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S.M. 1999, c. 39

THE MEDICAL AMENDMENT ACT


 

(Assented to July 14, 1999)

HER MAJESTY, by and with the advice and consent of the Legislative Assembly of Manitoba, enacts as follows:

C.C.S.M. c. M90 amended

1

The Medical Act is amended by this Act.

2

Section 1 is amended

(a) by repealing the definition "associate member" and substituting the following:

"associate member" means an individual who is registered on the clinical assistant register referred to in clause 6(1)(b); (« membre associé »)

(b) by repealing the definitions "duly qualified medical practitioner" and "educational register";

(c) by repealing the definition "licence" and substituting the following:

"licence" means a certificate issued by the registrar under section 14 or 22 indicating that the person named in the certificate is authorized to practise medicine in the province for the period specified in the certificate; (« licence »)

(d) by repealing the definition "member" and substituting the following:

"member" means an individual who is registered on the Manitoba Medical Register, and for the purposes of Parts VII to XI, includes an associate member; (« membre »)

(e) by repealing the definition "register";

(f) by repealing the definition "registrar" and substituting the following:

"registrar" means the individual appointed as registrar under section 34, and includes an individual appointed as deputy registrar or assistant registrar under that section; (« registraire »)

(g) by adding the following definitions in alphabetical order:

"licensed" means holding a licence that has not expired, is not currently suspended and has not been surrendered or cancelled;(« autorisé »)

"medical corporation" means a corporation that holds a valid licence issued under section 22; (« cabinet de médecins »)

3

Subsection 2(1) is amended by repealing clause (e).

4

Parts II, III and IV are repealed and the following is substituted:

Unauthorized practice

5(1)

No person other than a licensed member or associate member or a medical corporation shall practise medicine in the province, and such a person shall not practise medicine in the province except as permitted by this Act and the person's licence.

Medical officer of public service

5(2)

No person other than a licensed member shall act as a medical officer to any branch of the public service of the province, or in any hospital or other institution in the province.

PART II

REGISTERS

Registrar to maintain registers

6(1)

The registrar shall maintain the following registers:

(a) the Manitoba Medical Register, on which shall be registered the names and qualifications of the individuals registered under section 9;

(b) the clinical assistant register, consisting of two parts, in which shall be registered the names of the individuals registered under section 11;

(c) the specialist register, on which shall be registered the names of members registered under section 12 and the areas of medical practice in which they are recognized by the college as specialists; and

(d) the medical corporations register, on which shall be registered the names of corporations that have been licensed to practise medicine.

Information in registers

6(2)

Each register shall include

(a) the business address of the registered person;

(b) any practice restrictions or other conditions imposed on licences or certificates of registration;

(c) a notation of every suspension, surrender or cancellation of registration or of a licence;

(d) in the case of the Manitoba Medical Register or the clinical assistant register, the result of every disciplinary proceeding in which a panel has made a finding under section 59.5; and

(e) any other information that the regulations require to be kept in the register.

Incorrect entries

6(3)

An entry in a register proved to the satisfaction of the council to have been incorrectly or erroneously made may be amended or deleted from the register by written order of the council or of the executive committee of the council.

Inspection of register

7

Each register shall be open and may be inspected by any person at any time during reasonable business hours.

Certificate of registrar as evidence

8

A certificate signed by the registrar under the seal of the college certifying that anything is or is not recorded in a register is admissible in evidence as prima facie proof of the matter certified without proof of the signature or appointment of the registrar or of the seal of the college.

PART III

REGISTRATION AND LICENSING OF MEMBERS AND ASSOCIATE MEMBERS

REGISTRATION

Eligibility for registration as member

9(1)

Every individual who possesses one or more of the qualifications, and has completed a postgraduate clinical training program, prescribed by regulation is entitled, upon payment of the prescribed fee and providing evidence satisfactory to the registrar of his or her qualifications, to be registered on the Manitoba Medical Register and have particulars of his or her qualifications entered on the register.

