Fitness to Practise Frequently Asked Questions

 

These questions and the answers to them are intended as general guidance to the most commonly discussed issues relating to fitness to practice.  The responses are not legal advice and are not intended as such.  For more detailed information on fitness to practice, readers should review the relevant statutes and regulations and consult with independent legal advisors.

 

Index of Questions

 

What does Incapacitated mean?
What is the purpose of Fitness to Practise process?
How are the proceedings initiated?
What is the role of the Health Inquiry Panel?
What are the possible outcomes of the Fitness to Practise hearings?
Are the proceedings public?
Are decisions made public?
Can the decision be appealed?

Answers


What does Incapacitated mean?

The Health Professions Procedural Code, Schedule 2 (the “Code”) of the Regulated Health Professions Act, 1991 (RHPA), defines the term “incapacitated” as meaning that a member is suffering from a physical or mental condition or disorder that makes it desirable in the interest of the public that the member’s certificate of registration be subject to terms, conditions or limitations, or that the member no longer be permitted to practise.

A member with a physical or mental disability that has been properly addressed may not necessarily meet the definition of incapacitated; for example, a person who uses a wheelchair in an accessible workplace, or a person who has a mental or mood disability who takes appropriate measures to manage their condition may not necessarily meet the definition.
However, a member how has demonstrated a lack of insight into his or her illness, to the extent that there is a valid concern that she or she will practise inappropriately, will often be found to be incapacitated.

What is the purpose of Fitness to Practise process?

The fitness to practise provisions of the RHPA addresses situations where a member may be compromising patient care as a result of incapacity.
Incapacity proceedings differ significantly from disciplinary proceedings. First, incapacity hearings focus on whether the member is ill, not whether they have failed to maintain the standards of practice of the profession. A finding of incapacity usually results in rehabilitative rather than punitive measures.

How are the proceedings initiated?

Before a matter is referred to the Fitness to Practise Committee, an investigation (or inquiry) must occur in order to determine if the concerns are valid. The health inquiry process can be commenced in two ways:
  • Information that comes to the attention of the College suggesting that a member may be incapacitated is brought to the attention of the Registrar of the College.  If the Registrar believes the member may be incapacitated, the Registrar must, under section 57 of the Code, make inquiries he or she considers appropriate.  The results of these inquiries must be reported to a Health Inquiry Panel of the Inquiries, Complaints and Reports Committee (ICRC); or
  • A panel of the ICRC investigating a complaint or considering a report under section 26 of the Code may refer a member to a Health Inquiry Panel under section 58 of the Code for Incapacity proceedings.

What is the role of the Health Inquiry Panel?

The Health Inquiry Panel will conduct inquiries into a member’s health, consider all of the information obtained during the inquiries and consider any action, if any that should be taken. The panel may also require the member to undergo a physical or mental examination and may, subject to section 62 of the Code, make an order directing the Registrar to suspend the member’s certificate of registration until he or she submits to the examinations.
After considering all of the information obtained during the inquiries, the Panel may decide to refer the matter to the Fitness to Practise Committee for a hearing. Alternatively, the Panel might order a caution, recommend a disciplinary investigation, require an undertaking or take no action for the time being.

What are the possible outcomes of the Fitness to Practise hearings?

If a panel of the Fitness to Practise Committee finds that a member is incapacitated, it shall make an order doing any one or more of the following:
  1. Directing the Registrar to revoke the member’s certificate of registration.
  2. Directing the Registrar to suspend the member’s certificate of registration.
  3. Directing the Registrar to impose specified terms, conditions and limitations on the member’s certificate of registration for a specified period of time or indefinite period of time.
The panel may also specify criteria that must be satisfied for the removal of terms, conditions or limitations or for the suspension to be lifted.

Are the proceedings public?

Unlike disciplinary proceedings, incapacity proceedings are not public. Incapacity proceedings are strictly confidential and are intended to help the member regain their health while ensuring the public is protected from unsafe practice. Incapacity proceedings determine suitable restrictions and conditions on the member’s certificate of registration that are designed to enable the member to return to practise in a way that supports his or her recovery while helping to detect and prevent possible relapses.

Are decisions made public?

The public is entitled to know the results of an incapacity proceeding in which a member’s certificate of registration was revoked or suspended, or had terms, limitations or conditions imposed on it. This information is made available on the College’s Public Register.

If the Fitness to Practise Committee did not make a finding of incapacity, then no such information would be posted on the Register.

Can the decision be appealed?

The member may appeal a decision of the Fitness to Practise Committee to the Divisional Court.  Despite any appeal, an order or decision made by the panel or Committee will take effect immediately.