Fourth Session,

46th General Assembly

60 Elizabeth II,

BILL 22

AN ACT RESPECTING THE PRACTICE OF

MEDICINE IN THE PROVINCE

Received

and Read the First Time ...................................................................

Second

Reading ..............................................................................................

Committee ......................................................................................................

Third

Reading .................................................................................................

Royal

Assent ...................................................................................................

HONOURABLE JEROME P.

KENNEDY, Q.C.

Minister of Health

and Community Services

Ordered to be printed by

the Honourable House of Assembly

EXPLANATORY NOTES

This Bill would repeal and substitute

the Medical Act, 2005. The Bill would

incorporate quality assurance

measures by authorizing the appointment of a quality assurance committee to

perform quality assurance reviews, and by requiring compliance with those

reviews;

incorporate mandatory

continuing medical education and continuing competency measures;

revise and update disciplinary

processes; and

revise and update requirements

for licensure, and would include a provision which would authorize a limitation

on the scope of practice under a licence.

A BILL

AN ACT RESPECTING THE PRACTICE OF MEDICINE

IN THE PROVINCE

Analysis

Short title

Definitions

PART

MEDICAL ASSOCIATION

Association continued

Objects

Application of Corporations Act

Membership

PART

THE COLLEGE

College continued

Objects of the college

Council of college

Annual meeting

College officers

Quorum

Powers of council

Appointment of committees

By-laws

Regulations

Fees

PART

III

LICENSING AND REGISTRATION

Qualification for registration

Registration of specialists

Registration of students

Registers

Statements may require attestational

oath or affirmation

Appeal to Trial Division

Licence to practise

Provisional licences

Examination of applicants

Agreements

Validity of certificates

Continuing and remedial education

PART

PROFESSIONAL MEDICAL CORPORATIONS

Definitions

Professional corporation

Corporate register

Annual licence

Revocation of licence

Refusal to register or issue licence

Effect of incorporation

Liability of medical practitioner

Misconduct of a professional medical

corporation

PART

DISCIPLINE

Definitions

Committees

Report by member

Allegation

Effect of filing allegation

Complaints authorization committee

Adjudication tribunal

Hearing

Copies of books, etc. as evidence

Guilty plea by respondent

Powers of adjudication tribunal

Filing and publication of decisions

De-registration and suspension

Failure to comply

Reinstatement and readmission

Costs of the college

Collection of fine

Appeal

PART

PEER ASSESSMENT

Peer assessment committee

Agreement

Peer assessment program

Assessors

Assessment

Report and compliance

Costs

Termination of assessment

Annual report

Disclosure of information not required

Other documents

Evidence in disciplinary matter

PART

VII

QUALITY ASSURANCE

Quality assurance committee

Medical practitioner shall comply

Conduct of a review

Costs

Termination of review

PART

VIII

MISCELLANEOUS

Emergency treatments: liability

Disclosure of information

Protection from liability

Other prescription practices

Conflicting legislation

Offence

PART

TRANSITION, REPEAL AND COMMENCEMENT

Transition

RSNL1990 cM-4.01 Rep.

NLR 29/00 Rep.

Commencement

Be it enacted by the Lieutenant-Governor and

House of Assembly in Legislative Session convened, as follows:

Short title

1. This

Act may be cited as the Medical Act, 2011.

Definitions

2. In

this Act

(a) "assessment" means an assessment

directed by the peer assessment committee under the peer assessment program;

(b) "assessor" means an assessor

appointed by the peer assessment committee under

section 60 ;

(c) "association" means the Newfoundland and

Labrador Medical Association referred to in

section 3 ;

(d) "college" means the college

continued under

section 7 ;

(e) "council" means the council referred

to in

section 9 ;

(f) "licence" means a licence issued

under this Act to engage in the practice of medicine, and includes a provisional

licence;

(g) "medical practitioner" means a

person who is registered under this Act or who holds or has held a licence;

(h) "medical regulatory authority" means

a medical regulatory authority that has powers and duties substantially the

same as those of the college;

(i) "medical societies" means a medical society

or medical association of a province or territory of Canada ;

(j) "minister" means the minister

appointed under the Executive Council Act

to administer this Act;

(k) "peer assessment committee" means a

committee established under

section 57 ;

(l) "peer assessment program" means the

peer assessment program established under

section 59 ;

(m) "practice of medicine" means the

practice of medicine or surgery on the human body, and includes cardiology,

dermatology, geriatrics, gynecology, neurology, obstetrics, ophthalmology,

orthopedics, pathology, pediatrics, psychiatry and radiology and other

specialities and subspecialties of medicine;

(n) "professional medical corporation"

means a corporation that is permitted by this Act to provide the services of a

medical practitioner;

(o) "record" means a record of

information in any form, and includes information that is written, photographed

or stored in any manner, but does not include a computer program or a mechanism

that produced records on any storage medium;

(p) "register" includes the medical

register, education register, register of specialists, corporate register and

any other register established by the council in accordance with the by-laws;

and

(q) "registrar" means the medical

practitioner appointed as registrar under

section 11 .

PART I

MEDICAL ASSOCIATION

Association continued

3. The

Newfoundland

and Labrador Medical Association is continued as a corporation without share

capital for the purposes of

Part XXI of the Corporations

Act .

Objects

4. The

objects of the association are

(

a) to promote and advance medical and related

arts and sciences in all their branches, to increase the knowledge, skill,

standard and proficiency of its members in the practice of medicine, and to

maintain the honour and integrity of the medical profession;

(

b) to help in the furtherance of measures

designed to improve health and prevent disease and disability;

(

c) to co-operate with and to help public and

private medical associations, agencies and commissions properly engaged in the

task of providing or financing medical and health services of all kinds;

(

d) to promote measures designed to improve

standards of hospital and medical services; and

(

e) to improve the welfare and social standards of

its members and encourage the co-operation of its members in the protection of

their legal and equitable rights.

Application of Corporations Act

(1) Notwithstanding

its continuation as a corporation under this Act, the Corporations Act applies to the association and it shall be governed

by that Act for all purposes, including a change of name of the association.

(2) In addition to its powers and duties under

subsection (1), the association may

(

a) act as an agent within the province for the

Canadian Medical Association, or another association recognized as representing

medical practitioners in Canada, and to collect and remit fees levied by that

association; and

(

b) act on behalf of its members or a group or

section or division of its members, and negotiate for, and on their behalf,

with other persons or agencies, including government agencies.

Membership

6. All

persons who

(

a) are holders of a licence; and

(

b) pay the fee for membership

shall, notwithstanding anything contained

in the by-laws, be members of the association and shall have full voting rights

in the association.

PART II

THE COLLEGE

College continued

(1) The

College of Physicians and Surgeons of Newfoundland and Labrador is continued as

a corporation without share capital for the purpose of

Part XXI of the Corporations Act .

(2) All persons who hold a licence issued under

this Act are members of the college.

Objects of the

college

(1) The

college is authorized to regulate the practice of medicine and the medical

profession in the public interest.

(2) The objects of the college include

(

a) the promotion of

(

i) high standards of practice, and

(ii) continuing competence and quality improvement

through continuing medical education;

(

b) the administration of a quality assurance

program; and

(

c) the enforcement of standards of conduct.

Council of

college

(1) The

council shall consist of

(a) 7 medical practitioners, referred to in this

Act as "elected members", who hold a current licence and are elected

by secret ballot in accordance with the by-laws, 4 of whom shall be medical

practitioners who live in or carry on the practice of medicine in the region of

the City of Mount Pearl and the City of St. John's and 3 of whom shall be

medical practitioners who live in or carry on the practice of medicine in the

remainder of the province;

(b) 4 persons appointed by the minister, 3 of whom

shall not be medical practitioners, who are suitable to represent the public

interest, and one of whom shall be appointed from a list of not less than 3

nominees submitted by the Board of Regents of the Memorial University of

Newfoundland; and

(c) 2 medical practitioners appointed by the

minister, both of whom shall be appointed from a list of not less than 4 nominees

submitted by the association.

(2) Where a vacancy occurs in the membership of

the council as a result of the death, retirement, resignation or incapacity to

act of that member, the vacancy shall be filled

(

a) in the case of an elected member, by secret

ballot in accordance with the by-laws; and

(

b) in the case of another member, by appointment

in the manner provided in paragraph (1)(

b) or (c).

(3) When a vacancy is filled under subsection (2),

the person filling the vacancy shall serve only for the remainder of the term

of office of the member being replaced, and that person is eligible for re-election

or reappointment.

(4) A member of the council shall be elected or

appointed for a term of 3 years and is eligible for re-election or

re-appointment, but a member shall not serve on the council for a continuous

period exceeding 9 years.

