Transforming and Supporting Patient Care - Health Professions ...

39Chapter 2 – Excellence in Health Profession Regulation: Raising the Bar in OntarioOnce the College submits the final draft regulation, the Minister must followthe government’s regulation-making process. This includes review andapproval by the Cabinet Committee on Legislation and Regulation, approvalby the full Cabinet and signature by the Lieutenant Governor. In manyinstances this process can take several years, often rendering the subjectmatter of the standard of practice outdated or irrelevant. This processcreates endless challenges for health colleges that may not have standardsof practice in place that are current and enforceable. In circumstances whena health professional is found in contravention of the proposed standard ofpractice, the college may have limited authority to discipline, or in theworst case, deregister a member who is no longer fit to practise. To fill thisgap, many health colleges have decided that the regulation-making processis unworkable, do not submit regulations for approval, and have developedpolicies and guidelines to guide their members in lieu of regulations eventhough the legal status and enforceability of these mechanisms may bequestionable.In previous reports, HPRAC has found that the current process fordeveloping and approving regulations is unacceptable and does not servethe public, the government or the health colleges well.The regulation-making process is cumbersome and has not proven ableto deliver timely changes in requirements to keep up with evolvingtechnologies, clinical practices and population needs. The process ofdeveloping and passing legislation is even more unwieldy. A moreflexible way must be found to balance access to controlled acts withsafeguards to protect the public from risk of harm. 47While some voluntarily do so, health colleges are not required by law toconsult with other professions in the development of standards of practice,even in circumstances where professions share the same or similarcontrolled acts. HPRAC has found that there are inconsistencies, not only inhow Colleges develop standards of practice, but also in what is included inthese standards. This patchwork leads to confusion among colleges and thepublic about what is or should be included in standards of practice, and thestatus of other documents developed and published by health colleges todictate, limit or direct the activities of their members.With the increasing number of health colleges and the extent of overlappingscopes of practice under the RHPA, HPRAC has concluded that it is in thepublic interest for colleges to consult with other colleges in thedevelopment of standards of practice – most particularly where healthprofessions share the same or similar controlled acts, or where their scopesof practice overlap. Such collaboration is critical to breaking down thebarriers to interprofessional care, including the lack of understanding andappreciation among health professionals of the standards that otherprofessionals are required to meet.47HPRAC. A report to the Minister of Health and Long-Term Care on the Review of the Scope of Practicefor Registered Nurses in the Extended Class (Nurse Practitioners): 61.HPRAC Critical Links January 2009