Psychologists have, by legislation, though it differs by province, the authority to diagnose and deliver care. If someone decides to seek the services of a psychologist outside of a publicly funded system, of course, they could go straight there. The issue arises when they want to get reimbursed by their extended health care plans. There is great variability. Some underwriters will require a physician referral and some will not.
One part of the work we are commissioning will be surveys of stakeholders, including the insurance industry.
I can't give you any data on the differences in uptake when the bottleneck is created, but certainly it's happening. It creates an unnecessary delay, because the work that is going to be done is going to be done by the psychologist.