I likely need to say something to you about governance reform and the College.
Wait, please don’t stop reading yet. Hear me out.
Over the next few years, you will be hearing more and more from the College on activities relating to governance reform. At the last College Council Training Day, we spent a considerable amount of the day on the topic of governance reform.
So, since I am talking about it, what is governance reform?
The question is best put into context. Psychology has been a self-governing profession for over a half-century. Our current College has 9 Psychology members, 7 public members, and 3 Behaviour analyst members. No group is in the majority on the College Council, although we have a majority of professional members. Neither Psychology nor Behaviour Analysts are in the majority on the Council of the Ontario regulatory body that oversees their profession.
But, this type professional self-regulation, with public member input, is not required. It is a privilege. There are some who argue that professionals are neither educated nor trained to be regulators. Therefore, health care professionals should not self-regulate.
In many jurisdictions in North America, professional self-governance is not the standard. Professionals are brought in to assist regulators when expert advice is needed. Consolidation of regulators is occurring in some jurisdictions. For example, British Columbia reduced the number of health regulatory bodies from 22 in 2018 to 15 Colleges. Then, in June 2024, they further reduced to 6 Colleges. The government in British Columbia describes this as “setting the foundation for more robust regulation of health professionals” with the aim “to make sure people feel safe when visiting a health professional by creating larger and better-resourced colleges capable of providing stronger oversight”. Psychologists are now regulated under the College of Health and Care Professionals of British Columbia which also regulates audiologists, dietitians, hearing instrument practitioners, occupational therapists, opticians, optometrists, physical therapists, and speech-language pathologists. The new College Board has 6 “registrant members” and 6 “public members”, so both professionals and the public have an equal voice in decisions. And, in case you were wondering, with 9 professions and 6 registrant members, that means 3 professions are not represented at the College Board at any time. Currently, the professions not included in their Board are audiologists, hearing instrument practitioners, and psychology.
Ontario has 26 health regulatory Colleges for 28 professions. All Colleges are looking to modernize their model of regulation. Some of the Colleges are further ahead of this journey than we have been.
Our College is using much the same model of regulation as we have had since RHPA took effect over 30 years ago. It is time to look at what we do, ask ourselves why we do it and why we do in that way, determine if others do it and, if so, how they do it. Anyone familiar with process improvement methodologies, such as Kaizen, Lean, or Six Sigma, will recognize some of the need for any large organization to look at one’s own functioning to improve. Health care regulation has changed enormously since we started regulating.
We are also keenly aware of the parable of Chesterton’s Fence. In his book “The Thing”, G.K. Chesterson wrote the following:
There exists in such a case a certain institution or law; let us say, for the sake of simplicity, a fence or gate erected across a road. The more modern type of reformer goes gaily up to it and says, “I don’t see the use of this; let us clear it away.” To which the more intelligent type of reformer will do well to answer: “If you don’t see the use of it, I certainly won’t let you clear it away. Go away and think. Then, when you can come back and tell me that you do see the use of it, I may allow you to destroy it.”
In other words, our way of doing things were not set up due to arbitrary whims. The reasons why they were created may not be immediately obvious. Therefore, before making changes or “taking down the fence”, we also need to understand its original purpose and context.
Bottom line, this is a big job. It will take a while. Some of the regulatory changes will be easy changes in simple College policy and procedures. Others may require the province to make changes in our regulations. Perhaps some may mean a tweak to legislation.
However, our College Council are acutely aware of the need to make changes. We appreciate the need to modernize. We see that these changes are overdue. The College is a public institution and we need to ensure that it changes to meet the needs of the public. The world has changed enormously in the last 30 years and we need to keep up with it.
Ian Nicholson, Ph.D., C.Psych.
President