In November 2019, the Steering Committee on Modernization of Health Professional Regulation released its consultation paper, “Modernizing the provincial health profession regulatory framework: A paper for consultation” (here).
Here is a summary of the proposed changes on which the Steering Committee has sought comment by January 10, 2020.
1. Governance: Requiring College boards with equal numbers of registrant and public members.
2. Governance: Requiring that all board members (registrant and public) be recommended for appointment by the Minister of Health through a competency-based process, instead of elections.
3. Governance: Reducing board sizes, to between 8 and 12 members.
4. Governance: Providing consistent compensation for board and committee members, and moving away from volunteerism.
5. Efficiency: Reducing the number of regulatory colleges from 20 to 5 (or possibly 6):
a. Maintaining the College of Physicians and Surgeons of BC (which may absorb the College of Podiatric Surgeons) ;
b. Maintaining the BC College of Nursing Professionals (which may incorporate the College of Midwives);
c. Maintaining the College of Pharmacists of BC;
d. Creating an oral health regulatory college to replace the College of Dental Surgeons, College of Denturists, College of Dental Hygienists and College of Dental Technicians; and
e. Creating a College of Health and Care Professions of BC, to regulate the remaining health professions.
6. Efficiency: Recognizing that cabinet has approved a diagnostic and therapeutic professions regulatory college, and ministry representatives will work with those professions to determine any rationale for a regulatory college other than the College of Health and Care Professions.
7. Efficient amalgamation: Recognizing that existing amalgamation provisions may not be suitable in all situations, such that the HPA may require broader merger provisions to minimize disruption resulting from future amalgamations (e.g., by dismissing college boards).
8. Use of expertise: Continuing sub-committees with profession-specific expertise, with board members unable to serve as members of sub-committees.
9. Oversight: Creating a new oversight body for colleges, of which an arm will be the Health Professions Review Board. The oversight body could, among other things,
a. identify core elements of shared standards of ethics and conduct across professions;
b. require regulatory colleges to create or update standards of professional practice;
c. develop a common set of model bylaws;
d. oversee board member appointment;
e. hold a single register of all regulated health professionals; and
f. collect fees from regulatory colleges to fund the oversight body.
10. Oversight: Requiring that the Minister of Health present annual reports of regulatory colleges and the oversight body to the Legislative Assembly.
11. Inquiry Committee member appointment: Requiring that inquiry committee members be appointed using a fair and open process, and that they receive regular training and appraisal.
12. Investigation Timelines.
13. Commentary on investigations: Allowing colleges to make limited public comments if a complaint under investigation becomes known to the public.
14. Considering past history: Requiring that complaint and discipline decisions MUST take into consideration the professional’s past discipline history.
15. Investigation outcomes: Requiring that actions taken to resolve accepted complaints, including all or any sanctions imposed in relation to complaints, be accessible to the public.
16. Discipline: Allowing colleges to continue investigating complaints, but having disciplinary decisions made by independent discipline panels drawn from a pool of qualified discipline panel members established by the oversight body. Discipline panels would include at least one health professional with clinical competence in the same profession as the respondent, and at least one public member. Allowing single-member panels to decide simple matters. (Presumably, regulatory colleges would continue to “prosecute” matters before a discipline panel.)
17. Sexual misconduct: Implementing measures to establish consistency across regulatory colleges on addressing sexual abuse and sexual misconduct.
18. Information sharing: Making statutory changes allowing effective communication among regulatory colleges and other agencies, where necessary for public safety and protection.
Lisa C. Fong and Michael Ng