HSCI 305 Lecture Notes - Lecture 5: Allied Health Professions, Licensed Practical Nurse, Health Human Resources

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HSCI 305 Lecture 5  Delivery of Health Care: Professions, Power, Payment, and Provision
-Health care professionals and health care workers: independence, power, and control
-Health care divisions of labor and Health Human Resources: stratification of carers,
Rationalization and Rationing
-Privatization and contracting out of auxiliary workers in BC: saving money?
Who is a Public Worker?
-Wiki: “a service which is provided by government to people living within its jurisdiction, either
directly (through the public sector) or by financing provision of services.”
-Main questions to consider are ability to:
oBill as a contractor vs. paid on salary
oControl rate and volume of remuneration
oControl work environment and processes
-Is also an ideological question
Politics of Professions
-Development of independent professional colleges and regulatory bodies
-“successfully lobbied for protective legislation to place limits on who would be officially allowed
to practice medicine” (Bourgeault)
Elements of Independent Professionals
-Independent regulation under a professional College
-Reserved titles: “prescribes a title to be used exclusively by registrants of a college”
-Scope of practice and restricted acts: services which may be provided, including restricted
acts which only a member of the College may provide
-High skills level and educational attainment in area of expertise. Requires ongoing
educational and technical credentials and competencies, proof of ongoing skills
-Quality assurance, independent investigation of misconduct and withdrawal of registration
Health Care Professionals
-“There are 26 regulated health professions in BC, of which 25 are self-regulating professions
governed by 22 regulatory colleges under the Health Professions Act
-Professionals: Doctors, midwives, dentists, allied health professions, nursing
Health Professions Act
-(2) A college has the following objects:
-(a) to superintend the practice of the profession;
-(b) to govern its registrants according to this Act, the regulations and the bylaws of the college;
-(c) to establish the conditions or requirements for registration of a person as a member;
-(d) to establish, monitor and enforce standards of practice to enhance the quality of practice
and reduce incompetent, impaired or unethical practice amongst registrants;
-(e) to establish and maintain a continuing competency program to promote high practice
standards amongst registrants;
Examples of Restricted Acts
-“communicating a diagnosis
-Performing a procedure on tissue below the dermis
-Administering a substance by injection or inhalation
-Applying or ordering the application of a form of energy Eg. X rays” (Bourgeault)
Power of Professional Colleges
-Their economic power is tremendous
-Set guidelines for care: volume, frequency, duration, content, etc (control demand)
-Have great power in negotiating the remuneration for care provided (control supply and cost)
Pay Differentials in BC
-Average annual FFS payments to family doctors: $240 356
-Average nursing salary: $53 000 - $66 000
Privatization? Profitization
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Document Summary

Hsci 305 lecture 5 delivery of health care: professions, power, payment, and provision. Health care professionals and health care workers: independence, power, and control. Health care divisions of labor and health human resources: stratification of carers, Wiki: a service which is provided by government to people living within its jurisdiction, either directly (through the public sector) or by financing provision of services. Main questions to consider are ability to: bill as a contractor vs. paid on salary, control rate and volume of remuneration, control work environment and processes. Development of independent professional colleges and regulatory bodies. Successfully lobbied for protective legislation to place limits on who would be officially allowed to practice medicine (bourgeault) Reserved titles: prescribes a title to be used exclusively by registrants of a college . Scope of practice and restricted acts: services which may be provided, including restricted acts which only a member of the college may provide.

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