RED TAPE REDUCTION ACT, 1998 LOI DE 1998 VISANT À RÉDUIRE LES FORMALITÉS ADMINISTRATIVES
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
ONTARIO FEDERATION OF AGRICULTURE
COLLEGE OF DIETITIANS OF ONTARIO
COLLEGE OF MEDICAL RADIATION TECHNOLOGISTS OF ONTARIO
CONTENTS
Tuesday 6 October 1998
Red Tape Reduction Act, 1998, Bill 25, Mr Tsubouchi /
Loi de 1998 visant à réduire les formalités administratives,
projet de loi 25, M. Tsubouchi
College of Physicians and Surgeons of Ontario
Dr John Bonn
Ontario Federation of Agriculture
Mr Terry Otto
College of Dietitians of Ontario
Mr David Dawson
Ms Shirley Lee
College of Medical Radiation Technologists of Ontario
Ms Sharon Saberton
Ms Debbie Tarshis
STANDING COMMITTEE ON ADMINISTRATION OF JUSTICE
Chair / Président
Mr Jerry J. Ouellette (Oshawa PC)
Vice-Chair / Vice-Président
Mr E.J. Douglas Rollins (Quinte PC)
Mr Dave Boushy (Sarnia PC)
Mr Bruce Crozier (Essex South / -Sud L)
Mr Peter Kormos (Welland-Thorold ND)
Mr Gerry Martiniuk (Cambridge PC)
Mr Jerry J. Ouellette (Oshawa PC)
Mr David Ramsay (Timiskaming L)
Mr E.J. Douglas Rollins (Quinte PC)
Mr R. Gary Stewart (Peterborough PC)
Mr Bob Wood (London South / -Sud PC)
Substitutions / Membres remplaçants
Mr Ted Chudleigh (Halton North / -Nord PC)
Mr Tim Hudak (Niagara South / -Sud PC)
Ms Shelley Martel (Sudbury East / -Est ND)
Mrs Lillian Ross (Hamilton West / -Ouest PC)
Also taking part / Autres participants et participantes
Mr John C. Cleary (Cornwall L)
Clerk / Greffier
Mr Douglas Arnott
Staff / Personnel
Mr Avrum Fenson, research officer, Legislative Research Service
The committee met at 1659 in room 228.
RED TAPE REDUCTION ACT, 1998 LOI DE 1998 VISANT À RÉDUIRE LES FORMALITÉS ADMINISTRATIVES
Consideration of Bill 25, An Act to reduce red tape by amending or repealing certain Acts and by enacting two new Acts / Projet de loi 25, Loi visant à réduire les formalités administratives en modifiant ou abrogeant certaines lois et en édictant deux nouvelles lois.
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
The Chair (Mr Jerry J. Ouellette): I call to order the standing committee on administration of justice to further hear presentations on Bill 25. If the College of Physicians and Surgeons of Ontario could come forward and identify yourselves for Hansard, we would appreciate it. Just so you know, there is a total time allotted of 15 minutes. At the conclusion of any presentation, the time is divided equally between the three caucuses. Thank you for coming. You may begin.
Dr John Bonn: Mr Chair and members of the committee, thank you for the opportunity to comment on this bill. My name is John Bonn; I am the registrar of the College of Physicians and Surgeons of Ontario. On my left is Dr Joseph Homer, a family physician from Hamilton, who is the president-elect of that body.
I thank you for consulting with our college and the Federation of Health Regulatory Colleges during the drafting of this bill. As a result of that consultation, many of our concerns have been addressed, and we are generally supportive of the changes proposed. We are particularly pleased that the bill contains changes converting certain regulatory powers to bylaw-making powers of the college and provides for the loosening of confidentiality provisions in certain appropriate circumstances.
We believe that this will allow the CPSO to be a more effective regulator. While the joint submission from the federation speaks to our general support for this legislation, I would like to address two specific sections of Bill 25, subsection 15(4) regarding frivolous and vexatious complaints, and subsection 19(5) regarding the confidentiality protection for information received in the course of a quality assurance program.
To address the first issue, I think it would help the committee if I gave you a general description of our complaints process at the college. As required under the act, any complaint, in order to be investigated by our complaints committee, must be in writing by the complainant. This college receives, on average, 2,000 written complaints from the public every year. These involve a variety of concerns with physician behaviour or clinical practices and may include, for example, difficulties in communication, concerns about clinical deficiencies, allegations of sexual abuse, complaints about access to medical records.
The complaint goes through a thorough process. There is an assessment conducted by staff to determine the nature of the complaint. The complaint is assigned to a specially trained investigator, who will speak with both the complainant and the physician against whom the complaint was lodged. The investigator facilitates the exchange of information between the complainant and the physician by communicating each side's concerns to the other.
Our college believes in the efficacy of the general administrative and regulatory trend towards offering dispute resolution as the preferred approach to the settlement of complaints, and so we put a great deal of effort into mediating disputes at this level. Investigators collect and review pertinent medical records, speak with witnesses or experts, collect statements and take any other steps necessary to clear up misunderstandings, misperceptions or poor communication between the physician and the complainant.