(5) Notwithstanding subsection (4),

(

a) an elected member is eligible for appointment

to the council under paragraph (1)(c); and

(

b) a member appointed under paragraph (1)(

c) is

eligible for election as an elected member,

notwithstanding that the period of

membership may be for a continuous period exceeding 9 years.

(6) Where the term of office of a member of the council

expires and a successor has not been elected or appointed, that member may continue

to hold office until a successor is elected or appointed but time served by

that member under this subsection shall not be counted for the purpose of subsection

(4).

(7) The council governs the college and may

exercise the powers of the college in the name and on behalf of the college.

(8) A decision or action of the council under this

Act whether that decision was made before or after the coming into force of

this subsection, is not invalid or ineffective by reason only of a defect or

invalidity in the

(

a) regulatory requirement concerning the election

of council members;

(

b) regulatory requirement concerning the

qualifications of a council member; or

(

c) constitution of the council.

Annual meeting

(1) The

college shall hold an annual general meeting at a time and place in the

province that the council may determine, and may hold other meetings during

each year within St. John's upon the request of the chairperson, or the

registrar, or of 3 members of the council.

(2) At its annual general meeting the college

shall

(

a) appoint an auditor to audit the accounts of

the college and to report on the financial statements of the college; and

(

b) consider and vote on those other matters

required by the by-laws.

(3) The council shall prepare and submit to the

minister before July 1

(

a) a report on the activities of the college; and

(

b) the college's audited financial statements.

(4) The report referred to in paragraph (3)(

a) shall contain statistics respecting the frequency and circumstances of access

to patient records without patient consent under

section 71 .

(5) Where the council fails to comply with subsection

(3) or (4), the college is guilty of an offence and on

summary conviction may

be fined $1,000.

College officers

(1) At

a meeting for the purpose, held in accordance with the by-laws, the council shall

elect from its members

(

a) a chairperson who shall preside over meetings

of the college and the council; and

(

b) a vice-chairperson who shall, in the absence

of the chairperson, preside over meetings of the college and the council.

(2) The council shall appoint a medical

practitioner to be registrar and another to be a deputy registrar, either from

among the members of the council or from outside the council, and where the

registrar or deputy registrar is not an elected member he or she shall not have

a vote.

(3) The council may appoint one or more medical

practitioners as assistant registrars and may assign them duties which may

include duties assigned to the registrar by this Act.

(4) The registrar and the deputy registrar are, by

virtue of their offices, members of the council where they are appointed from

outside the council and in that case they are not subject to subsection 9 (4).

(5) Where the registrar and deputy registrar are

appointed from among the members of the council they may, with the approval of

the minister, be exempted from subsection 9 (4).

(6) The registrar shall carry out the duties

imposed upon the registrar by this Act and shall control all matters relating

to the finances of the college, including the receipt of all money paid to the college,

and the making of disbursements on behalf of the college.

(7) The deputy registrar may carry out the duties

and functions of the registrar where he or she is absent or unable to act or

where they are assigned to him or her by the council.

(8) At meetings of the council, each member of the

council shall have one vote and in the case of a tie, the chairperson or, in

the absence of the chairperson, the vice-chairperson shall have a second or

casting vote.

(9) Except where prohibited in the by-laws, a

member of the council may, where all the members of the council consent,

participate in a meeting of the council by means of the telephone or other telecommunication

device that permits all persons participating in the meeting to communicate

with each other.

Quorum

12. Six

members of the council, one of whom is a member appointed by the minister to

represent the public interest, shall constitute a quorum for a meeting.

Powers of council

(1) The

council shall govern the college, administer its affairs and exercise in the

name and on behalf of the college the powers, privileges and rights of the

college.

(2) The council may delegate duties to an employee

whenever they consider it necessary or desirable to do so.

(3) The council may

(

a) appoint delegates or representatives of the college

to represent the college and authorize their expenses;

(

b) employ persons on behalf of the college,

prescribe their duties and establish and pay compensation and benefits;

(

c) provide for inquiries, investigations,

inspections and audits for the purpose of ascertaining compliance with this Act

or the regulations;

(

d) prescribe the consequences of non-compliance

with this Act or regulations; and

(

e) enter into agreements with bodies similarly

constituted and having similar objects and authority respecting the recognition

of the registration and licensing of medical practitioners in each others

jurisdictions.

Appointment of

committees

(1) The

council may appoint committees and establish the duties and responsibilities of

the committees.

(2) The council may delegate a duty or power given

it by this Act to a committee.

(3) An action or decision of a committee to which

the council delegates a duty or power is considered to be the action or

decision of the council.

By-laws

(1) The

council may make by-laws

(

a) providing for the holding and procedure of its

and the college's meetings;

(

b) providing for a quorum for a meeting of the

college and the matters of business that may be addressed and voted on at a

meeting of the college;

(

c) providing for the election of members of the

council under paragraph 9 (1)(a);

(

d) respecting the participation of members of the

council in a meeting of the council by telephone or other telecommunications

device under subsection 11 (9);

(

e) providing for the types of registers to be

kept by the registrar and the maintenance, form and contents of them;

(

f) respecting the remuneration, and allowances

payable to members of the council for attending meetings and for carrying out

the functions of the council under this Act, with power to prescribe different

rates for different members and different functions;

(

g) respecting the appointment, termination and

duties of staff;

(

h) respecting the remuneration and payment of

travel expenses of members of committees and adjudication tribunals;

(

i) establishing a code of ethics which shall

include

(

i) a definition of "professional misconduct"

and "conduct unbecoming a medical practitioner" for the purposes of sections

39 to 56 ,

(ii) standards governing the practice of medicine,

including standards of professional competence and of capacity and fitness to

practise, and

(iii) rules respecting methods of advertising;

(

j) providing for voting at meetings of the

college and the council;

(

k) respecting the term of certificates and

licences;

(

l) respecting the information and verification of

information required of applicants for registration or licensing;

(

m) providing for the manner in which a matter may

be determined to be satisfactory to the council, and the manner in which a

matter may be approved by the council;

(

n) the recognition of medical schools, including

osteopathic medical schools, courses and examinations for the purposes of

registration and licensing; and

(

o) generally, to assist in the administration of

this Act and the regulations.

(2) A by-law may be made, amended or repealed at a

meeting of the council if 30 days notice, or the shorter period to which

members of the council may consent, is given of the intention to make, amend or

repeal a by-law, and of the meeting, to the members of the council.

(3) The council shall have the by-laws available

for inspection by the public on reasonable notice and at reasonable hours.

Regulations

(1) The

council may, with the approval of the minister, make regulations respecting

(

a) the conduct of inquiries, investigations,

inspections and audits for the purpose of determining compliance with the

Act or regulations;

(

b) the conduct and nature of examinations,

including the subjects for examinations;

(

c) the registration of persons under this Act;

(

d) the requirement of persons licensed to practise

medicine or admitted on to a register to carry professional liability insurance

or other liability protection;

(

e) the temporary registration and licensing of

medical practitioners for particular purposes including the undertaking of

special projects or procedures which, in the opinion of the council, warrant

that temporary registration and licensing;

(

f) the requirements, including education and

practice experience requirements for the licensing and registration of specialists,

medical practitioners and students, with power to adopt requirements set by

recognized medical bodies or associations of Canada;

(

g) the circumstances under which a waiver of

registration and licensing or of a registration or licensing requirement may be

made for a particular purpose;

(

h) the scope of practice and the terms and

conditions of a licence under subsection 24 (2);

provisional licences may be issued, granted or renewed;

a provisional licence holder;

(

k) the registration and annual licensing of

professional medical corporations;

(

l) post-graduate training;

(

m) the quality assurance program referred to in

subsection 69 (2);

(

n) continuing and remedial medical education

programs;

(

o) the duties and responsibilities of a sponsor

of a provisional licence holder;

(

p) the collection, use and disclosure of records

containing personal health information as defined in the Personal Health Information Act obtained in the context of a

quality assurance review undertaken under

section 71 ;

(

q) the monitoring and verification of medical

practitioner prescribing practices;

(

r) alternative dispute resolution for the

purposes of

section 44 and the procedure for

that resolution;

(

s) time limits for events in the disciplinary process

in sections 39 to 56 ,

including time limits for

(

i) the filing of an allegation,

(ii) the resolution of an allegation by the

registrar,

(iii) the conduct of an investigation under

section 44 ,

(iv) consideration of an allegation by the complaints

authorization committee following completion of an investigation,

(

v) responding to a complainant and respondent at

each stage of the process,

(vi) the conduct of a practice review under paragraph

44 (1)(

b) or an investigation under paragraph 44 (1)(d),

(vii) the appointment of an adjudication tribunal

under

section 45 , and

(viii) the conduct of a hearing and the filing of a

decision or order by an adjudication tribunal following completion of the

hearing;

(

t) peer review and assessment of medical practitioners;

(

u) the appointment of the peer assessment committee

under

section 57 ;

(

v) agreements made under

section 58 including required clauses for those agreements

respecting peer assessment committees, cost sharing, budgets, reports,

representation on the peer assessment committee, incorporation and the administration

of the peer assessment committee and program;

(

w) the disclosure of information under

section 75 , including

(

i) the purpose for which information shall be disclosed,

(ii) the manner and time periods in which

information shall be disclosed, and

(iii) the persons to whom information shall be

disclosed; and

(

x) generally to give effect to the purpose of this

Act.

