Thank you, Mr. Speaker. On Monday, February 17, 2014, during oral questions of the House, the Minister of Health and Social Services and the Member for Range Lake entered into a debate on why the GNWT has not given serious consideration for the quiet addiction we all know as prescription drug abuse. I for one have been a champion both in my prior legislative life and today on this being the sleeping giant of our generation.
Many Health Ministers have come and gone. In fact, we have two previous Health Ministers in this Chamber today who were given equal opportunity to do something, yet did nothing on this quiet addiction.
The overarching question is how can you fix something if you don’t count it or track it? In fact, if one was to use the recent arguments for species management of the Wildlife Act, we’d be witnessing the extinction of many caribou herds at risk, if not legislated to keep a watchful eye.
So the question is why would our people deserve any less right from this government on giving them the same courtesy? In other words, when is the life of a caribou more important than that of a human? Which brings me to today’s issue before the House. We have been given many signs that this quiet addiction is no longer. Case in point: the recent coroner’s report of an Aklavik woman echoes the same issues that have been reminded in 17 previous drug overdose cases from 2009 to 2012 by the same office. How many more of our residents have to die in order to give this government the wake-up call that they’re dealing with a ticking time bomb?
Further to this argument is my overall frustration that this Minister of Health and Social Services is not being fully informed on important files dealing with health and addictions. In fact, seeing not only this Minister pulling out one or two-page briefing notes from the prepared answer binders, when dealing with Member’s questions, is a bit of a disappointment to say the least. These assumed, carefully prepared briefing notes provided to the Ministers are the summary work of many hardworking department people behind the scene. This is fine to a point; however, I would expect that Ministers should know their files and challenge themselves to question the very Coles notes they are given. Regurgitating the work of others does not constitute fact. It does, however, reveal a definite lack of understanding of the truth.
Going back to this Monday, February 17, 2014, exchange, the Minister of Health and Social Services made the following comments on page 14 of Hansard, “Under the Pharmacy Act there is an ability to set up a prescription monitoring program, but due to privacy issues that we’re all aware of, we currently cannot require health care providers to enter information into the program. Because we cannot require health care providers to enter this information, we have not yet set up a program to monitor prescriptions.”
Upon review of the relevant legislation and with this being further reviewed and fact checked by legislative legal counsel, we looked at the Pharmacy Act of the Northwest Territories, the Access to Information and Protection of Privacy Act of the Northwest Territories, and the Personal Information Protection and Electronic Documents Act of Canada in response to the accuracy of the Minister’s comments.
I will be quoting and summarizing the relevant portions of each of these acts pursuant to clearly articulate to the Minister of Health, his deputy minister and his department, the conclusions of these findings.
I will start with the Pharmacy Act. Section 46(o) of the Pharmacy Act specifically gives the Minister of Health the ability to make regulations establishing and respecting a program to monitor prescriptions including, but not limited to:
establishing a committee or body to administer the program,
respecting the appointment of members to the committee or other body established to administer the program,
respecting the purposes for which the program is established.
respecting the nature of the personal information that may be collected, used and disclosed for the purposes of the program,
authorizing pharmacists to collect personal information required for the purposes of the program and authorizing their employers to permit the collection of such information by pharmacists,
authorizing pharmacists and their employers to disclose the information collected under subparagraph (v) to the Minister or the body established to administer the program,
requiring pharmacists to collect information, including personal information, for the purposes of the program, requiring their employers to permit and facilitate the collection of such information, and requiring pharmacists and their employers to disclose such information to the Minister or the body established to administer the program,
respecting the method by which personal information must be disclosed to the Minister or the body established to administer the program,
respecting the establishment of a system, including an electronic system, for recording, storing and accessing program information, including personal information,
respecting security measures relating to the recording, storing and accessing of personal information,
establishing requirements, restrictions or conditions relating to the collection, use and disclosure of personal information by
the body established to administer the program,
any support staff or other persons providing services to the body established to administer the program, and
any person or class of persons to whom personal information may be disclosed,
respecting persons or classes of persons to whom personal information may be disclosed, and
establishing requirements, restrictions or conditions relating to access to personal information by persons or classes of persons to whom such information may be disclosed.
I’m sorry, I know this was a bit long winded, but it is perfectly clear that our Minister of Health may, by regulation, create a program to track the use of prescription drugs. The Minister even mentions this in his response on February 17, 2014, but then alludes to the question whether the existing privacy legislation is applicable in this jurisdiction to prohibit the disclosure or use of information within such a program. Let’s see what the Access to Information and Protection of Privacy Act has to say about this.
