Canada - World Health Organization Regional Office for Europe

Health systems in transition Canada 51
Ontario’s ministry of health has been among the most active governments
in Canada in using regulation as a tool in human resource policy and
planning (O’Reilly, 2000). This has included the introduction of a single law
that provides a common regulatory framework for all the health professions
and the establishment of a permanent Health Professions Regulatory Advisory
Council (HPRAC) in the 1990s. The goals of the law include promoting
higher quality care, treating professionals equitably by providing a single set
of regulatory principles, improving the accountability of the professions to
patients and providing more choice by ensuring access to a range of providers.
In its 2006 report, HPRAC recommended a number of changes to the 21
regulatory colleges governing 23 health professions under Ontario’s Regulated
Health Professions Act to facilitate more effective human resource policy and
planning. For example, HPRAC recommended that new stand-alone colleges
with the powers of self-regulation be created for psychotherapists, kinesiologists,
naturopaths and homeopaths, and that optometrists be granted authority to
prescribe pharmaceutical therapies (HPRAC, 2006).
2.8.4 Regulation and governance of pharmaceuticals and natural
health products
Only physicians are legally permitted to prescribe a full range of pharmaceutical
therapies. However, in recent years, a number of provincial governments have
changed their laws and regulations in order to permit some providers, including
nurse practitioners, pharmacists and dentists, to have limited authority to
prescribe pharmaceutical therapies within their respective scopes of practice.
Through its Therapeutic Products Directorate and the Biologics and
Genetics Therapies Directorate, Health Canada determines the initial approval
and labelling of all prescription drugs. In 2004, the Natural Health Products
Directorate was established, and Health Canada began to regulate traditional
herbal medicines, vitamins and mineral supplements as well as homeopathic
preparations in terms of initial approval and labelling. Health Canada also
prohibits direct-to-consumer advertising (DTCA) of prescription drug products,
a prohibition that has been challenged as contrary to the Charter of Rights and
Freedoms by one of Canada’s largest media chains (Flood, 2010). Despite the
current prohibition, a large proportion of the Canadian public is influenced
by DTCA through cable and satellite television networks that originate in the
United States where DTCA is permitted. Advertising of prescription drugs to
health professionals is subject to federal legislation as well as to advertising
and ethical practices codes established by industry associations (Mintzes et al.,
2002; Paris & Docteur, 2006).