Chair: No. How about if we just do them all? All right.
Mr Callahan: All right.
The Chair: You can vote against ordering them if you do not like it. Shall I report bills 43 to 64, inclusive, as amended, on Thursday, November 7, 1991, to the Legislature? All those in favour? Any opposed?
Bills 43 to 64, inclusive, as amended, ordered to be reported.
Les projets de loi 43 à 64, inclusivement, modifiés, devront faire l'objet d'un rapport.
The Chair: Thank you all very much. We have completed a very significant package of bills with what I think is a kind of spirit at this committee which has been most productive on most occasions.
The committee adjourned at 1712.