Often, if both parties agree that their concerns have been adequately addressed, the complaint can be resolved at this level. On average, of the 2,000 complaints we receive each year, about 800 are resolved in this manner, without a referral to a formal complaints committee hearing. The remaining 1,200 cases are referred for full investigation and an ultimate decision. The complaints committee has the power under legislation to decide several outcomes: a decision of no further action; a verbal or written caution issued to the physician; a referral of the complaint to the executive committee for further review; a settlement through an alternate dispute resolution, with the mutual consent of both parties; a direction of the matter to a quality assurance program for assessment and remediation of a particular clinical deficiency; or a referral to the discipline committee with a charge of professional misconduct.
Of the 1,200 complaints investigated each year and presented to the complaints committee, between 10% and 30% can be considered, in the wording of the legislation, "frivolous, vexatious, made in bad faith or otherwise an abuse of process." Bill 25 would allow for the expedited processing of such complaints. Let me give you some specific examples of complaints we receive which in our opinion could be considered under this definition. All of these complaints were investigated fully.
One complainant demanded to be admitted to a hospital bed after the physician had appropriately investigated and diagnosed a cold. When the physician declined to offer this patient a hospital bed, a formal complaint was made to our college and a full investigation had to be undertaken.
Another complainant was a respiratory therapist employed by a hospital. It was a labour dispute. She was fired from her position with cause, but because the person who made that ultimate decision was a physician, the respiratory therapist complained to our college, and we were required to conduct a full investigation and review by a complaints committee. This is the type of complaint that we see very frequently, wherein a complainant may try, in our view inappropriately, to use our relatively fairly simple and open procedures rather than the more appropriate but costly and involved processes required of a legal challenge to settle the grievance.
We have had a complainant lodge a grievance against a physician as a result of the physician's personal views on social policy issues rather than anything to do with his ability to provide good clinical care, and we have complaints which are on their face implausible and sometimes involve individuals who wrongly believe that they are being persecuted by a physician or physicians, but because they hold a licence from our body, we are then looked to by the complainant to resolve a difficulty.
Thus, the proposed frivolous/vexatious clause in your legislation is important to the work the college needs to do to protect the public effectively and to deal expeditiously with other complaints. We fully support the provisions of Bill 25 which would allow a complaint deemed frivolous or vexatious to be withdrawn from the full complaints process. We are convinced that if these matters can be dealt with in an expedited manner, the college will be able to better use its time and its resources on complaints of a more serious and urgent nature. We know that all health regulatory colleges in Ontario have been lobbying for the ability to deal with inappropriate complaints via such a process since the passage of the RHPA. We note that both the health professions board and the College of Teachers have such a process incorporated into their legislation.
We appreciate that there have been concerns raised that this change would allow professional colleges to disregard public concerns and act in a self-serving manner. I can't emphasize enough that our college would in no way not take responsibility and act in the public interest. We would not use this section irresponsibly.
Every public complaint made in writing to the college will continue to be investigated and assessed. The only change this legislation would permit is that we would create a two-step process that would allow us to possibly treat inappropriate complaints in a more expeditious manner. We believe this is a preferred means of serving and protecting the public.
I would also like to emphasize that the existing second level of protection for the public will continue to function in the form of an appeal to the health professions board. If there is any disagreement between the public complainant and the complaints committee concerning the appropriateness of the disposition of the complaint, the individual will be free, as they are now, to appeal our decision to this board.
The second issue is that of the confidentiality provision for quality assurance materials. As you know, section 36 of the RHPA provides for the confidentiality of information received during the course of work at the CPSO. Basically anyone working at the college who in the course of their duties comes upon information is put under an obligatory duty of confidentiality, save and except for certain specified exceptions in the act. Subsection 19(5) of your bill specifically adds a confidentiality requirement for "information held by a member for the purpose of complying with the requirements of a prescribed quality assurance program."
This specific mention in the bill of quality assurance programs is considered necessary because these programs were developed by regulations after the RHPA came into effect. Subsequently there were concerns that QA programs might not be protected by the confidentiality provision of section 36 of the RHPA.
While we feel that this confidentiality protection is very important and needs to be included in the act, we are concerned that subsection 19(5) may weaken the confidentiality protection of other parts of section 36 of the RHPA. It's a legal maxim that once an express mention of one thing is made in legislation, it may exclude another. Once some function of the college is set apart for particular protection, the rules of legal interpretation indicate that other college functions not treated in the same manner will no longer receive that same level of protection.
We are confident that the drafters of this bill did not mean to weaken our confidentiality protection. To make this intention clear, we might suggest respectfully that subsection 19(5) be amended to include the initial phrase, "Without affecting the generality of section 36 of the RHPA," and then as printed. This amendment would not affect the confidentiality provisions of the RHPA, nor would it change the intent of Bill 25. It is our understanding that this suggestion will also be included in the brief presented by the Federation of Health Regulatory Colleges of Ontario.
This concludes our presentation. We would be pleased to respond to any questions the committee may have.
The Chair: Thank you very much. That allows each caucus approximately a minute and a half for questions. We begin with the government members.
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Mr Tim Hudak (Niagara South): Thank you very much, both of you, for your presentation. Let me say as well that we appreciated your consultation and the suggestions we have had from the College of Physicians and Surgeons. Your suggested amendment is welcome, and we appreciate that. The committee will be reviewing that suggested amendment.
Let me ask you this: If somebody had suggested in debate or otherwise that patients should have access to quality assurance records, why is it important in terms of a health care perspective to maintain the confidentiality of those quality assurance records?
