Policy Tensions in Regulatory Reform: Changes to Regulation of Health Professions in Australia, the United Kingdom, and Ontario, Canada

Leslie, Kathleen; Nelson, Sioban; Deber, Raisa; Gilmour, Joan M.

doi:10.1016/s2155-8256(17)30180-1

Cited by 21 publications

(21 citation statements)

References 12 publications

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“…Despite the involvement of these secondary stakeholders, the growing number of reports of misbehavior by individual professionals or firms raises the possibility of professions losing public respect and of becoming stigmatized (Dixon-Woods et al, 2011;Gabbioneta, Prakash, & Greenwood, 2014;Leslie, Nelson, Deber, & Gilmour, 2018;Muzio et al, 2019). A recent poll in Italy, for example, shows that Italian bankers "who used to be seen as pillars of the community" are no longer praised and even ranked "as among the most untrustworthy professionals" (The Economist, 2019: 68).…”

Section: Professions and Stigmamentioning

confidence: 99%

From Grace to Violence: Stigmatizing the Medical Profession in China

Wang

Raynard

Greenwood

2021

AMJ

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This study examines how the once prestigious medical profession in China has become criticized to the point of inducing widespread violence by patients. Drawing on archival documents, media articles, interviews, and secondary sources, we trace the lengthy and uneven trajectory by which the profession moved from collective approval through ambivalence towards stigmatization. We develop a process model of professional stigmatization that identifies dynamics that precipitate and then catalyze that trajectory; and highlight the underpinning mechanisms. By unpacking the complex process of stigmatization, the study extends understanding of how aspects of stigma emerge, and are attached by different stakeholders to a profession, and the consequences that follow. We conclude by highlighting implications for research on stigma and the challenge of stigma containment.

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Section: Professions and Stigmamentioning

confidence: 99%

From Grace to Violence: Stigmatizing the Medical Profession in China

Wang

Raynard

Greenwood

2021

AMJ

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“…Examination of regulated and unregulated Australian T&CM professions indicates that self-regulatory mechanisms are not as effective for improving public protection when using T&CM services [ 109 ]. Furthermore, research on health care workforce regulatory frameworks and reforms emphasise the growing global focus on the public interest, a move away from self-regulatory governance models, and increased independence of complaints handling and oversight of disciplinary proceedings [ 27 , 110 ].…”

Section: Discussionmentioning

confidence: 99%

Stakeholder attitudes to the regulation of traditional and complementary medicine professions: a systematic review

2021

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Background There has been a considerable increase in the number of traditional and complementary medicine (T&CM) practitioners over the past 20 years and in some jurisdictions are estimated to outnumber general practitioners. Despite this globally significant role, it is apparent that worldwide not all T&CM professions operate under adequate accountability and regulatory oversight for maintaining public protection. To date there has been no published systematic examination of stakeholder opinions regarding regulated and unregulated T&CM occupations. In response, this review aims to investigate, describe, and analyse attitudes held by a range of stakeholder groups towards the regulation of T&CM professions. Methods A database search of AMED, CINAHL, Embase, Ovid MEDLINE, ProQuest, PsycINFO, PubMed, Scopus, and Google Scholar was conducted for original research published between 2000 and 2020 on stakeholder opinions regarding the regulation of T&CM professions. Results Sixty studies across 15 countries reported on the views of six health care stakeholder groups: consumers, T&CM practitioners, conventional medicine practitioners, professional associations, education providers, and policy-makers. Across all stakeholder groups there was between 15% and 95% (median 61%) support for, and 1% to 57% (median 14%) opposition to the regulation of various T&CM professions. The main reasons for supporting regulation included providing greater public protection, raising training and practice standards, establishing title protection, and gaining acceptance from conventional medicine providers. Concerns regarding regulation included potential restrictions to practice, misappropriation of practice, and medical oversight of T&CM practitioners. Few studies canvassed the views of professional associations (n = 6), education providers (n = 2), and policy-makers (n = 2). Conclusions There appears to be broad support for the regulation of T&CM professions, although there was wide variation in attitudes as to how this should be applied. Further research, with a particular focus on policy-makers, education providers, and professional associations, is critical to inform appropriate health policy and practice recommendations relating to T&CM professional regulation across jurisdictions. Systematic review registration: the a priori protocol for this systematic review was registered in PROSPERO and is available at: www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42020198767.

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“…In comparison, international jurisdictions have historically regulated the nursing and midwifery professions under a single umbrella, including the Nursing and Midwifery Council in the United Kingdom, the Nursing and Midwifery Board of Australia, and certain states in the United States. There is also a wider international trend moving away from regulating professions in silos and instead encouraging collaborative forms of regulation (Leslie et al 2018).…”

Section: History and Contextmentioning

confidence: 99%

“…The policies stream included a recent emphasis on improving economic accountability and reducing the costs associated with professional regulation. These considerations are increasingly being used in the discourse around defining public interest in Canada (Adams 2016) and have been a major driver of change in both Australia and the United Kingdom (Leslie et al 2018). While a complex endeavour (particularly during the pandemic), the amalgamation was a technically feasible policy option given amendments to the Health Professions Act in 2017 to allow the amalgamation of regulators, including the prior amalgamation experience of the nursing regulators.…”

Section: Factors That Influenced How and Whymentioning

confidence: 99%

The Regulatory Amalgamation for Nursing and Midwifery in British Columbia

Leslie

Benoit

Freeman

et al. 2021

HRO-ORS

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On 1 September 2020, Canada's first combined nursing-midwifery regulator was created with the amalgamation of the separate nurse and midwife regulators in British Columbia (BC). The highly critical Cayton Report on health profession regulation, the previous experience of amalgamating nursing regulators in BC, and a broader call for more efficient and effective regulation were factors influencing this reform. The goals of the reform were to increase regulatory efficiency (by maximizing economies of scale) and effectiveness (by ensuring adequate resources to meet the public interest mandate) and, for the regulators, to control the pace and progress of the amalgamation ahead of impending government dictate. These goals of the regulators' proposal to amalgamate clearly fit with the BC government's vision for modernizing health profession regulation. To implement the amalgamation, the BC government released an Order in Council on 8 June 2020 that amended various regulations under BC's Health Professions Act and confirmed the September 1 date of amalgamation. There is currently no clearly articulated evaluation plan for this reform; however, evaluating regulatory efficiency and effectiveness in the interests of the public is likely to be a focus moving forward for both regulators and governments.

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Policy Tensions in Regulatory Reform: Changes to Regulation of Health Professions in Australia, the United Kingdom, and Ontario, Canada

Cited by 21 publications

References 12 publications

From Grace to Violence: Stigmatizing the Medical Profession in China

From Grace to Violence: Stigmatizing the Medical Profession in China

Stakeholder attitudes to the regulation of traditional and complementary medicine professions: a systematic review

The Regulatory Amalgamation for Nursing and Midwifery in British Columbia

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