This is page numbers 6787 - 6868 of the Hansard for the 19th Assembly, 2nd Session. The original version can be accessed on the Legislative Assembly's website or by contacting the Legislative Assembly Library. The word of the day was know.

Topics

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 6814

Katrina Nokleby

Katrina Nokleby Great Slave

Thank you, Mr. Chair. I appreciate the Member bringing this bill forward as well, and it was interesting to be the deputy chair on a Private Member's bill and get to learn that kind of aspect of it.

The Member did hear me say about the idea of being maybe innovative and adding this on to sort of the engagement or the piece that would be done for other professions. And I'm just wondering if she would speak to whether she thought that was actually possible given that she's much more procedurally minded than I am, and I often go to her to answer my procedure questions. I'd like to get her thought on that. Thank you.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 6814

The Chair

The Chair Ronald Bonnetrouge

Mahsi. MLA Kam Lake.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 6815

Caitlin Cleveland

Caitlin Cleveland Kam Lake

Thank you very much, Mr. Chair. I believe what the MLA is referring to is the ability to do travel and engagement on multiple pieces of regulatory work or legislative work at the same time. I mean, we as far as committee have done that, where possible, have kind of travelled on multiple pieces of legislation. That being said, it would depend on how the department chose to handle that work. If it was different staff that they had on it or at the end of the day if they chose themselves to contract that work out. And so as far as, you know, how things work in department land, I'd have to leave that to department to speak to. Thank you, Mr. Chair.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 6815

The Chair

The Chair Ronald Bonnetrouge

MLA Great Slave.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

October 5th, 2023

Page 6815

Katrina Nokleby

Katrina Nokleby Great Slave

Thank you, Mr. Chair. Has the Member had any -- and this is probably quite a high -- or wishful question. But does she have any idea how much not having this dental hygienist practice or this ability to have preventative care is really costing us as a territory? Was there any work done around characterizing or quantifying how much money are we spending to send people either to Yellowknife, to the south? Why, when we're waiting for things that are preventative to become emergent situations? We obviously are paying more for that. Does the Member have any feel for how much money we would save by having this? Thank you.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 6815

The Chair

The Chair Ronald Bonnetrouge

Mahsi. MLA Kam Lake.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 6815

Caitlin Cleveland

Caitlin Cleveland Kam Lake

Thank you very much, Mr. Chair. Mr. Chair, in the early days of this work, when reaching out to the department and asking for dollar figures on this, I was advised right away that the dollar figures would not be substantive as to the entire cost of it because you're also paying for preventative -- when you're paying for preventative care, you're also preventing things like heart disease, like diabetes, and so the costs like that really can't be easily measured. One of the things that I will say, though, is that one thing you can't put a dollar figure on is people's quality of life and their mental health. Thank you, Mr. Chair.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 6815

The Chair

The Chair Ronald Bonnetrouge

Mahsi. MLA Great Slave.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 6815

Katrina Nokleby

Katrina Nokleby Great Slave

Thank you. Yeah, I would definitely quantify or qualify that as immeasurable, really, the effects that this could have on people in those -- in those regions. I had a question, but I don't remember it. So thank you, Mr. Chair. And I appreciate the Member for her work on this. Thanks.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 6815

The Chair

The Chair Ronald Bonnetrouge

Clause 1, does committee agree? Minister of Health and Social Services.

Julie Green

Julie Green Yellowknife Centre

Thank you, Mr. Chair. I move that Bill 80 be amended in subsection in

(a) in subclause 1(2), by striking out "December 1st, 2025" in proposed subsection 5(2) and substituting "August 1st, 2027"; and

(b) in subclause 1(3), by striking out "November 30th, 2025" in proposed subsection 67.1(1) and substituting "July 31st, 2027."

The Chair

The Chair Ronald Bonnetrouge

The motion is in order. To the motion. Minister responsible for Health and Social Services.

Julie Green

Julie Green Yellowknife Centre

Thank you, Mr. Chair. The timing set out in Bill 80 now provides the department with just over two years to develop professional regulations. The department remains concerned that they may not be able to meet this deadline. The timing set out in the bill leaves little room for delays that are frequently encountered during the regulatory development. It does not reflect the challenges that the department anticipates when engaging the dental hygiene profession.

Dental hygienists in the NWT do not have a territorial association or organization representing the profession, nor has the department received any explicit indication from members of the dental hygiene profession regarding what changes they would like to see in the regulatory framework. This makes it difficult to know whom to engage in the development of the regulations, the content, and the estimated time required to draft them.

The current regulatory framework for dental hygienists is significantly outdated and silent on many of the elements found in modern professional regulatory frameworks, such as standards of practice, continuing competency requirements, and complaints considerations. We know significant work will be required to move the regulation of dental hygienists from the Dental Auxiliaries Act to the Health and Social Services Professions Act. This work cannot be done without thorough engagement with the profession.