Dr Bonn: Quality assurance was designed to be a program to rectify a perceived deficiency in clinical ability or care. It's not a form of punishment or a form of restriction on the practice of a physician or other health professional. If there is a problem, society is better off if we can fix that problem and put that professional back into the front lines of providing care. If confidentiality was not provided in the legislation, it is the opinion of the health professions that it would not be an effective program. You need buy-in to get quality assurance. You need physicians and other health professionals willing to undergo courses, training, retraining and assessment in an effort to bring them up to the mark that has been established by the college. So confidentiality is probably a key part of any quality assurance program in order for it to work.
Mr Bruce Crozier (Essex South): Welcome, doctors. I appreciate, as has been said, the completeness of your submission. I'm just curious. When the College of Physicians and Surgeons of Ontario prepares a brief like this, is there a committee that vets it? I suspect you can't contact every physician in the province of Ontario, so do you vet it through a committee to get comments? I'm just curious.
Dr Bonn: No, this was not vetted by a committee. The gist of our presentation is prepared by our staff. It is distributed to our executive committee, which advises that we're in the right direction or not in the right direction and what they would like expressed to a committee such as this. So there is a formal procedure wherein the opinion of the college is brought to the table. It's not the opinion of myself, my policy director or anyone else.
Mr Crozier: It's certainly no reflection on you, sir, but I just wondered.
Dr Bonn: I understand your question, sir. I appreciate it.
Ms Shelley Martel (Sudbury East): Thank you for coming this afternoon to share your views on this. Can you just outline for the committee again the complaints procedure that you would foresee, then, with respect to the changes that occur in the bill. I'm assuming you would still have an initial process where there would be an assessment conducted by one of the staff or several of the staff and that investigated and some mediation. Is that still part of the process, even if you have a complaint that you consider to be vexatious?
Dr Bonn: Absolutely. As you know, the bill has a formal procedure to be established, wherein if a college determines that a complaint is within the frivolous, vexatious or abuse-of-process classification, contact is made with the complainant to let them know that the process is considering not proceeding because it fits into this classification and inviting submissions, which are then assessed.
Certainly, we would never delegate these to a lesser stream. They would get a full workup up until the time that the frivolous and vexatious designation was made, and then we proceed carrying out the process that is set out in the bill to protect the complainant from someone just out of hand dismissing. We would not do that, and we don't foresee any problem with this legislation.
What we really are in favour of is the fact that the figure of 10% to 30% represents a huge investment, not only in dollars but in time and resources, that should be better spent looking after what, for want of a better term, would be called the more serious complaints. Our health college feels that is the biggest advantage, and I know the other 22 health colleges feel the same way.
The Chair: Thank you very much for your presentation today. We very much appreciate your coming forward.
ONTARIO FEDERATION OF AGRICULTURE
The Chair: At that, we call our next presenters forward, the representatives from the Ontario Federation of Agriculture. Thanks for coming. You may begin.
Mr Terry Otto: Thank you very much, Mr Chair. Good afternoon, members of the committee. My name is Terry Otto. I'm from the Ontario Federation of Agriculture. I'm an executive member. My associate here is Peter Jeffery. He's one of our staff people in research.
OFA will only comment on two schedules, schedule A and schedule I.
Schedule A amends the Drainage Act and the Tile Drainage Act and repeals the Sheep and Wool Marketing Act. We support these changes.
In schedule, I we'll focus our comments on the Conservation Authorities Act and the Forestry Act.
The amendments to the Conservation Authorities Act are far-reaching and fundamentally change the act's focus. They should be addressed in a stand-alone statute where they can be fully addressed.
OFA recommends the amendments to the Conservation Authorities Act be withdrawn.
Section 28 calls for ministerial regulations in place of regulations made by the Lieutenant Governor in Council. We oppose regulation-making authority of this scope in the hands of one person.
Clause 28(1)(b) is too broad. It could include municipal drains constructed under the Drainage Act. Municipal drains improve the productive capability of agricultural land by speeding up the removal of excess water. They are paid for by the landowners whose lands they benefit. These landowners are financially responsible for the maintenance of these drains.
Clause 28(1)(c) includes situations where the conservation of land "may" be affected by development. "May" and "conservation of land" are excessively vague.
Clause 28(1)(e) adds new entry powers to the conservation authorities' additional powers that are unnecessary.
Subsection 28(17), restoration for contravening a CA regulation, needs to exclude watercourses that are municipal drains.
Subsection 28(20) differs from the provincial policy statement under the Planning Act of 1996, developed without public consultations, only Conservation Ontario, the Urban Development Institute and an environmental group.
Subsection 28(20), development: There is no mention of requiring approval under the Planning Act. Would a farmer need approval to build or maintain a fence, place a water tank or build a livestock feeding structure?
Clause 28(20)(b) requires approval for changes in the use, potential use or size of a building. It should exclude changes in use that do not require Planning Act approval and be limited to actual changes, not potential ones. Potential use gives too much discretionary power to the conservation authority.
The "hazardous land" definition is essentially identical to the "hazardous lands" definition in the provincial policy statement. Separate definitions are confusing.
"Wetlands" and "wetland": What purpose is served by different definitions of the same term? The provincial policy statement definition includes the four types of wetlands: swamps, marshes, bogs and fens.
Ontario's farmers sought the "Periodically soaked or wet lands being used for agricultural purposes which no longer exhibit wetland characteristics are not considered to be wetlands for the purpose of this definition" paragraph.
