CHIROPODY ACT, 1991 / LOI DE 1991 SUR LES PODOLOGUES
CHIROPRACTIC ACT, 1991 / LOI DE 1991 SUR LES CHIROPRATICIENS
DENTAL HYGIENE ACT, 1991 / LOI DE 1991 SUR LES HYGIÉNISTES DENTAIRES
DENTAL TECHNOLOGY ACT, 1991 / LOI DE 1991 SUR LES TECHNOLOGUES DENTAIRES
DENTISTRY ACT, 1991 / LOI DE 1991 SUR LES DENTISTES
DENTURISM ACT, 1991 / LOI DE 1991 SUR LES DENTUROLOGISTES
DIETETICS ACT, 1991 / LOI DE 1991 SUR LES DIÉTÉTISTES
MASSAGE THERAPY ACT, 1991 / LOI DE 1991 SUR LES MASSOTHÉRAPEUTES
CONTENTS
Monday 21 October 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
Audiology and Speech-Language Pathology Act, 1991 /
Loi de 1991 sur les audiologues et les orthophonistes
Chiropody Act, 1991 / Loi de 1991 sur les podologues
Chiropractic Act, 1991 / Loi de 1991 sur les chiropracticiens
Dental Hygiene Act, 1991 / Loi de 1991 sur les hygiénistes dentaires
Dental Technology Act, 1991 / Loi de 1991 sur les technologues dentaires
Dentistry Act, 1991 / Loi de 1991 sur les dentistes
Denturism Act, 1991 / Loi de 1991 sur les denturologistes
Dietetics Act, 1991 / Loi de 1991 sur les diététistes
Massage Therapy Act, 1991 / Loi de 1991 sur les massothérapeutes
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)
Clerk pro tem: Decker, Todd
Staff: Spakowski, Mark, Legislative Counsel
The committee met at 1535 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.
The Chair: The standing committee on social development is now in session. We have agreed that today we will deal with Bill 43, with all the issues and clauses as they relate to the sexual assault recommendations, as well as section 81.1 of schedule 2 and all other related sections. Then, time permitting, we can move on to the other bills. I believe we are at Bill 55.
The parliamentary assistant has requested an opportunity to address the committee at this time.
Mr Wessenger: Before beginning clause-by-clause review of provisions relating to sexual abuse of patients, I would like to make some general comments. We are firmly committed to taking the necessary legislative action to deal with the problem of sexual abuse in a comprehensive manner. As we have said before, we are committed to a policy of zero tolerance of sexual abuse in health care.
The committee has already passed an amendment to section 3 of the Regulated Health Professions Act which adds to the minister's duties the duty of ensuring that individuals are treated with sensitivity and respect in their dealings with health professionals, the colleges and the health professions board.
The committee has also passed an amendment to section 3 of the procedural code adding to the objects of colleges the object of developing, establishing and maintaining programs to assist individuals to exercise their rights under the code and the RHPA.
We are proposing today a set of further amendments to require every college to establish a patient relations program. A new committee, the patient relations committee, would be created to advise the college council on the program. The patient relations program must include measures for preventing professional misconduct of a sexual nature. The Health Professions Regulatory Advisory Council would have in its mandate the duty to advise the minister on the colleges' patient relations programs.
This is not all. The minister will shortly be signing a letter addressed to the head of each regulatory body that exists under current legislation requesting it to develop a sexual abuse program and file it with her within three months. The letter suggests matters to be addressed within the program. It is expected that the plans will form the basis for the sexual abuse measures to be contained in the patient relations programs required under RHPA.
We have also announced our intention to strike an interministerial working group after the final report of the College of Physicians and Surgeons of Ontario Task Force on Sexual Abuse of Patients is delivered to the CPSO council. This is now scheduled for late November.
The working group will study the recommendations and conduct consultations on them with all health professions and with consumer and public interest groups. Legal experts will also be consulted, because the recommendations are likely to raise important Charter of Rights and administrative law issues. The group will, of course, be interested in the response of CPSO and the medical profession overall. However, the problem of sexual abuse is not unique to medicine. One great advantage of this legislative framework is that it enables us to deal comprehensively with all regulated professions. We therefore must consider the issues as they apply to all professions and listen to their viewpoints.
We do not want to delay third reading of these bills to capture the results of these consultations. After so many years of discussion and effort, we want to get them in place so that the hard work of implementation of the legislation can begin, but we will not hesitate to reopen the RHPA to make necessary amendments.
We think statutory provisions should be effective. There is no use in enacting provisions that will not really prevent sexual abuse or deal effectively and appropriately with perpetrators. Also, we must be realistic in what the legislation can achieve. Statutory provisions alone will not ensure that complainants are dealt with compassionately by college officials. A certain climate has to be created.
The Chair: In order that we can deal with all the amendments that have been placed before us, let me ask for unanimous consent of the committee to reopen section 6 and section 11. As well, there is a new proposed section 31.1 and a section 39. If we can have consent so that we can accept the amendments, we will move forward. All in favour? Any opposed?
Agreed to.
Mr J. Wilson: Could I take a few minutes also before we get into the whole area?
The Chair: Yes.
Mr J. Wilson: As members know, the Progressive Conservative Party of Ontario is also committed to the philosophy of zero tolerance of sexual abuse of patients by medical doctors and other health professionals. We believe many college procedures and policies should be changed to be more effective and sensitive to such abuse, and we are concerned that the regulated health professions legislation as currently drafted does not wholly reflect the zero tolerance philosophy. Of course, that is the object of today's debate. We commend the College of Physicians and Surgeons of Ontario for endorsing the zero tolerance philosophy.
As background to this, I just want to remind members that when doctors take on the responsibilities of life and death they also take the Hippocratic oath, which enshrines them with absolute trust. The oath reads in part as follows, "In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction, and especially free from the pleasure of love with women or with men."
As members know, the preliminary report of the Task Force on Sexual Abuse of Patients made a series of recommendations to change the legal and legislative systems to correct the bias against sexual abuse victims. I, along with my colleagues, am looking forward to reviewing the final report of the task force, as I know all members of this committee are.
I will just remind members too that Ernie Eves, the member for Parry Sound, my party's former Health critic, has shown a great deal of initiative in this area. On June 17, 1991, he introduced a private member's bill that would revoke the licences of physicians found guilty of sexually abusing their patients. Mr Eves began drafting the bill after the Task Force on Sexual Abuse of Patients released its preliminary report at the end of May. He has maintained that the fact that the former Minister without portfolio responsible for women's issues and the Minister for Northern Development and Mines felt they had no other recourse available to them than to personally interfere in a quasi-judicial process shows the gaping holes in the system dealing with sexual abuse by physicians. I will be introducing a number of amendments today to deal with this very matter.
Members know we will be introducing an amendment to really help victims. I noted in the parliamentary assistant's comments that he talked a lot about preventing, with corrective measures afterwards. We believe very strongly that a survivors' compensation fund is a cornerstone in effectively dealing with sexual abuse. We will get into that a little further as we get into the amendments.
Ms Poole: This is certainly a very important area, not only for this committee but for society as a whole, because what we are really looking at is changing attitudes and behaviour in society. It is perhaps more important when we are looking at the health care profession because there is an element of trust and respect involved. It is particularly important that patients be protected against any type of sexual abuse or misconduct.
I welcome the opportunity to join the committee today to speak to a number of amendments that are going to be put forward. It is my hope that these amendments will make interim report of the Task Force on Sexual Abuse of Patients come alive and will really entrench in the legislation an opportunity for the further amendments of the task force to come alive in future days.
Rather than speak at length right now, I would just like to indicate that the Liberal caucus is very supportive of measures to bring responsibility and sensitivity to the area of sexual abuse of patients in the health care field and that we feel our amendments will go a long way towards protecting the rights of those patients.
The Chair: I think it would be appropriate if we began with section 6.
Section/article 6:
The Chair: Ms Poole moves that section 6 of the bill be amended by adding the following subsection:
"(1.1) The advisory council shall report to the minister, within five years after this section comes into force, on the effectiveness of,
"(a) each college's patient relations and quality assurance programs; and
"(b) each college's complaints and discipline procedures with respect to professional misconduct of a sexual nature."
