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Bill 171 receives Royal Assent

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With relevant passage from the House Proceedings


2007-06-05

The relevant section of the House Proceedings:

I want to deal next with schedule P. In the original bill, schedule P created a

new college to regulate both naturopathy and homeopathy. As a result of the public hearings, it became very clear that both

groups of health care professionals really prefer to have their own colleges. So as a result of the public hearings, both I,

on behalf of New Democrats, and the government moved forward with amendments that would indeed create two new colleges, one

for each of those particular professions. The amendments, I think it’s safe to say, were similar regarding the governance

structure, bylaws, the roles and responsibilities, the committees that would be created etc. But there were three areas where

our NDP amendments and the government amendments were different, and I want to outline those on the public

record.

First of all, I want to make it clear that the amendments that we put forward were put to us by the Ontario

Association of Naturopathic Doctors, which we worked with during the course of the public hearings. So our amendments are a

reflection of what they wanted to see in this new schedule P in terms of the new college that they were going to be

establishing.

The first difference had to do with the appropriate name of the college. The government amendment puts

forward the “College of Naturopaths of Ontario.” Of course, that was accepted. Our amendment that I put forward would have

named the college the “College of Naturopathic Doctors of Ontario.” The reason that we did this is that very clearly amongst

those who provide naturopathic medicine there is a concern about title and how they are spoken about, what their title is and

how people see them. I think the best reflection of that had to do with a letter that was sent to all of us from their

association outlining their concerns with the bill before the public hearings started. I just want to read from this letter

with respect to this particular concern:

“Outlining a format for title protection that will result in Ontario’s

naturopaths being forced to use the title ‘doctor of naturopathy’ that has never been used before in Ontario: This title is

currently only used by poorly trained and unregulated practitioners in other jurisdictions who do not qualify to be

naturopaths and would therefore reduce the confidence of the public in Ontario that they are” really “seeing a regulated

health provider. Bill 171 should continue to use the titles already established in Ontario: ‘naturopathic doctor’ and ‘doctor

of naturopathic medicine.’”

Throughout the course of the amendments with respect to the new schedule P, those are the

amendments that we put forward, so that those titles that are already in use in the province would continue to be in use and

that there would be no sense from the public that somehow the changing of the title—a title change that in other

jurisdictions is reflective of those who are unregulated—would be carried into Ontario and give people the sense that they

were not being seen by a highly qualified, regulated health professional. So I wish the government would have gone with the

titles that naturopathic doctors have used for a long, long time now and one that certainly is their preference in relation

to what they know happens in other jurisdictions when there are different titles.

Secondly, we had a difference of

opinion with respect to the scope of practice. Our amendment read as follows with respect to schedule P: “The practice of

naturopathic medicine is the assessment of an individual, and the diagnosis and treatment of diseases, disorders and

dysfunctions through the integrated use of naturopathic techniques to promote, maintain or restore health.” If I look at the

government’s scope of practice, it was a little bit different. It did not talk about naturopathic medicine. It said: “The

practice of naturopathy is the assessment of diseases, disorders and dysfunctions and the naturopathic diagnosis and

treatment of diseases, disorders and dysfunctions using naturopathic techniques to promote, maintain or restore health.” The

difference really came around “naturopathic medicine,” which was the preference of the association, which was in our

amendment, and the government’s use of “naturopathy” as a stand-alone.

Again, it seems to me that naturopaths have been

working for some long time in the province of Ontario—for many years, actually—under the Drugless Practitioners Act. They

have titles that have been already established. They have practices that have already been established. I think it just would

have made some common sense to put into place a scope of practice that the association that’s been representing doctors of

naturopath for many years felt was the more appropriate one. But that did not happen.

The other difference in terms of

the amendments that were put forward by New Democrats and the government with respect to the new college had to do with the

controlled acts. We did put forward an amendment that would have added an additional controlled act to naturopaths, and in

particular is the following: “Prescribing, dispensing, selling or compounding prescribed substances that are consistent with

the practice of naturopathic medicine.” The government did not accept that amendment for that controlled act to be applied to

naturopathic doctors in the province of Ontario.

The reason that we moved that amendment goes back to the letter that

we received from the association before the public hearings started. It said as follows: “Taking away the ability of

naturopaths to prescribe, dispense, sell and compound many natural health products that are currently available to patients,

and that naturopaths are highly trained to use safely and effectively. HPRAC recommends that naturopaths be granted this

controlled act. Without this controlled act, naturopaths would only be able to use natural health products intended for over

-the-counter sale to consumers to treat patients, meaning we could no longer offer the optimal care that results when

naturopaths can customize a treatment plan based on the full range of natural medicines that are currently available.

