# Self-regulated vs Government Regulated



## mariomike (3 Dec 2021)

Saw this in "Unionizing the CAF".



Bluebulldog said:


> Unless I'm mistaken, only ACP paramedics are governed / regulated. PCP Paramedics aren't.
> 
> I do think they need to be. I've had some interactions with some superior people in the field, I've also seen some pretty big $#itpumps.



They are self-regulated in Alberta, Saskatchewan, Manitoba, Nova Scotia and New Brunswick.  

They are government regulated in British Columbia, Ontario, Quebec, Prince Edward Island and Newfoundland and Labrador.


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## KevinB (3 Dec 2021)

I wonder which has higher standards?

*I will go out on a limb and say Self Regulating...


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## mariomike (3 Dec 2021)

KevinB said:


> I wonder which has higher standards?
> 
> *I will go out on a limb and say Self Regulating...



I'm only familiar with Ontario. We had two regulatory bodies: The Emergency Health Services Branch (EHSB) of the Ministry of Health and Long Term Care (MOHLTC), and Base Hospital.

On top of that, our department had the Professional Standards Unit ( PSU ) for Complaint Investigation, Policies and Procedures.

I'm not sure if service in self-regulated provinces is any better or worse than in government regulated provinces.  🤷‍♂️


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## lenaitch (3 Dec 2021)

KevinB said:


> I wonder which has higher standards?
> 
> *I will go out on a limb and say Self Regulating...


I think it is separate issues.  Depending on the 'industry' and enabling legislation, sometimes the government both sets the standards and retains enforcement, government sets the standards but oversight/enforcement is through the business sector (professional college, industry council, etc,) and sometimes the legislation is broad and the industry both sets the rules and performs the oversight.  It is my sense that some circle the wagons faster than others.  Even when the enforcement may well be effective, it is often secretive, hidden behind phrases such as 'internal disciplinary matters' and 'privacy', even though it is public dollars (i.e. teachers, doctors).  Often, when the government has oversight, a lot of times it is just paper audits.  The situation in Ontario long term care homes revealed the gaps at the start of Covid.

The two I particular don't have faith in are the 'safety management systems' in rail and air transport, where carriers essentially establish their operating procedures and audit how well they are doing.  Proactive government oversight is minimal.


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## mariomike (4 Dec 2021)

I have not heard any paramedics or the union express enthusiasm for Self-Regulation.

The way it works now is when they screw the pooch they are disciplined behind closed doors and whatever sanctions they face are kept secret.

Any discplinary action taken is not available to the public. They do not face public hearings and their names are not released, unless they end up in court.

Contrary to self-regulated healthcare professions, which post all disciplinary decisions online via a publicly available registry, there are no published records that identify paramedics who face disciplinary action.


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## Bluebulldog (6 Dec 2021)

mariomike said:


> On top of that, our department had the Professional Standards Unit ( PSU ) for Complaint Investigation, Policies and Procedures.



I would venture a guess, that not unlike Police services, some are better than others on that front.

The one I've had a lot of experience with (NW of Ottawa), in combination with the local police, has earned the nickname "cowboy country"....

But I digress....


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## daftandbarmy (6 Dec 2021)

mariomike said:


> I have not heard any paramedics or the union express enthusiasm for Self-Regulation.
> 
> The way it works now is when they screw the pooch they are disciplined behind closed doors and whatever sanctions they face are kept secret.
> 
> ...



Kind of like ORNGE?