Do you wish to speak to the amendment?
Ms Poole: Just briefly, Madam Chair. I think it speaks for itself, but I would also like to mention that this amendment does not put anything on hold for a five-year period. What this amendment does is make sure that certain programs have to have a mandatory five-year review. In the meantime, many reports will be tabled and certainly the college's patient relations will be subject to ongoing review.
Again we come back to the fact that the Task Force on Sexual Abuse of Patients does want us to act and does recommend that we act, and act quickly. We cannot wait for five years. What this amendment does is make sure that at the end of the five-year period there is a review to make sure that what has been put in place is very effective.
Mr Wessenger: I would just like to say that we will be supporting this amendment because it adds to the effectiveness of the legislation by bringing in this mandatory review period to ensure that the programs are working well during the period.
Mr J. Wilson: I would like to indicate to committee members at this time that we will also be supporting this amendment.
Motion agreed to.
Section 6, as amended, agreed to.
L'article 6, modifié, est adopté.
Section/article 11:
Mr Wessenger: I would like to ask that the clause 11(d) amendment be withdrawn as it will be covered by the other amendments to be made.
The Chair: It is withdrawn.
The Chair: Ms Poole moves that section 11 of the bill be amended by adding the following subsection:
"(2) It is the advisory council's duty to monitor each college's patient relations program and to advise the minister about their effectiveness."
Ms Poole: Again, this amendment speaks for itself. I do not think committee members can underestimate the importance of monitoring programs, particularly the college's patient relations program, to ensure that it is effective. This is just a safeguard put in to make sure that a monitoring process does take place.
Mr Wessenger: I would just like to say we will be supporting this amendment because we think it is an appropriate role for the advisory council.
Mr J. Wilson: I wonder if it would be appropriate at this time for the parliamentary assistant to tell us a little bit more about the patient relations program and the patient relations committee, since we are now getting into voting on that.
Mr Wessenger: Yes. I just wonder if we are a little premature at this time since it will be the subject of later amendments.
Mr J. Wilson: This amendment before us now deals with the patient relations program, the monitoring role of the advisory council, and to support it would be to support the patient relations program. I would like to know exactly what I am supporting, especially in terms of comments with regard to how this program will help victims of sexual abuse.
Mr Wessenger: I can give you an indication of a future amendment that likely will be brought today which is going to establish a patient relations program. The program must include measures for preventing or dealing with professional misconduct of a sexual nature, and there have been some guidelines for what the program should include. For instance, it should set out educational requirements for members, guidelines for the conduct of members with their patients, training for the college staff and the provision of information to the public.
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Mr J. Wilson: As you know, also in the future amendments is our amendment for a survivors' compensation fund. Is there any contemplation in the patient relations program or the patient relations committee of authority to compensate victims of sexual abuse?
Mr Wessenger: Our position is that it is premature at this time, that the fund is something that is going to be considered in the whole consultation aspect. It will be an aspect of the further consultation, at least in our position with respect to a survivors' compensation fund.
Motion agreed to.
Section 11, as amended, agreed to.
L'article 11, modifié, est adopté.
The Chair: It is my understanding, just as we are going through the sections, that we are still holding down section 31.1 as well as section 39 -- those are the native issues -- until the end of the full package of bills, the end of Bill 64, as was previously agreed.
Mr Wessenger: Yes.
Schedule/annexe 2:
Section/article 9:
The Chair: Mr Wessenger moves that section 9 of schedule 2 of the bill be amended by adding the following paragraph:
"7. Patient relations committee."
Mr Wessenger: This is to add, of course, one of the required committees, the patient relations committee, of each college.
Ms Poole: I simply want to say that the Liberal caucus will be supporting this amendment. We think the patient relations committee is an excellent idea and are looking forward to fleshing out what the patient relations committee is going to be responsible for.
The Chair: We note there is a further amendment to be tabled. However, at this time, I think it is best, if all members agree, that we deal individually, amendment by amendment, as we go through -- Mr Wilson, speaking to this amendment only.
Mr J. Wilson: Again, dealing with the patient relations committee, I ask the parliamentary assistant, since I do not think you have been very specific to date on what exactly this committee will be doing, do you see a survivors' compensation fund as being outside the authority of this committee or something maybe we could agree upon today as a role the committee would see?
Mr Wessenger: I think the committee is obviously going to establish a program within each college for dealing with the problems of sexual abuse. At this time, we do not see it dealing with the issue, but a college could come up with its own individual program of how it wants to deal with the matter of sexual abuse. There may be a lot of similarities in the college's programs, but there may be some unique features with each college in the approach it takes, and hopefully that will guide us with respect to developing a more comprehensive program.
Mr J. Wilson: It is just so vague. I am still not convinced you did not come up with this patient relations committee as a result of our putting forward -- we did so first and made it very clear to Marilou McPhedran that we would be putting forward a survivors' compensation fund. It just seems so vague as to what this patient relations committee will be doing. It is like it was an afterthought.
Mr Wessenger: I do not think it is vague. Very clearly, it is going to set out the policy of the college with respect to dealing with the problem of sexual abuse.
Mr J. Wilson: But it does nothing for victims.
Mr Wessenger: The whole idea is to prevent the sexual abuse from occurring, and that is certainly the role of the patient relations committee, to develop a preventive program. The complaints and discipline process will deal with complainants, but this committee will be more on the educative and the preventive aspect.
Mr Jackson: That is the concern we have. We have seen too often that the thrust is really purely educational. I truly believe there is a lot of education out there, but if you are going to leave each college to establish a patchwork of procedures and protocols with patient relations programs, leaving each to develop minimum standards of conduct and responses, you have a framework which cannot lend itself to a consistent compensation package. Women suffer substantive psychological damage as a result of the kinds of breach of trust that occurs in this environment, and they do not automatically have access to health support services and suffer in financial ways as well.
One does not get a sense that the government has thought this thing through at all. Our amendments lead very clearly to recognizing where there has been harm -- it has been documented -- and that the principle of compensation offers in and of itself a further deterrent to the profession. It is not simply the degree to which their licence may be at risk or their ability to continue to practise, but also the pecuniary aspects that flow beyond that which also are involved in compensation. So I am not encouraged by your view that the purpose of this is educational.
Mr Wessenger: This amendment is purely to establish the committee. It is not to deal with the other aspects of the sexual abuse program. It is to establish the committee to establish programs for each college. I think that is a significant advance, to require each college to establish a program.
Mr Jackson: It may be an advance to you, but it does not advance the issues in Ms McPhedran's report.
Mr Wessenger: We are not debating the aspects of your amendments. Certainly we can debate those aspects when we reach them.
Mr Hope: The amendment talks about putting forward a committee. What I hear the Conservative Party talking about is the structure and the foresight of the committee. I think that is a debate that will take place later on as we develop that policy. Right now it is just a matter of dealing with whether or not there will be a committee.
Mr J. Wilson: That is the crux of it, and I am glad to hear the member agree. I gather the NDP members may agree that the survivors' compensation fund could very well be part and parcel of the patient relations committee and that we might be able to move on that today.
Mr Wessenger: I think it is premature at this time to say. When a compensation system is established, then of course it would undoubtedly be a part of the program.
Mr Jackson: I just to indicate clearly that we consider this a shallow offer to get at a very serious issue and I personally will not endorse the concept because it falls far short of what we believe is required as a standard for this province and a compensation model for victims of sexual harassment and abuse.
The Chair: All those in favour of the amendment? Those opposed?
Motion agreed to.
Section/article 39:
The Chair: Mr Wilson moves that section 39 of schedule 2 of the bill be amended by adding the following subsections:
"(2) A panel may at any time permit a notice of hearing of allegations of sexual abuse of a patient by a member to be amended if it is of the opinion that it is just and equitable to do so and the panel may make any order it considers necessary to prevent prejudice to the member.
"(3) In subsection (2), `sexual abuse' means conduct that is sexual including, without limiting the generality of the foregoing, improper touching or kissing."
