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View Ron McKinnon Profile
Lib. (BC)
Welcome, everyone, to meeting number 40 of the House of Commons Standing Committee on Health.
The committee is meeting today pursuant to Standing Order 106(4), as requested by four members of the committee, to discuss a work plan until the summer recess.
Before I recognize Ms. Rempel Garner to move her motion, I would like to acknowledge and recognize that Ms. Sidhu's private member's bill, C-237, an act to establish a national framework for diabetes, just passed third reading in the House. On my own behalf, and since it passed unanimously, I dare say on behalf of the committee as well, congratulations indeed.
Ms. Rempel Garner, if you please, go ahead.
View Michelle Rempel Garner Profile
CPC (AB)
Thank you, Chair.
I move:
That the following regularly scheduled meetings of the House of Commons Standing Committee on Health be programmed as follows:
On June 4, 2021 the committee undertake one more three-hour meeting regarding Patented Medicine Prices Review Board guidelines, that each political party represented on the Committee be given leave to invite two witnesses of their choosing to provide testimony on the topic for this meeting, and that upon the completion of this meeting, the analysts of the committee be directed to commence the development of a draft report based on witness testimony and written submissions received by the committee on this subject to date;
On June 7, 2021 that the Law Clerk and Parliamentary Counsel, the Clerk of the Privy Council Office, Canada’s Privacy Commissioner and Canada’s Information Commissioner be invited for the duration of a two-hour meeting to discuss issues related to, but not limited to, the production of documents regarding the October 26 House of Commons motion, and that the total time allotted for opening statements be limited to five minutes for each witness up to a maximum of 20 minutes in total to ensure adequate time for questions to be posed by committee members;
For the first hour on the meetings scheduled for June 11, 14, 18 and 21, 2021, each political party represented on the committee be given leave to invite one witness of their choosing to discuss issues related to, but not limited to, the federal government’s response to the COVID-19 pandemic, and that the total time allotted for opening statements be limited to five minutes by witnesses to ensure adequate time for questions to be posed by committee members;
For the second hour on the meetings scheduled for June 11, 14, 18 and 21, 2021 the deputy minister of Health Canada, the deputy minister of Public Safety and Emergency Preparedness, the deputy minister of Public Services and Procurement, the president of the Public Health Agency of Canada, the chief public health officer of Canada, the vice-president of logistics and operations for the Public Health Agency of Canada, and the head of the National Advisory Committee on Immunization, be invited to discuss issues related to, but not limited to, the federal government’s response to the COVID-19 pandemic, that the Minister of Health be in attendance for at least one of these meetings, that the meeting that the Minister of Health is in attendance be held on a Friday, be three hours in length, that the minister and officials be in attendance for two consecutive hours, and that the total time allotted for opening statements by officials (and the minister) during this portion of the meeting be limited to five minutes by witnesses up to a maximum of 20 minutes in total to ensure adequate time for questions to be posed by committee members.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Ms. Rempel Garner.
Mr. Davies, please go ahead.
View Don Davies Profile
NDP (BC)
Thank you, Mr. Chair.
I'm going to speak to the motion very briefly and then move an amendment. Having listened to the concerns expressed by my colleagues at the meeting on Friday, obviously this motion does one thing that's essential: It proposes further dates with a more updated calendar, since the motion on Friday would have allocated meetings for Monday and for this Friday, so it had to be changed.
I heard the concerns of some members of the committee. One was that deputy ministers were very busy people and it was seen that having four meetings with the deputy ministers at the health committee might be too taxing on them, given their responsibilities and duties. A second was that there was a desire for more witnesses, Canadians or stakeholders, or experts, or otherwise. I'm going to amend this motion to respect those wishes. Essentially I'll just explain it in plain English and then I'll read the motion into the record.
Essentially what my amendment will do is keep this Friday for the PMPRB meeting. I think there's consensus around the room that we will each have two witnesses, effectively combining two meetings into one, and that meeting will be extended to three hours so we can have a fulsome discussion. That then completely honours the motion of my colleague, Luc Thériault.
It would then allocate the following Monday to be a meeting for the law clerk and the Clerk of the Privy Council to deal with documents. For the first three of the remaining four meetings, the first hour would be one witness from each party and the second hour would be the deputy ministers. At the very last meeting, which is on June 21, there would be no deputy ministers; there would be only witnesses, and each party would have two.
Really what my motion does is remove the deputy ministers from having to attend four meetings down to three meetings. By adding the extra witnesses on the last meeting, it also increases the number of witnesses we'll be able to hear from.
I would finally just say that this motion puts everything under the general rubric of COVID, so it allows each party and each person to put forward whatever witnesses they believe are important. I've heard it expressed that some members have a great interest in long-term care. Others might have other issues they want. I think this gives the flexibility to call the witnesses you want.
I should give a spoiler alert, because I understand there may be a further amendment to this that might improve my amendment, but I'll move mine into the record now so we can deal with that and deal with any further amendments that need to happen.
I move that the motion be amended by deleting all the words after the second paragraph and substituting the following:
For the first hour of the meetings scheduled on June 11, 14, and 18, 2021, each political party represented on the committee be given leave to invite one witness of their choosing to discuss issues related to, but not limited to, the federal government’s response to the COVID-19 pandemic, and that the total time allotted for opening statements be limited to five minutes by witnesses to ensure adequate time for questions to be posed by committee members and for the second hour for these meetings, the deputy minister of Health Canada, the deputy minister of Public Safety and Emergency Preparedness, the deputy minister of Public Services and Procurement, the president of the Public Health Agency of Canada, the chief public health officer of Canada, the vice-president of logistics and operations for the Public Health Agency of Canada, and the head of the National Advisory Committee on Immunization, be invited to discuss issues related to, but not limited to, the federal government’s response to the COVID-19 pandemic; provided that
For one of the meetings scheduled on any of June 11, 14, or 18, 2021, the supplementary estimates (A) be discussed and disposed of, and that the Minister of Health be in attendance for this meeting with her officials, including the deputy minister of Health Canada, the president of the Public Health Agency of Canada, the chief public health officer of Canada, the vice-president of logistics and operations for the Public Health Agency of Canada, and that the head of the National Advisory Committee on Immunization, the deputy minister of Public Safety and Emergency Preparedness, and the deputy minister of Public Services and Procurement also be in attendance, that all witnesses be in attendance for at least two consecutive hours, and that the total time allotted for opening statements be limited to 10 minutes in total to ensure adequate time for questions to be posed by committee members; and
That for the meeting on June 21, each political party represented on the committee be given leave to invite two witnesses of their choosing to discuss issues related to, but not limited to, the federal government's response to the COVID-19 pandemic, and that the total time allotted for opening statements be limited to five minutes by each witness or witness group to ensure adequate time for questions to be posed by committee members.
