The health inspector has always played a key role in monitoring the abilities of health professionals and the quality of practice. This function has existed since the Health Act was enacted on the 1st September 1945.
Since 1 June 2019, two inspectors, one French-speaking and one Dutch-speaking, have been dedicated full-time to the supervision of health professionals and the protection of public health. They are called "Healthcare professional medical inspectors".
There are also other types of health inspectors. Some are competent to respond in the event of contagious diseases and infections, while others are dedicated full-time to emergency medical assistance activities.
The Federal Control Commission
The Medical Commissions are an ancient institution, predating the foundation of the Belgian State. With the evolution of legislation, notably the entry into force of Royal Decree No. 78 (1967), they gradually lost their competence in the accreditation of professionals and the recognition of practitioners from abroad.
However, the Commissions have remained competent for monitoring the physical and mental abilities of health professionals and the protection of public health. Their missions included the following:
- temporarily revoke or limit the endorsement of a health care professional when it is determined that the individual's continued practice raises concerns about serious consequences for patients or public health
- contribute to public health and prevent or combat diseases subject to quarantine and communicable diseases
- ensure that the healthcare professions are practised in accordance with the laws and regulations
- investigate and report to the prosecutor's office cases of illegal practice of healthcare professions
- withdraw or limit the endorsement of a healthcare professional who no longer has the physical or mental capacity to continue to practise safely
The Quality Act has modernised the organisation of these entities. The Medical Commissions have been replaced by a single, centralised Federal Control Commission, organised into language chambers. Like the Medical Commissions, it is responsible for controlling the physical and mental abilities of professionals.
In addition to the tasks taken over from the former Medical Commissions, new responsibilities have been added.
- the Quality Act entrusts the Commission with monitoring compliance with quality criteria for the practice of healthcare professionals
- the Control Commission has the power to temporarily ban professionals who represent a danger to patients or public health from practicing
The Federal Supervisory Commission consists of one or more French-speaking and one or more Dutch-speaking chambers. These language chambers take the necessary decisions within the framework of the requirements of the Quality Act on the basis of records or data.
The medical inspectors investigate these files if necessary. In this respect, their investigative powers have been strengthened. Inspections can also be carried out by inspectors of the Federal Agency for Medicines and the control and evaluation service of NIHDI. The Minister of Health also has the power of injunction to investigate facts.
All these measures have been put in place to protect public health. When a health care professional is no longer able to practise, for physical or mental reasons, it is imperative to be able to control the extent to which their activity must be limited or prohibited in order to guarantee patient safety. Furthermore, when a health professional's practice no longer meets quality standards, they must start an improvement process.
Some of the measures of the "Quality Act" are already in place, and others are still being implemented. The long-term goal is to adopt a more modern, transparent and effective monitoring policy than previously, in consultation and collaboration with all healthcare stakeholders.
CASES HANDLED BY THE FEDERAL COMMISSION IN 2020
The graphs above illustrate the number of cases processed by the two chambers of the Federal Commission in 2020 and the distribution of these cases by region. These numbers vary from year to year depending on a variety of factors. In their reports, the chambers may include other relevant details, such as:
- the number of files by profession
- the number of penalties
- the type of records (physical or psychological aptitude assessment, illegal practice, etc.)
- the records based on existing risk to the patient or public health