The Public Trust Test: Accountability in Professional Regulation
Professional regulators are entrusted with protecting the public. That responsibility must be evident in their decisions, their treatment of people who raise concerns and the conduct of the leaders who set their standards.
When people turn to a professional regulator, something has often gone wrong. They may have experienced harm, witnessed conduct that concerns them or lost confidence in a professional they trusted. Filing a complaint can be difficult. It may require people to revisit distressing events, gather records, navigate unfamiliar procedures and wait for answers while uncertainty about what happened, and what might happen next, continues. For these people, public protection is not an abstract promise. It is the reason they approach a regulator in the first place. NOTE: For Government of Canada Trauma and violence-informed approaches to policy and practice, please click here.
A regulator’s responsibility does not end with having a complaints process. It includes demonstrating that the process serves the public interest, that concerns are assessed competently and impartially, and that the people who rely on the system are treated with fairness and respect. Public trust depends not only on the standards a regulator publishes, but on whether its actions demonstrate that those standards mean something.
Accountability must be demonstrated
Professional regulation involves a difficult balance. Regulators must protect the public, act within their legal authority, respect procedural fairness and make evidence-informed decisions. They must also maintain appropriate independence from the professions they regulate. These responsibilities can be complex, but complexity does not remove the obligation to explain how decisions are made and how the public interest is served.
Research examining accountability among Canadian medical and nursing regulators illustrates that this is not a new or simple challenge. In a study published in Healthcare Policy, Andrea Baumann and colleagues interviewed 22 provincial and territorial chief executives from these regulatory fields. Their findings highlighted differing understandings of accountability and the challenge of demonstrating it in practice. One participant described the public as the regulator’s primary constituency: “We are accountable more broadly to the public … that's our primary owner.” Another emphasized the importance of transparent, evidence-informed decisions and explaining the evidence behind them.
These are perspectives from regulatory leaders interviewed for the study, not a universal definition of accountability. Nevertheless, they point to a fundamental question: how can the public evaluate a regulator’s performance if it cannot understand the basis for its decisions, the effectiveness of its processes or the actions it takes to address identified problems? Accountability requires more than publishing policies, annual reports or statements of commitment. It requires meaningful information about performance, an honest examination of shortcomings and evidence that lessons lead to improvement.
Complainants deserve more than a process on paper
For people who bring concerns to a professional regulator, accountability is experienced not only in the final decision, but throughout the process. It means receiving meaningful and timely updates, including when there has been little progress to report; understanding what stage a complaint has reached, what remains outstanding and what happens next; and having reasonable expectations about timelines. Where delays become unavoidable, regulators should explain what they can, communicate changes and take reasonable steps to prevent avoidable delays from becoming the norm.
These responsibilities depend on more than good intentions. Regulators need competent, adequately resourced teams, effective case management, appropriate oversight and ongoing staff training. Investigators and decision-makers must be equipped to assess complex evidence, communicate clearly and engage appropriately with people who may be distressed or have experienced trauma.
Ontario’s College Performance Measurement Framework recognizes the importance of timely investigations and communication with both complainants and registrants. It identifies these practices as supporting transparency, effective participation and procedural fairness. It also identifies opportunities for greater consistency in responses to inquiries about complaints processes and for more transparency about how risks are assessed and investigations prioritized. These are important benchmarks. They also raise a wider question for regulators across Canada: how consistently are such principles reflected in everyday practice, and how do institutions know when their processes are falling short?
For some complainants, the stakes are profound. They may be living with devastating harm, questioning whether it could have been prevented or fearing that the circumstances that gave rise to their concerns remain unresolved. In some cases, the potential for further harm may itself be part of the concern they bring forward. A regulator must remain impartial and cannot promise a particular outcome. But neither should impartiality become an excuse for avoidable silence, unexplained delay or a process that leaves people unable to understand what is happening with their concerns. Confidentiality and investigative integrity may limit what can be disclosed; they do not eliminate the value of meaningful communication. A regulator may not be able to undo harm, but it can demonstrate that concerns are being assessed carefully, that the process is being managed competently and that the person who came forward has not simply disappeared into an administrative system.
Trauma-informed practice must also mean more than a completed training course or a policy statement. Public Health Agency of Canada guidance describes the need for:
“fundamental changes in how systems are designed, organizations function and practitioners engage with people.” That principle has implications for regulatory institutions. Training must be reinforced through procedures, supervision, case management, leadership and organizational culture. Staff need the skills and support to handle sensitive complaints appropriately, while institutions need ways to assess whether their practices are actually helping to reduce harm. Fairness must be evident in the process as well as in the decision.
Public protection requires transparency about performance
Regulators cannot disclose everything. Privacy, confidentiality, legal obligations and the integrity of investigations can legitimately restrict the information available to the public. But these limits should not prevent meaningful accountability about institutional performance.
How does a regulator identify recurring concerns? How does it assess whether its interventions are effective? What happens when a process reveals a weakness in policy, oversight or practice? How are risks to the public assessed when concerns extend beyond the conduct of one individual? How does the regulator explain what it can do, what falls outside its authority and what other avenues may be available?
