Monday 4 November 1991

Regulated Health Professions Act, 1991, and companion legislation / Loi de 1991 sur les professions de la santé réglementées et les projets de loi qui l'accompagnent

Midwifery Act, 1991 / Loi de 1991 sur les sages-femmes

Psychology Act, 1991 / Loi de 1991 sur les psychologues


Chair: Caplan, Elinor (Oriole L)

Vice-Chair: Cordiano, Joseph (Lawrence L)

Beer, Charles (York North L)

Haeck, Christel (St. Catharines-Brock NDP)

Hope, Randy R. (Chatham-Kent NDP)

Malkowski, Gary (York East NDP)

Martin, Tony (Sault Ste Marie NDP)

McLeod, Lyn (Fort William L)

Owens, Stephen (Scarborough Centre NDP)

Wessenger, Paul (Simcoe Centre NDP)

Wilson, Jim (Simcoe West PC)

Witmer, Elizabeth (Waterloo North PC)

Clerk: Mellor, Lynn


Moisan, Michel, Legislative Counsel

Revel, Donald, Legislative Counsel

Spakowski, Mark, Legislative Counsel

The committee met at 1534 in room 151.


Resuming consideration of Bill 43, the Regulated Health Professions Act, 1991, and its companion legislation, Bills 44-64.

Suite de l'étude du projet de loi 43, Loi sur les professions de la santé réglementées et les projets de loi, 44 à 64, qui l'accompagnent.

The Chair: The standing committee on social development is now in session. It is my understanding that the Minister of Health will be here in approximately 15 minutes so I am going to suggest a slight reordering of the agenda and ask if the legislative counsels who are here and ready to proceed will begin with the discussions around translation of our French-language portions of the bill.

Mr Spakowski: Good afternoon. I would like to introduce my colleagues from the office of the legislative counsel. Donald Revell is chief legislative counsel and Michel Moisan is the head of our translation and linguistic services.

Last week a question was asked about the masculine and feminine forms in the French titles of some of the bills before the committee. This question raises a difficult issue. It involves two principles that are very important to our office, that our drafting be gender-neutral, and that our drafting be clearly written in proper French and English. These are principles that are not always easy to reconcile. Furthermore, their reconciliation is different in the two different languages. We have considered this matter and we are of the opinion that the way it has been dealt with reflects current French usage. We would be happy to answer any questions the committee might have.

Mr Beer: Thank you very much for the letter and the accompanying documents. I do not want to hold us up too long on this question. I think you have addressed the issues. I was just wondering, in terms of this overall question, is there a protocol, if you like, in terms of the way Parliament in Ottawa, the National Assembly in Quebec and the New Brunswick Legislative Assembly deal with these questions of terminology? I just wonder if there is something similar. I was not sure whether that might have been noted in the document. I did not see it and I wondered whether there was an attempt to use common terminology in both languages.

Mr Moisan: As far as I know, other bilingual jurisdictions try to follow current French usage. The general way of translating position titles, for example, in French would be to use the generic masculine. As you know, there is an exception in the case of the nurses. That is an exception you can also find in Quebec statutes and New Brunswick statutes, so other jurisdictions follow the same rules.

M. Beer : En terminant, je dirais simplement que je pense que c'est une des questions qui deviennent importantes à cause du fait que, de plus en plus, on essaie de mettre le terme correct à ces titres. Si on peut suivre la même approche qu'on suit à Ottawa, à Québec ou à Fredericton, où on a d'autres Assemblées législatives qui utilisent la langue française, je pense que ça peut être utile. Mais, je vous remercie pour la réponse à ma question de la semaine passée. Merci beaucoup.

Ms Haeck: I appreciate Mr Beer's remarks as well as your own. I was just wondering if in some respects we are not sending a message that -- how shall I put it? I am trying to be diplomatic here. Generally we are going to set an example of inclusion as opposed to exclusion. I understand that the basic form, and for many years the basic title for a lot of things was "he." That was the standard term when referring to contract language or whatever. In these days there are definitely many exceptions. I was wondering if we could not begin by setting an example that in fact both sexes are included in the title.

Mr Moisan: You have to remember that you are dealing with two very different languages here. French does not work the same way as English. You are absolutely right with "he" in English. Of course we have changed that in the recently revised statutes. In French, it is another matter altogether. The masculine generic is still considered inclusive in French in properly written text. That is why we use it and that is why other bilingual jurisdictions in the country use it. Obviously there are changes in the language in French as well as in English. We monitor the situation, and if the French language ever changes enough that we feel we are no longer following current usage by using the masculine generic, obviously we will revise our way of doing things.

