The Minister of Health and Long-Term Care has indicated he
intends to implement the recommendations set out in the recently
released report by Health Quality Ontario (HQO), pertaining to its
review of the quality oversight of non-hospital medical clinics
(NHMCs) in Ontario. Click here to view the report.
The implementation of HQO's recommendations would result in
a legislative overhaul of Ontario's current quality
oversight/inspection regimes for NHMCs and would include the
oversight of certain facilities performing medical procedures that
are not currently subject to regulation.
The review considered the current regulatory regimes governing
NHMCs, which are:
the Independent Health Facilities
Act (Ontario), which sets out the regulatory
oversight of Independent Health Facilities (IHFs). IHFs include
diagnostic imaging facilities, and ambulatory facilities providing
dialysis, ophthalmic/cataract surgery, abortion and gynecologic
surgery and vascular and plastic surgery; and
Regulation 114/94 made under the
Medicine Act, 1991 (Ontario), which establishes the
regulatory oversight for various Out-of-Hospital Premises (OHPs)
where the accepted standard of practice is to use certain types of
anesthesia or sedation for the performance of procedures. OHPs
include pain, endoscopy and cosmetic surgery clinics.
The HQO report recommends creating new legislation to
consolidate the IHF and OHP quality/inspection programs, and to
expand the quality oversight for certain NHMCs that offer
procedures not currently subject to regulatory oversight. The
report does not specify which procedures will become subject to
regulation, but it is anticipated that various "high
risk" procedures will be included. For example, the report
comments that "in vitro fertilization, cystoscopy, Lasik eye
surgery, sclerotherapy and non-permanent fillers fall beyond
existing oversight measures under the current regime[s], despite
posing relatively higher risks that may include infection,
disfigurement and blindness."
The recommended legislation envisions a regulatory authority
with accountability placed with an Executive Officer. Additional
An Executive Officer authorized to
establish rules and criteria for the program, act on inspection
results, and communicate and coordinate information between public
health authorities and professional regulatory colleges;
A requirement that clinic owners
apply for registration and that registration be contingent upon
passing an inspection;
A requirement that each clinic have a
single point of accountability for quality oversight, which in all
cases should be a regulated health professional;
A requirement that, as a condition of
registration, the clinics report utilization, performance and
Standardized plain language online
and in-clinic posting of summaries of inspection reports;
The requirement that clinics complete
and post Quality Improvement Plans; and
Standardized, fair and timely
We will be monitoring the development of this expected
legislation and will continue to keep you updated on the regulatory
requirements for IHFs, OHPs and other impacted NHMCs.
The content of this article is intended to provide a general
guide to the subject matter. Specialist advice should be sought
about your specific circumstances.
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