Finally, colleagues, you'll know that the one thing that's in there is that whichever meeting the Minister of Health chooses to come for, because it's in the second hour of the meeting after we've heard the first hour of witnesses, changing that wording to say they'll be here for two hours ensures that the meeting will be a three-hour meeting, so that we have ample opportunity to question the minister. She will be appearing on the supplementary estimates.
I would take it that that meeting would probably have to be on a Friday, because I think that's the only day we can get a three-hour meeting on.
Thanks.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Mr. Davies.
Can you submit that in writing to the clerk as well?
View Don Davies Profile
NDP (BC)
Yes, I will.
View Ron McKinnon Profile
Lib. (BC)
Would you happen to have that in French as well?
View Don Davies Profile
NDP (BC)
View Ron McKinnon Profile
Lib. (BC)
If you could get that to the clerk, he can distribute it to all the members ASAP.
View Michelle Rempel Garner Profile
CPC (AB)
On a point of order, Chair, I think the clerk might already have it, in both official languages. Things happen.
View Ron McKinnon Profile
Lib. (BC)
That would be great. Things happen like that.
Mr. Clerk, if you have it, please distribute it to the members.
Next up, after Mr. Davies, I have Mr. Kelloway. Do you wish to speak to Mr. Davies' amendment?
View Mike Kelloway Profile
Lib. (NS)
I think so, and it probably does touch to some degree on Michelle's main motion, but I'll be brief.
Number one, Don, I think you deserve a glass of water or a large bottle of water after that, so I won't take up too much time.
We've been talking a lot about the issues contained in the 106(4), and I think we have agreement, or we're almost there in terms of coming to some kind of conclusion here, which is really beneficial. What I normally did in the past, when I taught at the University of Calgary, or elsewhere, in Cape Breton, was I wanted to try to sum up the main components of what I was hearing.
Don and Michelle, please correct me if I'm wrong. I know there's a lot in what you said, Don, but I want to maybe bring it down to just some modular points. We have one PMPRB meeting for three hours. Following that we would have three meetings with the witnesses for the first hour, and then I believe the deputy ministers for the second hour. For these meetings, each party would select one witness. I don't think that's changed. In addition, we would have one three-hour meeting with the minister and one meeting with another of the officials in the motion.
It seems like we're really trending towards that right spot, from what I'm seeing. After I finish speaking, which will be in a few moments, I am going to read Don's amendment to it, to see if it captures what we're hoping to achieve here.
I don't know if I can ask this to Don, through you, Chair. Is that basically the meat and the guts of what we're talking about here?
View Don Davies Profile
NDP (BC)
May I respond, Mr. Chair?
View Ron McKinnon Profile
Lib. (BC)
View Don Davies Profile
NDP (BC)
It's pretty close, Mike. Again, I understand that there may be a further tweak we want to make to this, but we're going step by step.
Basically, what my amendment would do is nail down three hours this Friday for the PMPRB, with two witnesses each. The following Monday would be the law clerk and the Clerk of the Privy Council on documents. That's two meetings done. The next three meetings would be that structure of the first hour being a witness from each party and the second hour being the deputy ministers.
To one of those three meetings we invite the minister to come. We don't know which one that will be, but it likely would have to be on a Friday. She would come for the two hours on top of that one hour, so that would be a three-hour meeting. The last meeting, the sixth meeting, which is specified on June 21, is just a plain witness meeting, with two witnesses from each party.
I think you had it, but sorry if I didn't quite get up to that. I think it's important to be clear.
View Mike Kelloway Profile
Lib. (NS)
I appreciate it, Don, and I appreciate the cliffhanger to come. It reminds me of one of those serials back in the 1930s and 1940s.
I just wanted to make those comments and try to capture, in my own mind, where I think we're going, which I think is a better spot than we were in last week, and just to capture the key elements of what you're proposing in the amendments.
I appreciate that and I yield the floor.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Mr. Kelloway.
We go now to Dr. Powlowski, please.
View Marcus Powlowski Profile
Lib. (ON)
Yes, I wanted to make an amendment too, but my wish is to do so after we've dealt with Don's amendment, as we want our amendment to apply to the motion as a whole.
I'd like to note, in passing, that Mike Kelloway talked about when he taught at the University of Calgary and elsewhere in Cape Breton, thereby implying that Calgary was part of Cape Breton. I'm glad to see Cape Breton is expanding its borders across the country there, Mike.
View Ron McKinnon Profile
Lib. (BC)
It's clearly an expansionist government.
Ms. Gaudreau, you have the floor.
View Marie-Hélène Gaudreau Profile
BQ (QC)
I'd like to express an opinion, actually.
The result is indeed what is important, and given the analysis of the proposed amendment, the result seems to be good.
What is also important is my colleague Mr. Thériault's proposal. Indeed, if I am not mistaken, there is also a deadline. It is not in the amendment, but I am quite happy that it still falls under section 106(4) in terms of June 4.
Otherwise, I look forward to hearing other people's opinions, because that is very much in keeping with the objective we would like to use to get there.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Ms. Gaudreau.
Seeing no further hands up, we can proceed with the vote on Mr. Davies' amendment.
(Amendment agreed to: yeas 11; nays 0)
The Chair: Thank you, Clerk.
We'll go now to Dr. Powlowski.
I believe you indicated you wished to make a further amendment.
View Marcus Powlowski Profile
Lib. (ON)
Yes, Mr. Chair.
I'd like to move the following amendment: that all dates be removed from the motion, with the exception of the date for the PMPRB meeting, which is to occur this Friday for three hours.
I believe this leaves the minister still appearing on Friday with that change, as stated.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Dr. Powlowski.
We have Ms. Rempel Garner.
Go ahead, please.
View Michelle Rempel Garner Profile
CPC (AB)
I'm concerned that with this amendment, by removing the dates and not specifying that these meetings happen before the end of day on June 21, that might allow for wiggle room on when the meetings are going to be scheduled.