Additional qualifications

9(2)

Every individual who, after registration on the Manitoba Medical Register, obtains a further degree or qualification approved by the council is entitled, with the approval of the council and upon payment of the prescribed fee and providing evidence satisfactory to the registrar of the further degree or qualification, to have particulars of the further degree or qualification entered in the register in addition to or substitution for the particulars of any degree or qualification previously registered.

Membership

10(1)

Every individual who is duly registered in the Manitoba Medical Register and whose registration has not been cancelled or surrendered is a member of the college.

Honorary membership

10(2)

The college may, in accordance with its by-laws, confer an honorary membership in the college upon any person, but an honorary membership does not entitle the person to practise medicine.

Clinical assistant register – Part 1

11(1)

Every individual who is engaged in a pre-registration training program approved by the council and

(a) is certified by the faculty as a medical student qualified to act as an undergraduate clinical student; or

(b) is a graduate of a recognized medical school and has passed the screening process approved by the council;

is entitled, upon paying the prescribed fee and providing evidence satisfactory to the registrar of his or her eligibility for registration, to be registered in Part 1 of the clinical assistant register.

Clinical assistant register – Part 2

11(2)

Every individual who

(a) is a graduate of a clinical assistant education program approved by the council; or

(b) has satisfactorily completed an assessment, under an assessment process approved by the council, of his or her experience and competence;

and meets any other requirements set out in the regulations is entitled, upon payment of the prescribed fee and providing evidence satisfactory to the registrar of his or her eligibility for registration, to be registered in Part 2 of the clinical assistant register.

Associate membership

11(3)

Every individual who is registered in Part 1 or 2 of the clinical assistant register and whose registration has not been cancelled or surrendered is an associate member of the college.

Eligibility for registration as specialist

12(1)

A member in good standing who is a certified specialist of The Royal College of Physicians and Surgeons of Canada is entitled, upon application, payment of the prescribed fee and provision of evidence satisfactory to the registrar of his or her qualifications, to be registered as a specialist in the specialist register.

Specialist registration by order of council

12(2)

In special circumstances, the council maydirect the registrar to register as a specialist in the specialist register a member who has applied and paid the prescribed fee but is not a certified specialist referred to in subsection (1).

Holding out as specialist prohibited

12(3)

No member shall hold himself or herself out to be a specialist otherwise than as registered on the specialist register.

Refusal to register

13(1)

If the registrar is not satisfied by proper evidence that an applicant is eligible for registration on the Manitoba Medical Register, the clinical assistant register or the specialist register or, that an applicant who claims to possess a degree or qualification, does in fact possess it, the registrar

(a) shall refuse to register the applicant or to enter the degree or qualification on the register; and

(b) shall notify the applicant in writing of the decision to refuse the registration of the applicant or the degree or qualification, and of the reasons for the decision.

Appeal to council

13(2)

A person who is refused registration under subsection (1) may appeal the registrar's decision to the council, which may confirm or vary the decision of the registrar.

Notice

13(3)

An appeal under subsection (2) is to be made by filing with the council, within 30 days after the person receives notice of the registrar's decision under subsection (1), a written notice of appeal setting out the facts and the reasons for the appeal.

Refusal of registration because of conviction

13(4)

An individual who has been convicted of an offence that is relevant to his or her suitability to practise medicine may be refused registration.

Cancellation because of conviction

13(5)

The council may cancel the licence and registration of a member or associate member who has been convicted of an offence that is relevant to his or her suitability to practise, but it must first notify the member or associate member that it intends to do so and give him or her an opportunity to make representations.

LICENSING

Licence fee

14(1)

A member or associate member who wishes to practise medicine in the province shall pay to the college the licence fee prescribed by the council for the category of licence applicable to that member or associate member.

Issuance of licence

14(2)

On paying the licence fee and complying with any other requirements prescribed by regulation or by-law, the registrar shall issue a licence to the member or associate member in a form approved by the by-laws.

