Second

Session, 50th General Assembly

Charles III, 2024

BILL 83

AN ACT TO AMEND THE

MEDICAL ACT, 2011 NO. 2

Received

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

Second

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

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

Amendment

Nov. 19, 2024

Third

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

Royal

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

HONOURABLE JOHN

HOGAN, KC

Minister of Health

and Community Services and Attorney General

Ordered to be printed by

the Honourable House of Assembly

EXPLANATORY NOTES

This Bill would amend the Medical Act, 2011 to

authorize the regulation of

physician assistants;

amend the definition of licence,

medical practitioner, practice of medicine and registrar;

add

definitions of elected member,

health region 1, health region 2, health region 3, health region 4, health

region 5, learner, medical licence, physician assistant, physician assistant

licence and practice of physician assisting;

provide that medical

practitioners who hold a medical licence are members of the Newfoundland and

Labrador Medical Association;

amend the composition of the council;

remove the requirement that the

registrar, the deputy registrar and assistant registrars be medical practitioners;

amend the quorum for a meeting

of the council;

remove the requirement that a

code of ethics established by the council include a definition of

"professional misconduct" and "conduct unbecoming a medical

practitioner" for the purposes of sections 39 to 56 of the Act, standards

governing the practice of medicine and rules respecting methods of advertising;

authorize the council to make

by-laws defining the terms "professional misconduct", "conduct

unbecoming", "professional incompetence" and "incapacity or

unfitness to practise" for the purposes of sections 39 to 56 of the Act,

establishing standards governing the practice of medicine and the practice of

physician assisting and establishing rules respecting methods of advertising;

amend the expiry date of licences;

allow persons or a category of

persons prescribed in the regulations to be exempted, in accordance with the

regulations, from the requirement to be registered or licensed under the Act in

order to engage in the practice of medicine or the practice of physician assisting;

amend the definition of "complainant"

to exclude a person who makes a report under

section 41 of the Act;

remove the requirement that

members of the complaints authorization committee be

members of the council;

authorize the college to

appoint members of the public to the peer assessment committee;

authorize the college to

appoint the quality assurance committee to act as the peer assessment committee;

provide that

costs incurred by a medical practitioner for a reassessment directed by

the peer assessment committee be paid by the medical practitioner;

authorize an assessor or a

member of a peer assessment committee to provide to the council information

relating to any alleged conduct deserving of sanction;

remove the requirement for the

peer assessment committee to prepare and publish a report respecting its

activities for the preceding year; and

provide that the excusing of a

witness in a legal proceeding from providing information obtained as part of a

peer assessment or from producing documents made by the peer assessment

committee does not apply where the peer assessment committee refers a matter to

the council to be dealt with as a complaint.

A BILL

AN ACT TO AMEND THE MEDICAL ACT, 2011

NO. 2

Analysis

S.2 Amdt .

Definitions

S.6 Amdt .

Membership

S.8 R&S

Objects of college

S.9 Amdt .

Council

of college

S.11 Amdt .

College officers

S.12 R&S

Quorum

S.13 Amdt .

Powers of council

S.15 Amdt .

By-laws

S.16 Amdt .

Regulations

S.19.4 Added

Physician

assistant registration

S.20 Amdt .

Education

register

S.24 R&S

Medical

licence

S.24.1 Added

Physician

assistant licence

S.26 R&S

Examination

of applicants

S.27 Amdt .

Agreements

S.27.1 Added.

Registration and licensure exemption

S.28 R&S

Validity

of certificates

S.29 R&S

Continuing

professional development

S.33 Amdt .

Annual licence

S.39 Amdt .

Definitions

S.40 Amdt .

Committees

S.41 Amdt .

Report by member

S.42 Amdt .

Allegation

S.44 Amdt .

Complaints authorization committee

S.45 R&S

Adjudication

tribunal

S.48 Amdt .

Guilty plea by respondent

S.49 Amdt .

Powers of adjudication tribunal

S.51 R&S

De-registration and suspension

S.57 R&S

Peer

assessment committee

S.63 R&S

Costs

S.64 Amdt .

Termination of assessment

S.65 Rep.

Annual report

S.66 Amdt .

Disclosure of information not required

S.69 Amdt .

Quality

assurance committee

S.70 R&S

Duty to

comply

S.71 Amdt .

Conduct

of review

S.72 Amdt .

Costs

S.73 Amdt .

Termination of review

S.74 Amdt .

Emergency

treatments: liability

S.77 Amdt .

Other prescription practices

S.78 Amdt .

Conflicting legislation

S.79 Amdt .

Offence

SNL2018 cC-12.3 Amdt .

SNL2009 cC-14.01 Amdt .

RSNL1990 cE-9 Amdt .

SNL1995 cP-37.1 Amdt .

RSNL1990 cH-15 Amdt .

