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Health News Briefs
January 1987 - December 1991
Brief summaries of news items relating to health and health
policy in Canada during the period January 1987 to December 1991.
All items appeared in Medical Reform, the newsletter of the
Medical Reform Group of Ontario, and are in the order they
appeared, starting January 1987.
Powell Report urges improved access
Dr. Marion Powell, commissioned by the Ontario Ministry of Health
to report on abortion access, released her report at the end of
January, calling for improved access to abortion services in the
province. Powell's report recommended setting up regional abortion
centres, expanding services at women's clinics, and sending doctors
trained in the procedure to smaller communities. Women seeking an
abortion would no longer have to see their own family doctor first,
but would be able to go directly to a hospital-affiliated clinic.
Pro-choice groups welcomed Dr. Powell's recognition of severe problems
in access, but criticized the continuation of therapeutic abortion
committees under the proposed new model. The committees are required
by the present federal law. In her report, Dr. Powell also noted
that while 27,274 therapeutic abortions were done in Ontario in
1985, at least another 5,000 were obtained by Ontario women in freestanding
clinics in Canada and the United States. In addition, in some areas
women are forced to pay extra charges of up to $500 for administrative
fees and equipment.
Globe and Mail and Toronto Star, January 29, 1987
Vander Zalm seeks abortion cutbacks
British Columbia Premier William Vander Zalm has announced his government's
intention to introduce measures which he says will reduce the abortion
rate in the province. Vander Zalm, a strong anti-abortionist, said
that the B.C. government will improve support programs for single
mothers, increase day care fundings, increase welfare rates, crack
down on spouses who fall behind on support payments and make it
easier to adopt. He also said that he might consider reducing the
fees doctors are paid to perform abortions.
Toronto Star, March 10, 1987
Elston says women's health services to be improved
Ontario Health Minister Murray Elston announced plans for improved
health services for women while rejecting a recommendation by Dr.
Marion Powell for regional abortion centres. The new services being
planned include more family planning programs, more treatment centres
for rape victims, the establishment of a Women's Health Bureau,
and three new birthing centres in Toronto, Ottawa, and Northern
Ontario. Elston had little specific to say on the question of improving
abortion access. He said that therapeutic abortion committees, called
useless by 95% of the doctors interviewed by Powell, would be continued
and expressed doubt that abortions could be carried out in hospital-affiliated
women's centres as recommended by Powell.
Toronto Star and Globe and Mail, March 14, 1987
OFL seeks ban on drug tests
The Ontario Federation of Labour has called for legislation banning
compulsory drug testing in the workplace. OFL Gordon Wilson said
corporations are attempting to take advantage of high unemployment
rates by screening workers. He accused employers who are concerned
about drugs being taken by workers "don't seem the least concerned
about the poisons they inject into our bodies in the workplace."
OFL delegate Red Wilson said unions have been begging companies
for years to get involved in drug- and alcohol-abuse programs. Instead,
he said, they; came up with drug testing. Michael Lyons, president
of the Labour Council of Metro Toronto, told the convention that
"as often as not it's the workplace that forces workers to
turn to alcohol and drugs in the first place." He called drug
testing "nothing more than a management tool to better control
the workplace." William Reno of the United Food and Commercial
Workers suggested that unions agree to drug testing if politicians
agree to lie detector tests and company managers agree to breath
tests after their lunch breaks.
Globe and Mail, November 26, 1986
Nursing Homes Bill of Rights
The Ontario government has introduced legislation to ensure that
commercial nursing homes provide proper care and tend to the basic
medical and nursing needs of their residents. One of the major features
of the legislation was a ten-point bill of rights for residents.
The charter of rights would contain principles governing the dignity,
privacy and respect of patients, plus attempts to ensure that they
are properly sheltered, fed, clothed and groomed. The proposed amendments
include beefing up licensing regulations, more comprehensive financial
accountability for both non-profit and private nursing homes, mandatory
reporting by residents and staff of instances of abuse or neglect.
ONA Newsletter, Vol. 14, No. 2
Immigrant doctors protest policies
Foreign medical graduates have been protesting Ontario government
policies which block their access to internship positions. Under
the policy, only 24 immigrant doctors will be granted internships
next year. There are about 500 foreign-trained doctors in the province.
Before the new policy was announced, 63 to 70 (unpaid) internship
positions were open in Ontario to foreign-trained doctors. All physicians
must intern at a Canadian hospital before they can be licensed to
practise in Ontario. The foreign-trained doctors have been lobbying
for permission to take positions in northern and remote communities
which are currently under-serviced.
Toronto Star, December 24, 1986
Arbitration award in Manitoba
A three-member arbitration board gave Manitoba's 2,000 doctors a
one-year fee increase of 6.55 per cent in late December, to the
dismay of Manitoba's NDP government, which was the first province
to adopt a system of binding arbitration in fee disputes. Health
Minister Laurent Disjardins said the government is extremely concerned
about the size of the award. "We just haven't got the damn
money," he said. "We're certainly not happy with it. I
don't think it's reasonable." Earlier in the fee negotiations
the government has been offering 1.6 per cent plus an amount to
cover the increase in the volume of medical services, which the
Manitoba Medical Association had been seeking 12.7 per cent. The
Manitoba government, facing a budget deficit this year of $587 million,
has asked all government departments to put a two per cent limit
on their spending increases. In late January, Mr. Desjardins announced
that the government is terminating its agreement with the MDs to
submit disputes to binding arbitration. He also sent back the fee
increase to the arbitration, saying he wanted clarification and
discussion on the volume of medical services for which the province
is being billed. According to Mr. Desjardins, quoting an adjudicator's
report, Manitoba doctors increased their billings by three per cent
last year, of which only 0.8 per cent could be justified. The Manitoba
Medical Association has since responded by taking the government
to court to force it to pay the arbitrated increase.
Globe and Mail and Toronto Star, January 1987
Alberta MDs asked to take cut in pay
Alberta Hospitals Minister Marvin Moore has asked the provinces
doctors to accept a pay cut of ten per cent to help reduce health
costs. The province's doctors are the highest paid in Canada, said
Mr. Moore, and should take a share of the burden at a time when
other sectors of Alberta society are taking massive cuts in their
income. An arbitration board turned down his proposal to reduce
doctors' salaries in mid-February, but did impose a freeze on doctors
incomes. Mr. Moore then announced that the government will be looking
at the possibility of restricting the number of doctors allowed
to practice medicine and taking action to decrease enrolment in
provincial medical schools.
Globe and Mail, January 27, 1987, February 13, 1987
Hospitals called "bottomless pits"
The Toronto Board of Health has turned down a request from the Hospital
Council of Metro Toronto for financing of capital projects. Board
members said hospitals are like "bottomless pits" because
they have been chronically under- financed by the provincial government.
Board members said the money can be better spent on growing community-based
health programs.
Globe and Mail, February 3, 1987
Vander Zalm may sell B.C. hospitals
British Columbia Premier William Vander Zalm has said that every
crown corporation the government operates will be considered if
the price is right. Asked if this included hospitals, he affirmed
that the government is "not drawing the line anywhere."
Toronto Star, March 7, 1987
Private insurance in Alberta
The Alberta government has introduced legislation to allow private
firms to insure items not on the provincial health care plan. The
legislation originally would have allowed some items covered by
the plan to be insured, but this was withdrawn after extensive criticism.
The government has suggested that abortion may be one procedure
which will no longer be covered by provincial medicare.
Globe and Mail, March 12, 18, 1987
Call for laws to protect people with AIDS
The British Columbia Civil Liberties Association has urged the federal
and provincial governments to pass anti- discrimination laws quickly
to protect people with AIDS. The association states that the absence
of these laws may inadvertently be contributing to the spread of
AIDS because people are deterred from taking the AIDS antibody test
because they fear the results will not remain confidential. "If
you test positively, it's far more likely you will change your behaviour
and this will slow the spread of the disease," said John Dixon,
president of the liberties association. "We must create a climate
that will encourage the maximum number to test their blood to see
whether they're infected" according to Mr. Dixon.
Globe and Mail, April 3, 1987
AIDS test needed for insurance coverage
Canadians buying large amounts of life or health insurance must
now take a mandatory AIDS antibody test or risk being denied coverage,
insurance industry spokespeople say. According to Charles Black,
vice-president of insurance operations for the Canadian Life and
Health Insurance Association, the testing begins on policies ranging
from $200,000 to $500,000 and up. Because policies are considered
"a good-faith contract, if one party says they won't take the
test, the other (the insurance company) will say no way" to
granting a policy, he said. "Right now anybody with a positive
AIDS antibody test is considered uninsurable," according to
Dr. Walter Schlech, an expert on infectious diseases who is a member
of the National Advisory Committee on AIDS.
Globe and Mail, April 4, 1987
Last two provinces comply with Canada Health Act
British Columbia and New Brunswick, the last two provinces to allow
user fees or extra billing, have ended the practices in time to
meet the deadline for complying with the Canada Health Act. The
Canada Health Act states that any province which did not comply
with the Act by March 31 would lose any money withheld since 1984.
The law provides that provinces allowing extra billing or user fees
will lose federal transfer payments equivalent to the amount charged
patients. British Columbia recouped about $85 million withheld by
Ottawa over the past three years when it ended user fees. New Brunswick
recovered about $353,000.
Globe and Mail, March 26, 1987
Figures indicate low turnout in MD's strike
Ontario Health Ministry figures show that OHIP billings in June
of last year, when some Ontario doctors went on strike over the
extra billing ban, went down by only eight or nine per cent. The
figures seem to indicate that participation in the strike was much
lower than was claimed by the Ontario Medical Association, which
estimated last year that 55 to 60 per cent of doctors closed their
offices or curbed services to protest the ban.
Toronto Star, April 15, 1987
Toronto to make capital grants to hospitals
In a hotly debated move, Toronto City Council has voted 13 to 10
to set up a health care fund which will make capital grants to city
hospitals. The fund starts with $300,000 this year, and is slated
to go up to $3,000,000 over the next three years. The hospitals
lobbied for the funds, arguing that they are underfunded by the
province and that municipalities ought to support their local hospitals.
