When the Architect Raises Concerns, It’s Time to Listen

B.C.’s new health care law is now in force — but the concerns surrounding it are not going away.

02 April 2026 – Psychologists for Ethical Care and Governance

As British Columbia’s Health Professions and Occupations Act (HPOA) is now in effect, recent reporting in The Globe and Mail should give both government and the public pause.

In the article, “B.C.’s move away from self-regulation for health professionals was overdue, expert says”, Harry Cayton — the expert whose 2018 report helped shape B.C.’s move away from self-regulation — supports some aspects of the shift, including stronger public accountability. But he also raises issues that many psychologists and other health professionals have been voicing for some time.

In one sense, that is refreshing.

For years, regulated professionals across disciplines — including psychologists — have been raising thoughtful, measured objections to parts of this legislation and its implementation. These objections have not come from resistance to accountability or opposition to reform. They have come from front-line experience, professional responsibility, and a serious understanding of what safe, ethical care requires.

So, when someone involved in shaping this legislation begins identifying similar problems, that should not be brushed aside.

It should deepen concern.

If government relied on Mr. Cayton’s expertise in building this framework, then his warnings about how it has been structured and implemented should be taken seriously now. If his judgment mattered then, it should matter now.

And what he raises is not minor.

According to the article, Mr. Cayton describes the legislation as overly complex, warns that it leaves room for political influence, and expresses unease that the new oversight model may involve too much government direction over what should be independent regulation in the public interest. He also questions the loss of a statutory right to appeal, suggesting that model may prove difficult to sustain over time.

These are not just technical design issues.

They go directly to whether this new system is balanced, fair, and capable of functioning independently in the public interest.

That is where many psychologists have already been sounding the alarm.

What Psychologists Have Been Saying

Psychologists in British Columbia have not been arguing against accountability.

Accountability matters. Public protection matters. Reform can be necessary.

But the question has always been whether the HPOA, as structured, risks creating new problems while attempting to solve old ones.

Among the issues many psychologists have raised are:

• too much centralized control 
• reduced procedural fairness 
• the loss of independent appeal 
• an overly prescriptive and burdensome framework 
• and the broader impact on professional independence, retention, and patient care 

For psychologists, this goes even deeper.

Some aspects of this law raise serious questions about whether psychologists can fully uphold the ethical foundations of their profession — particularly around confidentiality, privacy, and the protection of sensitive client information.

These are not secondary values in psychology. They are central to the work.

Psychologists are bound by a professional code of ethics that requires them to safeguard privacy, protect confidential information, and create the conditions for clients to speak openly and safely. When legislation creates uncertainty around those obligations — or appears to place them in tension with new regulatory structures or powers — it raises a much more difficult question:

Can psychologists continue to practise ethically under these conditions?

That is not a rhetorical question. It is a practical and professional one.

And it matters especially in psychology, where the work is often nuanced, high-stakes, and deeply relational. Privacy and confidentiality are not side issues in psychological care — they are part of the conditions that make the work possible.

When those foundations become less clear or harder to protect, the effects can be significant. They may shape how safely clients feel they can speak, how confidently psychologists can carry out their ethical obligations, and whether experienced practitioners feel they can continue practising within a system such as the HPOA.

This Reaches Beyond the Profession

This is not just a professional issue.

When regulatory systems become too centralized, too difficult to challenge, or with areas not clearly defined, the effects do not stay confined to governance structures. They reach into the everyday reality of care.

They affect the people who provide it.

And they affect the people who need it.

A strong regulatory framework should absolutely protect the public. But to do that well, it must also be fair, workable, proportionate, and sufficiently independent.

That is the standard this legislation should be held to.

And if questions about that balance are now being raised not only by front-line professionals, but also by someone closely connected to the design of this shift, they should not be minimized or managed around.

They should be taken as a clear sign that this Act has gone too far, too broadly, and in some important ways, in the wrong direction.

At minimum, that should trigger a serious and transparent re-examination of the HPOA. But many psychologists and other health care professionals would argue that what is needed is more than minor revision.

This Act should be repealed and replaced with legislation that addresses the original areas in need of reform — without unnecessarily overreaching into areas that were functioning well, or extending too broadly into areas that were not directly related to the original problems it was meant to solve.

Sometimes, in the effort to modernize or create broad efficiencies, legislation can become too sweeping to be effective. Trying to fix too much at once can create new instability, new confusion, and new unintended consequences.

Sometimes, what is needed is a more careful approach: one issue at a time, with the specific attention it deserves.

In that sense, reform is not always better when it is broader.

What needed fixing should be fixed. What did not need fixing should have been left alone.

There is still time for review, accountability, and course correction — and the public interest is best served by acting before these issues become deeper systemic problems for psychologists, other health care professionals, and the people who rely on their care.