May 15, 2017
Hon. Jane Philpott, P.C., M.P.
Minister of Health
Brooke Claxton Building, 16th Floor
70 Colombine Driveway
Postal Locator: 0906C
Ottawa, ON K1A 0K9
Dear Minister Philpott:
I am writing on behalf of the Canadian Nurses Association (CNA), the national professional voice representing over 139,000 registered nurses (RNs) and nurse practitioners (NPs) in Canada, to provide you with our perspective on the amendments the Senate Standing Committee on Legal and Constitutional Affairs (hereinafter “the Committee”) made to Bill C-37, An Act to amend the Controlled Drugs and Substances Act and other Acts. We provided you with a copy of CNA CEO Anne Sutherland Boal’s letter of May 1, 2017 to Senator Bob Runciman, Chair of the Committee, (enclosed). Her letter outlined the concerns our national association has with three amendments outlined in the Committee’s report (tabled on April 13, 2017).
Your decision to delete Section 56.2 is welcomed by CNA because the requirement for community consultations for supervised consumption sites (SCS) is not based on evidence. While working with local communities can contribute to greater acceptance of a facility, providing communities with broad advisory powers is extreme and unwarranted. Municipal governments already have processes in place to consult their citizens. If implemented, the requirement would have perpetuated the stigma associated with SCS, further compounding the challenges faced by those individuals who need these health services most.
While we are in agreement with the decision to strike the above-noted amendment, we remain opposed to the two additional amendments that you have accepted: 1(a) in Clause 42, (a) and 56.3(1).
(1(a)), CNA believes the proposed Senate amendment is counterintuitive and we recommend that you reconsider your decision to accept it in the latest version of Bill C-37.
Rationale: RNs know the importance of a cohesive, timely, evidence-based approach to addressing public health emergencies. Yet, in the midst of this public health emergency, the Senate committee proposed an arbitrary, minimum 45-day waiting period prior to allowing SCS that offer health prevention and treatment services to open. Discretionary or not, the inclusion of this recommendation gives the perception that it would be acceptable to apply a minimum time frame to the application process, thereby implying that it is acceptable to delay the opening of such sites.
(56.3(1), CNA opposes the Committee’s recommendation for SCS staff to be required to offer a person using the facility alternative pharmaceutical therapy prior to each supervised drug use event.
We urge you to also reconsider your decision to accept it in the latest version of Bill C-37.
Rationale: Even with the change to replace the word “shall offer” with “may offer”, this particular amendment to the bill will undermine a large part of the success of SCS, which is based on RNs and clinic staff developing trusting relationships with those who need and use the service. It will place RNs in an untenable position of having to consider whether they will have to offer the same individual such a service several times each day, regardless of the person’s acceptance of or readiness for alternative treatment.
While this was perhaps intended to increase client access to treatment services, the reality is that it will more likely have the opposite effect. If implemented, the Committee’s amendments will hamper improvements to and entrench barriers to access for essential health services that could otherwise be saving lives.
Lastly, but not least important, we are disappointed that both the Standing Committee on Health (House of Commons) and Standing Committee on Legal and Constitutional Affairs (Senate) did not adopt our proposed amendments. Both briefs are enclosed.
If you have any questions or would like to address the concerns we have raised in this letter, please contact David Granovsky, CNA’s manager of government relations, at 613-237-2159, ext. 525, or firstname.lastname@example.org.
Barb Shellian, RN, MN