RSNL1990 cL-18 Amdt .

49. SNL2005 cO-4.1 Amdt .

50. SNL2008 cP-7.01 Amdt .

51. SNL2006 cP-12.01 Amdt .

SNL2024 cP-12.3 Amdt .

SNL2018 cP-37.3 Amdt .

SNL2009 cV-6.01 Amdt .

SNL2022 cW-11.1 Amdt .

NLR 45/15 Amdt .

NLR 114/96 Amdt .

CNLR 1154/96 Amdt .

59. NLR 121/18 Amdt .

CNLR 1156/96 Amdt .

61. NLR 34/18 Amdt .

Commencement

Be it enacted by the Lieutenant-Governor and

House of Assembly in Legislative Session convened, as follows:

SNL2011 cM-4.02

as amended

(1) Section 2 of the Medical Act, 2011 is amended by adding immediately after paragraph

(

e) the following:

(e.1) "elected member" means a member

elected in accordance with paragraph 9(1)(a );

(e.2) "health region 1" means the health

region referred to in paragraph 6(

a) of the Provincial

Health Authority Regulations ;

(e.3) "health region 2" means the health

region referred to in paragraph 6(

b) of the Provincial

Health Authority Regulations ;

(e.4) "health region 3" means the health

region referred to in paragraph 6(

c) of the Provincial

Health Authority Regulations ;

(e.5) "health region 4" means the health

region referred to in paragraph 6(

d) of the Provincial

Health Authority Regulations ;

(e.6) "health region 5" means the health

region referred to in paragraph 6(

e) of the Provincial

Health Authority Regulations ;

(e.7) "learner" means a person registered

on the education register;

(2) Paragraph 2(

f) of the Act is repealed and the

following substituted:

(f) "licence" means

(

i) a medical licence,

(ii) a physician assistant licence;

(3) Subsection 2 of the Act is amended by adding

immediately after paragraph (

f) the following:

(f.1) "medical licence" means a licence

issued under

section 24 to engage in the practice of medicine;

(4) Paragraph 2(

g) of the Act is repealed and the

following substituted:

(g) "medical practitioner" means a

person who

(

i) is registered

under

section 18, 19.1, 19.2 or 19.3 and holds a medical licence, or

(ii) was registered under

section 18, 19.1, 19.2 or

19.3 and held a medical licence;

(5) Section 2 of the Act is amended by adding

immediately after paragraph (l.1) the following:

(l.2) "physician assistant" means a person

who is or was registered under

section 19.4 and holds or has held a physician

assistant licence;

(l.3) "physician assistant licence" means

a licence issued under

section 24.1 to engage in the practice of physician assisting;

(6) Paragraph 2(

m) of the Act is repealed and the

following substituted:

(m) "practice of medicine" means the

practices and procedures usually performed by a medical practitioner and

includes

(

i) assessing,

diagnosing, and treating disease, disorder, and dysfunction in an individual,

(ii) promoting health and prevention of illness

and injury, and

(iii) performing other practices and procedures as

taught in undergraduate and post-graduate medical education and training

approved by the council;

(7) Section 2 of the Act is amended by adding

immediately after paragraph (

m) the following:

(m.1) "practice of physician assisting"

means the use of physician assisting knowledge, theory and skill to assist a

medical practitioner in the practice of medicine;

(8) Paragraph 2(

p) of the Act is repealed and the

following substituted:

(p) "register" includes

the medical register, education register, provisional register, associate

register, clinical assistant register, physician assistant register, corporate

register and any other register established by the council in accordance with

the by-laws; and

(9) Paragraph 2(

q) of the Act is repealed and the

following substituted:

(q) "registrar" means the person

appointed as registrar under subsection 11(2).

Section 6 of the Act is repealed and the

following substituted:

Membership

6 .

(1) All medical practitioners who hold a medical licence shall be members of the

association notwithstanding anything contained in the by-laws.

(2) The

association may charge fees for membership in the association.

(3) Where

the association charges a fee for membership all medical practitioners referred

to in subsection (1) who pay the fee established by the association shall have

full voting rights notwithstanding anything contained in the by-laws.

(4) Where

the association charges a fee for membership and a medical practitioner referred

to in subsection (1) does not pay the fee the

association may notify the college of that medical practitioner's failure to

pay the fee.

Section 8 of the Act is repealed and the

following substituted:

Objects of

college

(1) The college is authorized to regulate

(

a) the practice of medicine and the medical

profession in the public interest; and

(

b) the practice of physician assisting and the

physician assistant 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;

(

b) the registration and licensing of medical

practitioners, learners and physician assistants;

(

c) the establishment, maintenance and development

of standards for the practice of medicine and the practice of physician assisting;

(

d) responding to and managing complaints and discipline

related to the practice of medicine and the practice of physician assisting;

(

e) establishing and maintaining a quali ty assurance program;

(

f) the enforcement of

standards of conduct; and

(

g) ensuring that the public interest is protected

in all matters relating to the practice of medicine and the practice of

physician assisting.

