Deputations related to Bill 139 (OMB Reform) hearings will be available on Hansard, some days after each hearing
Updates
An Oct. 16, 2017 Toronto Star article is entitled: “Toronto tells province that clear planning reforms are needed as soon as possible: City officials praised the province’s plan to reform the OMB at a committee hearing while asking for a clear transition plan as the city sees an uptick in development applications.”
According to a message at a recent post, Oct. 23 and 24 hearings are cancelled and written submissions are now due on Wednesday Oct. 18 at 5:00 pm instead of the original deadline of Oct. 24.
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A previous post is entitled:
An electronic version of the Bill is available on the Legislative Assembly website at: www.ontla.on.ca
I’ve called the Procedural Services Branch at 416-325-3500 for details regarding the hearings on Oct. 17.
I was informed about the details, and I also learned that the deputations, from the Bill 139 hearings, will be available as Hansard transcripts – easily located at the Queen’s Park website – some days after a given hearing. I look forward to reading the transcripts!
I’m looking forward to attending one of the hearings.
Years ago, when I was involved in another line of volunteer work, than what keeps me occupied now, I made a couple of deputations (as a spokesperson for a volunteer organization) at Committee Hearings, on one occasion (in 1991) with regard to proposed legislation related to delivery of speech-language services in Ontario.
The other occasion was with regard to a bill related to human rights legislation in Ontario. It was on both occasions an enjoyable and informative experience for me; I enjoyed having the opportunity to express my views.
I recall that I worked on my presentations for hours and hours beforehand, making sure that I would be able to make my points in the allocated time frame.
It’s also a good thing to know the names of the Committee members, and to have some sense of what their backgrounds are. That’s part of being prepared, I would say.
A person has to be super well-prepared, in order to make a good presentation, and in order to contribute in a useful way to the Q & A that follows, with members of the Committee.
For my own part, with regard to Bill 139, I look forward to sending in written comments in time for the 6:00 pm deadline on Oct. 24, 2017.
In the meantime, today I’m following Twitter updates from Jennifer Pagliaro, City hall reporter for the Toronto Star – jpagliaro@thestar.ca
The Hansard deputation, one of a couple of deputations that I refer to above, from a time when I was involved with other forms of volunteer work, concerns a hearing in August 1991 of the Standing Committee on Social Development – 1991-Aug-08 – Bill 43, Regulated Health Professions Act, 1991, and Companion Legislation.
These many years later, I find it interesting to read such a document. The text is brief, focused, and fact-based, the result of many hours of fine-tuning.
Some key points in the presentation would also from time to time appear in news releases, and occasionally in media interviews that took place subsequently. I don’t know exactly what shape the legislation took, in its final form. It was enough, from my perspective, that I had the opportunity to speak out, as best I could, on behalf of a particular group of stakeholders.
Below is an excerpt from the above-noted hearing,
STUTTERING ASSOCIATION OF TORONTO
The Chair: Mr Jaan Pill, co-ordinator of the Stuttering Association of Toronto. Welcome, Mr Pill. You have 20 minutes for your presentation.
Mr Pill: I want to thank you for the opportunity to speak with you today. My name is Jaan Pill. I will be discussing Bill 43 as it affects speech-language pathologists.
I will begin by saying a few words about myself. I am the co-ordinator of the Stuttering Association of Toronto, which is a support group for people who stutter. I am also one of the organizers of the first-ever Canadian conference of self-help groups for people who stutter, which will be held August 22-25, 1991, in Banff, Alberta. These kinds of groups offer emotional support and help people maintain their fluency after treatment for stuttering. One of the outcomes of the Banff conference will be the creation of a Canada-wide network of self-help groups for people who stutter.
As well, I am a member of the support groups/consumer affairs committee of the International Fluency Association, a new, non-profit, international, interdisciplinary organization dedicated to international contacts among speech pathologists, researchers and support groups involved with fluency disorders.
My remarks will focus on the role of speech-language pathologists within the proposed legislation. I will begin by saying a few words about the area I am most familiar with, and that is stuttering.