The statement, "But does not mean agricultural land that is periodically soaked with water" in the Conservation Authorities Act does not provide farmers with the assurance the provincial policy statement does. Farmers must know that productive lands will not be defined as wetlands by CA staff.
The "watercourse" definition is too vague. Will ruts in a laneway or furrows in a plowed field be a watercourse? Could "regularly" be one day a year?
Pollution: Are the existing statutory prohibitions against pollution sufficient? The definition is too broad. It could include the spreading of manure or use of chemical fertilizers or pesticides. The Environmental Protection Act excludes the application of "animal wastes disposed of in accordance with normal farming practices." The Pesticides Act authorizes the use of various pesticides. Farmers over the years have demonstrated their responsible use of these products through the development and support of the grower pesticide safety course.
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In section 30.1 we object to expanded search powers for the conservation authority staff.
Clause 21(b) and both clauses 28(1)(d) and 28(1)(e) provide entry powers. A great deal of harm may be caused to farmland or livestock by an uninformed or unaccompanied inspector-enforcement person. Many livestock farms employ biosecurity measures to maintain herd health by prohibiting animal contact with non-farm per-sonnel. There is no reason for conservation authority staff to need to enter a livestock building. Fruit, vegetable and horticultural crops could experience crop loss through plant diseases transported from farm to farm on the tires and/or footwear of conservation authority staff.
Our comments on the Forestry Act: The OFA has a long-standing interest in tree policy. We commented on it in Before You Cut That Tree, in 1992, but not on these proposals.
Ontario farmers are the stewards of almost 14 million acres of land, and we have amply demonstrated our ability to responsibly manage natural resources in a manner that both maintains and enhances the environment. Farmers have preserved woodlots, they have planted windbreaks and they have reforested marginal lands. Only 15% of the productive forests in Ontario are found on private land; 85% are found on crown land.
In the definition of "good forestry practices" is included the phrase "the aesthetics and recreational opportunities of the landscape." There should be no public rights to recreation on farmland. The definition of "woodlands" should be expanded to exclude fruit and nut trees and trees grown for fibre or fuel.
Section 8 under the powers of entry is too broad and needs to be restricted to include only the inspection for forest pests. The Forestry Act must not provide entry powers to "survey and examine the timber and other natural resources on the land in order to determine the suitability of the land for forestry purposes." This is an unwarranted intrusion on the rights of private landowners. We demand that any rights to enter privately owned land be clearly limited to inspection for forest pests only. Entry for other than this reason should only be by invitation or by permission of the landowner.
Subsection 10(3), injury of trees: Nowhere is the term defined.
Clause 11(1)(a): "Woodlands of the size specified in the bylaw" is unacceptable to farmers. Farmers should not need permits to cut their own trees.
Subsection 11(4): Where tree bylaws do not apply, this section should include fruit, nut, pulp or other lumber and trees cut to clear land for agricultural production, including squaring up a field, clearing up fence rows, lanes or windbreaks.
We object to the repeated use of the phrase "destruction of trees" due to its negative connotation. Farmers harvest trees from their woodlots through selective cutting. Harvesting stimulates growth of the remaining trees, leading to improved woodlot health and a continuous supply of healthy trees.
Farm woodlots provide significant amounts of wood for a variety of uses -- building materials, fence posts, fuel, veneer logs, timber and pulpwood -- and are part of a normal farming operation and do contribute to the income of farmers.
That basically concludes our presentation. As I said earlier, we would like to see the changes to the conservation act withdrawn. We can live with the forestry practice, provided some of these changes as we have highlighted are made in the new draft legislation. We would be pleased to try to answer any of your questions, and I thank you for the opportunity to present this paper to you people.
The Chair: Again, that affords us approximately a minute and a half per caucus, and we begin with the official opposition.
Mr John C. Cleary (Cornwall): It seems to me that you didn't have much input into this when it was being drafted. Is that correct?
Mr Otto: I personally had no input, and neither did any other farmer in the province to my knowledge.
Mr Cleary: That's not what we've been led to believe around here. We were told that all this new legislation is what the residents of Ontario wanted, and the agricultural community in particular. I was a member of the conservation authority for a lot of years, and chair, and I found that we were in conflict at that time with the Drainage Act on a lot of issues. You know we're in the business here in rural Ontario to make a living and the farmers know what's best to do with their land. I just wonder, now that you've spelled this out, what are your next steps, or are there any?
Mr Otto: I guess it's up to this committee. If they pass the legislation without any changes, then there's not much we can do other than live with it and yell like hell after. But if you decide to go ahead with some of our recommendations, hopefully you'll set up another committee to look at these and ask for some of the landowners' input.
Mr Cleary: I kind of hope they would, because I come from agriculture, I've been involved in it all my life and I understand the problems you've mentioned here and I'm --
The Chair: Thank you, Mr Cleary.
Mr Cleary: I guess I'm cut off.
The Chair: Yes. We now move to the third party.
Ms Martel: Thank you for coming in today. You made it very clear you were very unhappy, especially with schedule I. Just to follow up on this, because we understand you haven't been consulted, is there any reason in what you've read to see that the government would have to continue with this schedule, any reason at all, or would it be fair to say there is nothing in here that is so time-sensitive or sensitive in any other way that it shouldn't be pulled and a full and adequate discussion take place with your organization to do this right, if the government intends to do it at all?
