Physicians need to read and understand the Health Professions and Occupations Act
The most important piece of legislation in the last 30 years to affect all health professionals was quietly passed by the government in November 2022. Bill 36, now known as the Health Professions and Occupations Act, was an enormous piece of legislation (276 pages with 645 sections). It was inadequately debated in the legislature (233 of 645 sections debated) and passed by the majority government.
Ostensibly to protect patients from harmful health professionals, to update the previous Health Professions Act (1990), and to address racism in BC health care, the Health Professions and Occupations Act completely changes the structure of health professional colleges and the relationship between patients and their health professionals. Several key features are:
- More bureaucracy. Two new offices, a discipline tribunal and a superintendent’s office, will be established to control the colleges and their members. The members of both new offices are appointed by the government and responsible only to the minister (s. 486).
- Lack of self-regulation. The number of health colleges will contract from 16 to 6 (the College of Physicians and Surgeons of BC is unchanged), but board members for each college will be appointed only by the government (s. 346).
- Health professionals are considered potential felons. In s. 6(a)(iii), health professionals are defined as those who “provide health services that may present a risk of harm to the public.”
- The minister makes the regulations. In s. 213: “The minister may … make regulations respecting the … practice standards for the purposes of protecting the public from harm.”
- Professional misconduct. In s. 514(2)(b): “A person … commits an offence” who “knowingly provides false or misleading information to a person,” with no definition of what is misleading or false information.
- Powers to search, inspect, seize, and record. In s. 131(2): “An investigator may … without a court order … enter premises used by a respondent to … inspect and copy any records … containing personal information or … confidential information.”
- Penalties. In s. 518(1): “An individual who commits an offence … is liable on conviction to a fine not exceeding $25 000 or to imprisonment for a term of not more than 6 months, or to both”; a “corporation is liable on conviction to a fine of not more than $500 000” (s. 518(2)).
- No review or appeal. In s. 212(1): “a health occupation director is not required to give to an applicant notice or an opportunity to be heard.” In s. 212 (2): “An applicant is not entitled to a review by the Health Professions Review Board.”
- Statutory immunity for regulatory colleges. In s. 400(2): “[N]o legal proceeding for damages … may be commenced … against a regulatory college.”
- Mandatory vaccination. In s. 49(1)(b)(v), vaccination for transmissible disease is mandated as a condition of licensing and employment. There is no definition of vaccine or transmissible disease.
Unfortunately, Doctors of BC was only minimally involved in this legislation. Only 56 members (out of 14 000 doctors) commented on the steering committee’s proposals (President’s Letter, June 2019). Considering the acute shortages in physicians and access to care, this act does not benefit health care.
—York N. Hsiang, MB ChB, MHSc, FRCSC
Vancouver
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