4. (1) Subsection 9(1) of the Act is repealed and

the following substituted:

Council of

college

(1) The council shall consist of

(a) 7 persons who are either medical practitioners

or physician assistants who

(

i) hold a current

licence, and

(ii) are elected in accordance with subsection

(1.1) by secret ballot in accordance with the by-laws;

(

b) one person appointed by the minister who shall

not be a medical practitioner or physician assistant, who is suitable to

represent the public interest;

(c) 2 persons appointed by the council who shall

not be medical practitioners or physician assistants, who are suitable to

represent the public interest;

(

d) one person appointed by the minister who shall

be appointed from a list of not less than 3 nominees submitted by the Faculty

of Medicine of Memorial University;

(e) 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; and

(

f) one person appointed by the minister 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, who shall be

appointed from a list of not less than 3 nominees submitted by the Provincial

Association of Residents of Newfoundland and Labrador.

(2) Section 9 of the Act is amended by adding

immediately after subsection (1) the following:

(1.1) For the purposes of subparagraph (1)(a)(ii),

(a) 3 medical practitioners or physician

assistants shall be elected from health region 1;

(

b) one medical practitioner or physician

assistant shall be elected from health region 2;

(

c) one medical practitioner or physician

assistant shall be elected from health region 3;

(

d) one medical practitioner or physician

assistant shall be elected from health region 4; and

(

e) one medical practitioner or physician

assistant shall be elected from health region 5.

(1.2) Notwithstanding subsection (1.1), where no medical

practitioners or physician assistants in a health region agree to be considered

for election, a medical practitioner or physician assistant from another health

region may be elected in place of a medical practitioner or physician assistant

from that health region.

(3) Paragraph 9(2)(

b) of the Act is amended by

deleting the reference "paragraph (1)(

b) or (c)" and substituting the

reference "paragraphs (1)(

b) to (f)".

(4) Subsection 9(5) of the Act is amended by deleting

the reference "paragraph (1)(c)" wherever it appears and substituting

the reference "paragraph (1)(e)".

5. (1) Subsection 11(2) of the Act is amended by

(

a) deleting the words "medical

practitioner" and substituting the word "person"; and

(

b) adding immediately after the word

"another" the word "person".

(2) Subsection 11(3) of the Act is amended by

deleting the words "medical practitioners" and substituting the word

"persons".

Section 12 of the Act is repealed and the

following substituted:

Quorum

A quorum of the council is 50% plus one member, at least 2 of whom shall be

members appointed to represent the public interest.

7. Paragraph 13(3)(

e) of the Act is amended by

deleting the words "medical practitioners" and substituting the words

"medical practitioners, learners and physician assistants".

8. (1) Paragraph 15(1)(

i) of the Act is repealed and the following substituted:

(

i) establishing a

code of ethics;

(2) Subsection 15(1) of the Act is amended by

adding immediately after paragraph (

i) the following:

(i.1) defining the following terms for the purposes

of sections 39 to 56:

(

i) professional

misconduct,

(ii) conduct unbecoming,

(iii) professional incompetence, and

(iv) incapacity or unfitness to practise;

(i.2) establishing standards governing the practice

of medicine and the practice of physician assisting, including standards of

professional competence and of capacity and fitness to practise;

(i.3) establishing rules respecting methods of advertising;

(3) Paragraph 15(1)(

n) of the Act is repealed and

the following substituted:

(

n) recognizing medical

schools, including osteopathic medical schools, courses

and examinations for the purposes of

(

i) registration under

section 18, 19.1, 19.2 and 19.3 except

for the purposes of registration under subsection 19.1(2), and

(ii) licensing under

section 24;

(4) Subsection 15(1) of the Act is amended by

adding immediately after paragraph (

n) the following:

(n.1) recognizing schools, courses

and examinations for the purposes of registration under

section 19.4 and

licensing under

section 24.1; and

9. (1) Paragraph 16(1)(

d) of the Act is amended by

adding immediately after the words "practise medicine" the words "or

physician assisting".

(2) Paragraph 16(1)(

e) of the Act is amended by

deleting the words "medical practitioners" and substituting the words

"medical practitioners, learners and physician assistants".

