CONTENTS
Monday 30 September 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
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)
Wilson, Jim (Simcoe West PC)
Witmer, Elizabeth (Waterloo North PC)
Substitution: Jackson, Cameron (Burlington South PC) for Mrs Witmer
Clerk: Mellor, Lynn
Staff: Spakowski, Mark, Legislative Counsel
The committee met at 1530 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.
Reprise 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: I see a quorum. The standing committee on social development is now in session.
We have had our opening statements. We will begin today with section 1.
Mr Owens: Madam Chair, just before we get into this, Frances Lankin, the minister, will be available next Monday to come in to discuss the diagnosis clause, as we had agreed previously, if that suits the committee.
The Chair: So your request, Mr Owens, is that section 26 be stood down.
Mr Owens: That is right, in case by some miracle of process we reach section 26 by Tuesday.
The Chair: That it be dealt with next Monday?
Mr Owens: Yes.
The Chair: Mr Owens moves that section 26 of Bill 43 be stood down and be dealt with next Monday, October 7.
Motion agreed to.
The Chair: The committee has decided to deal with section 26 next Monday, and the minister will be present. Any further motions at this time before we begin with section 1? In that case, we will deal with section 1.
Sections 1 and 2 agreed to.
Les articles 1 et 2 sont adoptés.
Section/article 3:
The Chair: I see that there are amendments to section 3.
Mr Wessenger moves that section 3 of the bill be amended by adding at the end "and that they are treated with sensitivity and respect in their dealings with health professionals, the colleges and the board."
Motion agreed to.
Section 3, as amended, agreed to.
L'article 3, modifié, est adopté.
Section 4 agreed to.
L'article 4 est adopté.
Section/article 5:
The Chair: Mr Jackson moves that clause 5(1)(c) of the bill be amended by striking out "require" in the first line and substituting "request."
Motion negatived.
Mr Jackson: What a shame.
The Chair: Any further amendments to section 5? Mr Jackson, you have an amendment to section clause 5(1)(d).
Mr Jackson: You are very helpful today. Thank you.
The Chair: Mr Jackson moves that clause 5(1)(d) of the bill be struck out.
Motion negatived.
Section 5 agreed to.
L'article 5 est adopté.
Section/article 6:
Mr Wessenger: I would like to ask that section 6 be stood down for further consideration.
The Chair: We have a request from the parliamentary assistant that we stand section 6 down. To the end of the --
Mr Wessenger: Yes, to the end. That would be fine.
Mr Jackson: The complete section?
Mr Wessenger: The complete section, yes.
The Chair: Any questions or comments?
Mr Beer: It is to be stood down till a particular time, or you want to do it at the end?
The Chair: The request, as I understand it, Mr Beer, is that at the end of the rotation of sections, we would come back to section 6. The request to stand down would be until the end?
Mr Wessenger: Perhaps when we get to the whole patient relations matters, we could deal with this at the same time.
The Chair: Which section is that? I would prefer, as Chair, that we be precise; that unless there is a specific request, then automatically, if it is approved, the section will be dealt with at the end. If anyone requests standing down the section to a specific time or a specific point, I would appreciate it if they made that point when we deal with the section, just for clarity.
Mr Wessenger: Could I ask that it be dealt with at the same time as schedule 2, section 81.1?
The Chair: The clerk has recorded that. Agreed?
Agreed to.
Sections 7 to 12, inclusive, agreed to.
Les articles 7 à 12, inclusivement, sont adoptés.
Section/article 13:
The Chair: Shall section 13 carry?
Mr Wessenger: I have an amendment. It is additional, so it will come after section 13.
The Chair: Shall section 13, as printed, carry? All in favour? Opposed?
Mr Beer: I am sorry, Madam Chair, what is it we are carrying here with an amendment?
The Chair: Section 13 as printed, as written. The parliamentary assistant has indicated that there is an amendment to add a new section. The question I have is that there is a government motion here on section 13.1. Is that a new section?
Clerk of the Committee: Yes.
The Chair: Okay, so as written, section 13. Carried?
Section 13 agreed to.
L'article 13 est adopté.
The Chair: We have a new section.
Mr Wessenger moves that the bill be amended by adding the following section:
"13.1 The function of the advisory council is advisory only and no failure to refer a matter or to comply with any other requirement relating to a referral renders anything invalid."
Mr Wessenger: The purpose of this amendment is to clarify that the position of the council is advisory only and that no regulation could be rendered invalid by reason of any procedural problems.
The Chair: All in favour? Opposed?
Motion agreed to.
Sections 14 to 21, inclusive, agreed to.
Les articles 14 à 21, inclusivement, sont adoptés.
Section/article 22:
The Chair: Shall section 22 carry?
Mr Wessenger: I have an amendment.
The Chair: Mr Wessenger moves that the French version of section 22 of the bill be amended by striking out "de décisions" in the third line.
And the rationale? Do you want to put that on the record?
Mr Wessenger: It is an amendment for grammatical clarity.
Mr Beer: Would the parliamentary assistant entertain a question on grammatical clarity en français?
Mr Wessenger: I do not know whether anybody here could give that explanation.
Mr Beer: I withdraw the question.
The Chair: In fact, I think Mr Beer might be able to.
Mr Wessenger: He might be able to do better; that is right.
Motion agreed to.
Section 22, as amended, agreed to.
L'article 22, modifié, est adopté.
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Section/article 23:
The Chair: Shall section 23 carry?
Mr Wessenger: I have an amendment.
The Chair: Mr Wessenger moves that subsection 23(5) of the bill be amended by striking out "and, in the case of a complainant review, to the complaints committee" in the fourth and fifth lines.
Mr Wessenger: The purpose of this amendment is that as the complaints committee is not a party at the complaint review, it is incorrect to require the health professions board to share with it the advice it receives in connection with a review.
Motion agreed to.
Section 23, as amended, agreed to.
L'article 23, modifié, est adopté.
Section 24 agreed to.
L'article 24 est adopté.
Section/article 25:
The Chair: Mr Wessenger moves that the French version of subsection 25(1) of the bill be amended by
(a) striking out "objets" in the sixth line of clause (b) and substituting "choses";
(b) striking out "à l'examen" in the second line of clause (c) and substituting "au réexamen" and by inserting "à" after "ou" in the third line; and
(c) striking out "révision de décision" in the first line of clause (d) and substituting "réexamen".
Any discussion on the proposed amendment?
Motion agreed to.
The Chair: You have a further amendment to section 25, Mr Jackson?
Mr Jackson: We will not be tabling our amendment.
The Chair: Withdrawn?
Mr Jackson: Withdrawn.
Section 25, as amended, agreed to.
L'article 25, modifié, est adopté.
The Chair: Section 26 has been stood down by a previous motion.
I would point out to Mr Owens that not only have we reached that section today, but we did so in approximately 20 minutes. I just wanted to point out that miracles can and do sometimes happen, even in the Legislative Assembly.
Mr Owens: I would like to commend the Chair for her speed in getting this bill through.
The Chair: All in favour? Shall we carry on?
Mr Owens: I do have a comment about the translation we are receiving from the parliamentary assistant, however. If we could have some --
The Chair: We will not make any comment on that today, Mr Owens. As we proceed, section 27.
Section/article 27:
Mr Wessenger: I have an amendment.
The Chair: Let me catch up with that. I think there are several amendments to section 27.
Mr Wessenger: No, just one.
The Chair: Mr Wessenger moves that section 27 of the bill be amended by:
(a) striking out "the regulations" in the third line of subsection (1) and substituting "any applicable regulations"; and,
(b) striking out "the regulations" in the second and third lines of subsection (2) and substituting "any applicable regulations."
Mr Wessenger: This amendment is to clarify that any controlled act may be delegated.
Motion agreed to.
Section 27, as amended, agreed to.
L'article 27, modifié, est adopté.
Section/article 28:
The Chair: I believe we have a government amendment.
Mr Wessenger moves that section 28 of the bill be amended by adding the following clause:
"(e) assisting a person with his or her routine activities of living and the act is a controlled act set out in paragraphs 5 or 6 of subsection 26(2)."
Mr Wessenger: This was the amendment which was negotiated with all the interest groups with respect to attendant care services. It is supported by the disabled groups and the Ministry of Community and Social Services. You may remember there was great concern addressed by persons who needed assistance in their daily living because of certain acts that were done within the framework of controlled acts. This is to remedy that situation.
The Chair: Any discussion on that amendment?