Mr J. Wilson: The reason for this amendment is that we believe the rule that the description of allegations can only be amended to correct errors or omissions of a minor or clerical nature does not allow a victim of sexual abuse, whose memory returns unpredictably and often in a disorganized series, to place before the decision-makers all the relevant information in time to be considered.
Mr Wessenger: We are opposing the amendment not because we necessarily oppose the content of it, but because it is premature at this time. We only have the preliminary recommendation. We still have to await the final recommendation of the sexual abuse task force and also we have to wait for the consultation process.
Mr Jackson: I think the parliamentary assistant's comments betray a lack of understanding of post-trauma experiences of victims in these circumstances. A portion of this legislation accepts a simple rule of justice and either we embrace that concept or we do not. To simply suggest that at some later date we will get to it, in my view betrays a complete lack of commitment in this area. I am sorry; we are talking about basic justice principles as an underpinning to this legislation.
The Chair: A;ll those in favour of the amendment? Those opposed?
Motion negatived.
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Section/article 9:
The Chair: I am going to go back and call, shall section 9 of schedule 2 carry? That is the previous amendment establishing the patient relations committee. All those in favour? Any opposed?
Section 9, as amended, agreed to.
L'article 9, modifié, est adopté.
Section/article 39:
The Chair: Now we are at section 39 of schedule 2. The amendment to that has not carried, so I am going to call, shall section 39 of schedule 2 carry? All those in favour? Those opposed?
Section 39 agreed to.
L'article 39 est adopté.
Section/article 46:
The Chair: I believe, Mr Wilson, you have an amendment.
Mr J. Wilson: I am going to withdraw this amendment, because we are concerned about the impact of cost to the complainant.
The Chair: So your amendment to subsection 46(1) is withdrawn.
Mr J. Wilson: We do not want to burden the colleges any further with yet another cost, so we will withdraw this. This is schedule 2, subsection 46(1).
The Chair: That is withdrawn.
Section 46 agreed to.
L'article 46 est adopté.
Mr Wessenger: On schedule 2, sections 81.1 and 81.2, I would like to withdraw this as there will be a further amendment.
The Chair: Withdrawn.
Mr J. Wilson: I just have a question. The parliamentary assistant just withdrew schedule 2, sections 81.1 and 81.2?
The Chair: That is correct.
Mr J. Wilson: Where is that dealt with again?
The Chair: It is the next one that is being placed.
Mr J. Wilson: Under the Liberal motion?
The Chair: Yes.
Ms Poole moves that schedule 2 of the bill be amended by adding, before the heading "Miscellaneous," the following sections:
"Patient Relations Program
"81.1(1) The college shall have a patient relations program.
"(2) The patient relations program must include measures for preventing or dealing with professional misconduct of a sexual nature.
"(3) The measures for preventing or dealing with professional misconduct of a sexual nature must include,
"(a) educational requirements for members;
"(b) guidelines for the conduct of members with their patients;
"(c) training for the college's staff; and
"(d) the report of information to the public.
"(4) The council shall give the Health Professions Regulatory Advisory Council a written report describing the patient relations program and, when changes are made to the program, a written report describing the changes.
"81.2 The Patient Relations Committee shall advise the council with respect to the patient relations program."
For clarification, Ms Poole, under clause (d), did you want it to say "the report of information to the public" or "the provision of information to the public"?
Ms Poole: Just one moment, Madam Chair, I will look at that. It would seem to me to be more accurate to say "the report of information to the public."
The Chair: Because you had it written, I just wanted to double-check.
Ms Poole: Could you amend my motion with a very friendly motion to say "the report of information"?
Mr Wessenger: The amendment I have in front of me reads "the provision of information to the public."
The Chair: That is what is written.
Mr Wessenger: So I would suggest that --
Ms Poole: Did I say "report"?
The Chair: You said "report," but it says "provision" in the written amendment.
Ms Poole: Then I will correct the record and say "the provision of information."
The Chair: Okay. Your intention is that as it is written, clause (d) should say "the provision of information to the public." Is that what you are moving?
Ms Poole: Yes, that is right, Madam Chair. I thought you were giving me gentle guidance as a former Minister of Health, saying, "You really mean `report'" and who was I to question you?
The Chair: No, I just noticed that you had said "report" and "provision" was written.
Ms Poole: Thank you for clarifying that. Yes, it does say "provision" and it should say "provision."
Basically, the government motion, as you are aware, sets up a patient relations committee, but we in the Liberal caucus felt there should be certain guidelines and criteria attached to that committee. We felt it very important, not only when dealing with physicians -- a number of people have used the word "physicians" today -- but with all health care professionals, that for all the colleges there be certain criteria that were common when they were dealing with the patient relations program.
The first, "educational requirements for members," is of vital importance. I cannot overstate the importance of educating the public and health care professionals. To me, it is at the root of the problem. Many people do things out of ignorance or because of behavioural patterns that have been established in the past, and it is time we stood up and said, "This is not acceptable," and provided the public and health care professionals with some guidelines on what is acceptable.
That leads, of course, to clause (b), "guidelines for the conduct of members with their patients." There has been far more awareness in the past few years of what is and what is not appropriate, but it is very important that this be spelled out by the colleges in these guidelines.
"Training for the college's staff" again would run hand in hand with the educational requirements. The guidelines and "the provision of information" -- you notice, not "the report of information -- to the public is all part of this process. This fleshes out to a greater depth what we would like to see in the patient relations program and I certainly think it would march very well with the McPhedran interim report.
Mr J. Wilson: Perhaps I can move an amendment to the Liberals' amendment.
The Chair: In writing? You have to submit it in writing.
Mr J. Wilson: I will be happy to do that as soon as I read it.
The Chair: It is, I see; okay.
Mr J. Wilson: No, I have another one. I just thought it up, independent thinker that I am.
I do not think we are getting anywhere with our survivors' compensation fund, so on behalf of victims of sexual abuse I will try to put some teeth in this amendment. Perhaps it would be to subsection 81.1(3) where you have clauses (a), (b), (c) and (d). I would propose a clause (e), that says one of the measures for preventing or dealing with professional misconduct of a sexual nature must include, "(e) compensation for victims of sexual abuse."
The Chair: We will receive that in writing. Speaking to your amendment to the amendment?
Mr J. Wilson: We are very concerned that perpetrators of sexual abuse are profiting from their offences. Since I suspect that in a very few minutes the survivors' compensation fund will be voted down, perhaps it would fit into the patient relations program that they also be mandated to actually look at compensation for victims of sexual abuse. From the comments of all parties today, I think that would be something that is amenable to everyone here.
Mr Owens: Just a quick comment around the amendments to (a), (b), (c) and (d): I certainly hope the parliamentary assistant will pass on these recommendations with respect to education to our colleagues in the Ministry of Colleges and Universities because I think one has to begin at that level, at the training point, where a person is becoming a health care professional. To simply have these guidelines in place at the college level is too little, too late, so I hope we will be passing on these recommendations to the Minister of Colleges and Universities that we have to put the kind of programming into the medical schools, into the professional schools, that will deal with this issue. They need to know immediately, if they do not know already, that sexual abuse is an inappropriate activity.
Mr Wessenger: I certainly appreciate and agree that we should have this in the initial training for members of the colleges, as well as in their continuing education programs. I think it should be involved in both aspects. Just speaking to the amendment, we will be opposing it because we believe it is premature at this time.
Mr Jackson: I would like a recorded vote on this section, please.
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The committee divided on Mr J. Wilson's motion, which was negatived on the following vote:
Ayes/Pour -- 2
Jackson, Wilson, J.
Nays/Contre -- 8
Grandmaître, Haeck, Hope, Malkowski, Martin, Owens, Poole, Wessenger.
Mr Owens: Just playing politics.
The Chair: Order, please. We are voting on the amendment. Did you want to speak to this before we are in the middle of a vote?
Mr Jackson: If some rookie wants to shoot off about it, that is his business, but he does not know the history of this issue in this province.
I have a further amendment, Madam Chair. I believe it is in writing before you.