(3) Paragraph 16(1)(

f) of the Act is repealed and

the following substituted:

(

f) the requirements,

including education and practice experience requirements for the licensing and

registration of medical practitioners, learners and physician assistants, with

power to adopt requirements set by recognized medical bodies or associations of

Canada;

(4) Paragraph 16(1)(

h) of the Act is repealed and

the following substituted:

(

h) the scope of

(5) Subsection 16(1) of the Act is amended by

adding immediately after paragraph (

i) the following:

(i.1) the exemption of persons or category of

persons for the purposes of

section 27.1;

(6) Paragraph 16(1)(

n) of the Act is repealed and

the following substituted:

(

n) continuing professional development and

remedial education for medical practitioners and physician assistants;

(7) Paragraph 16(1)(

q) of the Act is amended by

deleting the words "medical practitioner" and substituting the words

"medical practitioner, learner and physician assistant".

10. The Act is amended by adding immediately after

section 19.3 the following:

Physician

assistant registration

19.4 A person who

(

a) has completed a

post-secondary program in physician assisting and training approved by the

council as qualifying a person for registration on the physician assistant

register; and

(

b) possesses the other

qualifications and meets the other requirements that may be prescribed in the

regulations as qualifying a person for registration on the physician assistant

register

is entitled to be

registered on the physician assistant register upon payment of the fee for

registration set by the council.

11. Subsection 20(1) of the Act is repealed and the

following substituted:

Education

register

(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.

Section 24 of the Act is repealed and the

following substituted:

Medical licence

(1) A person may apply for a medical licence to practise

medicine in the province and the registrar shall issue the medical licence

provided that

(

a) the person is registered on one of the

following registers:

(

i) medical register,

(ii) provisional register,

(iii) associate register,

(iv) clinical assistant register, and

(

v) education register; and

(

b) the person has met

the requirements for licensure set out in this Act and the regulations.

(2) Where the registrar issues a medical licence

to a person, the registrar shall notify the association.

(3) A person who

receives a medical licence is only entitled to practise medicine in accordance

with

(

a) the person's

education and experience; and

(

b) the terms and

conditions that the council may, subject to the regulations, attach to the

medical licence.

(4) A medical licence

expires no later than one year after the date on which the medical licence was

issued.

(5) A medical practitioner

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 medical practitioner.

(6) Where a holder of a

medical licence does not comply with one or more of the terms or conditions

attached to the medical licence, the council may suspend or revoke the medical

licence.

(7) Where the association notifies the college

that a medical practitioner referred to in subsection 6(1) has not paid the fee

charged in accordance with subsection 6(2), the council shall revoke the

medical practitioner's medical licence within 30 days of receipt of the

notification.

13. The Act is amended by adding immediately after

section 24 the following:

Physician

assistant licence

24.1

(1) A person may apply for a physician assistant licence to

practise physician assisting in the province and the registrar shall issue the physician

assistant licence provided that

(

a) the person is

registered on the physician assistant 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 physician assistant licence under this

section

(

a) shall be supervised by a medical practitioner;

and

(

b) is only entitled to

practise physician assisting in accordance with

(

i) the person's education and experience, and

(ii) the terms and

conditions that the council may, subject to the regulations, attach to the physician

assistant licence.

(3) A physician

assistant licence expires no later than one year after the date the physician assistant

licence was issued.

(4) Where a holder of a physician

assistant licence does not comply with one or more of the terms or conditions

attached to the physician assistant licence, the council may suspend or revoke

the physician assistant licence.

(5) Only a physician assistant licensed under this

Act is entitled to use the title or designation physician assistant.

Section 26 of the Act is repealed and the

following substituted:

Examination of

applicants

(1) The council may require an applicant for registration

or licensure as a medical practitioner to pass an examination certifying

fitness and competence to engage in the practice of medicine.

(2) The council may

require an applicant for registration or licensure as a physician assistant to

pass an examination certifying fitness and competence to engage in the practice

of physician assisting.

(3) An examination

referred to in subsection (1) or (2) shall be conducted by an assessor

appointed by the council or another body approved by the council.

Section 27 of the Act is amended by deleting

the words "medical practitioners" and substituting the words "medical

practitioners, learners and physician assistants".

16. The Act is amended by adding immediately after

section 27 the following:

Registration and

licensure exemption

27.1 A person or category of persons prescribed

in the regulations may, in accordance with the regulations, be exempted from

the requirement to be registered or licensed under this Act in

order to engage in the practice of medicine or the practice of physician

assisting in the province.

Section 28 of the Act is repealed and the

following substituted:

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, medical practitioner, learner

or physician assistant, 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.

Section 29 of the Act is repealed and the

following substituted:

Continuing

professional development

(1) The college shall establish and operate, or

prescribe, programs of continuing professional development for medical

practitioners and physician assistants.

(2) The programs referred to in subsection (1) shall be mandatory for medical practitioners and physician

assistants.

19. Subsection 33(2) of the Act is repealed and the

following substituted:

(2) A licence issued

under this

section expires no later than one year after the date on which the

licence was issued.

(1) Paragraph 39(

b) of the Act is amended by

deleting the words "and includes a person making a report under

section

41".

