The Review of the Regulated Health Professions Act by the Health Professions Regulatory Advisory Council

by: Mia London

As part of its ongoing mandate to evaluate the effectiveness of the Regulated Health Professions Act (the “RHPA”), the Health Professions Regulatory Advisory Council (“HPRAC”) announced that it would be reviewing the current Act and the associated Health Professions Procedural Code. HPRAC solicited submissions and responses from interested stakeholders, including the unions who principally represent health care professionals covered by the RHPA.

The focus of this aspect of HPRAC’s review was on the currency of certain recommendations from HPRAC’s last report, Adjusting the Balance, which focussed on the health colleges’ quality assurance and patient relations programs, and their complaints and discipline procedures.

The recommendations found in Adjusting the Balance appear to be largely focussed on perceived concerns by members of the public with the complaints and discipline processes. Proposed changes to these college functions could have a serious impact on health care professionals who find themselves complained about or reported to their college. Some of the proposals include the following:

• merging the executive and complaints committees into one “Screening Committee”;
• the Complaints Committee, or the new “Screening” Committee, should be given the express jurisdiction to refer members to the Quality Assurance Committee;
• the Executive Committee and/or the Screening” Committee will have the authority to issue an interim suspension or practice limitation order with immediate effect if satisfied “on a balance of probability” that “the member would expose his or her patients to harm or injury”. The member would lose the ability to make submissions before the suspension is implemented and would be required to make submissions on the reasonableness of the order within three days rather than fourteen days;
• remediation settlements at the Complaints Committee stage would become available on the public register;
• the Fitness to Practice and Discipline Committees would be merged into one “Adjudicative” Committee;
• complainants will be given “party” status at Discipline Committee hearings. They would have the ability to conduct cross-examinations and present witnesses, make submissions to the panel, and be required to consent to agreed statements of fact and submissions on penalties.
• the information available on the public register will be increased to include referrals by the Complaints Committee to the Discipline or Quality Assurance Committee, information about voluntary remediation agreements or voluntary agreements to limit a member’s practice, and information about cautions issued to a member.

On behalf of our clients, we have made submissions to HPRAC objecting to a number of these proposals because of the considerable prejudice that would result to college members. HPRAC has presented little evidence that these proposals would result in a safer health care environment, nor has it indicated how public confidence in the system would be improved through these changes.

The Minister has requested that HPRAC provide its Advice Memorandum containing its recommendations on all of these issues to him by March 31, 2006. Consultations with associations representing Health Professions were held in Toronto on October 23rd and 24th. Liz McIntyre attended in order to provide feedback and information to HPRAC. Included in the issues discussed with the associations were: how the RHPA can be improved to take account of changing methods of health delivery, Quality Assurance Programs implemented by the Colleges, Patient/Public Relations, public access to member information kept by the Colleges and use of Alternative Dispute Resolution to deal with complaints. HPRAC is also considering the written submissions filled by many of the Associations, the Colleges and others.

As this process obviously has implications for any number of regulated health professionals in Ontario, we will continue to monitor the ongoing consultation process and will continue to update our clients as developments at HPRAC unfold.