Thank you, Mr. Speaker. Mr. Speaker, I move, seconded by the Member for Inuvik Twin Lakes, that Bill 80, Dental Hygienists Profession Statute Amendment Act, be read a second time.
Mr. Speaker, Bill 80 amends the Dental Auxiliaries Act and the Health and Social Services Professions Act to
Require the Minister to recommend to the Commissioner regulations under the Health and Social Services Professions Act on or before March 31st, 2024, to regulate the practice of dental hygienists;
Designate the profession of dental hygienists as a profession to which that act applies, effective April 1st, 2024;
Transfer the regulation of dental hygienists from the Dental Auxiliaries Act to the Health and Social Services Professions Act, effective April 1st, 2024; and,
Replace genderspecific language in the Dental Auxiliaries Act with genderneutral language.
Thank you, Mr. Speaker.
Thank you, Member for Kam Lake. The motion is in order. To the principle of the bill. Member for Kam Lake.
Thank you, Mr. Speaker. Mr. Speaker, over the last three and a half years, I have spoken about oral health on numerous occasions in this House. I have focused on the need of the GNWT to change and modernize the Dental Auxiliaries Act and the regulatory environment of dental hygienists to improve preventative oral health in small communities, and I have focused on the cost of the NWT's lack of equitable access to preventative oral health care. What I want to tell this House why it is important that I am moving forward with this bill.
We live in a unique part of the world with unique needs. In our remote communities, access to regular dental care is not consistent and treatment is not timely or immediate. Accessing treatment is complicated by the fact that dental services are not insured medical services under the Canada Health Act. Depending on an NWT resident's ancestry, their funding for dental care comes from different funding or benefit pots. Here in Yellowknife, there are multiple dental hygienists that residents can access on a regular basis dependent on financial and benefits the individual has access to. Some dentists and hygienists also travel to communities.
The Dental Auxiliaries Act stipulates that no dental hygienist shall practice dental hygiene except under the direction and control of a dentist. In this week's response to Oral Question 143519(2), Dental Hygienist Regulations, health and social services stated, quote, "access to dental services for Indigenous residents eligible for the noninsured health benefits program is funded by Indigenous Services Canada, or ISC, through a contribution agreement with the department. The department, on behalf of ISC, enters into contracts to pay for the travel costs of the dental providers to provide dental services in communities. ISC determines the number of dental days allocated to each community, and funding is in accordance with this number."
In reality, how services are delivered on the ground across our territory differs than how they are intended. Yes, there are contracts for dental providers to travel to northern communities but on the ground what this means is that dental providers offer dental services in short blocks of time outside of Yellowknife in community hubs and small remote communities. These services are triaged starting with dental emergencies. This makes sense. If someone needs a root canal or an extraction, this will always be the more emergent case. What this means is that prevention is pushed back or simply does not happen and the next visit is more teeth being pulled and a cycle where preventative care consistently sits on the back burner.
Separating dental providers to allow for the option of dental hygienists to work independent of a dentist is key to empowering dental hygienists to secure their own contracts; and, in turn, provide prevention oral health care in small remote communities.
This isn't only a challenge relevant to the NWT. Today all Canadian jurisdictions, except three territories and PEI, have legislation to support dental hygienists to be autonomous and selfregulated to varying levels. For example, some jurisdictions restrict the use of local anesthesia by dental hygienists. And I have to say a huge thank you to the Canadian Dental Hygienists Association, the Ontario Dental Hygienists Association, and the British Columbia Dental Hygienists Association. All three associations were incredibly generous with the information they shared with me on lessons learned through their own legislation, what they would do different and why, and how they have created a regulatory environment for dental hygienists, and have strongly encouraged new modern legislation for dental hygienists in the Northwest Territories.
Yellowknife residents don't encounter the same barriers accessing preventative oral health care as small and remote community residents. But, Mr. Speaker, access to preventative health care is an allofterritory concern.
Our oral health has a significant impact on our overall health. Oral health care, or lack thereof, can cause a cascading domino effect of health challenges down the road. According to the World Health Organization, almost all of the world's population suffer from oral diseases, and global cases of oral diseases have increased by 1 billion over the last 30 years, a clear indication that many people do not have access to prevention or treatment of oral diseases. Also acknowledged by the World Health Organization is the reality that people on low incomes, people living with disabilities, elders and seniors living alone or in care homes, those living in remote and rural communities, and people from minority groups, carry a higher burden of oral disease.