(2) Subparagraphs 39(c)(iii) and (iv) of the Act are

repealed and the following substituted:

(iii) conduct unbecoming,

(iv) incapacity or unfitness to practise, and

(3) Paragraph 39(

f) of the Act is repealed and the

following substituted:

(f) "respondent" means a medical

practitioner, a former medical practitioner, a learner, a former learner, a

physician assistant or a former physician assistant

against whom an allegation is made.

21. (1) Subsection 40(1) of the Act is repealed and

the following substituted:

Committees

(1) The council shall appoint at least 3 persons in accordance with subsection

(1.1) to constitute a complaints authorization committee.

(2) Section 40 of the Act is amended by adding

immediately after subsection (1) the following:

(1.1) The complaints authorization committee shall

consist of

(

a) at least 2 persons who are licensed as medical

practitioners or physician assistants under this or

another Act, including

an Act of another province or a territory of

Canada; and

(

b) at least one person who is a member of the

council appointed under paragraph 9(1)(

b) or (c).

(3) Subsection 40(4) of the Act is repealed and

the following substituted:

(4) A disciplinary panel shall consist of not less

than

(a) 10 medical practitioners appointed by the

council who are not members of the council;

(b) 5 persons appointed by the minister to

represent the public interest who are not

(

i) medical

practitioners or physician assistants, or

(ii) members of the council; and

(

c) where practicable, one physician assistant appointed

by the council who is not a member of the council.

(4) Section 40 of the Act is amended by adding

immediately after subsection (4) the following:

(4.1) The council

shall appoint a member appointed under paragraph (4)(

a) or (

c) to be the

chairperson.

22. (1) Subsection 41(1) of the Act is repealed and

the following substituted:

Report by member

(1) A medical practitioner or physician assistant who

has knowledge, from direct observation or objective evidence, of conduct

deserving of sanction of a medical practitioner, a physician assistant or a learner

shall report the known facts to the registrar.

(2) Subsection 41(3) of the Act is repealed and

the following substituted:

(3) An action shall not

be brought against a medical practitioner, physician assistant, person,

corporation, partnership or association or its directors or officers for the

sole reason that the medical practitioner, physician assistant, person,

corporation, partnership or association complied with

this section.

23. Subsection 42(3) of the Act is repealed and the

following substituted:

(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 or physician assistants in another province or territory

of Canada or another territory or country for reason of professional

misconduct, conduct unbecoming or professional incompetence, the information

shall be dealt with by the registrar as an allegation.

24. (1) Paragraph 44(3)(

b) of the Act is amended by

deleting the words "a continuing or remedial education program" and

substituting the words "continuing professional development or remedial

education".

(2) Subsection 44(8) of the Act is repealed and

the following substituted:

(8) An action for

damages does not lie against a medical practitioner, a physician assistant or another person to whom a request is made solely

because the medical practitioner, physician assistant or person provides

information requested under subsection (7).

Section 45 of the Act is repealed and the

following substituted:

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

(a) 2 shall be medical

practitioners or physician assistants; and

(

b) one shall be a

member of the disciplinary panel appointed to represent the public interest.

(2) For the purposes of subsection (1)

(

a) where the respondent is a medical

practitioner, at least one of the members appointed under paragraph (1)(

a) shall be a medical practitioner, where practicable; and

(

b) where the respondent is a physician assistant,

at least one of the members appointed under paragraph (1)(

a) shall be a

physician assistant, where practicable.

(3) The chairperson of

the disciplinary panel shall appoint one of the members appointed under

paragraph (1)(

a) to be the chairperson.

26. Subparagraph 48(2)(g)(

v) of the Act is repealed

and the following substituted:

(

v) engage in continuing professional development

or remedial education,

27. (1) Paragraph 49(3)(

e) of the Act is repealed

and the following substituted:

(

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;

(2) Subparagraph 49(3)(g)(

v) of the Act is

repealed and the following substituted:

(

v) engage in continuing professional development

or remedial education,

Section 51 of the Act is repealed and the

following substituted:

De-registration

and suspension

(1) Where a respondent is allowed or directed to surrender the

respondent's licence, the respondent's rights and

privileges as a medical practitioner to practise medicine, as a learner to

practise medicine or as a physician assistant to practise physician assisting,

cease.

(2) Where a respondent

requests that the respondent's name be removed, or where the respondent's name

is struck off a register maintained under this Act, the respondent's rights and privileges as a medical practitioner to practise

medicine, as a learner to practise medicine or as a physician assistant to

practise physician assisting, cease.

(3) Where a respondent is suspended, the respondent's rights

and privileges as a medical practitioner to practise medicine, as a learner to

practise medicine or as a physician assistant to practise physician assisting

cease for the period of suspension.