Many Ontario municipalities give money to local hospitals, but Toronto
has instead put its money into public health programs. The move
was strongly opposed by public health advocates who supported increased
emphasis on preventive and community- based programs, and who argued
that these programs would be gutted if Toronto puts most of its
health funds into hospitals. Said Toronto alderman Jack Layton,
"We are facing an AIDS epidemic. Should we invest in hospitals
that care for people after they have got AIDS? Or should we be working
on prevention that helps people from getting AIDS?"
Globe and Mail, April 22, 1987
Hospital spending rising
Hospital costs have been rising faster than health spending generally,
a study by the Economic Council of Canada shows. The Council's Report
on Canadian Hospital Costs and Productivity indicates that health
spending climbed from $2.1 billion in 1960 to $22 billion in 1980,
with rising hospital costs accounting for 40 per cent of the increase.
The study found that while Canada's population was growing 1.5 per
cent per year, the volume of hospital services was growing 5 per
cent per year. The report also revealed some striking regional variations
in hospital admission rates, with Quebec's rate being 17 per cent
below the national average and Saskatchewan's being 38 per cent
above.
Globe and Mail, April 23, 1987
Law Reform Commission criticizes workplace safety
The Law Reform Commission of Canada has criticized laws on workplace
safety in a recently released report. The Commission says that there
are "strikingly few" inspectors across Canada to help
enforce the laws, that the laws provide for weak penalties, and
that these are further diluted by bargains hammered out with governments
that see prosecutions as a last resort. "By declining to invoke
sanctions, they are in effect issuing permits for activities which
may endanger employee's health or environmental quality." The
Commission notes that between 1972 and 1981, 10,000 Canadians died
from injuries received on the job.
Globe and Mail, January 22, 1987
Health committees receive low marks
Many of the 8,000 labour-management committees at the heart of Ontario's
workplace health and safety system are employer-controlled and unable
to protect workers' interests, according to a report presented to
Ontario Labour Minister Bill Wrye. The report, by SPR Associates,
casts doubt on the entire scheme by describing a health and safety
committee system that in hundreds of workplaces exists not at all
or only on paper. The report says that many of the most effective
workplace committees include local union officers who sometimes
engage in "negotiating" or adversarial tactics rather
than using the co-operative style favoured by employers and labour
ministry officials. It concludes that workplace committees, unless
backed by strong law enforcement by labour ministry inspectors,
"lead not to self-regulation but to self-deception." Among
the report findings: -The committees are often perceived as ineffective
in the most dangerous workplaces. -The ministry concentrates its
inspection resources on large, unionized workplaces. -Nearly 80
per cent of all workplaces are in violation of the law in some manner.
-In 35 per cent of workplaces, worker safety representatives are
selected by management and not by workers, in direct violation of
the law. -Thirty-three per cent of workplaces with 2o or fewer employees
which use designated toxic substances have no safety committees,
again in violation of the law. -In 1,500 workplaces in which the
ministry says there are no designated toxic substances in use, workers
and management reported the use of designated substances
Toronto Star, February 11, 1987
Nova Scotia pharmacy body charged
The Nova Scotia Pharmaceutical Society and the province's pharmacy
association are among 13 pharmacies and other organizations and
individuals charged with conspiring to restrict competition. The
charges, laid under the federal Competition Act span the period
from January 1974 to June 1986. The charges deal with private pre-paid
prescription plans as well as with prices to the general public.
Canadian Press, March 18, 1987
End to tobacco ads planned
Federal Health Minister Jake Epp has announced that the federal
government plans to eliminate all tobacco advertising and phase
out smoking in federal offices. He said the new measures are to
be contained in a new Tobacco Products Control Act to be imposed
in the next two years. Newspaper advertising of tobacco is to stop
by January 1, 1988, electronic media ads July 1, 1988, and magazine
ads January 1, 1989. Tobacco companies will no longer be able to
deduct advertising expenses for advertisements placed in foreign
magazines which reach the Canadian market.
Globe and Mail, April 23, 1987
Polish trained MDs lose court case
A group of Polish-trained doctors have lost their court challenge
of an Ontario government policy restricting their access to internships.
Under Ontario policy, the province finances 603 internships and
reserves those positions for graduates of Ontario medical schools,
although graduates of other accredited medical schools are eligible
under certain circumstances. Only medical schools in Canada and
the U.S. are accredited, so graduates of other schools are not eligible
for internships. A new policy to become effective this fall creates
24 pre-internships and subsequent internship positions reserved
for doctors trained outside the currently accredited medical schools.
The Polish doctors had argued that the provincial rules violate
their constitutional right to equal benefit of the law without discrimination.
Globe and Mail, April 17, 1987
Chronic pain ruling says WCB should pay
The Workers Compensation Board (WCB) has been ordered for the first
time to pay money to workers for chronic pain that continues after
injuries heal. The Workers Compensation Appeals Tribunal said on
May 22 that the WCB has been wrong in taking the view that psychological
pain is not directly caused by workplace accidents. The decision
which the tribunal says constitutes "a historic change for
the Ontario board" could ultimately increase payments for many
workers.
Globe and Mail, May 23, 1987
Alberta plans cuts in medical insurance plan
The Alberta government is planning to drop services such as birth
control counselling, vasectomies, tubal ligations and premarital
counselling from Alberta's medical insurance plan beginning August
1. The plans have come under strong attack from critics who say
that the moves, designed to save money, are shortsighted and will
only increase costs in the long run. "This is a big mistake,
a great big error in judgment," said Dr. Gerald Bonham, Calgary's
medical officer of health. "It seems that anything to do with
choice in sex or reproduction is treated as if it is optional...the
province does not appreciate the consequences, such as an increased
demand for abortions, of putting up barriers to these services."
The province also plans to de-insure services such as contact lens
fitting and eye examinations for patients between 18 and 65, and
it will reduce the amount it will cover for visits to chiropodists,
physiotherapists and podiatrists.
Globe and Mail, May 23, 1987
Probe wants WCB hospital to be public
Queen's Park should cut ties between the Workers Compensation Board
and its 522-bed Downsview rehabilitation centre and make it a public
hospital, a task force has recommended in a report presented to
the Ontario Legislature by Labour Minister Bill Wrye. The report
of the review team headed by W. Vickery Stoughton says that both
patients and staff at the Downsview centre are caught in a climate
of mistrust and frustration because of the contradictory requirements
of medical treatment, rehabilitation and compensation benefit control.
"Patients were distrustful or suspicious of some rehabilitation
activities because these might be used to influence negatively their
assessment for compensation" the report said.
Toronto Star, April 30, 1987
Agreement reached on AZT
The federal and provincial governments have reached an agreement
in principle with Burroughs Wellcome Inc. to expand the use of the
experimental anti-AIDS drug AZT in Canada. The drug will be made
available for the first time to AIDS patients with a variety of
viral, parasitic and bacterial infections, federal Health Minister
Jake Epp announced May 22. Previously the drug was available only
to patients with PCP. The health department said Burroughs Wellcome
would be paid for the drug, but it has not yet been decided where
the money will come from. The cost of treatment is about $10,000
a year. Burroughs Wellcome was originally to provide the drug free
of charge for clinical trials that would last 18 months the standard
procedure when new drugs are being tested prior to licensing. A
few months into the trials, however, Burroughs Wellcome changed
its mind, threatening to curtail future supplies unless it was paid
for the drug and unless the government agreed to waive the normal
licensing procedure for new drugs. Mr. Epp criticized the company's
pressure tactics, pointing out that the government is already proceeding
with its drug-patent legislation which benefits companies such as
Burroughs Wellcome. The company has done well by the introduction:
in the first three months of the year, its share prices went up
360 per cent.
Toronto Star, Globe and Mail, & Fortune, April, May 1987
Remembering Illegal Abortions
The Childbirth
by Choice Trust has started a project to compile and publish
Canadian women's stories about their illegal abortions. According
to the Trust, "it is important that these stories be collected,
particularly from older women and health care professionals, before
they are lost to us. They are a significant part of our history
and a reminder of the times we are fighting not to repeat."
Stories will be published anonymously and confidentiality will be
respected. Those who are interested or would like more information
are asked to contact Louise Daw, Childbirth by Choice Trust, 344
Bloor Street West, Suite 306, Toronto, Ontario M5S 1W9 or call 416-961-1507.
CARAL Newsletter, June 1987
AIDS groups criticize bill
The British Columbia government has introduced amendments to the
provincial Health Act which would give the courts powers to order
persons carrying communicable diseases to be confined to places
other than hospitals, if the medical health officer feels it necessary.
Under current B.C. legislation, persons cannot be confined to a
hospital against their will. Although B.C. Health Minister said
that the legislation was primarily aimed at carriers of tuberculosis,
he agreed that it could also be used to deal with AIDS carriers.
AIDS groups believe that the legislation is really aimed at people
with AIDS. They argue that the proposed legislation will arouse
fears of quarantining, and will drive those at risk of infection
underground.
Toronto Star, July 3, 1987
Judge orders prostitutes be tested for AIDS
An Ontario Provincial Court judge is refusing to sentence any convicted
prostitutes or their clients until they have been tested for AIDS.
Judge William Ross ordered two women who pleaded guilty to communicating
for the purpose of prostitution to reappear in court in August with
the test results or face arrest warrants. Ross said he would make
the order for the tests in all future cases.
Toronto Star, July 4, 1987
Contaminated soil to be removed
The Ontario government has agreed to residents' demands to replace
lead-contaminated soil from about 1,000 homes in Toronto's South
Riverdale neighbourhood. The soil is to be replaced on all residential
and publicly accessible lands to a depth of 30 centimeters. Environment
Minister James Bradley said that the province will be asking Canada
Metal Company, the company believed to be responsible for the lead
buildup, to "make a meaningful contribution". Mr. Bradley
said the project will be a model for similar soil-lead problems
in the Niagara Street neighbourhood of Toronto. Tests have shown
that some children in South Riverdale have blood lead levels several
times higher than the acceptable limit of 20 micrograms per decilitre
set by the Toronto health department.
