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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.
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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.
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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
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