Alberta to limit self-regulation
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* Deborah Jones

*   © 2007 Canadian Medical Association or its licensors

Legislation that would curb self-regulation by 28 health care professions in Alberta will go to second reading this fall — outraging the province's doctors.

The Alberta Medical Association calls the bill “draconian” and “a threat to self-regulation” that would allow political interference in decisions that should be made only on the basis of evidence and best-practices. “Bill 41 allows the minister to direct the self-regulating body, the College of Physicians and Surgeons, to develop and amend its conduct according to a direction imposed by the minister. It gives him or her the free will to take over the college for no apparent reason,” says incoming President Darryl LaBuick.

But Alberta Health and Wellness spokesperson John Tuckwell says the amendments would merely “allow the minister to step in and make changes where necessary, working collaboratively with the health profession bodies.”

“It's seen as a last-ditch big stick.”

The bill was drafted following outbreaks of antibiotic-resistant bacteria in medical facilities last spring in the towns of Vegreville and Lloydminster. An ensuing review called for new standards of practice by all health professions in infection prevention and control. Tuckwell said Alberta Health Minister Dave Hancock, a lawyer, decided to amend the legislation because “public health trumps all.”

During the outbreaks, Hancock “did not have legal authority to step in and make changes where necessary,” Tuckwell said. In Alberta's 9 health regions, some hospitals are managed by faith-based organizations that “work ostensibly for health regions … but have a long standing tradition of independence and autonomy, not working well together. … The minister has proposed provincial standards for infection control [to] help the health professions work together to include these standards across all professions.”

But LaBuick says the changes extend well beyond setting standards. “There's no restriction to it, there's no responsibility, no requirement for [regulations] to go through the legislature.” He adds that the Bill 41 would allow such political interference as censorship, for example, of a nurse who speaks out about the effect of funding cuts on patient care.

Outgoing Alberta Medical Association President Gerry Kiefer warned in a Sept. 21 letter to members that the legislation empowers the minister to direct the college of physicians and surgeons “to develop or amend its code of conduct according to direction and directives imposed by the minister, direct the college to make bylaws or regulations directed by the minister and dictate the procedures to be followed in developing said code of conduct, bylaws or regulations. Bill 41 would empower the minister to appoint administrators for a college. The minister or cabinet could impose their direction without any oversight by the Legislative Assembly, and this direction could be imposed without the benefit of a full range of knowledge of the profession impacted.”

The association's general counsel recently passed a unanimous resolution calling on the minister “to discard the offensive amendments.”