I'm wondering if the mover can clarify what the intention of the motion was. Was it to, in fact, have these meetings scheduled before the end of day on June 21? I realize that the motion is on the floor and I would ask the clerk, procedurally, if you can amend a subamendment? I think you have to have one on the floor, but if we were to support this, we would then put forward another subamendment that would clarify that these meetings would be required to take place before the end of day on June 21.
View Ron McKinnon Profile
Lib. (BC)
My understanding is that we can have a subamendment. It's certainly my understanding, as the chair, that all these meetings need to be conducted prior to when the House rises.
View Michelle Rempel Garner Profile
CPC (AB)
With that clarity then, I would move an amendment to the subamendment. I believe that's correct.
I move that at the end of the proposed amendment the following be added: “but that the meetings referenced in this motion be scheduled during regularly scheduled meeting slots prior to the end of day on June 21, 2021”.
View Ron McKinnon Profile
Lib. (BC)
Thank you very much.
That's just a subamendment, because we're in an amendment. It's not an amendment to an....
Anyway, I have it.
We now have this debate on Ms. Rempel Garner's subamendment.
Mr. Davies, go ahead, please.
View Don Davies Profile
NDP (BC)
I think we can probably dispense with this just with the simple understanding, so that we're all on the same page, that the paragraph of the motion that remains unamended says, “That the following regularly scheduled meetings of the House of Commons Standing Committee on Health be programmed as follows”.
I think the intention, and I hope it's the consensus as to what we want to do by Dr. Powlowski's amendment, is that the meetings will happen on our regular scheduled time between now and June 21. All we're doing is saying that the first meeting, the only meeting that's scheduled for the topic on the date, is the one for this Friday, and then I suppose we leave it up to the clerk to determine when those other meetings will be.
We're going to have a meeting on the documents; we're going to have three meetings with the deputy ministers and we're going to have a meeting just with our witnesses, but we're not allocating those meetings to a certain date.
Dr. Powlowski, is my understanding correct as to what we're doing? Of course, that's with the understanding that, as you said, the meeting with the minister has to be on a Friday or we can't get the three hours.
Is that the intent?
View Marcus Powlowski Profile
Lib. (ON)
Yes, that is the intent. We're not trying to get out of any of these meetings. It's just the matter of the timing of the meetings. We just want to make sure that we have the PMPRB, and we have the minister on the Friday and then the other dates to be set by the clerk as agreed upon.
View Don Davies Profile
NDP (BC)
Right.
The only other thing I want to mention, just as a matter just of practicality, is that I believe the clerk has already lined up witnesses for this Friday for the PMPRB, so I think that's taken care of, but Monday is approaching fast.
It being Wednesday, in fairness to the clerk, and to all of us, really, we should have some idea of what meeting we want to have on Monday. The original motion called for that meeting to be the law clerk. If it's not going to be that meeting—and it's fine with me if it's not—that means it would have to be either one of the meetings where we each put two witnesses forward, or the first hour with our witness and the second hour with the deputy ministers.
Before we end this meeting today, we'll have to know what that meeting is because we'll have to get our witnesses in very quickly, I would say probably by the end of tomorrow.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Mr. Davies.
We will put a pin on that request and see where we end up with this motion.
We have Ms. Rempel Garner again, please.
View Michelle Rempel Garner Profile
CPC (AB)
I just want to reiterate that I would like my subamendment voted on. It seems to be a pretty simple technical request that gives clarity to the motion.
View Ron McKinnon Profile
Lib. (BC)
I'm 100% with that. I like following through so we know clearly what we're doing.
The discussion remains on the subamendment.
You now have the floor, Ms. Gaudreau.
View Marie-Hélène Gaudreau Profile
BQ (QC)
I completely understand the situation regarding the availability of witnesses, deputy ministers and ministers, among others.
Again, it is the intent and purpose that is important. If it will enable the committee to work more quickly and effectively for the well-being of our citizens, I am in favour of this.
I think things are going very well, even if there are subamendments. Things are proceeding.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Ms. Gaudreau.
We'll go back to Dr. Powlowski, please.
View Marcus Powlowski Profile
Lib. (ON)
I'm not sure if it's going to require a formal motion as to what happens on the Monday meeting, but I'm certainly happy with getting some witnesses and getting back to actually studying COVID again. We haven't had a genuine meeting about COVID for a while, so I'd be happy and I think we would be happy to try to get some witnesses together for the meeting on Monday.
I don't know whether that has to be formal or can be an informal agreement.
Jean-François Pagé
View Jean-François Pagé Profile
Jean-François Pagé
2021-06-02 16:59
Mr. Chair, the law clerk and all the witnesses for Monday have been contacted by me just to give them a heads-up that I was going to invite them for Monday, so they are prepared to come on Monday.
View Ron McKinnon Profile
Lib. (BC)
Thank you.
We will leave the discussion and vote at this point on the subamendment.
The subamendment is on whether to add the text that Ms. Rempel Garner has proposed, to provide that these meetings happen prior to December 23—well, certainly before December but before we rise at the end of September.
That's the vote in question. We have Mr. Davies.
Go ahead, please.
View Don Davies Profile
NDP (BC)
It was just that last comment you made, Mr. Chair, that confused me, and maybe I'm misunderstanding Ms. Rempel Garner's amendment.
I heard you say, “provided these meetings occur by September”.
View Ron McKinnon Profile
Lib. (BC)
No, I misspoke. Her amendment is that they happen prior to when we rise this June.
View Don Davies Profile
NDP (BC)
I don't even know if we need this necessarily in writing. I'm happy to do it if we want.
Are we not just in agreement that our regularly scheduled meetings between now and June 21 will be allocated this way?
View Ron McKinnon Profile
Lib. (BC)
I think that's—
View Don Davies Profile
NDP (BC)
Monday, Friday, Monday, Friday, Monday, Friday, Monday—
View Don Davies Profile
NDP (BC)
—and then we're just leaving the clerk open to have flexibility.
View Ron McKinnon Profile
Lib. (BC)
It's my fault that I misrepresented or misstated what the subamendment is, but that's exactly what Ms. Rempel Garner has proposed, actually, in better language.
View Don Davies Profile
NDP (BC)
Finally, just before we vote on this, I presume that afterwards we will have to come back to the issue of what we do on Monday.
View Ron McKinnon Profile
Lib. (BC)
Absolutely. Once we decide how we're proceeding, we will be able to carry on.