Naturopaths have been prescribing, dispensing, selling and compounding natural medicines as part of their current scope of

care in a safe and effective manner.”

I said earlier that naturopaths have been regulated under the Drugless

Practitioners Act for many, many years now, I think well over 70, and this is the kind of practice that they have already

undertaken on behalf of their patients. So it seemed a little silly to me that we wouldn’t recognize what has become common

practice among these health care professionals and enshrine that in the act in terms of an additional controlled act. It also

seemed silly to me that we wouldn’t do that when HPRAC, in its report New Directions, also recommended that this scope of

practice be provided to doctors of naturopathic medicine. So I think the government here had an opportunity to (a) do what

HPRAC had already recommended the government do, and (b) legitimize or put in legislation that which doctors of naturopathic

medicine have already done for many, many years now. The government missed that opportunity by not agreeing to those changes

in our amendments.

So I was pleased that we both—that is, the government and the New Democrats—put forward a specific

college for naturopathic doctors, but I regret that the government wouldn’t go that additional step further to actually put

in place practices that have been undertaken by doctors of naturopathic medicine for years and years now, especially with

respect to the controlled act of dispensing, selling and prescribing, that the government just wouldn’t do it, because HPRAC

had already recommended it. That part made no sense to me. Again, while it’s great that we’re going to have a new college, I

think we missed an opportunity to make sure that it was going to get off to the best start it possibly could.

The

government and New Democrats also created a new schedule to establish a new college for those who practise homeopathy.

Originally, under Bill 171, the college would have included both health care professionals. But again, there were amendments

in this section as a result of what we heard during the public hearings that clearly recognized that these health care

professionals do very different things and wanted to have their own separate colleges, and both New Democrats and the

government felt that at the end of the day they could work each under their own college and set in place what was necessary

to have proper regulation and proper protection of the public, which is what regulation really is all about.

So both

ourselves and the government put forward numerous amendments with respect to the creation of the new college. They are

similar in terms of other amendments that have been put forward for the creation of other colleges. The difference between

the NDP amendments and the government amendments, again, had to do with the scope of practice and controlled acts.

The

government defined the scope of practice for the new college as the following: “The practice of homeopathy is the assessment

of body system disorders and treatment using homeopathic techniques to promote, maintain or restore health.”

Our scope

of practice was fuller than that and reflected recommendations that had been made to us by the Ontario Homeopathic

Association, as follows: “The practice of homeopathy is the assessment of an individual’s state of health based on

homeopathic techniques and principles, and the identification and provision of appropriate homeopathic treatment using

homeopathic medicines, techniques and natural substances to restore, maintain and promote physical, mental and emotional

health.”

Clearly, the government amendment was the one that was carried. The government did not put forward any

controlled acts that homeopaths could provide, and we did, again based on recommendations that we received from the Ontario

Homeopathic Association. The amendments we made with respect to controlled acts are as follows:

“(2) Subject to the

regulations, a member may,

“(a) administer, by injection or inhalation, a prescribed homeopathic substance;

“(b)

communicate a homeopathic diagnosis that may be identified through an assessment that uses homeopathic techniques and that

includes assessing the individual’s physical, mental and emotional conditions and symptoms, and used to prescribe the

appropriate homeopathic remedy or therapy; and

“(c) prescribe, dispense, sell or compound a homeopathic medicine which

is defined as a drug in the Drug and Pharmacies Regulation Act.”

Again, the government would not accept those three

controlled acts that the NDP had put forward as amendments that the homeopaths would be allowed to participate in or carry

out under regulation.

I’m pleased that there are going to be two colleges. That’s what we heard during the course of

the public hearings, the need for that, but I think we could have gone further and really responded to the concerns and the

wishes that had been put forward to us, particularly by the homeopathic association, by using the scope of practice they had

put forward and by providing them with three controlled acts that they had asked for. That is not going to be the case.

Perhaps at some point in time, after the college is established and has a good look at what happens, the association will

come back and the college will come back to the government and say, “These things are really necessary in order for

homeopaths to very clearly and fully undertake their scope of practice and skill and profession,” and at some point in time,

we may have some change. But given how long it takes to open up these kinds of acts, I think we should have done it in the

first place. 


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2007-06-05

http://www.ontla.on.ca/house- proceedings/transcripts/files_html/31-MAY-2007_L180.htm#P893_225519

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