Ms Haeck: The Académie française has not yet been picketed by women's groups as far as changing usage is concerned. Is that what you are telling me?

Mr Moisan: The Académie française, of course, is a very important sort of regulating body but it is not the only source of current usage. We look at the French press -- when I say "French" I mean Quebec and New Brunswick, as well as France and Belgium -- and we try to see what the present state of the language is, whatever the Académie says.

Ms Haeck: I see. I appreciate it. I hope you will excuse my facetiousness, but I had wondered how inclusive we could be in the North American context.

Mr Grandmaître: My question is a very sincere one. Since the implementation of Bill 8, how have you been reacting or trying to accommodate the needs of Bill 8? What have you done in the present ministry or whatever?

Mr Revell: Unquestionably the most significant thing we have done, Mr Grandmaître, is to do the Revised Statutes of Ontario. I am not sure whether all the members have received the Revised Statutes of Ontario 1990 in their offices yet, but it is a 12-volume set. It contains the 547 public and general statutes of the province in fully bilingual form. That is our most significant step. Those statutes will be proclaimed in force on 31 December of this year, which is in full compliance with Bill 8.

The next thing we are doing is we have an ongoing project in the office to translate the existing body of regulations into French. We estimate this project to be about a five-year project in total. There was no mandate in the French Language Services Act for us to do this. There was a mandate on the Attorney General to select appropriate regulations. In fact, we have gone beyond just selecting appropriate regulations. We are attempting to have the great bulk of Ontario regulations in French by 1995. Of course, all new bills have been drafted in bilingual form since the beginning of the year.

Mr Grandmaître: But did you not have a deadline, though, of 1991? Did you not have five years to do all the needed translation? Was this not the program?

Mr Revell: On the regulations there is no deadline. On the statutes the deadline is indeed 1991 and that deadline is being fully complied with. It is December 31, 1991.

The Chair: Further speakers? On behalf of the committee I would like to thank you both very much for the clarification, the presentation today and the very fine work you have done in preparing the legislation. I know it is not often that we have an opportunity to see the people who prepare everything for us behind the scenes, and I think it would be appropriate. I know on behalf of all committee members we are very impressed with the work you have done and the thought you put into it. We would like to thank you very much.

My suggestion is that we recess until the minister shows up. How about starting with a five-minute recess, and hopefully the minister will be here at that time?

Clerk of the Committee: She is just outside the door.

The Chair: She is just outside the door? Okay, five minutes should do it.

The committee recessed at 1543.


The Chair: The standing committee on social development is in session. Are we ready to proceed? We are doing clause-by-clause discussion. We will begin with Bill 43. I would like to welcome the Minister of Health to our deliberations this afternoon.

Hon Ms Lankin: Thank you very much. I would like to officially table the proposed amendments with respect to Bills 43 and 56. They will be read into the record officially a little later when Mr Wessenger moves them, but I wanted to take a moment to address these amendments. I believe the committee members have them in front of them. You have had a chance to look at them. As you know, the purpose of these amendments is to acknowledge through exemption the practice of traditional healing and midwifery by members of aboriginal communities in Ontario.

These amendments the government is proposing today have evolved from discussions with aboriginal groups that took place since early this summer. I think it is fair to say that the first bill which raised these issues for us was the Midwifery Act. In the context of reviewing that, it served as a catalyst for aboriginal groups to express their concerns about the potential negative impact that the regulation of, first of all, midwifery, and then the discussion was broadened, would have on health services, particularly on the traditional midwives and possibly traditional healers in aboriginal communities.

Those organizations certainly expressed to us a very clear desire to have access to health care providers who are representatives of their culture and communities. As well, of course, they would like to have access to technology that is offered by allopathic care institutions. I think there is a clear indication that there are two streams of health care that are recognized through the aboriginal communities.

In the summer there was a brief consultation conducted by aboriginal groups and they proposed that aboriginal healers and midwives should be exempted from the legislation. The proposed amendments provide an exemption, but I think it is important that in the way we have tried to structure it, the exemption is for aboriginal healers and midwives when they provide services to aboriginal persons and to members of aboriginal communities. We have defined "aboriginal healer" as an aboriginal person who is providing traditional healing services and we have defined an "aboriginal midwife" as an aboriginal person who is providing traditional midwifery services.

I think one of the things that is important about the proposed wording is it recognizes that there are aboriginal communities other than Indian reserves as set out in the Indian Act. That was important because when we first started looking at it and speaking with some of the aboriginal community groups about how an exemption might be framed and how it might be applied, we looked at the issue of jurisdiction and the issue of band councils or others and we found very quickly that there were communities that would then fall outside the exemption, that it would not address the actual structure of where these traditional services are currently being performed; for example, Metis settlements in defined geographic areas or first nations without a land base at this point in time or a defined aboriginal population within an urban area. We certainly had clear examples and representations from groups of that nature.