I will begin by defining stuttering. Stuttering is a communication disorder in which speech is disrupted by involuntary repetitions, prolongations and blockages of syllables and words. It is usually accompanied by tension and struggle behaviours, such as facial grimacing. The person may feel frustrated and anxious when trying to talk and may attempt to avoid certain words and speaking opportunities.
Research indicates that stuttering is not a psychological or emotional disorder, but is instead associated with anomalies in neuropsychological functioning. There is no cure for stuttering, but treatment methods that are now available enable up to 80% of people who stutter to maintain control over stuttering and thus communicate effectively.
With reference to treatments, extensive research has also been conducted on the effectiveness of treatments for stuttering. Psychotherapy has not been found to be effective as a treatment for stuttering. However, behaviourally oriented treatment methods have enabled many people who stutter to achieve and maintain a marked increase in their level of fluency.
About 125,000 adult Canadians, 0.5% of the adult population, stutter. In Ontario we have an estimated 49,000 people who stutter. Also, up to 5% of very young children stutter during the time they are acquiring language. Up to 80% of these children subsequently acquire fluent speech during the normal course of maturation. The remaining children in this group require specialized assistance from speech pathologists who specialize in stuttering treatment. Among this group of children, the earlier the condition is accurately diagnosed and treated, the better.
I myself have been the beneficiary of two treatment programs for stuttering, conducted by PhDs in speech-language pathology. I undertook treatment in an intensive three-week program in Toronto in 1976 with Robert Kroll, who has a PhD in speech-language pathology. The program was called the precision fluency shaping program, developed by Dr Ronald Webster, a psychologist in Virginia. Dr Kroll introduced this program to Canada in 1974. Second, in 1987 I attended a program with Dr Einer Boberg at the Institute for Stuttering Treatment and Research in Edmonton.
Canada is recognized as a world leader in stuttering treatment and research. In this context, Einer Boberg, a treatment specialist at the University of Alberta, was recently elected head of a new organization, the International Fluency Association. William Webster, at Brock University in St Catharines and earlier at Carleton University in Ottawa, is a researcher specializing in the neuropsychology of stuttering whose work is widely cited in the international scientific literature on fluency disorders.
To turn to Bill 43, in most ways I find this is a good bill. It will define who does what in delivery of health services in Ontario.
However, the proposed bill does indicate that a person who has a PhD in speech pathology cannot use the title “doctor.” That title has been reserved for medical doctors, optometrists, dentists, chiropractors and psychologists. The rationale for this decision is that it will reduce confusion to the public. I submit it will instead add to the confusion and is likely to detract in the long run from effective delivery of treatment to people in Ontario who stutter.
In North America, advances in treatment and research have been made by professionals in a wide range of fields. Some MDs in the United States have made stuttering their specialty. There are also neuropsychologists who have devoted a significant part of their research to the topic of stuttering. One of the standard references in North America concerned with the maintenance of fluency skills after treatment for stuttering is written by two specialists living in Ontario, namely, Marie Poulos, a speech-language pathologist at the Ottawa Rehabilitation Centre, and a psychologist, William Webster, whom I referred to earlier. Also, one of the standard references for Canadian physicians seeking current information about stuttering in children is a recent article by William Webster and Einer Boberg, and I have the references at the end of this material.
I also wish to refer to diagnosis, which in Bill 43 refers to the “communication to a patient or his or her representative of a conclusion as to the cause or identification of a disease or dysfunction.”
Physicians are not typically experts in the diagnosis of stuttering. The literature available to physicians is sometimes out of date. For example, there are still references in standard medical tests as recent as 1988 which describe stuttering as primarily a stress disorder. That kind of perception of stuttering in scientific literature was popular around 1950, 1960. Members of self-help groups have offered anecdotal reports of physicians attempting to treat stuttering by prescribing tranquillizers.
As well, it takes expertise — expertise of the kind available to speech-language pathologists who specialize in the treatment of stuttering — to distinguish between those children who stutter and who will recover spontaneously as they mature, and those children who are not likely to recover without treatment by speech pathologists. If the parents of a child in the latter category are told by a physician that the child will grow out of it, that child loses the opportunity for timely treatment.