The Chair: Mr Jackson moves that subsection 81.1(3) of the bill be amended by adding the following clause:
"(e) health-related assistance to victims."
Mr Jackson: As I referenced earlier, the issue of a compensation fund is something we strongly support. Its purpose is because there is a variety of medical-related services that are not automatically available to a victim of sexual abuse in this province. Perhaps somehow we can at least acknowledge that health-related support services and assistance will be made available to victims who have been abused or misused in this fashion, as is set out in measures to combat sexual misconduct. There is not the right to access. This is difficult, where the medical community has broken faith with a victim. Finding those necessary services is not that easy, but it is none the less incredibly important for the victims that they have access to them.
My concern is that this is so caught up in proactive stancing and that the section is caught up in public relations. I am more concerned that we have in place the effective programs that are victim-centred as well. Minimally I ask this committee to strengthen the Liberal amendment by acknowledging that this committee should address the issue of ensuring that once a case has been found and is ruled on, the committee can go beyond that and say, "The following services are required and they should be an as-of-right for a victim in this province."
The suicide rate associated with victims of sexual abuse, where there is professional misconduct, is a growing concern, because they do not have adequate access, let alone having complete costs paid for. It takes years for them to get access to this kind of service. I just feel we could strengthen this section of the Liberal amendment by including that. Otherwise there is no real acknowledgement of how the patient suffers and how we are prepared to address that; it is simply to act as some sort of arbitrator with this relations program and is a public relations gesture at best. I really feel we should be making that kind of a commitment.
Therefore, I would like to have a recorded vote on this, at least as minimal support for the concept of assistance for victims.
Ms Poole: I just wonder if I might ask a question of the member for Burlington South. I wonder if you could be more specific about what type of health-related support systems, assistance and services to victims you would envisage. Obviously certain services would be covered by OHIP. Could you elaborate on where you would like to see it go beyond that?
Mr Jackson: I think I have stated that it is the right to access. We can get into very complex things, such as that where there is a communications difficulty there should be an as-of-right for someone to receive medical treatment and responses in the language he or she can comprehend, and that where we are dealing with severely challenged individuals in society they have the appropriate interpretative services so that they understand what the process is doing to them, so that medical treatment is accessible with those kinds of supports where communication is a problem, where language is a problem, and other disabilities. I could go on at length, but if you have read the report, you know there are people who are particularly vulnerable as victims, but then we do not provide the necessary services.
My point is that the health community can make these services available and I believe that victims of sexual assault as a result of professional misconduct should be assured that they are able to receive those treatments. After all, they have to go back to the same medical community for that support. Any program involving helping the profession deal with this issue should also include the special training and the support services those very same professionals must apply to helping a person who has been broken trust with.
If someone has had a bad experience with a police officer in a rape case, the courts have a system where there is an alternative so that someone does not present himself as a police officer, but when someone breaches trust as a physician, we still have to have somebody with the medical expertise to assist that person, somebody who is still a member of that professional community. Therefore, I would ask that professional community to come up with the proactive support medical services those victims need, and not simply to say, "We'll just have another psychiatrist deal with this," when in fact the first psychiatrist that woman dealt with destroyed that personal relationship.
Mr Wessenger: I will again be opposing the amendment, because I believe it is premature and also I think there are considerable difficulties with the aspect of colleges providing services in this regard individually. I think it is something that should be dealt with in a general way rather than in a specific college way with respect to the treating of victims. I think we have to have that comprehensive approach and not a sort of throwing it piecemeal to a college that would not be in a position to develop that area.
With respect to the matter of information, I would say that is indeed covered. The provision of information to the public would also include an information service to victims.
Ms Poole: While I certainly support what Mr Jackson has said is necessary for dealing with victims and giving them every assistance, I guess I am a little bit concerned about -- I do not want to use the word "vague" -- the unclear meaning of this particular sentence. When he read it out, I, who am somewhat more aware than maybe some other people of what type of support systems a victim would need, found myself querying what it meant. If I am querying it, I suspect a lot of the colleges would also wonder what specifically was meant by this section, so I think I would have difficulty including it in this amendment.
Mr Jackson: Recorded vote, Madam Chair.
The committee divided on Mr Jackson's motion, which was negatived on the following vote:
Ayes/Pour -- 2
Jackson, Wilson, J.
Nays/Contre -- 8
Grandmaître, Haeck, Hope, Malkowski, Martin, Owens, Poole, Wessenger.
Mr Jackson: Further discussion, Madam Chair?
The Chair: Mr Jackson, you have the floor.
Mr Jackson: Perhaps Ms Poole could be a little more specific about what is meant by "educational requirements for members." We are dealing with the section I was just attempting to amend, and I am unclear as to what she means by "educational requirements for members."
The Chair: It is appropriate in committee for you to place questions of the parliamentary assistant. If you want to discuss it with Ms Poole, yes, certainly.
Mr Jackson: It is her amendment. That is why I was asking.
The Chair: You can speak to it. It is up to her if she wants to respond. Do you want to speak to it?
Mr Jackson: I asked her the question.
The Chair: Any further speakers on this amendment?
Mr J. Wilson: I think the point is that Mr Jackson's amendment was just voted down because it was too vague. What does "educational requirements for members" mean?
Mr Jackson: We are not prepared to pass these unless the persons who support them -- if the Liberals, who drafted them, cannot speak to them, then I would be pleased to hear from the parliamentary assistant.
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Mr Grandmaître: Madam Chair, I thought we had just voted on Ms Poole's amendment.
The Chair: No, we voted on Mr Jackson's amendment to the amendment. Ms Poole, did you want the floor to speak to the amendment?
Ms Poole: Certainly, Madam Chair. When you are talking about "educational requirements for members," there is a body of thought out there right now on how to deal with sexual abuse and on guidelines for professional members. When you are talking about health-related support systems and assistance to victims, quite frankly that could be as narrow or as broad as one would like. What one college might interpret it as, another might have a completely diverse viewpoint on it.
Mr Jackson: It is clear you do not understand what I mean with clause (e). I am asking you what you mean with clause (a), "educational requirements for members." "Members" are members of the health profession?
Ms Poole: That is right.
Mr Jackson: Okay, we are making progress. "Educational requirements" as they become certified, or post-certification? What are we talking about here?
Ms Poole: What we are talking about in conjunction with the training of the college's staff is having a number of components in an educational program to make sure that people in the health care professions understand not only what is meant by sexual abuse, but what their responsibilities are as members of that health care profession, education about certain aspects of sexual abuse and what it means to our community and our society. Those are things, when I referred to having a common body of knowledge out there right now, on which we do not need to search for a lot of different answers.
The problem I had with your amendment to clause (e) was, is a college going to be sued because it is not providing a certain support system or a certain degree of assistance that another college is? Is it going to create difficulties in that regard? I still think that on clauses (a), (b), (c) and (d) there is already a common body of knowledge. I am not sure I could say that of the amendment you have brought forward.
Mr Jackson: Madam Chair, I am still having difficulty. Are we talking about going to the dental academy for the five years of dentistry, for example, and there are going to be units on the route to certification as a dentist in this province and those will form part of it, as has been suggested by several women's groups? Is that what we are talking about here, or with "educational requirements for members," are we talking about letting them know that, "By the way, it's wrong to do this and we have a committee that we'll haul you up in front of to talk about it"? I am trying to understand it.
The Chair: Mr Jackson, as you addressed the question to the Chair I can perhaps be helpful. As I read this, the amendment by the government establishes a patient relations committee and a patient relations program. The amendment that has been tabled by Ms Poole defines what components there will be of that program. It will then be up to each college and each patient relations program to define how that relates to each individual college and to the profession. It may differ from profession to profession. That is my understanding of the amendment that is proposed. If anyone else would like to enter into the debate to help clarify this for Mr Jackson, I think he would be quite willing to hear what anyone else has to say, but that is how I read it.