Globe and Mail, June 26, 1987
CMA opposes employee drug tests
Dr. Jacob Dyck, the president of the Canadian Medical Association,
says that the medical profession cannot endorse testing workers
for drugs or alcohol when there is no suspicion of abuse. According
to Dyck, mandatory testing for drug and alcohol abuse" is beyond
what the profession can accept." Dyck told the annual meeting
of the Ontario Medical Association on May 25 that he is worried
railway employees may have to undergo compulsory drug and alcohol
spot tests when a new Railway Act is brought in. He fears that railway
workers' personal physicians might be required to report to company
doctors on health conditions of their patients. Dyck said that mandatory
medical reporting and drug testing programs for railway employees,
if written into legislation, could be the thin edge of the wedge"
leading to similar tests for all sorts of workers.
Toronto Star, May 26, 1987
Government changes stand on treatment refusal
Ontario's Liberal government has abruptly withdrawn support for
its own proposed legislation that would have denied some psychiatric
patients the right to refuse medical treatment. The Liberals proposed
amendments to the Mental Health Act in December that would give
a doctor the power to ask a review board to override a competent
patient's decision to turn down medical treatment. Then on June
9, the government announced that it would be supporting NDP MPP
David Reville's proposal to delete that part of the bill that allows
a doctor to override a patient's right to refuse treatment.
Globe and Mail, June 10, 1987
CP's policy on diabetes ruled valid
A policy of Canadian Pacific Ltd. against employing diabetics as
trackmen is a bona fide occupational requirement, the Federal Court
of Appeal said in a ruling made public June 19. The court reversed
a ruling by a human rights tribunal, saying the tribunal made"
a fundamental error" in concluding that the policy was discriminatory
and that there was only a slight risk of serious damage if stable
diabetics were employed as trackmen.
Globe and Mail, June 20, 1987
AIDS policy for Metro Toronto employees
Metro Toronto Council has adopted a policy on AIDS which states
that people with AIDS have the right to work, and that no one can
refuse to work alongside someone who has AIDS. The policy stresses
education of Metro's 25,000 employees, including police and ambulance
workers.
Globe and Mail, June 24, 1987
Number of residents to be cut
Ontario's teaching hospitals will lose almost 300 medical residents
by 1992, in a series of cuts reducing the province's supply of doctors.
The Ontario government believes that the province has a surplus
of doctors. However, hospital officials and deans of medicine are
protesting the cuts. More than half the residency positions lost
will be at Metro Toronto's ten teaching hospitals." It's having
enormous impact; it's got everybody convulsing," according
to Dr. Kenneth Stuart, medical vice-president at University Hospital
in London. To fill the gap, Dr. Stuart said, hospitals are considering
alternatives such as hiring more salaried physicians or training
nurses and operating room technicians to perform some of the tasks
only residents are at present allowed to do.
Globe and Mail, June 11, 1987
Evans report released
The Ontario Health Review Panel, chaired by Dr. John Evans, released
its report in late June, with a key recommendation being the creation
of a Premier's Council on Health Strategies. The panel recommends
the panel as a way of bringing about needed changes in Ontario's
health care system. The report contends that the Ministry of Health
is too entrenched and too concerned with day-to-day crisis management
to be able to carry out needed long-term changes in the health care
system. In addition, it sees a need to deal with overlapping responsibilities
by the ministries of Health, Community and Social Services, and
Labour. Dr. Evans said that his panel diagnosed many of the same
problems as previous reports on the health system, and agreed with
most of the proposed solutions. The proposed Premier's Health Council
would have representatives from all the "stakeholders"
in the health care system, including doctors, hospital officials,
patient advocates, and health experts. The panel said that spending
on health care in Ontario is not extravagant, and said that it "found
no evidence that health-care costs in Ontario are out of control".
The report did not tackle the question of whether there is an oversupply
of doctors in Ontario.
Toronto Star and Globe and Mail, June 20, 24, 1987
Scarborough to discontinue hospital grants
Scarborough Board of Control has voted not to contribute any more
money toward hospital expansion. Over the past five years, Scarborough
Council has given local hospitals $10 million in capital grants.
Faced with provincial cutbacks in support, hospitals have been pressing
local municipalities to come up with some of the money which formerly
came from the province. Scarborough's decision reflects the borough's
problems in finding money for its own capital spending.
Globe and Mail, June 26, 1987
Province, OMA agree on new fee deal
The provincial government and the Ontario Medical Association have
agreed of a new medicare fee schedule which provides for a 4.8 per
cent fee increase, including a 1.5 per cent increase to compensate
doctors for no longer being able to extra-bill. The 1.5 per cent
compensation for extra- billing translates to about $41 million.
The government has also agreed to contribute $12 million to cover
increases in doctors' malpractice insurance premiums. This is the
first time the province has contributed to doctors' insurance costs.
The extra-billing and insurance payments total $53 million over
the one-year duration of the new schedule the same amount which
the government started recovering from the federal government when
it banned extra billing a year ago. This has led both opposition
parties at Queen's Park to criticize the government for breaking
its promise that the money recovered would go to hospitals and other
parts of the health care system, not to doctors.
Globe and Mail, June 26, Toronto Start June 27, 1987
U of T gets $1.5 million for AIDS research
The University of Toronto has been given $1.5 million by the provincial
government to establish an AIDS research laboratory. The money will
help the university build the province's first isolation facility
for AIDS and will be the reference centre for research into the
diagnosis and treatment of the disease.
Toronto Star, May 26, 1987
Province will pay for AZT
The provincial government will pay so that AIDS patients can get
the drug azidothymidine (AZT) for free. This became an issue after
the manufacturer, Burroughs-Wellcome, suddenly announced in April,
while the drug was in the middle of clinical trials, that it not
accept new patients into the clinical trials and would charge those
already enrolled $1000 a month, unless the federal government licensed
the drug without requiring the company to submit to normal licensing
requirements. In announcing that Ontario would pay the cost for
patients, Ontario Health Minister Murray Elston said that the government
was acting because most patients simply would not be able to afford
the drug otherwise. But he expressed his displeasure at Burroughs-Wellcome's
actions, noting that the procedure is that a company seeking to
introduce a new drug pays for the cost of the clinical trials. Now
that a precedent has been set, he said, "I don't know how many
others will try this. If we do it for one company, do we do it for
the next?" Asked if he agreed with one theory that AZT may
prove disappointing over time so the company is hoping to recoup
its development costs in the next two years, Elston said those suspicions
had been advanced to him but that he had no evidence to prove them.
Eight provinces have now agreed to pay for the drug.
Toronto Star, May 26, 1987
Hospitals insuring selves
Forty-nine Ontario hospitals have banded together to create their
own liability insurance plan. The move is a response to drastic
increases in insurance premiums over the last three years. Typical
hospital insurance premiums jumped from $29,000 to $400,000 in three
years. The newly created company, Hospital Insurance Reciprocal
of Ontario, which began operation on July 1, has already signed
up most of the larger provincial hospitals, representing 19,000
of Ontario's 27,000 hospital beds. George Speal, the chairman of
HIRO, predicted that hospitals in other provinces will follow HIRO's
example. HIRO has not yet decided whether it will invite about 100
smaller hospitals with fewer than 50 beds each to join the plan.
Companies that previously insured hospitals will lose about $13
million in premiums this year as a result of the move.
Globe and Mail, July 3, 1987; Toronto Star July 5, 1987
Blind River clinic investigated
A clinic in Blind River, Ontario is being investigated by the Ontario
College of Physicians and Surgeons because patients are being asked
to sign a statement saying the doctor they see will remain their
personal physician. Dr. I. G. M. Peer, who oversees the day-to-day
operation of the clinic, said that he and one other doctor use the
statement to provide an accurate patient register, which enables
them to arrange for the necessary clerical help to handle paperwork.
"This is not binding," he said. "The patient is free
to change doctors as they wish, but the statement gives a register
to work from."
Toronto Star, July 7, 1987
Court rejects bid for secret hearing
The Supreme Court of Canada has rejected a request by 10 Toronto
doctors for a closed hearing into the treatment they gave a Toronto
boy who died at the Hospital for Sick Children seven years ago.
A hearing open to the public and the media will now be scheduled.
The case involves Steven Yuz, an eight-year-old boy who died in
1980 following surgery. The boys mother complained to the College
of Physicians and Surgeons about the treatment he had received.
The College said that it could see no grounds to launch discipline
proceedings, so the mother appealed to the provincial Health Disciplines
Board, a tribunal comprised on non-doctors. The board had always
conducted its reviews into the disposition of complaints by the
College in private. But in the spring of 1982 the Toronto Star newspaper,
citing public interest in the case, asked that the review by held
in public. The board agreed and the doctors spent the last five
years trying to overturn the board's decision.
Toronto Star, June 5, 1987
U.S. to bar immigrants who test positive
All immigrants whose tests for the AIDS virus prove positive will
be barred from entering the United States, U.S. Attorney-General
Edwin Meese has announced. Meese also said that probation officers
will be notified when prisoners with the virus are released from
jail. He said the National Institute of Justice, a federal agency,
will set up a data collection bank to assist police officers who
may have been exposed to the disease. Meese said he has directed
the U.S. Immigration and Naturalization Service to develop a testing
program that will deny entry to "all immigrants, refugees and
legalization applicants" whose tests are positive. About 1.9
million people are expected to apply for legalization in the next
11 months in the U.S.
Globe and Mail, June 9, 1987
Elston criticized for fundraising
The Ontario Legislature's public accounts committee intends to question
Health Minister Murray Elston to explain his methods of raising
funds for the Liberal Party. Elston has been criticized for sending
invitations to a $200-a-ticket fundraising event to hospital administrators,
doctors, and others in the health field. Opposition MPP's charged
that this put unfair pressure on people who depend on the Health
Ministry for funds.
Globe and Mail, June 12, 1987
Tobacco firms battle ad ban
Canadian tobacco manufacturers have launched an $800,000 advertising
campaign to fight the proposed ban on tobacco advertising. The federal
government plans to ban all tobacco advertising and forbid smoking
in federal offices in 1989. Under the legislation, tobacco advertising,
already forbidden on television and radio, will be banned in newspapers
as January 1, 1988, and on January 1, 1989, the ban is to be extended
to billboards, magazines ads, and sponsorship of sports and cultural
events. The Canadian Tobacco Manufacturers' Council is arguing that
the ban won't achieve the desired effect of reducing the rate at
which young people take up smoking. They also argue that the proposed
legislation violates the Charter of Rights and Freedoms, in that
it forbids the advertising of products and activities which themselves
are perfectly legal.