While the department is committed to advancing these regulations as quickly as possible, these external variables pose risk that legislated timings for regulatory development will be missed. Missing these legislated timelines poses risks to both the dental hygiene profession and to the public as I mentioned in my opening remarks.

If Bill 80 came into force prior to finalizing with the regulations, there would be no legislation governing the regulation of dental hygienists in the NWT. During this gap, dental hygienists could not be licensed to practice in the NWT. This means that the public could not make a complaint about the professional's conduct and existing professional license would not be valid and no new licenses could be issued and non-licensed professionals could provide services without a license. It's also likely that professional insurance for dental hygienists practicing during this time would be difficult to obtain.

While this gap could be addressed through an amending bill in the next Assembly, such an approach would take away from the work to develop the regulations. For these reasons, I'm proposing that Bill 80 be amended to allow the department additional time, which they may or may not need, to 2027, to work with the dental hygiene profession to develop a comprehensive and modern regulatory framework for dental hygienists in the NWT. Thank you, Mr. Chair.

The Chair

The Chair Ronald Bonnetrouge

Mahsi. To the motion. MLA Great Slave.

Katrina Nokleby

Katrina Nokleby Great Slave

Thank you, Mr. Chair. I just don't accept these reasons that are being provided as to why this date needs to be pushed back even further. There's no reason that this could not be done with a professional association somewhere else. We have seen that in numerous other professions where because we don't have the people or the bodies to populate our own, we often will use others. For example, NAPEG uses the board of examiners for engineers in Alberta because we can't maintain that here on our own. So I do think that there was -- there is a method and a way that this could have been done by using, say, Alberta's association or others.

The people that did come and present to us told us that this is not going to be anything that's going to be rocket science as far as development of standard operating procedures. They're very general across the board. They -- what works in the south works up here. Really, I think that this could be done and, really, the want to move to back to even further to be four years I think really just speaks to the will to ensure the well-being of people outside of the capital. I don't think the will is there. I think that oftentimes communities are suffering as a result of a focus and a narrow mindedness about what we can do and what really is, you know, within the latitudes of this Assembly. This sound like it's going to be like we're regulating the profession of medicine itself, four years to develop. No. This is a standard piece of work that the government itself has already carved out exceptions for itself. The IRC's already got people working. So this has been done. There are people -- dental hygienists working in this manner already. But it seems like it's okay to make those exceptions for GNWT when they want to but when it comes time to do that for everybody else, that's no longer the case. The will and the want is not there.

And I find that, you know, it really does go against the true nature of the consensus government that we came to a compromise. We heard the concerns from the department. And yet we still now in the 11th hour are having amendments made to push this back even further, four years so kids can just get a cleaning. It's shameful, Mr. Chair. And I will not be supporting this motion. Thank you.

The Chair

The Chair Ronald Bonnetrouge

Mahsi. To the motion. MLA Kam Lake.

Caitlin Cleveland

Caitlin Cleveland Kam Lake

Thank you very much, Mr. Chair. Mr. Chair, I listened to what concerns the health Minister raised, and I think that they're very valid concerns. And I wanted to address some of them here before I move on.

I think one thing that is very valid in the Minister's concerns identifying that there is a small number of dental hygienists that live in the territory. And most of them live here in Yellowknife. They're serving Northerners. There's a very small number of them serving over half of the population of the Northwest Territories. And so I agree that it's not fair to put all of this on them to draft these regulations. They're very busy people. They're cleaning a lot of teeth right now, and I very much appreciate it and thank them for that. And that's why where I think that some of the conversation about bringing in some additional supports, both to support the work that would be required of the department in order to draft these regulations and also bringing in some additional supports from elsewhere in order to kind of gain some insight into some of the challenges of other jurisdictions.

I'm not a health care professional at all, Mr. Speaker. And so when I was working on this bill, I actually reached out to some other associations across Canada to help me learn about oral health care and about some of the challenges that have presented within legislation in other jurisdictions and in regulation in other jurisdictions, things they wished they did different and things that worked really well for them.

Yesterday I tabled these letters here in the House, and they were very supportive and helpful letters from three associations across Canada. There was the Canadian Dental Hygienists Association, the Ontario Dental Hygienists Association, and the British Columbia Dental Hygienists Association.

The president and executive director of the Ontario Hygienists Association shared a four-page letter of valuable suggestions about what to include in this work and concluded the letter with, quote, please do not hesitate to contact us if you have any questions as you move forward, end quote. So very supportive and willing to help.

