Law and Legislation: Canadian health care system and chiropractic, provincial legislation, professional regulatory bodies
The Canadian Health Act structures the health care system in Canada (1). This act is a federal legislation that establishes specific conditions for each province and territory, in which health care can be maintained (8). Since this act was established to accommodate the overall health care needs of the country, it is founded on five common principles (1). These five principles include: public administration, comprehensiveness, universality, portability, as well as accessibility (1). This foundation sets a certain standard of care, making it possible for every Canadian to have access to health care (2). In relation to the Canadian Health Act, each province and territory is responsible for providing and facilitating their unique health care system, which is funded by the federal government (2).
Much like other health professions, chiropractic is regulated Canada wide, and is also managed specifically in each Canadian province and territory. The distinction between the control of chiropractic and other health care services is that chiropractic is not yet federally funded to become an insured primary health care (2). Thus, the standard of chiropractic care is regulated not by the Canadian Health Act, but by the Canadian Chiropractic Association (CCA) (2). The CCA has a mission to have chiropractic integrated into the health care system by 2023 (2). The CCA is a governing body led by a board of directors, whose task is protecting chiropractic in the public light (2). It is divided into ten provincial and three territorial associations, each with their respective regulating bodies, who are responsible for licencing chiropractors, establishing standards of practice, and protecting the public (2).
In Ontario, the regulating body under the CCA is the Ontario Chiropractic Association (OCA) (3). The OCA was established to represent Ontario chiropractors (3). The OCA serves to advance the use and understanding of chiropractic in Ontario by supporting advertising, research, and public education (3). Another governing body in Ontario is the College of Chiropractors of Ontario (CCO), which regulates the province’s chiropractors, and is established by the provincial government (4). In order for chiropractors to practice in the province of Ontario, they must obtain a licence from the CCO (4). It is through this licencing and registration that the CCO sets the chiropractic standards in the province (4). Seeing as chiropractic is a self-regulated profession, it is evident that the CCO is an essential part of setting and maintaining standards of practice throughout the province (4). If this standard of practice is violated or not attained, the public has a right to contact the CCO about a certain practitioner, and the CCO can launch an investigation can discipline accordingly (4).
The CCPA (Canadian Chiropractic Protective Association) is an association created to that protects chiropractic professionals from any liability claims (5). Specifically, the CCPA protects its members and the public from malpractice, negligence and liability claims (5). The CCPA was formed by the CCA, and essentially is made of chiropractic lawyers how aim to protect the profession. Similar to the CCO licence, chiropractors of Canada must be insured under the CCPA to practice (5). Further protection is offered to the profession from the CCPA with the clinical consent forms they provide, which may be used in events of a liability claim (5).
Two more very important acts that set the grounds for standards of practice in Ontario and throughout Canada are the Personal Health Information Protection Act (PHIPA) and the Personal Information Protection and Electronic Documents Act (PIPEDA), respectively (6, 7). These acts are similar in that they strive to protect patient information from being disclosed, used or collected (6, 7). This pertains to chiropractic as it is a privatized profession and must abide by the laws of patient confidentiality (6, 7).
In conclusion, chiropractic is a highly regulated profession, as it is governed by many bodies, and under legislation of multiple acts. This is all in the best interest of the profession, as it aids in establishing a certain standard of care chiropractic must meet.