(2) Notwithstanding subsection (1), the minister

may make regulations to prescribe time limits for events in the disciplinary

process under sections 39 to 56 where the council does not do so in a time period

the minister considers reasonable.

Fees

(1) The

council may set and collect fees for the purposes of this Act.

(2) In setting fees the council shall ensure the

fees are sufficient to enable it to perform its duties under this Act, to the

extent practicable.

(3) The council shall apply all fees collected by

it to the performance of its duties.

PART III

LICENSING AND REGISTRATION

Qualification for

registration

18. A

person who

(

a) holds a medical degree granted by a medical

school or an osteopathic medical school approved by the council;

(

b) is a licentiate of the Medical Council of

Canada;

(

c) has completed the post-graduate education and

training approved by the council as qualifying a person for registration on the

medical register; and

(

d) possesses the other qualifications and meets

the other requirements that may be prescribed in the regulations as qualifying

a person for registration on the medical register

is entitled to be registered in the

medical register upon payment of the fee for registration set by the council.

Registration of

specialists

(1) A

person who

(

a) holds a licence under this Act;

(

b) holds the certification of the Royal College

of Physicians and Surgeons of Canada, or of another Canadian certification

body, approved by the council, as qualifying a person for registration on the

specialist register;

(

c) if he or she does not hold the certification

referred to in paragraph (b), holds the other specialist qualifications as may

be approved by the council as qualifying a person for registration on the

specialist register; and

(

d) possesses the other qualifications and meets

the other requirements approved by the council for registration on the

specialist register

is entitled to be registered in the

specialist register upon payment of the fee for registration set by the

council.

(2) The council may, subject to the regulations,

issue to a person who is not registered on the specialist register a licence

which permits a person to practice in a specialty of medicine.

Registration of

students

(1) The

registrar shall register in the education register

(

a) a person who is enrolled in a school of

medicine in the province approved by the council and whose registration under

this

section is recommended by the Dean of Medicine in that school;

(

b) a person who is a graduate of a school of

medicine or osteopathy approved by the council who is engaged in post-graduate

medical training approved by the council; and

(

c) a person who is a graduate of a school of

medicine or osteopathy approved by the council who is engaged in other medical

education or training approved by the council.

(2) The registration of a person under this

section

(

a) may be made subject to the terms and

conditions, including conditions as to the payment of fees, that the council

may prescribe; and

(

b) confers upon the person registered, the right

to practise medicine in the province, but only under supervision and direction

of a medical practitioner.

Registers

(1) The

registrar shall make the registers maintained by the council available for

inspection by the public on reasonable notice and at reasonable times.

(2) A copy of a register, certified by the

registrar, is, in the absence of evidence to the contrary, evidence in a court

that the persons whose names appear on the register are registered in the register

in which their names appear, and the absence of the name of a person from the

register is, in the absence of evidence to the contrary, evidence that the

person is not registered in the register in which the name does not appear.

Statements may

require attestational oath or affirmation

(1) The

registrar may require an applicant for registration under this Act to witness

upon oath or affirmation, before a commissioner for oaths, evidence required to

satisfy the council for the purpose of registration of the applicant.

(2) An entry shall not be made in a register,

unless the registrar is reasonably satisfied that the facts upon which the

entry is to be made are true, and the registrar may, and shall if directed in

writing by an applicant for registration, submit a question arising under this

subsection for the direction of the council.

(3) An entry in a register that is proved to the

satisfaction of the council to have been fraudulently or incorrectly made shall

be deleted by the registrar from the register upon an order to that effect from

the council.

(4) A person registered under this Act shall

notify the registrar of a change to the qualifications held by that person or

of an entry made with respect to that person in a register and the registrar

shall record that change with respect to that person in the register.

Appeal to Trial

Division

(1) A

person aggrieved by a refusal of the council to register the person, may,

within 30 days after receipt of notice of that refusal, appeal against the

refusal to a judge of the Trial Division by filing in the office of the

Registrar of the Supreme Court a notice of appeal, and by serving a copy of the

notice upon the registrar.

(2) Notwithstanding a rule or practice to the

contrary, a notice of appeal shall

(

a) set out in detail the allegations of the

appellant and the grounds upon which the refusal to register is appealed

against; and

(

b) be signed by the appellant or his or her

solicitor.

(3) The appellant shall within 14 days after

service of a notice of appeal under this section, apply to the judge for the

appointment of a day for the hearing of the appeal and shall not less than 14

days before the hearing serve upon the registrar a written notice of the day appointed

for the hearing.

(4) The registrar shall produce to the judge

hearing the appeal all papers and documents in the possession of the council

affecting the subject matter of the appeal.

(5) The judge shall hear the appeal and the

evidence brought forward by the appellant and the college, and shall decide the

matter of the appeal by

(

a) upholding or revoking the refusal to register;

(

b) making another decision or order which the

judge considers to be appropriate, with power to make orders as to costs for or

against the appellant or the college and to fix the amount of costs.

(6) An appeal may be taken from an order or

decision of the judge to the Court of Appeal upon a point of law raised at the

hearing of the appeal, and the rules governing appeals to that court from an

order or decision of a judge of the Trial Division shall apply to appeals under

this subsection.

Licence to

practise

(1) A

person may apply for a licence to practise medicine in the province and the

registrar shall issue the licence provided that

(

a) the person is registered in the medical

register; and

(

b) the person has met the requirements for licensure

set out in this Act and the regulations.

(2) A person who receives a licence under this

section is only entitled to practice medicine in accordance with the scope of

attach to the licence.

(3) It is a condition of the issuing of a licence

under this

section that the person to whom the licence is issued shall within

one month of the date of issuing become a member of the association, and the

failure of that person to comply with this condition makes the licence void

from that date.

(4) A licence issued under this

section expires on

January 15 following the day upon which it comes into force.

(5) A holder of a licence or a provisional licence

is entitled to recover from a person, in a court of the province having jurisdiction

to order payment from that person, reasonable charges for the provision of

medical services by that licence holder.

Provisional

licences

(1) The

registrar may issue a provisional licence to a person who is not registered on

the medical register but who is the holder of qualifications for provisional

licensure set out in the regulations.

(2) A provisional licence issued under subsection (1)

shall

(

a) be issued subject to the terms, conditions and

limitations set out in the licence and the regulations;

(

b) be valid for a period not exceeding one year;

and

(

c) permit the practice of medicine only within a

specific geographical location in the province.

(3) The holder of a provisional licence under this

section has the right to engage in the practice of medicine subject to the

scope of practice and the terms, conditions and limitations for the period and

the locality set out in the licence.

(4) A provisional licence expires on the January

15 immediately following the date on which it is issued but may be renewed on

application made in accordance with the regulations.

(5) The council shall require the holder of a

provisional licence to be sponsored by a sponsor approved by the council.

(6) Where a provisional licence holder or his or

set out in the licence, the council may suspend or revoke the provisional licence.

(7) It is a condition of issuing a provisional

licence under this

section that the person to whom the licence is issued shall

within one month of the date of issuing become a member of the association, and

the failure of that person to comply with this condition makes the licence void

from that date.

Examination of

applicants

26 . The council may require an applicant for

registration or licensure to pass an examination certifying fitness and

competence to engage in the practice of medicine and that examination shall be

conducted by a board of examiners appointed by the council or another body

approved by the council.

Agreements

27. The college may enter into an agreement with a medical college,

association or other body having responsibility for the licensing of medical

practitioners in a province, state or country, providing for the licensing of

agreement.

Validity of

certificates

28. Where,

by a law in force within the province, a certificate, statement or other

document is or may be required to be given or signed by a physician, surgeon or

medical practitioner, that certificate, statement or document is of no effect

unless the person giving or signing it is the holder of a licence under this

Act.