The proposed amendments also recognize that an aboriginal healer or midwife may become a member of a college. Should they choose this approach, they would then be subject to the college regulations. We hoped that would address concerns on that side of it.

The proposed amendment to Bill 56 would permit an aboriginal person practising midwifery to call herself an aboriginal midwife.

All in all, we believe these amendments are an appropriate response to the aboriginal aspirations for the recognition of the current practice and the potential revitalization of traditional healing. I was impressed in my discussions with representatives of the community with how important that was to them as a whole. As indicated by the aboriginal communities, these traditional midwifery and healing practices have been in existence for thousands of years and they have been under the governance of aboriginal communities and elders throughout this time. Those governance structures are different than what we propose in terms of how we regulate our processes and our services within our cultural definition of these things. This approach recognizes that difference.

These and other aboriginal health issues will be discussed on an ongoing basis as we develop an aboriginal health policy. We expect that process will span the next several months. I think in our preliminary discussions with representatives of aboriginal communities, we have had a suggested timetable to begin these broader consultations. We know that some of the things we may be discussing would be assisting those communities in establishing their own regulatory structure. There have been discussions about the possibility of an aboriginal native midwifery council. There are a number of things we are looking at exploring in joint consultation.

We think the broader framework of aboriginal health issues is very important for our province and important for us to continue discussions on. This is not a process that ends with these proposals we are putting forward. We want to develop jointly, and that was expressed by both sides to the consultation, the appropriate policy and structures that will guide the development and the delivery of services to the aboriginal community. We felt it was important to start that from the premise of what in practice and in history has been the case, that our aboriginal communities have had access to traditional healers and midwives in a delivery of service based in culture and history. That varies very much from those services under the proposed legislation and proposed bills that we are now determining to regulate in a different way.

I will leave my comments at that and perhaps can provide some other thoughts after hearing what other members of the committee have to say.

The Chair: I think it might be appropriate if we asked for the motions to be formally read into the record and then we can have discussion.

Mr Wessenger moves that the bill be amended by adding, after the heading "Miscellaneous", the following section:

"31.1(1) This act does not apply to,

"(a) aboriginal healers providing traditional healing services to aboriginal persons or members of an aboriginal community; or

"(b) aboriginal midwives providing traditional midwifery services to aboriginal persons or members of an aboriginal community.

"(2) Despite subsection (1), an aboriginal healer or aboriginal midwife who is a member of a college is subject to the jurisdiction of the college.

"(3) In this section,

"`aboriginal healer' means an aboriginal person who provides traditional healing services;

"`aboriginal midwife' means an aboriginal person who provides traditional midwifery services."

Mr Beer: I want to indicate at the outset that we will be supporting this amendment. I think the premise on which you based it is one that we have been trying to move towards for a number of years now in the provision of social services where previous governments have reached agreements with aboriginal bands around the provision of those services, as well as in other areas of health care.

The only point I would like to make in relation to this is simply the one you referred to. I encourage you to go forward in terms of the governance structures as we try to work with those structures that have historically existed, but there is none the less a concern we have had throughout, in dealing with all of this legislation, around the public interest, that there be developed a clear understanding of how this is in fact governed. I am sure for all of us, whether we are talking about aboriginal or non-aboriginal persons who may be receiving health care service from an aboriginal healer or an aboriginal midwife, there is a need, just as there is with the broader legislation, to have a clear understanding of the governance structures so that what we want to see happen here does happen.


You made reference to one of the issues you were exploring with the native leadership, perhaps around the creation of an aboriginal native midwifery council, which sounds like an interesting proposal. With whom are you developing these structures? Is this with the different bands or with two or three of the specific province-wide aboriginal organizations?

Hon Ms Lankin: It has been a combination. I do not actually have the list with me, but the people with whom we have met to date include groups such as the Union of Ontario Indians, Equay Wuk from NAN -- let me get the names right -- is it the Association of Iroquois and Six Nations? I think those may be some of the names. I am not very good at getting them all out yet, but there are a variety of those groups. There are some province-wide groups and particular treaty groups that have not been involved yet. Here we go: There is the Association of Iroquois and Allied Indians. We have not yet been able to have Grand Council Treaty 3 involved in the process because the kind of time frames we imposed on the groups were very difficult for all the groups to meet. Some of them were able to do some limited consultation with their own communities. We hope Grand Council Treaty 3 will be involved from here on in.