Mr J. Wilson: I just point out to members of the committee that we have also introduced an amendment. Unfortunately, it is in section 26. That also deals with attendant care. It is certainly our opinion that our amendment is -- I guess to use the word -- better than the government's in that it recognizes that a person with a disability and in need of attendant care is in charge of attendant care. We heard a great deal of testimony before this committee that vital to the point of attendant care was that the person receiving the care is in charge of the care. I ask members to consider our amendment in section 26.
The Chair: Section 26 is not before the committee at this time.
Mr J. Wilson: In light of that, Madam Chair, I ask that we stand down this particular clause because it is tied to our amendment. It is going to require a bit of debate.
The Chair: We have a motion that section 28 be stood down and be dealt with immediately following section 26. All in favour? Any opposed? Section 28 has been stood down.
Mr Beer: Madam Chair, I note that there is another amendment which would then be dealt with at that same time. I draw that to members' attention.
The Chair: We have a request from Mr Beer that all amendments to section 28 --
Mr Wessenger: There is no reason why we cannot deal with section 28.1, because that is a new section.
The Chair: Okay. We have a new section proposed, section 28.1.
Mr Beer moves that the bill be amended by adding the following section:
"(1) No person, other than a member treating or advising within the scope of practice of his or her profession, shall treat or advise a person with respect to his or her health in circumstances in which it is reasonably foreseeable that serious physical harm may result from the treatment or advice or from an omission from them.
"(2) Subsection (1) does not apply with respect to treatment by a person who is acting under the direction of or in collaboration with a member if the treatment is within the scope of practice of the member's profession.
"(3) Subsection (1) does not apply with respect to an act by a person if the act is a controlled act that was delegated under section 28 to the person by a member authorized by a health profession act to do the controlled act.
"(4) Subsection (1) does not apply with respect to counselling of an emotional, social or spiritual nature.
"(5) Subsection (1) does not apply with respect to anything done by a person in the course of,
"(a) rendering first aid or temporary assistance in an emergency;
"(b) fulfilling the requirements to become a member of a health profession if the person is acting within the scope of practice of the profession under the supervision or direction of a member of the profession;
"(c) treating a person by prayer or spiritual means in accordance with the tenets of the religion of the person giving the treatment;
"(d) treating a member of the person's household; or
"(e) assisting a person with his or her routine activities of living.
"(6) Subsection (1) does not apply with respect to an activity or person that is exempted by the regulations."
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Mr Beer: I think there were two particular reasons we wanted to bring this amendment in. One is, members will recall the original clause that dealt with this issue had been removed earlier by another minister, and at that time there had been no real discussion as to the kind of balance we were seeking in this particular area with respect to the risk of harm. What we have tried to do is to meet the concerns that were expressed by people who had concerns about the original clause. Again, the Chair, when she was minister, had suggested that at the committee the committee would deal with this question in trying to find if there was a way of meeting the needs both of the original clause and then of the concerns that have been raised about it.
We bring this forward for discussion with all members, but with the concern that after hearing from all of the witnesses and from Mr Schwartz, in our view there was still a need for a balance with respect to this question of harm. It was our thought that through this we have caught the specific concerns of those who are social workers, those who are in the clergy and others who are counselling. Clearly, we would welcome any discussion of this amendment, but believe it provides a balance that is still required in the act.
I would leave my opening comments on the amendment and, if there are any questions, try to deal with them.
Mr Jackson: We will be supporting the new section, but we had a further amendment to subsection 28.1(4) to read, "Subsection (1) does not apply with respect to counselling of an emotional, social, educational or spiritual nature."
The purpose of that motion, Madam Chair, is to ensure that it is abundantly clear, as was stated during testimony, with examples occurring in educational institutions across this province, that we surely do not wish to entrap teachers and certain counselling activities which are occurring in the classroom and are of a routine nature and required by the Education Act to be in any way seen to be connected. Therefore, we want them clearly stated here as an exemption. I hope the Liberals will consider that as a friendly amendment, but it is certainly one that our caucus is very committed to.
The Chair: Are you prepared at this time to submit that in writing?
Mr Jackson: Would you like me to write out the one word?
The Chair: Yes. You must submit it in writing.
Mr Jackson: It is like school, is it not?
The Chair: This is educational.
Mr Jackson: I left the door open, Madam Chair. If the Liberals would accept it as a friendly amendment, then Mr Beer would have to do the writing out and then I could get to my meeting.
The Chair: I have been advised by the clerk that you must submit it in writing, but we are writing it out for you, to be helpful.
Mr Jackson: What a clerk.
Mr Beer: This is a friendly committee.
Mr Jackson: I did have the spelling correct, I want you to know, in both official languages.
Mr Owens: Just to comment on the initial amendment before the friendly amendment was made, the government will support the initial amendment put forward by Mr Beer. The issues that became clear to me as we heard from deputants across the province were that on one hand they wanted the system to be opened up to try and eliminate some of the hierarchies that have existed in medical practice throughout history, but on the other hand they also insisted that consumers be protected. I think it was the College of Physicians and Surgeons that used the term "cabbage leaf wrappers" as being the folks we would want to protect innocent people from.
I think this amendment protects consumers from, I guess, the best of the worst, if you want to put it in terms of the hit parade. I think Mr Beer has put forward quite a reasonable amendment and has dealt with the kinds of exemptions that were expressed specifically by the unregulated folks. I know there has been some consternation within that community with respect to harm clauses, but I think this not only addresses the safety issue but also addresses the concerns the unregulated practitioners have. I think these people, whether they are in the churches, whether they are counsellors, will be free to practise as they have up to this point.
Mr Beer: I just say to my colleague who moved the amendment to add the word "educational" that it would be quite acceptable to us.
Mr J. Wilson: Certainly we agree with the wording in section 28.1. That does not preclude that we may want to bring in further amendments in section 26, again to address the concerns as mentioned by Mr Owens of the unregulated professionals.
Mr Jackson: It was a good offer from Mr Owens.
The Chair: Any further discussion? We will call the vote first on the amendment to the amendment, as proposed by Mr Jackson, to include the word "educational." All in favour? Any opposed?
Motion agreed to.
The Chair: The motion now on the amendment as placed by Mr Beer. All in favour?
Motion agreed to.
The Chair: There is a section 28.2, which is a new section. I point out that it refers to section 26. Do you want to stand that down? All in favour of standing down discussion of the amendment to section 28.2, to be dealt with immediately following section 26?
Agreed to.
Section 29 agreed to.
L'article 29 est adopté.
The Chair: Mr Wessenger moves that the bill be amended by adding the following section:
"29.1 (1) No person shall design, construct, repair or alter a dental prosthetic, restorative or orthodontic device unless,
"(a) the technical aspects of the design, construction, repair or alteration are supervised by a member of the College of Dental Technologists of Ontario, of the Royal College of Dental Surgeons of Ontario; or
"(b) the person is a member of a college mentioned in clause (a).
"(2) A person who employs a person to design, construct, repair or alter a dental prosthetic, restorative or orthodontic device shall ensure that subsection (1) is complied with.
"(3) No person shall supervise the technical aspects of the design, construction, repair or alteration of a dental prosthetic, restorative or orthodontic device unless he or she is a member of the College of Dental Technologists of Ontario or the Royal College of Dental Surgeons of Ontario.
"(4) This section does not apply with respect to the design, construction, repair or alteration of removable dentures for the patients of a member of the College of Denturists of Ontario if the member does the designing, construction, repair or alteration or supervises the technical aspects.
"(5) This section does not apply with respect to anything done in hospital as defined in the Public Hospitals Act or in a clinic associated with a university's faculty of dentistry or the denturism program of a college of applied arts and technology."
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Mr Wessenger: Basically what this amendment does is ensure that the design and manufacture of dental plants, as in commercial dental laboratories, is supervised by a registered dental technologist and contains the appropriate exceptions for dentists and denturists.
Mr Beer: I just want to make sure I understand this. With respect to subsection 29.1(4), I take it that in that list of designing, construction, repair, etc, the denturist could do all or one of?
Mr Wessenger: Yes, that would be correct. All or one of.
Motion agreed to.
Section/article 30:
The Chair: Mr J. Wilson moves that section 30 of the bill be amended by adding the following subsection:
"(2.1) Subsection (1) does not apply to a person who is a member with a doctoral degree in his or her profession from a university approved, for the purpose of this subsection, by the council of the member's college."