Continuing and

remedial education

29. The

college shall establish and operate, or prescribe, programs of continuing and remedial

medical education for medical practitioners that shall be mandatory for medical

practitioners.

PART IV

PROFESSIONAL MEDICAL CORPORATIONS

Definitions

30. In

this Part

(a) "non-voting share" means an issued

share of a professional medical corporation that is not a voting share; and

(b) "voting share" means an issued share

of a professional medical corporation with the right to vote at a meeting of

shareholders attached to it.

Professional corporation

(1) One

or more medical practitioners may incorporate a corporation to provide the

services of a medical practitioner.

(2) The corporation shall be incorporated under

the Corporations Act .

(3) The name of the corporation shall meet the

requirements of subsection 17(1) of the Corporations

Act .

(4) A corporation shall not use the words

"professional medical corporation" or an abbreviation of those words

as part of its corporate name unless it is registered and licensed as a

professional medical corporation under this Act.

(5) A corporation shall not provide the services

of a medical practitioner unless it is registered and licensed under this Act.

Corporate

register

(1) The

registrar shall maintain a register of professional medical corporations known

as the Corporate Register of the College

of Physicians and Surgeons of Newfoundland

and Labrador .

(2) The registrar shall register a professional

medical corporation that establishes that

(

a) all the voting shares of the corporation are

beneficially owned by and registered in the name of one or more medical

practitioners licensed under this Act and there is no restriction on the right

of each medical practitioner to exercise his or her vote as he or she wishes;

(

b) the non-voting shares are owned by a natural

person;

(

c) all the directors of the corporation are

medical practitioners licensed under this Act, and there is no agreement restricting

the powers of the directors to manage the business and affairs of the

corporation in relation to the practice of medicine;

(

d) all of the persons who will be practising

medicine as employees of or on behalf of the corporation are medical practitioners

licensed under this Act;

(

e) the articles of the corporation restrict it to

providing the services of a medical practitioner and related matters;

(

f) the corporation is in good standing under the Corporations Act ; and

(

g) the corporation has complied with other

requirements for registration in the regulations made under

section 16 .

(3) The corporate register shall be made available

for inspection in accordance with subsection 21

(1) and subsection 21 (2) applies to a copy of the

register as if it were a register referred to in that subsection.

(4) The college may enter into a reciprocal

agreement with a medical college, association or other body having

responsibility for the registration and licensing of professional medical

corporations in another jurisdiction for the registration of corporations from

that jurisdiction in the Corporate Register of the College

of Physicians and Surgeons of Newfoundland

and Labrador .

(5) Notwithstanding subsection (2), the voting

shares of a professional medical corporation may be held by

(

a) an executor or administrator of the estate of

a deceased medical practitioner to discharge the duties of that position; or

(

b) a trustee in bankruptcy to discharge his or

her duties as trustee in respect of the corporation or a medical practitioner,

for no longer than 180 days, or a longer

period where the registrar permits.

Annual licence

(1) A

professional medical corporation may apply for a licence to provide the

services of a medical practitioner in the province and the registrar shall

issue the licence provided that

(

a) the professional medical corporation is

registered under this Act;

(

b) the application is accompanied by a licence

fee which may be established by the council; and

(

c) the professional medical corporation continues

to meet the requirements for registration set out in

section 32 and other requirements for being licensed which

may be set out in this Act and the regulations made under paragraph 16 (k).

(2) A licence issued under this

section expires on

January 15 following the day upon which it comes into force.

Revocation of

licence

34. A

licence issued under

section 33 may be revoked

by the registrar where

(

a) the professional medical corporation ceases to

meet a requirement for registration or licensing under this Act;

(

b) the professional medical corporation

contravenes this Act or the regulations; or

(

c) a medical practitioner is disciplined under sections

39 to 56 in

respect of professional services performed by him or her as an employee of or

on behalf of the professional medical corporation.

Refusal to

register or issue licence

(1) Where

the registrar refuses to register a professional medical corporation, refuses

to issue a licence to a corporation or revokes a licence under

section 34 , the professional medical corporation may within

30 days after receiving notice of the decision of the registrar appeal the

decision to the Trial Division by filing a notice of appeal with the Registrar

of the Supreme Court.

(2) An appeal under this

section does not stay the

decision of the registrar being appealed unless the Trial Division orders

otherwise.

Effect of

incorporation

(1) A

medical practitioner who provides professional services to or through a

professional medical corporation is, notwithstanding his or her relationship to

the professional medical corporation or the relationship between the patient

and the professional medical corporation, subject to

(

a) the application of this Act as if he or she

were providing services as an individual medical practitioner; and

(

b) the same duties and responsibilities in

connection with his or her dealings with patients of the professional medical

corporation as if he or she were providing services directly to those patients.

(2) The relationship between a professional

medical corporation and a patient receiving services from or through that

corporation is subject to the laws relating to the confidential and ethical

relationship between a medical practitioner and his or her patient.

(3) All rights and obligations pertaining to

communications made to, or information received by, medical practitioners apply

to the shareholders, directors, officers and employees of a professional medical

corporation.

Liability of

medical practitioner

(1) Notwithstanding

a provision to the contrary in the Corporations

Act , a medical practitioner who provides services or practises medicine

through or on behalf of a professional medical corporation is liable to a

person in relation to those services and the practice of medicine to the same

extent and in the same manner as if the medical practitioner provided those

services as an individual and that liability is not affected because of the

medical practitioner's relationship to the professional medical corporation as

a shareholder, director, officer, employee or in another capacity.

(2) A medical practitioner is jointly and

individually liable with a professional medical corporation for all claims made

against the corporation in connection with the provision of services or the

practice of medicine by the medical practitioner.

Misconduct of a

professional medical corporation

(1) A

medical practitioner is liable to be disciplined under

section 39 to 56 for the

actions or conduct of a professional medical corporation while the medical

practitioner was a shareholder, director, officer or employee of the

professional medical corporation.

(2) A medical practitioner shall not be liable to

discipline under subsection (1) where the medical practitioner proves that he

or she did not know and could not reasonably have known about the relevant

actions or conduct of the professional medical corporation.

(3) The powers of inspection, investigation or

inquiry that may be exercised in respect of a medical practitioner under sections

39 to 56 may be

exercised in respect of a professional medical corporation or its records in

connection with an inquiry under subsection (1).

(4) A professional medical corporation is jointly

and individually liable with the medical practitioner for all fines and costs

the medical practitioner is ordered to pay in connection with an inquiry under

subsection (1).

PART V

DISCIPLINE

Definitions

39. In

this Part

(a) "allegation" means a written

document alleging that a person has engaged in conduct deserving of sanction;

(b) "complainant" means a person making

an allegation and includes a person making a report under

section 41 ;

(c) "conduct deserving of sanction"

includes

(

i) professional misconduct,

(ii) professional incompetence,

(iii) conduct unbecoming a medical practitioner,

(iv) incapacity or unfitness to engage in the

practice of medicine, and

(

v) acting in breach of this Act, the regulations

or the code of ethics adopted under

section 15 ;

(d) "costs incurred by the college"

includes

(

i) out of pocket expenses incurred by or on

behalf of the college,

(ii) amounts paid by the college to adjudication

tribunal members as remuneration and for expenses, and

(iii) the actual cost of legal counsel for the college

and the adjudication tribunal;

(e) "disciplinary panel" means the panel

of persons appointed under

section 40 from

which the members of an adjudication tribunal are chosen; and

(f) "respondent" means a medical

practitioner, a former medical practitioner or a person who is registered in

the educational register against whom an allegation is made.

Committees

(1) The

council shall appoint at least 3 of its members, at least one of whom was

appointed by the minister to represent the public interest, to constitute a

complaints authorization committee.

(2) The council shall appoint the chairperson and

vice-chairperson of the complaints authorization committee from the persons

appointed under subsection (1).

(3) The registrar is not eligible to be a member

of the complaints authorization committee.

(4) The council shall appoint at least 10 medical

practitioners who are not members of the council, one of whom shall be

appointed to serve as chairperson, and the minister shall appoint at least 5

persons, who are not medical practitioners or members of the council, to represent

the public interest, who shall together constitute a disciplinary panel.

(5) Members appointed to the disciplinary panel

shall be appointed for a term of 3 years.

(6) Notwithstanding the expiry of his or her term,

a member of the disciplinary panel continues to be a member until he or she is

re-appointed or his or her replacement is appointed.

(7) Persons appointed to the disciplinary panel

may be reappointed.

