Debates of October 26, 2006 (day 16)

Thank you, Mr. Chairman. I am pleased to introduce Bill 7, Pharmacy Act. This bill reflects a significant number of differences from the existing Pharmacy Act to ensure the public receives quality pharmaceutical service and care, and to modernize the definition of the "practice of pharmacy."

Many stakeholders were involved in the development of this act, including the Pharmaceutical Association of the Northwest Territories, the NWT Medical Association, the Registered Nurses' Association of the NWT and Nunavut, the NWT Medical Director's Forum, and the regional health and social services authorities. We appreciate their involvement and the time they have dedicated to helping develop this act. They will continue to be involved during the development of the regulations.

We need to bring the Pharmacy Act up to date with modern practices, as the existing act is 53 years old. IT does not permit pharmacists to accept faxed prescriptions. The existing act has an inadequate discipline process not consistent with modern practice. The drug schedules are too out of date to be useful, and provisions of the act make it very difficult to respond in a timely manner when there are changes needed to the list of drugs that nurse practitioners or midwives are permitted to prescribe.

The new Pharmacy Act will recognize health care professionals and will also recognize the National Association of Pharmaceutical Regulatory Authorities' drug schedules. These national lists are kept up to date. The department will enact regulations in a variety of areas including the establishment of a prescription-monitoring program.

In the provinces, regulatory colleges for each profession are in charge of licensing and registered pharmacists, and discipline. They also regulate the operation of pharmacies, including business hours and store layout.

In the NWT, there are too few pharmacists to establish a college structure. The GNWT will continue to administer licensing and registration, and an independent committee of peers who will manage any disciplinary process. The new act will also allow for disciplinary provisions such as an alternative dispute resolution process. It should be noted that we have never had a complaint about a pharmacist in the NWT. The new act will not regulate the business aspects of pharmacies but focuses on the profession only.

When this act was reviewed by the Standing Committee on Social Programs, concerns were raised by stakeholders regarding section 20 of the initial bill, which gave pharmacists prescribing powers. Concerns were also raised regarding the unclear authority of the practice of a nurse dispensing. The department worked with the standing committee and stakeholders to resolve these concerns, which resulted in amendments being made to the bill by the standing committee. I am confident this amended bill still gives pharmacists the flexibility they need to successfully practice in the NWT. That concludes my opening remarks. Thank you, Mr. Chairman.

Thank you, Minister Roland. I'd now like to ask the chairman of the Standing Committee on Social Programs, Ms. Lee, to provide committee's comments on the bill. Ms. Lee.

Thank you, Mr. Chair. The Standing Committee on Social Programs conducted a public review of Bill 7, Pharmacy Act, on September 5th, 2006, and October 16th, 2006. The committee would like to thank the representatives of the NWT Pharmacists Association, the NWT Medical Association and the Registered Nurses' Association of the NWT and Nunavut for appearing before committee to discuss the ramifications of the passage of the Pharmacy Act for all health practitioners in the NWT.

It became apparent to committee members at the September 5th public hearing that there were serious concerns on the part of the NWT Medical Association representing the doctors and the Registered Nurses' Association of the NWT/Nunavut over the scope of practice for pharmacists proposing the new legislation. These concerns centred on the pharmacist's proposed ability to issue and alter prescriptions without consulting with a doctor or nurse who originated the prescription, and on the availability of nurses in the health centres and nurse practitioners to issue drugs under the proposed legislation. It is a tribute to the professionalism and dedication of all three associations, that they were able to meet with the Department of Health and Social Services and come to an agreement on new wording that satisfied their needs and allowed the act that regulates the practice of pharmacy to be modernized to recognize existing best practices. This collaborative approach is reflected in the five amendments that were passed during the clause-by-clause review at the committee stage.

Mr. Chairman, I would now like to ask my colleague Mr. Pokiak to conclude the statement. Thank you.

Thank you, Ms. Lee. Mr. Pokiak.

Thank you, Mr. Chairman. The bill we have before us will modernize the practice of pharmacy in the Northwest Territories. It provides pharmacists with their scope and regulation of practice, and further clarifies the roles of doctors, pharmacists and nurses in issuing and…(inaudible)…prescriptions.

It also moves the drug schedules from legislation to regulation, which will allow the department the ability to add and de-list drugs from the schedules as required, and respond to emerging health care crises by temporarily moving drugs to a lower schedule in order to increase availability.

Following the committee's review, a motion was carried to report Bill 7, Pharmacy Act, as amended and reprinted, to the Assembly as ready for Committee of the Whole.

This concludes the committee's opening comments on Bill 7. Individual Members may have additional questions or comments as we proceed. Thank you, Mr. Chairman.

