Patient safety focus of plan for regulatory overhaul
An all-party legislative committee is proposing an overhaul of the system that regulates B.C.’s 120,000 health providers to better protect patient safety.
Health Minister Adrian Dix said the changes are meant to streamline and modernize the province’s health professions regulatory system, to increase transparency and to put a “relentless focus on patient safety.”
B.C. residents would be able to get more information online about health-care providers and actions taken and sanctions applied after complaints made against health providers. Because of a patchwork system, many of the regulatory bodies only post the results of patient complaints if they involve a serious threat to patient safety. Many health professionals who were penalized are not named. Some colleges drop investigations and allow registrants to retire instead.
The new system would lift the curtains around the complaints process.
Regulatory colleges like the College of Physicians and Surgeons exist to ensure medical doctors are licensed and competent. It handles complaints against physicians, penalizing them with fines or suspensions, for example, when they have been found to have breached professional standards and codes of conduct.
Dix said the number of colleges should be reduced to five from 20. Some colleges, like the College of Podiatric Surgeons of B.C. with only 85 registrants, are too small to have the resources to operate properly. Regulatory colleges use fees paid by registrants to fund their operations. It’s proposed that podiatrists be folded into the College of Physicians and Surgeons, which has almost 18,000 registrants.
The B.C. College of Nursing Professionals is the largest with nearly 60,000 registrants including registered nurses, nurse practitioners, licensed practical nurses, registered psychiatric nurses and graduate/employed students. It has agreed to take into its fold 400 midwives. The college’s size means that it has annual revenue of over $25 million and registration fees that are the lowest among health professionals.
Dix said it is proposed that the four oral health colleges amalgamate under one college.
The existing four include the College of Dental Surgeons, College of Denturists, College of Dental Hygienists and College of Dental Technicians. That means that patients could more easily navigate the system when they have concerns about oral health professionals.
There will also be an umbrella entity that oversees and audits the regulatory colleges to ensure they are performing well.
The report Wednesday — by the committee comprising Dix, Liberal health critic Norm Letnick and Green health critic Sonia Furstenau — proposed several other changes to ensure colleges place the public interest before the professionals’ interests. For example, college boards will have equal numbers of professional and public members. The ministry would appoint all board members after a process that considers the competency and diversity of proposed members. The report says board members should be fairly compensated rather than relying on volunteers.
The review began last year when Dix appointed Harry Cayton, a British expert in the field of professional regulation, to look into problems at the College of Dental Surgeons. His report recommended a major revamping of the B.C. system because it lacks transparency and public accountability.
Cayton referred to instances in which the College of Naturopathic Physicians, for example, dealt with complaints about a naturopath who prescribed a remedy containing rabid dog saliva to an autistic child. In that case, the B.C. Naturopathic Association ended up filing a complaint to protect the profession’s reputation. Cayton said in his report that it seemed the association was more committed to safe, ethical care than the regulatory college, the latter which allowed the registrant to resign without any sanctions.
“This renders the purpose of professional regulation meaningless,” Cayton said, adding: “If it is a defence to say, after the event, “I didn’t agree with the standards’, then both regulation and standards are pointless.”
Before the proposed changes are implemented, the government is seeking comments from the public and health professionals. Submissions can be made until Jan. 10, 2020 through an online survey or by written submissions.
Dix said the B.C. Patient Safety and Quality Care Review Board will not be affected by the reforms. It handles complaints about health care in facilities like hospitals and health authority operated care homes.