(4) Where conditions or

restrictions have been imposed upon a respondents ability to carry on the

respondent's practice, the respondent's rights and

privileges as a medical practitioner to practise medicine, as a learner to

practise medicine or as a physician assistant to practise physician assisting

shall be limited to the extent specified by the conditions or restrictions.

Section 57 of the Act is repealed and the

following substituted:

Peer assessment

committee

(1) The college may establish a peer assessment committee in the manner prescribed

by regulation.

(2) Notwithstanding subsection (1), the college

may appoint the quality assurance committee to act as the peer assessment

committee.

(3) Notwithstanding subsection 69(1) where the

college appoints the quality assurance committee to act as the peer assessment

committee, the quality assurance committee shall consist of at least 2 persons

who are licensed as medical practitioners under this Act or another Act,

including

an Act of another province or a territory of Canada.

Section 63 of the Act is repealed and the

following substituted:

Costs

63. The

following costs shall be paid by a medical

practitioner and shall not be a cost of the peer assessment committee, the

medical regulatory authorities or the medical

societies:

(

a) c osts incurred by

the medical practitioner in implementing remedial recommendations of the peer

assessment committee; and

(

b) costs incurred by the medical practitioner for

a reassessment directed by the peer assessment committee.

31. Subsection 64(2) of the Act is repealed and the

following substituted:

(2) An assessor or a

member of a peer assessment committee shall not provide information to the

council except for information relating to any alleged conduct deserving of

sanction.

Section 65 of the Act is repealed.

33. Subsection 66(3) of the Act is repealed and the

following substituted:

(3) Subsection (2) does not apply to

(

a) medical records maintained by attending

physicians pertaining to a patient; or

(

b) a legal proceeding where the matter which is

the subject of the legal proceeding was referred to the council under

subsection 64(1) to be dealt with as a complaint.

34. (1) Subsection 69(1) of the Act is repealed and

the following substituted:

Quality assurance

committee

(1) T he college shall establish a quality assurance

committee consisting of the number of medical practitioners and physician

assistants determined by the college and at least one person appointed to the

council under paragraph 9 (1)(

b) or (c).

(2) Subsection 69(2) of the Act is amended by deleting

the words "medical practitioners" and substituting the words

"medical practitioners, learners and physician assistants".

(3) Subsection 69(3) of the Act is amended by deleting

he words "medical practitioners" and substituting the words

"medical practitioners, learners or physician assistants".

Section 70 of the Act is repealed and the

following substituted:

Duty to comply

70. A medical practitioner, a learner and a physician assistant

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 by the committee with respect to

(

a) the medical

practitioner or the medical practitioner's practice;

(

b) the learner or the learner's practice; or

(

c) the physician assistant or the physician

assistant's practice.

36. (1) Subsection 71(1) of the Act is repealed and

the following substituted:

Conduct of review

(1) The quality assurance committee shall conduct a review of a medical

practitioner or the medical practitioner's practice, a learner or the learner's

practice or a physician assistant or the physician assistant's practice where

(

a) the quality assurance committee receives a

referral of a concern about the quality or competence of the medical

practitioner or the medical practitioner's practice, the learner or the learner's

practice or the physician assistant or the physician assistant's practice from

(

i) the registrar, or

(ii) the complaints authorization committee; or

(

b) the quality assurance committee determines

that a review is necessary on its own accord.

(2) Paragraph 71(2)(

a) of the Act is amended by

(

a) deleting the words "medical

practitioner" and substituting the words "medical practitioner,

learner, physician assistant"; and

(

b) deleting the words "medical

practitioner's practice" and substituting the words "medical

practitioner's practice, learner's practice or physician assistant's practice".

(3) Paragraph 71(2)(

b) of the Act is repealed and

the following substituted:

(

b) order a medical

practitioner, learner or physician assistant to undergo an examination,

evaluation, assessment or review of the medical practitioner's, learner's or

physician assistant's professional practices or capacity or fitness to

practise, to the extent and under the circumstances required by the committee;

(4) Paragraph 71(2)(

c) of the Act is amended by deleting

the words "medical practitioner's" and substituting the words

"medical practitioner's, learner's or physician assistant's".

(5) Paragraph 71(2)(

d) of the Act is repealed and

the following substituted:

(

d) order a medical

practitioner, learner or physician assistant to

(

i) obtain counselling, including substance abuse counselling,

until the medical practitioner, learner or physician assistant 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 the medical

practitioner's practice, the learner's practice or the

physician assistant's practice,

(

v) obtain supervised

clinical experience as directed by the committee and to the satisfaction of the

committee,

(vi) continue the medical

practitioner's practice, the learner's practice or the

physician assistant's practice under conditions the committee may specify, or

(vii) report compliance

with an order of the committee and authorize a person to report to the

committee on whether the medical practitioner, learner or physician assistant is

complying with an order.