Seeing no more hands, I will call the vote on Ms. Rempel Garner's subamendment.
(Subamendment agreed to: yeas 11; nays 0)
The Chair: Thank you, Mr. Clerk. The subamendment carries.
We go now back to Dr. Powlowski's amendment, which was to remove the dates. Is there any further discussion on this amendment?
(Amendment agreed to: yeas 11; nays 0 [See Minutes of Proceedings])
View Ron McKinnon Profile
Lib. (BC)
Thank you.
That brings us back to the main motion of Ms. Rempel Garner, as amended several times.
Is there any further discussion on the main motion as amended?
(Motion as amended agreed to: yeas 11; nays 0 [See Minutes of Proceedings])
The Chair: Thank you. The motion as amended carries.
That leaves us with the question of what to do on Monday. I'm very happy to work with the clerk and the various officials involved to plan out the next several weeks and do things as best we can.
Ms. Rempel Garner, I see your hand up.
View Michelle Rempel Garner Profile
CPC (AB)
On that point, Chair, just for clarification perhaps, I have a question for the clerk. Did he say the law clerk and other officials would be available on Monday for a meeting? That seems reasonable to me. I would look for consensus from other colleagues, but first I'd like clarification from the clerk that they are available on Monday.
Jean-François Pagé
View Jean-François Pagé Profile
Jean-François Pagé
2021-06-02 17:04
View Ron McKinnon Profile
Lib. (BC)
I know from the clerk that he has approached them. I'm not sure that all of the witnesses who have been requested for that meeting are going to be available on that day, but I would like to be able to adjust the schedule according to the availability of ministers and so forth for the other meetings as well, so that we can properly deal with all the matters that are before us.
That being the case, I would ask members to submit their witnesses for Monday, assuming it is not through the clerk, and then we'll do the best we can to make this motion a reality.
Jean-François Pagé
View Jean-François Pagé Profile
Jean-François Pagé
2021-06-02 17:05
Mr. Chair, I must inform the committee that I will make the request for a three-hour meeting for Friday, but the whips have to decide in the end, so I don't know if we'll get permission to extend for one hour, to make it three hours. I just wanted to inform the committee.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Mr. Clerk. We will try to adjust the schedule however we can or fit in that extra hour, if need be, somewhere else to make it happen. We'll do the best we can.
Dr. Powlowski, please go ahead.
View Marcus Powlowski Profile
Lib. (ON)
I would just like the Monday meeting to be back on COVID. I don't think we've actually talked about COVID for a couple of weeks. There are some issues that have come up in the meantime. For example, mixing and matching vaccines is kind of a new strategy. There are several other issues that we haven't addressed because of what's happened in the last number of weeks. I think we're all agreed that in previous speeches in our last meetings we've been taken away a little from our duty, which is dealing with COVID in the time of a pandemic, so I would hope that at our next meeting we could actually get back to the business of dealing with COVID.
Thanks.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Doctor.
We'll go to Mr. Davies.
View Don Davies Profile
NDP (BC)
Thank you.
That being the case, I think we have to know what Monday's meeting is going to be on. If it's not going to be on the documents issue, then the only other two choices are to have the meeting on Monday, for which we each call two witnesses or to call one of those meetings where we have one witness in the first hour with the deputy ministers in the second.
I'm going to ask the clerk which he prefers, and I will canvass my colleagues as well, because if we're going to use Monday for that, we have to have our witnesses in by the end of tomorrow for sure in order to give the clerk a chance to notify the witnesses. Imagine calling witnesses who don't even know on a Thursday that they're being called to testify on the Monday—
Jean-François Pagé
View Jean-François Pagé Profile
Jean-François Pagé
2021-06-02 17:07
The headsets are an issue also. I will have to ship them a pair of headsets.
View Don Davies Profile
NDP (BC)
I'm easy with either of those options, whether it's two witnesses or one, but if we do the one, then it's a fairly healthy list of deputy ministers. I'd like to ask the clerk if he thinks he can get the vast bulk of the deputy ministers to the meeting on Monday, if he asks them tomorrow.
View Ron McKinnon Profile
Lib. (BC)
Let's leave that as something the chair and the clerk can work out together with the officials and see what we can work out as a schedule. I would agree with you that by tomorrow you should have together your witnesses for Monday. That will give us the scope of action we'll need.
View Don Davies Profile
NDP (BC)
Is it one or two, Mr. Chair?
View Ron McKinnon Profile
Lib. (BC)
Let's make it two...whatever works. We can do it either way, but I just want to be able to schedule the meetings coming forward according to the availability of all the different parties. There are a lot of chess pieces on the board. We'd like these meetings to be as effective as possible, so we want to make sure all the people who need to be in them are available.
Please do get your witnesses in to the clerk by tomorrow, and then we'll do the best we can to make all of this stuff happen in good order.
View Don Davies Profile
NDP (BC)
Might I suggest then, Mr. Chair, that by the end of the day tomorrow we have our two witnesses in and prioritized, and then if the meeting on Monday will have only one witness in the first hour, with the DMs in the second hour, the clerk will know the schedule to contact the first witness.
In fact, that gives the clerk the flexibility to pick one or the other.
View Ron McKinnon Profile
Lib. (BC)
Absolutely. I think that's a great suggestion, and I think that's what we should go with.
Ms. O'Connell, please go ahead.
View Jennifer O'Connell Profile
Lib. (ON)
Thank you, Mr. Chair.
I was going to suggest that committee members should probably get their witnesses in. The fact that these meetings are no longer kind of themed, providing, as Don said, if you want to put a priority list so that the whole point of not having fixed dates was for flexibility based on attendance.... I would suggest that, even if you have more than two witnesses, maybe send that in, and the clerk can start sending the headsets. Even if they're not until next week or the week after, that gives the clerk something to work from.
We should be prepared for that, given that we need to be a bit flexible with schedules and House resources, etc., but I would suggest we put in our priority lists of witnesses, and if multiple witnesses are available, those parties can decide which ones, on which date and whatnot, but you can't do so until you get them in and get those headsets out.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Ms. O'Connell.
We'll go back to Mr. Davies, please.
View Don Davies Profile
NDP (BC)
Thank you.
That is a really good suggestion by Ms. O'Connell.