Globe and Mail, July 9, 1987
Two dentists challenge ad rules
Two Toronto dentists are asking the Ontario Court of Appeal to strike
down regulations that prevent dentists from engaging in promotional
advertising. The two, Drs. Howard Rocket and Brian Price, are facing
disciplinary action before the Royal College of Dental Surgeons
of Ontario because of an advertisement which appeared in a number
of magazines in 1985. The ad, promoting Holiday Inns, told how the
two had founded Tridont Dental Centres and saw it grow into "North
America's largest storefront dentistry group". College regulations
restrict dentists' advertising to professional cards and announcements
concerning the opening of new practices. Rocket and Price are maintaining
that the rules are an infringement on guarantees of freedom of expression
within the Charter of Rights and Freedoms. A lawyer for the College
is arguing that the Charter's protection should not extend to commercial
expression, and that the regulations are in the public interest.
Globe and Mail, June 26, 1987
Gays refused OHIP's family rate
The Canadian Union of Public Employees is taking the Ontario government
to court for denying a lesbian couple the lower health insurance
premiums paid by heterosexual couples and their families. Health
Minister Murray Elston reaffirmed the government's refusal to recognize
same-sex couples on July 8. Ontario Ombudsman Daniel Hill has criticized
the government for its policy, saying he finds it inconsistent that
the government can take away welfare assistance from a woman because
she is being supported by a lesbian partner, but will not let the
couple pay the family rate. "It seems reasonable that if a
homosexual couple can be penalized for their 'dependent' relationship
as far as one Government service is concerned, they should be able
to benefit from another Government service offered to 'dependents."'
NOW, July 16, 1987
Ontario plans to move on abortion
Health Minister Elinor Caplan has said that the Ontario government
will spend $2.5 million on a proposed network of women's health
centres which are supposed to improve access to abortion services.
She that that ministry officials are reviewing about 12 proposals
from hospitals to establish centres that would provide abortions
and other medical services for women. According to Dr. Marion Powell,
who prepared the study that recommended creation of the centres,
the first one should open in January or February 1988. Dr. Powell
estimated that each year at least 6,000 women seek abortions outside
hospitals, at private clinics in Toronto, Quebec, and the U.S. Dr.
Powell said that the new centres will also provide services such
as counselling on birth control, menopause or premenstrual syndrome
and treatment for sexual assault victims, and low risk birthing
centres. However, the government's plans have been criticized by
the Ontario Coalition for Abortion Clinics (OCAC) and the Ontario
Public Health Association (OPHA). The OPHA said at its November
general meeting that the plan will do little or nothing to improve
access to abortion. By relying on hospitals to provide the service,
it does nothing to address the problem in those areas of the problems
where no hospitals provide abortions, the OPHA said. The OPHA called
on the government to allow free-standing clinics to operate legally.
"Let them designate, for example, every clinic as a hospital,"
said OPHA spokesperson Dr. Peter Cole.
Globe and Mail, Nov. 17, 21; Toronto Star, Nov. 18, 21
Toronto passes smoking bylaw
The City of Toronto has passed a new workplace smoking bylaw which
requires every employer in the city to draw up and enforce a workplace
smoking policy which is agreeable to non-smoking employees. Employers
will be responsible for enforcing the bylaw and city health inspectors
have the authority to enforce compliance.
Toronto Star, Nov. 9, 1987
B.C. takes custody of fetus
The British Columbia courts have upheld a recent move by the B.C.
Ministry of Social Services to apprehend a child while it was still
in its mother's womb. The move occurred after the mother initially
refused a caesarian section birth, even though doctors told her
that without the procedure the child would die or suffer permanent
injury. Following the apprehension order, the mother underwent a
caesarian and the child was born healthy 90 minutes later. The case
has aroused strong debate in B.C., with a number of human rights
and women's advocacy groups charging that the province has abused
its powers. It also opened the question of whether provincial authorities
could legally apprehend a fetus. The court accepted evidence that
the mother, an alcoholic and drug user, could not be an adequate
parent. He ruled that the baby should remain a ward of the state.
Toronto Star, Sept. 4, 1987
Routine tests for drugs violate Human Rights Code
Employers who routinely test job applicants for drug and alcohol
use are violating the Ontario Human Rights Code, the Ontario Human
Rights Commission has ruled. The Commission said that drug tests
are a type of medical examination, and that under the code medical
examinations can only be given after a written job offer has been
made, and then only when the examination is specifically to look
for medical conditions that can directly affect an employee's ability
to perform a job safely and effectively.
Toronto Star, Globe and Mail, Nov. 245, 1987
Report suggests pollution health peril
Environment Canada has released but refused to endorse a controversial
report by two of its researchers that suggests that people living
in the area of the Great Lakes are suffering from the effects of
pollution. The report, Toxic Chemicals in the Great Lakes Basin
Ecosystem, suggests that pollution is increasing the rates of cancer,
birth defects, and other diseases among people living around the
lakes. It was completed over a year ago, but was not made public
because the department could not decide whether to endorse its findings.
In the end, the decision was to publish it with a disclaimer. Department
officials say that they agree with the report's conclusion that
pollution is harming wildlife, but say there is no proof it is harming
humans. The researchers say that pollution is now so complex that
it is impossible to clearly prove the link between health and widespread
pollution.
Globe and Mail, December 1, 1987
Drug makers' help sought in AIDS fight
The World Health Organization (WHO) is seeking help from private
North American companies to design a global strategy for biomedical
research against AIDS. The WHO says that even if existing trials
of an AIDS vaccine go as well as possible, it will still be 1992
before a vaccine is available for large populations. The WHO estimates
that in the meantime, between 10 and 30 per cent of the five to
10 million carriers of the AIDS virus worldwide could develop the
disease. This would mean between 500,000 and three million new cases
around the world, and an enormous challenge for pharmaceutical companies
to produce a range of options short of an actual vaccine or cure.
One of the main technological challenges for the immediate future
is development of simple, cheap and reliable diagnostic test to
shorten the time between infection and detection. One of the WHO's
major concerns is that when improved tests and drugs - - or a vaccine
-- emerge from private sector research and development, they be
affordable and available in sufficient quantity for AIDS patients
in all countries, including poor ones.
Globe and Mail, October 24, 1987
Cuts hit Alberta health spending
Despite protests from handicapped groups, welfare recipients, women's
organizations and some churches, the Alberta government has removed
a range of services and items from the province's medicare plan.
Expenses no longer covered by medicare include birth control counselling,
vasectomies, respiratory aids, most eye examinations, and wheelchairs.
Also included in the cuts are substantial reductions in insurance
benefits for physiotherapy and chiropractic care.
Globe and Mail, August 1987
B.C. considers private hospitals for the wealthy
B.C. Premier Bill Vander Zalm says that his government will be looking
at the possibility of allowing businesses to build and operate private
hospitals which would serve the wealthy. According to Vander Zalm,
this would be one way of taking pressure off the public health system
and reduce costs.
Toronto Star, October 26, 1987
Hospitals divert pension funds
The Ontario Hospital Association will take $80 million usually budgeted
for an employee pension fund and divert it to the purchase of hospital
equipment in 1988. The hospital employers declared the "contributions"
holiday because it says that the Hospitals of Ontario Pension Plan
has a surplus. The plan covers 216 Ontario hospitals with about
100,000 employees. The diversion drew strong criticism from hospital
unions. They said employer contributions should be maintained at
a level high enough to provide full inflation protection for 20,000
retired workers and for future retirees instead of being siphoned
off for non-pension purposes. "We should be moving to index
the pensions, and instead we'll have the employers not paying a
nickel while the purchasing power of the pensions shrinks,"
said John Van Beek of the Service Employees International Union.
The unions are not represented in the management of the pension
funds, nor can they apply collective bargaining clout to the pension
dispute. Ontario law prohibits hospital strikes and sends all disputes
to arbitrators appointed by the government.
Toronto Star, November 19, 1987
Sewage workers' health problems
A report by the Ontario Workers Health Centre shows that 60 per
cent of sewage workers tested by its doctors have been affected
by hepatitis viruses. The preliminary report, based on an analysis
of medical examinations of 100 employees, also showed that three-quarters
of the workers have been afflicted by skin ailments and 95 per cent
display some evidence of kidney malfunction which may be a sign
of heavy metal contamination.
Toronto Star, August 14, 1987
Workers get right to pick own MD
Ontario employers can't make workers submit to tests by a company
doctor to determine the effects of toxic workplace chemicals, the
labour ministry has ruled. The decision, which settled a test case
at Fleet Aerospace of Fort Erie, says workers have the right to
choose their own doctor at company expense when being tested for
the effects of lead, isocyanates and other substances regulated
under the Occupational Health and Safety Act. Union spokesman Mike
Daley said that "we wanted our members to have the right to
choose a doctor they can trust and who knows a lot about workplace
health. We weren't getting much information from the general practitioner
chosen by the company. This decision protects our right to get expert
advice."
CUPE focuses on back injuries
The Canadian Union of Public Employees says it wants to raise awareness
of what it calls a "hidden epidemic" of back injuries
across Canada. Delegates to the union's biennial convention adopted
a policy paper that called for legislation imposing limits on how
much workers have to lift. A position paper said that workers are
blamed too often for injuries that could be prevented with new equipment
or weight limits. The paper said that in 1984, about 137,400 workers
were incapacitated by work-related back injuries. The injuries,
it says, account for 27 per cent of workers compensation costs.
Globe and Mail, October 28, 1987
Hospital uses surveillance in disability claim
Mississauga Hospital is trying to challenge an employee's disability
claim by using videotapes of his daily activities made by a private
investigator. The hospital's actions have frightened the family
of the employee and threaten to bring intrusive surveillance techniques
into an area of dispute in which they do not belong, said Andrew
King, a lawyer representing the worker. "They are now, to a
certain level, paranoid," said Mr. King. "They don't know
when they are being watched....I find it particularly incongruous
that a hospital, which is publicly financed and concerned primarily
with health, would get into this activity." Having viewed the
videotapes, Mr. King stated that in any case they supported his
client's case. "You can see times he is clearly holding his
back in pain. We're not saying my client is a vegetable and can't
move. We are saying his limitations are such that he can lift something,
but he suffers pain from it."
