A recent investigation by Michael Lista in Toronto Life magazine delved into the issues related to accountability of regulatory bodies. Lista revealed shocking misconduct by a formerly distinguished ob-gyn, Paul Shuen, who was found to have been secretly inducing pregnant women into labour without their consent.
Following an investigation by the College of Physicians and Surgeons (CPSO) and the revocation of Shuen’s license in 2018, a public warning was posted on Shuen’s CPSO page. However, unlike courts, the inner workings of regulatory discipline panels like that of the CPSO, are not open to the public — as Lista points out, “It turns out that it’s easier to see the evidence against a murderer than the evidence against a doctor in Toronto.”
The potential consequences of a case like Shuen’s underscore the importance of transparency for regulators, which govern the conduct of thousands of professionals and industry registrants like Shuen. As the College of Nurses of Ontario (CNO) pointed out in its 2018 annual report, members of the public should have “absolute trust and confidence in the care nurses provide.” Healthcare workers like nurses and doctors constantly make decisions that affect people’s lives — yet the inner workings of the agencies that certify, govern, and discipline those workers often remain inscrutable to the public.
As Lista’s piece demonstrated, perfect transparency between regulators and the public does not yet exist. But in recent years, the healthcare sector in particular has made significant moves to bring the public closer to the work of its regulating agencies to increase transparency more broadly. The Citizen Advisory Group, which was formed in 2015 to include patient voices in healthcare regulating agencies, now includes 15 Colleges, including the CPSO, CNO, and others. The Group meets regularly to discuss building public trust in the healthcare system, improving accessibility and transparency, and increasing public awareness of patients’ rights.
Members of the Federation of Health Regulatory Colleges of Ontario, the organization that brings together the 26 colleges regulated by the Regulated Heath Professions Act (RHPA), also broadly supports the goals of the Protecting Patients Act in 2017. This piece of legislation focuses on strengthening protection against sexual abuse of patients by health care professionals, in addition to adding new self-reporting obligations and making more information about health care providers available to the public.
Also in 2017, the CNO’s task force on regulatory governance released a report that outlined current trends in the area, with an eye towards establishing the College as a leader in the field. “The underlying theme…” wrote the task force members, “was that regulators must be proactive in order to strengthen public trust.”
Undeniably, the healthcare sector has been proactive in ongoing consideration of building public trust for years. The Transparency Principles, a comprehensive set of guidelines aimed at regulating agencies developed by the Advisory Group for Regulatory Excellence (AGRE), founded in 2012, show that public confidence is being taken seriously. The goal is not necessarily perfect transparency, and regulating agencies may never achieve that, but there is certainly a considerable effort being undertaken to develop public trust in Ontario’s healthcare industry that should not be taken lightly.
According to an August report by the Canadian Human Resources Professionals Association, professional regulatory bodies are increasingly under scrutiny, their value no longer unquestioned. Today’s customers, consumers, and patients no longer merely value transparency and accountability — they expect it. Responsiveness and confidence in a brand are also rewarded by factors such as social media, which so easily amplifies both the negative and positive aspects of a service experience. Agencies, institutions, and regulating bodies that interact with the public should seriously consider the value of developing accessibility and transparency, as public trust remains at a premium.