The Regulated Health Professions Act

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The Regulated Health Professions Act

• R.H.P.A.

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Professional Status
Body of scientific knowledge Ongoing research
Autonomy self-regulation
Recognized authority with sanctions
Profession
Professional standards code of ethics
Advanced educational preparation
Strong service orientation
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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
  providers
• Promoting flexibility and efficiency in health
  service provision

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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

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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

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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

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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

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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

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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

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Controlled Acts
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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

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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

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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

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Professional Regulation
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Bill 47 The Dental Hygiene Act

• Long Name
• An Act respecting the regulation of the
  Profession of Dental hygiene (1991)
• Contains specific regulations

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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

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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

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Dental Hygiene Act

• Authorized controlled acts
• Scaling teeth and root planing including
  curetting surrounding tissue
• Orthodontic and restorative procedures

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Problems with The Dental Hygiene Act
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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

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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

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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

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The End