Globe and Mail, September 16, 1987
Cannery workers protest company lead tests
More than half the employees on the workfloor at Continental Can
in Concord have complained to the College of Physicians and Surgeons
about their company doctor's tests for lead poisoning. The workers
say Dr. Abraham Friesner has conducted insufficient tests, and refuses
to turn their medical files over to a workers' health clinic. At
the heart of the dispute are workers' concerns about lead and chemicals
to which they are exposed in the workplace, and their perception
that the company doctor is not independent of the company which
employs him. Damian Bassett, a company spokesman, said that "I
think it's an insult to the medical community to suggest that their
opinions can be purchased."
Toronto Star, November 22, 1987
Obstetricians warned about fees
The Ontario Ministry of Health has warned obstetricians who charge
pregnant women a fee for personally delivering their babies that
they are violating the Health Care Accessibility Act. The College
of Physicians and Surgeons has been receiving complaints that some
obstetricians are charging women "stand-by fees" --as
much as $1500 -- so the women are assured the specialists will actually
show up to deliver their babies. The Ministry says that patients
who are charged the fees will be reimbursed if the fees are reported,
but has announced no plans for cracking down on the practice.
Toronto Star, December 4, 1987
Patients said poorly fed
Many patients in Canadian hospitals are suffering from malnutrition,
according to Paul Pencharz, the head of the clinical nutrition division
at the Hospital for Sick Children. Some patients were malnourished
when they entered hospital, and others became malnourished during
their stay because of their disease, he said. There are not enough
medical personnel in hospitals charged with diagnosing nutritional
problems, he said. And other doctors may not understand the problems
that malnutrition can cause, and may be reluctant to have others
on their turf. "Medicine is organized by organ-specific specialties,
the liver, the heart, and so on. And when you come in with something
that cuts across these specialties, you stand on people's corns."
Globe and Mail, November 4, 1987
Patients to get right to see records
The Liberal government will be introducing an amendment to the Public
Hospitals Act which will give patients the right to see their hospital
records.
Globe and Mail, October 29, 1987
Red Cross concerned about private blood banks
Canada's first private blood banks have opened their doors this
fall. For a price of $200 a unit, people who fear catching AIDS
or other viruses from transfusions will be able to store their own
blood in one of the banks. The Canadian Red Cross has expressed
concern about the banks, fearing that they will undercut Canada's
system of voluntary blood donations.
Globe and Mail, October 23, 1987
Complaint files on doctors ordered opened
A court ruling has opened files kept by the Ontario Health Disciplines
Board when it reviews the handling of complaints against doctors.
The Divisional Court allowed appeals by two complainants who were
appealing against decisions of the Board refusing them access to
reports used by the College of Physicians and Surgeons in rejecting
their complaints.
Globe and Mail, September 23, 1987
Law Reform Commission on Fetal Rights
The Law Reform Commission released a working paper on Crimes Against
the Foetus in February. It recommends legislation which would make
it a crime to purposely or negligently cause death or serious harm
to a fetus. There would be exceptions for medical treatment and
legal abortions. On abortion, it recommends that in the first 22
weeks, a woman can terminate her pregnancy "if medically authorized
on the ground that her physical or mental health was threatened."
Thereafter, legal abortions would be permitted only when necessary
to save the woman's life or to protect her against serious physical
injury. The Commission also recommends that abortion could be lawfully
performed at any stage if the foetus suffers from a lethal defect.
The recommendations regarding abortion were criticized by pro-choice
groups as a step backward by requiring medical authorization rather
than allowing the woman to choose on her own.
Canada's population all lives in Ontario -- says OHIP computer
A new computer will be required for the Ontario Health Insurance
Plan (OHIP) to enable a new OHIP number to be given to everyone
in the province. The old computer (1971) is "dying", and
"cannot produce statistics of the patterns of illness."
A legislature committee is investigating OHIP's problems "because
provincial Auditor reported last fall that the computer has files
for three times as many people as live in Ontario and contains records
of such impossibilities as hysterectomies for men. None of the MPPs
on the committee was very critical of the Health Ministry officials
yesterday, although Lake Nipigon New Democrat Gilles Pouliot called
the high number of registrations "more than a small discrepancy...
an astounding situation.." Mr. Gibson (OHIP General Manager)
and Dr. Martin Barker (Deputy Minister of Health) explained that:
"OHIP's claims reference files contain about 25 million participants,
although Ontario's population is about 9.1 million...."
Globe and Mail, February 17, 1988
Legislating "snake oil?" US policy on drugs for desperately
ill
"New US rules... allow desperately ill patients to receive
experimental drugs could be used by drug companies to skirt the
approval process, says James Sammons, executive vice president of
the American Medical Association. Doctors support the principle
behind rules on treatments of last resort, Dr. Sammons said.. but...
the AMA fears... safeguards in the new US Food and Drug Administration
regulations may not be strong enough to prevent the drug approval
process from being compromised... The new rules... took effect last
June... some patient groups in Canada are pressing federal Health
Minister Jake Epp to adopt a similar regulation. The US rules permit
doctors to treat desperately ill patients with new drugs that are
still being investigated under the FDA'S regular rules requiring
clinical testing before a drug can be commercially licensed... The
(normal) approval process from laboratory tests on animals to final
marketing... can take up to 8 years. Pressure from patient advocacy
groups and the deregulatory climate fostered by the US administration
led to the rule change... Dr. Young, head of the FDA said: "we
have no intention of offering snake oil to the public." There
are 4 general criteria the must be met before an experimental drug
can be used in treatment: the drug must be intended to treat a "serious
or immediately life threatening disease"; there is no comparable
or satisfactory alternative drug or therapy; the drug is under investigation
in a controlled clinical trial; and the drug maker is pursuing marketing
approval with "due diligence". Doctors must also obtain
consent.."
Globe and Mail, February 17, 1988
If you can't beat them with argument - burn them, say "Pro-Life
"activists
"The weekend before the Supreme Court decision on abortion,
someone climbed on the roof of the Morgentaler Clinic in Toronto
and tried to burn through a plastic bubble skylight with a propane
torch. There's nothing new in anti-abortion forces using illegal
methods to intervene with the activities of the clinic. Over the
past 3 years the clinic's carpenter David Butt has suffered beatings,
threats to his life, and a host of assault charges laid by demonstrators
that judges have never found valid... In August 1985 he was standing
outside the clinic when an anti-abortionist demonstrator hit him
over the head with a stick placard... His left eye was temporarily
blinded and blood poured down as another demonstrator struck him
with a sharp object, cutting his right hand to the bone. As he flailed
around trying to protect himself, other demonstrators piled on.
Police intervened and laid numerous charges against his assailants,
some of whom were convicted. But one of his attackers went to City
Hall and laid a private charge of assault against the carpenter.
His trial lasted 2 days and he was acquitted. His legal bill, which
he only recently succeeded in paying was $3,800 and there is lasting
impairment to his left eye. He was advised that he would be killed.
Strangers accosted him on the streets screaming "God will punish
you". On the Don Valley... his jeep went out of control, he
got to the shoulder safely and discovered that the bolts had been
loosened on one wheel. Last fall Butt was served a flurry of summonses
on assault charges laid by anti-abortion demonstrators. With police...
attesting to his innocence... charges against him have been dismissed
repeatedly but he has been left with legal charges ... totalling
more than $7000."
Globe and Mail
An Orlandish Swipe
In 1983 the last full year he graced the deputy minister's office
of the Ontario Ministry of health, Graham Scott made a salary of
$76,000. He left at the end of the year to take up a more lucrative
career with Toronto law firm of McMillan Binch... he is currently
paid $250/hour to head up a task force into increasing utilization
of the Government's health system. The going rate at McMillan Binch.
For the task force the Government has budgeted a mere $750,000 -
$100,000 for administration cost (to be matched by OMA) and a further
650,00 for research... big numbers never frightened Mr. Scott. As
Deputy Minister in 1982, he played a key role in the Government's
golden fleece award to the OMA to buy peace with the doctors...
After the sunshine of McMillan Binch, Mr. Scott took on directorship
at CDC Life Sciences Inc. and Connaught Labs. The former has now
purchased the latter so Mr. Scott now holds a directorship in only
CDC which rewards him with $10,000 - $12,000/year and he also holds
300 shares. Connaught Labs makes vaccines and other related medical
materials, adding an interesting side to Mr. Scott's career that
he does not consider a conflict of interest in his new part time
job... Premier Peterson boasted... Ontario had been liberated from
"cigar smoking Tories operating out of some club." Mr.
Scott is a director of the Albany Club, a famous Tory hidey-hole...."
Globe and Mail, February 6, 1988
Who's An Old Fogey: British Medical Association vs Thatcher
The nurses are only the most recent to join the chorus of complaints.
Perhaps the most devastating critique came from none other than
the heads of the three ancient royal medical colleges, who made
their case last fall. The Government is not accustomed to having
its knuckles rapped by persons so discreet and so exalted. Even
the British Medical Association, which 40 years ago led the fight
against the very idea of the NHS had become a trenchant critic.
On the day the nurse held their strike, the BMA called for an immediate
cash injection of 1.5 billion pounds. What is more the BMA dismissed
the various schemes for alternative funding, such as hospital charges
and private insurance being examined by the government. As BMA chairman
John Marks noted, lotteries and other stunts do not provide long
term money. The NHS must be financed by taxation. "There is
a crisis in the health service... stemming from chronic underfinancing...
we spend far too little of our wealth on health. We are at the bottom
of the European league"... The solutions offered... by Cabinet...
involve an expansion of the private sector, particularly insurance.
One suggestion has been a tax credit on medical insurance. On that
the BMA was surprisingly blunt. John Marks: "The great consumers
of health care are the under 5's and the over 65s. They don't pay
insurance. The chronic sick are not insurable"
Globe and Mail, February 20, 1988
Between a rock and a hard place: The Government Quandary re:
Abortion
"Health and Welfare Minister J. Epp and Justice Minister R.