Mr J. Wilson: Our bottom-line concern is that this is pretty vague stuff. They are going to set up educational requirements and guidelines for the conduct of members and training for college staff, and as I understand it, between this and a previous amendment, reporting back their progress on this at some point. Perhaps we could have some indication from the parliamentary assistant, to be fair, on what some of the regulations might be around this area. What is the intent behind it? This is pretty vague stuff. My worry is that there is nothing in here, for instance, to address the needs of the victims of sexual abuse. It is pretty pappy, vague stuff and I do not think it does much to really help the whole issue of sexual abuse. Perhaps for the record the parliamentary assistant could tell us what the intention would be from here on.
Mr Wessenger: I would tend to disagree that it is not very substantial. I think this requirement that members take certain courses to retain their licence is a very powerful tool. That is certainly within the framework of what could be involved in educational requirements.
It could involve being part of the ethics course, or a special course on patient sensitivity included in the training of each member of the college, or a requirement that members take continuing education programs in order to retain their certificates to practise. It would also involve the whole question of general information. It would be a comprehensive program, the way I see it, and it is up to the college to indicate that program. I think it is fair to say that there are certain colleges that have a greater problem than others because of the nature of the health services provided.
Ms Poole: Perhaps it would help also if I mention to Mr Wilson subsection 11(2), which we passed earlier, whereby it is the advisory council's duty to monitor each college's patient relations program and to advise the minister about the effectiveness of those programs. So there is a built-in tool, an ongoing monitoring process whereby if a particular program was not effective it would be brought to the minister's attention very shortly. Second, there is of course the outside limit of five years that has been set for a review of the whole thing. What I am saying is that there are built-in safeguards to ensure the programs are effective.
Mr J. Wilson: I understand the safeguards and in my comments I tried to allude to the amendment we had passed earlier today regarding the safeguards and the role of the advisory committee. But the word "effective" itself is in question. Effective for what? How do you measure effectiveness of this sort of thing? Do you count how many fewer sexual abuses there are? It seems to me in this area that if you are setting up a patient relations program you should put in some teeth other than having the advisory committee reviewing and reporting to the minister. As I say, there is nothing for compensation. There is nothing to ensure victims will be entitled to the services they need.
The Chair: Are we ready for the vote? All those in favour? Any opposed?
Motion agreed to.
The Chair: Mr J. Wilson moves that schedule 2 of the bill be amended by adding, before the heading "Miscellaneous," the following sections:
"Survivors Compensation Fund
"81.3(1) The college shall establish a fund to be known in English as the survivors compensation fund and in French as the fonds d'indemnisation des victimes.
"(2) The survivors compensation fund shall be administered by the survivors compensation fund committee.
"81.4(1) The college shall have a committee called the survivors compensation fund committee.
"(2) The committee shall be composed of three persons, at least two of whom must be members of the council appointed to the council by the Lieutenant Governor in Council.
"(3) The chair of the committee shall be selected by the committee from among its members who are members of the council appointed to the council by the Lieutenant Governor in Council.
"81.5(1) The fund shall be used for the purpose of assisting patients and former patients who have been victims of professional misconduct of a sexual nature by members or former members."
"(2) The committee may make payments from the fund for treatment or counselling related to the misconduct and for associated expenses.
"81.6(1) A member or former member who is found to have committed an act of professional misconduct of a sexual nature with respect to a patient shall pay into the survivors compensation fund any fees received for services rendered to the patient in the period during which the misconduct occurred.
"(2) An amount required to be paid under subsection (1) is a debt that may be recovered by the committee in a civil proceeding."
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Mr J. Wilson: This came out of discussions with Marilou McPhedran and the preliminary report of the Task Force on Sexual Abuse of Patients that was established by the College of Physicians and Surgeons of Ontario. I do not believe, as the parliamentary assistant said in his remarks on voting against our previous amendments, that this is premature. Ms McPhedran has made it very clear to all parties that this concept and the idea of a fund will be very much part of her final report. She has let us know that and has certainly made it clear publicly.
I guess the task force found that abusing medical doctors who abuse have often continued to bill OHIP for the time spent sexually exploiting their patients. This, we are hearing now, applies to some other professions, not just to physicians. Recovery from sexual abuse is often enormously difficult, requiring very specialized care which is seldom readily available and fully funded by OHIP, and that was the point of Mr Jackson's amendment a few minutes ago. We do not want the perpetrators of sexual abuse to continue to profit from their offences.
This amendment requires that each college establish a fund to be known as the survivors compensation fund, and it will be administered by the survivors compensation fund committee. It is much along the same lines as the law society fund. The fund is to be used for the purpose of assisting patients and former patients who have been victims of professional misconduct of a sexual nature by members or former members of the college.
The committee is to make payments from the fund for treatment or counselling related to the misconduct and for associated expenses. A member or former member found to have committed an act of professional misconduct of a sexual nature will be required to pay into the survivors compensation fund any fees received for services rendered to the patient in the period during which the misconduct occurred.
Just to wind up, the patient relations committee, which other members have voted in favour of this afternoon, is designed, as we see it, to prevent professional misconduct of sexual abuse, but in no way will it help those who are victims of sexual abuse. The survivors compensation fund is designed to help victims. I am all for prevention, but we cannot turn a blind eye to the victims.
Mr Wessenger: We will be opposing this amendment because there is a consultation process that has to go through after the final report becomes available. First, this report goes to the College of Physicians and Surgeons. Second, it will go out to all other health professions for consultation. After that, it will go out to interest groups for consultation, and finally it has to be reviewed by legal counsel to ensure that the proposals and changes comply with the Charter of Rights and administrative law requirements.
Ms Poole: When I read over this amendment I guess it offers more questions than it actually answers, when it talks about forfeiture of fees in sexual misconduct, for instance. Those fees of the person who has perpetrated the act would go into the survivors compensation fund, but I am not sure exactly how the fund is set up to receive other donations to it. If it only relied on what the person accused of professional misconduct put into it as his or her fees received for services rendered to the patient in that period, then obviously it would not be a very healthy fund.
I do not know where the money would come from. I do not know if each college would be responsible for funding this fund individually. I do not know what kind of rules would be set out for the type of remuneration and reimbursement. As you said, some of these questions could probably be answered now, but they are certainly not obvious on the surface of it.
But I am also concerned that when we set up a survivors compensation fund it be as effective as possible, that it does not leave any room for loopholes or errors or possibilities that the fund would not be administered properly. To this effect, I would like to see the final version of the McPhedran report. I would also like to see a consultation process, not only with the various colleges and various professionals but also with some of the victims, to see what they envisage as an effective survivors compensation fund.
While I think the idea is an excellent one, I think it may not have been fleshed out enough quite yet, and I would like to see that when it is put in place it is very effective and does what we really want it to do. Right now, I think it is somewhat premature to expect that we can do that.
Mr J. Wilson: Ms Poole has brought up some very good points. When we sat down to draft the wording of this amendment with Ms McPhedran, we too had similar concerns. That is why we put in the survivors compensation fund committee, which will have some flexibility. It is clear where the money is coming from. We too have concerns that it may not be enough money, but the way it is worded here does not rule out the survivors compensation fund committee bringing forward other suggestions on how the fund may operate.
Ms McPhedran was trying to model it after the Law Society of Upper Canada's fund. Every lawyer pays into a fund, to which grieving clients may apply as a remedy for various harms against them. That is the idea here, that victims will actually be able to be compensated, that survivors of sexual abuse will actually receive some compensation to help with further treatment they may need, often treatment that is not covered by OHIP under our current system.
We believe it is actually doing something, rather than setting up reports and spending a lot of time -- prevention is important, but we know it is out there; we know the sexual abuse task force will come back with a similar recommendation. You could spend years consulting on this. We have spent years doing nothing about helping victims of sexual abuse, and it is time we did something.
Ms Poole: Madam Chair, may I ask for a clarification of Mr Wilson's comment? He also mentioned his concern that there might not be enough in the fund. Could he clarify for me whether every member of the college would be subject to a payment into the fund or whether it would rely solely on the fees of the person who had engaged in professional misconduct?