Mr J. Wilson: The purpose of the amendment is to ensure that those health care professionals who have earned a PhD degree may be able and entitled to use the term "doctor" in a health care setting. It is not only a very strong personal belief of mine, but caucus believes that as this committee and this legislation and previous legislation have extended the use of the term "doctor" to other professionals, certainly those who have achieved the highest level of academic excellence, as reflected in the PhD, should be allowed to use the term "doctor" in a health care setting.
We do not believe the public will be confused by this. In fact, in consulting with the College of Physicians and Surgeons, it is my understanding that they do not believe the public will be terribly confused. Mr Schwartz's own rationale in some areas has been that the public will be confused, and other times he has told us that, when it comes to restriction of certain titles, the public are going to have to get used to certain titles that they may not be used to now. That may be the case here. We think allowing PhDs in health care professions to refer to themselves as "doctor" certainly is in order.
Mr Beer: This was a topic that came up at great length, and I know we were all very much troubled by not allowing someone who has a doctorate to be able to use that title. It seems to me that it is not beyond the imagination of the various councils to find a way by which the fact that one has a doctorate can be indicated.
It just does not seem right that we are telling somebody they cannot use a title they have earned in the normal fashion. And this is something whereby, within a health care setting or a hospital setting, different kinds of identification can make it clear that the person is a doctor in this or that profession.
A number of people suggested, for example with speech therapists, that it say, "Dr Anne Smith," and then underneath that, "speech therapist." That is perhaps a way the different councils can find of making sure it is clear what a person has a doctorate in. But for that reason, we would support the amendment made by the Conservative member.
Mr Wessenger: I would like to speak in opposition to the amendment. I think it is very clear that the public would be confused in a health care setting by the use of the word "doctor" on a title, because in all the presentations made before us it was quite interesting that generally even other health professions, in making comments about the physicians and surgeons, always tended to refer to them as doctors. So I think it is quite clear there would be confusion.
There is nothing in the legislation that prevents a person from showing their degree, their PhD, and there is nothing that prohibits someone who knows what a PhD is from calling a person "doctor" if they so wish. The restrictions now exist in the Health Disciplines Act.
We believe it would create some confusion between members of the public and certain individuals such as audiologists and speech/language pathologists if some of them were called "doctor" and some of them were not. We do not want to create that confusion among members of the public.
This legislation is not designed to create status. It is designed to facilitate designations and avoid confusion among the public. Also, the minister has regulation-making authority to make exceptions, and I understand there is an intention to make an exception for use of title in regulated settings such as schools and hospitals, where administration is accountable and there is assurance the public will not be misled.
Motion negatived.
Section 30 agreed to.
L'article 30 est adopté.
Section 31 agreed to.
L'article 31 est adopté.
The Chair: Mr Beer moves that the bill be amended by adding, after the heading "Miscellaneous," the following section:
"31.1(1) The council of a band prescribed by the regulations may authorize persons to provide, on the band's reserve, health care services to members of the band.
"(2) This act does not apply with respect to the provision of health care services provided under the authorization of the council of a band prescribed by the regulations.
"(3) In this section, "band," "council of a band," "members of the band," and "reserve" have the same meaning as those terms have, with necessary modifications, in the Indian Act (Canada)."
The Chair: I have a request from Mr Wessenger to make a comment.
Mr Wessenger: Mr Beer, I am wondering if you would consider standing this section down on the basis that we are in a consultation process right now with the native community and it would seem more appropriate to wait until that consultation process is finished. In fact, we are going to stand down, I understand, this whole Bill 43 until that consultation process is finished, and that we deal with your amendment at that time. Would that be agreeable?
Mr Beer: I have no problem about standing this down. I think if there is discussion, that makes every sense. Did I hear you correctly, though? You are saying we are going to stand down the whole of Bill 43?
Mr Wessenger: The completion of the bill.
Mr Beer: We have agreed that we are going to hold Bill 43 open until we have completed all of the bills. Is it still your intention that at the end of that time we would then come back?
Mr Wessenger: That is right, yes.
Mr Beer: Okay, I just wanted to be clear.
The Chair: For the record, let me be clear with what I have heard and make sure all members of committee are satisfied that this is the process. We have a request to stand down proposed section 31.1 until the conclusion of Bill 43. Further, we have a request from Mr Wessenger that Bill 43 be dealt with finally after all the bills inclusive of Bill 64 have been dealt with, so at the end of Bill 64 we will deal once again, finally, with Bill 43 and section 31.1 at that time. That is my understanding.
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Mr Wessenger: That is my request, yes.
The Chair: Any discussion? All in favour? Any opposed? Section 31.1 has been stood down until we deal with Bill 43 at the completion of all other bills in the package, and that would be Bill 64.
Section/article 32:
The Chair: Mr Wessenger moves that subsection 32(1) of the bill be amended by inserting after "employed" in the first line "retained" and by striking out "council" in the sixth line and substituting "college."
Mr Wessenger: The purpose of this amendment is to cover the fact that certain individuals are retained rather than employed or appointed, such as a court reporter, interpreter, expert and private investigator. The substitution of "college" for "council" is a housekeeping amendment.
Motion agreed to.
The Chair: Mr Wessenger moves that clause 32(1)(d) of the bill be struck out and the following substituted:
"(d) as may be required for the administration of the Health Insurance Act, Independent Health Facilities Act, 1989 or the Prescription Drug Cost Regulation Act, 1986."
Mr Wessenger: The purpose of the amendment is to permit the flow of information from college officials in order to administer and enforce the named acts. This is necessary because the colleges perform part of the enforcement of the acts.
Motion agreed to.
The Chair: Mr Wessenger moves that subsection 32(3) of the bill be amended by inserting after "report" in the third line "document or thing."
Mr Wessenger: The purpose is to ensure that all documents and objects, ie, the complaints investigation records, are protected. These could be physical objects rather than just reports.
Motion agreed to.
Section 32, as amended, agreed to.
L'article 32, modifié, est adopté.
Sections 33 to 35, inclusive, agreed to.
Les articles 33 à 35, inclusivement, sont adoptés.
Section/article 36:
Mr Beer: Madam Chair, in view of the fact that we have stood down section 26 and that this relates to 26, I ask that this be stood down and we will bring it back next time.
The Chair: I have a motion that section 36 be stood down and dealt with immediately following section 26 in chronological order. There is another motion in between there that would come right after that. Agreed? Section 36 has been stood down and it will be dealt with following the determination on section 26.
Section 37 agreed to.
L'article 37 est adopté.
Section/article 38:
The Chair: Mr Wessenger moves that section 38 of the bill be amended by adding the following subsection:
"(3) Subsection (2) does not apply with respect to a corporation that operates a public hospital within the meaning of the Public Hospitals Act or to a corporation to which part III of the Corporations Act applies."
Mr Wessenger: This amendment excepts members of boards of public hospitals and non-profit corporations from personal liability if they approved, permitted or acquiesced in the hospital or corporation employing a person who unlawfully performs a controlled act.
Motion agreed to.
Section 38, as amended, agreed to.
L'article 38, modifié, est adopté.
Section/article 39:
The Chair: Mr Beer moves that clause 39(1)(b) of the bill be amended by adding at the end "or 28.1(1)."
Mr J. Wilson: Perhaps Mr Beer would provide a reasoning for the amendment.
The Chair: Section 28.1 was carried.
Mr Beer: Section 28.1 was carried, the new amendment we made was carried -- just to cover that off here because it is appropriate.
The Chair: All in favour? Any opposed?
Motion agreed to.
Mr Beer: We have an amendment to clause 39(1)(e) and I would have that stood down pending the discussion of the whole new addition.
The Chair: Mr Beer moves that the amendment to clause 39(1)(e) be stood down until such time as we have dealt with the new proposed section 31.1.
Mr Beer: I think this refers to a band, and it was section 31.1.
The Chair: Any discussion? Motion to stand down. All in favour? Carried. We will stand down clause 39(1)(e) to be dealt with at the same time as the determination on the motion which dealt with this matter previously.
Motion agreed to.
The Chair: At this point, then, we will stand down section 39 in its entirety. All in favour? Carried.
Sections 40 to 42, inclusive, agreed to.
Les article 40 à 42, inclusivement, sont adoptés.
Section/article 43:
The Chair: Mr Wessenger moves that paragraph 1 of subsection 43(1) of the bill be amended by inserting after "(r)" in the fourth line: "subsection 113(2), section 114, clauses 119(1)(d) and (j) and clause."
Mr Wessenger: It is really to correct supposedly an inadvertent omission. It should have been there.
