Clause 22. Ms. Lee.

Thank you, Mr. Chairman. I had a question on section 27.4, which I believe is under section 20? Does that make sense? I have a question.

Does the committee agree that we go back to clause 20 to allow Ms. Lee to ask her question?

Ms. Lee.

Thank you, Mr. Chairman, and thank you, colleagues. I have a question on section 27.4 and it has to do with the possibility of conflict between the Medical Profession Act and the Nurse Practitioners Act. I do not know if the Minister has been made aware of the concern raised by myself during the committee hearings. In the Social Programs Committee's report about this legislation, it was mentioned that the Minister address or consult with the medical association prior to the Minister proceeding with the permanent legislation regarding this concern. I believe the concern of the medical association was a lack of clarity about what would happen if there was for some reason a conflict between, or maybe there was the potential likelihood of a conflict between the Nurse Practitioners Act and the Medical Profession Act. My question is whether or not the Minister has been made aware of this and what is his response to that concern? Thank you, Mr. Chairman.

Thank you, Ms. Lee. The Minister of Health.

Thank you, Mr. Chairman. Mr. Chairman, the medical association has been involved in this particular process. We are aware that they have some concerns and I think fundamentally, that is why the collaborative practice agreement has to include nurse practitioners and the doctors as signatories to the agreement that is going to be entered into. Thank you.

Thank you, Mr. Minister. Ms. Lee.

Thank you, Mr. Chairman. I believe the concern of the medical association was that the requirement for the practitioners to have a collaborative practice agreement will not address sufficiently the concerns that the medical profession has. As we know, in the North we have locum doctors who work in many facilities and not all of them may understand, realize or appreciate when they enter into these agreements that they may enter into something that may get them into trouble under the Medical Professions Act, or something like that. I do not believe that the fact that there is a requirement for a collaborative practice agreement will address that. I would like to know if the Minister could commit to working with the medical association to address their concerns in this regard, rather than just relying on that requirement for the agreement. Thank you, Mr. Chairman.

Thank you, Ms. Lee. The Minister of Health and Social Services.

Thank you, Mr. Chairman. Mr. Chairman, that is a commitment that I am prepared to make. We have a relationship with the medical association, involving them in issues like the nurse practitioners. We are involving them in a number of other issues through the medical directors and access to the table when we look at other action plan issues. This nurse practitioner pilot project is a new initiative. Very clearly, we are going to have to stay very engaged with both the nursing association and the medical association as we work through the implementation to make sure that things are being done as they were anticipated and hoped to be carried out when the process started. Thank you.

Thank you, Mr. Minister. When we left off, we were at clause 20.

Clause 21.

Page 7, clause 23.

Clause 24. Ms. Lee.

Thank you, Mr. Chairman. I have a question under this section, section 34.1, subsection 1, where it gives powers to the Minister to make regulations. In subsection 2, "The Minister shall consult with the association before making or amending regulations," but it does not make any reference to the medical association. My concerns are the same. I would like to seek a commitment.

Actually, I would like to first ask why the requirement to consult with the medical association is not in this clause? Secondly, I would like to ask whether or not the Minister could give us a commitment to work with the medical association for improvement in this area in preparation for the permanent legislation. Thank you, Mr. Chairman.

Thank you, Ms. Lee. The Minister of Health and Social Services.

Thank you, Mr. Chairman. Mr. Chairman, the NWT Nurses Association is a self-regulating profession. As I have indicated, given the importance of this new initiative, we will continue to commit to work with the medical association, but given the fact that they are a self-regulating profession, it is not deemed appropriate to enshrine in legislation the medical association having to be consulted about a self-regulating profession any more than we would contemplate possibly including the nurses association and having that same kind of consultative capacity in a medical association legislation. Thank you.