These questions matter because individual complaints can sometimes reveal issues that extend beyond one person or one incident. A regulator may not be able to discuss a particular case publicly, but it should still be able to explain its broader responsibilities, its approach to identifying risk and how it evaluates whether its systems are working as intended. When reasonable public-interest questions repeatedly receive no substantive explanation, the public can be left without a clear basis on which to understand or assess the institution’s work. That is an accountability problem in its own right. Public confidence cannot depend solely on an expectation that people will trust a regulator because it is the designated authority.
Leadership must practice what it promotes
The responsibility for accountability does not rest solely with frontline staff. Senior leaders establish priorities, allocate resources, oversee performance and shape the culture in which decisions are made. They also represent their institutions to the public.
Leadership biographies should accurately reflect accomplishments, but claims of leadership in legislative reform must also be measured against the protections legislation delivers. Where gaps may leave risks undisclosed and the public inadequately protected, leaders and regulators should explain what safeguards exist and what remains to be done.
Ontario’s veterinary legislation raises an important question about whether mandatory-reporting provisions adequately protect the public. Section 14 of the Provincial Animal Welfare Services Act, 2019 expressly requires veterinarians to report reasonable grounds to believe an animal is being abused or neglected. By contrast, the current Veterinarians Act does not expressly establish a comparable, general reporting duty specifically addressing suspected abuse of a person by another veterinarian.
The incoming Veterinary Professionals Act, 2024, which received Royal Assent in June 2024 but is not yet in force, introduces a reporting duty under section 37 when a veterinarian learns, in the course of practicing veterinary medicine, of information giving reasonable grounds to believe another member’s fitness to practice is impaired. However, abuse of a person is not expressly identified as a separate reporting trigger. Section 106 also addresses reporting where a member learns, before the transition date, that another member’s fitness to practise may be impaired.
This raises a significant public-protection question: will the new framework provide adequate safeguards when a veterinarian is suspected of abusing a client, colleague or staff member, including where the conduct has already occurred? Although such conduct may engage the reporting duty depending on the circumstances and the statutory threshold, the legislation does not expressly identify abuse of a person as a distinct trigger. Whether the framework adequately addresses this risk deserves clear, transparent consideration by regulators and policymakers.
For a regulator whose stated mission is to govern the profession in the public interest and whose vision is public confidence in veterinary regulation, this is more than a technical legislative question. It goes to whether the protections established in law are sufficiently clear, comprehensive and effective to support public safety and trust. Legislative reform should be assessed not only by the changes it introduces, but also by the risks it addresses, the safeguards it provides and any gaps that may remain.
Legislative reform is not, in itself, proof of effective public protection. Its safeguards, implementation and unresolved gaps must be examined. Public-facing biographies of regulatory leaders may highlight their contributions to legislative reform and public protection, but those claims must be considered alongside the protections the legislation actually delivers, including the risks it may leave insufficiently addressed. Leadership is demonstrated not simply by advancing reform, but by working to ensure that its provisions adequately protect the public and by being transparent about the limitations that remain. The same standard applies to claims about transparency, accountability and trauma-informed practice. These commitments should be evident in decisions, procedures, communication, staffing and the experiences of people who interact with the regulator. They should be open to scrutiny and improvement.
Trust must be earned
Professional regulators have the opportunity to perform an important public function. Their authority carries a corresponding responsibility to demonstrate that their work is competent, fair, proportionate and directed toward the public interest. That means providing meaningful updates to complainants, taking reasonable steps to limit avoidable delays, investing in capable teams, supporting ongoing staff development, explaining decisions within appropriate legal limits and examining whether institutional practices are achieving their intended purpose. It also means considering legitimate questions about the adequacy of existing safeguards and the effectiveness of reforms, explaining how authority is exercised, and demonstrating a commitment to learning and improvement. The public should be able to ask difficult questions without those questions being treated as proof of hostility or as a challenge to the legitimacy of regulation itself. Constructive scrutiny is part of the accountability that makes public authority worthy of confidence.
Ultimately, a regulator’s credibility depends on the relationship between what it says and what it does. Public trust is earned when its processes reflect its stated values, its leaders uphold the standards they promote and its institutions are prepared to explain their work, acknowledge shortcomings and address risks. The standard a regulator promotes publicly must also be the standard it is prepared to demonstrate in practice.
About the author:
Catherine Cameron is a Communications Executive and Strategic Advisor with more than 30 years of experience. Her work focuses on trust, reputation, leadership communication, stakeholder engagement, crisis communications, and public confidence.
Editorial note: This article presents commentary on professional regulation, public accountability and legislative safeguards. It is intended to encourage informed public discussion about the effectiveness of regulatory systems and the protection of the public.
Sources and further reading
Baumann, A. et al., “Accountability: The Challenge for Medical and Nursing Regulators,” Healthcare Policy, 10 (Special Issue), 2014, pp. 121–131. Read the study.
Government of Ontario, College Performance Measurement Framework, including Domain 6: Suitability to Practice.
Public Health Agency of Canada, Trauma and Violence-Informed Approaches to Policy and Practice.
Government of Ontario, Provincial Animal Welfare Services Act, 2019, section 14.
Government of Ontario, Veterinary Professionals Act, 2024, section 37.
College of Veterinarians of Ontario, Veterinary Professionals Act: implementation and transition.