Mr J. Wilson: We envision both, not only that every member will pay into the fund but also ensure that any fees received during the time a member of the college was found to be sexually abusing a patient would have to be turned over to that fund. I believe there are documented cases of sexual abuse going on for some 25 years. That would be a lot of fees that particular professional received. In one case I was reading about recently, the member of the college was found to be guilty of sexual abuse over a 25-year period, twice a week. He indeed profited from that harmful relationship with a patient. I believe there are a number of similar horrific stories out there to be told.
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The Chair: In light of Mr Wilson's comments, what I have just heard is that this amendment would have financial implications for the Treasury.
Mr J. Wilson: No.
Mr Jackson: No. I appreciate counsel's attempt at directing the Chair in this matter, but our amendment, with its four-page supplement, would indicate it is driven by the college.
The second source of revenue for this fund would come from penalties through criminal charges the crown would lay. Currently that model is sitting in limbo in the office of the Attorney General of this province. We are the last province to comply with criminal penalties being put back into these funds. We are simply providing an option that is being implemented in other jurisdictions for dealing with criminal activity. It is a criminal act to sexually assault someone.
The Chair: In light of that clarification, there is no suggestion that there would be a charge on the Treasury. I accept that.
Mr J. Wilson: Madam Chair, you raised a very good point. When I read it into the record, under subsection 81.3(2), I said "Administered by Treasurer." That should be deleted and it should say "Administered by Fund Committee." The first draft did envision the Treasurer being involved.
The Chair: Are you amending your own amendment?
Mr J. Wilson: Yes.
The Chair: I have been advised by the clerk that it will be amended appropriately. "Administered by Treasurer" would be considered a margin note that does not form part of the bill, so it is not a requirement. You have specified that it would be administered by the committee, so that is acceptable as it stands.
Mr Jackson: The genesis of this section is not only through the outstanding work of a committee in this province in response to a clearly defined, documented need for the monitoring of and appropriate response to this criminal activity; we seem to be making a commitment to ensure that the public is aware there is a structure in place to make sure the colleges are advised of how wrong this is, but in the wake of that we are still doing nothing for the victim. It strikes me it is an odd paradox in our province that we have a compensation fund for people who invest in taking a trip. All the travel agencies contribute to a little fund so that when a charter travel company gets into financial difficulty people can be compensated for their loss. That principle has been applied to commercial goods throughout North America for many years; we were one of the first jurisdictions.
A growing number of jurisdictions in North America are now looking at victims' compensation from two sources: from the professional group in which the misconduct originated, and ultimately from court award settlements that include fine surcharges which are put into these types of funds.
If the members of the Liberal Party who are expressing difficulty with the technical problems associated with this were more aware of these human needs in terms of compensation for victims, perhaps we might be able to garner their support. But in no way should that lack of understanding or information about this important issue be, in and of itself, the reason for not supporting it. As I said earlier, particularly for violent crimes, there is a national program, and our province has been hesitant in implementing the fine surcharges. I ask for no less for the children and the women who are the primary victims of sexual assault, that they be given at least a fund from which they can be assisted with their medical needs which, I have to underscore, is still not a guaranteed right in this province.
Victims in other provinces have the right of access to health-related services when they have been victimized by the very professionals they are seeking help from. In that context, not to proceed along this route when other provinces clearly are, in my view flies in the face of what the citizens of this province deserve.
God only knows, in the last round of negotiations with the Ontario Medical Association, the government was able to indicate to it that maybe the liability insurance is a burden, and that some of our fee structure transfer payments to its payment schedule will help offset that. It strikes me that if we have the level of political commitment to ensure liability insurance for a profession, surely we can expect the profession to help fund compensation with its own fees when one of its colleagues performs in such a heinous fashion.
I cannot underscore how important an issue this is for our caucus, and the Chair herself would be very much aware -- as the government has no veteran members here -- of the level of commitment that has been enunciated in this area. Therefore, we ask for a recorded vote on this amendment as well.
Ms Poole: Quite frankly, I take offence at the words of the member for Burlington South when he talks about the Liberal caucus having a lack of information and understanding on the issue.
Mr Jackson: I was referring to you personally, not to your whole caucus. I want to make that straight; sorry.
Ms Poole: I take even greater offence then, Mr Jackson.
Mr Jackson: Fine.
The Chair: Order, Mr Jackson. You do not have the floor.
Mr Jackson: I apologize, Madam Chair.
Ms Poole: Quite frankly, I do not think it shows any lack of understanding of the issue when we are pointing out problems and problematic features of the survivors compensation fund. Your own colleague has admitted he is concerned about the funding.
Mr Jackson: "I do not think doctors will cough it up," is what you are saying.
The Chair: Mr Jackson, you do not have the floor.
Ms Poole: I read this amendment and the only source I see of payment into the fund is by a member or former member who has been convicted of sexual misconduct. Now, how far is this fund going, Mr Jackson, if that person has had one trip to the doctor, at which time the sexual abuse occurred, and there is all of $60 put into the fund? I do not think that is going to go very far. Quite frankly, I would rather vote against what I think is a faulty amendment that does not go far enough in providing victims with real compensation than to just throw something out to make Brownie points, without really having consulted or gone into any depth.
I would be the first to urge the government to proceed with something along this line, but I want to make sure that when we do it, it is done properly. So I take great offence at your comments because I am trying to provide some discussion base for what I feel needs improvement in this amendment.
Mr Jackson: Madam Chair.
The Chair: I am sorry, you do not have the floor. I will put you on the list, if you wish. Mr Hope, then Mr Wessenger, then Mr Wilson, then Mr Jackson.
Mr Hope: I agree with Ms Poole on this whole issue. We may be rookies but some of us do know what we are talking about. When we talk about helping people in our communities, we do not need to be politicians to understand that.
When I look at the issue of compensation, it is nice that we establish a fund, but it is the mechanism and how that fund has generated revenues put in there. I heard a comment from Mr Wilson about a person who was victimized for 20 years, two times every week. I would like to know how we are going to get that revenue out of there. It talks, in the last part, about civil proceedings. Civil proceedings could take some time, and by the numbers and the sincerity of what is taking place, there are a lot of people out there being victimized.
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Where I really have concern is that we are premature on the report. The report has not come back and added proper dialogue. The other concern I really have is that we have identified a survivors compensation fund, but what if there are no revenues there and somebody is victimized? Where is our recourse? Do we say, "Sorry, we're out of money and there are no revenues available"? One of the questions the committee will have to deal with is, how do we get revenues in there to make sure that the safety of people is there, that people will come forward with a lot of the issues they have?
Mr Wessenger: I would just like to make it clear that we are not rejecting the concept of compensation for survivors at all with respect to this matter. We want to ensure that the matter of compensation for survivors is done in a workable manner that works best for the victims.
Mr J. Wilson: It sure sounded like you were copping out. I gave the committee an out in my first amendment to the Liberal motion, which simply said "compensation for victims." Had we introduced clause (e) to your amendment it would have been fine, but what I am hearing is that the NDP and the Liberals are not committed. I do not think you are committed to the principle. If there is a problem with a particular clause here in terms of you want it specified where more people pay into this fund or what the fees would be, we can work with that and introduce amendments. There is no reason this has to be done today; there is no definitive time line here.
As for Brownie points, the history of this is that we brought forward our survivors compensation fund before the government gave any indication it was going to do anything about this issue. I know very well how the behind-the-scenes play worked. I met with Marilou McPhedran one day. That next morning she met with the minister, and a week later the minister says, "Okay, we're going to do something about it," because Marilou told me. She told me: "You guys are going to bring forward a compensation fund. Thanks very much for bringing it forward because you are helping to force the government to adopt our agenda." That is the politics of it, so the Brownie points argument is just God-awful, and I hope people will refrain from bringing that forward.
Ernie Eves brought forward a private member's motion some months ago that has real teeth to it in dealing with the licences of physicians who are found guilty of abusing patients. It is a very serious private member's bill. Our caucus is extremely committed to this. We have been on the record for several months now, in fact since last year. The political history of this, I think, is now clear.
I would simply say to members to introduce amendments if they have problems with one or two sentences in it, but the principle is extremely important and I certainly ask for their support.
