Pan-Canadian Licensure: Without Having to Change the Constitution

The regulatory system in Canada for self-regulated health care professions is like a propeller plane with as many propellers as there are provincial/territorial regulatory colleges/councils for the particular profession. The challenge with having more than one propeller, is that they all rotate at different speeds and sometimes not even in the same direction. This makes for a bumpy, noisy, and long ride. Should one of the propellers require repair or maintenance the whole plane has to return to the jurisdiction from which the propeller originated — not particularly climate sensitive or efficient. The impact of this regulatory framework for regulated health care providers is that providers can only practice in the province/territory (“PT”) in which they are licensed. If providers wish to practice in another PT, they must apply and present documentation to that PT and pay applicable fees. The desire for timely access to health care that is supported by technology are expectations of the public, especially with the COVID-19 pandemic having made obvious the inequities and gaps in our health system. The regulatory solution is ideally pan-Canadian licensure so that providers may work across the country under one license. Pan-Canadian licensure is a multi-faceted challenge which usually begins and ends with a comment that “it cannot be done” because it would require constitutional change. This article focuses on the legal framework of how to achieve pan-Canadian licensure without having to change the constitution and sets out a proposed regulatory-legal model, inspired by the Australian model and the Canadian securities models. There are myriad of other issues that would need addressing to implement pan-Canadian licensure, but these are not the subject of this article