(8) Members of the disciplinary panel shall serve

on the panel without payment for their services, but may be remunerated for

service as a member of an adjudication tribunal and paid their travel and other

expenses associated with the work of that tribunal by the council, in accordance

with and at the rates set by the by-laws.

(9) The complaints authorization committee, an

adjudication tribunal appointed under

section 45

and a person appointed by either of them may summon a respondent or other person

and require the respondent or other person to give evidence, orally or in

writing, upon oath or affirmation, and produce the documents and things that

either of them considers necessary to the full investigation and hearing of an

allegation or complaint and shall have the powers, privileges and immunities

that are conferred on a commissioner appointed under the Public Inquiries Act, 2006.

Report by member

(1) A

medical practitioner who has knowledge, from direct observation or objective

evidence, of conduct deserving of sanction of another medical practitioner or a

person who is registered on the education register shall report the known facts

to the registrar.

(2) A person who dissolves a partnership with a medical

practitioner, or a corporation, partnership or association that terminates or

imposes restrictions on the employment or privileges or other practice relationship

with a medical practitioner based on direct knowledge of the medical

practitioner's conduct deserving of sanction shall report the known facts to

the registrar.

(3) An action shall not be brought against a

medical practitioner, person, corporation, partnership or association or its

directors or officers for the sole reason that he or she or the corporation,

partnership or association complied with this section.

(4) This

section does not apply to knowledge

obtained through a peer assessment review.

Allegation

(1) An

allegation shall be in writing and signed by the complainant or his or her

solicitor, and filed with the registrar.

(2) The registrar may on his or her own motion

make an allegation and file it, and the allegation shall have the same effect

as an allegation referred to in subsection (1).

(3) Where the registrar has been informed that a

respondent has been convicted of an offence under the provisions of the Controlled Drugs and Substances Act (Canada),

Criminal Code or a similar penal

statute of another country or has been suspended by a governing body of medical

practitioners in another province or territory of Canada or another territory

or country for reason of professional misconduct, conduct unbecoming a medical

practitioner or professional incompetence, the information shall be dealt with

by the registrar as an allegation.

(4) For the purpose of subsection (3), a certified

copy of the record of a conviction or findings made or the action taken by an

external regulatory body constitutes proof, in the absence of evidence to the

contrary, of the conviction or findings made or the action taken by that body,

without proof of the signature of the convicting justice or person purporting

to have signed on behalf of that body.

Effect of filing

allegation

(1) Where

it appears to the registrar after notifying the respondent of the allegation

that the allegation may be resolved satisfactorily and where the complainant

and the respondent consent, the registrar may attempt to resolve the matter.

(2) Where the allegation is not satisfactorily

resolved by the registrar under subsection (1), the registrar shall refer the

allegation and all other allegations to the complaints authorization committee.

(3) The registrar shall inform a complainant and a

respondent of the referral of the allegation to the complaints authorization committee.

Complaints authorization

committee

(1) After

an allegation has been submitted to the complaints authorization committee, the

committee may exercise one or more of the following powers:

(

a) refer the allegation back to the registrar for

an investigation or alternative dispute resolution in accordance with the regulations;

(

b) conduct a practice review into the

respondent's practice or appoint a person to conduct a review on its behalf;

(

c) refer the allegation to the quality assurance

committee;

(

d) conduct an investigation itself or appoint a

person to conduct an investigation on its behalf; and

(

e) require

the respondent to appear before it.

(2) Where the complaints authorization committee

is of the opinion that there are no reasonable grounds to believe the

respondent has engaged in conduct deserving of sanction, the committee shall dismiss

the allegation and give notice in writing of the dismissal to the complainant.

(3) Where the complaints authorization committee

is of the opinion that there are no reasonable grounds to believe the

respondent has engaged in conduct deserving of sanction, the committee may, in

dismissing the allegation, direct the respondent with respect to his or her

practice, including direction that

(

a) the respondent comply with a specified

provision of the Act or regulations or of a by-law, policy or guideline of the

college;

(

b) the respondent successfully complete a

continuing or remedial education program;

(

c) the respondent complete an assessment of his

or her clinical skills and successfully complete a course of studies or clinical

experience recommended by the assessment; and

(

d) provide documentation, information or an

explanation in relation to the medical treatment of the complainant or of

another person represented by the complainant where the person is deceased or

incompetent

and the respondent shall comply with the

direction of the committee.

(4) The committee may give a person or body it

considers appropriate notice of a direction, caution or counsel given under this

section, and may specify the time within which the direction, caution or

counsel is to be complied with and that the costs of compliance with the

direction, caution or counsel shall be borne by the respondent.

(5) Where a respondent fails to comply with a

direction, caution or counsel of the committee under subsection (3), the registrar

may deal with the failure as an allegation.

(6) Where the complaints authorization committee

is of the opinion that there are reasonable grounds to believe that a

respondent has engaged in conduct deserving of sanction, the allegation shall

be considered as constituting a complaint, and the committee may

(

a) counsel or caution the respondent; or

(

b) instruct the registrar to file the complaint

against the respondent and refer it to the disciplinary panel; and

(

c) suspend or restrict the respondent's licence.

(7) A person conducting an investigation under

paragraph (1)(

a) or (

d) or a practice review under paragraph (1)(

b) may require

(

a) the respondent to

(

i) undergo an examination or assessment he or she

considers necessary and as arranged by the registrar, and

(ii) permit the registrar or a member of the complaints

authorization committee or a person appointed by the complaints authorization

committee to inspect and copy the records of the respondent and other documents

relating to the subject matter of the investigation; and

(

b) a person other than the respondent to permit

the registrar or a member of the complaints authorization committee or a person

appointed by the complaints authorization committee to inspect and copy records

and other documents relating to the subject matter of the investigation held by

that person,

and the respondent or other person shall

comply.

(8) An action for damages does not lie against a medical

practitioner or another person to whom a request is made solely because he or

she provides information requested of him or her under subsection (7).

(9) Where the registrar, a member of the complaints

authorization committee or a person appointed by the complaints authorization

committee requires that a respondent or another person provide information

under subsection (7), that information shall be provided within 7 days of

receipt of the request or a different period as specified in the request.

(10) A complainant whose allegation is dismissed by

the complaints authorization committee under subsection (2) may, within 30 days

after receiving notice of the dismissal, appeal the dismissal to the Trial

Division by filing a notice of appeal with the Registrar of the Supreme Court.

(11) Subsections (7), (8) and (9) apply to the

Crown.

Adjudication tribunal

(1) For

the purpose of dealing with complaints referred to the disciplinary panel, the

chairperson of the disciplinary panel shall appoint from it an adjudication

tribunal consisting of 3 persons, of whom 2 shall be medical practitioners and

one shall be a member of the panel appointed to represent the public interest.

(2) The chairperson of the disciplinary panel

shall appoint one of the medical practitioners on an adjudication tribunal to

be the chairperson.

Hearing

(1) Where

a complaint has been referred under paragraph 44 (6)(b),

an adjudication tribunal shall hear the complaint.

(2) The parties to a hearing are the college and

the respondent and a party may be represented by his or her counsel at a

hearing.

(3) A hearing shall be conducted in public but an adjudication

tribunal may exclude the public from a hearing, or from part of it, where it

considers the desirability of protecting a party to the complaint or another

person against the consequences of possible disclosure of personal matters

outweigh the desirability of holding the hearing in public.

Copies of books,

etc. as evidence

47. A

copy or extract of a book, record, document or thing certified by

(

a) a member of the complaints authorization

committee; or

(

b) a person authorized under subsection 44 (7) to conduct an inspection,

who made the copy or extract under

subsection 44 (7) is admissible in evidence in

an action, proceeding, hearing or prosecution, in the absence of evidence to

the contrary, as evidence of the original book, record, document or thing and

its contents.

Guilty plea by

respondent

(1) Where

a respondent pleads guilty to one or more of the charges set out in a

complaint, the adjudication tribunal shall, without calling evidence or hearing

witnesses, unless the tribunal believes it is appropriate to do so, hear

submissions from the parties.