Motion agreed to.
The Chair: Mr Wessenger moves that section 43 of the bill be amended by adding the following subsection:
"(14.1) Subsection 142(3) of the act is repealed and the following substituted:
"(3) Every manager of a pharmacy shall publicly display his or her licence in the pharmacy."
Mr Wessenger: This replaces the provision requiring a licence of every pharmacist employed in the pharmacy to be displayed. It was felt it was not practical because of the part-time pharmacists coming in and out. It is just the manager's that has to be displayed, and it has been requested by the Ontario College of Pharmacists.
Motion agreed to.
Section 43, as amended, agreed to.
L'article 43, modifié, est adopté.
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Section/article 44:
The Chair: Mr Wessenger moves that section 44 of the bill be struck out and the following substituted:
"44. The Ontario Dietetic Association Act, 1958 is repealed."
Mr Wessenger: This is amended because the association has requested the repeal of this private act. The association prefers to re-incorporate under the Corporations Act.
Mr Beer: I take it you say that the Dietetics Act, 1991 is proposed. Is there going to be then a time frame between which there is no association act? Is there anything that could go awry because one may come after the other?
Mr Wessenger: I understand the association is well aware it has to incorporate its new corporation before this act is proclaimed.
Motion agreed to.
Section 44, as amended, agreed to.
L'article 44, modifié, est adopté.
Sections 45 and 46 agreed to.
Les article 45 et 46 sont adoptés.
Table/tableau:
The Chair: Mr Wessenger moves that the French version of the table to the bill be amended (a) by striking out "techniciens" in the second line of the entry in column 2 of item 2 and substituting "technologues," (b) by striking out "denturologues" in the second line of the entry in column 2 of item 3 and substituting "denturologistes," and (c) by striking out "techniciens" in the second line of the entry in column 2 of item 16 and substituting "technologues."
Mr Wessenger: The purpose of this amendment is that it accommodates each profession's preference for a particular French title. It is the profession's own preference of what language be used and we are merely accommodating that.
Motion agreed to.
Table, as amended, agreed to.
Le tableau, modifié, est adopté.
Schedule/annexe 1:
The Chair: Mr Wessenger moves that the French version of schedule 1 of the bill be amended (a) by striking out "audiologues" in the first item and substituting "audiologistes," (b) by striking out "denturologues" in the fourth item and substituting "denturologistes," (c) by striking out "techniciens" in the third last item and substituting "technologistes," and (d) by striking out "techniciens" in the last two items and substituting, in each item, "technologues."
Mr Wessenger: The reason is the same as for the previous amendment.
Motion agreed to.
Schedule 1, as amended, agreed to.
L'annexe 1, modifiée, est adoptée.
Schedule/annexe 2:
Section/article 1:
The Chair: Mr Wessenger moves that subsection 1(1) of schedule 2 to the bill be amended by adding the following definition:
"`Council' means the council of the college; (`conseil')."
Mr Wessenger: Just a housekeeping amendment again.
Motion agreed to.
The Chair: Mr Wessenger moves that subsection 1(1) of schedule 2 of the bill be amended by adding the following definition:
"`patient relations program' means a program to enhance relations between members and patients."
Mr Wessenger: This is a definition section related to the new patient relations committee and program.
Mr J. Wilson: Perhaps we could stand this down a little. It is just a definition at this point. We should have some discussion about the new patient relations program and what the government's intention in this whole area is, because we have only had brief introductory comments last week from the parliamentary assistant and I think we should have a further discussion on it.
The Chair: So are you requesting that all of schedule 2 be stood down until section 26 has been dealt with, or are you asking that just this amendment to schedule 2 be stood down?
Mr J. Wilson: This amendment at the moment.
The Chair: Okay. We have a request to stand this amendment down. Any discussion? All in favour? Any opposed? We shall stand down this amendment to schedule 2, subsection 1(1) until we deal with section 26 next Monday.
Mr Wessenger: Madam Chair, it is 81(1).
The Chair: Just to be clear, schedule 2, subsection 1(1) is stood down until there is discussion of 81(1) on the schedule.
Section 2 agreed to.
L'article 2 est adopté.
Section/article 3:
The Chair: Mr Wessenger moves that subsection 3(1) of schedule 2 of the bill be amended by adding the following paragraph:
"5.1. To develop, establish and maintain programs to assist individuals to exercise their rights under this code and the Regulated Health Professions Act, 1991."
Mr Wessenger: The purpose of this amendment is to ensure that colleges have responsibility to develop programs so individuals can exercise their rights under the legislation.
Motion agreed to.
Section 3, as amended, agreed to.
L'article 3, modifié, est adopté.
Section 4 agreed to.
L'article 4 est adopté.
Section/article 5:
The Chair: Mr Wessenger moves that section 5 of schedule 2 to the bill be struck out and the following substituted:
"5(1) No term of a council member who is elected shall exceed three years.
"(2) A person may be a council member for more than one term, but no person who is elected may be a council member for more than nine consecutive years.
"5.1 A majority of the members of the council constitute a quorum."
Mr Wessenger: This is an amended version of an amendment previously circulated. The earlier version limited terms of both elected and appointed public members to six years. In responding to submissions from the colleges, the maximum length has been extended to nine years and the limit applies to elected members only. Government policy traditionally limits public members' terms to six years. It is felt there is a limit necessary to ensure that fresh blood is brought on to the councils. Also, nine years, we feel, permits progression through committee and offices and lessens the member's reliance on college bureaucrats.
Motion agreed to.
1630
The Chair: Mr Wilson moves that section 5 of schedule 2 of the bill be amended by adding the following subsection:
"(2.1) A council member may not be appointed by the Lieutenant Governor in Council if the appointment would reduce the percentage of elected members of the council to less than 60% of the total number of members of the council."
Mr J. Wilson: The purpose of this amendment is that the government has announced its intention to increase the number of lay representatives to just under half of the composition of the college councils. We do not believe that a council made up of almost equal numbers of health care professionals and laypeople is a self-regulated body. We believe the government's intention to have just under 50% lay members would erode self-regulation and the principle of peer review. Therefore, the amendment supports the contention that the ratio should be 60-40, 60% members of the college and 40% lay members.
Mr Wessenger: I would like to speak in opposition to the amendment. In most cases we have negotiated with the college's specific representation. The principle that has been used is just under half, not a fixed percentage. It is contrary to government policy to require that 60% of the representatives be members of the college.
Mr Beer: I have a question to the parliamentary assistant. Could you elaborate on these agreements with the colleges? I take it you mean by this that some of the councils will be perhaps 42% or 44%, but that they will all vary because the numbers are different and those have been negotiated with each council directly. Is that correct?
Mr Wessenger: That is correct. The percentages will vary with each council because the representation is negotiated with the council and the government, so there are variations. In some cases it might be 49%. Also, the arithmetic does not work out exactly in percentage terms, so it will be a varying percentage.
Motion negatived.
Section 5, as amended, agreed to.
L'article 5, modifié, est adopté.
Sections 6 and 8, inclusive, agreed to.
Les articles 6 à 8, inclusivement, sont adoptés.
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: I might explain that this is the patient relations committee mentioned in my opening remarks. This makes the patient relations committee a mandatory committee of each college.
The Chair: Do you want to stand that down, Mr Wilson?
Mr J. Wilson: Yes, Madam Chair.
The Chair: We have a request to stand it down until we deal with all of the related sections. Any comment? All in favour? Any opposed? We will stand down section 9 of schedule 2 to the appropriate time.
Mr Beer: I believe I can move --
The Chair: Just a second. Do you want to just put it on the record and then we will stand it down?
Mr Beer: Yes. Is that the way we might proceed with subsections 9(2) and (3) of schedule 2?
The Chair: Yes.
Mr Beer moves that section 9 of schedule 2 of the bill be amended by adding the following subsections:
"(2) The council shall appoint the members of the committees.
"(3) The composition of the committees shall be in accordance with the regulations."
Mr Wessenger: Mr Beer, I think we can proceed with this, because it does not relate to the patient relations committee.
The Chair: Did you want to comment on this?
Mr Beer: I think it is fairly self-explanatory, just to make clear the council's role, that it will be appointing the members.
Mr Wessenger: I would like to support this amendment because I think it provides a more flexible way of determining committee composition.
Motion agreed to.
The Chair: So we are going to stand down section 9 to be dealt with, but we have amended part of it already.
Sections 10 to 12, inclusive, agreed to.
Les articles 10 à 12, inclusivement, sont adoptés.