This motion we've passed means we'll have five witnesses. There will be one meeting with two, and three meetings with one witness each. I would suggest that it not be a requirement necessarily, but perhaps we should try to get five to eight witnesses in by the end of tomorrow.
I want some flexibility, though, because if I'm going to be rushed to put five.... I haven't thought of all five witnesses yet. I can easily put in a couple, but if we try to put in five witnesses in a priority order, that might be helpful for the clerk.
The other thing I was going to mention, Mr. Chair, is that it will help the committee if, over the next few days, you come back with a schedule of how you want the next five meetings to go. I don't think we can know this meeting by meeting. It's hard to prepare that way—not to put a deadline on you—but it would be helpful if early next week you had some basic map of how the meetings are going to go.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Mr. Davies. I agree 100%, and I'll do the best I can. I will talk to the clerk and work with all the various moving pieces involved here, and make sure we do the best we can.
That being the case and seeing no more hands, I believe we have reached a meeting of minds. Therefore, thank you, everybody, and I declare the meeting adjourned.
View Ron McKinnon Profile
Lib. (BC)
I call this meeting to order.
Welcome, everyone, to meeting number 39 of the House of Commons Standing Committee on Health.
The committee is meeting today to study the emergency situation facing Canadians in light of the COVID-19 pandemic. Today we are specifically examining Canada's national emergency response landscape.
I'd like to start by welcoming the witnesses. Appearing as an individual, we have Dr. James Maskalyk, associate professor of emergency medicine, University of Toronto, and Toronto-Addis Ababa academic collaboration in emergency medicine. Also appearing as individuals, we have Dr. Andrew Morris, professor and physician, and Mr. Patrick Taillon, professor, faculty of law, Université Laval.
From Switch Health, we have Dilian Stoyanov, chief executive officer; Jordan Paquet, vice-president, public affairs; and Olga Jilani, chief financial officer.
I will now invite the witnesses to present short statements of six minutes. We will start with Dr. Maskalyk. Please go ahead.
James Maskalyk
View James Maskalyk Profile
James Maskalyk
2021-05-28 13:02
Thank you so much. It's such a pleasure to be here.
I'm an emergency physician and trauma specialist here in Toronto and with Médicins Sans Frontières. I've worked in epidemics before the COVID-19 pandemic and I intend to afterwards.
First, I'd like to say that the response overall by Canada and Canadians has been remarkable and exceeded my and so many peoples' expectations. I just wanted to extend my thanks as a citizen and a clinician for feeling so well supported...having mitigated the worst of this for all of us.
Normally, I speak about issues of global equity, particularly knowledge translation through critical care and emergency medicine to the global south. Today I want to speak about issues that are particularly relevant to the Canadian context in the emergency landscape that the COVID-19 pandemic has made so clear. I will focus my testimony today on how we might continue these lessons from the pandemic to create a stronger, more robust and safer health system for Canadians. In particular, I will focus the discussion today on the topic of national licensure for doctors, nurses and other health care professionals in our country.
As you likely know, provincial licensure is what health care professionals require to gain the ability to treat patients. It's only in the confines of their province. Should you want to move to another province, either in times of disaster, pandemic or otherwise, you require an emergency order to do so. That process is cumbersome, ineffective, risky and really unsafe.
I believe we are the last remaining Commonwealth country—I wasn't able to go through the whole list, but we were the last—that doesn't have national licensure. It prevents more equitable distribution of health care resources, particularly as we move into greater virtual care opportunities. What's happening now is that I can't treat a patient in Iqaluit without a special reciprocal licence between our provinces. I think that needs to change.
As you can see, the nature of this pandemic, like all disaster, is one of asymmetry. This means that it doesn't just happen demographically; it happens geographically. You're seeing Manitoba going through a crisis right now that Ontario's just coming through to the other side of. You're seeing patients being transited from Manitoba to Ontario. That's dangerous. It's risky for the individual because if you're a sick person, it's much more risky to send you to Ontario than send a healthy nurse, doctor or RT to Manitoba. I think that through national licensure, we can start to equilibrate some of these resources.
While mathematical modelling can help predict something with the COVID-19 pandemic, it certainly can't predict an earthquake on the west coast or how high the Red River will rise. Giving physicians, nurses and other health care professionals the ability to move freely throughout the country would be an easy way to start redistributing these resources in times of emergency, and also overall.
I think, as you'll see in the coming months, we're about to face a crisis of a different kind. We're about to face a crisis of burnout. Pretty much every doctor I know, as they look to the future of their whole careers perhaps wearing the mask and shield, is thinking about doing something else. This is real.
I bring up this issue of national licensure because it's close to my heart. It initially came up when working in Inuit, Métis and first nation communities as a way to distribute health care resources there. Now I see it as a way to respond to a need in our health care community, which is the freedom of mobility to allow doctors and nurses to do what they love to do best, which is treat patients no matter where they are.
It's safer for Canadians, it's better for doctors and 91% of physicians want it. More than half of them say that it would increase the likelihood of their working in remote communities.
If we don't take this step, virtual care is going to move into a private sphere and we're going to miss an opportunity to keep it affordable for the average Canadian. With President Biden moving to insure up to 40 million Americans, there's no reason to stop a doctor in Alberta from now treating Americans using virtual care. We have to get ahead of that, in my opinion, and a national licence is the way to do that.
Reciprocity for this licence and allowing greater training is one thing that would encourage it as well, particularly as these people are committed to working in remote and indigenous communities or with those populations that have been made vulnerable by systemic inequity.
I would suggest that the federal government consider immediately establishing a reciprocal arrangement, or encouraging a reciprocal arrangement, between provinces that allows freedom of mobility of health care professionals during the COVID-19 pandemic. Then it should look to develop a plan to extend this reciprocal licensing arrangement between provinces, territories, indigenous and federal governments, allowing these health care professionals licensed in one to work in other provinces and territories.
The requirements are all the same. The training is the same. The fact is there is this expanse in the hurdles to jump over. It is kind of redundant. It makes the system vulnerable, because if someone has malfeasance in their past, it's less easy to track because they can go to another provincial college. They are siloed organizations.
Luckily, as Canadians, we haven't endured the big crimes that we've seen in the U.K. and Australia that allowed doctors to operate truly unqualified and hurt people. We're just waiting for that. Maybe that will never happen, but having a national autonomy and licensor is one way to do it.