(2) Where a respondent pleads guilty, and

following submissions under subsection (1), the adjudication tribunal may

(

a) reprimand the respondent;

(

b) order that the respondent be suspended for a

fixed period that it considers appropriate, until conditions which it may

impose are fulfilled, or until further order of the adjudication tribunal;

(

c) allow or direct the respondent to surrender

his or her licence to the council upon those conditions that may be considered

appropriate and, where the respondent's name appears on a register maintained

under this Act, strike the respondent's name from the register;

(

d) impose a fine not to exceed $10,000 to be paid

to the college;

(

e) order that the respondent pay the costs or a

part of the costs incurred by the college in the investigation and hearing of

the complaint;

(

f) order that the registrar publish a

summary of

the decision including the information set out in subsection 50 (4) and other information that the tribunal may

specify; and

(

g) order that the respondent comply with one or

more of the following:

(

i) make restitution to the complainant or other

person affected by the conduct of the respondent,

(ii) obtain medical treatment,

(iii) obtain counselling,

(iv) obtain substance abuse counselling or

treatment, until the respondent can demonstrate to the council or other body or

person designated by the adjudication tribunal that a condition related to

substance abuse rendering the respondent incapable or unfit to practise has

been overcome,

(

v) engage in continuing education programs,

(vi) complete a course of studies or obtain

supervised clinical experience, or both, to the satisfaction of the council or

another body or person designated by the adjudication tribunal,

(vii) report on his or her compliance with an order

made under this

section and authorize others involved with his or her treatment

or supervision to report on it,

(viii) restrict his or her professional practice or

continue his or her practice under specified conditions,

(ix) permit periodic inspection of his or her

practice,

(

x) permit periodic inspection of records relating

to his or her practice, or

(xi) impose other requirements that are just and

reasonable in the circumstances.

(3) The costs incurred by the college to ensure

the compliance of a respondent with an order or direction of an adjudication

tribunal under this

section shall be borne by the respondent.

Powers of adjudication

tribunal

(1) Upon

the hearing of a complaint, an adjudication tribunal shall decide whether or

not a respondent is guilty of conduct deserving of sanction.

(2) Where an adjudication tribunal decides that a

respondent is not guilty, it shall dismiss the complaint and may, where it

believes that the submission of the complaint to the tribunal for a hearing was

unreasonable,

(

a) order that those costs that the tribunal

considers appropriate be paid by the college to the respondent; and

(

b) make another order that it considers appropriate.

(3) Where an adjudication tribunal decides that a

respondent is guilty, it may

(

a) reprimand the respondent;

(

b) order that the respondent be suspended for a

fixed period that it considers appropriate, until conditions which it may

impose are fulfilled, or until further order of the adjudication tribunal;

(

c) allow or direct the respondent to surrender

his or her licence to the council upon those conditions that may be considered

appropriate and, where the respondent's name appears on a register maintained

under this Act, strike the respondent's name from the register;

(

d) impose a fine not to exceed $10,000 to be paid

to the college;

(

e) order that the respondent pay the costs or a

part of the costs incurred by the college in the investigation or hearing of

the complaint;

(

f) order that the registrar publish a

summary of

the decision including the information set out in subsection 50 (4) and other information that the tribunal may

specify; and

(

g) order that the respondent comply with one or

more of the following:

(

i) make restitution to the complainant or other

person affected by the conduct of the respondent,

(ii) obtain medical treatment,

(iii) obtain counselling,

(iv) obtain substance abuse counselling or

treatment, until the respondent can demonstrate to the council or other body or

person designated by the adjudication tribunal that a condition related to

substance abuse rendering the respondent incapable or unfit to practise has

been overcome,

(

v) engage in continuing education programs,

(vi) complete a course of studies or obtain

supervised clinical experience, or both, to the satisfaction of the council or

other body or person designated by the adjudication tribunal,

(vii) report on his or her compliance with an order

made under this

section and authorize others involved with his or her treatment

or supervision to report on it,

(viii) restrict his or her professional practice or

continue his or her practice under specified conditions,

(ix) permit periodic inspection of his or her

practice,

(

x) permit periodic inspection of records relating

to his or her practice, or

(xi) impose other requirements that are just and

reasonable in the circumstances.

(4) The costs incurred by the college to ensure

the compliance of a respondent with an order or direction of an adjudication

tribunal under this

section shall be borne by the respondent.

Filing and publication

of decisions

(1) An

adjudication tribunal shall file a decision or order made under subsection 48 (2) or 49 (3) with

the registrar and provide a copy to the complainant, the respondent, the

respondent's employer and sponsor, where he or she has one, and the minister.

(2) The registrar shall maintain a copy of a

decision or order filed under subsection (1) for a minimum of 10 years after

the day the decision is filed and shall upon receiving a request to view the

disciplinary records in relation to a medical practitioner permit a person to

view those records.

(3) The registrar shall publish a

summary of a

decision or order of an adjudication tribunal in a newspaper of general

circulation in or nearest to the community in which the respondent practises

within 14 days of the expiry of the appeal period under

section 56 , unless a court orders otherwise, where the decision

or order

(

a) suspends the respondent;

(

b) allows or directs the respondent to surrender

his or her licence;

(

c) restricts the respondent's practice;

(

d) specifies conditions for the continuing

practice of the respondent; or

(

e) requires that a

summary of the decision or

order be published.

(4) The

summary of the decision published under

subsection (3) shall include

(

a) the name of the respondent and the address

where he or she practises;

(

b) the date, location and a brief description of

the conduct of the respondent that was found to be deserving of sanction;

(

c) the name of the complainant, unless the

complainant has requested that his or her name be withheld;

(

d) the contents of the order in relation to the

actions referenced in paragraphs (3)(

a) to (d); and

(

e) other information specified for publication in

the decision or order.

(5) Where a decision published under this

section is

varied or set aside, the registrar shall within 14 days of the filing of the

subsequent decision or order publish a

summary of the decision or order and subsections

(3) and (4) apply, with the necessary changes.

(6) The registrar may give notice of the decision

and information respecting the decision to the other persons the council may

direct and shall include a

summary of the decision in a certificate of good

standing issued in relation to the respondent.

De-registration

and suspension

(1) Where

a respondent is allowed or directed to surrender his or her licence, his or her

rights and privileges as a medical practitioner to practise medicine cease.

(2) Where a respondent requests that his or her

name be removed, or where his or her name is struck off, a register maintained

under this Act, his or her rights and privileges as a medical practitioner to

practise medicine, or as a person registered on the education register, cease.

(3) Where a respondent is suspended, his or her

rights and privileges as a medical practitioner to practise medicine cease for

the period of suspension.

(4) Where conditions or restrictions have been

imposed upon a respondent's ability to carry on his or her practice, his or her

rights and privileges as a medical practitioner to practise medicine shall be

limited to the extent specified by the conditions or restrictions.

Failure to comply

(1) On

application by the college to the disciplinary panel, an adjudication tribunal

may make an order suspending the licence of a respondent, or the registration

of the respondent where he or she is registered on the education register, where

it determines that the respondent has failed to comply with a decision or an

order under sections 39 to 56 .

(2) The parties to the application are the college

and the respondent.

(3) An order of an adjudication tribunal under

this

section may suspend the licence of the respondent, or the registration of

the respondent where he or she is registered on the education register, for a

fixed period that the adjudication tribunal may consider appropriate, or until

conditions which it may impose are fulfilled, or until further order of the

adjudication tribunal.

Reinstatement and

readmission

(1) Where

a decision or order of an adjudication tribunal

(

a) suspends the respondent;

(

b) allows or directs the respondent to surrender

his or her licence or to be removed from a register maintained under this Act;

(

c) restricts the respondent's practice; or

(

d) specifies conditions for the continuing

practice of the respondent,

and where the respondent alleges that new

evidence has become available or a material change in circumstances has

occurred since the making of the decision or order, the respondent may apply to

the complaints authorization committee for a supplementary hearing to discharge

or vary the decision or order based on the new evidence or material change in

circumstances.

(2) An application under subsection (1) shall be

made not more than 90 days after the new evidence becomes available or the

material change in circumstances has occurred.

(3) Where an application is made to the complaints

authorization committee under subsection (1), and the committee is of the opinion

that new evidence has become available or that a material change in

circumstances has occurred, as alleged by a respondent, the matter shall be

referred to an adjudication tribunal as if it were a matter referred under

paragraph 44 (6)(

b) and sections 46 to 51 apply, with

the necessary changes, to the referred matter.

(4) The parties to a supplementary hearing under

this

section are the respondent and the college.

(5) For the purpose of this section, in addition

to an order that an adjudication tribunal may make under

section 49 , a tribunal may

(

a) vary the original decision or order made under

section 49 ; or

(

b) discharge the original decision or order, with

or without conditions.

Costs of the college

(1) Where

a person who was ordered to pay the costs of the college under paragraph 48 (2)(

e) or 49 (3)(

e) fails to pay in the time required, the council may suspend the registration or

licence of that person until the costs are paid.

(2) Costs ordered to be paid under paragraph 48 (2)(

e) or 49 (3)(

e) are a debt due to the college and may be recovered by the college by a civil action.