There is the Nishnawbe-Aski Nation, and I mentioned Equay Wuk specifically. there are the Ontario Federation of Indian Friendship Centres, the Ontario Métis and Aboriginal Association, the Ontario Native Women's Association, and the union, as I mentioned. The Chiefs of Ontario were not able to attend the last meeting we had, but we will, I am sure, have them involved from here on in.

We will take a moment with those groups to ensure that we have the appropriate list of people and that we are not missing specific organizations, but also to ensure that in the process we put in place now for a consultation, clearly we we do not have the kind of unrealistic time frames placed on the groups that we had in leading up to these exemptions, and that we allow for sufficient time and resources for them to do proper consultations, which they feel are proper, with their own communities to bring forward the best consensus of ideas.

Mr J. Wilson: I want to very briefly commend the minister for bringing forward the amendments and for appearing before the committee in person today. I think that underlines the importance of the issue for committee members. It also ensures that the NDP members are quieter today than they normally are.


The Chair: Order. I knew that was going to provoke a response, Mr Wilson. I have cautioned others in the past not to provoke.

Mr J. Wilson: It was getting a little dull.

In all seriousness, thank you, Minister. I had an opportunity, of course, over the weekend to review the amendment and I do not have any major concerns at all. I have implicit faith that you are negotiating and ensuring that the information about governance will get out to the communities affected. I can understand that the time frames were tight. I am very appreciative, as a committee member, that you have been able to come back before the windup of our debate on Bill 43 to bring forward this amendment. Good work.

Mr Beer: One thing I forgot to say is that we will be withdrawing our amendments, and as I said before, we will be supporting the government amendments.

Mr Martin: I also want to express how important this is from my perspective in terms of a sign to the native community and in terms of recognition of what they have done for years, and the respect in which, because of this, they are now being held and will be held, and in which they will be held in the communities I am closest to in northern Ontario. I think in the context of everything else that is happening in this country today as Canada evolves, this piece is probably even larger than we, at this moment here in this room, can really appreciate and understand. In supporting this particular amendment to the bill, I am rather proud today.

Motion agreed to.

Schedule/annexe 2:

The Chair: We have had a withdrawal of Mr Beer's two motions. We have an outstanding section that has not been called. Perhaps it was just overlooked. It was Section 91 of Schedule 2.

Section 91 agreed to.


Title agreed to.


The Chair: Shall the bill, as amended, carry? All those in favour? Any opposed? Carried. It will be ordered with the rest of the bills when we have concluded them all.


The Chair: I would ask for unanimous consent from the committee to reopen section 15 so that the government can place its amendment.

Agreed to.

Section/article 15:

The Chair: Mr Wessenger moves that section 15 of the bill be amended by adding the following subsection:

"(2.1) an aboriginal person who provides traditional midwifery services may,

"(a) use the title "aboriginal midwife," a variation or abbreviation or an equivalent in another language; and

"(b) hold himself or herself out as a person who is qualified to practise in Ontario as an aboriginal midwife."

Motion agreed to.

Section 15, as amended, agreed to.


The Chair: Shall Bill 56, as amended, carry? All those in favour? Any opposed? Carried.

We have now completed both Bills 43 and 56. I believe you want to stand down Bill 60.

Hon Ms Lankin: Yes.

The Chair: We have had a request from the government to deal with Bill 60 tomorrow, if that is agreed. For anyone with an interest in Bill 60, tomorrow at 3:30 in the afternoon the committee will be considering Bill 60.

I believe you are prepared to proceed with Bill 63.

Hon Ms Lankin: We are. Actually, I will be leaving at this time and handing it back over to Mr Wessenger.

Perhaps if I could say a few words to the committee with respect to the two bills that the amendments were just passed on, I sincerely appreciate the support from all members on this committee. I think, Mr Martin, you are right in terms of indicating the historic importance of these amendments and the part they play in the process of developing a relationship on a government-to-government basis and developing an understanding of things like the inherent right to self-government. This is a process we are all engaged in in this province that has importance on a national level. I think all of us feel a sense of accomplishment at each step along the way as we try to work through this. The consultations that will follow this will be very important and will have more of a basis of opportunity for success because of the committee's support for this kind of starting point, and I truly appreciate that.

Just before I leave, let me say, as you will be closing the clause-by-clause very quickly, my great sense of appreciation of the overall work the committee has done on this package of bills. As we have all said, it has had a very long history. There are all sorts of groups whose careers and professions are affected by the work you have been doing that have come to me and have been very pleased with the process of understanding and amendments and compromise where that has been able to be achieved. A number of people are very impressed and appreciative of the process the committee has undertaken, and I certainly appreciate that work as well.