(6) Subsection 71(3) of the Act is repealed and

the following substituted:

(3) The quality

assurance committee may accept the terms of an agreement entered

into by the college and a medical practitioner, learner or physician

assistant as constituting compliance by the medical practitioner, learner or

physician assistant with a requirement or order imposed by the committee on the

medical practitioner, learner or physician assistant under subsection (2).

(7) Subsection 71(4) of the Act is amended by deleting

the words "medical practitioner" and substituting the words

"medical practitioner, learner or physician assistant".

(8) Subsection 71(5) of the Act is repealed and

the following substituted:

(5) An action for

damages does not lie against a medical practitioner, learner, physician

assistant or another person to whom a request is made, solely because the

medical practitioner, learner, physician assistant or person provides

information requested under paragraph (2)(a).

(9) Subsection 71(6) of the Act is amended by deleting

the words "medical practitioner" and substituting the words

"medical practitioner, learner, physician assistant".

Section 72 of the Act is amended by deleting

the words "medical practitioner" wherever they appear and

substituting the words "medical practitioner, learner or physician

assistant".

38. Subsection 73(1) of the Act is amended by

deleting the words "medical practitioner" wherever they appear and

substituting the words "medical practitioner, learner or physician

assistant".

Section 74 of the Act is amended by deleting

the words "medical practitioner" wherever they appear, and

substituting the words "medical practitioner, learner or physician assistant."

Section 77 of the Act is amended by deleting

the words "medical practitioner" wherever they appear and

substituting the words "medical practitioner, learner or physician

assistant".

41. (1) Subsection 78(2) of the Act is repealed and

the following substituted:

(2) Nothing in this Act

affects or applies to the practice of medicine or the practice of physician

assisting permitted to be carried out by a person under another statute of the

province.

(2) Subsection 78(4) of the Act is repealed.

Section 79 of the Act is amended by adding

immediately after the words "the practice of medicine" wherever they appear,

the words "or the practice of physician assisting".

SNL2018 cC-12.3 Amdt .

43. Paragraph 2( 1)( bb) of

the Children, Youth and Families Act

is repealed and the following substituted:

(bb) "qualified health practitioner"

means a physician, physician assistant, nurse, nurse practitioner, licensed

practical nurse, dentist or dental hygienist;

SNL2009 cC-14.01

Amdt .

(1) Paragraph 3(

a) of the Chiropractors Act, 2009 is amended by deleting the reference " Medical Act, 2005" and substituting

the reference " Medical Act,

2011".

(2) Section 3 of the Act is amended by adding

immediately after paragraph (

a) the following:

(a.1) a physician assistant registered under the Medical Act, 2011 ;

(3) Paragraph 39(4)(

b) of the Act is repealed and

the following substituted:

(

b) a medical

practitioner or physician assistant registered under the Medical Act, 2011 and

practising in a hospital or other health care facility; or

RSNL1990 cE-9 Amdt .

(1) Section 2 of the Emergency Medical Aid Act is amended by deleting the word

"and" at the end of paragraph (

a) and adding immediately after

paragraph (

a) the following:

(a.1) "physician assistant" means a person

who is lawfully entitled to practise physician assisting in the province; and

(2) Section 3 of the Act is amended by

(

a) deleting the words "a physician or

registered nurse" and substituting the words" a physician, physician

assistant or registered nurse"; and

(

b) deleting the words "the physician,

registered nurse" and substituting the words "the physician,

physician assistant, registered nurse".

SNL1995 cP-37.1 Amdt .

Section 3 of the Health and Community Services Act is amended by deleting the words

"medical practitioner, nurse" and substituting the words

"medical practitioner, physician assistant, nurse".

RSNL1990 cH-15 Amdt .

47. Paragraph 2(

c) of the Human Tissue Act is repealed and the following substituted:

(c) "legally qualified medical

practitioner" means a person who holds a medical licence under the Medical Act, 2011 ;

RSNL1990 cL-18 Amdt .

48. (1) Subsection 65(1) of the Liquor Control Act is amended by

deleting the words "physician, dentist" and substituting the words

"physician, physician assistant, dentist".

(2) Paragraph 65(2)(

a) of the Act is amended by

deleting the words "druggist or physician" and substituting the words

"druggist, physician or physician assistant".

(3) Paragraph 65(2)(

b) of the Act is amended by

deleting the words "physician or dentist" and substituting the words

"physician, physician assistant or dentist".

(4) Paragraph 65(2)(

c) of the Act is amended by

deleting the words "physician or dentist" and substituting the words

"physician, physician assistant or dentist".

SNL2005 cO-4.1 Amdt .

49. Paragraph 34(

a) of the Occupational Therapists Act, 2005 is repealed and the following

substituted:

(

a) by a legally qualified medical practitioner or

physician assistant; or

SNL2008 cP-7.01 Amdt .