Hnatyshn face nightmarish choices on the abortion issue, as activists
on both sides push for a clear national policy... pro-choice activists
are urging Mr. Epp to use the power he holds under the Canada Health
Act to withhold funds from British Columbia because the province
refuses to pay for abortions. Instead of changing its policy, the
province could begin to close hospitals for lack of funds. An alternative
nightmare... if abortion is outlawed, as pro- life activists wish,
is a return to the era of backstreet abortions. The problem the
2 ministers face is both political and territorial. Abortion falls
under federal control... under the Criminal Code. But the actual
administration of abortion as a medical procedure is purely under
provincial control. If Ottawa... makes policy about... provincial
obligation to pay for abortions in free standing clinics -- or even
to pay for abortion at all -- senior officials warn it could establish
an awkward precedent. If the Government (interferes) on health administration...
matter of provincial jurisdiction -- on grounds... of national obligation
to provide equal quality services nationally, what might follow?...
legislation on pupil- teacher ratio? Or welfare rates? Or minimum
wage?... Without invading provincial jurisdiction there are at least
four avenues for Government. (1) Section 33 of the Charter of Rights
and Freedoms; the so called "notwithstanding" clause to
exempt the old law (just struck down by the Supreme Court).... Unlikely
that Mr. Hnatyshyn would protect a law which has been discredited
and attacked pointedly by the Supreme Court... (2) Study of the
3 different explanations offered by the Supreme Court judges to
work out new legislation making abortion a criminal offence after
a certain stage of pregnancy... making early abortions legal...
this would not answer... pro-lifers... Pro- Choicers... argue...
late abortions only occur when women are unable to get early access
to abortion (3) Simply defer to the Provinces. (4) Use the almost
unlimited power in the Canada Health Act to withhold money for provincial
health systems unless provinces agreed to pay for abortions. More
than any past Liberal government, the Mulroney Government has been
scrupulously respectful of provincial jurisdiction in social policy...
not using its spending powers to set social polices... provincially."
Globe and Mail
Buddy can you spare a dime?
Manitoba Medical Association Manitobans face a doctors strike on
April 5 unless the provincial government agrees to binding arbitration
as solution to fee contract disputes says Manitoba Medical Association.
Manitoba Premier Pawley... said province is not eager to go back
to arbitration with the doctors after past awards that cost more
than the politicians wanted to pay... Health minister Parasiuk said
doctors are asking for a 14% increase in fees, which works out to
an average $16,000 a year. The Government has offered 3% this year
and 3% next. The MMA refused to be specific... but said Mr. Parasuik's
figures were "totally remarkably erroneous", and doctors'
incomes in Manitoba are 25% lower than other provinces. Federal
Statistics from Health and Welfare show average professional income
per doctor: Ontario $108,000, Manitoba $86,000, Saskatchewan $96,000,
BC $94,000."
Globe and Mail, March 5, 1988
Exhalations of fire and brimstone, by appointment -- Van Der
Zalm or Zeus
"In a gore dripped public attack on abortions and the women
who have them BC Premier Van Der Zalm this week further unsettled
his friends and enraged his enemies... he talked of agony afflicted
babies being ripped apart in the womb "at the slightest whim
or notion of women.... without so much as an anesthetic being given
to the baby... no-one here can imagine such suffering and no one
ever lived to tell about it"... the speech was immediately
denounced by medical authorities as the product of folklore and
fanaticism instead of fact... a growing number of Social Credit
party officials... expressed their dismay at the Premier's determination
to impose his personal views upon an uncomfortable province... many
reckon that the courts will save them from long term political damage
by declaring his refusal to finance abortions as illegal or unconstitutional.
In his speech, Van Der Zalm made it clear that he believes he is
engaged in a struggle against barbarism."
Globe and Mail, March 5, 1988
"Van Der Zalm in Powell River... was overcome by questions
about victims of rape and incest: "Don't ask me those questions
I don't want to hear them. I don't like those questions. I don't
want to hear them"... The Premier clasped his hands over his
ears, squeezed his eyes shut and stepped away... He does not concede
that poverty may influence a woman's decision about having children,
or that his actions place an unfair burden on the poor... he repeatedly
suggested that the vice of selfishness is the biggest factor in
motivating women to have abortions..."
Globe and Mail, February 13, 1988
Not only AIDS a problem. Incidence TB on rise in US
"TB cases nationally have started to reflect the New York trends.
The Center for Disease Control reported... in 1986 TB cases showed
their first nation-wide increase since Federal recording began in
1953. TB cases in New York declined to a low of 1,307 in 1978 (17.2/100,000
residents). But since then caseload has risen to 2,223 in 1986 (31.4/100,000)...
an 83% increase... Officials blame its rise on the proliferation
of AIDS, (oh and by the way perhaps also because of-) and on the
increase in homeless people... Among proposals is that the city
open one or more residential centers to treat contagious patients
who fail to take medication on their own, with special units too;
lock up those who require court ordered quarantine... city officials
said the proposal was under consideration... the highest rate was
among black males 35-44 yrs... who had 9x the city average... Neighborhood
variations were also extreme... historically TB has been disease
of the impoverished."
New York Times, January 24, 1988
College and Government
"Certain subtle shifts in the College's (of Physicians and
Surgeons of Ontario) outlook... suggest the body wants to be seen
as more helpful and responsive to doctors... CPSO registrar Dr.
Michael Dixon described the changes as part of the college's natural
evolution. They stem from events of 1986 extra-billing ban as well
as polled doctors' views on the role of the college. Respondents
to the survey indicated they favour more frequent communiques. 0%
also want the college to become more active in health policy issues...
Dr. Dixon: "we've started to address issues we wouldn't have
looked at in past years". He cited the college's recent review
of certain treatment modalities (specifically HCG and chelation
therapy) and its adoption of regulations defining the use of these
treatments as professional misconduct. Dr. Dixon: "Of course
the profession might look at this skeptically and say that's all
very well but we're going to be held up to that standard,' and the
answer is yes, probably will be and you probably should be."
... The new approach will be to develop standards prospectively
"We will begin to develop some guidelines in areas where there
are problems." Other areas the college is looking at to develop
standards are: The appropriate training requirements for physicians
staffing emergency departments, obstetric care in smaller hospitals
particularly those lacking anesthetic and surgical support; and
guidelines for Px of deep venous thrombosis... OMA General secretary
Ed Moran said he suspects the college will not rush to get involved
in the larger issues: "Because they function under a legislative
mandate that tracks back to the ministry, I think it would be awkward
for them to find themselves with a profile on an issue that was
anti-government; it might cause them problems if they were pro-government
with their other audiences..."
Ontario Medicine, January 18, 1988
Prepare for lessons from the private sector -Ted Ball
"Private sector incentives, techniques and indirect participation
in some areas of the health care system will have increasing significance
on the delivery of health care in Ontario," says Ted Ball,
President of PoliCorp Inc; and Chief of Staff for the Ministry of
Health under the former Conservative Government of Ontario. Mr.
Ball said... because of skyrocketing costs of health care, there
should be a merger between the private sector and the current public
system. He feels that hospital managers can learn a great deal from
the private sector in terms of management techniques and incentives...
he predicts an economic recession in 1988."
Toronto and Region Hospital News, February 1988
HMO's Overgrown -- Pruning time
"After 15 years of spectacular growth in which Hospital Maintenance
Organizations (HMO's) have enrolled nearly 30 million Americans,
there are signs that consumers are losing their enthusiasm for the
plans which offer comprehensive medical care for a set fee. Many
HMO's are raising their fees... employers who pay most of the bills
are demanding tighter cost controls, and doctors are protesting
HMO's efforts to hold down their compensation... at least 16 HMO's
disappeared in 1987 because of mergers or business failures... experts
predict... the $28 billion industry becoming dominated by a handful
of giants. For consumers... these are important concerns... employers
have held the increasing cost down by pitting plans against one
another... many HMO's are instituting tighter control over the treatment
patients receive. They are also bearing down on the fees paid to
the 200,000 physicians they employ or contract to... physicians
in Minneapolis even threatened to unionize... Jerry Baker an analyst
at... an investment bankers: "To be profitable HMO's will continue
to clamp down on payments to doctors." ... Incentive systems
for physicians to control their costs have been tried: "If
the health plan has losses the doctors lose part of their yearly
income... some argue that such incentive systems compromise the
quality of care. One such group is Physicians Who Care Inc., represents
2000 doctors in practice in Texas and California... " Doctors
get paid more if they refer less. The concept is immoral".
But most non-partisan studies have found that the care provided
by HMOs is as good as any... concentration of larger concerns will
grow... Executive vice-president of US Health Care A. F. Wise: "For
people who do things right and survive it is going to be a great
business"
New York Times, January 31, 1988
Environmental Toxins implicated for Parkinsonism
"P. Spencer et al... describe... primate data supporting the
notion that certain neurological diseases such as Parkinsonism,
Alzheimer's and motorneurone disease... may be caused by environmental
toxins... monkeys given doses of an amino acid (b-N-methylamoino
alanine -BMAA) "developed corticomotorneuronal dysfunction,
parkinsonism, and degeneration of motor neurones." ... the
monkeys display symptoms that occur at very high incidence in the
Chamorro people of Guam. Until recently the Chamorro ate large quantities
of seed of the false sago plant Cycas circinalis (source of BMAA)...
the link has taken 30 years to unravel... Spencer: "the fact
that motorneurone disease, Parkinson's, and Alzheimer's... can each
be triggered by the same neurotoxin implies that the disease may
be linked at a fundamental level. Another is that just because a
disease may occur at high frequency and affect individual families
throughout generations does not necessarily mean it is genetically
caused as is often inferred... but the key lesson is the notion
of early exposure to a neurotoxin whose effects are expressed clinically
only many years later, e.g. many Guamanians who left the island
at the age of 20 to live in the US have developed the disease 30
years later: hence Spencer's term slow toxin.... Spencer: "I
expect our search will lead to a class of environmental chemicals
that act as triggers for neuronal death.."
Science July 31, 1987
Toronto Birth Centre to go it alone
After several years of attempting to work out a funding arrangement
through the Ministry of Health, the group working to set up the
Toronto Birth Centre has decided to launch a fundraising campaign
so that the centre can exist independently. The Centre had been
trying to negotiate an agreement with Doctors Hospital, but the
two sides couldn't come to an agreement. According to hospital spokeswoman
Diana Moeser, "It was too difficult to work out. The autonomous
model promoted by the Toronto Birth Centre just did not fit the
system. On the one hand, as hospitals, we're legislated to operate
a certain way, and on the other, from the point of view of the birth
centre, we were not supposed to impose on their operation. It was
like pushing apples and oranges together."
