A report, An Inquiry into the Performance of the College of Dental Surgeons of British Columbia (CDSBC) and the Health Professions Act, outlines 21 recommendations for the CDSBC to implement to ensure the college is functioning effectively and in the best interest of the public.
The government announced on Thursday that it has accepted all recommendations and Health Minister Adrian Dix, who released the report, has directed the CDSBC to bring forward an implementation plan within 30 days. Dix will also continue to monitor the college’s progress in implementing all the recommendations.
In March 2018, in response to concerns regarding the College of Dental Surgeons of British Columbia (CDSBC), Dix took the rare and significant step of launching a review into the administrative and operational practices of the college. He asked Harry Cayton, former chief executive of the United Kingdom’s Professional Standards Authority, to conduct the review.
“I want to thank Harry Cayton for leading this review and for the comprehensive report,” said Dix. “The findings of this review will assist the college in restoring public trust in the college. Putting people first is a primary concern for the ministry and the full implementation of these recommendations will help strengthen the college’s ability to deliver on its mandate to protect the public.”
Cayton was tasked with inquiring and advising whether the college follows best practices for governance of regulated professionals and whether it is fulfilling its mandate to serve and protect the public. Cayton was further asked to review the Health Professions Act and its regulations, to make recommendations to help modernize the regulatory system in B.C.
The report also puts forward a series of suggestions to renew B.C.’s overall health-regulatory framework. In response to these suggestions, Dix has established a steering committee to consider options and draft a proposal on how to modernize the regulatory framework for health professions in B.C. The committee will be chaired by Dix, with Norm Letnick, health critic for the official Opposition, and Sonia Furstenau, health critic and house leader for the BC Green Party caucus, joining him as committee members.
Cayton has been commissioned to advise the steering committee in its review of B.C.’s health profession regulatory system.
Additionally, health professional colleges have been asked to look at proposals where it makes sense to come together. B.C.’s service delivery environment has changed, where team-based care is becoming the norm. The amalgamation of colleges, where appropriate, is part of the shift towards team-based care, improved efficiency and the delivery of comprehensive care. This move was recently successful with the amalgamation of the three nursing colleges and is beneficial both to the college, to registrants and to patients.
Health regulation plays a vital role in B.C. by setting and enforcing the standards of professional behaviour, competence and ethics that underpin the day-to-day interactions patients and the public have with health professionals. In 2017, amendments to the Health Professions Act were brought into effect to strengthen the powers of the minister to intercede when appropriate to ensure the public’s best interests are being met.
Cayton is currently an international advisor to the Professional Standards Authority and a leader in the field of professional regulation. He has assisted many regulators throughout Canada and internationally, including the former College of Registered Nurses of BC, to enhance and reform their regulatory oversight mechanisms and processes. Cayton was chief executive of the U.K. Professional Standards Authority from 2007-18.
The CDSBC registers, certifies and regulates more than 3,000 dentists, more than 6,000 certified dental assistants and seven dental therapists in the public interest.
Below is a summary of these recommendations:
Governance, conduct and probity
* The board should continue with its plans to reduce its size, to increase the representation of public members and to appoint officers from within its membership.
* No one who has held an officer position in the British Columbia Dental Association or any other representative organization for dentists should be allowed to stand for election until at least three years has passed since they held office.
* No dentist under investigation for a complaint should stand for election or be appointed to a committee until the complaint has been resolved in their favour.
* Any dentist on a board or committee who is under investigation for a complaint should step down until the complaint has been resolved in their favour.
* The board should review its committee structure with the aim of reducing the number of committees making the college’s decision making more streamlined and effective.
* Board officers, the registrar and college staff should be more diligent in monitoring progress on workstreams and recording the implementation of decisions.
* The college should create a risk register to be maintained by senior staff and monitored by the audit committee. Results will be reported to the board.
* The board should continue to increase transparency and be ready to be held accountable to the public it serves.
* The college should renew its commitment to proper procurement policies and should conduct legal contracts through its general counsel.
* The board must mend its relationship with its professional staff.
Performance of the college
* The college should significantly improve its internal data collection and performance management.
* The college must sort and organize its documents. Standards should be gathered together in a single document and titled accordingly.
* The board should remove itself from the complaints process and should not attempt to influence or interfere in complaints in any way.
* As part of its new strategic plan, the college should develop a stakeholder mapping and communications strategy.
* The college should work to improve the reach and response rate of its annual complaints survey.
* The college should open part of its board meeting to questions and comments from the public.
* The college should aim to build a relationship of both mutual respect and distance with its dentist registrants.
* The college should commit greater time, respect and interest to both certified dental assistants and dental therapists.
* The college should encourage better and more regular engagement with the three other dental colleges to promote the safety of patients and public protection.
* The college should be clearer about the collection and distribution of fees.
* The college should resolve to stop collecting fees for the BC Dental Association in a phased-in manner. The suggested transition time is no more than three years for the two organizations to separate.