Mr Otto: I can't see anything pressing in the new legislation at all, and there's absolutely no reason as far as I'm concerned, and probably the rest of the people I work with, that we could not set up something, and we could partake in these meetings and find some other landowners who have interest in this as well.
Ms Martel: So there are changes that might be worthwhile? Probably not the ones that are listed here, but there are some changes that if the government would sit down, you could probably come to some kind of solution?
Mr Otto: I think so, yes.
The Chair: We now move to the government members.
Mr Ted Chudleigh (Halton North): Thank you very much for coming in today and thanks for your presentation. It's a very complete presentation.
I'd like to ask you a question regarding the access to private lands and also wetlands. Halton North is the riding I represent and in my area the conservation authority has done a reasonable job in erosion control. As you know, the Niagara Escarpment runs through that area and there's a hilly aspect to it and controlling erosion is an important part of their responsibilities.
From that point of view, would you agree or would you have comment that within the flood plains of watercourses there is a responsibility for the conservation authorities to have access to those lands? Second, in the definition of "wetlands" I have a concern about wetlands which are not part of a year-round watercourse, a well-defined watercourse. I guess we all know of fields that have wet spots in them and those wet spots in some years may be 100 acres, may be 10 acres, whatever, and they're not part of conservation lands, never have been, in my opinion, and in some places may be defined as such. Would you comment on those two aspects of the bill? Is there a need for conservation officers to have access to some areas within a watercourse?
Mr Otto: I guess the government has given them powers to have access. I would argue that if they're coming on to my land, they should at least give me the opportunity to say yes or no. They should not be able to just go on whenever they bloody well like.
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In regard to fields having wet spots in them, yes, we all know fields that have wet spots in them but some of this legislation, I'm led to believe, is so vague that they can declare a field with a wet spot in it as part of a conservation land that should be protected in some sort of way, and then they would be able to apply some of these extraordinary powers they are being given. That's what we're very frightened of. In our area where I come from there's a feeling that the conservation authorities are trying to create jobs for themselves and trying to get more and more power all the time. I think there is presently legislation in effect that handles a lot of the things these people are actually after.
The Chair: Thank you very much for your presentation today. We appreciate your coming forward.
COLLEGE OF DIETITIANS OF ONTARIO
The Chair: We now call upon our next presenters, the College of Dietitians of Ontario. You may begin.
Mr David Dawson: My name is David Dawson. I live in the city of Hamilton and have been a public member of the council of the College of Dietitians since July last year. I am currently the chair of the discipline committee as well as the vice-president of the college, which is the designated position for public members on the executive of the council. The president -- and not to be too confusing because you now have the past president listed on the agenda -- the current and new president, Brenda Wines-Moher, would have liked to make this presentation but was unable to rearrange her schedule. We had elections of the executive just two or three weeks ago and Micheline LaForme was the one who requested that we have time here at the committee.
With me today is Shirley Lee, who is a registered dietitian and the registrar of the college. Shirley is here to provide professional or administrative background to any questions you may have.
As we outline in our brief, in general the college is supportive of many of the initiatives of Bill 25. Any bill that can streamline the administrative process as well as providing additional clarity to our role as a regulatory body is welcome. We know that you have received many written briefs from other regulatory health care professions. We know that the physicians and surgeons have just presented and that you will have another one just after us.
We wanted in particular to highlight some of the aspects of the changes to the RHPA, partly because we're a relatively new college, and also we believe that administratively we may have more in common with the newer colleges that were enacted in 1991. We knew many of them would not be able to appear because of time and because they wouldn't have had the inclination, and we thought we could provide a different perspective.
On the parts in the first part of our brief that are supportive of the bill, we would encourage all members of the committee and the respective parties to adopt these changes. We feel these amendments will help us and strengthen our role to protect the citizens and residents of Ontario.
The first part of our brief talks about evidence in proceedings, amending section 83 of schedule 2 of the Regulated Health Professions Act by adding a provision to prevent the quality assurance information presented by members from being admissible in civil proceedings. We believe this is essential for our quality assurance program. This program includes, for our members, a self-assessment component. In order to achieve improvements in their quality of practice, members are required to be reflective and assess their current knowledge, skills, attitudes and to identify the needs and opportunities for improvement. We are just in the process of implementing the QA program. We are asking our members to identify areas where they need improvement, to identify how they can improve, and to put in quantitative measures so that at the end of the year or two years they know whether they have achieved that. This will be a yearly process, and we feel that for this program this provision would encourage our members to be candid in their self-assessment without fear that this information could then be provided or would have to be provided against them in civil proceedings.
Complaints about sexual abuse: The proposed amendment to subsection 26(3) of schedule 2 of the RHPA clearly delineates the type of sexual abuse that cannot be referred by a complaints panel to the quality assurance committee. This is a positive move towards protecting the interests of the public, clarifying what stream the complaint should take, whether it should go as professional misconduct or to the QA committee.
Complaints made in bad faith: You heard the College of Physicians and Surgeons talk about that. It's probably a bigger issue for them than it is for us, but we believe that the committee should have the right, while doing an initial investigation, not to have to proceed with complaints that are frivolous or vexatious or made in bad faith. We believe there are sufficient safeguards in the current amendment, both for the complainant and for the member, and that the requirement to refer the complaint to the complaints committee will remain. Both the member and the complainant will be given notice of the college's intention not to investigate if a complaint is found to be frivolous or vexatious. In addition, both parties will be given the opportunity to make submissions to the college. CDO expects this provision to be used sparingly and with great care.