Collection of

fine

(1) Where

an order is made under

section 48 or 49 imposing a fine on a respondent, the college may

issue a certificate stating the amount of the fine due and remaining unpaid and

the name of the person by whom it is payable, and file the certificate with the

Registrar of the Supreme Court.

(2) Where a certificate is filed with the

Registrar of the Supreme Court under subsection (1), it has the same effect and

all proceedings may be taken on the certificate as if it were a judgment of the

Trial Division for the recovery of the amount stated in the certificate against

the person named in the certificate.

(3) A person named in a certificate filed under

this

section may, within 30 days after the certificate is filed, apply to a

judge of the Trial Division for a review, on a question of law or jurisdiction,

of the certificate.

(4) On an application under subsection (3), the

judge may make any amendment to the certificate that is necessary to make the

certificate accord with the judge's decision.

(5) There is no appeal from a decision of a judge

made under this section.

(6) A certificate filed under this

section may

also be filed in the judgment enforcement registry on the expiration of the 30

day period referred to in subsection (3) in accordance with

Part III of the Judgment Enforcement Act and be enforced

in accordance with that Act.

Appeal

(1) The

college or the respondent may, within 30 days after receiving notice of a

decision or order of an adjudication tribunal under this Part, appeal the

decision or order or a part of it to the Trial Division by filing a notice of

appeal with the Registrar of the Supreme Court.

(2) An appeal under this

section does not stay the

decision or order being appealed unless the Trial Division orders otherwise.

PART VI

PEER ASSESSMENT

Peer assessment

committee

57. The

college may establish a peer assessment committee consisting of licensed

medical practitioners and persons licensed to practise medicine by the medical

regulatory authority in the manner prescribed by regulation.

Agreement

(1) The

college may enter into an agreement with one or more of the medical regulatory

authorities and medical societies for the establishment of a peer assessment

committee.

(2) An agreement made under subsection (1) may be

amended by the college and the other parties to that agreement.

(3) The college may by regulation determine those

things or requirements that shall be included in an agreement entered into

under subsection (1).

Peer assessment

program

(1) The

peer assessment committee shall, subject to the approval of the college,

develop and administer a peer assessment program that shall include

(

a) assessment standards of practice for medical

practitioners including

(

i) standards for the clinical assessment and care

of patients, and

(ii) standards for the maintenance of records of

care administered to patients;

(

b) procedures and requirements for the selection

and education of assessors;

(

c) standards and methods of communication with

physicians to be assessed;

(

d) budgetary and expense arrangements;

(

e) requirements and methods respecting the

preparation of assessment reports;

(

f) the development of policies and procedures for

the peer assessment committee and the delegation of these to subcommittees,

assessors or employees as the peer assessment committee considers appropriate;

and

(

g) the determination of further activities

including the establishment of other committees and subcommittees to better

administer the peer assessment program.

(2) The peer assessment committee, a committee,

subcommittee or assessor of the peer assessment committee may carry out those duties

and activities established by the peer assessment program.

Assessors

60. The

peer assessment committee may appoint persons licensed as medical practitioners

in the province or in another province as assessors for the purpose of the peer

assessment program.

Assessment

(1) An

assessor may, for the purposes of the peer assessment program and with the co‑operation

of the medical practitioner

(

a) enter and inspect the premises where that

medical practitioner engages in the practice of medicine; and

(

b) inspect that medical practitioner's records of

care administered to patients.

(2) The peer assessment committee, or an assessor

on behalf of the committee may

(

a) require that medical practitioner to provide information

respecting the clinical assessment and care of patients by that medical

practitioner or his or her records of care administered to patients; and

(

b) require that that medical practitioner confer

with the peer assessment committee.

(3) A medical practitioner whose standards of

practice are the subject of an assessment under the peer assessment program

shall cooperate fully with the peer assessment committee and assessors.

Report and compliance

(1) Upon

completion of an assessment an assessor shall submit a report of his or her

findings to the peer assessment committee and the peer assessment committee

shall review the report and may

(

a) make no recommendation to the medical

practitioner who has been assessed; or

(

b) confer with the medical practitioner assessed

and make those remedial recommendations to him or her that the peer assessment

committee considers appropriate.

(2) The peer assessment committee may

(

a) direct the medical practitioner who has been

assessed to comply with recommendations made by the peer assessment committee

under subsection (1); and

(

b) direct that a medical practitioner be

reassessed.

Costs

63. Costs

incurred by a medical practitioner in implementing remedial recommendations of

the peer assessment committee shall be paid by that medical practitioner and

shall not be a cost of the peer assessment committee, the medical regulatory

authorities or the medical societies.

Termination of

assessment

(1) Where

an assessor or a member of the peer assessment committee learns, in the course

of an assessment, that a medical practitioner may be guilty of conduct

deserving of sanction within the meaning of subparagraphs 39 (c)(

i) to (v), the assessment shall be terminated,

the medical practitioner shall be advised, and the matter shall be referred to the

council to be dealt with as a complaint.

(2) An assessor or a member of a peer assessment

committee shall not provide information to the council except the information

necessary to identify the nature of the complaint.

(3) This

section shall not prevent another person

from providing evidence to establish conduct deserving of sanction on the part of

a member.

Annual report

65. Each

year the peer assessment committee shall prepare and publish a report on its

activities for the preceding year.

Disclosure of

information not required

(1) In

this

section

(a) "legal proceeding" means

(

i) a proceeding in a court, including a

proceeding for the imposition of punishment by fine, penalty or imprisonment to

enforce

an Act or a regulation made under

an Act, or a civil proceeding, and

(ii) a disciplinary proceeding under this Act or

under the governing legislation of another licensing authority; and

(b) "witness" means a member or

associate member or officer or employee of the college or council, an assessor

or former assessor, or another person who, in connection with, or in the course

of, a legal proceeding is called upon to provide information, to answer, orally

or in writing, a question, or to produce a document, whether under oath or not.

(2) A witness in a legal proceeding, whether a

party or not, is excused from

(

a) providing information obtained by the witness

in the course of or in relation to an assessment under the peer assessment program;

and

(

b) producing a document made by the peer

assessment committee, an assessor or another document which was prepared under

or in relation to an assessment.

(3) This

section does not apply to

(

a) records to which regulations made under

paragraph 27(

j) of the Regional Health

Authorities Act apply; or

(

b) medical records maintained by attending

physicians pertaining to a patient.

Other documents

67. Notwithstanding

that a witness is or has been an assessor or a member of the peer assessment

committee or a member of a subcommittee of that committee, has participated in

the activities of or has prepared a document for or has provided information to

the peer assessment committee, the witness is not, subject to

section 66 , excused from answering a question or producing a

document that the witness is otherwise bound to answer or produce.

Evidence in disciplinary

matter

(1) An

assessor or a member of the peer assessment committee shall not provide

evidence against a medical practitioner in a disciplinary matter with respect

to information given by the medical practitioner to the assessor or a member of

the peer assessment committee in the course of an assessment of the medical

practitioner unless the medical practitioner has knowingly given false

information during the assessment or the disciplinary matter.

(2) This

section shall not prevent another person

from providing evidence against a medical practitioner in a disciplinary matter

with respect to the information given by the medical practitioner in the course

of his or her assessment.

PART VII

QUALITY ASSURANCE

Quality assurance

committee

(1) The

college shall establish a quality assurance committee consisting of the number

of medical practitioners determined by the college and at least one person

appointed to the council under paragraph 9 (1)(

b) but that person shall not be a medical practitioner.

(2) The committee shall have responsibility for,

and shall establish and operate, a program of quality assurance for medical

practitioners.

(3) The committee may appoint persons licensed as

medical practitioners under this or another Act, including

an Act of another

province or a territory

of Canada , to assist the

committee to perform its duties and exercise its powers under this Act.

(4) The committee and a person appointed under

subsection (3) shall have the powers, privileges and immunities that are

conferred on a commissioner under the Public

Inquiries Act, 2006 .

(5) A person appointed under subsection (3) has

the powers of the committee under paragraphs 71 (2)(

a) to (d).

Medical

practitioner shall comply

70. A

medical practitioner shall comply with a request or a directive of the

committee, or a person appointed to act on behalf of the committee, in

connection with the conduct of a quality assurance review with respect to the

medical practitioner or his or her practice by the committee.

Conduct of a

review

(1) The

quality assurance committee may itself initiate a quality assurance review of a

medical practitioner or his or her practice or at the request of the registrar

or the complaints authorization committee.

