Yes, I do, Mr. Chairman. I am pleased to have an opportunity to speak with the members of the committee about Bill 8, which proposes to change the Nursing Profession Act and the Pharmacy Act.

This bill is a step towards recognition of expanded nursing functions as performed by nurse practitioners. Nurse practitioners are registered nurses with advanced training in nursing and health sciences. They perform expanded nursing functions, including diagnosis and prescribing medications. Currently in the Northwest Territories, there is no legislation that allows for the registration and licensing of nurse practitioners. This bill is interim legislation until a new Nursing Profession Act is passed.

This bill will amend the Nursing Profession Act to authorize the practice of nurse practitioners under certain specified conditions. The bill sets the qualifications for the registration of nurse practitioners and provides for the approval of scope of practice guidelines. The bill provides the framework for nurse practitioners to practice while this interim legislation is in place.

The nurse practitioner must be party to a collaborative practice agreement and must practice at a designated site. Other minor amendments have been made to ensure that certificates of registration, temporary certificates of exemption and certificates of registrations as a nurse practitioner are treated consistently throughout the act.

The Pharmacy Act is also amended by this bill to allow prescriptions signed by nurse practitioners in accordance with the regulations to be filled by pharmacists.

I would like to thank the members of the standing committee for their consideration of this bill and I look forward to discussing Bill 8 with the Members in committee of the whole. Thank you, Mr. Chairman.

Thank you, Mr. Minister. At this time, I would like to ask the committee responsible for reviewing this bill if they have any comments. Mr. Bell.

Thank you, Mr. Chairman. The Standing Committee on Social Programs reviewed Bill 6, An Act to Amend the Nursing Profession Act and the Pharmacy Act, at its meetings on June 12 and 14, 2002.

This bill amends the Nursing Profession Act to authorize the practice of qualified nurse practitioners who are parties to collaborative practice agreements to practice at pilot project sites designated by the Minister. The bill sets qualifications for the registration of nurse practitioners and provides for the development and approval of guidelines respecting their practice. The bill authorizes a nurse practitioner who is a party to a collaborative practice agreement to make a diagnosis, order and interpret screening and diagnostic tests, prescribe and monitor drugs and perform other procedures as authorized by the Minister.

The bill also amends the Pharmacy Act so that prescriptions signed by nurse practitioners may be filled by pharmaceutical chemists.

The committee would like to thank the Honourable Michael Miltenberger, Minister of Health and Social Services, his officials and those of the Department of Justice who appeared before the committee to present the bill and respond to the issues raised by committee.

The committee would also like to thank the Honourable Roger Allen, Minister of Justice, who represented the Minister of Health and Social Services at the resumption of the public hearing on June 14, 2002.

The committee would also like to thank the Northwest Territories Registered Nurses Association and the Northwest Territories Medical Association for their helpful presentations. In particular, with respect to the presentation by the Northwest Territories Medical Association, the committee would suggest to the association that their concerns be brought back to the committee when the government brings forward new nursing legislation, which is likely to deal more comprehensively with the question of nurse practitioners.

During our review of Bill 8, three motions were passed to amend the bill. The motions provided for consequential amendments to the Disease Registries Act, Emergency Medical Aid Act, Interpretation Act and Labour Standards Act, and clarified that only persons holding registrations as nurses or nurse practitioners are entitled to be so designated by title and initials. The bill as amended and reprinted is before Members today.

Mr. Chairman, this concludes the committee's comments on Bill 8, An Act to Amend the Nursing Profession Act and the Pharmacy Act. Thank you, Mr. Chairman.

Thank you, Mr. Bell. At this time, I would like to ask the Minister if he would like to bring in any witnesses. Mr. Minister.

Yes, Mr. Chairman, I would.

Does the committee agree that the Minister brings in his witnesses?

Sergeant-at-Arms, would you please escort the witnesses in? Mr. Minister, for the record, could you introduce your witness?

Thank you, Mr. Chairman. Mr. Chairman, I have with me Ms. Janis Cooper, legislative counsel from the legislation division of Justice. I expect to be joined in the not-too-distant future by Mark Cleveland, deputy minister. We are prepared to proceed.

Thank you, Mr. Minister. Welcome, witness. General comments. Mr. Roland.

Thank you, Mr. Chairman. Just on the Minister's opening comments, you referred to "The bill sets qualifications for the registration of nurse practitioners and provides for the approval of scope of practice guidelines." Can we have further clarification on what that is to entail?

Mr. Minister.

Thank you, Mr. Chairman. Mr. Chairman, in terms of scope of practice, would the Member like some specific examples?

Thank you, Mr. Minister. Mr. Roland.

Thank you, Mr. Chairman. I would like to know what it would be. I had a call the other day regarding what this bill would mean and how it would be set up and the transfer of responsibilities and so on, so some clarification as to what is required that provides for the scope of practice guidelines. Thank you.

Thank you, Mr. Roland. Mr. Minister.

Thank you, Mr. Chairman. Mr. Chairman, I would like to first point out that the nurse practitioners are here to work in conjunction with doctors and nurses. In many cases, especially in the communities where there are only nurses, they are going to be given the legislative base to cover off the many cases of work that they have done for many years.

There are going to be issues in terms of diagnosis, being able to order and interpret selected diagnostic tests. There is the issue of therapeutics, which is the selection, recommending, prescribing and monitoring of the effect of selected drugs, the interventions. If you, in the broad sense, touch on those, I can go into greater detail in terms of the scope of practice.

This is going to be done, Mr. Chairman, on a pilot project basis to allow us to clearly see how this process works. As you can see here, I have extensive and detailed information in terms of the scope of practice, which I would be happy to share with the committee. Thank you.

Thank you, Mr. Minister. Mr. Roland.

Thank you, Mr. Chairman. I would be happy to receive that information the Minister has. I think a lot of people have been waiting for an act of this nature, even though it is interim at this point, to move to the nurse practitioners and establish them in the Northwest Territories, but it is still unclear as to the extent. What would actually be set up? The Minister has referred to pilot projects. Maybe he can tell the committee if in fact they have designated where those pilot projects will take place. Thank you.

Thank you, Mr. Krutko. Mr. Minister.

Thank you, Mr. Chairman. Mr. Chairman, we have had some interest expressed by various authorities. We have not yet determined the specific sites. When we do, there will be an agreement signed. The scope of practice will be laid out clearly. Each site will in all probability be somewhat unique, since they do not necessarily all have the same type of services available, but all the service providers will be involved -- the doctors, the nurses, the nurse practitioners, and other allied health professions -- so that it is truly a collaborative effort. Once the legislation has passed, we will be moving to determine with the authorities the sites that are best suited for this particular initiative. Thank you.

Thank you, Mr. Minister. Mr. Roland.

Thank you, Mr. Chairman. Can the Minister inform us as to how long he thinks this will take?

Thank you, Mr. Roland. Mr. Miltenberger.