The most common oral diseases are tooth decay, severe gum disease, tooth loss, and oral cancers. But, Mr. Speaker, we're not only talking about oral disease. Core oral systemic health directly increases the risk of diabetes, cardiovascular disease, cancer, Alzheimer's disease, periodontal disease, and high-risk pregnancies. Every one of these jeopardizes a person's quality of life, may shorten their life, and is a significant financial cost to the government.
The operations budgets for the Department of Health and Social Services of the Northwest Territories is half a billion dollars, and the cost of health care is not going down. In fact, Mr. Speaker, our expectations of our health department continue to grow, and the associated budget is not keeping pace, forcing the department to come back time and time again for supplementary appropriations to pay for a system that has outgrown its means and sits in significant deficit.
So, Mr. Speaker, the challenges of Northerners thousands of kilometres away matter because the success of the NWT depends on the health and safety of all its people and because the cost of reactionary health care is almost always higher than the cost of prevention.
It is also worth noting, Mr. Speaker, that in the Northwest Territories, 86 percent of dental hygienists identify as women. Denying dental hygienists the opportunity to practice outside of the control of a dentist means that the government is unintentionally denying employment opportunities in a sector that is largely female. In addition, less than a handful of NWT communities have resident dentists. This means that less than a handful of NWT communities can be home to practicing dental hygienists. Nurses work in our small remote communities without doctors, preventative health care professionals like chiropractors and massage therapists are free to work under professional accreditation using their professional discretion to provide services to NWT residents. Given the huge can demand for oral health practitioners, and the known fact that prevention saves future burdens on our health care system, creating a regulatory environment that supports more prevention is critical. This, Mr. Speaker, also creates opportunity for economic diversification and employment outside of Yellowknife.
Do I believe that all dental hygienists want to be selfemployed or work outside of a dentist's office? No, Mr. Speaker. But some want the autonomy and the ability to choose. Beyond the autonomy of this industry, Mr. Speaker, it is doing what makes sense for the health of our territory. One of the key objectives of the GNWT's oral health strategy calls for establishing systemic supports for improved oral health services, including improving the regulatory environment. But in the same tabled response to Oral Question 143519(2), Dental Hygienists Regulations, health and social services stated, quote, "delivery of dental services is not part of the NWT Health and Social Services system. Dental treatment remains the exclusive domain of private dental practices. As such, the department has no authority to dictate how dental providers deliver their scope of practice."
This response shows me the importance of building the regulatory framework originally referenced in the oral health strategy years ago. To remove systemic barriers to preventative oral health for all residents of the Northwest Territories, we must improve the regulatory environment that will support a preventative oral health system. This bill helps us accomplish just that.
Mr. Speaker, I have not carried this conversation on my own. My colleague from Inuvik Twin Lakes has also spoken frequently in this House about the same. And without the opportunity to listen and learn from her lived experience as a northerner, a parent, a public health nurse, a nursing manager at the Inuvik Hospital, and as the Inuvialuit health systems navigator, I would not have had the opportunity to appreciate the depth of the challenges many of our residents face when accessing dental services.
I'd like to thank the MLA for Inuvik Twin Lakes for her consistent collaboration throughout this Assembly, this bill, and ultimately as the seconder of this bill. Thank you, Mr. Speaker.
Thank you, Member for Kam Lake. The motion is in order. To the principle of the little. Government House Leader.
Thank you, Mr. Speaker. The government has not had time to do an analysis of this bill. What the bill proposes would take government resources and we cannot endorse something without doing our due diligence. That said, we do want to Cabinet has taken the position that in the spirit of consensus government, we don't stand in the way of bills as they make their way through second reading. So Cabinet will be abstaining. Thank you.
Thank you, Government House Leader. The motion is in order. To the principle of the bill.
Question.
Question has been called. All those in favour? All those opposed? All those abstaining? The motion is carried. Bill 80 has had second reading.
Carried
Second reading of bills. Minister responsible for Education, Culture and Employment.
