Thank you so much.
Hello, everyone. My name is Theresa Agnew, and I am the chief executive officer of the Nurse Practitioners' Association of Ontario. With me here today is my colleague, Dr. Dawn Tymianski, a director on the board of NPAO. Dawn will shortly become the interim CEO of the NPAO as I step down from this role after five years.
We thank the Standing Committee on Finance for giving NPAO the opportunity today to provide feedback on Bill C-63. I will start by providing the committee with a short background on the role of NPs and NPAO.
The Nurse Practitioners' Association of Ontario is the professional association representing more than 3,100 nurse practitioners and NP students in Ontario. The NPAO formed in 1973 as an independent association representing NPs. NPAO has the largest percentage of voluntary members of any professional nursing association in Ontario.
Nurse practitioners are registered nurses with advanced university education and experience who provide a full range of health care services to millions of patients across the province and across Canada. In Ontario, NPs can order and interpret all laboratory tests and most diagnostic imaging tests. NPs are also able to refer to specialists and admit, treat, and discharge hospital patients. Nurse practitioners can also do minor surgical procedures.
Nurse practitioners are authorized to prescribe controlled drugs and substances, and this long-anticipated change to scope of practice now enables nurse practitioners, as primary care providers, to deliver all aspects of palliative and end-of-life care to their patients across the province, including medical assistance in dying for those eligible patients who request it. You will be interested to know that in Ontario more than half of the practitioners on the ministry's MAID registry are nurse practitioners.
Nurse practitioners work across the health care system in a wide variety of settings, including hospitals, family health teams, community health centres, NP-led clinics, and long-term care centres. Nurse practitioners work with individuals and families, from newborn babies to the elderly, and serve many vulnerable and marginalized populations.
I'm going to jump now to our support of Bill C-63.
As you know, Bill C-63 is an omnibus budget bill. We have not read all 275 pages of the bill, nor have we examined the many pieces of corollary legislation that would be amended if the bill is passed, so we will keep our comments to a very high level.
First, NPAO is pleased to see proposed changes to the Canada Labour Code that would provide Canadians with greater flexibility to take vacation time, to add more bereavement days in the event of losing a loved one, and with time to attend traditional healing practices. In addition, we strongly support statutory time off work to recover after experiencing family violence. This is a compassionate approach, and we know that all of those affected by family violence can be traumatized and need time to begin to heal. NPAO would, however, recommend that the statutory time off be with pay, rather than an unpaid leave. This would help to ensure that families are not penalized financially when they have already been through so much.
Potentially, the bill could also go further in supporting families experiencing domestic violence. I speak in loving memory of Zahra Abdille, who was a nurse practitioner I had the honour of getting to know when she was an NP student. Zahra was passionate about the care of the elderly. Sadly, she kept the fact that she was a victim of domestic violence from her colleagues and friends.
In July of 2014, Zahra had left her husband and had taken the boys to a women's shelter. She then sought legal assistance to pursue leaving her abusive husband. She worked as a nurse practitioner and was the family's sole breadwinner, and because it was determined that she earned too much money, Zahra was denied access to free legal aid—this despite the fact her husband controlled the family's bank account. Feeling that her options were limited, she and the boys returned to her husband. On November 29, 2014, Zahra and her two children, Faris and Zain, were killed by her husband. He later killed himself.
On behalf of women like Zahra Abdille, NPAO implores the government to ensure that all women who are victims of domestic violence have access to free legal assistance. If this amendment cannot be made as part of Bill C-63, we urge the government to find a way to enshrine this access into legislation.
NPAO also supports measures within Bill C-63 that seek to make our tax system more transparent and fair. Canadians pay tax to support the programs we hold near and dear, such as medicare, affordable housing, and subsidized day care. Those who make more should pay more. We support any amendments that would close tax loopholes that unjustly benefit the top income earners. Revenues from fair and equitable taxation could then go to improving the social determinants of health, thereby improving health for all Canadians.
We also speak in favour of proposed amendments within Bill C-63 that provide enhanced incentives to use geothermal energy.
Finally, we'd like to thank the committee and thank the federal government for introducing changes in the omnibus bill that enable nurse practitioners to sign many federal forms. Despite the fact that nurse practitioners are independent assessors of patients, make diagnoses, and treat and manage health conditions, there are currently many federal forms that do not accept the signature of a nurse practitioner. This results in patients having to return to a clinic or health care setting to see a physician who may not know them. This causes additional expense for the client and the system.
We're thrilled with the omnibus changes in Bill C-63 that enable nurse practitioners across Canada to serve clients in a more expeditious and efficacious way. We'd like to take this opportunity to thank the Canadian Nurses Association and the Nurse Practitioner Association of Canada for their extensive work and advocacy to make these changes a reality.
Again, we thank you for the opportunity, and we look forward to your questions.