Explainer on new rules under B.C.’s Health Professions and Occupations Act

British Columbia’s sweeping overhaul of regulatory systems for health professionals come into effect on Wednesday amid concerns from the organization representing thousands of doctors in the province.The new rules under the Health Professions and Occupations Act cover doctors, nurses, dentists, pharmacists, chiropractors, dietitians and others on various amalgamated colleges.B.C. Health Minister Josie Osborne says the changes are aimed at strengthening accountability, transparency and public trust, while Doctors of BC warns they run the risk of politicizing jobs that are meant to protect patients.Starting April 1, an independent superintendent office will oversee the colleges that govern more than 120,000 regulated professionals, and the office will supervise a new discipline tribunal run by a provincial appointee.Under the new rules, the colleges will investigate complaints but the provincially appointed director of discipline will establish a panel to decide how someone will be disciplined.The changes also do away with the election of board members by medical professionals. Boards will now be made up of half professionals and half members of the public, all appointed by the health minister after being recommended by the superintendent oversight office.“This is new legislation that will improve patient safety by increasing transparency and ensuring strong and consistent oversight and governance of health regulators,” Osborne said Tuesday.Government officials who spoke to reporters during a technical briefing said the change was made after concerns that elected board members could be “beholden” to the people who elect them.A 2018 inquiry into dentists and the former Health Professions Act made recommendations, including a call for “structural reform,” arguing that the “current model of professional regulation will not be adequate to protect patients and the public or to represent the interests of citizens in the future.”The government also points to a 2003 report from the provincial ombudsperson on self-governance in the health professions.It said some colleges have demonstrated a “fundamental lack of understanding of their legal responsibilities.”“In other cases, the professions do not appear to have fully accepted or understood what it means to act in the public interest,” it said.“They still believe, perhaps because it is the members who elect the governors and pay for the colleges’ operations, that the colleges are primarily there to protect the interests of the members.”Doctors of BC, which represents physicians in the province, is among the medical organizations that have raised concerns about the changes, saying that having disciplinary bodies appointed by government creates concerns over fairness, political influence and the appointees’ qualifications.Dr. Adam Thompson, the president of Doctors of BC, said in an interview that the self-regulation process has been effective for doctors and that a combination of appointed and elected members are already on the board for the College of Physicians and Surgeons of BC.“The new approach actually means that there is a risk that a future government, through appointing the superintendent, could appoint politicized appointees to the board,” he said.“There could be a risk that the college becomes more about enacting the political health-care policy whims of a particular government, rather than being about protecting patient care.”Osborne said in almost all cases the health minister must appoint the board members that are recommended by the independent superintendent.She said the “independent merit-based process” will ensure board members have the skills, competence and understanding of the role that involves “serving the public interest, not serving the licensees, not serving the members.”“This is a really important distinction to make, and for a future government to undo that process would require legislative changes,” she said.Doctors of BC says the new rules eliminate the right for physicians to appeal disciplinary decisions in court, which raises concerns about fairness.It says even minor disciplinary actions will now have to be disclosed, potentially causing undue harm to a physician’s reputation.Dr. Thompson said publishing more disciplinary actions without context could affect the province’s ability to recruit and retain doctors.“Physicians, like anybody else, are not immune from making mistakes, and so how we manage and highlight those mistakes is important to ensure that you maintain physician wellness, and you maintain physicians wanting to continue in practise,” he said.The Health Professions and Occupations Act was passed in B.C.’s legislature in 2022.In 2018, B.C.’s three nursing colleges were amalgamated into one. Two years later, the nursing college was amalgamated with the College of Midwives, and the College of Physician and Surgeons was amalgamated with the College of Podiatrists. In September 2022, B.C.’s four oral-health colleges became one.

Explainer on new rules under B.C.’s Health Professions and Occupations Act

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