In conclusion, there are two ways I think it can be done. One would be to start to focus on health care as administered through federal bodies, like indigenous, Métis and first nations communities. That is something that could allow them certain types of autonomy with registration, regulating who comes in and certain types of accountability.
The second and more robust way to do it would be to have the provinces, which have mandated to the college the licensing authority, mandate that authority to a national body. It wouldn't change the machinery of the provinces necessarily, but it would allow national licensure to be possible. I think ultimately it would be a good step not only to buoy the spirits of the health care workers who have been working very hard during this time, but also to encourage harmonization of health care in the country, improve accessibility to care and universality of care.
That is what I think is possible. It is what I imagine would be a positive step for the health care of Canadians.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Doctor.
I would just note that I have these cards. The yellow one I will display when there is roughly a minute left in your time, unless I become totally enthralled in the testimony. The red one is when your time roughly is up. If you see the red card, you don't have to stop instantly, but try to wrap up.
We will go now to Dr. Morris.
Doctor, please go ahead for six minutes.
Andrew Morris
View Andrew Morris Profile
Andrew Morris
2021-05-28 13:10
Thanks so much. I have never paid attention when given any yellow card before, so I don't know why I should start now.
Mr. Chair and honourable committee members, thanks for allowing me to address you. Before I start, I want to acknowledge that I'm currently speaking on what I believe to be the unceded ancestral territory of the Haudenosaunee, where my family home currently rests.
I'm a professor of medicine and infectious diseases at the University of Toronto, and I'm also a consultant in infectious diseases at Sinai Health and University Health Network. Prior to this pandemic, most of my academic work was focused on antimicrobial resistance, that is, drug resistant infections.
I currently co-chair, with Dr. Gerry Wright, a project to conceive of a national network to tackle antimicrobial resistance, or AMR, and support the anticipated—and I'll say, massively overdue—pan-Canadian AMR action plan.
This is my fourth such appearance before your Standing Committee on Health related to infectious diseases over the past four years, and I'm really quite honoured to be able to have this privilege of presenting to you again.
I want to cover two things: pandemic strategy and antimicrobial resistance.
Pandemics require strategy. Strategy should be based on the best available information and should be adaptive to new information. The pace of new information that we have received has been rather incredible and unprecedented. In my first and second HESA appearances, I highlighted for this committee the potential cost involved in preparing properly for an antimicrobial resistance pandemic. I think I quoted $100 million price tag at the time. Just imagine now only spending $100 million in exchange for properly preparing for a costly pandemic. My guess is, by the way, that this government still won't commit $100 million for an antimicrobial resistance pandemic.
If we consider Canada's performance to date regarding this pandemic, and with deference to my colleague who just spoke, I think my personal and, I would say, reasonable assessment is that it was not good, but it could have been worse. We've lost over 25,000 Canadians directly to COVID-19. The fact that we will see well over 10,000 COVID-19 deaths since January 1 will remain one of the most catastrophic and tragic failures of our nation.
However, the cost to Canadians in terms of quality of life, sickness and death from other illnesses, including mental illness, will be orders of magnitude greater than this for years to come, and it didn't have to be this way.
If you compare our response in outcomes with the U.S., most of Europe and, say, Brazil, we've done quite well. When I was a kid, when I came home with a grade that was below my parents' expectations, I always mentioned the classmates who did worse. I never made a comparison when I received an A, however.
Canada's first responsibility moving forward will have to be an honest assessment of our performance, and, indeed, the Auditor General is doing some of this work, but we need a more fulsome assessment of our performance. I would suggest that the time to start such a commission, perhaps titled “Why did Canada not get an A in COVID-19?”, is now.
The U.K. and Brazil are both holding similar such commissions. Apart from the obviously gripping theatre both have provided, they've offered insight into the flawed mindset of two governments that dramatically failed their electorate. The question that should be on the minds of all of you and indeed all Canadians is: Why have you failed to seek a maximum suppression strategy?
In November, I used the term “COVID-zero” publicly, but “Zero COVID”, “Canadian Shield Strategy” and “No More Waves” have all been monikers to a strategy I've affixed my name to. It's been abundantly clear that exponential growth has meant that living with COVID-19 was never an acceptable strategy, even though it was attempted. This would be true for any future pandemics.
Moving forward, Canadian governments should have a stated policy that says, “We will work to maximally contain and suppress any new infectious diseases throughout until the nature of that threat is fully understood.” This would have meant clear and consistent pan-Canadian communication, closing our borders sooner, reducing interprovincial and regional travel, making no assumptions on the nature of its transmission, protecting the most vulnerable members of our society with a focus on obtaining the data to demonstrate this protection, rapidly and transparently sharing this data, starting up clinical trials similar to what was done in the U.K., relying on the best available scientific evidence and stating, most importantly, that the primary goal of government and public health with infectious disease threats is not to protect the health care systems or the economies from the threat, but to protect the health of Canadians.
On May 28, 2021, we can start learning from this. Our government can make a commitment to maximum suppression of COVID-19. This does not mean locking down our society for the entire summer, but doing everything possible to continue to drive our cases down so that we'll be able to start the school year in full force, with an economy that can start working in full force.
Before I address AMR, I want to make one last point. It's very possible that in an upcoming school year we will be faced with an outbreak of a non-COVID infectious disease. It could be influenza or maybe another virus. In that situation, it would be important that we do not dismiss it. I have found myself at times dismissing other infectious diseases. Do we need a flu-zero approach? I doubt it. However, the famous and proudly Canadian overburdening of hospitals in winter is unquestionably due to respiratory viruses. We can and should do much to reimagine respiratory viruses.
That brings me, lastly, to antimicrobial resistance. I've spent most of my career tackling AMR. It has not gone away, and it won’t go away. Moving forward, the AMR pandemic, which is a much slower moving one than COVID, will continue to require close and careful attention. It is not going to come and go like the COVID-19 virus. It will endure and grow in nature.
This very committee has a responsibility to Canadians. It has failed in the past to address and push government on properly addressing this. We need to address AMR in Canada and globally in the same manner that we've been addressing COVID-19. Thank you.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Doctor.
Professor Taillon, you have the floor for six minutes.
Patrick Taillon
View Patrick Taillon Profile
Patrick Taillon
2021-05-28 13:17
Thank you, Mr. Chair.
My name is Patrick Taillon, and I am a professor in the faculty of law at the Université Laval.
