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Medical Professionals Complaints - Hearings

Written Hearing

Some people are satisfied to have their review conducted without being there. In this case, neither party attends the hearing. Only the three members of the HPARB panel are present.  The College will provide the ROI, and the Appellant will be asked to give his or her comments to the HPARB in writing. The panel will go over the complaints committee decision, the ROI, and the Appellant's written statement, and make their decision.  There is no transcript. 

Oral Hearing

An oral hearing at the Board similar to a court hearing, but less formal.

At the hearing there will be three HPARB members, called the panel. Other people that might attend the hearing are: the professional the complaint was made about, a legal representative for the professional, a representative from the College, and maybe a lawyer for HPARB.

Before the hearing, the panel will have reviewed the ROI. They will be ready to listen to what you and the health professional or their representative has to say.

Since the HPARB panel will be looking only at whether the investigation done by the complaints committee of the college was adequate, and that their decision was reasonable, it is important that any comments are only about these issues. HPARB will allow you to show documents at the hearing to help them tell your story. If you bring in other issues or get off topic, the Panel may ask you to stop. The Panel may ask questions to be sure they understand what you are saying.

You will speak first. You cannot ask the health professions any questions, and must direct all your questions to the Panel. The health professional or their representative will speak next.  You will have a chance to ask questions and respond to what they say.

During the hearing, you are allowed only to speak to the Panel. You cannot speak directly to other parties. If you have a question, ask the Panel. The Panel will decide whether they will ask the question to the other party. Once the parties have had a chance to present all their arguments, and all the questions that are allowed have been asked and answered, the panel will thank everyone for their participation and the hearing will be closed.

How the HPARB panel makes a Decision

After the hearing, the panel will meet in private, review the ROI, and consider all the information provided by both sides. They will decide whether the investigation of the complaints committee was adequate and whether the decision reached by the complaints committee was reasonable.

It is important to understand that the decision of the complaints committee does not necessarily have to be right, either in your opinion or in the opinion of the HPARB panel.  The HPARB panel will consider only whether the complaints committee has conducted an adequate investigation, and has come to a reasonable decision based on the information in the ROI.  The HPARB panel will not consider any other issues. 

The panel will write their decision, including the reasons for their decision, and mail it to the parties. 

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Medical Professionals Complaints - Further Help

 

To obtain free legal advice, you can contact:

Legal Aid Ontario
Toronto Line: 416-979-1446
Toll-free: 1-800-668-8258

Law Society of Upper Canada Lawyer Referral
Toronto Line: 416-947-3330
Toll-free: 1-800-268-8326

Ombusdman Ontario

The Ombudsman cannot overturn or alter a decision from an administraive tribunal, but if you believe you have been treated unfairly by an adminstrative tribunal you can file a complaint with the Ombudsman.  If the Ombudsman agrees, he can make recommendations to a tribunal to address the issue.  The Ombudsman can also make recommendations to government about legislation, policies and programs.

 

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Medical Professionals Complaints - Considerations

Was the Complaint Committee's Investigation Adequate or Inadequate?

The HPARB panel will decide only whether the decision of the complaints committee was reasonable and adequate, so all of your arguments must focus on either or both of those issues.

It is difficult to show that the investigation of the complaints committee was inadequate.

The HPARB will look at the record of investigation (ROI) and decide whether the complaints committee looked at all available documents and spoke with people whose information would be relevant when they made the decision.  

If you would like the HPARB to look at the adequacy of the investigation, think about:

  • Whether there are any missing documents that would have been helpful for the complaints committee to see.
  • Whether there are people with important information about the complaint who were not interviewed by the complaints committee.  
  • Whether the complaints committee didn’t consider a piece of information that they should have.

You will not win your case by showing that a document is missing from the ROI if the document would not have changed the complaints committee decision.

For example, in previous cases, the HPARB panel has written,  “an investigation has to be adequate and not exhaustive and the panel is satisfied that a reasonable attempt was made by the college investigator to provide this material to the committee. The board finds the investigation adequate.”

Was the Complaints Committee's Decision Reasonable or Unreasonable?

Within the HPARB, the word reasonable has a special meaning. It means that the decision of the complaints committee is supported by the information in the ROI.

It is difficult to show that the decision of the complaints committee was unreasonable. It is important to understand that the decision of the complaints committee does not need to be right; it just needs to be reasonable, i.e., supported by the information in the ROI.

For example, in previous decisions, the HPARB panel has written, "In considering the reasonableness of the Committee’s decision, the question for the Board is not whether the Board would arrive at the same decision as the Committee; rather it is whether the Committee’s decision is within a range of reasonable outcomes."

