The Regulated Health Professions Act

R.H.P.A.

Professional Status

Profession

Body of scientific knowledge &Ongoing research

Autonomy & self-regulation

Professional standards & code of ethics

Recognized authoritywith sanctions

Advanced educational preparation

Strong service orientation

Professional Regulation

Purpose: Aimed at advancing the public interest by:

Protecting from unqualified/incompetent health care providers

Developing mechanisms to encourage highest quality care

Permitting freedom of choice of health care providersPromoting flexibility and efficiency in health service

provision

Regulation Review

Dental Hygiene was regulated under the Health Disciplines Act (1974)

The Royal College of Dental Surgeons (RCDS) was the regulatory body

In November 1982 the Ontario government announced the creation of: “The Health Professions Legislation

Review”

Review of Regulation

Why? Public wanted a more open and accountable

system Government wanted a more efficient, flexible

system Unregulated Professions wanted recognition,

autonomy and self-regulation

Regulation

More than 75 health care professions requested self-regulation

On April 3, 1986 The Minister of Health announced that 24 professions, including dental hygiene, would be granted self-regulation

The Regulated Health Professions Act [RHPA] was passed in November, 1991

Core regulations were completed and the Act was Proclaimed December 31, 1993

Self-Regulation

Criteria for Selection Profession must have a body of knowledge to form the

basis for Standards of practice Professional services must pose a substantial risk of

harm to patients Profession must be able to regulate itself in that:

Leaders put public good above self-interest Members comply with and can bear cost of self-regulation There is a recognized training program in canada

RHPA Innovations

Public representation on councils of governing bodies increased from 25% to 42-49%

Discipline hearings are open to the public Reasons for decisions on complaints must be given

to compainant and professional Quality Assurance programs are mandatory to test

knowledge and continued competence of members of the profession

The RHPA

The RHPA omnibus or umbrella Act sets out the general framework for regulation

The Controlled Acts concept: Under RHPA specialized activities carrying a

significant risk of harm are contolled or restricted to specific, qualified practitioners

All other health care services will be unrestricted or in the “public domain”

Controlled Acts

Controlled acts

There are 13 controlled acts . 1. Surgery [includes dental surgery] 2. Putting a hand , finger or instrument

beyond a certain point in any opening of the body

3. Setting bone fractures 4. Moving joints of the spine 5. Delivering babies

Controlled Acts (continued)

6. Using dangerous forms of energy 7. Giving a substance by inhalation or

injection 8. Prescribing or dispensing prescription

drugs 9. Fitting contact lenses or eyeglasses 10. Fitting hearing aids

Controlled Acts (continued)

11. Fitting/dispensing a dental prosthesis or orthodontic or periodontal appliance or device

12. Allergy challenge testing 13. Communicating a diagnosis

identifying a disease or disorder as the cause of symptons

Professional Regulation

Bill 47 “The Dental Hygiene Act”

Long Name= An Act respecting

the regulation of the Profession of Dental hygiene (1991)

Contains specific regulations

Terminology

College= The College of Dental Hygienists of Ontario The regulatory body for the profession

Members= Dental hygienists who are registered with the College and

hold a certificate of competence This certificate must be renewed annually

Restricted Title= No one other than a “member” of the College shall use the

title “dental hygienist”

The Dental Hygiene Act

FEATURES: A general statement describing “Scope of Practice”

The practice of dental hygiene is the assessment of teeth and adjacent tissues and treatment by preventive and therapeutic means and, on the order of a member of the Royal College of Dental Surgeons of Ontario, the provision of restorative and orthodontic procedures and services”

Dental Hygiene Act

Authorized controlled acts:

Scaling teeth and root planing including curetting surrounding tissue

Orthodontic and restorative procedures

Problems with The Dental Hygiene Act

The Order Issue

Under The Dental Hygiene Act (1991) a dentist must issue an order before a dental hygienist can provide periodontal therapy

Because this restricts these services to the dental office it limits availability of care for underserviced populations-seniors, those residing in isolated areas or collective living centres, the poor or unemployed

Self -initiation

The extensive education of dental hygienist in client assessment and record keeping ensures that they have the necessary skills and knowledge to self-initiate [to decide for themselves] to provide periodontal therapy

Problems

Refusing to acknowledge this demeans the professionalism of dental hygienists

It was not the intent of the RHPA that one profession should regulate another

The End