Not 24 hours after non-government House members and the province’s medical association were introduced to the details of an Act Respecting the Monitoring of Prescriptions in the Province, the bill was under debate in the House of Assembly.
On Wednesday, there was a news conference and second reading. The Newfoundland and Labrador Medical Association (NLMA) flagged that timeline, saying the association was previously consulted, but had not seen the detailed text until Tuesday.
The association claims to have found multiple points in the text where, in its opinion, clarification is needed. And some details need more than clarification, according to NLMA executive director Robert Thompson.
“We’re very disappointed with the lack of opportunity for a good consultation between ourselves and the government,” he told reporters, “because we do see some deficiencies in the act, some areas where it can be improved, and we think these changes still need to be made.”
Thompson spoke at the NLMA office in St. John’s, describing the doctors’ concerns. They are also in a six-page news release issued by the association, titled, “Doctors fear prescription monitoring legislation may have unintended consequences for patients.”
One issue is around new government inspectors and the power afforded to them, including the ability to enter a doctor’s office without a warrant and examine records. Thompson said if the province wants to confirm compliance, it can be done without these inspectors being introduced.
That aside, he said, doctors would also like to see statistics on their individual prescription activity. Regularly seeing data from the Newfoundland and Labrador Centre for Health Information could help address prescription issues, he said.
Generally, there is a concern of too much of a focus from government on enforcement activities and not enough focus on encouraging education and behavioural change within the system.
There were points raised around specific jurisdictional comparisons, with the NLMA touching on everything from enforcement to privacy protection and ministerial powers.
“In principle, I support it,” said Progressive Conservative MHA David Brazil.
Brazil said the seriousness of drug addiction and opioid abuse means it makes sense to move down a road other provinces have already gone down — more closely monitoring drug prescriptions.
That said, he echoed the NLMA’s concern of a limited period of time to review and challenge the details.
He said he will press concerns with the powers afforded to the minister through the act, as opposed to existing regulators or co-operative bodies.
NDP MHA Gerry Rogers raised a red flag over whether or not the province was stepping atop the College of Physicians and Surgeons with some of the provisions set out.
“We were given this bill yesterday at 11 o’clock,” Rogers said.
“And with such a significant piece of legislation that has ramifications also for medical practitioners and patients? This is really significant. And the Newfoundland and Labrador Medical Association has raised some very important concerns. And some of these issues can be worked out, but I don’t know why they rammed this through so quickly in terms of starting the debate.”
Independent MHA Paul Lane said he is also in support of the legislation in principle, but with reservations.
For his part, on the issue of inspectors, Health Minister John Haggie said they will be custodians under the Personal Health Information Act and trained in privacy protection.
As for the timeline, Haggie said the government completed a thorough jurisdictional review and consulted an extensive list of people in developing the bill, including the medical association.
