The Health Professions Appeal and Review Board (HPARB) is an independent adjudicative body established under the Regulated Health Professions Act (RHPA). The RHPA reviews certain types of decisions made by regulatory health care bodies and Colleges in Ontario. It is the final legislative venue of review.
The most common type of adjudication follows the request by a health care professional or patient, to review the decision of the Inquiries, Complaints and Reports Committee of one of the applicable self-regulating health profession colleges in Ontario.
Complaint Review Mandate
The HPARB is granted authority to review the outcomes of decisions made by the applicable health professional college’s following a complaint pursuant to the Health Professions Procedural Code (HPPC) which is found as Schedule 2 to the RHPA. That authority though is limited to considering, in its review, the adequacy of the committee’s investigation or the reasonableness of its decision or both.
Either party to the process may request a review of the Committee’s decision. The parties are entitled to have a lawyer or agent represent them. The parties do generally attend the hearings. The health care workers are invariably represented by counsel. The applicable College, although not a party, is generally present through a representative.
Complaint reviews are conducted orally in person, by teleconference or by written proceedings. They are conducted in most major centres throughout the province.
Adequacy of an Investigation
The requirement is to ensure that the relevant Committee has conducted its investigation such that all of the essential information had been obtained which is relevant in order to be able to make an informed decision regarding the complaint. It does not need to be an exhaustive investigation.
This means that not every possible document, record, and/or memorandum needs to be obtained and reviewed. If additional material is suggested as being relevant, which the Committee did not have or ignored, the test for adequacy is whether the information, if it had been obtained or reviewed, would be expected to have changed the Committee’s decision. If it would the investigation is considered inadequate, the converse being if it would not, the investigation would be considered adequate.
Reasonableness of the Decision
The HPARB role is not to decide whether it would have arrived at the same decision as the Committee below. Rather the Board must consider whether the decision below can reasonably be supported by the information it had before it and that it can further, withstand a somewhat probing examination. In doing so the Board considers whether the decision made falls within a range of reasonable, possible and acceptable outcomes. The decision must also be defensible based on the facts and the law.
Decisions can be given orally at the hearing but that is a rarely done. Most often the decision is rendered in writing and delivered to all parties a few months after the hearing.
The Board may,
- Confirm all or any part of the Committee’s decision;
- Make recommendations to the Inquiries, Complaints and Reports Committee (regarding, for example, professional standards or practice issues); or
- Require the Inquiries, Complaints and Reports Committee to do things it has the jurisdiction to do, such as further investigating and/or considering all or particular aspects of the complaint, or to make a particular disposition of the matter such as;
- Taking no further action;
- Requiring remedial action of the member who is the subject of the complaint; or
- Referring the health care professional under investigation to the applicable Discipline Committee.
The Board cannot recommend or require the Committee to do things outside its jurisdiction. This includes requesting a finding of misconduct or incompetence. It also may not require a referral of allegations to the applicable Discipline Committee that would not, if proved, constitute either professional misconduct or incompetence.
At Wise Health Law, we focus on health and administrative law, including matters relating to appearances and representation before the Health Professions Appeal and Review Board. Our lawyers have significant trial and appellate experience and are passionate about helping regulated health professionals and healthcare organizations understand and protect their legal rights. We will guide you through the HPARB hearing process, help you understand potential risks and legal implications, and assist you with or skillfully represent you at the proceedings. To find out how we can assist, contact us online, or at 416-915-4234 for a consultation.