Professional regulation, profession-state relations and the pandemic response: Australia, Canada, and the UK compared

Abstract

The COVID-19 pandemic provoked a surge in demand for health services. To help meet this demand, governments and health profession regulators implemented regulatory policy change to enhance professional availability and flexibility. Some nations may have been better positioned to make such changes due to their systems of healthcare profession regulation. More specifically, countries like Australia and the United Kingdom with their national regulatory structures could be more adaptable than Canada with its provincial system of regulation. To determine if this is the case, and guided by Abbott's (1988, 2005) ecological approach, we conducted a policy analysis. We find few differences in regulatory policy changes in terms of what was done, with the exception of scope of practice changes, which were implemented in Canadian provinces, but were not necessary in Australia and the United Kingdom. Instead, in the latter two countries practitioners were asked to bear responsibility for their own scopes. Additional content analysis of medical journals explored what professionals thought about policy responses, finding that Australian professionals were more positive than others. Moreover, government responses were regarded more favourably when they were perceived to be collaborative. Although there is little evidence that one regulatory system is better than another in facilitating crisis responses, regulatory structures do shape the nature of regulatory policy change.