NOW, March 2, 1989
Weapons Plant Critic Dies
Dr. Carl J. Johnson, an early and outspoken critic of the Rocky
Flats nuclear weapons plant (see article by him in February 1989
issue of Medical Reform) has died at the age of 59. Johnson
was forced to resign as Jefferson County, Colorado, health director
in May 1981 after his publication of studies showing a higher incidence
of cancer in areas close to the Rocky Flats plant 16 miles northwest
of Denver.
Los Angeles Times, February 1, 1989
Enquiry on Mental Competency
The Ontario Ministry of Health has set up an Enquiry on Mental Competency,
chaired by Prof. David N. Weistubb, to examine the issues involved
in developing criteria for determining the mental competence of
individuals to make decisions relevant to health care. A report
is to be submitted within nine months; the deadline for submissions
is April 7.
Generic Companies sue OMA
The Canadian Drug Manufacturers Association (CDMA) and two manufacturers
of generic drugs are suing the Ontario Medical Association, the
Upjohn Company, a video company, and eight doctors over a video
recording "What Did the Doctor Order?", which has been
used in a campaign to discourage generic drug substitution. The
CDMA alleges that the video is slanderous and damaging, and is asking
in excess of $100 million in damages.
Globe and Mail, January 26, 1989
Nurses get seats on hospital committees
The Ontario cabinet has changed regulations under the Public Hospitals
Act to require that ordinary nurses be represented on hospital management
committees. Currently the committees are staffed by hospital managers,
doctors, and nursing managers. Glenna Cole-Slattery of the Ontario
Nurses Association said that "It's just what hospitals need
-- input from the people who do the work."
Toronto Star, Globe and Mail, February 16, 1989
OMA proposes binding arbitration
The Ontario Medical Association is proposing that the provincial
government agree to binding arbitration in future fee negotiations.
Premier Peterson and Health Minister Elinor Caplan said that they
would be willing to consider the request, but made no commitment.
Globe and Mail, February 9, 1989
College allows computer deal
The College of Physicians and Surgeons of Ontario has reached an
agreement with Squibb Canada which will allow the drug company to
continue to provide computers to doctors who prescribe Squibb's
drug Capoten. The computer remains the property of Squibb, but may
remain in the doctor's office indefinitely. Doctors will be required
to sign an agreement promising not to use the computers for personal
purposes. Joel Lexchin of the Medical Reform Group criticized
the agreement, pointing out that it is unenforceable.
Globe and Mail, February 21, 1989
British Tories shake up National Health Service
The Thatcher government is moving to implement some major changes
in the British National Health Service. The main proposals include:
the creation of self-governing trusts to run bigger NHS independently
of district health authorities, employing their own staff and setting
their own pay rates; development of an internal market allowing
patients to be treated in the private sector; tax relief to help
pensioners pay private health insurance premiums; GP practices to
be allowed to apply for their own budgets and to buy hospital care;
imposition of audit controls on doctors to ensure value for money;
monitoring of prescription costs to control GPs' drug bills. The
plan for larger general practices to run their own budgets, with
scope to keep any money left over after they have bought treatment
for their patients from hospitals and clinics, was criticized on
the grounds that their would discourage GPs from taking on elderly
or chronic patients. Fear was also expressed that practices would
have to close if they ran over budget, depriving patients of treatment.
It was also suggested that the changes would encourage hospitals
to concentrate on the more lucrative treatments while opting out
of the economically less attractive treatments.
Manchester Guardian Weekly, February 12, 1989
Hospital considers disclosing negligence
The Royal Victoria Hospital in Montreal is considering draft guidelines
that would require disclosure of negligence in patients who may
have been harmed by its care or treatment. The guidelines were drafted
by the hospital's ethics committee, and are now to be considered
by its executive council. Insurers of Canadian hospitals say many
incidents of negligence are not disclosed to patients. The Royal
Victoria proposal "demonstrates a new sensitivity that people
have the right to know what's happened to them," according
to Margaret Somerville of McGill University's Centre for Medicine,
Ethics, and Law. "It's the other side of the coin of informed
consent." She said hospitals have been reluctant to consider
disclosure because their lawyers have advised them that this would
leave them open to more lawsuits. "That's wrong. If the truth
is handled well and sensitively, people are less likely to sue."
She said patients who suspect something has gone awry but are met
with a wall of silence often feel the only way they can get answers
is by legal action.
Globe and Mail
WCB rejects cancer study
The Ontario Workers Compensation Board has rejected a McMaster University
study which found cancer in a group of women factory workers to
be linked to their jobs at a Canadian General Electric plant in
Toronto. The industrial disease standards panel of the Board ruled
that there is no provable connection between the cancer cases and
working conditions in the coil and wire drawing area of the lamp
plant. The McMaster study was of 203 women who worked in the area
between 1960 and 1975. It concluded that statistics supported a
work-related cause of 11 cases of cancer -- eight of them breast
cancer. The matter was before the WCB because three of the women
had filed for compensation. According the Shelly Martel, the NDP
critic for the WCB, the WCB had previously made compensation awards
on the balance of probabilities, but is now insisting on conclusive
proof. Ms Martel said that this places an almost impossible burden
of proof on the claimants.
Globe and Mail, February 16, 1989
Supreme Court refuses to rule on fetal rights
The Supreme Court of Canada has refused to rule on whether a fetus
has rights. In a 7-0 ruling, the court said that since there is
no abortion law in Canada, Joseph Borowski's attempt to have fetuses
declared citizens endowed with a constitutional right to life and
to equality raised a moot point. The court said that to decide the
case would have meant intruding in a policy area reserved for Parliament.
March 10, 1989
Abortion clinics banned in Nova Scotia
Nova Scotia's Progressive Conservative government has outlawed free-standing
abortion clinics in the province. The province's health minister
said that abortions in the province can only be performed in provincially
approved hospitals. However, Dr. Henry Morgentaler announced four
days later that he would set up a Halifax abortion clinic in defiance
of the Nova Scotia regulations. The regulations "clearly endanger
the security of women," he said. "This is an enormous
abuse of power which should not, and will not, go unchallenged."
Globe and Mail, March 17, 1989, Toronto Star March 21, 1989
New Brunswick abortion policy toppled
The New Brunswick government's abortion policy, under which the
procedure was covered by medicare only if two doctors certified
that it was medically necessary and if it was performed in an accredited
hospital by an obstetrician or gynecologist, has been struck down
by the Court of Queen's Bench. The law was challenged by Dr. Henry
Morgentaler, who was refused medicare payments for three abortions
he performed on New Brunswick women in Montreal.
Toronto Star & Globe and Mail, April 15, 1989
Morgentaler clinic wins injunction
Toronto's Morgentaler clinic has won a court injunction that bans
picketing within 500 feet of the Harbord Street clinic. The injunction
was ordered May 5 by Mr. Justice M. A. Craig of the Ontario Supreme
Court, who found that the daily anti- abortion picketing poses a
risk to patients and amounts to intimidation. The injunction is
to remain in force until a lawsuit by Dr. Morgentaler against some
of the picketers comes to court. However, both Dr. Morgentaler and
his lawyer, Clayton Ruby, have admitted that the injunction itself
was the clinic's main objective.
Globe and Mail, May 6, 1989
AIDS advisor resigns
Dr. Norbert Gilmore, the chairman of the National Advisory Committee
on AIDS since its inception six years ago, has resigned. He linked
his resignation to government measures which he said impaired "the
Committee's ability to act independently without government interference."
AIDS activists regretted his departure, saying Gilmore has been
instrumental in guiding the debate over how to fight the disease
in Canada. "Gilmore commands widespread respect across the
country," said Dr. Philip Berger. "This means there will
be a total vacuum of leadership. Nationally, he was the only figure
who tried to provide leadership. It's a real loss."
Toronto Star, April 12, 1989
Anonymous AIDS test clinics backed
Toronto's Board of Health has changed its policy to come out in
support of clinics where people can be testing anonymously for the
HIV virus. Under current Ontario law, no one is supposed to receive
an AIDS test anonymously, and positive results are supposed to be
passed on the local board of health. However, some doctors and clinics
have been quietly ignoring the law. Anonymous testing has met with
resistance because it would permit AIDS-infected people to disappear
back into the community. However, AIDS activists told the Board
that many people simply don't get tested because they fear their
names being made public. Dr. Philip Berger told the Board that "it
is better to get tested and counselled anonymously than not to get
tested and counselled at all."
Globe and Mail, April 6, 1989
Public Trustee sues hospital unions
The Quebec Public Trustee has launched a law suit against hospital
unions on behalf of mentally handicapped residents of a chronic
care hospital. The suit alleges that when the unions went on a 33-day
`illegal' strike five years ago, they caused residents of the hospital
to suffer emotional distress and insecurity. $10 million in damages
are being sought. Three unions whose members took part in the strike
- - the Confederation of National Trade Unions, La federation des
affaires sociales and Le syndicat national des employes de l'hopital
St. Julien are being sued. The claim of emotional harm is partly
based on the premise that the residents were deprived of contact
with the only people who are a constant in their lives.
Globe and Mail, February 27, 1989
Quebec MDs reject 'smart' cards
The Quebec Federation of General Practitioners has rejected a proposal
from the provincial minister of health to issue `smart' cards to
Quebec residents for their health care. The proposed cards would
contain a microchip which would store a patient's health records,
including medical history, medical treatments received, etc. Dr.
Clement Richer, president of the doctors' group, said that "the
dangers of abuse are too great. Imagine if an insurance company
or an employer got access to your file. It could be devastating."
Globe and Mail, May 13, 1989
OHIP to be replace by payroll tax
The new Ontario budget contains a plan to eliminate OHIP premiums
and replace them by a payroll tax. Eliminating premiums was one
of the Liberal government's election promises. The move was opposed
by Dr. Henry Gasmann, the outgoing president of the Ontario Medical
Association, who said that he fears that government could divert
tax dollars, now spent on health because they come from OHIP premiums,
to other things. The Medical Reform Group's position, adopted
in 1979, is that "OHIP premiums be abolished and funding for
health care come from progressive forms of taxation."