For the record, the Access to Information and Protection of Privacy Act, ATIPP for short, applies to public bodies such as our government and addresses how personal information may be collected.
Within ATIPP “personal information” is defined as information about an identifiable individual including, and I will not go through the entire list, but it does speak to name, address, age, marital status and much more.
In dealing with the relevant portions of ATIPP on personal information, it mentions the following:
Section 40: No personal information may be collected by or for a public body unless:
the collection of the information is expressly authorized by an enactment;
the information is collected for the purposes of law enforcement; or
the information relates directly to and is necessary for:
an existing program or activity of the public body, or and the important one,
a proposed program or activity where collection of information has been authorized by the head with the approval of the Executive Council.
Again, the important one is Section 42: The head of a public body shall protect personal information by making reasonable security arrangements against such risks as unauthorized access, collection, use, disclosure or disposal.
Finally, Section 43: A public body may use personal information only:
for the purpose for which the information was collected or compiled, or for a use consistent with that purpose.
Again, it is abundantly clear that the Minister can obtain personal information through another entity, such as a pharmacist, if it is authorized by an enactment. However, to be fair, what may be not entirely clear, and to the Minister’s defence, I must add, he did suggest, is whether a private organization may collect, use or disclose the personal information to the Department of Health.
In the jurisdiction of the NWT we do not have the privacy legislation that applies to commercial or private organizations, so for this answer we have to go to the federal legislation that this applies, and this is found in the Personal Information Protection and Electronic Documents Act of Canada, we call PIPEDA for short.
The main principles concerning the collection, use and disclosure of personal information by an organization is set out in Section 4.3 of Schedule 1 of PIPEDA, which states: “the knowledge and consent of the individual are required for the collection, use, or disclosure of personal information, except where inappropriate.”
Further, Section 5(3) provides that: “an organization may collect, use or disclose personal information only for purposes that a reasonable person would consider are appropriate in the circumstances.”
Although consent or knowledge of an individual is usually acquired to use or distribute his or her personal information, PIPEDA does allow an organization to use and disclose personal information without knowledge or consent in certain circumstances.
With respect to use of this personal information, I wish to draw your attention to Section 7(2)(c) of PIPEDA, which states: “it is used for statistical, or scholarly study or research purposes that cannot be achieved without using the information, the information is used in a manner that will ensure its confidentiality, it is impracticable to obtain consent and the organization informs the Commissioner of the use before the information is used.”
With respect to disclosure of personal information, I wish to draw your attention to Section 7(3), which states: “for the purpose of clause 4.3 of Schedule 1, and despite the note that accompanies that clause, an organization may disclose personal information without the knowledge or consent of an individual only if the disclosure is:
(c.1), made to a government institution or part of a government institution that has made a request for the information, identified as lawful authority to obtain the information and indicated that – and it’s a bit further down in number (iii) the disclosure is requested for the purpose of administering any law of Canada or a province.
Finally, a bit further down you see the repeat phrase (f) for statistical, or scholarly study or research, purposes that cannot be achieved without disclosing the information, it is impracticable to obtain consent and the organization informs the Commissioner of disclosure before the information is disclosed.
Again, sorry for being lengthy, but you cannot just summarize law. To be accurate, in defence you have to quote the appropriate passages when referring to it.
I’ll be wrapping up shortly here.
It should now be without question this detailed review of all these legislations do lend argument that for many years any Minister of Health could have legally directed – the current Minister prefers to use the word force – particularly our NWT pharmacists the ability to use and disclose personal information to this government for statistical purposes, as long as this information did not relate to an identifiable person.
The key message today: We could have been monitoring prescription drug abuse in the NWT for many years if there was the will to do so and a full understanding of the law, especially the laws we create. Again, as we await the long intended Health Information Act that is currently under committee review, this will further assist in the statistical ability of prescription drug abuse issues in our territory, and I, like many, look forward to that day.
I only ask that Ministers do their homework and not only rely on the one or two-page briefing notes that are provided to them for the sake of debate in this House.
Let me end with page 14 of Monday, February 17, 2014, in Hansard: “We can require individuals to put information into a prescription monitoring program or we can, rather, ask them to do, but we cannot force them to do it at this particular point in time.” He later references: “The Member actually is, in fact, wrong.”
Regular Members are doing our homework with very limited resources. We ask that the Ministers do theirs. For the record, Mr. Speaker, this Member was not wrong. Thank you, Mr. Speaker.