Standards of practice: The addition of subsections (1)(n), (1.1) and (1.2) under section 95 of schedule 2 of the RHPA enables each college to make a standard of practice regulation which can refer to other documents. This will provide colleges with legal power to enforce practice standards. The provision also ensures that future changes to these standards are recognized and enforceable immediately. Most important, this amendment will promote widespread use of these documents and ensure the maintenance of current standards, and would also, we could add, protect members of the public.
When information can be withheld: The CDO supports the addition of subsection (3.1) to section 23 of schedule 2 of the RHPA, which gives the registrar the power to refuse disclosure of a member's business address and business telephone number when there is reasonable grounds to believe that this disclosure of information may jeopardize the member's safety. We understand that this is a balancing act of confidentiality and also our role as the regulatory body, but this is particularly important to our college as the vast majority of its members are female.
Changing of regulations to bylaws: Overall, the proposed amendments to subsection 94(1) of schedule 2 of the RHPA represent a step towards streamlining the administrative process. The college supports the conversion of the administrative regulations to bylaws.
For much the same reasons, we are supportive of the next section, the setting of fees. We just want to add and emphasize in that paragraph that it is essential that the proposed amendment to section 24 of the code allowing suspension for non-payment of fees be passed simultaneously.
I now would like to address three issues that we have some concerns about as a college and hope that there could be changes before the bill is enacted. The first is late submissions. The proposed addition of subsection (1.1) to section 26 of schedule 2 would make it an obligation for the complaints panel to consider late submissions under certain conditions. There is a potential danger, or least potential entanglement, that this provision may be used to prolong unnecessarily the complaint process, thus making it difficult for the complaints panel to dispose of complaints within 120 days, which is the statutory limitation specified in subsection 28(2). We would hope that could be changed from "shall" to "may." Again, there are some rationales set out in the act, but we feel that would be of benefit to the complaints committee.
Non-exemptible registration requirements: In order to ensure that the non-exemptible registration requirements prescribed by the college are truly non-exemptible, the college recommends that the proposed amendment (1)(d) to section 95 of schedule 2 be adjusted to read "prescribing certain registration requirements as non-exemptible requirements for the purposes of subsection 18(3) and subsection 22(8)," which is the non-exemptible clause.
Disclosure of criminal behaviour about a member to the police: The additions of clause 36(l)(d.1) and subsections 36(l.2), 36(l.3) and 36(l.4) permit the disclosure of criminal behaviour about a member to the police. This is a good amendment because colleges have in the past been in a position to become aware of significant criminal behaviour but they were precluded, because of the confidentiality, from bringing this to the attention of the police. However, CDO is concerned that the wording suggests that criminal behaviour by employees of the college cannot be brought to the attention of the police, and that may, in terms of administration, have a much wider implication in disruption of the carrying on of the college.
That concludes our brief. We would like to thank the committee for this opportunity to be before you, and we hope that your deliberations can include some of what we have talked about today.
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The Chair: Thank you very much for your presentation. That allows us just under two minutes per caucus. We begin with the third party.
Ms Martel: Thank you for coming today. I was curious about the last statement you made with respect to disclosure of criminal behaviour. What is it in the wording that leads you to feel that criminal behaviour cannot now be brought to the attention of the college?
Ms Shirley Lee: The wording that is used specifies "member," which refers to member of the college, which doesn't include the staff of the college.
Mr Dawson: There may be cases where that could be brought forward but it's not clear in the actual wording.
Ms Martel: Is there a proposal you could make that would make you more comfortable in terms of having the law reflect what you hope is a situation that would be helpful to you?
Ms Lee: I think if the wording can be broadened, not just to focus on members only --
Mr Dawson: But also staff.
Ms Lee: We're employees.
Ms Martel: I'm just curious: How many complaints have you had registered? I take it from your earlier comments that the college itself is relatively new, so I'm not sure what your track record is.
Mr Dawson: We're still at the end of the initial five-year start-up period. We don't receive that many complaints, certainly nothing in comparison to the College of Physicians and Surgeons.
Ms Lee: So far we've received, on average, two a year. I think part of the reason is because the college is not yet well known; it's very new.
Mr Dawson: There are issues that we would like to address, but not related to this bill, in terms of public understanding of what the regulatory authority of the college is.
The Chair: We now move to the government members.
Mr Hudak: Thanks to you both for your presentation. In fact, Mr Dawson's reputation precedes him. Our parliamentary assistant, Mrs Ross, speaks very highly of you, so the least we can do is take your proposed amendments into very serious consideration or else Mrs Ross will come after us.
Mr Dawson: As long as that doesn't impair the voting of the opposition members.
Mr Hudak: Thank you very much for your support. There are a number of issues here that frankly are long overdue that this government is acting upon, and we appreciate your support, especially for the first -- you list about six or eight different things.
One thing in particular that we haven't had a chance to address yet in this committee: The theme of the bill is cutting red tape to allow the colleges, in this particular part of the act, to attend more of their time to their most important duties. In your opinion, why is it important to allow the colleges to work through bylaws as opposed to going through regulations with the ministry?
