Agreed.

---Agreed

Agreed.

---Agreed

Agreed.

---Agreed

Thank you, Mr. Chairman. Mr. Chairman, we are prepared to deal with Bill 12, An Act to Amend the Mental Health Act, and subsequently, Bill 5, An Act to Amend the Social Assistance Act. If time allows, we can go into the Department of Transportation. However, Mr. Chairman, we are not prepared to go beyond the adjournment time because there is an Ordinary Members' Caucus meeting immediately after. Thank you.

Agreed.

---Agreed

Thank you, Mr. Chairman. The Standing Committee on Legislation reviewed Bill 12, An Act to Amend the Mental Health Act, at public meetings in Yellowknife on January 22 and February 17 of 1993. The committee would like to thank the Government Leader, the Honourable Nellie Cournoyea, the Minister of Health, the Honourable Rebecca Mike, and the officials from the Departments of Health and Justice for presenting this bill and responding to committee Members' questions and concerns.

Bill 12 would amend the Mental Health Act in several ways. Currently, there is no procedure in the Mental Health Act to appoint a substitute consent giver for a mentally incompetent person when a hospital wishes to disclose the patient's health records, if no consent giver has been appointed for treatment purposes. The bill would allow the procedure now in the act for the appointment of a substitute consent giver for the purpose of consenting to treatment to be used to appoint a substitute consent giver to consent to the disclosure of health records.

This bill would also amend sections of the Mental Health Act which deal with consent to treatment. At present, the act allows treatment to be given to involuntary patients under certain circumstances, even though the treatment is refused by the patient or substitute consent giver. This bill would amend the act to remove the authority of physicians in the Northwest Territories to treat a patient without the consent of the patient, where the patient is mentally competent.

Where the patient is not mentally competent, treatment would only be authorized when the substitute consent giver appointed under the act consents to the treatment, or when no substitute consent giver is available and the situation is an emergency. These amendments are consistent with recent court decisions respecting treatment without consent.

This bill would also amend the Mental Health Act to broaden the access of health care workers to patients' health records. Currently access to health care records may be given to administrators of other hospitals involved in a patient's care upon a written request. This bill would allow records to be transmitted to those administrators without the need for a written request. As well the Mental Health Act now allows health care records to be given to another person involved in the patient's care without the consent of the patient or substitute consent giver if the delay in obtaining consent would endanger the patient.

This bill would allow health care records to be released to medical practitioners, nurses and psychologists outside the hospital for the purpose of the patient's assessment or treatment. It would not be necessary to obtain the consent of the patient or to consider whether a delay in obtaining consent would endanger the patient. This bill would also amend the Mental Health Act to include definitions for aboriginal language, medical practitioner and a nurse to amend the French terminology.

Members of the standing committee questioned the Government Leader and the Minister of Health extensively on this bill. The committee was concerned that the provisions of the bill dealing with the appointment of a substitute consent giver for consenting to the disclosure of health records were not clear as to whether these consent givers are subject to other good faith provisions of the act. The good faith provisions require other consent givers to act in good faith to attempt to ascertain the wishes of the patient, to encourage the patient to participate in decision-making and to sign a statement agreeing to perform in this manner. The committee was concerned that the position of substitute consent givers for the disclosure of health records was not clear under the legislation. The committee questioned the rational for not placing the new substitute consent givers clearly within the jurisdiction of the good faith provisions. Some Members of the committee also questioned the need and rational for broadening of access to health records by health care workers outside the hospital. It seemed inconsistent to some Members that this bill strengthened the right of patients to refuse treatment while removing their ability to refuse the disclosure of their health records. Members may want to pursue these issues in committee of the whole.

This concludes my remarks on Bill 12, Mr. Chairman. I invite other committee Members to make any additional comments on this bill. Thank you, Mr. Chairman.

Yes, Mr. Chairman.

Agreed.

---Agreed

Thank you, Mr. Chairman. The assistant deputy minister, Elaine Berthelet, and Shawn Flynn the legislative counsel from the Department of Justice. Thank you.

Thank you, Mr. Chairman. I need to make a correction to my earlier comments. We will not be doing Bill 5 today. Mr. Chairman, to the issue at hand, I have no problem with Bill 12 because we have discussed this extensively in the Standing Committee on Legislation. I think the act speaks for itself. I have no problem with that. Thank you.

Clause By Clause

Agreed.

---Agreed