Evidence of meeting #25 for Access to Information, Privacy and Ethics in the 39th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was care.
A recording is available from Parliament.
Conservative
Liberal
The Chair Liberal Tom Wappel
Sorry, Mr. Tilson, it's already been seven minutes.
Would you like to finish?
Chair, Committee on Ethics, Canadian Medical Association
I would just like to say we would worry that patients, if they were aware that their physician's prescribing information could be sold to other commercial interests, might be more cautious about what they would reveal to their physicians, and that would be an impediment to their care.
Liberal
Liberal
The Chair Liberal Tom Wappel
Are there members besides Mr. Tilson and me who want to ask a question?
Mr. Van Kesteren, go ahead.
Conservative
Dave Van Kesteren Conservative Chatham-Kent—Essex, ON
What happens in property? I want to understand the property rights.
A patient has a history, and that history is worth money, as far as a medical doctor is concerned. If he were ever to sell his practice, could the courts ever be challenged and say that history is actually the patient's property?
Chair, Committee on Ethics, Canadian Medical Association
I'm going to start, and I'm going to ask Jean, probably, to elaborate a bit more on the legal aspects. The actual record is, I believe, the physician's property, because you actually have an obligation to maintain your records for at least seven to ten years after you've stopped taking care of that patient. However, the patient absolutely has the right to review their medical data at any point, unless there's something in the record that the physician really feels could be detrimental to the patient's health, in which case they may need to take it someplace else to be arbitrated.
Would you like to clarify that a bit?
Assistant Director, Legal Services and Chief Privacy Officer, Canadian Medical Association
I'd just like to say that there was a Supreme Court case in 1992 in which it was decided that the physician owns the paper record but is actually a fiduciary agent or trustee for the information that belongs to the patient. In the case of a transfer of a physician's practice, that's regulated at the college level as well. There are guidelines about notices and guidelines about the kinds of appropriate custodianship, because it's something taken very seriously. The information belongs to the patient, but the actual paper that it's kept on is something that's kept separate and apart.
I'd like to go back to something, with the chair's permission. Mr. Tilson asked a question regarding what CMA would like to see. I think we'd like to see personal information be broad enough to encompass prescribing information, and then have within that tent the appropriate regulation oversight, such as exists in Quebec, where there is a commission that looks at situations and says this reason is more compelling than others, so there actually is a vetting of it. At the end of the day, it might turn out, as Dr. Cham and Mr. Poston were saying, that the information is used, but at least there is an analysis of it. It's not just cut off from any kind of overview or analysis.
Conservative
Assistant Director, Legal Services and Chief Privacy Officer, Canadian Medical Association
In Quebec it's the Commission d'accès à l'information. There's an actual formal request to have it. There's a process in place.
Assistant Director, Legal Services and Chief Privacy Officer, Canadian Medical Association
It's the commission that views the application to use professional information, as it's called. There is a process enshrined in law in Quebec to do that.
Assistant Director, Legal Services and Chief Privacy Officer, Canadian Medical Association
That's a recommendation that CMA would make to the committee.
Conservative
Liberal
The Chair Liberal Tom Wappel
You're done? Okay.
Mr. Poston, our information is that the private sector privacy legislation in British Columbia has an exemption for work product. But we have information that the B.C. pharmacists have recently passed a resolution not to disclose physician prescribing patterns to anyone.
Do you know anything about that?
Executive Director, Canadian Pharmacists Association
I don't have a lot of information around the detail, but I do know that the situation in British Columbia is fairly unique in Canada.
First of all, information from both the public and private prescriptions would be collected through the government. All prescriptions in British Columbia, actually, whether they've been paid for by the private sector or public sector, are collected at one point in time. That's been one of the important features of the pharmacare data. The licensing body for pharmacists in British Columbia is the body that acts as the custodian of that data. I know that specific parts of that have been looked at recently, but I'm not familiar with the details of it.
B.C. is in somewhat of a unique situation in Canada in that they have that single point of collection for both public and private data. As well, the custody of the system is in the hands of the licensing body of pharmacists.
Liberal
The Chair Liberal Tom Wappel
Not to be irritating about it, but is your answer then, no, I don't know whether the pharmacists passed such a resolution?
Executive Director, Canadian Pharmacists Association
I don't know the details relating to that. I know it has been under review, but I'm not current on the recent changes.