In 2005, the Ministry announced that it was appointing a not-for-profit corporation called the Ontario Air Ambulance Corporation to be responsible for all air ambulance operations. This was done to establish clearer lines of authority among the different parts of air ambulance operations. An arm’s-length corporation was also consistent with the Ministry’s objective of moving away from direct service delivery. The corporation's name was subsequently changed to Ornge.[6] Ornge was described in 2012 as being neither a Crown corporation nor an agency directly controlled by the Government of Ontario, but rather a non-profit organisation incorporated under the federal Canada Corporations Act.[14]

The Ministry operated an air ambulance dispatch centre in Toronto until Ornge took over and MATC (Medical Air Transport Centre) became the Ornge Communications Centre.[15]

On 17 September 2007, Ornge Air was created. It would purchase aircraft and compete with the private-sector providers.[13]









						Ornge - Wikipedia
					






					en.wikipedia.org


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## dapaterson (6 Dec 2021)

Ornge is the poster child for a lack of oversight, and an MBA culture of entitlement and masking of self-enriching expenditures.


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## daftandbarmy (7 Dec 2021)

dapaterson said:


> Ornge is the poster child for a lack of oversight, and an MBA culture of entitlement and masking of self-enriching expenditures.



Impressive salaries too!


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## mariomike (7 Dec 2021)

daftandbarmy said:


> Impressive salaries too!



According to the Ontario Sunshine List, we make more than they do.

And, they make more than their pilots.

Original post, ( 2008 )


> Why such a large discrepancy between what Ornge is paying their pilots vs. the medics in the back??








						Ornge Pilot Pay vs. Medics Pay -
					






					www.avcanada.ca
				



Four pages.


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## Colin Parkinson (7 Dec 2021)

Problem with self-regulation is the competitive business world. The best companies will be forced down the road of non-compliance by companies willing to cut corners who can under bid and get the contracts. If your not getting the work because your costs and standards are to high, then you must either change or die. I saw this as a regulator and felt it was my job to apply the regs fairly, it's easy to end up focusing your efforts on the compliant companies and avoid the ones who will stymie you and your efforts to keep them working within the regulations, which then punishes the compliant companies. I recall a good conversation out in the field with an environmental monitor hired by the company to maintain compliance, he said: 'My power flows from you regulators, by following my advice I avoid the company from being hit with Stop Work Orders and fines. If we don't play the heavy, eventually the company will not listen to the monitors they hired"


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## mariomike (7 Dec 2021)

daftandbarmy said:


> Kind of like ORNGE?


I don't know. Other than they do not make house calls.

They say if you know one paramedic service, that's exacty what you know. One paramedic service.
It's all I know.

That's just for Ontario. Regulation, registration/licensing/certification requirements and practise standards differ in each provincial jurisdiction.



> ORNGE is "a Canadian not-for-profit corporation[2] and registered charity[1].








						T3010 Registered Charity Information Return
					






					apps.cra-arc.gc.ca
				








						Federal Corporation Information - 986166-1 - Online Filing Centre - Corporations Canada - Corporations - Innovation, Science and Economic Development Canada
					






					www.ic.gc.ca
				




We worked for a city.

I don't know if ORNGE was subject to the internal "Complaint Investigation Policies and Procedures" that we were.


			https://www.toronto.ca/wp-content/uploads/2017/11/96fc-Toronto-EMS-CIPP-Approved-June-25-2014-3.pdf


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## Good2Golf (7 Dec 2021)

It was certainly subject to criminal investigation by the OPP…

Five-year ORNGE criminal probe wrapping up | The Star


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## daftandbarmy (7 Dec 2021)

Good2Golf said:


> It was certainly subject to criminal investigation by the OPP…
> 
> Five-year ORNGE criminal probe wrapping up | The Star



Might have had something to do with the $1.4m salary the boss paid himself


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## lenaitch (7 Dec 2021)

daftandbarmy said:


> Might have had something to do with the $1.4m salary the boss paid himself


There was a whole host of allegations, not necessarily all criminal; money changing hands during the aircraft procurement process, money re-directed to non-core expenditures (Orange County Choppers motorcycle in the lobby), a girlfriend getting an executive position and on and on.  One problem was many of the Persons of Interest, witnesses and records were in a foreign country, and the need to obtain ministerial approval for out-of-country investigative travel, which took forever to be approved, by which time it was largely pointless.


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