I will summarize my main remarks briefly based on a very simple idea: one of the best decisions the federal government made in managing this unprecedented crisis was definitely its decision not to invoke the federal Emergencies Act, for the following reasons.
First, we can now see, particularly from a rights and freedoms perspective, that there was no need to invoke the act. We can also see how far the judiciary adapted its interpretation of rights and freedoms to our circumstances at the time. The government's decision not to use the act thus enabled it to maintain control and to let the judges do their work, while at the same time adapting that work.
Second, it is clear that, under our federalist regime, governments did not lack authority. The federal and provincial governments had all the necessary authorities in their toolbox to address the crisis. All they had to do was invent solutions that they could not yet know of at the time.
In short, we must not fall into the trap of thinking that each level of government inevitably did good and bad things and that uniform and centralized solutions would suddenly have solved all problems. On the contrary, the logic of subsidiarity, cooperation and autonomy that federalism presupposes runs somewhat contrary to this idea of uniformity. Federalism made a minimum level of experimentation possible during the crisis. No one had a magic solution, and federalism, under which the member states of a federation enjoy autonomy, enabled each state to exercise a degree of innovation.
British Columbia did some things right. Each province handled mask-wearing in its own way. The Atlantic bubble was an original idea suited to that part of the federation. As a member state of the federation, Quebec, where I come from, did good and bad things in its own way. Its curfew and the reopening of its schools in the spring of 2020 made it possible to gather data and to test a solution that was subsequently imitated by others. Quebec did the same when it decided to administer second doses of vaccine sooner than previously planned.
This degree of autonomy, experimentation and innovation in the spirit of cooperation was absolutely necessary in managing the crisis. With a combination of diversified measures, the two levels of government were able to imitate each other and adjust their game plans. Federalism, which fosters the autonomy of every member state in the federation, especially enabled each to play the role of countervailing power, which is essential in times of crisis.
At the lowest points, when nothing was working and the courts were virtually closed, newspapers were on the brink, incomes were clearly declining and parliamentary assemblies were closed, how else could we have exercised that countervailing power in Canada? What countervailing power could have protected citizens? The tensions and disputes that continued between the federal and provincial governments nevertheless bolstered citizens' trust in our institutions, to the extent that the sight of two leaders and two governments confronting and monitoring each other afforded a form of control, surveillance and countervailing power that were particularly necessary during those difficult times.
Obviously, the federal government could have done better. Its performance was partly shaped by circumstances. We can debate at length the state of necessary equipment reserves. We can say that borders should have been managed more quickly and efficiently. However, at some point, we have to accept that what was done is done. We must especially take note of mistakes that must not be repeated. On that point, the serious impact of underfunding for health definitely suggests that we could have intervened more effectively in that field and that we will have to do better in future.
It is therefore important to establish stable health funding. To do so, the federal government should either make a lasting commitment, over years, so that the provinces can rely on its participation, or else disengage and allow the provinces to use the necessary fiscal room. Whatever it does, we cannot play at yoyos or Russian roulette with health funding. It cannot be subject to circumstantial fluctuations. It must be stable.
Lastly—and this will be my final comment—as for what was done well but could have been done even better, I would say that cooperative federalism, that necessary cooperation between levels of government, could have gone further. Considering the powers it has, the federal government could have made adaptation measures available to the provinces. Consider travellers, for example. When it had to make decisions on how to manage the borders, the federal government could have played the cooperative federalism card to a greater degree. In the "Atlantic bubble", for example, borders and flights could have been shut down at the request of the provinces concerned, whereas other provinces could have established mandatory quarantines, a measure that moreover was ultimately adopted.
Uniformity is not the most suitable solution. It is an instinctive reaction that is contrary to the spirit of federalism and should be avoided. Management of the crisis required cooperation between the federal government and the provinces. It also called for respect for the autonomy of each government instead of the instinctive impulse to claim that one level of government is, by definition, better than another and thus shielded from the necessary interplay of trial and error, good and bad ideas and the competition between levels of government. That competition enabled us to secure countervailing powers, innovate and imitate each other. In that respect, I want to emphasize the importance of the autonomy of the federal government and federated entities in managing such a crisis.
Thank you.
View Ron McKinnon Profile
Lib. (BC)
Thank you, Professor Taillon.
We'll now go to Switch Health for six minutes.
Jordan Paquet
View Jordan Paquet Profile
Jordan Paquet
2021-05-28 13:24
Thanks, Mr. Chair. We're going to split our time very quickly, but we'll be under six minutes.
Thank you, and good afternoon, honourable members. Thank you so much for inviting us today to talk about Switch Health's innovative at-home testing solution that was developed in response to Canada's fight against COVID.
I am Jordan Paquet, the VP of public affairs, and I am pleased to be joined today by Dilian Stoyanov, our CEO, and Olga Jilani, our CFO.
We want to thank the members of this committee for the important work you are doing on this study.
This past year and a half has been very difficult for Canadians, especially frontline workers. We are pleased to be here to tell you a bit more about our company, our services, and to answer any questions you may have.
Dilian Stoyanov
View Dilian Stoyanov Profile
Dilian Stoyanov
2021-05-28 13:25
In essence, we are a homegrown Canadian success story that met a daunting task during the pandemic, bringing critical health care services to an increasingly virtual world. Meeting this need for increased domestic testing capacity required a company that was forward thinking, flexible and patient-focused.
In a matter of months, we were able to hire hundreds of experienced health care professionals, meet the needs of Canadians and collaborate with Canada's leading laboratories. This is a service Canada needed. Canada needed a novel solution to collect specimens at home with the oversight of a telehealth employee through our proprietary privacy compliant telehealth and results reporting software.
Despite the logistical challenges and early hiccups, we're proud to say that our at-home collection kits met demand and, most importantly, minimized exposure to the virus.
It is about a 10-minute process, and the results are usually returned to patients within 24 hours of reaching one of our partner labs. Courier times may vary by location. With our partner, Purolator, and other third party logistics providers, we can reach 100% of Canada. Additionally, we are proud to work with Uber to ship kits in Toronto, Vancouver and Montreal.
Our instructional manual is available in 15 languages, including three indigenous languages.
In February 2021, Canada introduced new border measures to help prevent further introduction and transmission of COVID-19, including new variants. It needed help with PHAC-directed testing of international travellers, and we applied.
