As part of its mandate, the College of Midwives of Ontario works to protect the public interest by investigating complaints received about midwives to ensure Ontarians have access to safe, effective, and ethical care. There is a formal process that the College follows to receive, investigate, and process complaints. This process is set out in the Regulated Health Professions Act, 1991 (RHPA), and the Health Professions Procedural Code.
If you have a concern or complaint about the care you received from your midwife, you have a right to complain to the College. Anyone can file a complaint about a midwife, including a client, a family member or friend of the client, or a general member of the public. There is no time limit on filing a complaint.
The Inquiries, Complaints, and Reports Committee (ICRC) is responsible for investigating complaints and determining what action should be taken to protect the public. The ICRC deliberates on complaints in panels. These panels are comprised of both midwives and members of the public who are appointed by the provincial government to represent the views of the public. In coming to a decision, the ICRC will consider the conduct, the College standards, and the legislation and regulations that govern midwifery practice in Ontario. Each step of the complaints process is designed to ensure fairness to both the person filing the complaint, and the midwife who is named in the complaint
The College offers Alternate Dispute Resolution for some complaints.
If you are comfortable doing so, you can discuss your concerns with the midwife or Practice before filing a complaint. In some cases, you may be able to resolve any concerns you have before filing a complaint.
If you have questions with respect to the care you received and want to speak to a Professional Practice Advisor before filing a complaint, you may do so. While the advisor cannot help you make a decision about a particular clinical situation, understanding how the standards, legislation and regulations relate to that situation may inform your decision on whether to file a complaint. To contact our Professional Practice Advisor, please email email@example.com or by telephone at 416.640.2252 ext. 230.
If you have questions about the complaints process or are unsure if you would like to file a formal complaint, please contact the Professional Conduct Department by email at firstname.lastname@example.org, or by telephone at 416.640.2252 ext. 224.
If you are unsure of the name of the midwife you want to complain about, Professional Conduct staff can help you. Professional Conduct staff assists in the administration of the complaint, but are not members of the ICRC, nor are they involved in the decision making.
File a Complaint
To initiate a complaint against a midwife, please provide the following information in a written or recorded form, such as a letter, or audio or video recording:
- Your full name, mailing address, email, and phone number
- Name(s) of midwife/midwives you are complaining about
- Name of the midwifery practice associated with your complaint
- A clear statement indicating that you are filing a formal complaint and if possible, confirm the issues you would like to complain about
- Date(s) of the incident(s)
- Description of events, and the details of the complaint in your own words
- If applicable, the name(s) of the hospital(s) or other health clinics related to your complaint
- Any supporting documentation you wish to include
- Your expectation of outcome(s)
There are three ways to submit your complaint:
- Submit your complaint as an attachment. Please include the information listed above, as well as any additional supporting evidence relevant to your complaint. You can submit your complaint on our secure deposit box by clicking here.
- Submit your complaint by mail:
- Professional Conduct, College of Midwives of Ontario
21 St. Clair Ave E, Suite 303
Toronto, ON M4T 1L9
- Professional Conduct, College of Midwives of Ontario
- Submit your complaint by email: email@example.com. Please note that personal health information should not be submitted by email. If you would like to submit your complaint electronically the College recommends using our secure deposit box. If you need assistance with this, please contact a Professional Conduct staff member at 416.640.2252 ext. 224.
For additional support, please email firstname.lastname@example.org, or phone 416.640.2252 ext. 224.
The Complaints Process
After your complaint is received, a staff member will contact you within two business days confirming receipt. After this, you will receive documents in the mail to complete and return to the College. Once these are received, the College will gather the materials that are relevant to the investigation, and these will be provided to the midwife for an opportunity to submit a written response. More information on the documents you will receive can be found in the Guide to Filing a Complaint.
The ICRC has the power to make an interim order at any time following the receipt of a complaint. The ICRC can make an order if it believes a midwife’s conduct exposes or is likely to expose clients to harm or injury.
The midwife’s submission and all of the other materials from the investigation are then provided to a panel of the ICRC that reviews your complaint.
The ICRC panel will use the College’s Risk Assessment Framework to make a fair, consistent and transparent decision on your case. The panel could do one or more of the following:
- Take no further action, should the panel decide that the midwife met the standards of the profession
- Provide advice and recommendations to the midwife
- Require the midwife to complete a Specified Continuing Education or Remediation Program (SCERP) which can include courses, papers or chart audits
- Administer an oral caution, where the midwife appears before the panel
- Require the midwife to sign an acknowledgment and undertaking, which is a voluntary agreement between the midwife and the College to place certain restrictions on the midwife’s practise
- Refer specified allegations of professional misconduct and/or incompetence in the complaint to the Discipline Committee
- Refer the matter to the Fitness to Practise Committee, should the matter involve an allegation regarding the physical or mental capacity of the midwife.
