The Health Professions and Occupations Act, which changes the oversight of regulatory colleges for the first time in about 30 years, will come into force on April 1.Jennifer Gauthier/The Globe and Mail
The regulation of health care workers in British Columbia will change drastically next Wednesday as legislation that upends how professional colleges are structured, governed and operated comes into effect.
Bill 36, the Health Professions and Occupations Act, was passed four years ago but will come into force on April 1. The legislation, which spans 276 pages and contains more than 600 provisions, changes the oversight of regulatory colleges for the first time in about 30 years.
Josie Osborne, B.C. Minister of Health, said the legislation needed to be modernized to better protect the public and promote an accountable and transparent health system.
“This is about ensuring that patients are kept safe from harm and discrimination. That’s always been the role of regulatory colleges. This is modernized legislation that creates a stronger framework to do this,” she said.
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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 appeals process. Additionally, board members will be provincially appointed rather than elected by college licensees.
B.C. has already streamlined the number of health-profession regulatory colleges through amalgamation, from 22 in 2017 to six as of June, 2024, with further consolidations to follow. The province says this will improve efficiency, enhance the colleges’ ability to regulate and make it easier for patients to understand where to direct complaints.
But the legislation has come under intense scrutiny, including from health care providers, opposition politicians and legal experts, who have raised concerns about provincial overreach and compromises to professional autonomy. One of the most vocal critics has been Doctors of B.C., a provincial advocacy organization that represents more than 16,000 health care professionals.
Adam Thompson, president of Doctors of B.C., said he would not go as far as calling for the legislation to be repealed but wants changes to be made. His major concerns are with the loss of appeal rights and the transition to provincially appointed board members.
He is concerned that the new rules will place an administrative burden on medical professionals and warned that some doctors may no longer want to work in the province, worsening an existing shortage.
“As physicians, we’ve always felt that we have our patients’ care in mind. It’s top of our personal mandates and that’s why we’ve always felt very capable of self-regulating,” Dr. Thompson said, adding there are fears the college will become a “vehicle to enact health care policy rather than protection of the public.”
The law also establishes an oversight office with centralized authority that replaces the self-governance of profession-specific colleges. The office will be led by Superintendent Sherri Young, who previously served as the public service commissioner in the Yukon.
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Colleges currently investigate complaints and determine and enforce disciplinary orders. Next week, 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.
The tribunal will consist of one person of the same profession that is being disciplined, a member of the public and a specialist in the area of concern. Colleges will retain limited disciplinary power for administrative and other less-serious matters.
Independent MLA Jordan Kealy introduced his own bill earlier this month to repeal the legislation, arguing it has not been properly debated and gives the provincial government undue power. Trevor Halford, Leader of the B.C. Conservatives, has also called on the New Democratic Party to walk back the legislation.
The legislation is based on recommendations included in a 2018 report from Harry Cayton, a regulatory administrative expert who was commissioned by the B.C. government to look into health professional regulations, centred on dentistry. He raised concerns about record keeping, internal communications and patient safety.
Christoph Kind, a naturopath on Vancouver Island, said he is closing his practice in Courtenay because of the new legislation. He told his 1,800 plus patients in January that the new conditions are “abhorrent to the true principles of democracy and autonomy for individual choice in health care.”
In an interview, Dr. Kind, who has been practising for 40 years, said his biggest concern is that the law creates an offence for misleading information but does not properly define what constitutes as such. He is worried this will create significant risks for alternative medicine.
“The vagueness of this law actually allows for abuse,” he said, adding that the law itself positions health care professionals as dangerous to patients.
“By declaring health care providers a risk to cause harm to the public and imposing political control over the practice of medicine, I cannot with integrity or in any good conscience continue to practise in B.C.”
Ms. Osbourne, responding to concerns, said the role of colleges is to be responsible to the public, not its members. She said there are guardrails to ensure board appointments are not a “political process.”
She added that her doors are open to feedback and that the province is making some regulatory amendments based on feedback from traditional Chinese medicine practitioners.