Renewal of licence

14(3)

A licensed member or associate member is entitled, upon applying to the registrar, paying the licence fee and complying with any other requirements prescribed by by-law or regulation, to a renewal of his or her licence.

Late application for renewal

14(4)

Where a member or associate member applies for a renewal of his or her licence after its expiry date, the registrar may, with the approval of the council, issue a renewal of the licence subject to any terms, conditions and penalties the council considers appropriate.

Effective date of renewal

14(5)

Where a member or associate member fails to obtain a renewal of his or her licence before its expiry date but obtains a renewal of it within 30 days after that date, the renewal of the licence is deemed for all purposes to have been issued and effective as of that expiry date.

Reduction or waiver of fee or penalty

15(1)

The council may reduce or waive any fee, or penalty for non-payment of a fee, payable by any member or associate member, and may declare a member or associate member whose fee or penalty has been reduced or waived to be entitled to some or all the rights and privileges to which he or she would have been entitled had it been paid in full.

Limitation on practice

15(2)

The council may limit the area or areas of practice of a member while the member is engaged in a postgraduate study or training program and the licence fee ordinarily payable by the member has been reduced or waived, at the member's request, for the period of the engagement.

GENERAL

Cancellation of registration

16(1)

The registrar shall cancel the registration of a member or associate member who, for a period of two years without the approval of the council,

(a) has not resided in or has been absent from the province; or

(b) has not practised medicine.

Application for re-registration

16(2)

An individual whose registration has been cancelled under subsection (1) and who wishes to resume the practise of medicine in the province may reapply for registration in accordance with this Act.

Registration or licence based on misrepresentation

17

Where a person has obtained a licence or registration under this Act by oral or written misrepresentation, the registrar, upon receipt of sufficient evidence of the misrepresentation, shall refer the matter to the council and, if so directed by the council, shall cancel the licence or registration and notify the person in writing of the cancellation.

Appeal to court

18(1)

A person who is aggrieved by a decision of the council under this Part to

(a) refuse registration; or

(b) alter or refuse to alter a registration;

(c) refuse to issue or renew a licence;

(d) cancel a registration;

may appeal the decision to the court by filing a notice of appeal within 30 days after the day on which the person is notified of the decision.

Powers of court on appeal

18(2)

On hearing an appeal, the court may

(a) make any decision that in its opinion should have been made; or

(b) refer the matter back to the council for further consideration in accordance with any direction of the court.

Regulations by council

19

The council may, with the approval of the Lieutenant Governor in Council, make regulations

(a) respecting professional qualifications and other criteria for registration, and the proof that may be required as to the professional conduct and general fitness of an applicant to practise medicine;

(b) respecting the definition of general or specific areas of medical practice, for the purpose of establishing the eligibility for registration and amendment of registration of members and associate members;

(c) prescribing standards of continuing medical education to be met by members as a condition of obtaining a licence or renewal of a licence;

(d) exempting from the application of this Act persons or classes of persons performing specified medical services or treating specified ailments or injuries;

(e) prescribing conditions or circumstances under which registration or a licence under this Act is not required;

(f) respecting standards of advertising to be observed by any member, associate member, or medical corporation or by any facility in which a member or associate member is practising medicine;

(g) respecting professional liability coverage, or other liability protection, for members, associate members and medical corporations;

(h) respecting medical responsibilities and duties of associate members that are not inconsistent with any Act that defines the privileges or responsibilities of licensed members.

PART IV

MEDICAL CORPORATIONS

Definitions

20

In this Part,

"voting share", in relation to a corporation, means a share of its capital stock that entitles the holder to vote in any election of directors of the corporation; (« action avec droit de vote »)

"voting shareholder", in relation to a corporation, means a person who owns a voting share of the corporation or is a voting shareholder of another corporation that owns a voting share of the corporation. (« actionnaire avec droit de vote »)

Medical corporation may practise

21

A medical corporation may carry on the practice of medicine through one or more licensed members

(a) under its own name; or

(b) as a member of a general partnership of medical corporations or of medical corporations and licensed members, under a name approved by the registrar in accordance with the by-laws of the college.

