As British Columbia’s health-care system verges on collapse, provincial lawmakers have enacted sweeping changes to the oversight of medical professionals in a surprise move workers are denouncing as an unnecessary, years-long transition ripe for potential political interference.
When hospitals and doctors’ offices began seeing an onslaught of sick patients this fall, politicians were busy passing Bill 36, new legislation merging colleges but also fundamentally changing how those colleges will function going forward.
Regulatory colleges oversee whether technical standards and professional guidelines are followed for health-care personnel including nurses, doctors, psychologists and pharmacists.
Complaints ranging from improper treatment or dispensation of medication to bodily harm or sexual assault are overseen by those bodies.
B.C. currently has 15 colleges, which the new Health Professions and Occupations Act will streamline down to six. In addition, the colleges’ oversight system will be expanded to include more professions.
Merging and adding is not controversial, but what’s rankling many healthcare professionals is the changes to the administration of those colleges.
Going forward, the board members who hear and make decisions on issues of professional misconduct will be appointed by the province, as will the superintendent who oversees the colleges and has the ability to change or overrule board decisions.
BACKLASH OVER LITTLE FEEDBACK ON MASSIVE BILL
Bill 36 was introduced by a multi-party committee and passed into full law this fall without much fanfare. Multiple health-care professionals have since contacted CTV News, and say the massive 278-page document sailed through the legislature with minimal efforts made to consult the people who will be most impacted.
“This is not the time to implement and make these kinds of sweeping changes without deep consultation that could actually impact our profession and our patients,” Dr. Ramneek Dosanjh, the president of Doctors of BC, told CTV News.
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Her association had already been busy incorporating physician feedback into a new compensation system for family doctors, while compiling more feedback from physicians and surgeons alarmed at the soaring backlog of surgical and imaging patients. Her biggest concern, echoed by dozens of her peers on social media and in messages to CTV News, is the removal of doctor-elected members to the college boards.
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“Why are we going to have political influence in bodies and jurisdictions and regulatory authorities where there was none before?” Dosanjh asked.
The BC Nurses Union, which represents the majority of the members in the province’s largest college, raised similar concerns about potential political interference, as well as the erosion of due process.
Until now, only allegations substantiated by investigations and board deliberations have been made public, but it appears all allegations will now be published under the new act.
“We need to ensure that they are allowed due process and that their privacy is protected, balancing protection of our communities and the public, but also the privacy of our members,” said BCNU president, Aman Grewal. “We also need nurses to be on that body to be able to direct and provide guidance to any body that does not have experience as to what is the proper standard of care.”
The consensus from other health-care professionals can be summarized as a system that’s not broken and doesn’t need fixing, with workers subjected to discipline already publicly identified.
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MINISTER ON THE DEFENSIVE
When the government announced they’d be introducing new legislation under the health professionals act, they characterized it as a necessary move to streamline the colleges.
The minister kept returning to that point when pressed by CTV News about concerns the government could potentially appoint insiders party loyalists or others without any medical background to make decisions about the conduct of health-care professionals.
“This is designed to improve the efficiency of the health-care system,” said Adrian Dix. “Yes, there’s a superintendent to protect the public interest and ensure the colleges are acting fairly and responsibly and efficiently — that’s the purpose of it.”
He also claimed that part of the impetus for the new bill was complaints from members of both the media and public that the colleges were opaque and unresponsive to requests about disciplinary proceedings and other actions.
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Dix did not explain how a superintendent and government appointees will lead to more transparency. B.C.’s government has been repeatedly criticized for concealing and obfuscating basic information about the COVID-19 pandemic and other public health issues in recent years.
NEW ADDITIONS AND COMBINATIONS
In recent years, several nursing colleges and midwives were merged into the BC College of Nurses and Midwives, while podiatrists were added to the College of Physicians and Surgeons of BC.
Data by the health ministry show 129,313 health-care workers were governed by colleges in the province of British Columbia at the time of the bill’s passage.
A total of 25 professions will be governed under the college system through Bill 36, and those about to be welcomed into the fold are enthusiastic.
“We are excited,” said Michael Radano, CEO of the BC Association of Clinical Counsellors, in an interview with CTV News. “P.E.I, New Brunswick, Quebec and Ontario already regulate clinical counsellors and psychotherapists so we are catching up.”
Until now, the association has set standards and expectations of members, but Radano acknowledges there are inconsistencies across the province. He believes having more clarity around credentials and the complaint process will strengthen the profession while making mental health services more accessible.
“The BC Government has not yet released an implementation schedule and in force date for the Health Professions and Occupations Act,” the College of Physical Therapists wrote in a memo to its members after the bill passed.
“One amalgamation will combine the colleges for dietitians, occupational therapists, opticians, optometrists, physical therapists, psychologists, and speech and hearing professionals into one regulator,” the health ministry noted in its October announcement. “The other amalgamation will combine the colleges for chiropractors, massage therapists, naturopathic physicians, traditional Chinese medicine and acupuncturists.”
Multiple sources tell CTV News the process will be complex and that the changes will likely take years to implement due to all the moving parts.
“It’s going to take up a lot of time and effort at a time our members are already busy and exhausted doing their jobs,” said Dosanjh, who worries the changes will be one more stressor pushing doctors out of the health-care field altogether. “Why are we doing this now?”