Section/article 13:
Mr Wessenger: I have an amendment to section 13.
The Chair: Mr Wessenger moves that section 13 of schedule 2 of the bill be struck out and the following substituted:
"13(1) A person whose certificate of registration is revoked or who resigns as a member continues to be subject to the jurisdiction of the college for professional misconduct referable to the time when the person was a member.
"(2) A person whose certificate of registration is suspended continues to be subject to the jurisdiction of the college for incapacity and for professional misconduct or incompetence referable to the time when the person was a member or to the period of the suspension."
Mr Wessenger: The purpose of this is to cover a situation that should have been covered in the original version.
Motion agreed to.
Section 13, as amended, agreed to.
L'article 13, modifié, est adopté.
Sections 14 to 17, inclusive, agreed to.
Les articles 14 à 17, inclusivement, sont adoptés.
1640
Section/article 18:
The Chair: Mr Wessenger moves that subsection 18(1) of schedule 2 be struck out and the following substituted:
"18(1) A member may apply to the registration committee for an order directing the registrar to remove or modify any term, condition or limitation imposed on the member's certificate of registration as a result of a registration proceeding.
"(1.1) The right to apply under subsection (1) is subject to any limitation in the order imposing the term, condition or limitation or to which the member consented and to any limitation made under subsection (6) in the disposition of a previous application under this section."
Mr Wessenger: This is merely an amendment to clarify the earlier version.
Motion agreed to.
Section 18, as amended, agreed to.
L'article 18, modifié, est adopté.
Section 19 agreed to.
L'article 19 est adopté.
Section/article 20:
The Chair: Mr Wessenger moves that subsection 20(3) of schedule 2 be amended by striking out "forthwith" in the third line and substituting "within 15 days after receiving the notice."
Mr Wessenger: This amendment requires the college to send a record of complaint investigation to the health professions board within 15 days of notice of complaint instead of forthwith. This was recommended by the Health Discipline Board council, because it gives it a more definite time frame rather than just the word "forthwith," which in effect almost means immediately.
Motion agreed to.
The Chair: Mr Wessenger moves that subsection 20(4) of schedule 2 be amended by renumbering clause (a) as clause (a.1) and adding the following clause:
"(a) the applicant has given the registrar notice that the applicant will not be requiring a review or hearing."
Mr Wessenger: This is just a procedural refinement.
Motion agreed to.
Section 20, as amended, agreed to.
L'article 20, modifié, est adopté.
Section/article 21:
The Chair: Mr Wessenger moves that subsection 21(8) of schedule 2 be struck out and the following substituted:
"(8) The board, in making an order under subsection (6), shall not require the registration committee to direct the registrar to issue a certificate of registration to an applicant who does not meet a registration requirement that is prescribed as a non-exemptible requirement."
Mr Wessenger: It is to correct a technical error in the original provision.
Motion agreed to.
Section 21, as amended, agreed to.
L'article 21, modifié, est adopté.
Section/article 22:
The Chair: Mr Wessenger moves that clause 22(2)(f) of schedule 2 be struck out and the following substituted:
"(f) information that a panel of the registration, discipline or fitness to practise committee specifies shall be included; and."
Mr Wessenger: This, again, is a housekeeping amendment clarifying that in addition to the registrar being authorized to enter information on a register, the panel of the registration, discipline or fitness to practise committees can specify what information is to be included on that entry.
Motion agreed to.
The Chair: Mr Wessenger moves that the French version of subsection 22(3) of schedule 2 to the bill be amended by inserting after "bureau" in the second line "normales."
Motion agreed to.
The Chair: Mr Wessenger moves that subsection 22(3) of schedule 2 to the bill be amended by adding the following paragraph:
"1.1 Information described in clause (2)(d) relating to a suspension that is in effect."
Mr Wessenger: This amendment is necessary because the public interest warrants public access to information on anyone currently suspended.
Motion agreed to.
Mr J. Wilson: Madam Chair, were those last comments actually directed to that amendment?
The Chair: No. It was actually grammatical clarity, I think.
Mr J. Wilson: I think so. I thought maybe I was in a different committee for a minute.
The Chair: At least everyone is paying attention.
Mr Wessenger moves that subparagraph 22(3)2ii of schedule 2 to the bill be amended by striking out "the discipline or fitness to practise committee" in the last two lines and substituting "a panel of the discipline or fitness to practise committee."
Mr Wessenger: This allows a panel rather than the whole committee. It is a housekeeping amendment.
Motion agreed to.
The Chair: Mr Wessenger moves that section 22 of schedule 2 of the bill be amended by adding the following subsections:
"(3.1) In disposing of a matter, a panel of the registration, discipline or fitness to practise committee may, for the purposes of clause (2)(f), specify information to be included in the register.
"(3.2) In disposing of a matter, a panel of the discipline or fitness to practise committee may, for the purposes of subparagraph (3)2ii, direct that the results of the proceeding be included in the register."
Mr J. Wilson: Obviously the amendment helps to clarify what information may be contained in the register. I would just like to ask the parliamentary assistant, does it serve to help those nurses, for instance, who were very much worried about their home addresses and that sort of thing being released?
Mr Wessenger: No, it really does not speak to that matter. This really relates to where there has been a proceeding and a finding. The panel can specify what specifically its finding was and how it should be entered in the register to make sure it is accurate.
Motion agreed to.
Section 22, as amended, agreed to.
L'article 22, modifié, est adopté.
Section/article 23:
The Chair: Mr Wessenger moves that section 23 of schedule 2 of the bill be amended by striking out "revoke" in the first and last lines and substituting "suspend."
Mr Wessenger: This is a housekeeping amendment substituting the word "suspend" for "revoke."
Motion agreed to.
Section 23, as amended, agreed to.
L'article 23, modifié, est adopté.
Section/article 24:
The Chair: Mr Wessenger.
Mr Wessenger: I move that section 24 of schedule 2 of the bill be amended by adding the following subsection --
The Chair: That is a PC motion.
Mr Wessenger: Oh, excuse me.
The Chair: I take back what I said about paying attention. The Chair apologizes. I called on Mr Wessenger. It was not a test; it was an oversight.
Mr J. Wilson: I am certainly grateful for the indication of support from the parliamentary assistant. If he likes, he can read our motion into the record.
The Chair: We were on a roll there, but I do apologize.
Mr J. Wilson: He is doing well. I sure hope he will vote for it.
The Chair: I would not count on that, Mr Wilson.
Mr Wilson moves that section 24 of schedule 2 of the bill be amended by adding the following subsection:
"(4.1) Despite subsection (4), a panel shall be selected if the complainant has a disability and the complaint is recorded on a tape, file, disc or other medium."
1650
Mr Owens: Just a quick question to the mover of the amendment. Would you agree, as a friendly amendment, to deal with folks who also have literacy problems, as people with literacy problems are unable to read or write as well?
Mr J. Wilson: I think this attempts to deal with some of those problems. Currently the way the subsection reads is that the complaint must be in writing before a complaints panel will be constituted. This allows other options of communicating.
Mr Owens: But I think you would have to agree that when one talks about a disability, one does not usually include literacy problems in that definition.
Mr J. Wilson: I would think a person with literacy problems would be able now -- and you should agree with the amendment -- to put forward a complaint on tape or film or disc or another medium, and I certainly think your concerns are encompassed in the amendment.
Mr Owens: I think what I am suggesting, Jim, is that --
The Chair: I think he said no to your request.
Mr J. Wilson: No, I did not say no.
The Chair: If you wish to move an amendment to the amendment, you must do so in writing. You can do that, but from the debate and the discussion, he has not agreed to amend his amendment at this time.
Mr J. Wilson: I do, but I do not understand your amendment. Perhaps you could give me some wording on it. I see this amendment as encompassing that already, without specifying each and every possible disability.
Mr Beer: I think this does cover the way in which a complaint can be recorded. I am asking a question of the parliamentary assistant that follows on from what Mr Owens was just asking in terms of the definition of disabilities. This would capture anyone who would need to use tape, film, disc or other media and that would be useful to have in the legislation.
Mr Wessenger: I would like to ask that this be stood down so we can have further time to consider it and come up with appropriate language. I think it is a good concept that has been put forward here, but I think we would like to have it stood down to see what we can come up with in the appropriate language.
Mr J. Wilson: This is not a controversial amendment, but sure, if you would like to.
The Chair: All in favour? Any opposed?
Agreed to.
The Chair: We will stand that down until the appropriate time.