The HPARB will not replace the complaints committee decision for its own just because they might disagree with it. If the complaints committee decision seems logical, and is based on the information in the ROI, it will be considered reasonable. It is only when HPARB thinks the committee’s decision does not make sense that it will find it unreasonable.

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Medical Professionals Complaints - Application Steps

The Application Steps

Before you can ask the the Health Professions Appeal and Review Board (HPARB), to review a decision by a complaints committee of a regulatory college, you must have received a decision from the college's complaints committee. 

The request for a board review must be in writing and must be addressed to both HPARB and to the college’s complaints committee.

The request for a board review must be received within 30 days from the date on the letter you receive telling you about the college's complaints committee decision.  

What Happens Next

When you request a review you will receive:

  • A letter of acknowledgment
  • A file number that will appear on all of your paperwork from the tribunal. You should have this number ready if you call HPARB about your case.
  • A copy of the Record of Investigation prepared by the college dealing with your complaint. 
  • A Pre-Review Conference (PRC) notice. This tells you the date, location and time of your pre-review conference.

The Pre-Review Conference

You must pay attention to the date and location of the pre-review conference. It is important not to miss the PRC unless you have a very good reason. If you cannot make it on that date and at that time, you can contact the HPARB to reschedule the PRC. If you do not reschedule, and do not show up for the PRC, the HPARB might not proceed with your review.

The PRC will be held 4-6 weeks after you receive your package from HPARB.

The PRC can be held in person, in writing or over the phone. 

If you have any questions, you can call HPARB to clarify.

There are a number of people who will be at the PRC:

  • you, the appellant
  • HPARB will have a board member present who will manage the PRC
  • the college where you filed the complaint will also have a representative present
  • the health professional you are complaining about may be present, or the person's lawyer might be there to represent him or her.

Topics for discussion at the PRC: 

  • resolving simple issues that do not need to be discussed at the hearing
  • making sure everybody understands what is being reviewed
  • finding out whether there are any facts or evidence both parties can agree on
  • deciding how long the hearing might take
  • identifying any documents that are missing from the ROI
  • anything else on your mind - this is the time to ask any questions you have about the process or the hearing

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Medical Professionals Complaints - Overview

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Issues the HPARB Hears
 


The information presented here about the Health Professions Appeal and Review Board (HPARB) is intended to give an overview of the HPARB and how it holds reviews of investigations and decisions by self-regulated professions in Ontario.

This information aims to help people understand the HPARB's process, and to be able to make a complaint if they feel they have been treated in an unprofessional way by a member of one of the regulated health colleges.

You do not need a lawyer to have the HPARB review a decision by the complaints committee of a college. But if your issue is complicated or difficult to explain, you may want to see a lawyer before you begin.

Regulated Health Professions

In Ontario, there are 28 self-regulated health professions that have regulatory colleges. Everyone who is in one of these health professions must belong to his or her college and follow the rules on how they carry out their profession.  Find a list of the 28 Regulated Health Professions here

Each college must have a way of dealing with complaints from the public. Before anyone can take a complaint about a professional to the HPARB, they must first go through the complaint process at the college.  

For Example: a complaint against a doctor must first be sent to the College of Physicians and Surgeons. The College of Physicians and Surgeons must investigate every complaint and must respond to every complaint in writing.  

If someone makes a complaint to one of the regulatory colleges about one of its members, and they feel the investigation done by the college was inadequate.or that the investigation resulted in a decision that is  unreasonable, the person can ask the HPARB to review the decision.

Will the HPARB work for you?

The HPARB’s Mandate

If you have made a complaint about a health professional to the complaints committee of their college, and you are not satisfied with the decision reached by the complaints committee, you can go to the HPARB for a review of that decision.

The HPARB is independent. Members of the HPARB are not government employees, nor will they ever have been a member of one of the colleges.  

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Issues the HPARB Hears

The HPARB can only consider two very specific issues.

  1. Whether the investigation of the complaints committee was inadequate/adequate.
  2. Whether the decision of the complaints committee was unreasonable/reasonable.

    What the HPARB Can Do  

    The HPARB review can have 3 different results:

    1. You win: This means the HPARB thinks the investigation of the college complaints committee was inadequate, or unreasonable. Your issue will be sent back to the complaints committee of the college, where the committee will consider it again.
    2. You lose: This means the decision of the college complaints committee remains the same.
    3. HPARB might, in some cases, make a recommendation to the complaints committee.

    What the HPARB Cannot Do

    The law limits what HPARB can do for you.

    The HPARB cannot:

    • give you medical advice.
    • examine patients or give a diagnosis.
    • make a finding of malpractice.
    • give a money award.
    • do its own investigation.
    • replace its decision for the one made by the complaints committee if it finds the complaints committee decision was reasonable.
    • make findings of fact.
    • make findings of credibility.

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