50. Subparagraph 2(1)(j)(ix) of the Personal

Health Information Act is amended by deleting the reference " Medical

Act, 2005 " and substituting the reference " Medical Act, 2011 ".

SNL2006 cP-12.01 Amdt .

51. Paragraph 2(

p) of the Pharmaceutical Services Act is amended by adding immediately after

subparagraph (

i) the following:

(i.1) a physician assistant licensed under the Medical Act, 2011 ;

SNL2024 cP-12.3 Amdt .

52. Subsection 3(1) of the Pharmacy Act, 2024 is amended by adding immediately after paragraph

(

a) the following:

(a.1) a physician assistant licensed and acting

under the Medical Act, 2011 ;

SNL2018 cP-37.3 Amdt .

53. Paragraph 2(

j) of the Public Health Protection and Promotion Act is amended by adding

immediately after subparagraph (ii) the following:

(ii.1) a physician assistant as defined in the Medical Act, 2011 ,

SNL2009 cV-6.01 Amdt .

54. (1) Subsection 2(1) of the Vital Statistics Act, 2009 is amended by adding immediately after

paragraph (

p) the following:

(p.1) "physician assistant" means a

physician assistant as defined in the Medical

Act, 2011 ;

(2) Paragraph 14(3)(

c) of the Act is amended by

adding immediately after the words "registered nurse" the words

"or physician assistant".

(3) Paragraph 15(4)(

b) of the Act is amended by

adding immediately after the words "registered nurse" wherever they

appear the words "or physician assistant".

(4) Subsection 16(1) of the Act is amended by

deleting the words "nurse practitioner or registered nurse" and

substituting the words "nurse practitioner, registered nurse or physician

assistant".

(5) Subsection 16(2) of the Act is amended by

deleting the words "nurse practitioner, registered nurse" and

substituting the words "nurse practitioner, registered nurse, physician

assistant".

(6) Paragraph 26.1(2)(

b) of the Act is amended by

adding immediately after subparagraph (

i) the

following:

(i.1) a physician assistant,

SNL2022 cW-11.1 Amdt .

55. Subsection 64(2) of the Workplace Health, Safety and Compensation Act, 2022 is amended by

adding immediately after the words "nurse practitioner" the words

"or physician assistant".

NLR 45/15 Amdt .

56. Paragraph 2(

b) of the Access to Information and Protection of Privacy Regulations under

the Access to Information and Protection

of Privacy Act, 2015 is amended by deleting the words "medical

practitioner" and substituting the words "medical practitioner,

physician assistant".

NLR 114/96 Amdt .

57. Subsection 18.1(6) of the Pension Benefits Act Regulations under the Pension Benefits Act, 1997 is amended by adding immediately after

paragraph (

g) the following:

(g.1) a physician assistant as defined in the Medical Act, 2011 ;

CNLR 1154/96 Amdt .

58. (1) Paragraph 10(2)(

a) of the Radiation Health and Safety Regulations under

the Radiation Health and Safety Act

is amended by deleting the reference " Medical Act " and

substituting the reference " Medical Act, 2011 ".

(2) Subsection 10(2) of the regulations is amended

by adding immediately after paragraph (

a) the following:

(a.01) a physician assistant as defined in the Medical Act, 2011 ;

(3) Paragraph 10(3)(

a) of the regulations is

amended by deleting the reference " Medical Act " and

substituting the reference " Medical Act, 2011 ".

(4) Subsection 10(3) of the regulations is amended

by adding immediately after paragraph (

a) the following:

(a.1) a physician assistant as defined in the Medical Act, 2011 ;

NLR 121/18 Amdt .

Section 2 of the Residential Tenancies Regulations under the Residential Tenancies Act, 2018 is amended by adding immediately

after paragraph (

a) the following:

(a.1) a physician assistant registered and licensed

under the Medical Act, 2011 ;

CNLR 1156/96 Amdt .

60. Paragraph 2(i.1) of the Wild Life Regulations under the Wild

Life Act is amended by deleting the words "as a medical practitioner

under the Medical Act, 2011 " and

substituting the words "as a medical practitioner under the Medical Act, 2011 , as a physician

assistant under the Medical Act, 2011 ".

NLR 34/18 Amdt .

61. Paragraph 2(

k) of the Workplace Hazardous Materials Information System (WHMIS) Regulations,

2018 under the Occupational Health

and Safety Act is amended by deleting the word "and" at the end

of subparagraph (

i) and adding immediately after

subparagraph (

i) the following:

(i.1) a physician assistant who is registered and

entitled under the laws of a province to practise physician assisting and who

is practising physician assisting under those laws in that province, and

Commencement

62. This Act comes into force on a day to be

proclaimed by the Lieutenant-Governor in Council.

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