A major overhaul of how health professionals are regulated in British Columbia took effect Wednesday.
The Health Professions and Occupations Act (HPOA) covers doctors, nurses, dentists, pharmacists, psychologists and a wide range of other regulated health professions.
B.C. Health Minister Josie Osborne has said the overhaul is intended to provide more independent oversight and transparency, improve the complaints process, and better address anti-Indigenous racism in the health-care system.
“These changes will not disrupt day-to-day operations for health-care providers or the care that patients receive,” Osborne said Tuesday.
But critics say the act represents government overreach in the health-care system, and groups representing health professionals argue they were not adequately consulted on the changes.
The province passed the HPOA in 2022, and regulations were approved last year to bring it into force this April.
It replaces the previous Health Professions Act, which had governed health professionals and regulatory colleges since the ’90s.
In 2024, the province moved to amalgamate B.C.’s 15 health-profession regulatory colleges into six. The province also established a new oversight office under the HPOA and appointed a superintendent to oversee the six colleges.
The new framework includes a tribunal to oversee the discipline process for regulated health professions. The tribunal will be able to hold disciplinary hearings, hear appeals, and decide what information to make public after each case is finished.
One key change under the HPOA is that the oversight office will make recommendations for appointments to college boards, replacing the previous internal election process within the colleges.
The province said the superintendent will recommend board appointments to the health minister based on merit and diversity of perspectives.
Osborne said boards will continue to be composed of at least half professionals and half public members.
“This is to make it more clear that colleges are there to regulate the professionals…in the interests of the public, not in the interests of the professionals themselves,” Osborne said.
The province said the HPOA also creates new safeguards for addressing the spread of false and misleading information.
B.C. Conservative health critic Anna Kindy, who is a physician, said the changes amount to government overreach.
“Now it’s government that’s government that’s going to decide what is misinformation, without input from the frontlines,” said Kindy.
Doctors of B.C. president Dr. Adam Thompson said in an interview that while most doctors are well prepared for the changes, many are not welcoming them. He said the ministry did not properly engage with physicians in B.C. to understand and address their concerns.
“We’ve had a regulatory system for physicians in British Columbia for decades that’s been very effective,” Thompson said. “There’s a health-care crisis at the moment, not a regulatory crisis.”
He said some doctors are concerned the legislation limits their right to appeal disciplinary decisions largely to an internal process. Previously, they had the right to take appeals to the B.C. Supreme Court, but now they will instead be allowed to seek a judicial review.
Thompson said many are also concerned the new disciplinary structure will require complaints to be published online.
“The risk is that as doctors become fearful of the complaints system…they will practise what’s called ‘defensive medicine,’ so they will go above and beyond and start ordering investigations like CT scans that really aren’t warranted,” Thompson said, adding that it can also increase patient anxiety.
The province said the HPOA aims to increase transparency around the complaints process. It said only disciplinary orders made with the consent of the respondent, or following a finding of misconduct by the discipline tribunal, will be published.
Angela Wignall, CEO of the Nurses and Nurse Practitioners of B.C., also said there has been a lack of engagement from the province around the legislation.
She said, while nurses broadly support the province’s goals of improving patient protections, the HPOA goes too far.
“It goes so far that it removes those disciplinary functions from the profession and puts them into a ministry office,” she said. “These are really big, very significant changes that potentially will change how professions behave.”
Wignall said she would have liked to see the rollout of the changes happen more slowly, with more engagement with health professionals.
“We know from our partners across the system that they are not ready for this to go into full force on Day One,” she said.
Osborne said the health ministry engaged with health professionals and colleges as the legislation was developed and implemented, and she expects that to continue. She encouraged health-care professionals to provide feedback to their colleges and trade associations.
Ayendri Riddell with the B.C. Health Coalition said the legislation provides stronger mechanisms for addressing anti-Indigenous racism in the health-care system.
Riddell said she believes the changes under the HPOA will allow more patients to have their voices heard.
“We know through research that communities having a say in health-care provision is always better,” she said. “It means better access, better health care.”