Mr Jackson: I hope Mr Hope did not misunderstand my statement about the rookies. Last Thursday in the House we talked about the fact that they are refreshing because they do not know all the history. The issue was the vaccine-damaged children's compensation fund, which we had been working on for six years. What I was saying was that you would have been aware, if you had sat in the House for the last six years, that this matter has come up time and time again and it has been advanced, consistently, from our perspective.
The fact that the Liberals did not see fit to support these principles was the point I was making, not that there is anything wrong with being a new member of the Legislature. I just want to make that point clear. It was simply that you would be more intimately aware of the struggle that has been going on to get these principles of compensation for victims of sexual assault entrenched. It was resisted by the former government, and that is a matter that can be interpreted openly for those who were members of it.
Ms Poole has indicated concern with not understanding the intent and the framework of a compensation fund. All she had to do was move two or three pages farther, to section 91.1, where it indicates it is a surcharge. There are many programs I can refer to. With the travel compensation fund in this province, when it drops below, there is a surcharge to all the members and the members have to define it. But I can tell you that in the travel industry, they weed out bad operators. They change their rules. They modify their conduct. I am simply saying that a system based entirely on public relations and prevention does nothing but reduce the incidence, but there will continue to be incidents and those victims are the people who require some support.
Had you simply agreed that these committees we previously approved could at least suggest a compensation system or a recognition of the victim's needs, and if you could put those two generally worded principles in the bill and then turn to the government of the day and say, "Now you have some time to put in regulations. Now you can develop these programs," and if you had given just a morsel in this legislation for those victims, we would not be pushing this fund. But we are not getting anything. If the parliamentary assistant says he is committed to the principle and the concept, he had his opportunity 20 minutes ago to amend the previous Liberal motion about the patients relations program, but it is not even on the agenda for that committee.
I do not want to be called off topic because we had our opportunity to have a victim-centred concern raised in that environment. As I look through that, I do not see that. I see prevention, public relations and public education. We are fooling and deluding ourselves if we think anything we have done is going to help the victims who are in the wake of this.
Morally, I have difficulty that we have opened up this bill. Probably, if history serves us well, it will be 20 more years before we get a chance to open this bill again. While in this short time in our province's history we can open up this bill, I have to put those concerns on the record with a recorded vote, because today, tomorrow, there will be cases of victimization and we will continue to pay lipservice to victims in this province.
We have the lowest access rate for criminal injuries compensation for women in this country, and sexual assault is the worst category. Here we have an opportunity where the profession is willing to publicly admit that it wants zero tolerance. We should be putting in this fund. I appeal to the parliamentary assistant, replete with his marching orders, that if he really was committed to this, then he would have approved the amendment on the patient relations committee. It is clear he has not.
Mr Owens: I think the member of the third party is fully within his rights to call for a recorded vote on this issue, but simply because we do not support the third party's amendment is clearly no indication that we are not in support of victim compensation or victims' rights. I think it is a fallacious statement to make that kind of association.
Mr Jackson: I apologize. Could you please show me what page your amendment is on?
The Chair: Mr Jackson, you do not have the floor. I am going to have to call for order.
Mr Owens: These hearings have been distinctly non-partisan up until this point.
Mr J. Wilson: Up until you ruled out every one of my amendments.
The Chair: I am sorry, Mr Wilson, you do not have the floor. I would ask for order from the committee members. Through the hearings today, I think all members have had the opportunity to be heard when they have been speaking. I would ask that you give Mr Owens the courtesy of listening to his remarks.
Mr Owens: I think I have made my views known.
The Chair: Mr Hope, did you want to comment or can we take the vote.
Mr Hope: Just a quick comment. I will not be intimidated by the opposition because I have no use for that. There is a very serious concern here. What I am saying is there has been a suggestion made that the government is abandoning it. Is it not true that under an amended section we just did, schedule 2, sections 81.1 and 81.2, where it talks about report of the program and the program itself, if the survivor or compensation spouse comes forward, we can introduce it under regulations, which makes flexibility there on implementing the program?
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Mr Wessenger: I think it is very difficult to have a levying of fees, Mr Hope, without explicit authority in the act, with respect to your question. I could not see, under the existing amendment that has been passed, that it would authorize such action. I think there is no question that the whole problem of sexual abuse is prevalent throughout our society. It is not just the regulated health professions that are the problem; there is also a problem with respect to the unregulated health professions. I think what we are all looking for is the most appropriate solution and we need to go through the process to make sure we get it right.
The committee divided on Mr J. Wilson's motion, which was negatived on the following vote:
Ayes/Pour -- 2
Jackson, Wilson, J.
Nays/Contre -- 6
Hope, Malkowski, Martin, Owens, Poole, Wessenger.
Section/article 85:
The Chair: Mr J. Wilson moves that section 85 of schedule 2 of the bill be amended by adding the following subsections:
"(3) This section and the Limitations Act do not apply with respect to an action arising out of a person's sexual abuse of a patient while the person was a member.
"(4) In subsection (3), `sexual abuse' means conduct that is sexual including, without limiting the generality of the foregoing, improper touching or kissing."
Mr J. Wilson: We do not believe there should be a limitation period on sexual assaults occurring in or as a result of a relationship of authority, trust or dependency, in particular with any health care professional. This amendment is in keeping with the draft bill released by the Attorney General on June 27. As part of this bill, the Attorney General is proposing that in cases of sexual assault the limitation period be removed. I understand the government may argue that it is going to be introducing a new Limitations Act. I would say this legislation has not yet been dealt with by the House and now is the opportunity to ensure there will be no limitation with respect to dealing with cases of sexual abuse.
Mr Wessenger: I would like to oppose the amendment, first of all on the basis that we believe it is premature, but more importantly, as far as I am concerned, the Attorney General has circulated a discussion paper on amendments to the Limitations Act. The new Limitations Act will comprehensively set out the limitation periods, including the limitation period for suing health professionals. There are specific provisions set out in that act and I think the most appropriate place to deal with the question of limitations is within one act, the Limitations Act. I must say, as a person who formerly practised law, I think it is important that we have all limitations periods set out in the Limitations Act for the better administration of a legal situation.
Mr Jackson: The problems associated with the Limitations Act should be well known to several members. There are no assurances or guarantees that the matter will be dealt with in an expeditious manner, nor in particular in a sensitive fashion. Here we have a situation where, to my knowledge, I do not believe the medical profession is concerned about the limitations period. Second, there is not a women's group in this province that supports the reduction of the limitations period, especially because of the deep psychosomatic nature of a broken trust as it relates to sexual misconduct.
As to the mindset of the Attorney General's office, I appreciate they are not here to defend themselves, but it was your own colleague Mr Cooke, the former member for Kitchener, who brought in on two occasions amendments to the Limitations Act in the form of bills, not as resolutions, and they were not allowed to be expressions of the will of the House, to proceed for final amendment. I therefore am quite clear about the mindset on this important issue.
Therefore, I must reiterate that in cases involving sexual assault and abuse of children and women, who are the primary victims, a statute of limitations should not be considered. They should be left in accordance with our amendment. I have heard no difficulty from the various health professions with this amendment. It has nothing to do with compensation; it has to do with what value at all we are going to put in this legislation on matters outstanding. We are essentially prejudging. We are, in a sense, telling the committee that there is a benchmark; that is, we do not wish you to close the books on these matters after 5, 10 or 15 years.
Mr Wessenger: I understand there are no limitation periods set out in the proposed Limitations Act with respect to sexual assaults. I had understood, certainly from our counsel, that Marilou McPhedran was actually supportive of dealing with this matter through the Limitations Act, or at least supported the changes to the Limitations Act.
Mr Jackson: It is precisely on that point that I would like it clear in this that we are saying there will be no limitations. We know that in the Attorney General's office they have expressed clear opinions, which are very well documented, around incest and sexual assault. I am not encouraged by that mindset. We all know these bills tend to be amended. Notwithstanding anything they may come up with, it is simply a principle and a line we wish to draw, that there should be no limitations in these matters.