Mr Dawson: I think there are a couple of aspects to that. The first one is that it's done at the council level rather than then having to deal with the various bureaucracies within the Ministry of Health, through legislative branch, through legal counsel up to the cabinet and ultimately being sealed after cabinet approval, where within the bylaws you can change it.
In particular with the issue as it relates to standards of practice, we can relate to a number of documents that we have generated or that have been generated within the profession that will allow us to earmark that. As times change those standards of practice change and therefore they become immediately enforceable; otherwise, as health care changes, as the role of dietitians changes within the province, we would have to go back through the process. That would be a very cumbersome thing. It would tie up a number of legislative committees and ultimately the cabinet of the province. I think it's a major, significant change in terms of how colleges can administer themselves but still have that protective edge.
Ms Lee: I also would like to add that the regulations that were changed to bylaws are all administrative regulations. Any regulation that is aimed at protecting the public still remains in the regulation section and we support that.
The Chair: We now move to the official opposition.
Mr Crozier: Thank you, folks. I want to draw your attention to your suggestion that you're concerned about the criminal behaviour of employees being reported. I take it that no other part of the RHPA applies to employees. In other words, the RHPA is for members of various colleges.
Mr Dawson: Yes.
Mr Crozier: To suggest that in one little section you include employees -- I think we should be very careful if we look at that. In fact, maybe counsel or somebody can advise us on that. I know your intent and I think your intent is good, but the act doesn't apply to employees, so my suggestion would be it has to be handled a different way than through the RHPA.
Ms Lee: This is the college's suggestion. Your point is certainly respected. Where we are coming from is that the college's main role is for the protection of the public. The role of the staff or employees of the college certainly has impact, because members of the college are also members of the public. That's where we're coming from.
Mr Crozier: OK. I think we understand each other. I'm just saying it may be a big problem area and the act doesn't apply in any other way to employees. I point that out.
Mr Dawson: There may be other ways to address it. It's simply that as we open up that aspect of it to include members so the college now has to turn it over to the police, it leaves a gap there. Whether this is the appropriate place to do it or there is some other legislation --
The Chair: Thank you very much for your presentation today. We very much appreciate you coming forward.
COLLEGE OF MEDICAL RADIATION TECHNOLOGISTS OF ONTARIO
The Chair: We now ask our last presenters of the day to come forward, the representatives of the College of Medical Radiation Technologists of Ontario. Thank you for coming. You may begin.
Ms Sharon Saberton: Chair and members of the committee, I am Sharon Saberton, the registrar of the College of Medical Radiation Technologists of Ontario. With me today is the president, Mr James Roberts, from Ottawa, and our legal counsel, Debbie Tarshis, representing Weir and Foulds. I thank you on behalf of the College of Medical Radiation Technologists of Ontario for providing this opportunity to address two important issues with respect to Bill 25.
The College of Medical Radiation Technologists is the regulatory body which governs approximately 5,200 medical radiation technologists in Ontario. The council of the College of Medical Radiation Technologists of Ontario is made up of both publicly appointed persons and members of the college who are elected by medical radiation technologists. The council of the college discussed the Red Tape Reduction Act both at their July 17, 1998, and their September 25, 1998, meetings. The mandate of the council is to work in collaboration with the college membership to safeguard the public interest, and it is in the spirit of this mandate that the following recommendations are made.
First, the College of Medical Radiation Technologists of Ontario would like to commend the government for its work on Bill 25. For the most part, the college is of the view that the changes proposed in schedule G are both appropriate and helpful to the college in conducting its work in the public interest. There are, however, two provisions of schedule G which the college feels strongly should be amended. The following two points are supported by council as important issues to present to your committee today.
The first issue relates to section 7(l) of schedule G, which amends section 36(l)(d) of the Regulated Health Professions Act, the RHPA. I refer you to page 107 of Bill 25. This section amends the exceptions to the confidentiality provision of RHPA. Section 36(l)(d) has been expanded to permit disclosure as may be required for the administration of the Healing Arts Radiation Protection Act, the HARP act, and the Laboratory and Specimen Collection Centre Licensing Act.
We suggest that the drafting of this exception should be changed to permit more flexibility for the college to make a disclosure. We suggest adding the words "or in connection with" so that the amended subsection 36(l)(d) will read as follows: "as may be required for or in connection with the administration of the Drug Interchangeability and Dispensing Fee Act, the Healing Arts Radiation Protection Act...." etc.
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In our view, the words "as may be required for" may not be broad enough to expressly permit the college, on its own initiative, to disclose information to the X-ray inspection service of the Ministry of Health, because there are no requirements under the HARP act for a person, such as a member of the college, to report breaches of the HARP act of which the college becomes aware. We feel this proposed amendment would expressly permit the college to share information with the X-ray inspection service should the college become aware, as a result of a complaint, an investigation, an assessment or otherwise, that a person is operating an X-ray machine without the required certificate of registration from the College of Medical Radiation Technologists of Ontario, contrary to the provisions of the HARP act. This proposed amendment is in the public interest because it would support the college's ability to report to the X-ray inspection service on the college's initiative where the college becomes aware of breaches of the HARP act.
The second issue relates to section 23(l) of schedule G of the draft bill, which amends section 95 of the Health Professions Procedural Code -- the regulation-making powers of the college -- and includes a new subsection 1.4 respecting circulation of a proposed regulation. I refer you to page 117 of Bill 25.
