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The Winds of Change in Professional Regulation are Approaching Gale Force

On November 27, 2019, the British Columbia Ministry of Health Steering Committee on Modernization of Health Professional Regulation released a report titled “Modernizing the provincial health profession regulatory framework”. The report announces proposed changes to the regulation of health professions in British Columbia and invites consultation on the proposed changes. The report was prepared in response to a review of the College of Dental Surgeons of British Columbia that was completed in April 2019 by Harry Cayton, a review that made 21 recommendations to dramatically overhaul the health-regulatory framework.

Although the Steering Committee report does not include Cayton’s most dramatic recommendations, it proposes significant changes to professional regulation. The proposed changes intended to modernize British Columbia’s health profession regulatory framework focus on five key themes:

  1. Improved governance: The recommendations include smaller regulatory boards with equal numbers of registrants and public members and eliminating board elections and replacing them with a transparent, competency-based appointment process. A separate body for board appointments would be created. The Steering Committee also recommends moving away from volunteerism for boards and providing consistent compensation for board members. 
  2. Improved efficiency and effectiveness through a reduction in the number of regulatory colleges: The report recommends reducing the number of regulatory colleges from 20 to 5. The College of Physicians and Surgeons of British Columbia, the British Columbia College of Nursing Professionals, and the College of Pharmacists of British Columbia would be maintained while an Oral Health Regulatory College would be created to replace the College of Dental Surgeons, College of Denturists, College of Dental Hygienists and College of Dental Technicians. A College of Health and Care Professions of British Columbia would be created to regulate all remaining health professions.
  3. Strengthening the oversight of regulatory colleges: The Steering Committee recommends establishing an oversight body for all colleges, similar to the Professional Standards Authority in the United Kingdom. The oversight body would have a range of functions, including routine audits, public reporting on common performance standards, conducting systemic reviews and investigations, reviewing registration and complaint investigation decisions, identifying core elements of shared standards of ethics and conduct across professions, overseeing the board member appointment process, requiring colleges to create or update standards of professional practice, the development of model bylaws, and holding a single register of all regulated health professionals. 
  4. Complaints and adjudication: The report recommends a simplified disciplinary process in which a new and independent adjudicative body, separate from the regulatory colleges, would make decisions regarding all regulated health professionals. This would separate the investigation of complaints from the decision-making stage. Transparency would be increased as all agreements between registrants and regulatory colleges would be public and colleges would be allowed to provide limited public comment if complaints became known to the public. The Steering Committee also recommends investigation time limits, removing the ability of professionals to negotiate agreements late in the discipline process, and that complaint and discipline decisions must take into consideration the professional’s past history.
  5. Information sharing to improve patient safety and public trust: The Steering Committee recommends that colleges and other agencies be enabled to share information where necessary for public safety and protection.

Consultation on the Steering Committee’s recommendations will run until January 10, 2020 and the Steering Committee will then provide final recommendations. Field Law will provide an update on the recommendations when they are made as they suggest that significant reformation of the regulation of professions is on the horizon. 

In other news and closer to home in Alberta, the Fair Registration Practices Act has been proclaimed in effect March 1, 2020. This legislation was introduced on June 19, 2019 and received royal assent on June 28, 2019. Its provisions, unless otherwise noted in the legislation, will now come into force as of March 1, 2020. A summary of the changes introduced in the Fair Registration Practices Act, previously reported by Field Law, can be found here.