(Mr. Tim Mercer): Mr. Speaker, I have a Return to Written Question 5019(2) asked by the Member for Kam Lake to the Minister of Health and Social Services on October 31st, 2022, regarding treating infertility.
In the case of infertility, when a known underlying, medical condition is identified as the. Probable cause of the infertility, treatment of that underlying condition is covered under the NWT healthcare Plan as an insured health service.
Where the cause of the infertility it is not readily known, these cases may be submitted to the Medical Advisor for review of the specifics of the case and decision. This process, referred to as 'prior approval', is used in situations where the treatment may be outside the Health and Social Services system’s usual referral pathway or when circumstances warrant deeper examination.
To clarify, it is important to differentiate between specialist services for treatment of an underlying condition and specialist services providing fertility treatments, such as in vitro fertilization.
Fertility treatments, are not considered medically necessary procedures in most jurisdictions, including the Northwest Territories. Public policy regarding funding of fertility treatments varies across Canada. For example, in Alberta and British Columbia, fertility treatments such as intrauterine insemination and in vitro fertilization are not funded, whereas in Quebec some fertility treatments are funded, such as one single in vitro fertilization cycle if the woman is between 18 and 40 years old.
The NWT Medical Travel program is in place to assist eligible residents to access medically necessary insured services not available in their home community. The NWT Medical Travel program requires a medical referral from an NWT medical practitioner. This requirement is to validate that the medical travel is tied to an insured health service, the referral is to the appropriate service provider and nearest facility, and to ensure continuity of care is maintained.
The request made by the Member for direction to the Medical Travel Office to accept referrals from specialists outside of the territory does not align with the practice of ensuring NWT residents' health needs are managed and monitored through NWT primary healthcare providers as a best practice for continuity of care. There is no plan to move away from this practice.
The assertion that vasectomies and vasectomy reversals are covered, whereas fertility treatments for birth givers are not covered, is incorrect. Vasectomy procedures for men are covered in the NWT, as are the analogous tubal ligation procedure for women. Neither the reversal of a vasectomy nor the reversal of a tubal ligation are covered in the NWT.
The determination of services medically necessary and who makes that decision is not straightforward. Under the Canada Health Act, services delivered by physicians and within hospitals are generally considered insured health services. Medically necessary services are not defined in the Canada Health Act. Provincial and territorial healthcare insurance plan providers consult with their respective physician groups and across jurisdictions to identify a set of services that each jurisdiction accepts as medically necessary, insured services provided by physicians and in hospitals. This common set of services then meets the Canada Health Act’s Principles of Universality, Portability and Accessibility.
Thank you, Mr. Speaker.
