College Connection | Page 2

college connection college connection LEGISLATIVE REFORM LEGISLATIVE REFORM Key principles guide legislative reform efforts Right-touch Regulation Good regulators support professionalism The College’s governing authority, the Veterinarians Act, was enacted by the Ontario government in 1990. The legislation is due for a substantive review which would take into consideration changes to the veterinary profession and also shifts in public expectations. continued from front page The only one of these that is different from the first version is ‘quantify and qualify the risks’. Quantifying risks means gauging the likelihood of harm occurring and its severity. Qualifying risks means looking closely at the nature of the harm, and understanding how and why it occurs. Without this two-fold evaluation, which must be based on evidence, it is not possible to judge whether regulatory action is necessary, what type of regulatory response might be needed, or whether it would be better to use other means of managing the issues. Regulation should only be chosen when it clearly provides the best solution. Simply identifying a real or potential risk is not sufficient. Understanding the role that regulation has in reducing actual harm by managing the risk of harm is an important step. There is much harm done in heath care that is avoidable but not all of it is susceptible to regulation. Equally there is risk of harm which is not avoidable and which may even be necessary if a beneficial outcome is to be achieved. If we think about the use of pharmaceuticals for instance; the elimination of harms from manufacturing errors and prescribing errors is susceptible to regulation and can in many ways be well controlled but all drugs have side effects and the possibility of harm is always traded off against the likelihood of benefit. While the provincial government ultimately decides on changes to the legislation which govern the College, the College’s objective is to seek changes to the law which enhance regulatory transparency and also support flexibility and efficiency. The total elimination of risk would also prevent beneficial innovation and the development and uptake of innovative practice and working. In rethinking their purpose, regulators need to reopen a dialogue with their licensed members and the public about the nature of risk in practice, and the regulator’s attitude to risk. Regulators should address the perception that regulation is an ‘iron cage’, inhibiting professional judgement and standing in the way of innovation, by setting out clearly its role, that of registrants and that of others in managing the hazards that inevitably arise from innovative practice. Of course getting the balance right both in daily professional practice and in regulatory oversight is never easy. It is nearly always a matter of judgement based on best evidence. That is where the right-touch approach can help; using the eight principles can identify problems clearly, address the risks of harm appropriately, use the correct and least intrusive regulatory tools for the task and support professionals is safe and effective care. Harry Cayton is chief executive of the Professional Standards Authority in the UK. The Authority oversees professional health and care registration and regulation in the UK and encourages good practice and learning in regulation. The College of Veterinarians of Ontario adopted a right touch regulation approach to policy making in 2012. PRofessionals Health Program In preparation for the task of initiating legislative reform, the College Council established an Oversight Advisory Group which includes representation from the College, the Ontario Ministry of Agriculture, Food and Rural Affairs and the Ontario Veterinary Medical Association. Stay Well - Your health is important to your competence. 2 / College Connection Professionals Health Program The Council has confirmed six key principles to guide the working groups as they analyze the Veterinarians Act and prepare recommendations for change. The key principles include: measurement and reduction of risk of harm • Transparency – balancing delivery of information to the public with fairness and privacy The Council looks forward to involving licensed veterinarians and the public as the project unfolds. Hearing the perspectives of those most connected to veterinary medicine is essential. • Right-touch regulation – the minimum regulatory approach to achieve an outcome • Agility – flexibility to implement change as required • Just culture – linking discipline measures to an individual’s intent • Collaborative self-regulation – partnership in the safe delivery of veterinary medicine • Risk mitigation – focus policy on the decision tree brings focus to council’s deliberations The College Council is attentive to ensuring policy debate is focused on the safety and quality of veterinary medicine. Since 2012, the Council has been using a decisionmaking tool, the Public Policy Decision Tree, to support its efforts in keeping the public interest central during deliberations. The tool is adapted for the College’s use from the Council on Healthcare Regulatory Excellence in the United Kingdom, and encourages Council to consider other solutions, aside from regulation, and reflecting the principle that regulators should only intervene when necessary. 1. At the outset, the tree asks that the problem be defined and whether or not it is about patient or public risk. If not, there is no need to regulate. 2. If the risks are confirmed, then they are defined and evaluated and it is determined whether or not the risks are Confidential Ontario Toll-free Line: 1-800-851-6606 http://php.oma.org The Professionals Health Program is a free, confidential service. The PHP provides prompt advice and support to veterinarians and/or their family members. Working groups, including veterinarians currently practising, have also been established to focus on scope of practice, investigations and resolutions, and quality practice. currently managed. If they are being managed, there is no need for further regulation. 3. If the risks aren’t managed, the next level asks for further explanation of where and why the problem is occurring and whether it can be solved locally, either by the employer, consumer or government. If yes, continue to use the local approaches as there is no need to regulate. 4. In the absence of local solutions, the question is whether or not there is a regulatory solution in line with the principles of good regulation, and, if so, then proceed. 5. When a solution is established, Council considers whether there are any new risks or unintended consequences to this solution. Council currently engages the tool early in its deliberations to ensure the public interest is front and centre and to also determine whether or not Council needs to take action. Find the Decision Tree at www.cvo.org/Resources Fall 2015 / 3