Major changes to health professions and occupations to add oversight

Oct 27, 2022 | 42-3, Bills, Blog, Governance, Legislature, Sessions, Video | 0 comments

I spoke to Bill 36: Health Professions and Occupations Act. It must be the heftiest, all 645 clauses, that has been tabled in my time in the British Columbia Legislative Assembly.

This is new legislation comes out of the work of a steering committee created by the Minister of Health, Hon. Adrian Dix, and including the Member for Kelowna-Lake Country, Norm Letnick and the Member for Cowichan Valley, Sonia Furstenau. This process demonstrates how good collaborative work can be accomplished in the legislature.

This legislation creates a new oversight role of health professions, reduces the number of colleges from 20-6, reforms the complaint process, independent discipline tribunal, and changes the college boards from elected to government appointed.

[Transcript]

Thank you for this opportunity to speak to Bill 36, the Health Professions and Occupations Act. It’s dense work, from what it looks like from the Minister of Health — indeed the largest, I think, piece of legislation that I’ve seen in my days here in the Legislature. As has been mentioned by the speakers previous, it’s going to take some time to get to get through this as we as we do the second reading and, as well, the committee stage on this bill.

This particular act repeals and replaces the former Health Professions Act. It’s building on the work of a steering committee that was created from the 2019 Cayton report. This goes back to when we were in the confidence and supply agreement with the B.C. NDP government. I was about to get there. They’re really wanting to make sure that there’s full and broad all-party support on this.

Interjection.

A. Olsen:

Alright, everybody’s got their opinions and arm-waving that’s going on. Thanks, Madame Chair, for keeping the decorum in this place.

Deputy Speaker:

Serious.

[2:05 p.m.]
A. Olsen:

Anyway, this was this goes back to a time when the Leader of the Third Party, the member from Kelowna–Lake Country and the minister worked together in a really good way to bring forward the recommendations into this legislation that we are debating today. This is a good piece of collaborative democratic work, and everybody was very eager for me to get to that point. But I think that it should be held up. It should be held up as to how work in this Legislative Assembly can happen across party lines despite the differences of opinion that happen here frequently or infrequently, depending on your perspective.

The reality is that there is a lot of agreement that happens in this Assembly.

Yes, we do like to highlight the areas that we may not agree with each other. However, I think that it is important to recognize that when we sit around the committee table together, when we look at the work that needs to be done on behalf of creating legislation and regulation that works for British Columbia, there is a lot of agreement on all sides, in all seats, of this House.

I think that what we see here in Bill 36, as a result of work that was done — collaborative work, proactively collaborative work — that was undertaken by the Minister of Health…. He didn’t need to take this approach, but chose this approach to be one that was going to give the outcome the greatest chance of success.

As the member who spoke previously to me mentioned, there is a role that the opposition plays, going through, clause by clause, in the legislation, to ask the minister why this choice or why that choice was made when the bill was being drafted. That’s the work that we do here on this side of the House.

It doesn’t mean that there’s disagreement on the bill overall. There might be some different opinions about how we would approach certain aspects of this policy work. However, overall, I think what you’re hearing and what the people are hearing about this important legislation is that broad support out of that 2019 steering committee and the Cayton report from before that. This bill is taking those recommendations and bringing them into law or providing the regulatory ability for the government, the minister, to regulate.

The bill creates an oversight role, the superintendent role, which currently doesn’t exist, as well as a reformed complaint process and independent discipline tribunal and changes the structure of the boards from elected to appointed on these colleges. It continues to reduce the number of colleges, in a process that the minister has been undertaking in advance of this bill, from 20 colleges that currently exist in the province down to six.

The regulatory colleges hold a register of all of the professionals working in a field, in a sector. They set standards of practice. They set and maintain standards of education and training and hold professionals to account through complaints, investigations and discipline processes.

These bodies are really critical to ensure that the people who are treating British Columbians, who are assessing their health and well-being and administering the treatment, are professionals, that they’re accredited, that they’re educated and that there is a process to hold those individuals accountable should they make mistakes in the work that they’re doing.

There are currently — or there was, and in the process of reducing — 20 regulatory colleges in the province that was established under the Health Professions Act. That now, as I mentioned earlier, is being reduced to six. Reducing the number of colleges makes for more efficiency, specifically from a government relations perspective. I can imagine the Ministry of Health and ministry staff are going to be quite happy to have fewer bodies and to be able to relate to larger cohorts of health care professionals and occupations.

It also creates more efficiency for smaller professions like podiatrists, for example, and be able to set consistent standards across professions as people move towards team-based care.

I think as the province…. It’s been a project that I know the minister, when he visited my riding shortly after the 2017 election…. The minister visited my riding, and we talked with my constituents about the move to team-based primary care. I think that this is a process that is underway. It continues to be underway. I know that many people in my community and communities across the province really yearn for a time when we see the fruits of that labour and can benefit from it.