Section/article 25:
The Chair: Mr Wessenger moves that paragraph 25(2)3 of schedule 2 to the bill be amended by inserting after "panel" in the second line "or another panel of the complaints committee."
Mr Wessenger: This is required because in practice it cannot be guaranteed that the panel that considers the submissions will be the same panel that cautions the member.
Motion agreed to.
Section 25, as amended, agreed to.
L'article 25, modifié, est adopté.
Section 26 agreed to.
L'article 26 est adopté.
Section/article 27:
Mr J. Wilson: We are withdrawing our amendment regarding subsection 27(1) of schedule 2.
The Chair: That is withdrawn, thank you.
Section 27 agreed to.
L'article 27 est adopté.
Section/article 28:
The Chair: Mr Wessenger moves that the French version of subsection 28(2) of schedule 2 of the bill be amended (a) by striking out "avait pour objet" in the fourth line; (b) by striking out "de renvoyer" in the first line of clause (a) and substituting "renvoyait"; and (c) by striking out "d'adresser" in the first line of clause (b) and substituting "adressait."
Motion agreed to.
Mr J. Wilson: I point out at this time that we are withdrawing our proposed amendment to subsection 28(4).
Section 28, as amended, agreed to.
L'article 28, modifié, est adopté.
Sections 29 and 30 agreed to.
Les articles 29 et 30 sont adoptés.
Section/article 31:
The Chair: Mr Wessenger moves that subsection 31(2) of schedule 2 of the bill be amended by striking out "and to the complaints committee" in the second and third lines.
Mr Wessenger: This amendment is recommended because requiring the board to disclose to the complaints committee everything given to it by the registrar is redundant where the complaints committee has investigated the complaint.
Motion agreed to.
Section 31, as amended, agreed to.
L'article 31, modifié, est adopté.
Section/article 32:
The Chair: Mr Wessenger moves that clause 32(2)(b) of schedule 2 of the bill be struck out and the following substituted:
"(a.1) may require the college to send a representative;
"(b) may question the parties and the representative of the college."
Mr Wessenger: This amendment authorizes the Health Disciplines Board to require college representatives to attend for questioning at complaint review. It was suggested by the board counsel because sometimes no college representatives attend, to the detriment of the review.
Motion agreed to.
Section 32, as amended, agreed to.
L'article 32, modifié, est adopté.
Section/article 33:
The Chair: Mr Wessenger moves that paragraph 2 of section 33 of schedule 2 of the bill be struck out.
Mr Wessenger: This is a housekeeping amendment.
Motion agreed to.
Section 33, as amended, agreed to.
L'article 33, modifié, est adopté.
Sections 34 and 35 agreed to.
Les articles 34 et 35 sont modifiés.
Section/article 36:
The Chair: Mr Wessenger moves that clause 36(1)(a) of schedule 2 to the bill be struck out and the following substituted:
"(a) an allegation is referred to the discipline committee."
Mr Wessenger: Again, it is just a housekeeping amendment.
Motion agreed to.
The Chair: Mr Wessenger moves that section 36 of schedule 2 to the bill be amended by adding the following subsection:
"(3.1) In a matter in which an order under subsection (1) was made, an order of a panel of the discipline committee directing the registrar to revoke, suspend or impose conditions on a member's certificate takes effect immediately despite any appeal."
Mr Wessenger: The purpose of this is because the college has power to suspend registration before a discipline hearing in extraordinary cases, and usually an order of the discipline committee is stayed pending appeal. In those extraordinary cases, an order should not be stayed,
Motion agreed to.
Section 36, as amended, agreed to.
L'article 36, modifié, est adopté.
1700
Section/article 37:
The Chair: Mr Wessenger moves that subsection 37(3) of schedule 2 of the bill be amended by striking out "one" in the first line and substituting "at least one."
Mr Wessenger: This amendment is to require at least one member of a discipline panel to be both a member of the college and a member of the council.
Motion agreed to.
The Chair: Mr J. Wilson moves that subsection 37(5) of schedule 2 of the bill be struck out and the following substituted:
"(5) Three members of a panel, at least one of whom must be a member who was appointed to the council by the Lieutenant Governor in Council, constitute a quorum."
Mr J. Wilson: The intention here it to ensure that a public member is present throughout the discipline hearing process and the decision-making process, and not just for a hearing to commence.
Mr Wessenger: I support this amendment because the discipline committee must have between three and five members, of whom at least two must be public members. I think it is important to ensure that there will be a consistency of one public member through the hearing.
Motion agreed to.
The Chair: Shall section 37, as amended, carry? All in favour? Any opposed? Carried.
Section 37, as amended, agreed to.
L'article 37, modifié, est adopté.
Mr Wessenger: Could we hold for a minute?
The Chair: We have a request from Mr Wessenger to just hold the proceedings. You may want to recess for five minutes. We will stand down for five minutes and recess.
The committee recessed at 1702.
1709
The Chair: The standing committee on social development is now in session.
Mr Beer: It was drawn to my attention that one of the clauses I asked to be stood down need not be stood down, if I might just return to it. It is subsection 36(1).
The Chair: A section of the bill, not in the schedule.
Mr Beer: Not in the schedule.
The Chair: We have a request to go back to the bill to subsection 36(1).
Mr Beer moves that subsection 36(1) be amended by inserting after "26(1)" in the second line "or 28.1(1)."
Mr Beer: I do not know how anybody following this on television would understand. We are talking gobbledegook. I stood this down because of the reference to subsection 26(1), but in fact it is subsection 36(1) and any discussion or changes we make to section 26 later on can then be changed. All we are doing here is adding "or 28.1(1)" which we had in fact approved. I would ask that we now approve this amendment.
Mr Wessenger: Yes, I agree with that. It is a consequential amendment to the previous amendment that passed.
The Chair: I am going to call the vote on the amendment to subsection 36(1) of the bill. All in favour of the amendment? Any opposed?
Motion agreed to.
The Chair: We still have some parts of section 36 that have been stood down; is that correct?
Clerk of the Committee: Yes, subsection 36(2).
The Chair: So there are still some parts of section 36 that have been stood down for discussion at another time.
Schedule/annexe 2:
Section/article 38:
The Chair: Mr Wilson, we are now back on schedule 2. You have an amendment that I believe you want to place at this time to section 38.
Mr Wilson moves that subsection 38(1) of schedule 2 of the bill be struck out.
Mr J. Wilson: The purpose is to make that consistent with my previous amendment.
Mr Wessenger: Yes, I support that. It is consistent and it should be passed.
The Chair: All in favour? Any opposed?
Motion agreed to.
Section 38, as amended, agreed to.
L'article 38, modifié, est adopté.
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."
I have a motion from Mr Wilson that this matter be stood down and dealt with at the appropriate time.
Mr Beer: With the committee's indulgence, I would agree with that. I just wanted to be clear, as I am going to have to leave shortly. There are several others that I think relate to this. Is there agreement that all of the ones that relate to sexual abuse and the patients' committee would then be dealt with together?
Mr J. Wilson: Agreed.
The Chair: The motion to stand down section 39 will be amended to include the standing down of all amendments to the schedule which relate to the issue of sexual abuse, sexual assault, that they also be stood down and dealt with at the appropriate time.
Motion agreed to.
Mr J. Wilson: On a point of information for the committee, you should not spend time this evening considering our amendment, which was coming along next, to schedule 2, section 40, the PC motion. We are withdrawing that.
Sections 40 to 43, inclusive, agreed to.
Les articles 40 à 43, inclusivement, sont adoptés.
Section/article 44:
The Chair: Mr Wessenger moves that subsection 44(2) of schedule 2 be amended by striking out the first three lines and substituting:
"The panel may make an order that the public be excluded from a hearing or any part of it if the panel is satisfied that."
Mr Wessenger: This increases the flexibility of orders that have been made to exclude the public from the hearings.
The Chair: On the amendment, Mr Wilson.
Mr J. Wilson: Excuse me, Madam Chair, is that section 44.1?
Mr Wessenger: No, it is subsection 44(2).
Mr J. Wilson: I think the parliamentary assistant skipped one.
The Chair: We are dealing first with 44(2). In your book, Mr Wilson, they are just out of order. Mr Wessenger is correct in moving the amendment to subsection 44(2) first.
Motion agreed to.
Section 44, as amended, agreed to.
L'article 44, modifié, est adopté.