Earlier discussions about the bill have noted that a number of participants in previous reviews have submitted that members of other professions with doctorates should be permitted to use the title “doctor” and that it was insulting to suggest they would mislead consumers about their profession or be permitted to do so by their college. Against these submissions, according to earlier documents, “The review has balanced the consumer’s right not to be confused or misled, especially when seeking primary health care.”
Is there strong evidence that a person with a medical problem, let’s say a severe abdominal pain, would walk into the office of a PhD in speech pathology and mistake that person for a medical doctor?
I also note that the restriction on the use of the title “doctor” may also have long-term consequences on salary levels among PhDs in speech-language pathology in Ontario. The quality of service delivery and the quality of research in a rapidly developing field such as stuttering treatment and research are likely to be affected negatively. In economic terms, when you enable a person to gain control over stuttering, you enhance his ability to communicate effectively and you enhance his ability to secure employment that matches his capabilities.
Ontario has the opportunity to continue to play a leading role in stuttering treatment and research. However, Bill 43, as it stands, is apt to discourage young PhDs specializing in speech-language pathology. They are likely to go to more hospitable climates, such as Alberta’s Institute for Stuttering Treatment and Research.
In conclusion, as one spokesperson for people in Ontario who stutter, I want to emphasize that the needs of people who stutter would be better served if PhDs in speech pathology in Ontario were able to continue to use the term “doctor” in the same way as psychologists and if they were permitted to diagnose speech disorders that come under their area of expertise.
Mr J. Wilson: Thank you for your presentation. Just on the title “doctor” again, I think the government’s intent in bringing forward this legislation, particularly that section which deals with the title protection of “doctor,” was not to open a can of worms.
I have a brother, for instance, who has a PhD in zoology and teaches at the med school at the University of Western Ontario. Under the current act, he is allowed to put “PhD” behind his name but he is not to be using “doctor” under the Health Disciplines Act now. It is already restricted to certain — well, this act is expanding it to chiropractors and psychologists.
I do not know what group of politicians started on this slippery slope, but clearly, in my opinion, I agree with you that it is a political decision. We are now going to chiropractors, giving a prestigious title of “doctor.” It has been given in the past — I do not know what remedy we can come up with — to essentially people with undergraduate degrees. Society has placed a high regard on the term, when in academia a doctorate of philosophy is the highest degree possible.
I am not sure what we are going to do. If we continue the slippery slope of adding everyone else to the list of people who can use “doctor,” I do not think we are serving any useful purpose there, widening the system further. If we stick to what the intent of the bill is now, which is to let people continue to use PhD behind their names, there is no prohibition on the use of “PhD” in this bill.
Mr Pill: There is a very clear indication that, for example, a PhD in psychology can call himself or herself “doctor.” I see no rational reason, no reason I can think of in the world, in terms of people who are doing research in the field, why, let’s say, a PhD in neuropsychology or a PhD in speech-language pathology cannot call himself or herself a doctor.
Mr J. Wilson: I agree, so I guess my question is, given that under the current legislation in Ontario three different groups — optometrists, MDs and dental surgeons — have the ability, and given that I think we are going to have a difficult time as a committee deciding where we should be granting the ability in the future and where that list should stop, do you perhaps think maybe we should not do what this act proposes, which is just to extend it to chiropractors and psychologists, but stop whatever has been done in the past and not proceed with it, take it out of this bill, for instance, and just let things stand as they are? If you are using “doctor” in practice, that is fine. The only onus now is if the medical profession decided to sue you — and the fact is that I do not think there have been any law cases. My brother is not going to get sued because at the university he is known as Dr Wilson, even though technically under the Health Disciplines Act — I could be wrong — he is not really supposed to be using that. He is supposed to be John Wilson, PhD.
Mr Pill: I could also refer to something in the background documentation. There is a reference to the fact that: “Any person may use the title in a hospital laboratory or other regulated institution. Restrictions apply only to persons using the title as an occupational designation relating to the provision of human health care.” That particular statement is not in the final bill, as far as I know. There is no clarification on that point. In terms of logic and consistency and in terms of practice in other jurisdictions, I think it might be an idea to look more closely at that.
The Chair: Thank you very much for your presentation. We appreciate it.