PHAC required an operation with supervised testing and self-collection, kit transportation, electronic results reporting, and laboratory partnerships supported by the latest technological operations. Prior to the federal program, Switch Health was providing testing services via our clinics and mobile units with other levels of government, public health units, major companies, individuals and families.
Olga Jilani
View Olga Jilani Profile
Olga Jilani
2021-05-28 13:27
We scaled up efforts at an extremely rapid pace, with close to 1,200 telehealth staff now servicing travellers. Within this federal program alone, we have administered over 600,000 tests for travellers entering Canada. We have identified over 6,400 positive cases of COVID-19, including over 2,200 second-test positives and 1,500 variants of concern. Because most of these individuals were at home when they took their test, the risk of community spread was greatly reduced.
Of course, we have experienced some growing pains, with the volume of demand for testing rising exponentially and sometimes causing delays in service. We have been working diligently to improve our operations and processes and the speed with which we deliver results, by adding more telehealth and customer service staff. For example, since introducing appointment times for telehealth sessions, the average wait time has been reduced to 10 to 15 minutes. Currently, over 99% of travellers, including those in rural and remote regions, receive their results on or before their 14th day of quarantine.
We are still adding new resources so we can better serve travellers in both official languages.
Although we've been hired to provide additional testing services for temporary foreign workers in Ontario only, we've been asked to intervene temporarily to assist in providing additional testing services for temporary foreign workers from Quebec.
Recognizing the importance of Canada's food security, we are honoured to provide assistance until a permanent solution is found. We are pleased to continue serving travellers from Quebec by supplying our Day-8 test kits.
Before I conclude, I want to take a moment to address last night's report on Global News. We're proud to employ over 1,100 nursing professionals. We also employ a small number of trained telehealth generalists, who are permitted to oversee this type of testing process. Any suggestion that Switch Health has ever instructed employees to identify themselves as a nurse when they are not is categorically false. We acknowledge the hard work of all medical professionals during this pandemic and have never instructed any of our staff to mislead the public.
Developing an innovative and accessible testing solution in Canada’s fight against COVID-19 is helping transform how health care is delivered. And with the pandemic having a disproportionate effect on women, we're proud that we're not only offering a flexible work experience for the majority of our employees, who are women, but also that we're a company with women in positions of origin and leadership.
Earlier this week, we were proud to announce our new chief medical officer, Dr. Gregory Taylor, who served our country as Canada's chief public health officer. We are proud to be at the forefront of protecting the health and safety of Canadians in one of the most challenging times in global history. We very much appreciate your support in doing so. Thank you, again, for this opportunity.
Thank you, everyone.
View Ron McKinnon Profile
Lib. (BC)
Thank you to Switch Health, all of you. Thanks to all of the witnesses for your statements. We will start our round of questions now with Ms. Rempel Garner.
Please go ahead, Ms. Rempel Garner, for six minutes, please.
View Michelle Rempel Garner Profile
CPC (AB)
Thank you, Chair.
Mr. Stoyanov, as it relates to services provided to the Government of Canada for at-home COVID-19 testing of international travellers, has Switch Health ever been legally obligated to ensure that samples collected via the online portal were collected under the supervision of a nurse?
Dilian Stoyanov
View Dilian Stoyanov Profile
Dilian Stoyanov
2021-05-28 13:31
Thank you for the question. Can you just clarify the last part of the question, please?
View Michelle Rempel Garner Profile
CPC (AB)
Has Switch Health ever been legally obligated to ensure that samples collected via the online portal were collected under the supervision of a nurse?
Dilian Stoyanov
View Dilian Stoyanov Profile
Dilian Stoyanov
2021-05-28 13:31
All specimens collected under the supervision of a telehealth professional, a nurse or a telehealth generalist, are done in compliance with laws in the respective provinces.
View Michelle Rempel Garner Profile
CPC (AB)
Were you ever contractually obligated to have the supervision observed by a nurse?
Dilian Stoyanov
View Dilian Stoyanov Profile
Dilian Stoyanov
2021-05-28 13:31
I believe my colleague Olga Jilani will have more details about the contract, if I may, please.
Olga Jilani
View Olga Jilani Profile
Olga Jilani
2021-05-28 13:31
The contract calls for any individual who is overseeing specimen collection over telehealth to comply with the regulations of the province in which they reside. As you can imagine, over—
View Michelle Rempel Garner Profile
CPC (AB)
Thank you. Has that ever changed?
Olga Jilani
View Olga Jilani Profile
Olga Jilani
2021-05-28 13:31
Over the scope of the pandemic, in fact, at the time of the pandemic the scope of service—
View Michelle Rempel Garner Profile
CPC (AB)
Thank you. I don't have time. Have you ever been contractually obligated to have the samples collected overseen by a nurse, and has that ever changed?
Olga Jilani
View Olga Jilani Profile
Olga Jilani
2021-05-28 13:32
The contract calls for a telehealth appointment to be overseen by a medical professional.
View Michelle Rempel Garner Profile
CPC (AB)
By a “medical professional”. What percentage of samples collected by Switch Health to date were collected by the online portal under the supervision of somebody other than a medical professional?
Olga Jilani
View Olga Jilani Profile
Olga Jilani
2021-05-28 13:32
We employ 1,172 registered nurses and registered practical nurses and 17 medical generalists. For reference, those medical generalists are respiratory therapists—
View Michelle Rempel Garner Profile
CPC (AB)
Thank you. That's not what I asked.
Have any samples been collected while not under the supervision of a medical professional?
Olga Jilani
View Olga Jilani Profile
Olga Jilani
2021-05-28 13:32
A medical professional, under the regulation of the individual provinces, can be someone who is trained to comply with oversight of a bilateral anterior swab.
View Michelle Rempel Garner Profile
CPC (AB)
Again, that's not what I asked.
Were any samples not collected under the supervision of a medical professional?
Olga Jilani
View Olga Jilani Profile
Olga Jilani
2021-05-28 13:33
The medical professional who is overseeing collection of samples was trained to the standard of compliance with the regulatory—
View Michelle Rempel Garner Profile
CPC (AB)
Thank you.
Were any samples collected while not under the supervision of a medical professional?
Olga Jilani
View Olga Jilani Profile
Olga Jilani
2021-05-28 13:33
Over telehealth, specimens were collected with the oversight of a medical professional—
View Michelle Rempel Garner Profile
CPC (AB)
Would it be safe to say that's a “yes”, that there were samples that weren't collected under the supervision of a medical professional?
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