Professional Practice News
Special E-Bulletin: Implications for Social Workers of Bill 171, The Health Care Improvements Act
Monday, February 05, 2007
WHAT HAS HAPPENED?
On December 12, 2006, Bill 171: The Health Care Improvements Act received First Reading in the Ontario Legislature.
Although the timeline has not been confirmed, it is expected to receive Second Reading after March 2007 when the Legislature resumes sitting and then will be referred to Standing Committee for hearings. Bill 171 proposes amendments to a number of Acts, including the Regulated Health Professions Act, 1991 (RHPA).
Three of the proposed amendments to the RHPA will have significant implications for social workers. These include: the regulation of psychotherapy by proposing a “controlled act” of psychotherapy and by establishing a College of Psychotherapists under the Psychotherapy Act, 2006; a proposed amendment to the “harm clause” of the RHPA; and the use of the title “Doctor” by health care professionals who have earned this credential.
WHAT ARE THE ISSUES?
Controlled Act of Psychotherapy and the Psychotherapy Act
It is deeply concerning that the Ministry of Health and Long-Term Care (MOHLTC) has not followed the recommendations made by the Health Professions Regulatory Advisory Council (HPRAC) in the highly credible Regulation of Health Professions Ontario: New Directions report (April 2006), which recognizes social workers as one of the key professions qualified to provide psychotherapy. Unjustifiably, the MOHLTC, through Bill 171, excludes social workers from the regulation of psychotherapy.
Bill 171 proposes to make psychotherapy a “controlled act” under the RHPA and has not made a complementary amendment to the Social Work and Social Service Work Act, 1998, authorizing social work members of the Ontario College of Social Workers and Social Service Workers to perform this controlled act, as had been recommended by HPRAC, if the MOHLTC chose this option to regulate psychotherapy.
Under the Psychotherapy Act, only members of the newly established College of Psychotherapists of Ontario will be able to use the title “psychotherapist” or “registered mental health therapist”.
Amendment of the “Harm Clause”
Subsection 30(1) of the RHPA is to be amended so that no person other than a regulated health professional, treating or advising within the scope of practice of their profession, is able to treat or advise a person with respect to that person’s health in circumstances where it is reasonable and foreseeable that “serious bodily harm may result from the treatment or advice or from the omission of treatment or advice”.
This is a change from the current standard of “serious physical harm”. “Serious bodily harm” is intended to include psychological and emotional harm. No amendment has been proposed to the RHPA exempting social workers practising within the scope of practice of their profession from the “harm clause”.
Without such an exemption, social workers may be in breach of the harm clause when providing social work services. This concern is heightened by Bill 171’s exclusion of social workers from the proposed amendments to regulate psychotherapy.
Use of the Title “Doctor”
HPRAC recommended that the existing restrictions (to five professions) on use of the title “Doctor” be eliminated recognizing that this restriction, an anomaly to Ontario, did not enhance public protection and is discriminatory. Again, the MOHLTC failed to follow this recommendation and simply expanded use of the title to naturopaths.
WHAT IS OASW DOING?
OASW is currently in the process of implementing a campaign strategy to seek amendments to Bill 171, which will reflect HPRAC’s recommendations, i.e., fully recognizing the skills of qualified social workers to provide psychotherapy and authorizing the College to set standards and regulate psychotherapy.
To date, OASW has spoken directly to Minister Smitherman and communicated our serious concerns to the Minister of Community and Social Services. We are also in the process of contacting key MPPs, members of the Opposition Parties, and will be communicating with political, as well as bureaucratic staff in our efforts to attain full recognition of qualified social workers to provide psychotherapy.
WHAT CAN INDIVIDUAL SOCIAL WORKERS DO?
Contact your local MPP to seek their support in ensuring that HPRAC’s recommendations are implemented. Use points from the following template to write a letter and follow up with a meeting with your MPP. Address one issue in your letter – either psychotherapy or use of the title “Doctor”, but not both issues, as this may be confusing. If you wish, you can raise the second issue when you speak to your MPP.
The proposed Psychotherapy Act has serious implications for a large number of social workers, not simply private practitioners.
Points to include in a letter/meeting regarding psychotherapy are:
Social work is one of the largest, if not the largest, providers of psychotherapy services in North America.
The exclusion of qualified social work psychotherapists is unjustifiable and completely at odds with the HPRAC recommendations, which recognized social workers as key providers of psychotherapy.
Major disruptions to publicly, as well as privately funded services, will occur if amendments are not made.
Ask your MPP to seek amendments in-line with the HPRAC recommendations and to let you know what actions they have taken on your behalf.
Points to include in a letter/meeting about use of the title “Doctor”:
Ontario is the only English-speaking jurisdiction in the world that places restrictions on use of the title “Doctor” by health care providers.
The public has a right to know about advanced credentials - this information informs decisions about treatment and care.
The public interest is not served by maintaining the restriction.
The monopoly on use of the title “Doctor” is discriminatory.
Ask your MPP to seek amendments in-line with the HPRAC recommendations and to let you know what actions they have taken on your behalf.
Document prepared by OASW, January 30, 2007
About OASW
The Ontario Association of Social Workers (OASW) is the voice of social workers in Ontario. OASW is a voluntary, provincial, non-profit bilingual association for social workers. All practising members have a university degree in social work at the bachelor's, master's or doctoral level. Incorporated in 1964, OASW has over 3,800 members and 15 branches across the province.
Contact: Pina Simonetta
Phone: 416-923-4848
Email: info@oasw.org
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