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

Read the Doctors of BC president’s response in “Physicians need to read and understand the Health Professions and Occupations Act. Doctors of BC president replies.” 

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York N. Hsiang, MB ChB, MHSc, FRCSC. Physicians need to read and understand the Health Professions and Occupations Act. BCMJ, Vol. 66, No. 8, October, 2024, Page(s) 282 - Letters.



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Norma Leakey says: reply

Mr. John Rustad of Vanderhoof BC fought against Bill 36, he sent information and made a public petition to sign against the bill which was passed. The only option was to request the Legislative Assembly take steps to repeal the Act. The NDP did not safeguard health care with this bill but is acting more like a dictatorship with the government appointing and deciding all guidelines,suspensions,all issues really that control the medical profession. This is a step backwards and not legislation that represents the “land of the free and the brave” no wonder doctors and nurses are leaving BC as well as informed citizens.

Larry Lowry says: reply

This is draconian legislation drafted and passed by a majority authoritative totalitarian government. No appeal process huge fines and the government hires the college board members.

lorene benoit says: reply

This bill is egregious to all health care professionals and ALL citizens of BC. Very little, if anything in this bill, is for the benefit of the people paying for the system! Government has to STOP STICKING it's nose where it does not belong. That definitely includes govt. deciding what a medical professional knows best, that also included govt. acting as a judicial overseer.

Peter Olesen says: reply

In my opinion this is the most important political concern of the doctors of BC. Both the Green Party and the Conservative Party of BC have stated that the HPOA needs to be repealed. Dr. Hsiang has presented a concise summary but having read the whole bill and discussed it with a legal colleague (same concerns with Legal Professions Act) I believe it is dangerous to our profession. If the new president does not address this in his first month in office they need to be brought to task by the membership. Peter Olesen

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