Thank you, Mr. Speaker. Your Standing Committee on Social Development is pleased to provide its report on review of Bill 80, Dental Hygienists Profession Statutes Amendment Act.
Mr. Speaker, I move, seconded by the Member for Monfwi, that Committee report 6019(2), Standing Committee on Social Development Report on the Review of Bill 80: Dental Hygienists Profession Statutes Amendment Act, be deemed read and printed in Hansard in its entirety. Thank you, Mr. Speaker.
Thank you, Member for Great Slave. The motion is in order. To the motion?
Question.
Question has been called. All those in favour? All those opposed? Any abstentions? The motion is carried. Bill 80 is deemed read.
Carried.
Bill 80: Dental Hygienists Profession Statutes Amendment Act (Bill 80) received second reading on March 30, 2023, and was referred to the Standing Committee on Social Development (Committee) for review. Bill 80 is a private member’s bill, sponsored by the Member for Kam Lake, to amend the Health and Social Services Professions Act and the Dental Auxiliaries Act. This Bill proposes to provide dental hygienists with the option to work independently of a dentist. Specifically, Bill 80:
Will require the Minister of Health and Social Services to recommend to the Commissioner regulations under the Health and Social Services Professions Act, on or before March 31, 2024;
Designate the profession of dental hygienists as a profession, effective April 1, 2024;
Transfer the regulation of dental hygienists from the Dental Auxiliaries Act to the Health and Social Services Professions Act, effective April 1, 2024; and
Replace gender specific language in the Dental Auxiliaries Act with gender neutral language.
This report outlines key events leading up to the introduction of Bill 80; describes Committee’s engagement with the public; and summarizes stakeholders’ positions and Committee’s decisions on key issues.
The purpose of Bill 80 is to permit dental hygienists to work independently of a dentist. Currently, under the Dental Auxiliaries Act, all dental hygienists working in the NWT must be supervised by a dentist. Section 6 of the Dental Auxiliaries Act reads:
6. No dental hygienist shall practice dental hygiene except under the direction and control of a dentist who assumes direct professional responsibility for the patients in respect of whom the services are being provided.
On May 12, 2023, Committee held a public hearing on Bill 80. Committee heard comments focused on the important role of oral health in preventative healthcare, and its significance within the overall health of individuals. Members expressed concern with the current state of oral healthcare delivery across the NWT, especially in small communities and regional centres. Members also voiced concern about the lack of equitable access to preventative oral healthcare across the NWT. Committee agreed unanimously with the intent of Bill 80 and all Members agreed to support it.
While the Department of Health and Social Services (the Department) did not present at the public hearing, Committee did meet with the Minister to discuss the Department’s concerns with the Bill. Committee also exchanged correspondence with the Minister to try reaching consensus on an agreeable timeline for when the proposed changes within Bill 80 will take effect.
The Minister stated that the estimated timeline for the Department to complete the work within Bill 80 would take up to four years to complete. The Department also sent draft motions to amend Bill 80 with the dates of July 31, 2027, and August 1, 2027, as the dates of enactment for professional designation of dental hygienists, as well as the date for the creation of dental hygienist regulations, respectively.
However, Committee did not agree with the proposed amendments from the Department and advanced motions with a more aggressive timeline to implement the regulatory work.
Committee held a clause-by-clause review with the Member for Kam Lake on August 10, 2023. Committee engaged with the Member for Kam Lake on a compromised date of enactment on the Bill’s proposed timelines. Committee then passed two motions to amend the Bill’s timelines for when dental hygienists become a designated profession, and the date by which the Department shall establish dental hygienist regulations.
Originally, clauses 1 and 2 of Bill 80 read:
1. (1) The Health and Social Services Professions Act is amended by this section.
(2) Section 5 is repealed and the following is substituted:
5. (1) The Commissioner in Executive Council may, by order, designate professions to which this Act applies.
(2) The profession of dental hygienists is designated as a profession to which this Act applies, effective April 1, 2024.
Additionally, the original wording for Clause 3 read:
(3) The following is added after section 67: 67.1. (1) The Minister shall, on or before March 31, 2024, recommend to the Commissioner regulations under section 67 to regulate the practice of dental hygienists.
(2) Before recommending regulations under subsection (1), the Minister shall consult with
a) Indigenous governments;
b) the Canadian Dental Hygienists Association; and
c) dental hygienists actively practicing in the Northwest Territories.
Committee proposed two motions to amend the timelines (included in Appendix 1). These amendments will extend the timelines proposed in the Bill to December 1, 2025, and November 30, 2025, respectively giving the Department more time to enact the proposed legislative changes. Committee believes these amendments, which will come into force approximately halfway through the 20th Assembly, will be a sufficient timeline for the Department.
On August 10, 2023, at the clause-by-clause reading of Bill 80, the Member for Kam Lake, sponsoring Member of the Bill concurred with these amendments.
Committee sought public feedback on Bill 80 with a public notice and targeted engagement letters. Committee received written submissions from:
- Ms. Nadja Lennie;
- Ms. Ashley Morine; and
- Hon. Julie Green, Minister of Health and Social Services.
All written submissions are included in Appendix 2 to this report.
Moreover, during the public hearing on Bill 80, Committee heard remarks from the Member for Kam Lake, along with Mr. Todd Orvitz, CAO of the Inuvialuit Regional Corporation, and Ms. Nadja Lennie, owner of Fireside Denture Clinic. Committee thanks Mr. Orvitz and Ms. Lennie for their engagement. Their participation helped inform Committee discussions on key issues for future consideration.
Committee strongly agrees with the Member for Kam Lake’s concerns about the lacking areas of oral healthcare delivery within the NWT. Committee supports the intent of Bill 80 and acknowledges that the Department has stated its support of the Bill’s intent as well. Committee considers oral healthcare as an urgent matter that must be addressed by the Department sooner, rather than later. While the amended Bill sets fall 2025 as the deadline for a new designation and regulations for dental hygienists, the Department should aim to complete this work even sooner.
In addition, during the public hearing on Bill 80 the CEO of the Inuvialuit Regional Corporation (IRC) stated that their organization had recently established a Memorandum of Understanding with the Northwest Territories Health and Social Services Authority (NTHSSA) enabling IRC to employ their own practicing dental hygienist under the direction and control of the NTHSSA’s contracted oversight dentist. Committee believes this type of arrangement is a great interim option to increase access to oral preventive care while the department works on designating dental hygienists a profession and creating accompanying regulations. Committee would like to see similar types of agreements as that between the IRC and the NTHSSA be established with other communities and organizations that deliver health services. Therefore, Committee recommends the following:
Recommendation 1: The Standing Committee on Social Development recommends that the Department of Health and Social Services increase efforts to improve oral preventative care in communities. This work should include:
Providing interim options for dental hygienists to work independently of a dentist prior to fall 2025; and
Ensuring Indigenous Governments and other organizations that deliver health services are aware of other options to provide oral preventive healthcare.
On August 10, 2023, Committee held a clause-by-clause review. Committee passed a motion to report Bill 80, as amended, to the Legislative Assembly as ready for consideration in Committee of the Whole.
This concludes the Standing Committee on Social Development’s review of Bill 80: Dental Hygienists Profession Statutes Amendment Act. Typically, Committee includes a recommendation in each report requesting a response from government within 120 days. The recommendation is then moved as a motion in the House and Cabinet is required to respond. However, since the 19th Legislative Assembly will dissolve in less than 120 days, Committee has decided to leave out this recommendation and requests that the government provide a public response to this report, even of a preliminary nature, before the beginning of the 20th Assembly.
Reports of standing and special committees. Member for Kam Lake.