Thank you, Mr. Pokiak. I'd now like to ask Minister Roland if he'd like to bring in witnesses.

Yes, Mr. Chairman.

Thank you. Does committee agree?

Agreed.

Thank you, committee. I will now ask the Sergeant-at-Arms to escort the witnesses in.

Thank you. Minister Roland, I would now like to have you introduce your witnesses for the record.

Thank you, Mr. Chairman. Mr. Chairman, to my left is Ms. Janis Cooper, the legislative counsel for Justice; to my immediate right is the deputy minister of the Department of Health and Social Services, Mr. Chuck Parker; and further over is Ms. Gay Kennedy, director of policy, legislation and communications.

Thank you, Minister Roland. Welcome to our proceedings here this afternoon. We have general comments next. Anybody for general comments, committee? Mr. Braden.

Thank you, Mr. Chairman. This has been an interesting, multi-faceted piece of legislation. It's been working its way through committee for some time now and I'm pleased to speak in favour of the bill, as a member of the standing committee. I guess in general comments, very general comments, a couple of things that the public, as consumers, may be interested in in relation to pharmacies and the business of dispensing drugs. One of the things that has been quite controversial for the last couple or three years, in Canada especially, is the industry established through Internet purchase and merchandising of prescription drugs. I was wondering whether this was something that the NWT considered in the context of the…Even though we have relatively few drug dispensing pharmacists here in the NWT, this is something that causes some concern or some interest in other parts of Canada. Was this addressed or how is this addressed in this bill, Mr. Chairman?

Thank you, Mr. Braden. Minister Roland.

Thank you, Mr. Chairman. Mr. Chairman, the Internet pharmacy issue that's been out there in Canada is something that this bill doesn't deal with particularly. It doesn't deal with that section of it. That more falls into the actual physicians' side of the equation and how they deal with that. So that part of it is not covered in this act. Thank you.

Thank you, Minister Roland. Mr. Braden.

Okay. So then the bill does not either restrict or enable this kind of thing to happen. It's simply silent on this aspect of dispensing drugs, Mr. Chairman. It's silent.

Thank you, Mr. Braden. Minister Roland.

Thank you, Mr. Chairman. The act itself, this Pharmacy Act doesn't cover, or I guess the term is "silent" on that. But there are some other categories or effects here that I guess would fall in the territory. Ms. Cooper may be able to address that.

Thank you, Minister Roland. Ms. Cooper.

Mr. Chairman, the act does regulate anybody who dispenses, any pharmacist who dispenses drugs in the Northwest Territories. Somebody can't just set up a dispensary from which they send things all over the place, without complying with the act. So if pharmacists are up here dispensing…It doesn't prohibit people from purchase online, but we can't do that.

Thank you, Ms. Cooper. Anything further, Mr. Braden?

I guess that's enough on Internet. I take it that it's not going anywhere.

Mr. Chairman, something that is always a consideration with a bill of this nature is that there's usually a large package of regulations also bolted onto it. The legislation, of course, is the platform. The detail is implemented through regulation. I wanted to ask the Minister if he could give us some sense of when we will see the regulations that affect this new legislation completed and when this new legislation could potentially come into effect, Mr. Chairman.

Thank you, Mr. Braden. Minister Roland.

Thank you, Mr. Chairman. Mr. Chairman, as with most legislation that flows through this House, as the Member stated, the bill itself, the law that gets put in place follows with regulation being worked on. I understand that they're aiming for April, but Ms. Kennedy can provide more detail, as well, on that.

Thank you, Minister Roland. Ms. Kennedy.

Thank you, Mr. Chair. We intend to work on just the registration regulations. That's all that would be needed to get it operational. So we hope by April that we can bring the bill into force with enough of the registration guidelines. They can be used to start the registration process over the course of the year. Then there are numerous other regulations we will probably need to get started on, but probably are not needed for implementation.

Thank you, Ms. Kennedy. Anything further, Mr. Braden?

Thank you. That will do for now, Mr. Chairman.

Thank you, Mr. Braden. No further general comments. We will now move, Bill 7, Pharmacy Act, clause by clause, committee?

Agreed.

Thank you. We will begin on page 6, Bill 7, Pharmacy Act, interpretation, clause 1.

Agreed.

Page 8, part 1, registration, clause 2.

Agreed.

Clause 3.

Agreed.

Page 9, clause 4.

Agreed.

Page 10, clause 5.

Agreed. Page 11, clause 6.

Clause 7.

Agreed.

Page 12, clause 8.

Agreed.

Page 13, clause 9.

Agreed.

Page 14, clause 10.

Agreed.

Part II, practice of pharmacy, clause 11.