The recent public consultation, and the surrounding social media posts, raised a large number of important, valuable points. A column, such as this one, does not allow for a thorough response to all of the points that have been made. However, I would like to take the space to respond to one area of concern raised by several contributors; that is, the issue of self-regulation.
It was noted by several people that psychology was or is a self-regulating profession. By that, the inference was that others do not have a right to determine our regulations, including those for registration. They argued that psychology regulation should be solely up to psychology.
It is easy to see why that argument would be made. Schedule 1 of the Regulated Health Professions Act, 1991 lists the “Self-Governing Professions”. In that long list of professions is “Psychology and Applied Behaviour Analysis”.
However, I would propose that RHPA was never meant, in self-governing, that each profession would be the ONLY ones determine their own regulation. For example, since 1991, Audiology and Speech-Language Pathology have shared a health professions act. Their CASLPO Council was set up with 8-9 members of the professions, 6-7 members of the public, and 2 members of the professions’ faculties. Currently, their Council has 6 speech-language pathologists, 4 audiologists, and 6 members of the public. Neither profession, Audiology or Speech-Language Pathology, has a majority on their own Council.
Psychology regulation in Ontario was set up in 1961, and then carried over in 1991 with RHPA, with psychology having the majority of the membership on our Council. That model of governing the profession was in effect until July 2024. At that time, the current Psychology and Applied Behaviour Analysis Act, 2021 came into force. Under that legislation, our College Council was set up in this manner:
6 (1) The Council shall be composed of,
(a) at least eight and no more than 12 persons who are members elected in accordance with the by-laws, at least three and no more than five of whom must hold a certificate of registration in applied behaviour analysis;
(b) at least eight and no more than 13 persons appointed by the Lieutenant Governor in Council who are not,
(i) members,
(ii) members of a College as defined in the Regulated Health Professions Act, 1991, or
(iii) members of a Council as defined in the Regulated Health Professions Act, 1991; and
(c) at least two and no more than four persons selected, in accordance with a by-law made under section 11, from among members who belong to the faculty of a department of a university in Ontario, if that department is,
(i) a department of psychology, or
(ii) a department, however described, that offers a specialization in applied behaviour analysis.
(2) At least one of the members selected pursuant to clause 1 (c) must belong to the faculty of a department that offers a specialization in applied behaviour analysis.
Currently our College has 9 psychology members, 4 applied behaviour analysis members, and 8 public members. As with the CASLPO, while the majority of members of regulated health professions, no one profession has a majority of the Council.
As one can see from the legislation, there is not considered to be any distinction between who can vote on which issues, depending on how they arrived at Council. All Council members’ votes are equal as all members of Council are equal. The role of the College Council is to manage the affairs of the organization and, similar to what you will see in Parliament, the Council members will debate and decide these policy decisions. Debates at our College are to follow “Modern Parliamentary Procedure” (2nd edition, 2018), written by Ray E. Keesey and published by the American Psychological Association.
In other words, the decisions that are debated and decided by our College are debated and decided by ALL members of our Council, not a select group of Council. Those decisions include those pertaining to all of the 11 RHPA Objects of the College, including Object 2: “To develop, establish and maintain standards of qualification for persons to be issued certificates of registration.”
The changes to our Council were part of Bill 283, Advancing Oversight and Planning Ontario’s Health System Act, 2021. The Act was to amend and enact various Acts with respect to the health care system. As such, there were several public presentations to the Standing Committee on Social Policy on May 13 and 14, 2021 on the proposed changes to Ontario health legislation. None of the presentations, by either individuals or associations, raised concerns with the shift in the membership of our College Council. In fact, the Minister of Health, Christine Elliott, made the point in her presentation that our College “would be governed by a slightly expanded council that would aim to provide equitable representation for each profession.”
One question that is raised is why are we moving away from self-regulation. This is not unique to our College. The United Kingdom Public Standards Authority for Health and Social Care is often now cited as the standard for health care regulation. They are often referenced by those currently reviewing Canadian health care regulation. That number includes Harry Cayton, whose review of the College of Dental Surgeons in British Columbia ultimately led to a major revision of the health regulatory legislative framework in that province. In their document “Fit and Proper?: Governance in the Public Interest” (2013), they wrote:
However, it is taking a while for health professions to recognise that self-regulation is over. Too often in public discussion of regulation it is claimed that professions remain in charge of their own regulation. Of course it is essential that professions remain engaged and committed to their own regulation; professional regulation must retain the consent of those it regulates.
It is this model that is currently the standard in British Columbia, where Psychology is regulated by the College of Health and Care Professionals of BC which regulates 9 different professions. That College has 6 professional members and 6 public members and one of these public members is their designative Board Chair.
Why am I taking so much time writing all of this. I guess I am trying to explain that there are many arguments that can be made about the process and content of the recent decisions that were made by our College. However, the argument that only Psychology can determine who can become a regulated member of our profession is no longer accurate. It has not been that way for a while now and, given the current zeitgeist for professional regulation, arguing that it should not be the case is unlikely to be a successful point in those arguments.