Changes in Profession Regulation

Lessons for the legal profession?

Changes in Profession Regulation

Changes happening in the regulation of BC nurses may have implications for other self-regulating professions like lawyers.

In BC, three different bodies govern nurses: the College of Licensed Practical Nurses of BC, the College of Registered Nurses of BC and the College of Registered Psychiatric Nurses of BC. Each is mandated by the Health Professions Act to protect the public by regulating their nurses. Each does the same job of establishing and enforcing qualifications for entry, setting practice standards, and acting when those standards are not met. 

In May 2014, then Minister of Health Terry Lake asked nurses: “would it not make sense for all BC nurses to be regulated by a single body?” This question kicked off a chain of events whereby the three bodies decided to unite and become one to better serve the public through more efficient and consistent regulation. A motivating factor was the regulators’ desire to control their own future rather than wait for government to direct it. They were mindful that government can take away self-regulation, as the province did in 2012 with BC teachers. They also considered global trends. 

In Canada, the regulation of professions is splintered by profession and by province, a notable exception being the recent national merger of the accountants as CPAs. In comparison, in the UK, for example, the Nursing & Midwifery Council regulates all nursing professionals, numbering almost 700,000. As for legal professionals, while there are eight separate regulators, one for each type (solicitor, barrister, notary, paralegal, etc.), the regulators are overseen by one super body, the Legal Services Board. 

In this context, in 2016, the three BC nursing regulators agreed to become one. On October 24, 2017, the government introduced a Bill to amend the Health Professions Act to enable the amalgamation. In a testament to the all-party political support for the initiative, the Bill received Royal Assent just over a week later – no small feat given the other priorities of the fledgling minority government. Under proposed Regulations, the new BC College of Nursing Professionals, governing about 55,000 nurses, will come into existence on September 4, 2018. The intention is that this body will also eventually regulate more than 50,000 health care aides.

Other health profession regulators in Canada are closely watching these events for the precedent they may set. There are also parallels with the experience of the legal profession in BC. In 2012, then Attorney General Shirley Bond directed the Law Society and the Notaries Society to develop a proposal for regulatory reform. The two societies agreed that a single, unified body to oversee the regulation of legal service providers in BC, including paralegals, was the optimum model. A recommendation of a Law Society task force to merge regulatory operations with the Notaries Society was approved by the Benchers in December 2013. Through 2014 and 2015, discussions were pursued – but without result.

While lawyers and notaries have so far been unsuccessful in unifying, the trend in profession regulation is to be less fragmented. The time will come when they will be asked to try again. And to be successful, they may wish to look to the nurses for lessons on how to overcome professional territoriality and fears around loss of identity. The details would require further articles, but it has not been an easy journey, with hard work and compromise. The reward will be more effective regulation and a better-served public. 

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