The Chair: I point out to all members of the committee that you received today a copy of an agreement that has been reached. I know the committee received many representations and deputations on the issues contained in the agreement and the amendments that are being tabled by the government today are a reflection of the agreement. I know there are people here with a great interest in that.



The Chair: I call Bill 63, An Act respecting the regulation of the Profession of Psychology. In light of the agreement that has been reached, Mr Wilson, are you withdrawing your amendment?

Mr J. Wilson: Yes, Madam Chair.

Section/article 15:

The Chair: In that case, we are at section 15 and I call Mr Wessenger. I believe you have amendments to replace the ones you had originally tabled.

Mr Wessenger: Yes, that is correct.

The Chair: Withdrawing the old ones?

Mr Wessenger: Yes, I am withdrawing the old ones.

The Chair: Mr Wessenger moves that subsection 15(1) of the bill be struck out and the following substituted:

"(1) No person other than a member shall use the titles `psychologist' or `psychological associate,' a variation or abbreviation or an equivalent in another language.

And he further moves that subsection 15(2) of the bill be amended by adding after "psychologist" in the third and fourth lines "or psychological associate."

Mr Wessenger: If I might speak to the amendment, there has been a memorandum of agreement entered into between the MA psychologists and the practising existing psychologists with respect to the practice of psychology, which gives a status to the MA psychologists under the term "psychological associate," and this amendment is to recognize that memorandum of agreement.

Mr Owens: Just to gently correct the parliamentary assistant, this is not only a memorandum; this is a landmark memorandum of agreement. If applause were appropriate to this committee, I think we should all stand up and give the various associations a very loud round of applause for work well done.

Mr Wessenger: I would just like to add that I think the speed with which this agreement was concluded was very commendable. I wish we could all work that quickly.

Mr Beer: I would like to add my voice to that. When we began our discussions back in the summer and this issue arose, the various representatives went off to try to sort out an agreement, and it really is remarkable that they have been able to do it in such a short period of time.

This is one place in particular where we can all underline some real progress made, both in terms of protecting the public and expanding the opportunities for people to access services. Everybody involved had to really sit down and have a look at what they did and give and take. What has come out of that is something that is going to be, without any question, much better for our health care system. So I would want to say well done to all our friends here who were involved in that process.

Mr J. Wilson: Just briefly again, I commend the government on bringing forward the amendment and the associations involved, but rather than share credit with all members of the committee I would like to particularly give credit to you, Madam Chair. You put a considerable amount of subtle, behind-the-scenes pressure on these people, and just for the record, when you decide to get something done, it is proof positive today that it gets done. Congratulations, because I know this predated this government. It is something that is long overdue, and I hope the agreement does not fall apart now that the legislation is going through. I trust all parties signed the agreement in good faith, and I look forward to further co-operation there.

Motion agreed to.

The Chair: Mr Wessenger moves that section 15 of the bill be amended by adding the following subsections:

"(2.1) A person who is not a member contravenes subsection (2) if he or she uses the words `psychology' or `psychological,' an abbreviation or an equivalent in another language in any title or designation or in any description of services offered or provided.

"(2.2) Subsections (1) and (2.1) do not apply to a person in the course of his or her employment by a university."

Mr Wessenger: This continues the protection that was continued in the former act. With the changes made with respect to the memorandum of agreement, I think it is an excellent amendment. It also provides for the exceptions with respect to those people employed as faculty of universities, which is essential for their protection.

Motion agreed to.

Section 15, as amended, agreed to.


The Chair: I think it might be appropriate at this time to clarify what has occurred regarding the profession of psychology. For those who are listening, what this agreement means and what the amendments that have been accepted today mean is that, for the first time, people with masters degrees, MAs, in psychology following this agreement will be considered professionals in the practice of psychology. That agreement was a result of the work done both by the existing board, which will soon become the college, as well as the associations of those who are presently regulated under the old legislation and those soon to be regulated.

Mr Wilson, I want to acknowledge what you have said. These discussions have been ongoing for 10 years. However, I believe that the people who are here today, the leaders of the professions, are the ones who are deserving of the praise, as they came together and worked very expeditiously to resolve problems that are professional in nature. As I call the bill, I think it is with acknowledgement of the significant progress that has been made in the practice of the profession of psychology and the access to services for the people of Ontario.

Shall Bill 63, as amended, carry? All those in favour? Any opposed? Carried. It will be ordered along with all of the other bills at the appropriate time.

The Chair: Any other business today that anyone can see on the agenda? In that case, the committee stands adjourned until 3:30 tomorrow afternoon when we will consider Bill 60.

The committee adjourned at 1618.