The panel has no authority to assess injury or award compensation to the complainant. That is the subject of civil court proceedings.
Alternative Dispute Resolution
Alternative Dispute Resolution (ADR) is an alternative to the College’s complaint process. It allows for the complainant, the midwife, and a third-party facilitator to work together to create a resolution that satisfies all parties. With ADR, there is no formal investigation. The midwife considers the complainant’s perspective and provides an account of their conduct that was considered to be problematic by the complainant. The ADR process will only take place if both the complainant and the midwife agree to resolve the complaint through this process.
Many complaints are eligible for ADR, but the Health Professions Procedural Code states that complaints involving alleged sexual abuse or matters that have already been referred to the Discipline Committee cannot be referred to ADR. The ADR Eligibility Policy further outlines the types of complaints that are not eligible for ADR.
Resolutions vary depending on each case, but they can include the midwife agreeing to engage in some form of education. In other cases, the midwife may apologize to the complainant.
Cases that go through ADR are often completed sooner than those that go through the formal complaints process. Resolutions must be reached within 60 days, with a possibility of an extension to 120 days.
You can find additional information about the ADR process at the College here in the College’s Guide to ADR.
Overview of the Complaints Process
The Inquiries, Complaints and Reports Committee (ICRC) investigates and makes decisions on complaints. This infographic provides a high-level overview of the College’s ICRC complaints process. All complaints are processed by the College in accordance with the Regulated Health professions Act, 1991 (RHPA).
For more information about this process, please review the College’s Guide to Filing a Complaint, or contact a Professional Conduct staff member by email email@example.com or by telephone 416.640.2252 ext. 224.
To submit a complaint, please complete the Online Submission Form.
Complaints Process Overview Infographic (LINK to PDF version)
Frequently Asked Questions
Who can make a complaint to the College?
Anyone can make a complaint, including former clients, family members, and other health professionals.
Can I make an anonymous complaint?
You can report your concerns to the College anonymously, but you will not be a party to the process and will not receive a copy of the decision. If you wish to proceed with a formal complaint, we require your information in order to investigate the matter fully.
Can I make a complaint about a Midwifery Practice?
No, you can only make a complaint about individually named members, however, the College can help you identify the Practice Partners and your complaint can be made against them.
Is there a time limit to complain?
There are no time limitations on filing a complaint with the College, but it is recommended that it is filed as soon as possible so the College can investigate your concerns in a timely way.
Will my information be kept confidential?
Health regulatory college investigation procedures are designed to keep information about the complaint confidential. However, it is important to note that your personal information will be released to the health care provider that is the subject of the complaint. You should also be aware that if your complaint is appealed to the Health Professions Appeal and Review Board, or if the complaint is referred to the Discipline Committee, the case will be heard in a hearing which is open to the public.
Will the midwife know I made a complaint?
As a part of the process, the midwife is notified once we receive your letter of complaint. They will also have an opportunity to provide a written response to the College once all of the investigation materials are received.
What happens after a complaint is submitted to the College?
College staff will review the complaint. The College may contact the complainant to introduce themselves, confirm the issues in the complaint if needed, explain the complaints process, and answer any questions the complainant may have about the process.
The complainant will receive a formal acknowledgment of complaint within 14 days of receipt of complaint.
If the complaint is eligible for Alternative Dispute Resolution, this acknowledgment may include a request that the complainant respond in writing as to whether they consent to participate in this process.
If the ICRC deems certain records to be relevant to their investigation, this acknowledgment may include a request that the complainant provide written consent to authorize the release of medical records, and the relevant consent forms.
The midwife will receive a formal notice of complaint within 14 days of receipt of complaint. The midwife will be provided with a copy of the complaint. If applicable, the College will request the Member to submit the midwifery record to the College.
Note: As part of the investigation process the Client’s personal health information may be obtained by the College. Midwives are permitted to disclose personal health information about a Client to the College for the purpose of the administration of the Regulated Health Professions Act, 1991 and in accordance with Personal Health Information Protection Act, 2004.
The Complaints Process Overview provides more information about this process.
How is a complaint investigated?
Before the ICRC makes a decision on a complaint, they must complete an adequate investigation. The first step in any investigation is obtaining the midwifery record of the Client (if the complaint is related to a client). The ICRC will determine if further investigation is required. This could include obtaining other health records including hospital records, or other documents relevant to the investigation. It could include interviewing people or witnesses.
Some documents include obtaining the client’s consent to release the medical records. Consenting to release records is voluntary, however, if a complainant chooses not to release records, it may impact the ICRC’s ability to make an informed decision.
Sometimes, the ICRC may request the appointment of a formal investigator.
The ICRC may obtain an expert or legal opinion for some complaints.
