New medical act introduced

Health Minister Jerome Kennedy says a new medical act, introduced in the House of Assembly Monday, is aimed at enhancing public protection and patient safety, while supporting physicians in maintaining high standards of practice.

Titled An Act Respecting the Practice of Medicine 2011, the new legislation, when passed, will re-place the province’s Medical Act, 2005.

It will require physicians in the province, for the first time, to participate in mandatory continuing education in order to maintain their licences.

The new act will also give the College of Physicians and Surgeons of Newfoundland and Labrador (CPSNL) broader powers, including authorization to make regulations with ministerial approval for such things as monitoring and verifying physician prescribing practices, to ensure that sponsors of provisionally licensed physicians have appropriate orientation, supervision and ongoing assessments and to determine who should have access to information gathered during the college discipline process.

Kennedy said the legislative changes are partly in response to recommendations from the Cameron Inquiry into breast cancer testing errors, as well as recommendations from the OxyContin Task Force and other concerns from complainants about access to information during the disciplinary process.

In the past, a physician’s licence couldn’t be suspended until after an investigation into allegations resulted in a tribunal hearing and guilty verdict.

 The new legislation, however, contains provisions for the college’s complaints authorization committee to be able to act quickly to suspend or restrict a physician’s licence where there is a reasonable belief that the physician has engaged in “conduct deserving of sanction.”

Kennedy and Dr. Vinod Patel, chairman of the council of the CPSNL, couldn’t say Monday whether names of physicians suspended pending an investigation will be released publicly.

Patel said the college would like to be “transparent and open and more approachable and accessible in terms of the complaints process,” but if there’s an accusation being investigated against a doctor, that physician’s reputation has to be considered as well.

“That’s one of the things we’ve tried to incorporate into this new act, the public’s right to know balanced against the right of the individual physician to ensure that his or her reputation is protected in accordance with the rules of natural justice and the basic presumption of innocence,” Kennedy said.

The province will engage in more discussions with the college in terms of making regulations, the minister said, and there will be more discussion in the legislature before the act is proclaimed.

Kennedy said one of the big concerns was ensuring that complainants or a family member can access information they require from the disciplinary process.

The new act will also provide for the establishment of a quality assurance committee, including members who are not physicians, who will be appointed to represent the public interest.

This committee will have the ability to subpoena records, order a physician to undergo an evaluation, assessment, examination or practice review and restrict a physician’s practice. The committee will also be able to order a physician to obtain counselling and order the completion of an education or training program.

Patel said the establishment of this committee will give the college “the appropriate tools it needs to deal with issues that are not disciplinary in nature but where some intervention is required by the college to assist a doctor and protect the public.”

Last month, the CPSNL agreed to reinstate a licence for a central Newfoundland physician, who voluntarily withdrew from his family medicine practice in 2009, while dealing with his own alcohol and drug abuse issues.

His lawyer, Paul Stokes, said in just about every other profession this doctor wouldn’t have had to go before a public tribunal because his personal health problems would have been dealt with through an internal supportive process, considering no patients were harmed by his illness.

Patel acknowledged Monday that personal problems like this will be dealt with differently through the quality assurance committee under the new legislation.

When asked how, Patel said, “Well, I guess this would be dealt like with any other society or self-regulating bodies. Personal health issues and such would be handled in the manner they should, as long as there’s no harm to a consumer.”

This quality assurance committee is expected to be established by the end of this year.

Kennedy said the new act also addresses concerns raised about prescription drug abuse and access, particularly relating to methadone and OxyContin availability.

“The OxyContin Task Force recommended that narcotics should not be prescribed outside the indications and dosing in the approved Health Canada product monographs and that the College of Physicians and Surgeons should monitor physician prescribing compliance,” Kennedy said. “Under the new act, the college with the approval of the minister can make regulations with respect to the monitoring and verification of physician prescribing practices.”

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