The Chair: Mr Wessenger moves that schedule 2 to the bill be amended by adding the following section:
"44.1 If a panel makes an order under subsection 44(2), wholly or partly because of the desirability of avoiding disclosure of matters in the interest of a person affected, the panel may allow the person and his or her personal representative to attend the hearing."
Mr J. Wilson: Perhaps we could have a further explanation from the parliamentary assistant.
Mr Wessenger: The discipline committee may exclude the public from hearings to protect an individual's interests, and this amendment ensures that the individual and representative may remain despite the exclusion order. A general order excluding the public would also exclude the complainant, so this allows the complainant to remain.
Mr J. Wilson: I appreciate the comments.
Motion agreed to.
Section 45 agreed to.
L'article 45 est adopté.
Section/article 46:
The Chair: Mr J. Wilson moves that subsection 46(1) of schedule 2 be amended by adding the following clause:
"(b.1) copies of the transcript of the hearing are available to the complainant on the complainant's request."
Mr J. Wilson: The intent here is that copies of the transcript of a hearing are to be made available to the patient where the patient is not a party.
Mr Wessenger: Mr Wilson, could I ask you a question with respect to this amendment, and that is, who would pay the cost of the transcript?
Mr J. Wilson: It is a very good question. We feel, none the less, that it is important that the patient be allowed to have a copy, and perhaps cost is something we should discuss right now.
Mr Wessenger: Yes, I think it is something we should discuss, because again --
Mr J. Wilson: It can be very costly. I understand that, yes.
Mr Wessenger: If a transcript has already been prepared, then there is a fairly minimal cost to providing a copy of the transcript to the complainant. If, however, there has been a hearing and no transcript has been prepared, the cost of preparing a transcript could be very expensive, $300 or something.
Mr J. Wilson: As is the case with our court systems, I certainly would not be opposed to the patients having to pay for the transcripts themselves.
Mr Wessenger: If you would like to make that amendment --
Mr J. Wilson: I would make that amendment.
The Chair: You have to make it in writing, Mr Wilson. Shall we stand it down for a moment?
Mr J. Wilson: Yes, fine. We move to stand it down.
Motion agreed to.
Sections 47 and 48 agreed to.
Les articles 47 et 48 sont adoptés.
1720
Section/article 49:
The Chair: Mr Wessenger moves that clause 49(1)(a) of schedule 2 of the bill be amended by striking out "convicted" in the first line and substituting "found guilty."
Mr Wessenger: The purpose of this amendment is that we want to include the situation where a member has been found guilty of an offence but has been granted a conditional or absolute discharge by the court.
Motion agreed to.
Section 49, as amended, agreed to.
L'article 49, modifié, est adopté.
Sections 50 to 63, inclusive, agreed to.
Les articles 50 à 63, inclusivement, sont adoptés.
Section/article 64:
The Chair: Mr Wessenger moves that subsections 64(1) and (2) of schedule 2 to the bill be struck out and the following substituted:
"64(1) A report prepared and signed by a health professional containing his or her findings and the facts upon which they are based is admissible as evidence at a hearing without proof of its making or of the health professional's signature if the party introducing the report gives the other parties a copy of the report at least 10 days before the hearing.
"(2) A health professional may not give evidence in his or her professional capacity at the hearing unless a report, prepared and signed by the health professional containing his or her findings and the facts upon which they are based, is introduced as evidence."
Mr Wessenger: The reason for this amendment is to make the rules similar to the courts with respect to the providing of medical reports as evidence.
Motion agreed to.
Section 64, as amended, agreed to.
L'article 64, modifié, est adopté.
Sections 65 to 67, inclusive, agreed to.
Les articles 65 à 67, inclusivement, sont adoptés.
Section/article 68:
The Chair: Mr Wessenger moves that subsection 68(3) of the bill be struck out and the following substituted:
"(3) In an appeal under subsection (1), the court has all the powers of the panel that dealt with the matter and, in an appeal from the board, the court also has all the powers of the board."
Mr Wessenger: This is necessary to ensure that the court can substitute its decision for that of the board, if that is appropriate.
Section 68, as amended, agreed to.
L'article 68, modifié, est adopté.
Sections 69 to 79, inclusive, agreed to.
Les articles 69 à 79, inclusivement, sont adoptés.
Section/article 80:
The Chair: Mr Wessenger moves that subsections 80(2), (3) and (4) of schedule 2 to the bill be struck out and the following substituted:
"(2) Every person who controls premises where a member practises, other than a private dwelling, shall allow an assessor to enter and inspect the premises.
"(3) Every person who controls records relating to a member's care of patients shall allow an assessor to inspect the records.
"(4) Subsection (3) does not require a patient or his or her representative to allow an assessor to inspect records relating to the patient's care."
Mr Wessenger: This amendment gives the college quality assurance, assessors wider access to practice premises and patient records when they are doing an investigation.
Motion agreed to.
Section 80, as amended, agreed to.
L'article 80, modifié, est adopté.
Section 81 agreed to.
L'article 81 est adopté.
The Chair: Mr Wessenger moves that schedule 2 of the bill be amended by adding, before the heading "Miscellaneous," the following sections:
"81.1(1) The council shall make regulations under paragraph 22.1 of subsection 91(1) prescribing a patient relations program.
"(2) The patient relations program must include measures for the prevention of professional misconduct of a sexual nature.
"81.2 The patient relations committee shall advise the council with respect to the patient relations program.
"81.3(1) There shall be a patient relations monitoring board to monitor the patient relations program.
"(2) The board shall be composed of representatives of,
"(a) the public;
"(b) the members; and
"(c) the unions and professional associations that represent members.
"(3) The number of representatives shall be determined by the council.
"(4) The number of representatives of the public shall be at least equal to the total number of representatives of the members and the unions and professional associations that represent members.
"(5) The minister shall appoint, as representatives of the public, persons who are not,
"(a) members of the college or any other college as defined in the Regulated Health Professions Act, 1991; or
"(b) members of the council or any other council as defined in the Regulated Health Professions Act, 1991.
"(6) The council shall appoint the representatives of the members.
"(7) The council shall determine the unions and professional associations that represent members and they shall appoint their representatives.
"81.4 The Patient Relations Monitoring Board shall make an annual report to the college."
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Mr Wessenger: I would ask that this be stood down to be considered with the other items.
The Chair: All right. You could go back at this point if you wish, Mr Wessenger, and deal with schedule 2, subsection 1(1), the patient relations program, and schedule 2, section 9, which deals with the patient relations committee, or do you want to stand the whole thing down?
Mr Wessenger: I think I would prefer to stand down. I think we would rather deal with it tomorrow.
The Chair: There is a motion to stand down the amendment, new sections to schedule 2, 81.1 to 81.4.
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:
"81.1(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.
"81.2(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.
"81.3(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.
"81.4(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."
Mr J. Wilson: As per our previous agreement, this dealing with the matter of sexual abuse, I move, of course, that this amendment be stood down.
The Chair: I have a motion that this amendment be stood down and dealt with at the appropriate time with the other amendments on this issue.
Motion agreed to.
Sections 82 to 84, inclusive, agreed to.
Les articles 82 à 84, inclusivement, sont adoptés.
Section/article 85:
The Chair: Mr Wilson moves that section 85 of schedule 2 to 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: I also move, Madam Chair, consistent with the previous amendment that I introduced, that this be stood down at this time.
The Chair: There is a motion that the amendment be stood down till the appropriate time.
Motion agreed to.
The Chair: There is a motion to stand down all of section 85.
Motion agreed to.
Section/article 86:
The Chair: Mr Wessenger moves that section 86 of schedule 2 of the bill be amended by adding the following subsection:
"(1.1) If a person intended to terminate the employment of a member or to revoke the member's privileges for reasons of professional misconduct, incompetence or incapacity but the person did not do so because the member resigned or voluntarily relinquished his or her privileges, the person shall file with the registrar within 30 days after the resignation or relinquishment a written report setting out the reasons upon which the person had intended to act."
Mr Wessenger: This amendment is to cover the situations where an employee resigns from his position of employment, such as in a health care facility, for a reason relating to professional misconduct, and requires that the information be reported to the college so it is on record.
Mr J. Wilson: The person who actually is resigning has to file with the registrar within 30 days?
Mr Wessenger: An employer has to file the information.
Mr J. Wilson: So "person" here means employer?
Mr Wessenger: Yes, because if a person intended to terminate the employment, it is the person terminating the employment, not the employee.
Motion agreed to.
Section 86, as amended, agreed to.
L'article 86, modifié, est adopté.
