Jennifer Gauthier/The Globe and Mail
A new law overhauling how health care workers are regulated in B.C. will take effect April 1. It marks a significant change that will upend how professional colleges are structured, governed and operated.
What prompted the legislation?
The legislation was drafted in response to an investigation of the College of Dental Surgeons of British Columbia. Harry Cayton was hired in March, 2018, to review how the CDSBC was being managed, and whether it functioned in the public interest.
Mr. Cayton’s report found that the college sometimes put the interests of its members over those of the public, highlighting a case where a patient was sedated to the point of brain injury. The dentist in that case was not qualified to administer the sedation, and had repeatedly published misleading statements claiming that he was. After its investigation, the CDSBC declined to cancel the dentist’s registration. He was handed only a three-month suspension.
Along with investigating the dentistry college, Mr. Cayton’s report called for a sweeping assessment of how medical practitioners are regulated in B.C. The new act is a response to that and the result of subsequent provincial reviews.
Doctors and patients, how do you feel about B.C.’s regulation changes? Share your thoughts
When was Bill 36 passed? And when does it take effect?
The bill was passed in November, 2022, three years after Mr. Cayton’s report. It takes effect on April 1.
What’s changing, and how is it different from the existing Health Professions Act?
While there are more than 600 individual provisions in the act, the biggest overall change is that it significantly curtails the power of health practitioners’ professional colleges.
The act applies to all health professionals regulated by a professional college, from doctors, surgeons and nurses to dentists, optometrists and dietitians, among others. B.C. had already streamlined the number of health profession regulatory colleges from 22 in 2017 to six as of June, 2024.
It replaces the self-governance of profession-specific colleges with a centralized oversight authority that includes the power to set their performance standards, review operations and require corrective action.
Under the old system, colleges elected their boards from within their own membership, in keeping with traditional self-governing models. Under the new act, college board members will be appointed by the provincial government.
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The new law also affects how regulatory colleges will review, investigate and discipline their members.
Under the old act, self-governing colleges were responsible for all elements of the process. Under the new act, they will still conduct their own reviews and investigations, but will then pass their findings to a new director of discipline appointed by the Minister of Health. The director will strike a three-person tribunal, consisting of one person from the same profession that is being disciplined, a member of the public and a specialist in the area of concern, to determine what action needs to be taken. Colleges will retain limited disciplinary power for administrative and other less serious matters.
The results of all investigations that lead to disciplinary action will be made public, regardless of how serious or minor. It will increase penalties for those found to have breached professional standards, and it will make knowingly publishing false or misleading medical information a punishable offence.
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Why is the government saying this is necessary?
Several other inquiries and reviews have pointed to gaps in B.C.’s health care protections. In particular, a 2020 report by Mary Ellen Turpel-Lafond investigated systemic anti-Indigenous racism. Her report found “extensive profiling of Indigenous patients based on stereotypes about addictions,” and made 23 recommendations to correct it.
B.C.’s Health Ministry says this new act helps address those concerns, while prioritizing patient safety and promoting transparency and public accountability.
“This is about ensuring that patients are kept safe from harm and discrimination,” B.C. Minister of Health Josie Osborne said. “That’s always been the role of regulatory colleges. This is modernized legislation that creates a stronger framework to do this.”
What are the naysayers saying?
The new legislation has faced significant backlash from medical practitioners’ groups, including an advocacy group called Doctors of B.C., which represents more than 16,000 physician members. They say physicians were not meaningfully consulted, and the curtailing of self-governing power risks politicizing the delivery of health care.
Critics also say the new disciplinary process deprives medical practitioners of a meaningful appeals process, and that publicly disclosing minor disciplinary actions could unfairly harm practitioners’ reputations.
Doctors and patients, how do you feel about B.C.’s regulation changes?
This week, B.C.’s Bill 36 will take effect, marking the province’s biggest change to how healthcare professionals are regulated in decades. We want to hear from B.C. health professionals and their patients about how they feel about the changes. Do you think these regulations will make a difference? Has it affected your plans for your career? Patients, what have you heard from your providers? Share your story in the box below.