Health Committee on March 4th, 2014

[Col Hugh MacKay]

We have some very strict access rules as to who can access which parts of the health records. But yes, somebody that has the access authorities on a base can access a member's record.

[Terence Young, Conservative, Oakville, ON]

That sounds fantastic.

Debra Gillis, thank you for coming today.

Do you authorize or support naturopathic medicine, in first nations or in any of your areas of authority?

[Debra Gillis]

At this time through our non-insured health benefits program, naturopathic medicine is not included as an approved—

[Terence Young, Conservative, Oakville, ON]

And why is that?

[Debra Gillis]

We have a pharmacy and therapeutics committee, and as my colleague says, we are looking.... As evidence comes forward, we put forward...so it's the same situation.

[Terence Young, Conservative, Oakville, ON]

Who is on the therapeutics committee? Is it medical doctors?

[Debra Gillis]

It's a variety of people, medical doctors, scientists, pharmacists, a wide variety like that.

[Terence Young, Conservative, Oakville, ON]

On a reserve, I noticed that the role of nurse practitioners has increased in remote communities, which I think is a great idea. What can a doctor do in medical practice that a nurse practitioner can't do in remote communities?

[Debra Gillis]

Oh dear. That's a very broad question because it's more like what can a nurse practitioner do as opposed to a doctor.

I honestly don't have the details with me. But there are more invasive procedures that a physician can do that, of course, a nurse practitioner can't do. The nurse practitioner is limited to diagnostics and prescribing within a certain range that is not as broad as what a physician can do.

[Terence Young, Conservative, Oakville, ON]

Can a nurse practitioner prescribe addictive opioids?

[Debra Gillis]

A nurse practitioner, according to the Controlled Drugs and Substances Act, can prescribe controlled drugs if it is allowed on-reserve, if the nurse practitioner is working on-reserve or for the federal government, and if it is allowed by the province.

So, for example, in Ontario, while the Controlled Drugs and Substances Act allows nurse practitioners, potentially, to prescribe controlled drugs, at this point in time the Province of Ontario has not allowed that. A nurse practitioner working for Health Canada cannot prescribe controlled drugs in Ontario. But it's allowed in B.C., so they can prescribe in B.C.

[Terence Young, Conservative, Oakville, ON]

You talked about the best brains exchange on optimal scopes of practice, which sounds very interesting. Could you tell us a little about that?

[Debra Gillis]

Generally a best brains exchange brings together in a comfortable setting a variety of people who are free to speak their minds on a topic. They may have a lot of information. It's to draw out more details, more opinions, more thoughts. This is a way that has been developed, through the Canadian Institutes of Health Research, to try to combat some of those tricky questions we need to look at.

[The Chair, Conservative, Ben Lobb]

Your time is up. Thank you.

[Terence Young, Conservative, Oakville, ON]

Thank you.

[The Chair, Conservative, Ben Lobb]

Now we're going to Mr. Morin for his questions. Mr. Morin, I understand you're going to share your time with Ms. Morin.

Go ahead, sir.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Thank you very much.

My question goes to Ms. Gillis.

This morning, Le Devoir published an article with a headline saying that Quebec wants to repatriate its health care dollars from Ottawa. The Minister for Canadian Intergovernmental Affairs, Alexandre Cloutier, must often talk to you about those claims. Personally, as I read the article, I learned things that I did not know. I would like you to comment on the subject.

According to the article, the federal government spends $210 million per year in health care in Quebec. I assume that most of that money comes from Health Canada. In their 120-page report, Mr. Lalumière and Mr. Malouin point out that the federal government spends that money for promotion and prevention activities and for funding treatment and rehabilitation services.

If that $210 million that Quebec is claiming really does come from your department, what consequences would repatriating the amount have? Your department's mission is to promote health all across the country. What consequences would it have on your Canada-wide prevention campaigns?

[Debra Gillis]

You've asked a number of different questions in a number of different topic areas that are beyond issues related to the study here today. If you wouldn't mind, I would prefer if we could respond to those questions more specifically in writing, if you wish, so we fully understand their scope.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

It's not a problem. It was not a trick question. It was just something I saw in the paper this morning that is linked to Health Canada spending across Canada. I want to make sure that my colleague has plenty of time to ask her questions. Isabelle.

[Isabelle Morin, NDP, Notre-Dame-de-Grâce—Lachine, QC]

Thank you very much.

Mr. MacKay, in your presentation, you say: “Given that we span the country, we face challenges with respect to scopes of practice for some regulated professionals as they are not consistent across provincial jurisdictions.”

Can you suggest any solutions? Is there a way of getting around that difficulty, or can nothing be done?

[Col Hugh MacKay]

I think we've had discussions certainly around the health human resource table for some time about trying to standardize scopes of practice and licensure to permit mobility across provincial and territorial lines. Although that does present some challenges I believe it is very much worth pursuing as a possible solution to the difficulties or frictions that might arise as a result of different scopes of practice as people try to move from province to province or territory.

[Isabelle Morin, NDP, Notre-Dame-de-Grâce—Lachine, QC]

Are professional associations open to that at the moment? Do you have good dialogue going on or is it kind of a tough situation?

[Col Hugh MacKay]

From what I understand it's not an issue of the professional associations. I believe the professional associations may be open to that, but it's the regulatory bodies from province to province that set the standards. It's a matter of having those regulatory bodies all come to some agreement with respect to what practitioners are permitted to do or not to do.

[Isabelle Morin, NDP, Notre-Dame-de-Grâce—Lachine, QC]

That's fine, I will wait for the next round. Thank you.

[The Chair, Conservative, Ben Lobb]

Thank you.

Mr. Wilks, you have five minutes, sir.