Thank you, Mr. Speaker. Under the current Mental Health Act, the courts are the only recourse for people who wish to have a decision reviewed or appealed. This approach is expensive, inefficient and out of step with best practices elsewhere in Canada. The new

act will enhance patient rights by establishing a quasi-judicial review board for hearing complaints. Applications to the review board may pertain to such matters as involuntary admissions, findings of mental competence or objections to treatment. Every application will be handled by a three-person review panel consisting of a lawyer, medical doctor and lay person. In response to a stakeholder query, the committee confirmed that members of the review board will be paid for their services.

To enhance patient rights, the committee sought two changes pertaining to the review board. The first change requires the chair of the review board to appoint an elder as a cultural advisor where an applicant requests it. The purpose is to ensure that matters are handled in a culturally sensitive manner. The Minister concurred with this motion, but noted that the review panel already includes a lay person who will play a patient-advocate role and that the panel has the ability to call an elder as a witness at a hearing. The Minister cautioned that providing patients with the option to request a cultural advisor may result in delays or increased operational costs. The committee therefore agreed to the inclusion of a notwithstanding clause that will allow the review panel to continue its proceedings if, in rare circumstances, a suitable cultural advisor cannot be found. A second change pertaining to the review board provisions requires that the composition of the review board reflect the diversity and gender balance of the population.

The committee contemplated ways of enhancing patient rights in other ways too. Initially, it drafted a motion to allow a voluntary patient who disagrees with a doctor’s discharge decision to remain in the designated facility until the case has been considered by a review panel. However, the Minister explained that an order from a review panel would likely result in undue delays and hardship for the patient and unnecessary operational costs. He subsequently proposed to grant every patient – voluntary and involuntary alike – the right to a second medical opinion. The committee accepted this line of reasoning and introduced a motion to that effect. At the request of the Minister, a companion motion was introduced to ensure that notice of the patient’s right to a second opinion is conspicuously posted.

The committee also introduced a motion to facilitate greater involvement on the part of family members and other support persons. Recognizing that a patient’s right to privacy imposes certain justifiable constraints and, further, that some patients do not want their family involved, the committee introduced a motion that will impose a duty on the attending doctor to ask a voluntary patient if he or she would like someone to be notified of their circumstances. A companion motion was introduced to ensure that the doctor makes reasonable efforts to notify the person, and the Minister concurred with these motions at the clause-by-clause review.

In addition, the committee acted on recommendations from the Northwest Territories chapter of the Canadian Bar Association (CBA). The CBA explained that mentally ill people are criminalized whenever they come into conflict with the law and end up in correctional facilities instead of medical facilities. Individuals who suffer from psychiatric disorders, the CBA continued, are frequently subjected to apprehensions or periods of detention that are virtually identical to those resulting from criminal offences. To mitigate against these tendencies, the committee and the Minister settled on several additional provisions. First, a peace officer will be required to convey a person to a health facility without delay. Second, a peace officer will be required to inform the apprehended person, again without delay, of the reason for their detention and their right to legal counsel. Third, the peace officer will be required to facilitate the person’s access to legal counsel. Fourth, in the event of a necessary delay in conveying the person to a health facility, the patient will have the right to communicate with a family member, health professional or other person. Finally, in the event of a delay, the peace officer will be required to contact a health professional to discuss the person’s condition and circumstances. At the clause-by-clause review, the Minister indicated that these changes are consistent with Charter rights and the intent of the legislation.

With respect to the selection of substitute decision-makers, the committee acted on concerns of the Information and Privacy Commissioner and the Status of Women Council of the NWT. Because the original language in Bill 55 would only have allowed for an express wish to be considered after the selection process had begun, the committee introduced a change. It states that, notwithstanding the prioritized eligibility list set out in Section 30, if a medical doctor believes a patient is competent to participate in the selection of a substitute decision-maker, the patient’s express wish must be first in priority. The Minister concurred with this motion at the clause-by-clause review, but cautioned that the change will complicate the process of selecting a substitute decision-maker and place additional burdens on the department to establish practice standards and train health care providers.

Protection of Privacy

The Information and Privacy Commissioner provided a lengthy submission on Bill 55. The committee asked the Minister to respond to it and then deliberated on the issues. First and foremost, the committee determined that privacy issues pertaining to the Mental Health Act will largely be governed by the Health Information Act.

Second, the committee observed that points of disagreement between the Minister and the Commissioner focused largely on whether privacy provisions should be contained in the statute or in regulations. Recognizing that regulations can be more easily changed and brought into force without the scrutiny of the Legislative Assembly, the committee nonetheless concluded that privacy protections will have the force of law in either case.

Third, the committee took up the Commissioner’s concern about the bill’s failure to prohibit board members from disclosing information obtained in their role as board members. A motion to establish a confidentiality clause was introduced at the clause-by-clause review with the Minister’s agreement.

Fourth, in reference to Section 56, which authorizes the creation of a registry of certificates issued under the act, the committee noted that the Health Information Act expressly permits the creation of such a registry. The Commissioner asked for a statutory amendment to clarify the registry’s purpose, but the committee concluded that regulations are an appropriate place to specify this. Moreover, the committee was satisfied with the Minister’s explanation that the registry will be used to keep track of the number of involuntary patients and thereby assist in long-term planning. The Minister also offered assurance that certificates will be securely filed and that only relevant information from certificates will be entered into the registry.

Fifth, in reference to the concern about law enforcement’s access to certificates—and, specifically, access to the sensitive information contained therein, the committee confirmed that federal legislation protects personal information and places obligations on RCMP officers to respect confidentiality. The Minister further indicated that unnecessary information will be redacted from certificates, a practice consistent with the department’s obligations under Section 28 of the Health Information Act. These matters will be prescribed in regulations, and the committee concluded that regulation-making authority relating to the apprehension of persons will include the authority to prescribe how information is shared.

Mr. Speaker, I would now like to turn the reading of the report over to my colleague Mr. Moses.