Sections 87 and 88 agreed to.
Les articles 87 et 88 sont adoptés.
Section/article 89:
The Chair: Mr Wessenger moves that subsection 89(1) of schedule 2 to the bill be amended by adding after "section 44" in the second line "or 45."
Mr Wessenger: This amendment clarifies that breach of an order made under section 45 of schedule 2 is an offence.
Motion agreed to.
The Chair: Mr Wessenger moves that subsection 89(3) of schedule 2 to the bill be amended by striking out "80(3), (4)" in the second line and substituting "80(2), (3)."
Mr Wessenger: This is a housekeeping amendment.
Motion agreed to.
Section 89, as amended, agreed to.
L'article 89, modifié, est adopté.
Section 90 agreed to.
L'article 90 est adopté.
Section/article 91:
The Chair: Mr Wessenger moves that paragraph 3 of subsection 91(1) of schedule 2 to the bill be struck out and the following substituted:
"(3) Prescribing conditions disqualifying elected members from sitting on the council and governing the removal of disqualified council members."
Mr Wessenger: This amendment enables a college to impeach a committee member who initially qualified.
Mr J. Wilson: Madam Chair, that replaces a section that also gave the authority for filling vacancies on the council. How is that now done? It is probably covered somewhere else; I just do not know where.
Mr Wessenger: There is a second motion that will clear that up, the next motion, 5 and 5.1.
Mr J. Wilson: Okay, thank you.
Motion agreed to.
1740
The Chair: Mr Wessenger moves that paragraph 5 of subsection 91(1) of schedule 2 to the bill be struck out and the following substituted:
"5. Prescribing conditions disqualifying committee members from sitting on committees and governing the removal of disqualified committee members;
"5.1 Respecting the filling of vacancies on the council or its committees."
Mr Wessenger: This amendment authorizes the council to make regulations governing the creation of a vacancy by disqualification and removal, in addition to the existing regulatory power governing how to fill any vacancy.
Motion agreed to.
The Chair: Mr Cordiano moves that subsection 91(1) of schedule 2 of the bill be amended by adding the following paragraph:
"5.2 Providing for the composition of the committees mentioned in section 9."
Interjection: It is consequential.
Mr Wessenger: Yes, it is consequential. Yes, we do support that amendment.
Motion agreed to.
The Chair: Mr Wessenger moves that subsection 91(1) of schedule 2 of the bill be amended by adding the following paragraph:
"14.1 Governing or prohibiting the delegation by or to members of controlled acts set out in subsection 26(2) of the Regulated Health Professions Act, 1991."
Mr Wessenger: This amendment in the code authorizes college councils to make regulations governing the delegation of controlled acts by or to members of the college.
Mr Hope: It seems we have not dealt with subsection 26(2). Is it appropriate that it be carried at this time?
Mr Wessenger: Yes, I believe it is appropriate, because it is just the procedural code.
Mr J. Wilson: My reading of it is it simply clarifies the authority of the college for something that all committee members agree is within the scope of this act.
The Chair: I think that is an accurate reading of what is proposed.
Motion agreed to.
The Chair: Mr Wessenger moves that subsection 91(1) of schedule 2 of the bill be amended by adding the following paragraph:
"22.1. Prescribing a patient relations program;"
And he further moves that subsection 91(2) of schedule 2 of the bill be amended by inserting after "22" in the first line, "or 22.1."
Mr Wessenger: I think we should stand this down for consideration with the others.
The Chair: There is a motion to stand this amendment down until the appropriate time.
Motion agreed to.
The Chair: Mr Wessenger moves that paragraph 25 of the subsection 91(1) of schedule 2 to the bill be struck out and the following substituted:
"25. Requiring members to give the college their home addresses and prescribed information about the places they practise the profession, the services they provide there and the names, business addresses and telephone numbers of their associates, partners and employees and prescribing the form and manner in which the information shall be given."
Mr Wessenger: This amendment authorizes the council to require members to provide their home addresses and prescribed information about where they practise and the services provided.
Motion agreed to.
The Chair: Mr Wessenger moves that paragraph 28 of subsection 91(1) of schedule 2 to the bill be amended by striking out "and for anything the registrar is required or authorized to do" in the fourth and fifth lines.
He further moves that subsection 91(1) of schedule 2 to the bill be amended by adding the following paragraph:
"28.1. Requiring persons to pay fees, set by the registrar or prescribed, for anything the registrar is required or authorized to do."
Mr Wessenger: This really authorizes the council to make regulations governing fees for purposes other than those specified.
Motion agreed to.
Mr J. Wilson: As that amendment has been adopted, I will change my motion just slightly, Madam Chair. I think it will now have to become 28.2, not 28.1, since we just put in a 28.1.
The Chair: That is correct.
Mr J. Wilson moves that subsection 91(1) of schedule 2 to the bill be amended by adding the following paragraph:
"28.2. Requiring members to pay a prescribed annual levy to the survivors compensation fund and requiring members to pay prescribed penalties for the late payment of the levy."
Mr J. Wilson: I move that this be stood down in accordance with other amendments along the line of the sexual abuse debate.
The Chair: I have a motion that this amendment be stood down to the appropriate time.
Motion agreed to.
The Chair: Mr Wessenger moves that paragraph 30 of subsection 91(1) of schedule 2 to the bill be struck out and the following substituted:
"30. Requiring members to have professional liability insurance satisfying prescribed requirements or to belong to a prescribed association that provides protection against professional liability and requiring members to give proof of the insurance or membership to the registrar in the prescribed manner."
Mr Wessenger: This amendment was recommended because professional liability insurance does not accurately describe the Canadian Medical Protective Association that medical doctors belong to for the purposes of protection against professional liability.
Motion agreed to.
The Chair: We cannot at this time move section 91 because we have stood down some parts of it, so that all of section 91 will be stood down, Mr Wessenger, until such time as -- we, of course, have a motion to stand down section 91 to be dealt with at the appropriate time.
The Chair: The clerk will prepare for all members of the committee a list of all of those items which have been stood down. Everything else to this point has been dealt with.
Title agreed to.
Le titre est adopté.
The Chair: I would just point out regarding the motions "Shall the bill, as amended, carry?" and "Shall it be ordered?" that it has been agreed, and we have a motion, that this will not take place until Bill 64 has been ordered. Agreed? Agreed.
Mr J. Wilson: Can I just ask for a clarification of that? I did miss the introductory remarks of the parliamentary assistant earlier today. Will we proceed tomorrow with the stood-down amendments in the omnibus Bill 43 or are we setting them aside until after Bill 64? Is that what you just said?
The Chair: No, what I understand we are doing is that the ones that have been stood down will be stood down until next Monday when the minister will be here. The last two that I mentioned, "Shall the bill carry?" and "Shall it be ordered?" have been deferred until Bill 64 has been ordered. Is that correct, Mr Wessenger?
Mr Wessenger: Yes, that is correct.
The Chair: As well, the amendments regarding the native motion that has been placed will also be after Bill 64 has been ordered. Is that clear, as far as process is concerned?
Mr J. Wilson: Thank you. I appreciate that clarification.
The Chair: In light of the motions and the schedule, the committee must decide what if anything it would like to do tomorrow. Mr Wessenger, would you suggest that we stand adjourned until next Monday?
Mr Wessenger: Yes, I think we should stand adjourned until next Monday.
Mr Cordiano: As a matter of fact, there is very little to deal with other than the things that have been stood down, amendments. I think we should just meet on Monday and deal with those.
The Chair: It would be helpful, however, as we seem to be moving right along, if all three caucuses, or the government and the two caucuses, could table their amendments to the first few other bills by Friday of this week, so they can be circulated. Then we hopefully will be ready to deal with them Monday or Tuesday, depending on how discussions go, but I think there is an interest. So could we try to have all amendments to the first five bills to the clerk by Friday? That would be Bills 44 to 49 inclusive. Is that possible? Or as many as possible ready for Friday.
Mr J. Wilson: Certainly the first three, but when you get into Bills 47, 48, 49 and the dentistry stuff, it does get a bit complicated. Perhaps we could at least agree on the first three.
The Chair: Agreed for the first three.
Mr Cordiano: Okay, agreed. I will check on that, but that is fine.
The Chair: It is a request, it is not a motion, that we try to have all of the amendments for the first three bills, Bills 44, 45 and 46, tabled with the clerk by this Friday so they can be circulated. The committee stands adjourned until Monday following question period, approximately 3:30. Thank you all.
The committee adjourned at 1754.