1. The Regulated Health Professions Act
R.H.P.A.

2. Professional Status Body of scientific knowledge & Ongoing research
Autonomy &
self-regulation
Recognized authority
with sanctions
Profession
Professional standards &
code of ethics
Advanced educational
preparation
Strong service
orientation

3. Professional Regulation
Purpose:
Aimed at advancing the public interest by:
Protecting from unqualified/incompetent health care providers
Developing mechanisms to encourage highest quality care
Permitting freedom of choice of health care providers
Promoting flexibility and efficiency in health service provision

4. Regulation Review
Dental Hygiene was regulated under the Health Disciplines Act (1974)
The Royal College of Dental Surgeons (RCDS) was the regulatory body
In November 1982 the Ontario government announced the creation of:
“The Health Professions Legislation Review”

5. Review of Regulation Why?
Public wanted a more open and accountable system
Government wanted a more efficient, flexible system
Unregulated Professions wanted recognition, autonomy and self-regulation

6. Regulation
More than 75 health care professions requested self-regulation
On April 3, 1986 The Minister of Health announced that 24 professions, including dental hygiene, would be granted self-regulation
The Regulated Health Professions Act [RHPA] was passed in November, 1991
Core regulations were completed and the Act was Proclaimed December 31, 1993

7. Self-Regulation Criteria for Selection
Profession must have a body of knowledge to form the basis for Standards of practice
Professional services must pose a substantial risk of harm to patients
Profession must be able to regulate itself in that:
Leaders put public good above self-interest
Members comply with and can bear cost of self-regulation
There is a recognized training program in canada

8. RHPA Innovations
Public representation on councils of governing bodies increased from 25% to 42-49%
Discipline hearings are open to the public
Reasons for decisions on complaints must be given to compainant and professional
Quality Assurance programs are mandatory to test knowledge and continued competence of members of the profession

9. The RHPA
The RHPA omnibus or umbrella Act sets out the general framework for regulation
The Controlled Acts concept:
Under RHPA specialized activities carrying a significant risk of harm are contolled or restricted to specific, qualified practitioners
All other health care services will be unrestricted or in the “public domain”

10. Controlled Acts

11. Controlled acts There are 13 controlled acts .
1. Surgery [includes dental surgery]
2. Putting a hand , finger or instrument beyond a certain point in any opening of the body
3. Setting bone fractures
4. Moving joints of the spine
5. Delivering babies

12. Controlled Acts (continued)
6. Using dangerous forms of energy
7. Giving a substance by inhalation or injection
8. Prescribing or dispensing prescription drugs
9. Fitting contact lenses or eyeglasses
10. Fitting hearing aids

13. Controlled Acts (continued)
11. Fitting/dispensing a dental prosthesis or orthodontic or periodontal appliance or device
12. Allergy challenge testing
13. Communicating a diagnosis identifying a disease or disorder as the cause of symptons

14. Professional Regulation

15. Bill 47 “The Dental Hygiene Act”
Long Name=
An Act respecting the regulation of the Profession of Dental hygiene (1991)
Contains specific regulations

16. Terminology College= Members= Restricted Title=
The College of Dental Hygienists of Ontario
The regulatory body for the profession
Members=
Dental hygienists who are registered with the College and hold a certificate of competence
This certificate must be renewed annually
Restricted Title=
No one other than a “member” of the College shall use the title “dental hygienist”

17. The Dental Hygiene Act FEATURES:
A general statement describing “Scope of Practice”
The practice of dental hygiene is the assessment of teeth and adjacent tissues and treatment by preventive and therapeutic means and, on the order of a member of the Royal College of Dental Surgeons of Ontario, the provision of restorative and orthodontic procedures and services”

18. Dental Hygiene Act Authorized controlled acts:
Scaling teeth and root planing including curetting surrounding tissue
Orthodontic and restorative procedures

19. Problems with The Dental Hygiene Act

20. The Order Issue
Under The Dental Hygiene Act (1991) a dentist must issue an order before a dental hygienist can provide periodontal therapy
Because this restricts these services to the dental office it limits availability of care for underserviced populations-seniors, those residing in isolated areas or collective living centres, the poor or unemployed

21. Self -initiation
The extensive education of dental hygienist in client assessment and record keeping ensures that they have the necessary skills and knowledge to self-initiate [to decide for themselves] to provide periodontal therapy

22. Problems
Refusing to acknowledge this demeans the professionalism of dental hygienists
It was not the intent of the RHPA that one profession should regulate another

23. The End