Corporate licence

22(1)

Subject to subsection (4), the registrar shall issue a licence or a renewal of a licence to a corporation if he or she is satisfied that

(a) the corporation is incorporated, formed by amalgamation or continued under The Corporations Act and is in good standing under that Act;

(b) the name of the corporation includes the words "medical corporation" and is approved by the registrar in accordance with the by-laws of the college;

(c) each voting share of the corporation is legally and beneficially owned by a licensed member or a medical corporation;

(d) each other share in the capital stock of the corporation is legally and beneficially owned by

(i) a person who is a voting shareholder of the corporation or a spouse or child, within the meaning of section 252 of the Income Tax Act (Canada), of a voting shareholder of the corporation, or

(ii) a corporation each share of the capital stock of which is legally and beneficially owned by a person referred to in subclause (i);

(e) each director of the corporation is a licensed member;

(f) the president of the corporation is a licensed member;

(g) each person through whom the corporation will be carrying on the practice of medicine is a licensed member;

(h) the corporation has filed an application, in the form prescribed by the council, and paid the fee prescribed by the council, for the licence or renewal of the licence; and

(i) all other requirements prescribed by the council for the issuance or renewal of the licence have been satisfied.

Late application for renewal of licence

22(2)

Subsections 14(4) and (5), apply with necessary modifications, to the renewal of a licence under subsection (1) after its expiry date.

Validity of licence

22(3)

Subject to subsection (2), unless it is cancelled, surrendered or under a suspension, a licence issued under subsection (1) is valid for the period specified in the licence.

Refusal to issue or renew licence

22(4)

The registrar

(a) shall refuse to issue a licence to, or to renew the licence of, a corporation if the registrar is not satisfied by proper evidence that the corporation meets the requirements of subsection (1); and

(b) may refuse to issue a licence to, or to renew the licence of, a corporation if

(i) a licence previously issued to the corporation has been cancelled or surrendered, or

(ii) a director, officer or shareholder of the corporation is or has been a director, officer or shareholder of a corporation whose licence has been cancelled or surrendered.

Notice of refusal

22(5)

If the registrar refuses to issue or renew a licence under subsection (4), the registrar shall notify the corporation in writing of his or her decision and the reasons for the decision.

Appeal to council

22(6)

A corporation that is refused a licence or renewal of a licence under subsection (4) may appeal the registrar's decision to the council, which may confirm or vary the decision of the registrar.

Notice

22(7)

An appeal under subsection (6) is to be made by filing with the council, within 30 days after the corporation receives notice of the registrar's decision under subsection (4), a written notice of appeal setting out the facts and the reasons for the appeal.

Business without licence prohibited

23(1)

A corporation whose name includes the words "medical corporation" shall not carry on any business in the province unless it holds a valid licence.

Restriction on business of medical corporation

23(2)

A medical corporation shall not carry on any business or activity other than the practice of medicine and the provision of services directly associated with the practice of medicine carried on by it.

Interpretation of business restriction

23(3)

Subsections (1) and (2) shall not be construed so as to prohibit a medical corporation from investing its funds in real property, other than for development purposes, or in stocks, mutual funds, debt obligations, insurance, term deposits or similar investments.

Validity of corporate act

23(4)

No act of a corporation, including a transfer of property to or by the corporation, is invalid merely because it contravenes subsection (1) or (2).

Voting agreements void

24(1)

An agreement or proxy that vests in a person who is not a licensed member the authority to exercise any voting right attached to a share of a medical corporation is void.

Unanimous shareholders' agreements void

24(2)

A unanimous shareholders' agreement within the meaning of subsection 140(2) of The Corporations Act in respect of a medical corporation is void unless each shareholder of the corporation is a licensed member or a medical corporation.

Application of Act and rules

25(1)

This Act, the regulations and the by-laws of the council apply to a member despite any relationship he or she may have with a medical corporation.

