A healthcare worker walks past the emergency bay outside of Vancouver General Hospital on March 26.Jennifer Gauthier/The Globe and Mail
New legislation overhauling how health professionals are regulated in British Columbia comes into force this week, marking the most significant changes to regulatory colleges oversight in the province in about 30 years.
Bill 36, the Health Professions and Occupations Act, was passed four years ago but will take effect on April 1. The legislation spans 276 pages and contains more than 600 provisions.
The act applies to all health professionals regulated by a professional college, from doctors, surgeons and nurses to dentists, optometrists and dietitians among others.
Changes include the amalgamation of colleges, new disciplinary procedures and the elimination of the disciplinary appeals process. Additionally, board members will be provincially appointed rather than elected by college licensees.
Colleges currently investigate complaints and determine and enforce disciplinary orders. Beginning Wednesday, colleges will continue to investigate complaints but, upon completion, a new director of discipline appointed by the Minister of Health will strike a three-person tribunal to determine disciplinary action.
Law overhauling regulation of health professionals in B.C. set to take effect
Health care providers and opposition politicians have criticized the province for not consulting with doctors on the legislation, despite the impact on their profession, and have raised concerns of government overreach.
Doctors of B.C., a provincial advocacy organization that represents more than 16,000 health care professionals, has opposed the legislation for years, with primary concerns being the loss of appeal rights and the transition to provincially appointed board members.
The organization facilitated a webinar this month with representatives from the College of Physicians and Surgeons of BC and the Health Professions Discipline Tribunal to provide an update on the act and fielded questions.
Among concerns raised, Doctors of B.C. CEO Anthony Knight said “many doctors are concerned that if they make any statements publicly about the health care system” that they will be subject to college complaints. He asked whether they would be more vulnerable under the new legislation and if there is a way for physicians to safely advocate for system changes.
Benson Cowan, who will lead an independent discipline tribunal as director, said it is likely that the act will generate an uptick in complaints related to free speech and advocacy.
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“If you’ve got a new act that scopes out discipline more broadly and highlights these things, it’s more likely that there will be complaints of this nature,” Mr. Cowan said at the March 3 event. “Is it going to be a significant amount? Probably not. But I think if we’re being honest, yeah, it’s a little more likely.”
Mr. Cowan said complaints deemed vexatious or without merit will be screened out, while cases involving speech will be assessed with attention on context and constitutional values.
A critique of this system in the abstract is not going to result in discipline, he said, but “in that critique of the system, there are sometimes other comments that are problematic that can cause harm.”
“If the speech causes harm to people, then we’re concerned about it. If it criticizes the system, we’re not concerned about it,” Mr. Cowan said.
The Ministry of Health says the act will not limit critical or free speech by a physician or health practitioner but does have provisions to protect the public from those who spread misinformation that could bring harm to people.
Graeme Kierstead, chief legal counsel at the College of Physicians and Surgeons of BC, said matters of public commentary can be particularly tricky.
“Freedom of expression is one of the most jealously guarded of our Charter rights, and so it’s an area in which, frankly, it’s very difficult to tread,” he said.
“But legitimate advocacy on behalf of patients is very unlikely to attract any kind of regulatory outcome, although of course everything needs to be examined.”