Mr J. Wilson: I have a quick question to the parliamentary assistant. Do you know what the time frame is for the Attorney General's proposed Limitations Act?
Mr Wessenger: Going by memory, I believe there was supposed to be approximately a year's consultation period. I am just going from memory. It has been out for at least six months.
Mr J. Wilson: What would the current limitation be in the area of sexual abuse?
Mr Wessenger: I will ask counsel. Under the present Health Disciplines Act, there is a one-year limitation period from when the person discovered it.
Mr J. Wilson: Do you have any worry that the victims of the sexual abuse going on today are possibly going to be denied a degree of justice when there is no definite time frame as to when a new Limitations Act will come in?
Mr Wessenger: One of the problems is that people do not sue for civil liability with respect to the matter of sexual abuse. In fact, civil liability has not proved an effective method of dealing with the matter of sexual abuse. That is why it has to be dealt with by other means.
The Acting Chair (Ms Poole): Just before we go to Mr Jackson, Mr Owens.
Mr Owens: I yield my time.
Mr Jackson: What I am hearing is that because we have a one-year limitation from the time it has become known, we should not be very surprised that people do not resort to the courts.
Mr Wessenger: No, that is not the reason. The basic fact is that the court system is so expensive and so cumbersome for most people that they do not resort to the court system in situations involving sexual abuse.
Mr Jackson: But the limitation period is a function.
Mr Wessenger: No, I do not think the limitation period is the basic problem. The basic problem is that people are inhibited from taking the civil process by the cost and the complexity. It is not the Limitations Act that is the problem. The problem is that for most people the civil court system is not the method that is going to work with respect to dealing with this matter.
1710
Mr Jackson: Some of the models for justice reform in other jurisdictions in Canada and one that is currently before the current Attorney General for consideration is that matters of civil litigation in these matters could be supported with public funds and/or that ultimate costs are borne by the accused. All that we are simply suggesting here is that if your government is prepared to have an open-ended limitations period, but it might be a year or two or three years down the road, clearly we are defining two sets of justice opportunities for citizens, based on which side of amendments to the Limitations Act they fall on.
We are simply freeing those victims from being encumbered by the current restrictions of the Limitations Act, which is something you again say that you are committed to and can very simply implement with this statement. I believe we are offering you an opportunity to not incur a great expense, but to make sure that victims today are treated the same as victims will be treated three years from now when we finally get around to finishing the Limitations Act. That is all we are suggesting here.
We would like a recorded vote on this one, that is for sure.
Mr Wessenger: I think it is fair to say that when the Limitations Act amendments are passed this legislation will be retroactive, so people will benefit from it when it is passed.
The committee divided on Mr J. Wilson's motion, which was negatived on the following vote:
Ayes/Pour -- 2
Jackson, Wilson, J.
Nays/Contre -- 5
Haeck, Malkowski, Martin, Owens, Wessenger.
Section 85 agreed to.
L'article 85 est adopté.
The Acting Chair: The next amendment is a Conservative motion.
Mr J. Wilson: Madam Chair, we will be withdrawing this amendment grudgingly and with regret, since the survivors compensation fund amendment did not pass.
Mr Jackson: But the Chair is now aware of how we would fund it? Great.
The Acting Chair: Shall section 91 carry?
Sorry, before I do that, there is a motion that is necessary because of another motion which passed today, and that is to rescind a previous motion.
I move that the vote on the government motion dealing with paragraph 22.1 of subsection 91(1) of schedule 2 of the bill and subsection 91(2) of schedule 2 of the bill be rescinded.
Mr J. Wilson: Will you repeat that, Madam Chair?
The Acting Chair: Earlier in the proceedings today we passed sections 81.1 and 81.2. Because that motion superseded the previous government motion we need a motion to rescind the previous motion.
Mr J. Wilson: Understood.
The Acting Chair: I am glad somebody does. Any discussion, or anybody want to clarify their version of this motion?
Mr Wessenger: I understand what you are doing. Your new 81.1 and 81.2 make this --
The Acting Chair: That is right; new 81.1 and 81.2 supersede the old motion. All in favour? Opposed?
Motion agreed to.
The Acting Chair: It is my understanding that when we completed the discussion and the amendments on Bill 43 we would adjourn for the day. Is that the understanding?
Mr Wessenger: No, I think we were going to include the provisions with respect to the acts we have already covered with respect to the patient relations committee. We were going to finish those off and then at that stage adjourn for the day.
The Acting Chair: I thank the parliamentary assistant for that assistance.
AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY ACT, 1991 / LOI DE 1991 SUR LES AUDIOLOGUES ET LES ORTHOPHONISTES
Mr Wessenger: We are dealing with subsection 21(4) of Bill 44. We just need to vote on it.
The Acting Chair: The clerk has confirmed that subsection 21(4) of Bill 44, An Act respecting the regulation of the Professions of Audiology and Speech-Language Pathology, has been moved, so we will go directly to the vote. All in favour of subsection 21(4)? All opposed?
Motion agreed to.
Section 21, as amended, agreed to.
L'article 21, modifié, est adopté.
CHIROPODY ACT, 1991 / LOI DE 1991 SUR LES PODOLOGUES
Section/article 24:
The Acting Chair: The clerk confirms that subsection 24(4) has been moved. All in favour? All opposed?
Motion agreed to.
Section 24, as amended, agreed to.
L'article 24, modifié, est adopté.
CHIROPRACTIC ACT, 1991 / LOI DE 1991 SUR LES CHIROPRATICIENS
Section/article 22:
The Acting Chair: The clerk confirms that subsection 22(4) has been moved. All in favour? All opposed?
Motion agreed to.
Section 22, as amended, agreed to.
L'article 22, modifié, est adopté.
DENTAL HYGIENE ACT, 1991 / LOI DE 1991 SUR LES HYGIÉNISTES DENTAIRES
The Acting Chair: We now move to Bill 47, An Act respecting the regulation of the Profession of Dental Hygiene.
Mr J. Wilson: Is there any way we can just have one motion? They are all different subsections, I guess.
The Acting Chair: We will try to move through them quite quickly.
Section/article 22:
The Acting Chair: Bill 47, subsection 22(4), all those in favour? All those opposed?
Motion agreed to.
Section 22, as amended, agreed to.
L'article 22, modifié, est adopté.
DENTAL TECHNOLOGY ACT, 1991 / LOI DE 1991 SUR LES TECHNOLOGUES DENTAIRES
Section/article 21:
The Acting Chair: All in favour of subsection 21(4)? All opposed?
Motion agreed to.
Section 21, as amended, agreed to.
L'article 21, modifié, est adopté.
DENTISTRY ACT, 1991 / LOI DE 1991 SUR LES DENTISTES
Section/article 24:
The Acting Chair: All in favour of subsection 24(4)? All opposed?
Motion agreed to.
Section 24, as amended, agreed to.
L'article 24, modifié, est adopté.
DENTURISM ACT, 1991 / LOI DE 1991 SUR LES DENTUROLOGISTES
Section/article 22:
The Acting Chair: Shall subsection 22(4) carry? All in favour? All opposed?
Motion agreed to.
Section 22, as amended, agreed to.
L'article 22, modifié, est adopté.
DIETETICS ACT, 1991 / LOI DE 1991 SUR LES DIÉTÉTISTES
Section/article 20:
The Acting Chair: Shall subsection 20(4) carry? All in favour? All opposed?
Motion agreed to.
Section 20 agreed to.
L'article 20 est adopté.
MASSAGE THERAPY ACT, 1991 / LOI DE 1991 SUR LES MASSOTHÉRAPEUTES
Section/article 21:
The Acting Chair: Shall subsection 21(4) carry? All in favour? All opposed?
Motion agreed to.
Section 21 agreed to.
L'article 21 est adopté.
The Acting Chair: Unless anybody has any other surprises, I presume that is it. Tomorrow, for the information of committee members, we shall be starting on Bill 53 and proceed until that is completed.
Mr Wessenger: And the other bills.
The Acting Chair: And whatever bills are still outstanding.
The committee adjourned at 1721.