Mahsi, Madam Speaker. This morning, I wish to present a report from the Standing Committee on Agencies, Boards and Commissions on the review of the Medical Registration Committee.

Introduction

Following recent events which drew attention to the issue of certification of physicians in the Northwest Territories, the Standing Committee on Agencies, Boards and Commissions selected the Medical Registration Committee for review.

The standing committee considered this matter in meetings in Yellowknife from April 25 to 29, 1994. On April 28, 1994, public hearings were held with the Minister of Health, the Honourable John Pollard, the chair of the Medical Registration Committee, Dr. Margaret Woodside and the president of the Northwest Territories Medical Association, Dr. Perry Caplan.

The standing committee wishes to acknowledge the input of the witnesses and thank them for their appearance at the public hearings. We would also like to thank Ms. Helen Roberts, registrar of the Medical Registration Committee, for her assistance in our review.

Background

The Medical Registration Committee (MRC) considers applications for registration of physicians in the Northwest Territories and makes recommendations regarding registrations to the Minister of Health. Their responsibility is derived from the Medical Profession Act.

This is a role that is usually adopted in the provinces by the College of Physicians and Surgeons. These colleges also deal with the discipline of physicians, whereas the Medical Registration Committee does not.

Both the government and the Northwest Territories Medical Association have indicated that they would prefer an arrangement where physicians had more independence. It may be too expensive or difficult to establish a full college in the Northwest Territories. However it should still be possible to amend the act to give Northwest Territories physicians that independence, either by amending the committee's mandate or through the establishment of a new body.

As well, Members of the standing committee support the general principle that non-departmental agencies should generally be at arm's length from the government. This holds true for the Medical Registration Committee.

Forthcoming Changes

Committee Members see the present relationship between the department and the Medical Registration Committee as too close. An arm's-length relationship would be more appropriate and would better serve the principle of physicians' self-governance.

The Minister indicated that amendments to the act are being drafted which would change the Medical Registration Committee in the following ways:

- more independence from the department;

- majority of members would be physicians;

- stronger representation of non-physicians on the committee;

- allow better representation of aboriginal views and concerns.

The standing committee is encouraged by these suggestions and looks forward to seeing the draft legislation when it is introduced early next year. Committee Members especially commend the proposals to have more lay representatives on the Medical Registration Committee and to ensure that aboriginal people and issues are well represented on the new committee.

While the new body will not have all of the powers and duties of a provincial college of physicians, it will be a step towards that position. We understand the concerns of the Minister and the Northwest Territories Medical Association that establishing a full college in the Northwest Territories would be unnecessarily expensive and complicated. The standing committee agrees that the proposal, as outlined by the Minister, is a suitable step for physicians in the Northwest Territories.

For routine registration of physicians wishing to practise in the north, the Minister and the department need not be involved. The current practice of only registering physicians who have been licensed by the Medical Council of Canada is quite adequate to ensure that physicians practising in the north are properly trained.

The appropriate role for the Minister and the department would be in dealing with appeals. If a physician has been refused registration, or has been suspended or otherwise disciplined, the Minister would be the next avenue of appeal. Otherwise, committee Members agree that the Minister and the department need not be directly involved with the decisions of the Medical Registration Committee. To that end, the present practice of having a representative of the Department of Health as a voting member of the Medical Registration Committee should be reviewed. The status of the registrar on the committee should also be reviewed, perhaps by making the registrar a non-voting member of the Medical Registration Committee.

Also related to disciplinary issues is the balance between protecting the interests of the public and the desire of physicians to be self-regulating. Any amendments to the disciplinary procedures in the act must take this balance into account. While self-regulation is a desirable goal, the interests of the public must not only be protected, but must be seen to be protected.

Traditional Healers

While not directly related to the mandate of the Medical Registration Committee, the issue of traditional healers and traditional medicine was raised by the standing committee. Committee Members were concerned that valuable skills possessed by traditional healers are often ignored, as northerners focus more and more on the western model of health care.

Committee Members raised the example of the Navajo First Nation. Traditional healers there are a respected part of the health care system. In fact, Navajo traditional healers have established a college, similar to a college of physicians, which has the responsibility for training, registering and disciplining traditional healers.

The Special Committee on Health and Social Services, in their final report of November 1993, recommended that "Traditional healing methods must be recognized, funded by government and incorporated into our system of health and social services". The standing committee endorses this recommendation and encourages the Department of Health to act upon it. Specifically, the standing committee recommends that the Department of health must ensure that traditional healers and healing methods are considered in the department's strategic plans. The department should meet with traditional healers in the north in order to receive their views on how they might be better recognized and respected by the Northwest Territories Health Care System.

Madam Speaker, that concludes the report of the Standing Committee on Agencies, Boards and Commissions on its review of the Medical Registration Committee.

Motion To Receive And Adopt Committee Report 8-12(6), Carried

Therefore, I move, seconded by the honourable Member for Yellowknife Centre, that the report be received by the Assembly and adopted. Mahsi.