Proposed Changes to Ontario Regulation 682 (O. Reg. 682)

Background

On May 22, 2003, the Ministry of Health and Long Term Care (MOHLTC) issued a memo to a number of health care stakeholders seeking feedback on proposed amendments to Ontario Regulation 682 (O. Reg. 682).

The function of O. Reg. 682, a regulation pursuant to the Laboratory and Specimen Collection Centre Licensing Act, 1974, is to provide a general regulatory framework for the operation of laboratories. Of particular concern to the CMLTO is that the Regulation empowers the Director of Laboratories at the MOHLTC, to allow someone who is not a member of the CMLTO to be employed as a medical laboratory technologist.

Prior to the creation of the CMLTO, there was a clear and legitimate public policy purpose for the Ministry to set standards for persons who act as medical laboratory technologists in Ontario. After the creation of the CMLTO, logic and regulatory efficiency should have dictated that the Ministry would withdraw from this activity and leave it exclusively to the CMLTO. This did not happen, and as a consequence, there are now two regulatory streams for the de facto registration of medical laboratory technologists: one operated by the CMLTO under the Regulated Health Professionals Act; and another operated by the Ministry under O. Reg. 682.

CMLTO has had numerous discussions with the MOHLTC, expressing its concerns with this duplication. The CMLTO also raised the issue with the Government's Red Tape Commission and presented the Commission, as well as MOHLTC with some alternatives to rectify the duplication. The Ministry responded with the aforementioned discussion paper, outlining proposed amendments to O. Reg. 682.

MOHLTC Proposed Amendments to O. Reg. 682

According to the Ministry, the goal of the proposed amendments to O. Reg. 682 is to "ensure that appropriately qualified staff continue to be available to meet Ontario's laboratory staffing needs as new technologies are developed".

The proposed amendments are as follows:

• Delete "laboratory technologist" in recognition that it is a protected title.
• Recognize individuals with certificates of registration in good standing from the College of Medical Laboratory Technologists of Ontario.
• Recognize individuals with certificates of registration in good standing from the College of Medical Radiation Technologists of Ontario, or from the College of Respiratory Therapists of Ontario, for the practice of that part of the profession that includes the performance of the tests.
• Retain university degrees and the current equivalency provision to be approved by the Director.

CMLTO's Response

On July 15, 2003, the CMLTO responded to the MOHLTC's proposed amendments. In its response, the CMLTO expressed its support for amending O. Reg. 682 to reflect the current regulatory environment in Ontario.

In particular, the CMLTO supports and has always supported the following amendments proposed by the Ministry:

• Recognition of "medical laboratory technologist" as a protected title.
• Recognition of CMLTO members
• Recognition of CMRTO and CRTO members who perform laboratory tests as part of their professional practice.

However, the CMLTO is emphatically opposed to the following amendment:

• Retain university degrees and the current equivalency provision to be approved by the Director.

The CMLTO believes that this amendment is at odds with the provisions of the RHPA and will perpetuate the current dual regulatory system which is unnecessary and potentially puts public health and safety at risk.

Under RHPA, regulated health professionals must meet minimum entry to practice criteria set by their College prior to being registered and once registered must adhere to the standards of practice and code of professional conduct of the profession. It has never been clear exactly what entry to practice criteria are being used when the Director exercises discretion under O. Reg. 682. This is an unacceptable risk to the public when one considers the importance of laboratory test results to patient health.

The CMLTO believes that the public of Ontario should be able to expect that their laboratory tests are being performed by regulated health professionals who are accountable and must maintain the established standards of practice. If the Director of Laboratory Licensing retains the discretion to allow unregulated individuals to conduct laboratory tests, the public will not have this assurance.