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St. John's, Newfoundland and Labrador, Canada

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Statutes of Newfoundland and Labrador 2011


RSN1990 CHAPTER M - 4

CHAPTER M-4.02

AN ACT RESPECTING THE PRACTICE OF MEDICINE IN THE PROVINCE

(Assented to May 31, 2011)

Analysis


††††††† 1. Short title

††††††† 2. Definitions

††††††††††††† PART I
MEDICAL ASSOCIATION

††††††† 3. Association continued

††††††† 4. Objects

††††††† 5. Application of Corporations Act

††††††† 6. Membership

††††††††††††† PART II
THE COLLEGE

††††††† 7. College continued

††††††† 8. Objects of the college

††††††† 9. Council of college

††††† 10. Annual meeting

††††† 11. College officers

††††† 12. Quorum

††††† 13. Powers of council

††††† 14. Appointment of committees

††††† 15. By-laws

††††† 16. Regulations

††††† 17. Fees

††††††††††††† PART III
LICENSING AND REGISTRATION

††††† 18. Qualification for registration

††††† 19. Registration of specialists

††††† 20. Registration of students

††††† 21. Registers

††††† 22. Statements may require attestational oath or affirmation

††††† 23. Appeal to Trial Division

††††† 24. Licence to practise

††††† 25. Provisional licences

††††† 26. Examination of applicants

††††† 27. Agreements

††††† 28. Validity of certificates

††††† 29. Continuing and remedial education

††††††††††††† PART IV
PROFESSIONAL MEDICAL CORPORATIONS

††††† 30. Definitions

††††† 31. Professional corporation

††††† 32. Corporate register

††††† 33. Annual licence

††††† 34. Revocation of licence

††††† 35. Refusal to register or issue licence

††††† 36. Effect of incorporation

††††† 37. Liability of medical practitioner

††††† 38. Misconduct of a professional medical corporation

††††††††††††† PART V
DISCIPLINE

††††† 39. Definitions

††††† 40. Committees

††††† 41. Report by member

††††† 42. Allegation

††††† 43. Effect of filing allegation

††††† 44. Complaints authorization committee

††††† 45. Adjudication tribunal

††††† 46. Hearing

††††† 47. Copies of books, etc. as evidence

††††† 48. Guilty plea by respondent

††††† 49. Powers of adjudication tribunal

††††† 50. Filing and publication of decisions

††††† 51. De-registration and suspension

††††† 52. Failure to comply

††††† 53. Reinstatement and readmission

††††† 54. Costs of the college

††††† 55. Collection of fine

††††† 56. Appeal

††††††††††††† PART VI
PEER ASSESSMENT

††††† 57. Peer assessment committee

††††† 58. Agreement

††††† 59. Peer assessment program

††††† 60. Assessors

††††† 61. Assessment

††††† 62. Report and compliance

††††† 63. Costs

††††† 64. Termination of assessment

††††† 65. Annual report

††††† 66. Disclosure of information not required

††††† 67. Other documents

††††† 68. Evidence in disciplinary matter

††††††††††††† PART VII
QUALITY ASSURANCE

††††† 69. Quality assurance committee

††††† 70. Medical practitioner shall comply

††††† 71. Conduct of a review

††††† 72. Costs

††††† 73. Termination of review

††††††††††††† PART VIII
MISCELLANEOUS

††††† 74. Emergency treatments: liability

††††† 75. Disclosure of information

††††† 76. Protection from liability

††††† 77. Other prescription practices

††††† 78. Conflicting legislation

††††† 79. Offence

††††††††††††† PART IX
TRANSITION, REPEAL AND COMMENCEMENT

††††† 80. Transition

††††† 81. SNL2005 cM-4.01 Rep.

††††† 82. NLR 29/00 Rep.

††††† 83. 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

††††††† 5. (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

††††††† 7. (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

††††††† 8. (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

††††††† 9. (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

††††† 10. (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

††††† 11. (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

††††† 13. (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 it considers 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 other's jurisdictions.

Appointment of committees

††††† 14. (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

††††† 15. (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

††††† 16. (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);

††††††††††††† (i)the terms and conditions on which licences and provisional licences may be issued, granted or renewed;

††††††††††††† (j)terms and conditions respecting sponsorship of 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

††††† 17. (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

††††† 19. (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

††††† 20. (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

††††† 21. (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

††††† 22. (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

††††† 23. (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; or

†††††††††††† (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

††††† 24. (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 practice and terms and conditions that the council may, subject to the regulations, 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

††††† 25. (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 her sponsor does not comply with the regulations or the terms and conditions 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 persons upon reciprocal terms and conditions that shall be specified in the 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

††††† 31. (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

††††† 32. (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

††††† 33. (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

††††† 35. (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

††††† 36. (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

††††† 37. (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 practitionerís 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

††††† 38. (1) A medical practitioner is liable to be disciplined under sections 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

††††† 40. (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

††††† 41. (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

††††† 42. (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

††††† 43. (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

††††† 44. (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

††††† 45. (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

††††† 46. (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

††††† 48. (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 respondentís 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

††††† 49. (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 respondentís 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

††††† 50. (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 respondentís 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

††††† 51. (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 respondentís 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

††††† 52. (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

††††† 53. (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 respondentís 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

††††† 54. (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

††††† 55. (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 judgeís 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

††††† 56. (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

††††† 58. (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

††††† 59. (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

††††† 61. (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

††††† 62. (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

††††† 64. (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

††††† 66. (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

††††† 68. (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

††††† 69. (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

††††† 71. (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

††††† 73. (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

††††† 75. (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

††††† 76. (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

††††† 77. (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

††††† 78. (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 the Government of Canada, but only for the purpose of carrying out the duties of employment by that government.

Offence

††††† 79. (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

††††† 80. (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.

SNL2005 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

††††† 83. Section 29, paragraph 44(1)(c) and Part VII of this Act come into force on December 31, 2011.