Obligations to clients not diminished

25(2)

The fiduciary and ethical obligations of a member, and the obligations of a member respecting confidentiality, to a person receiving medical services

(a) are not diminished by the fact that the services are provided on behalf of a corporation; and

(b) apply equally to a corporation on whose behalf the services are provided and to its directors, officers and shareholders.

Liability of members

25(3)

The liability of a member to a person receiving medical services is not affected by the fact that the services are provided on behalf of a corporation.

Liability of voting shareholders

25(4)

A person is jointly and severally liable with a medical corporation, or a corporation acting in contravention of section 5, for all professional liability claims made against the corporation in respect of errors or omissions that were made or occurred while the person was a voting shareholder of the corporation.

Investigation of member practising through corporation

25(5)

If the conduct of a member through whom a medical corporation was practising medicine at the time the conduct occurred is the subject of a complaint, investigation or inquiry,

(a) any power of inspection, investigation or inquiry that may be exercised in respect of the member or the member's records may be exercised in respect of the corporation or its records; and

(b) the corporation is jointly and severally liable with the member for all fines and costs the member is ordered to pay.

Member's licence restrictions apply to corporation

25(6)

Any restriction imposed on the licence of a member through whom a medical corporation practises medicine applies to the licence of the corporation in relation to its practice of medicine through that member.

Suspension or cancellation of licence

26(1)

Subject to subsections (2) and (3), a medical corporation's licence may be cancelled or suspended by the council if

(a) the corporation ceases to meet any of the requirements of eligibility for a licence set out or referred to in subsection 22(1);

(b) the corporation contravenes any provision of this Act, the regulations, the by-laws of the college or any restriction on the corporation's licence; or

(c) a member, in the course of providing medical services on behalf of the corporation, does or fails to do anything as a result of which the member's licence is cancelled, surrendered or suspended.

Limitation

26(2)

A medical corporation's licence shall not be cancelled or suspended by reason only of the fact that

(a) one or more shares of the corporation have vested in

(i) an executor or administrator of the estate of an individual as a consequence of the death of the individual, or

(ii) a trustee in bankruptcy on the bankruptcy of the owner of the shares,

unless the corporation is not practising through any other member or the shares continue to be vested in the executor, administrator or trustee for more than 180 days, or for any longer period allowed by the registrar;

(b) a share of the corporation continues, after a divorce, to be owned by the former spouse of a voting shareholder of the corporation;

(c) the fact that the licence of a member has been suspended, unless the member remains a director or officer of the corporation more than 14 days after the suspension; or

(d) the fact that the licence or registration of a member has been surrendered or cancelled, unless

(i) the member remains a director or officer of the corporation more than 14 days after the surrender or cancellation, or

(ii) the member remains a voting shareholder of the corporation for more than 90 days after the surrender or cancellation or for any longer period allowed by the council.

Alternatives to cancellation or suspension

26(3)

Instead of suspending or cancelling the licence of a medical corporation, the council may take any other action it considers appropriate, including one or more of the following:

(a) reprimanding the corporation or one or more directors or voting shareholders of the corporation;

(b) imposing restrictions on the licence;

(c) imposing a fine on the corporation, payable to the college, in an amount not exceeding $10,000.

Appeal to court

26.1(1)

A corporation aggrieved by a decision of the council under this Part to

(a) refuse to issue or renew a licence;

(b) suspend or cancel a licence; or

(c) impose a fine on the corporation or restrictions on the corporation's licence;

may appeal the decision to the court by filing a notice of appeal within 30 days after the day on which the corporation is notified of the decision.

Powers of court on appeal

26.1(2)

On hearing an appeal, the court may

(a) make any decision that in its opinion should have been made; or

(b) refer the matter back to the council for further consideration in accordance with any direction of the court.

5(1)

Subsection 31(1) is amended

(a) in clauses (a) and (b), by striking out "duly qualified medical practitioners" and substituting "licensed members"; and

(b) in clause (d), by striking out "from the persons on the educational register" and substituting "by the associate members".