The ICRC attempts to complete its investigation and render a decision within 150 days of receipt of complaint, however this is not always possible. Any additional investigation steps taken may cause delays in the process and impact the ICRC’s ability to complete a timely investigation.
How long does the complaints process take? What are reasons for delays?
The Regulated Health Professions Act ,1991 (RHPA) sets out that complaints shall be disposed of within 150 days after the complaint is received. The legislation requires the College to send notices to the midwife and complainant when this is not possible and provide a reason for the delay.
Reasons for delays can include:
- Delays in receiving medical records from hospitals or other health care providers
- Delays in receiving coroner reports or other documentation
- Delays experienced in scheduling and conducting interviews
- Providing extensions submission deadlines to parties involved
- Providing the midwife with an opportunity to comment on new information (including subsequent submissions from the complainant) before the ICRC meets
- Obtaining an expert opinion
- Obtaining legal advice on a complaint matter
- Time required for the ICRC to draft their reasons
Letters explaining the delay are sent to the complainant and midwife when the complaint has exceeded 150-days, 210-days, and every thirty days after that until the complaint is disposed of by the ICRC.
How will I find out the outcome?
You and the midwife will both receive a copy of the final decision made by the panel of the Inquiries, Complaints and Reports Committee in the mail.
What decisions can the ICRC make?
After a thorough investigation and deliberation of the complaint, the ICRC makes decisions based on clinical and/or practice issues along with the risk of harm they pose to clients and the public interest. The outcomes of the complaint process aim to be remedial in nature, rather than punitive.
The ICRC has no authority to assess injury or award compensation to the complainant. That is the subject of civil court proceedings.
The ICRC has a number of options available to them and can include:
- Taking no action on the complaint.
This disposition occurs when the ICRC is of the view that the midwife’s conduct presents no/minimal risk to the public. The ICRC would be of the view that the information in the record does not support taking any regulatory action and there is no impact on client care, safety or the public interest. The ICRC may also be of the view that the midwife appears to be in compliance with the standards of the profession.
- Offer advice and recommendations on an issue raised in the complaint
This disposition occurs when the ICRC is of the view that the midwife’s conduct is low risk to the public and are unlikely to have an impact on client care, safety or the public interest. The ICRC would be of the view that the midwife could benefit from advice or recommendations that improve practice.
- Require the midwife to complete a Specified Continuing Education or Remediation Program (SCERP)
This disposition can occur when the ICRC is of the view that the midwife’s conduct may have a direct impact on client care, safety or the public interest. The ICRC would be of the view that the issues raised in the complaint require improvement or remediation. The specific requirements ordered by the ICRC can include that the Member must engage in activities such as educational courses, mentoring, reflective papers and/or undergo chart reviews. This disposition is generally utilized by the ICRC for moderate to high risk matters.
- Issue an oral caution to the Member
An oral caution is issued when the ICRC has a significant concern that the midwife’s conduct may have a direct impact on client care, safety or the public interest if not addressed. This disposition requires the midwife to appear before a panel of the ICRC and the ICRC will communicate a clear message to the midwife that the conduct is unacceptable and must be changed in order to avoid similar incidents from happening in the future. This disposition is utilized by the ICRC for moderate to high risk matters.
- Require the midwife to sign an acknowledgment and undertaking
The ICRC may decide to engage in a voluntary agreement between the midwife and the College to place certain restrictions on the member’s practise in order to address moderate risk issues that are likely to have an impact on client care, safety, or the public interest.
- Refer specified allegations of professional misconduct and/or incompetence in the complaint to the Discipline Committee
This outcome is reflective of high-risk conduct or practise that is likely to have an impact on client care, safety or the public interest. The ICRC would be of the view that the issue is serious enough and there is enough evidence to refer and that the concerns cannot be adequately addressed though other dispositions, or previous dispositions have been unsuccessful in remediating concerns.
- Refer the matter to the Fitness to Practise Committee, where the matter involves an allegation regarding the physical or mental capacity of the midwife
After a health inquiry is completed, the ICRC may make this decision for high-risk matters if concerned that the midwife’s illness and/or capacity will adversely affect their practise and there is a risk posed to both the member and the public. You and the midwife will both receive a copy of the final decision made by the panel of the ICRC. The Decision and Reasons document that you receive will advise you of the outcome and explain the reasons why they made the decision that they did.
Both you and the midwife will receive a copy of the panel’s written decision in the mail. Within 30 days of the decision being issued, you and the midwife have the right to request an appeal of the decision to the Health Professions Appeal and Review Board (HPARB). The appeal can be made to:
Health Professions Appeal and Review Board
151 Bloor St W, 9th Floor, Toronto, ON M5S 1S4
Tel: 416.327.8512 Toll-Free: 1.866.282.2179
Fax: 416.327.8524 Email: firstname.lastname@example.org