(2) In connection with a quality assurance review,

the quality assurance committee may

(

a) require a medical practitioner, or another

person who has possession of records that relate to the medical practitioner's

practice, to produce records, including patient records for inspection or

review, and to permit them to be copied, by the committee or a person appointed

by the committee for the purpose;

(

b) order a medical practitioner to undergo an

examination, evaluation, assessment or review of his or her professional

practices or capacity or fitness to practice, to the extent and under the

circumstances required by the committee;

(

c) engage in periodic or random reviews of a

medical practitioner's performance including the consequential review of patient

records; and

(

d) order a medical practitioner to

(

i) obtain counselling, including substance abuse

counselling, until the medical practitioner can demonstrate to the committee,

or another body or a person designated by the committee, that a condition

related to the counselling has been overcome,

(ii) obtain medical treatment and authorize a

person participating in the provision of that treatment to report on it to the

committee,

(iii) complete a course of studies or an educational

or training program,

(iv) restrict his or her medical practice,

(

v) obtain supervised clinical experience as

directed by the committee and to the satisfaction of the committee,

(vi) continue his or her medical practice under

conditions the committee may specify, or

(vii) report his or her compliance with an order of

the committee and authorize a person to report to the committee on whether he

or she is complying with an order.

(3) The quality assurance committee may accept the

terms of an agreement entered into by the college and a medical practitioner as

constituting compliance by the medical practitioner with a requirement or order

imposed by the committee on the practitioner under subsection (2).

(4) Where a medical practitioner fails to comply

(

a) with a requirement or an order of the quality

assurance committee under subsection (2); or

(

b) with an agreement referred to in subsection

(3) within the time required by the committee for compliance,

the committee shall refer the failure to

comply to the registrar who shall refer it to the complaints authorization

committee as an allegation within the meaning of paragraph 39 (a).

(5) An action for damages does not lie against a

medical practitioner, or another person to whom a request is made, solely

because he or she provides information requested of him or her under paragraph

(2)(a).

(6) Where the quality assurance committee or a

person appointed by the committee requires that a medical practitioner or

another person provide information under paragraph (2)(a), that information

shall be provided within 7 days of receipt of the request or a different period

as specified in the request.

(7) Paragraph (2)(

a) and subsections (5) and

(6) apply to the Crown.

Costs

72. The

costs incurred by a medical practitioner in implementing an order of the

quality assurance committee shall be paid by the medical practitioner and shall

not be a cost of the committee or the college.

Termination of

review

(1) Where

the quality assurance committee believes, in the course of or as a result of a

review, that a medical practitioner may be guilty of conduct deserving of

sanction within the meaning of paragraph 39 (c),

the review, if still in progress, shall be terminated, the medical practitioner

shall be advised, and the matter shall be referred to the registrar who shall

refer it to the complaints authorization committee to be dealt with as an allegation.

(2) The quality assurance committee shall provide

all information and documents in its possession relating to the review to the

complaints authorization committee.

(3) An order of the quality assurance committee

issued before it refers a matter to the complaints authorization committee

under subsection (1) remains in effect notwithstanding the referral of the

matter to the complaints authorization committee.

PART VIII

MISCELLANEOUS

Emergency treatments:

liability

74. The

voluntary rendering by a medical practitioner of first aid or emergency

treatment, without the expectation of monetary compensation, at the scene of an

accident or other location, not within a hospital, medical practitioner's

office or another place having proper and necessary medical equipment, to a

person who is unconscious, ill or injured, shall not render the medical

practitioner liable in damages for injuries alleged to have been sustained by

that person or for the death of that person because of

an act or omission in

the rendering of first aid or emergency treatment, unless it is established

that the injuries were, or the death was, caused by the gross negligence on the

part of the medical practitioner.

Disclosure of

information

(1) The

council may disclose information in its possession, including information that

identifies the individual to whom it relates, to other bodies having authority

to regulate health professionals.

(2) The council, the complaints authorization

committee and the quality assurance committee shall disclose information in

their possession, including

(

a) information that identifies the individual to

whom it relates; and

(

b) personal health information

for those purposes, in the manner and to those

persons prescribed in the regulations.

Protection from

liability

(1) An

action for damages does not lie against

(

a) the registrar, a member of the council, an officer,

employee or agent of the college or council, a person or committee designated

by the college or council, the college as a corporation, the council as

governing body of the college, the complaints authorization committee, a person

appointed by the complaints authorization committee, the disciplinary panel, an

adjudication tribunal, the quality assurance committee, a person appointed by

the quality assurance committee or the individual members of those bodies; or

(

b) medical regulatory authorities, medical societies,

the peer assessment committee, the registrar, an officer or employee of the medical

regulatory authorities or medical societies, a member of a committee or

subcommittee of the medical regulatory authorities or medical societies or an

assessor appointed under

section 60

for

an act or failure to act or a

proceeding initiated or carried out in good faith under this Act or purportedly

under this Act, or for carrying out duties or obligations as the registrar, a

member, officer, employee, designate, agent, committee member or other person authorized

under this Act or for a decision or order made or enforced in good faith under

this Act, or purportedly under this Act.

(2) An action for defamation against a council

member, a member of a committee or panel, the chairperson, the vice-chairperson

or another officer or employee of or counsel for the college may not be founded

on the publication of a communication that consists of or pertains to an

allegation or complaint, where the communication is published in the course of

investigating the allegation or complaint or in the course of proceedings under

Part V.

(3) A member of the college is not personally

liable for a debt of the college beyond the amount of unpaid dues, fees, fines

and penalties owed to the college, but all property of the college shall be held

for the payment of the debts of the college.

Other

prescription practices

(1) A

medical practitioner who prescribes a drug included in the list of drugs and

drug products under subsection 26(2) of the

Pharmaceutical Services Act shall write or type the prescription on a

tamper resistant prescription drug pad approved by and provided to the medical

practitioner by the minister.

(2) A medical practitioner may prescribe a drug or

drug product electronically, including a drug or drug product included in the

list under subsection 26(2) of the Pharmaceutical

Services Act, through the pharmacy network established by the Centre for

Health Information under the Centre for

Health Information Act.

Conflicting

legislation

(1) Nothing

in

an Act shall be construed to prohibit or prevent a medical practitioner from

doing, in the course of administering medical aid or treatment on the human

body, anything for which a licence or permit may be required under that

statute, and to recover reasonable charges for the service provided.

(2) Nothing in this Act affects or applies to the

practice of medicine or a specialty or subspecialty of medicine, permitted to

be carried out by a person under a statute of the province, by a person under

(

a) the

Dental Act, 2008 ;

(

b) the

Optometry Act, 2004;

(

c) the

Pharmacy Act;

(

d) the

Physiotherapy Act, 2006; and

(

e) the

Registered Nurses Act, 2008 .

(3) Nothing in the Pharmacy Act, shall be construed to prevent a medical practitioner

from practising pharmacy and from making reasonable charges for pharmaceutical

services rendered or goods supplied in emergency situations or when the

services of a pharmacist are not readily available.

(4) Nothing in this Act limits or restricts the

practice of medicine within the province by a physician or surgeon employed by

of employment by that government.

Offence

(1) A

person, other than a person who is licensed under this Act, shall not

(

a) engage in the practice of medicine;

(

b) hold himself or herself out or allege by

advertisement, sign or statement of any kind to be entitled to engage in the

practice of medicine; or

(

c) take or use a name, title or description

implying or calculated to lead the public to believe that he or she is licensed

under this Act.

(2) A person who violates subsection (1) is guilty

of an offence and is liable upon

summary conviction to a fine not exceeding $10,000

or to imprisonment for a term not exceeding 6 months or to both a fine and

imprisonment.

(3) In a prosecution under this section, the onus

of proof that the person accused of the offence has the right or privilege to

engage in the practice of medicine is on the person accused.

PART IX

TRANSITION, REPEAL AND COMMENCEMENT

Transition

(1) The

members of the council elected under

section 8 of the Medical Act, 2005 are continued as members of the council until an

election is held under

section 9 of this Act.

(2) The appointments of the members of the council,

the complaints authorization committee and the disciplinary panel made under the

authority of the Medical Act, 2005

are continued for the purpose of this Act.

(3) Where, before the coming into force of this

Act an allegation was filed or a disciplinary hearing had commenced under the authority

of the Medical Act, 2005 , that

allegation or disciplinary hearing shall continue to be investigated or heard

in accordance with

Part V of this Act.

RSNL1990 cM-4.01

Rep.

81. The Medical

Act, 2005 is repealed.

NLR 29/00 Rep.

82. The Prescription

Drug Monitoring Program Regulations , Newfoundland

and Labrador Regulation 29/00, is repealed.

Commencement

Section 29, paragraph 44(1)(

c) and

Part VII of

this Act come into force on December 31, 2011.

William E. Parsons, Queen's Printer