This amendment proposes a new requirement that a regulation shall not be made unless a proposed regulation is circulated to every member at least 60 days before it is approved by the council. As has been evident from the regulation-making process to date, the regulation-making approval process involves negotiation with the Ministry of Health, professional relations branch and legal services branch, and the Attorney General's office. A proposed regulation that is first approved by council may have many changes before it is in a form which is acceptable to the Ministry of Health and the Attorney General's office. Changes made to a proposed regulation as a result of comments received from the Ministry of Health and the Attorney General's office frequently require further approval by council.
Because of changes to the original regulation proposed by the college through this negotiation process, we are concerned that as this section stands it may require that the college recirculate a proposed regulation to the members a number of times. This would entail multiple mailings to the membership of the college, with the associated costs for mailing and production, and in addition would, in the case of more complex regulations, entail an overwhelming paper flow to the members as we sought their input on each version of a proposed regulation. Our recently passed quality assurance regulation, for example, went through seven different versions before it achieved final passage. These different versions included substantive changes to incorporate the policy and legal requirements of the Ministry of Health.
The intended purpose of this new subsection 1.4 is to encourage consultation with members, a goal which we wholeheartedly embrace. The requirement may, however, defeat this purpose because the only efficient way to deal with the requirement in the end may be to distribute the proposed regulation only after it has received a final signoff from the Ministry of Health and the Attorney General's office.
We would suggest that either (1) this requirement be deleted and we continue with the current process where the Ministry of Health requires confirmation that consultation has been made with the members prior to the regulation proceeding to cabinet for approval or (2) subsection 1.4 of section 95 of the Health Professions Procedural Code be changed to clarify the stage at which the proposed regulation is to be distributed to the members of the college.
We therefore propose that subsection 1.4 be amended to read as follows:
"A regulation shall not be made under subsection (1) unless the regulation proposed by the council to the minister for review is circulated to every member at least 60 days before it is initially approved by the council."
We believe that consultation with the members has been taking place in accordance with the current Ministry of Health's processes. However, if it is necessary to formalize this process into a legislative requirement, we believe it is imperative to be clear at what stage in the regulation-making process consultation is to take place. We also believe that this suggested amendment would clarify the appropriate consultation stage to permit optimal input from our members.
Thank you for your kind attention, and I would be pleased to entertain any questions you may have.
The Chair: That affords us approximately two minutes per caucus for questions. We begin with the government members. We will have to recess for the vote, which will allow us to come back for the questions after the vote, so this committee will sit -- that was quick. I believe the vote has been deferred, so we will continue with the questioning until we hear otherwise. We begin with the government members.
Mr Hudak: Thank you for your presentation and the detailed suggestions that you've given the government. Just to make sure I have it on the record from your point of view, some of the other groups talked in generality about the changes in this act. I want to make sure you're supportive of that. For example, the frivolous and vexatious dismissal, you're supportive of what's in the bill?
Ms Saberton: Yes.
Mr Hudak: And the protection of quality assurance, for example? How about the changing of regulation powers to the ability to make bylaws, in general?
Ms Debbie Tarshis: The college intends to make a written presentation, but for purposes of the oral presentation we really wanted to take the opportunity to commend the legislation overall on what it's doing but raise the two particular points. But yes, the college is supportive of changing the regulation-making powers to bylaws and the QA confidentiality.
Mr Hudak: To your particulars, I'm glad you brought them up, because you're the first group that brought them up to this committee at this level. Can you explain how it operates currently in terms of proposed regulations circulating to your members for their input.
Ms Saberton: For example, the quality assurance regulation, because it was a whole new notion, was introduced through Insights, which is our publication to our members. Then there was consultation with our members, with me visiting all five centres in Ontario. We reached 1,000 of our members through teleconferencing, so there was dialogue about the proposed regulations at that very early stage, and consultation continued right up until the point we developed our regulations and they went to our council for approval.
Mr Hudak: In the case of a complex regulation, you're very concerned that the changes in Bill 25 will cause repetition of this being delivered to members, and that sort of thing.
Ms Saberton: That's right.
The Chair: Thank you, Mr Hudak. We'll move to the official opposition.
Mr Crozier: I suspect what the member opposite was getting at is that the proposed changes could create more red tape than you have at the present time, and that's not the objective of this legislation. I appreciate your suggestion that it be amended so members still may be informed, which I assume you agree they have the right to be. It's hard to speak in generalities, but I suppose not too many regulations, even if they do go through consultation with the government and amendment, change their intent at least. So I think your solution is fine. You consult with your members, you go on and work with whomever you have to, but generally the intent of the amendment isn't changed. I don't see any problem with that.
The Chair: We now move to the third party.
Ms Martel: Thank you for coming today. I was curious about the first amendment because I was wondering what happens now without this amendment being in place. If the college becomes aware that someone is operating without a certificate, are you not in a position now to inform the ministry about that? If so, what happens to that individual and what happens to the public member at this point?
Ms Tarshis: That's really an issue of legal interpretation of the other disclosure provisions of section 36(1). We would like it clarified so it's absolutely clear that the disclosure is permitted.
Ms Martel: So right now you would do this, but using discretion, which would make people uncomfortable or worry about protecting yourself as well, or protecting the college.
Ms Tarshis: That's right.
The Chair: Thank you very much for your presentation today. We very much appreciate you coming forward. At that, this committee is recessed until Tuesday, October 13, at 1700.
The committee adjourned at 1800.