[2:10 p.m.]
However, I think that as we’re taking a look at the regulatory side of the colleges, and the consolidation of these colleges from 20 to six, it will really help in that work environment on the ground, in communities, in that team-based environment. You can just imagine having 20 different colleges involved and the complexity that that brings.

The six new colleges that will exist as the minister continues the work will be the College of Physicians and Surgeons, the College of Oral Health, the College of Allied Health and Care Professionals, the College of Pharmacists of B.C., the College of Nurses and Midwives, and the college of complementary and alternative health care professionals.

As I mentioned earlier, this bill will create a superintendent role to act as the oversight over the colleges. The superintendent is responsible for setting and guiding principles of the colleges, supervising their conduct and investigating when necessary, running an independent discipline office when that’s needed and running disciplinary panels as they’re required. It creates an independent discipline tribunal and a reformed complaints process that increases accountability and transparency.

Really, I think what is important to highlight here is that when it comes to people and their health care, when it comes to people and the relationship with those who are delivering that care, these are some of the more sensitive conversations that we have with professionals — our personal health and well-being, the state of our health. I think that what’s important is that the outcome of this process is to ensure that people who are in these vulnerable states are protected and, as well, that we’re ensuring that the most qualified people are working in the field.

This bill distinguishes between a profession and an occupation and creates a regulatory program for lower-risk occupations to be regulated but not designated. I think an example of this would be health care assistants versus counsellors. It expands the regulation of service providers, and in the next steps, the minister is going to be regulating counsellors and then, following that, diagnostic and therapeutic professionals. I know, since my election in 2017, I’ve had some regular advocacy in my constituency office of requesting that the provincial government regulate counsellors, and I’m very pleased to see that that advocacy has turned into a process where that will be undertaken.

As well, it streamlines the process for designating new health professions and occupations. So this gives, I think, a pathway for this minister and future ministers to be able to recognize and acknowledge new health professions or occupations that may emerge as time passes.

We know that in October of 2020 B.C.’s three nursing colleges were amalgamated into one college. In September of 2021 the nursing college was amalgamated with the College of Midwives, and the College of Physicians and Surgeons was amalgamated with the college of podiatrists. So as I mentioned, this is a process that…. Even as this bill is being developed, the minister has been proactively working towards the consolidation of these colleges, the simplification of this. In September of 2022, just a few weeks ago, B.C.’s four oral health colleges, which included the dentists, dental assistants, dental therapists, denturists, dental hygienists and dental technicians, were all amalgamated into one regulatory college.

Also in this bill, I think it’s important to acknowledge here…. I’ve got a few of the recommendations from the In Plain Sight report, and this has been an unfortunate part of our history, just with respect to how Indigenous people can access health care in our province and the experience that they have.

[2:15 p.m.]
We know that just a year or so ago…. We have a report that highlights the experience of many thousands of Indigenous people in British Columbia who courageously shared those experiences, and those have been identified and published in the 2020 In Plain Sight report.

Well, it’s not one year ago. It’s two years ago. It just goes to show how quickly time passes in this place. This bill is beginning to take some actions on that report. There are a number of recommendations, but specifically, there are four recommendations that are highlighted here and that may be addressed with this bill: recommendation 4, 5 and 20.

I think it’s important to acknowledge that in the committee stage of the debate, I will be taking some time to talk with the minister about just exactly how this bill addresses the report that the government has in front of it. It might give some opportunity to ask the minister, on the record and just for his purposes, the progress that’s been made overall on that report and how the government will work with these new colleges to ensure that anybody who is a registered professional or working one of these occupations is implementing, through their colleges, all of the recommendations from the In Plain Sight report. That will be something that I’ll be asking the minister about.

It’s important to acknowledge that this will be going from a process of where the members of the boards of these colleges will be no longer elected from the membership, but rather, they will be appointed from the government. There will be some questions about that and the choice to move from election process to an appointment process from the government. But overall, I think that what I’d like to highlight in this debate is really the first remarks that I made as I’m speaking to second reading here, and that is the collaborative process.

So often we can land on the disagreements and the differences of opinion. Also, we need to stop and pause and recognize the areas of collaboration. If we’re just passing over them and not reflecting on the areas where we’ve been successful together, then it’s going to feel fleeting. So, it’s important for us to be able to recognize the member from Lake Country, the member from Cowichan Valley and the Minister, of Health have really, over the last number of years, worked together to get this very substantial reform in our government, and how the health care professionals and occupations are governed — their oversight, transparency and accountability. How that’s managed.

I look forward to asking and to engaging the minister in questions. I look forward to the questions from our colleagues here and the members of the official opposition, and I appreciate this opportunity to speak to second reading today.

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