CMPA Member Advice: Ontario, Patients First Act, 2016 (Bill 41)
Posted June 2016 / revised December 2016
Bill 41, Patients First Act, was recently passed by the Legislative Assembly of Ontario. While many provisions of the Act are now in force, some other substantive provisions will come into force later. The Act provides Ontario’s Local Health Integration Networks (LHINs) with additional powers and authorities. To further Ontario’s "Patients First: Action Plan for Health Care", the Act is intended to improve access to primary care, as well as home and community care, and to encourage greater integration of the health system.
The following are some of the changes expected under the Act that relate to questions asked of the Canadian Medical Protective Association (CMPA) by members:
- The Minister of Health and Long-Term Care is empowered to issue operational or policy directives to LHINs as well as provincial standards for the provision of health services.
- Once proclaimed into force, the Minister will be empowered to appoint investigators to investigate and report on LHINs. The investigators will have broad powers to investigate and report on the quality of the management and administration of a local health integration network, or any other matter relating to a LHIN, where the Minister considers it in the public interest to do so.
- Once proclaimed into force, LHINs will also be empowered to engage in or permit audits of accounts and financial transactions, operational reviews or peer reviews of a "health service provider’s" activities and to appoint investigators to investigate certain “health service providers”.
- Such investigators cannot access personal health information without the consent of the individual in question except in prescribed circumstances.
- While the legislation focuses on the LHINs and "health services providers", which expressly excludes physicians, it is possible that physicians may be indirectly involved in investigations under these provisions. In this regard, it will be important to be aware of the broad powers of the investigators to investigate in these cases.
- The establishment of a Health Professionals Advisory Committee becomes optional for LHINs. The establishment and requirement for such committees was the result of efforts to provide a formal role for physicians vis-à-vis decisions made by LHINs. Such committees currently consist of at least 12 members, four of whom are required to be physicians.
- Once proclaimed into force, LHINs will be empowered to issue operational or policy directives to a "health service provider" to which it provides funding. "Health service providers" include hospitals, psychiatric facilities and long-term care homes, but, as noted above, they do not include physicians. Once proclaimed into force, entities that operate family health teams will be added to the definition of "health service provider".
- The Ontario Health Quality Council is authorized to make clinical standards recommendations to the Minister. The Council was already permitted to provide similar recommendations to healthcare organizations.
The CMPA is aware that concerns have been raised about the Act. The CMPA is monitoring its implementation and considering its implications on Ontario members. In the interim, CMPA members who have specific questions are encouraged to contact the Association for advice.