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Nova Scotia bill targets medical paperwork, aims to reduce number of sick notes for employers

By Lyndsay Armstrong

The Nova Scotia government tabled a bill Tuesday aimed at making life easier for medical professionals by reducing some licensing fees and limiting when employers can require sick notes from their workers.

Health Minister Michelle Thompson said at a briefing on the first day of the legislature’s spring sitting that in order to fix Nova Scotia’s health-care system, “we cannot continue to do things the same way.”

50,000 hours

Thompson said one component of this bill will save up to 50,000 hours of physician time per year by restricting when employers can ask for sick notes.

“This has been a waste of the valuable time of our physicians, and it’s time that they cannot afford to waste,” she said. “It’s also a waste of time for Nova Scotians who would be better off at home getting better.”

New rules on asking for notes

Under the new bill, provincially regulated employers in Nova Scotia would only be allowed to require sick notes from staff who have been off work for more than five days or who have already had two absences for illness within the previous 12 months.

As well, application fees and first-year licensing fees paid by physicians, nurses, pharmacists and other regulated medical professionals who move to Nova Scotia from elsewhere in Canada will be waived. Application fees are about $200 and licensing fees range from $1,000 to $2,000.

Dr. Leisha Hawker, the president of Doctors Nova Scotia, said in an interview Tuesday that she expects the waived fees for doctors working in Canada could be a good recruitment tool for early-career physicians.

“One of the key demographics for recruitment are those just finishing residency,” Hawker said, adding that it’s at that point in their career when many are “wanting to test the waters” and figure out where they want to practise.

“And at that point in time you typically have a lot of high costs, large student loans switching into payment mode, and you’re maybe considering licensing fees in various jurisdictions,” Hawker said, making the potential cash savings all the more important.

“That’s great, because if we get them while they’re young and fresh, they might fall in love with Nova Scotia and hopefully stay for their whole career,” she said.

Expanding role of pharmacists, nurse practitioners

The legislation, which includes two new acts and amendments to two other acts, will also allow the province to change how regulated medical professionals are able to expand their scope of care. Thompson said the change will allow government to move quickly to allow all health-care professionals to “work to their full training.”

For example, nurse practitioners and pharmacists could take on some roles currently reserved for other health professionals.

The minister said work on expanding areas of care will be done in consultation with the relevant medical college or regulator, though wording of the bill gives the government final say on what changes are made.

Dr. Gus Grant, the CEO of the College of Physicians and Surgeons of Nova Scotia, said in an interview Tuesday that he’s pleased to see the government “really leaning into the challenge of access to care.”

He said he agrees that all regulated medical professionals should be permitted to work to their full scope of care.

“Nurses and pharmacists and occupational therapists are best positioned to knowwhat nurses and pharmacists and occupational therapists are trained to do and can do safely,” Grant said.

Opposition Liberal Leader Zach Churchill said Tuesday he’s concerned that the bill gives government final say on scope of care.

“The colleges should be the final decision-makers because they have standards around patient safety,” Churchill said. NDP Leader Claudia Chender also expressed concerns about this proposed change Tuesday, calling it “troubling.”