Major shakeup in regulation of health professionals proposed in B.C. to improve patient safety

Patients in British Columbia could soon know about every single action taken by professional colleges in response to complaints about health-care workers, rather than just a select few.

That's just one in a substantial list of proposals for reforming B.C.'s system for regulating health professionals, released by a cross-party government committee on Wednesday morning.

The committee is recommending reducing the number of regulatory colleges in B.C. from 20 to five, revamping the makeup of college boards, making the complaint process more transparent and creating a new oversight body that would perform routine audits and systemic reviews of the colleges.

"These changes will help ensure health professions are regulated more thoroughly and transparently, so that they are providing British Columbians the best care when they need it most," Health Minister Adrian Dix said.

He revealed the proposals alongside Liberal health critic Norm Letnick and Green Party health critic Sonia Furstenau, who described the proposals as non-partisan.

The news comes seven months after a critical report from international professional regulation expert Harry Cayton that recommended a complete overhaul of B.C.'s system, charging that the current system lacks transparency and consistency.

"There is a lack of relentless focus on the safety of patients in many but not all of the current colleges. Their governance is insufficiently independent, lacking a competency framework, a way of managing skill mix or clear accountability to the public they serve," Cayton wrote.

His report cited a number of examples of issues first reported by CBC News, including how the College of Naturopathic Physicians handled complaints against a naturopath who treated a small boy with a homeopathic remedy made with rabid dog saliva and anti-vaccination misinformation that was spread by registered chiropractors.

Cayton recommended a complete replacement of the Health Professions Act, which sets the framework for regulation, saying it's inadequate to serve the patients of the future.

The committee's proposals don't go that far, suggesting instead extensive amendments to the act.

Nonetheless, Cayton said he was pleased with the committee's work.

"I welcome these bold proposals for reform. It is important that the regulatory colleges and the health professions engage with the consultation and embrace change to improve the safety of patients and the public in B.C.," he told CBC in an email.

'A clear focus on patient safety'

If the proposals become reality, the College of Physicians and Surgeons of British Columbia, the College of Pharmacists of British Columbia and the British Columbia College of Nursing Professionals would be maintained, while the other professions would be grouped under a new college of oral health and another for the remaining health and care professions.

The boards of each college would include equal numbers of public members and college registrants, each appointed by the province rather than elected by registrants. Board members could only be recommended after an independent process to assess their competency.

The new oversight body that would sit above all five colleges would be responsible for holding a single register of all health professionals in B.C., and could develop model bylaws, oversee the appointment of college board members and establish a range of standards of practice.

How the colleges handle complaints is a major focus of the recommended changes, which aim to "provide a clear focus on patient safety, public protection and strengthening public trust in regulation."

Right now, the colleges only publicize the outcomes of patient complaints when they are deemed to be a "serious matter."

For instance, when the former vice-chair of the College of Chiropractors of British Columbia was reprimanded and fined after posting an anti-vaccination video online, in clear violation of college policy, there was no public notification of the disciplinary action.

The committee wants to see all of those actions made public, including agreements that are made by consent.

No negotiating agreements

Meanwhile, the committee has suggested that professionals should not be able to negotiate agreements with their colleges late in the complaint investigation process to head off disciplinary proceedings.

That comes on the heels of a CBC News report on the response to numerous complaints against former psychologist Allan Posthuma. After five investigations found serious concerns with his work in child custody disputes, Posthuma negotiated an agreement to give up his registration rather than face a disciplinary hearing.

The proposals also include a new body that would handle any disciplinary decisions, acting independently from the colleges.

The province is now asking for feedback from the public, which will be accepted online until Jan. 10.