The regulation of laboratory assistants/technicians has been on the minds of many and is now the attention of a number
of laboratory stakeholders.  In fact, the College of Medical Laboratory Technologists of Ontario (CMLTO) has included the
exploration of regulation for lab assistants/technicians in its current strategic plan.  Over the course of the summer the
College conducted an environmental scan to evaluate the support it would have with this initiative.

We know that this subject has also been on the minds of many OSMT members.  The results of a survey done by the
OSMT indicate that, while generally both MLTs and MLA/Ts are in favour of regulation for lab assistants/technicians,
MLA/Ts need further education about what regulation is and how it would impact them.  So, a number of things need to
be done before taking the big step of filing an application for regulated health profession status with the Minister of Health
and Long-Term Care.  One of these is ensuring that MLA/Ts know exactly what it means to be a ‘regulated health
profession’ and that they are aware of the responsibilities that go along with it.  The OSMT is developing a communications
strategy for this educational process.

Another item that needs to be addressed is that of credentialing.  Since 1988, the OSMT Medical Laboratory
Assistant/Technician (MLA/T) Certification program has established quality standards for laboratory assistants and
technicians according to the requirements of Ontario laboratories.  MLA/T certification is based on current laboratory
workplace practices in Ontario and is in compliance with provincial regulations.  Over 6,500 individuals have worked
long and hard to earn their MLA/T Certificate.  The Society is committed to exclusively supporting this credential as
the entry-to-practice requirement in Ontario. 

Explaining regulation – what it is and what it takes to get there – is a challenging task.  In a nutshell, being a regulated
health profession means working within the framework of the Regulated Health Professions Act, 1991 (RHPA) using
the concept of ‘self-regulation’.  The RHPA regulates 23 health professions, including physicians, laboratory technologists,
nurses, psychologists, etc.

The RHPA is enforced by regulatory bodies called Colleges that govern and hold professionals accountable.  Regulated
health professionals must be able to put aside their self-interest in favour of the public interest; hence the primary
mandate of the Colleges is to protect the public using the processes stipulated by the RHPA.  Each College also has
its own profession-specific act that is written for the profession which it regulates, e.g. the Medical Laboratory Technology
Act.  Colleges are financially supported by the professions they govern.

How do healthcare providers achieve regulated health profession status?  A process has been put in place by the Ontario
government with the RHPA.  The RHPA mandates that there be an arms-length organization called the Health
Professions Regulatory Advisory Council (HPRAC) whose job it is to receive referrals from the Minister and advise him or
her on how to respond to submissions.  Submissions may include applications to become regulated, requests to change
the scope of practice of a profession, additions to the controlled acts listed in the RHPA and who is authorized to carry
them out, etc.  As a general rule, HPRAC consults with stakeholders, professions, and the public, in order to formulate
its recommendations to the Minister.

For healthcare provider groups wishing to be regulated, HPRAC has adopted the following nine criteria that must be met
for regulating a new profession under the RHPA: 

1.         Risk of Harm
A substantial risk of physical, emotional or mental harm to individual patients/clients arises in the practice of the profession.

2.         Sufficiency of Supervision
A significant number of members of the profession do not have the quality of their performance monitored effectively;
either by supervisors in regulated institutions, by supervisors who are themselves regulated professionals, or by
regulated professions who assign their professions’ services.

3.         Alternative Regulatory Mechanism
Regulation under the RHPA must be a more appropriate means to regulate the profession than other means.

4.         Body of Knowledge
The members of this profession must call upon a distinctive, systematic body of knowledge in assessing, treating or
serving their patients/clients.  The core activities performed by members of this profession must be discernible as a clear
and integrated whole and must be broadly accepted as such within the profession.

5.         Educational Requirements for Entry-to-Practice
To enter the practice of the profession, the practitioner must successfully complete a post-secondary program offered
by a recognized educational institution.  The educational program must be available in Canada.

6.         Leadership’s Ability to Favour the Public Interest
The profession’s leadership has shown that it will distinguish between the public interest and the profession’s self-interest
and in self-regulating will favour the former over the latter.

7.        Membership’s support and willingness to be regulated and likelihood of complying with regulation
The members of the profession support self-regulation for themselves with sufficient numbers and commitment that
widespread compliance is likely.  The practitioners of the profession are sufficiently numerous to staff all committees of
a governing body with committed members and are willing to accept the full costs of regulation.  At the same time, the
profession must be able to maintain a separate professional association.

8.         Economic Impact of Regulation
The profession must demonstrate an understanding and appreciation of the economic impact of regulation on the
profession, the public and the healthcare system.

9.         Public Need for Regulation
The profession must demonstrate that a significant public need would be met through regulation.

Currently HPRAC has a number of pending issues which it is considering for the Minister and will not likely be receiving
any additional referrals until its recommendations on these have been completed.  The Minister has requested that these
issues be cleared by March 31, 2006 at which time it is expected that new submissions will be received.   

The following article provides an excellent overview of the current issues referred to HPRAC.  The outcome of a number of
these will undoubtedly set the course for future submissions.