Transforming and Supporting Patient Care - Health Professions ...

31Chapter 2 – Excellence in Health Profession Regulation: Raising the Bar in OntarioOversight bodies have been key pieces in the process of regulatoryreform, working as “engines of reform”, maintaining a whole strategicpoint of view, coordinating inside the administration. Oversight bodies’general role, besides supervision, control and coordination, consists inforcing regulators to demonstrate and justify the relevance of theirregulation (potential and existing), using accountability and assessmentmechanisms, as well as offering them technical advice and promotingregulatory reform. 37“Supervision of self-regulation” may also develop more organically througha process of policy learning. In Australia, John Braithwaite and others haveidentified the process of “triple loop learning” in self-regulation as astrategy for spreading innovation throughout the healthcare system:The first loop occurs when a good self-regulatory innovator monitorshis/her own effectiveness at improving an outcome. The second loop isthat this policy learning is then monitored by senior managers of theresponsive firm, who change their corporate management systems,culture, and practices in response to the learning. The third loop occurswhen government learns from monitoring the company’s double-looplearning, and evaluates and revises its regulatory goals and strategiesfor the whole field. International regimes can foster a fourth loop byassisting the world community to learn from a nation, such as Australia,which has a rich experience of triple-loop learning in the health sector. 38Based on its research and consultations in the context of the Minister’srequest and in consideration of advice included in HPRAC’s previousreports, HPRAC makes the following general observations:1. The public demands transparency and accountability, and thedemonstration of measurable results in both the public and privatesectors.2. In response, Canada and other jurisdictions have establishedagencies in the health sector and in other sectors (e.g., environment,finance) with mandates to coordinate specific elements of reform andimprove transparency and accountability. In health care, many ofthese agencies are arms-length to government and are focused onimproving health system performance and the quality and safety ofpatient care.3. With the introduction of the RHPA, Ontario became a global leader inthe regulation of health professions and protection of the publicinterest. The RHPA increased flexibility and innovation by shiftingfrom professional monopolies to a controlled acts model andoverlapping scopes of practice.4. Since the introduction of the RHPA, the number of regulated healthprofessions and Colleges has increased. Ontario will soon have 26Colleges and is considering the establishment of others.37OECD. Background Document: Oversight bodies for Regulatory Reform: 3.38Braithwaite, J., Healy, J., Dwan, K.: 31.HPRAC Critical Links January 2009