5(2)

Subsection 31(5) is amended by striking out "who is a member of the college".

5(3)

Subsection 31(6) is amended

(a) in clause (b) of the English version, by striking out "involes" and substituting "involves"; and

(b) in clause (c),

(i) by striking out "elected under clause (1)(d)", and

(ii) by striking out "from the educational register as a councillor as selected by associate members" and substituting "to fill the vacancy".

6(1)

Subsection 32(1) is amended by striking out "duly qualified medical practitioners" and substituting "licensed members".

6(2)

Subsection 32(2) is repealed.

7

Section 34 is repealed and the following is substituted:

Appointment of president and president-elect

34(1)

The council shall annually appoint from among the councillors a president and a president-elect.

Appointment of registrar, treasurer and other officers

34(2)

The council shall appoint from among the licensed members a registrar, a treasurer and such other officers as the council considers necessary for carrying out the purposes and objects of the college, and each officer appointed under this subsection shall hold office during the pleasure of the council.

8(1)

Subsection 36(1) is amended

(a) in clause (a), by striking out "members of the college" and substituting "members, associate members and medical corporations";

(b) by repealing clause (f) and substituting the following:

(f) cancel the licence of any member, associate member or medical corporation for non-payment of fees under this Act or the by-laws of the college, and impose terms or conditions on the reinstatement of the licence;

8(2)

Subsection 36(2) is amended

(a) by repealing clause (b) and substituting the following:

(b) the fees to be paid by applicants for registration or licences or renewals of licences, which may be different for different classes of registration and different classes of licences;

(b) by adding the following after clause (h):

(i) the issuance, expiry and renewal of licences under Part IV, including conditions that must be met before a licence may be issued or renewed;

(j) conditions that may be imposed on licences issued under Part IV;

(k) names by which medical corporations or partnerships referred to in section 21 may be known;

(l) any matter the council considers necessary or advisable for the purposes of Part IV.

9

Clause 38(1)(a) is amended by striking out "of any member that relate to his practice of medicine, at his place of practice or elsewhere" and substituting "of any member or medical corporation that relate to the member's or corporation's practice of medicine in the province, at the place of practice or elsewhere".

10

Subsection 39(1) is repealed and the following is substituted:

Reporting of members

39(1)

Every member who has reason to believe that another member

(a) is suffering from a mental or physical disorder or illness to such an extent that his or her fitness to practise may be affected; and

(b) continues to practise when counselled not to practise, shall disclose to the registrar the name of the other member together with particulars of the suspected disorder or illness.

11(1)

Subsection 40(1) is amended by striking out "registered medical practitioners" and substituting "members".

11(2)

Subsection 40(5) is amended by striking out "medical practitioner shall continue" and substituting"member or medical corporation shall".

12

Section 61 is amended

(a) in the English version of the section heading, by striking out "against members"; and

(b) in the section,

(i) by striking out "member of the college" and substituting "member or medical corporation", and

(ii) in the English version, by striking out "rendered," and substituting "rendered".

13

Section 62 is amended by striking out "member of the college" and substituting "member or medical corporation".

14

Part XII is repealed.

15

Subsection 66(1) is amended

(a) in the English version of the section heading, by striking out "fraudulent representation on application for registration" and substituting "false or fraudulent representation"; and

(b) in the subsection, by striking out "his registration" and substituting "a licence, a registration or an alteration of a registration".

16

The following is added after section 68.1:

Directors, officers and employees of corporations

68.2

If a corporation commits an offence under this Act, a director, officer or employee of the corporation who authorized, permitted or acquiesced in the commission of the offence is also guilty of an offence and is liable on summary conviction, whether or not the corporation has been prosecuted or convicted,

(a) for a first offence, to a fine of not more than $6,000.; and

(b) for a second or subsequent offence, to a fine of not more than $30,000.

17

Section 69 is repealed.

Coming into force

18

This Act comes into force on a day fixed by proclamation.