RHPA and Health Services
The RHPA and Innovations to Health Service Delivery in Psychology
In 1982 the Ontario government began the Health Professions Legislation Review (HPLR). At that time the regulatory landscape showed a patchwork of laws:
- four professions were regulated by the Drugless Practitioners Act of 1925
- seven professions had individual acts, including the Psychologists Registration Act of 1960
- 7 professions were unregulated
- 6 professions fell under the Health Disciplines Act of 1980
The culmination of 9 years of extensive HPLR consultations with many hundreds of stakeholders was the Regulated Health Professions Act (RHPA) of 1991, which was designed to first and foremost advance the public interest over professional interests by:
1) “Protecting the public, to the extent possible, from unqualified, incompetent, and unfit health care providers;
2) Developing mechanisms to encourage the provision of high quality care;
3) Permitting the public to exercise freedom of choice of health care providers within a range of safe options;
4) Promoting evolution in the roles played by individual professions and flexibility in how individual professionals can be utilized, so that health services are delivered with maximum efficiency.” [Striking a New Balance: a Blueprint for the Regulation of Ontario’s Health Professions, 1989]
RHPA provided a single framework of regulation for all of the health professions that met certain criteria for inclusion. Thus patients and clients could expect the same high standards for care and protection from all of the professions:
- each profession would have a scope of practice,
- all acts and procedures which could result in harm could only be carried out by qualified providers, and
- the use of professional titles would be restricted to members of the regulated health professions so that the public could distinguish regulated from unregulated providers
Each College would be self-regulating in terms of entry requirements, standards of professional practice, quality assurance, fitness to practice, complaints, and discipline but only within the range of the overarching and unified RHPA framework and procedural code. Professional interests could not dominate the public interest.
In psychology, RHPA brought into regulation a multitude of unregulated providers who were providing essential services and had been supervised by licensed Psychologists. Masters-level providers with additional professional experience would be rigorously examined by the College for the skills and knowledge necessary for independent practice. As members of the College they would have to fulfill demanding requirements for professional behaviour, continuing education and skill development. Their title, Psychological Associate, would identify them as regulated providers to the public, so that any harmful and unprofessional service to clients would be subject to College complaints and disciplinary procedures.
This extension of regulation to a group of unregulated health providers became part of the landmark establishment of 24 professions under RHPA. In 1994 the first group of 32 Psychological Associates became members of the College of Psychologists. Twenty years later over 600 Psychological Associates and master’s-prepared Psychologists provide necessary psychological services that respond to growing demands for assessment and/or treatment. This history is consistent with the aims of the designers of Ontario’s RHPA.