Early last year, the Protecting Patients Act, 2017 (the PPA), came into force. The PPA amends several pieces of other legislation, including bringing in major changes to the Regulated Health Professions Act (RHPA) which governs doctors, nurses, pharmacists, and other health care professionals that are regulated by Colleges (such as the College of Physicians and Surgeons of Ontario (CPSO), which regulates doctors across the province). These changes are likely to have a big impact on patient care in Ontario.
The Reason the Changes were Made
The PPA was designed, in part, as a response to changes proposed by the Task Force Report on the Prevention of Sexual Abuse of Patients.
The task force, an independent entity, was commissioned by Ontario’s Minister of Health to review the RHPA and make recommendations to the Minister about the prevention of sexual abuse of patients by regulated health professionals.
The PPA is intended to strengthen the province’s zero tolerance policy on patient sexual abuse by a regulate health professional.
The Ministry of Health and Long-Term Care has said that:
Acts of professional misconduct involving the sexual abuse of a patient are always unacceptable. The relationship between a patient and their regulated health professional must be built upon a foundation of trust, confidence and safety.
The PPA is intended to:
- strengthen the protection of, and response to, incidents of patient sexual abuse;
- increase support for victims of sexual abuse by regulated health professionals;
- improve regulatory oversight and accountability of the various regulatory colleges (like the CPSO).
Problem for Patients Affected by Medical Malpractice: Lack of Transparency
One of the major challenges facing victims of medical malpractice face is a lack of transparency.
Currently, patients who believe they have been mistreated by physicians can file complaints to the College of Physicians and Surgeons of Ontario (CPSO). The CPSO will conduct an internal investigation. It has the power to hold hearings and make findings against the physician’s conduct. The College’s decision is posted on the doctor’s profile on the CPSO website. Penalties can include public cautions, continuing remediation, or resignation.
However, the CPSO cannot order monetary payment or compensation to victims of medical malpractice. In order to get financial compensation, injured patients must issue a civil lawsuit.
However, even if a physician’s care is found to be inappropriate by the CPSO, Section 36(3) of the Regulated Health Professions Act, states that no report prepared for the proceeding or decision of a proceeding is admissible as evidence in a civil proceeding. Meaning, even if the CPSO decided that the physician’s care was negligent, this decision cannot be used in a lawsuit against the physician for financial compensation.
Problem for Patients Affected by Medical Malpractice: The Canadian Medical Protective Association (CMPA)
The Task Force Report on the Prevention of Sexual Abuse of Patients found that there is currently a significant imbalance that creates numerous deficiencies including “greatly reduced accountability on issues of patient safety”. In fact:
Put more bluntly, patient advocacy — a crucial accountability mechanism for patient safety in Ontario — has been starved “nigh unto death,” in significant contrast to the robust legal defence schemes available to regulated health professionals and institutions.
The CMPA is a “hugely influential” organization that defends physicians. The Report identified the CMPA as:
…having considerable influence on the negative experiences reported by many patients in CPSO cases, often due to how CMPA-funded legal counsel represented their clients (i.e., physicians) in CPSO sexual abuse cases… Twenty-four years later, this task force finally heard relevant information presented for the first time at a public hearing by an expert that, while specific to the CMPA and, in turn, the CPSO, informed our analysis of the impact of the resource imbalance across the entire health regulatory system. This imbalance is addressed in our recommendations for one simple reason: patients do not have insurance that will cover the costs of their complaints, but regulated health professionals do. Taxpayers in Ontario largely fund this insurance coverage for physicians facing complaints by patients…
Major Changes in the Act
The PPA provides increased oversight of the healthcare regulatory process to Ontario’s Minister of Health and also increases the amount of information available to the public about a health care provider.
Major changes in the Act include:
- Increased fines for regulated health professionals (i.e. doctors, nurses, etc.) and organizations (i.e. hospitals, etc.) that fail to report an allegation of patient sexual abuse to a college;
- An increase in the required information that colleges must post on their public registers (they must now, for instance, post every caution that a health care professional has received, any continuing education program they have had to attend, a copy of any specified allegations against a regulated health professional that have been referred to a Discipline Committee but have not yet been resolved, etc.);
- An expansion of the list of acts that would result in the mandatory revocation of a regulated health professional’s certificate of registration;
- Removal of the ability of a college (such as the CPSO) to impose gender-based restrictions on a regulated health professional’s certificate of registration;
- Creation of minimum time period of one year following the end of a patient-professional relationship, during which time activities of a sexual nature between regulated health professionals and former patients are prohibited;
- Ensure more timely access to funding for therapy and counseling for patients who have been affected by sexual abuse by a regulated health professional.
These are major changes that are set to have a significant impact on how the colleges governing each regulated health profession will handle patient complaints, and how they will carry out investigations in response to those complaints.
Although Sommers Roth & Elmaleh does not make complaints to the CPSO or litigate sexual abuse cases, we regularly track changes and developments in the law as it pertains to patient safety and care. We are committed to providing excellent legal representation to patients who have been affected by inadequate or unprofessional medical care. We are one of the oldest medical malpractice firms in Toronto, and offer compassionate and knowledgeable guidance on every aspect of a medical malpractice claim. Call us at 1-416-961-1212 or contact us online for a free consultation.
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