The executive director of the British Columbia Dental Hygienists Association wrote in a three-page letter stating, quote, over the years, BC dental therapists and certified dental assistants have reached out to the BCDHA for professional support. In recent months, BCDHA has expanded membership for dental therapists and has developed a pilot membership program for CDAs through the CDA Alliance. Thus, we speak not only for dental hygienists in BC, we also carry the voices of both dental therapists and dental assistants. We invite you to speak with us so that our parties can both connect and discuss our perspectives in greater detail. And so not only that, but an organization looking at supporting additional health care -- or oral health workers and also operating in licensing additional folks too and willing to help out and lend their experience.

Lastly, the chief executive officer of the Canadian Dental Hygienists Association and a six-page letter of support and suggestions, including CDHA is very pleased to hear that you're working to improve access to preventative oral health care. Please do not hesitate to contact our director of dental hygiene practice if you require more information or guidance in your quest to draft a proposed amendment to the Dental Auxiliaries Act to broaden the scope of practice of dental hygienists in the Northwest Territories.

So while there's limited dental hygienists here in the territory, there's an abundance of need to improve access, Mr. Chair, and to do the work. And I think that the big key for me that I think shows that -- and while the Minister said that they support this work, but the thing that shows to me that I think they can get it done in this timeline is in the 2018-2019 to 2020-2021 oral health action plan, which is the two-year action plan, the objective to establish systemic supports for improved oral health services has the number activity, which is to -- which speaks to the regulatory environment. And the deliverable there is revised legislation regulations to support the oral health professional role by 2020-2021. And so to me, health has already acknowledged that they can get this work done in this action plan. They weren't able to meet it for 2020-2021. We're now three years later. And so I believe in their original action plan and their original goal to do this work and believe that they will find the support out there to get it done. Thank you.

The Chair

The Chair Ronald Bonnetrouge

Mahsi. To the motion. MLA Frame Lake.

Kevin O'Reilly

Kevin O'Reilly Frame Lake

Yeah, thanks, Mr. Chair. I have a question about the amendment, and I want to ask the law clerk.

I'm just -- the Minister said that the -- if this motion is not passed that dental hygienists would be completely unregulated. And I believe that the motion actually is to the first part of the bill, not the second part, which is where you would remove the Dental Auxiliaries Act application. But thanks.

The Chair

The Chair Ronald Bonnetrouge

Member for Frame Lake, we can't entertain any questions while the motion is on the floor. To the motion. MLA Frame Lake.

Kevin O'Reilly

Kevin O'Reilly Frame Lake

All right. So I don't know, Mr. Chair. I would like to get some clarification of this. But my reading -- and I'm only a lowly Regular MLA that doesn't have access to the law clerk right now. My reading of this is that it's the next part of the bill that actually would remove dental hygienists under the Dental Auxiliaries Act. And the Minister, in moving, the motion talked about how the profession would be completely unregulated if this amendment is not accepted. And I don't think that that's the case. So I think -- if there's something the Minister wants to do about the next clause, that might be the place where that is dealt with. But I don't -- my reading of this is that I don't think that this is the case. But I can't ask anybody about it. So thank you.

The Chair

The Chair Ronald Bonnetrouge

Mahsi. To the motion. MLA Yellowknife north.

Rylund Johnson

Rylund Johnson Yellowknife North

Thank you, Mr. Chair. I won't try to answer that. Maybe I will. I think what the Minister said is that if this bill is passed and the date is not met, then you are all of a sudden under a new Act requiring regulation but they don't have regulation, so then you're just in this no-man's-land. But anyway, it had nothing to do with the specific motion or my understanding the whole bill as a whole.

My only comment was going to be, you know the GNWT is full of action plans and commitments to finish regulatory work and then we blow by them, and we don't get them done. We all know there's limited capacity in policy shops to get work done. I'm actually pretty hesitant for the legislature to start prescribing dates in regulation to complete work. You know, I don't think we've done it anywhere else, and I'm not sure I would even start with the Hygienist Profession Statutes Amendment Act. There's probably a lot of bills I think need regulatory work done. But, you know, I think -- why not give it a shot, Mr. Chair. We've missed a lot of timelines, and the Member has shown that this has been an action plan for years and missed timelines. And, you know, if the department's sitting here in 2025 and isn't going to make it well, then the next Minister of health's problem is to bring a motion to amend the legislation, I guess. So thank you. I'll vote for it. Thank you.

The Chair

The Chair Ronald Bonnetrouge

Mahsi. To the motion. MLA Monfwi.

Jane Weyallon Armstrong

Jane Weyallon Armstrong Monfwi

Thank you, Mr. Chair. Mr. Chair, every child matters in NWT, especially those in small communities with limited services. These young children, they have the same rights as children living in larger regional centre with regular dental services. And I thank my colleague for introducing the Private Member's bill. Thank you. Mr. Speaker, we cannot wait four years for our young kids to have proper dental treatment. We have kids as young as -- like she said, as young as 12 years old needing dentures. That is unacceptable. That is unacceptable. And it is the year 2023. We should have all these services available in small communities, especially with preventative work. Thank you.