C.H.O. pilot project
The Ontario government will spend $8 million over the next three
years to set up Comprehensive Health Organizations (C.H.O.s) as
pilot projects in several municipalities. C.H.O.s are non-profit
corporations which receive funding on a capitation basis. Physicians
will be paid by the C.H.O., rather than by billing OHIP. According
to Ontario Health Minister Elinor Caplan, the province hopes to
enroll five per cent of Ontario's population in C.H.O.s within five
years, and 15 per cent within 10 years. C.H.O.s might operate differently
in different communities, she said. For example, in one place it
could be independent from the local hospital and arrange hospital
services through contracts; in another place, the C.H.O. might be
directly linked to a particular hospital.
Globe and Mail, April 6, 1989
Health Goals for Ontario
The Premier's Council on Health Strategy has issued its first paper
on health goals for Ontario. The council is recommending that the
government adopt these goals as a first step in setting a broad
agenda for health. The goals are listed under five headings: "Shift
the Emphasis to Health Promotion and Disease Prevention", "Foster
Strong and Supportive Families and Communities", "Ensure
a Safe, High Quality Physical Environment", "Increase
the Number of Years of Good Health for the Citizens of Ontario by
Reducing Illness, Disability and Premature Death", and "Provide
Accessible, Affordable, Appropriate Health Services for All".
Health Survey
The Premier's Council on Health Strategy is launching a health survey
of 52,000 Ontario residents this fall. The survey, designed by the
Ministry of Health, will gather information about present health
status, health risk factors, the impact of health problems and awareness
of health issues. The data is to be used to produce health profiles
of various age/gender groups and to give a "snapshot"
of the current health of the population. The intention is to repeat
the survey every few years to document changes in the population's
health status. Information collected will be kept confidential,
but a summary of the findings with no identifiers will be made available.
MDs seeking to incorporate
Three Ottawa doctors have initiated a court case challenging the
provision in the Ontario Health Disciplines Act which prevents physicians
from incorporating. They are invoking the Canadian Charter of Rights
and Freedoms in claiming that the legislation discriminates against
them. The Ontario Medical Association, which has been lobbying for
professional incorporation for 15 years, supports the case in principle.
Globe and Mail, March 23, 1989
Who's Paying for Medicare?
The Canadian Health Coalition (CHC) has issued a discussion paper
raising concerns about impending cutbacks in federal transfer spending,
and also about the way some provincial governments are spending
medicare funds. The paper points out that the federal share of health
care spending has fallen from 45 per cent in 1977-78, to 38 per
cent in 1988- 89. The CHC also argues that "if corporations
paid their fair share not only could we adequately fund current
Medicare programmes but we could afford major improvements in Canada's
health and social programmes." It urges that Canada's medicare
system not be victimized by concern for the federal deficit and
strategies to cut transfer payments.
Canadian Health Coalition, April 17, 1989
Ontario cuts list of subsidized drugs
About 1,400 of the 1,600 drugs and other health products that have
been free to senior citizens and people on social assistance under
the Ontario Ministry of Health's Special Authorization Program will
no longer be free after June 30. About 200 products, including two
AIDS medications, Acyclovir and Ensure, will remain eligible for
government coverage. The Special Authorization Program enabled physicians
to receive authorization for drugs not listed in the Ontario Drug
Benefit Plan formulary. The Ontario Drug Benefit Plan formulary
remains unchanged. The Lowy Commission on Pharmaceuticals in Ontario
had recommended that the list be trimmed.
Globe and Mail, April 4, 1989
Hoffmann-La Roche fined
Hoffman-La Roche Ltd. was fined $50,000 in April for breaking the
federal competition law. The company pleaded guilty to price maintenance,
or influencing the price at which its products are sold by client
firms. In 1985, the company offered a discount to a Saskatchewan
wholesale co- operative, United Pharmacists Enterprises, on condition
that it agree not to resell the product at less than the standard
price. United Pharmacists refused to sign such an agreement, and
Hoffman-La Roche retaliated by refusing to offer its standard discount
on purchases.
Globe and Mail, April 5, 1989
Workers' Compensation Boards upheld
The Supreme Court of Canada has upheld a law which bars injured
workers from suing their employers. In a 9 - 0 ruling, the court
said that the Newfoundland Workers Compensation Act does not violate
the Charter of Rights and Freedoms by preventing workers from suing
their employers for damages in workplace accidents. The ruling pleased
unions officials, who had feared that the workers compensation system
would be undermined by an explosion of lawsuits, with workers suing
employers and each other for negligence, and employers counter-suing
their employees. The existing system is in essence a no-fault system.
The case had been brought to court by Shirley Piercey, whose husband
was electrocuted in 1984 at the General Bakeries Ltd. plant where
he worked. Mrs. Piercey contended that the company was responsible
for her husband's death, and that she should be allowed to sue it.
Labour spotlights workplace deaths, injuries
The Ontario Federation of Labour (OFL) has erected a billboard in
front of its headquarters to publicize the toll of workers killed
and maimed on the job. As of the end of April, 91 workers had been
killed and 117,936 injured in Ontario, according to the OFL. In
1988, 293 workers were killed and 489,819 were injured in workplace
accidents.
Multicultural Health Services
The Multicultural Health Coalition is receiving funding from the
Ontario government to assist it in establishing a health information
service. The coalition will gather information on multicultural
health services and how they could be improved, and will then develop
a directory of available services.
Scott Task Force suggests cholesterol testing changes
The Task Force on the Use and Provision of Medical Services, headed
by Graham Scott, has released recommendations that discourage the
trend toward mass screening of the population for cholesterol levels.
Instead, physicians are being encouraged to test only those people
who are at high risk for elevated cholesterol levels, to request
cheaper tests, and to prescribe anti-cholesterol drugs as a last
resort. The task force that the changes could save tens of millions
of dollars in health care costs.
Globe and Mail, April 8, 1989
Quebec MDs vehemently reject midwifery
Quebec physicians have reacted strongly to a announcement from Health
Minister Therese Lavoie-Roux that she will introduce legislation
to set up six pilot projects involving midwives. "You might
as well make prostitution legal. More people are asking for prostitutes
than midwives," said Augustin Roy, president of the 16,500-member
Quebec Corporation of Physicians. Clement Richer, president of the
Quebec Federation of General Practitioners, said that "It's
like letting an apprentice pilot take charge of a Boeing 747 loaded
with passengers." Helene Corneillier, president of the Quebec
Alliance of Practicing Midwives, called the doctors' reaction "stupid
and insulting....It really shows how little respect the medical
establishment has for women." She said doctors' fears of midwifery
are based on financial self-interest, and said they are "determined
to maintain a monopoly of what they call medicine."
Globe and Mail, May 11, 1989
MD punished for using midwife
A Montreal doctor has had his hospital privileges suspended for
six months as punishment for letting a midwife deliver the baby
of one of his patients. Dr. Clifford Blais was present during the
birth, but let a midwife "catch" the baby, born February
21. The hospital said only a doctor could legally have performed
the midwife's work.
Globe and Mail, April 12, 1989
Meat inspections slashed
Canada's Agriculture Department has drastically reduced its border
inspections of U.S. meat products as a result of the free trade
agreement. Only about five per cent of U.S. meat products are now
being inspected, compared with 100 per cent before free trade. Under
the new system, Canadian inspectors are only make spots checks of
meat. The National Farmers Union (NFU) has charged that the reductions
prove that food quality standards are being lowered to conform to
U.S. levels. Wayne Easter, president of the NFU, said that "this
is especially critical with regard to chicken imports, because the
production lines in many American poultry processing plants are
so fast it is virtually impossible to inspect everything that goes
through."
Globe and Mail, March 2, 1989
Tobacco companies skirt ad ban
RJR-Macdonald and Imperial Tobacco have set up new subsidiaries
to skirt the spirit of Ottawa's new restrictions on tobacco advertising.
The Tobacco Products Control Act allows tobacco companies to sponsor
sports and cultural events under corporate but not brand names.
That posed a problem for RJR-Macdonald, whose Export brand represents
about 80 per cent of the company's total sales. To circumvent the
difficulty, it has set up a new subsidiary to be called Export `A'
Inc., which won't actually produce tobacco but will sponsor sports
and cultural events. Imperial Tobacco has set up four similar subsidiaries:
Players Ltd., DuMaurier Ltd., Matinee Ltd., and DuMaurier Council
Ltd. Rothmans Benson & Hedges Inc. didn't have the same problem
because its brands are already reflected in the company's corporate
name.
Toronto Star, April 14, 1989
'Alternative' Healers Fear Changes
The Natural Healers Association is expressing concern about the
changes being proposed by the Ontario Health Legislation Review.
The Association states that "should this proposed legislation
become law, many holistic practitioners outside the medical field
would be adversely affected and their treatments become unavailable."
Their concern is especially with those provisions in the new legislation
which would prevent unlicensed practitioners from performing diagnosis,
performing procedures on tissue beyond the dermis, and prescribing
or dispensing drugs.
Nurses boycott Toronto General
The Ontario Nurses Association is calling on nurses to boycott the
Toronto General Hospital. The nurses charge that the hospital is
failing to live up to the conditions of their contract. They say
there have been delays in paying salary increases, failures to pay
retroactive increases for part-timers, and preferential treatment
for newly recruited nurses.
Toronto Star, April 27, 1989, Globe and Mail, April 26, 1989
WHO turns down PLO
The World Health Organization has turned down a proposal to admit
the Palestinian Liberation Organization as a member at this time.
The WHO voted 80-49 against the Nicaraguan- sponsored proposal in
a secret ballot. The proposal led the United States to threaten
to withdraw funding from the WHO.
Abortion Gallup poll
A new Gallup poll indicates that 57 per cent of Canadians believe
a woman should be allowed to have an abortion even if the man involved
in the pregnancy disagrees. Thirty-one per cent said an abortion
should not be permitted under such circumstances. The poll also
shows that 26 per cent believe that abortions should be legal under
"any circumstances" and an additional 63 per cent believe
they should be allowed "under certain circumstances".
Ten per cent believe abortions should be illegal.
Toronto Star, August 24, 1989
Tory women endorse abortion choice
The National Progressive Conservative Women's Federation has voted
overwhelmingly in favour of a statement urging that abortion be
considered, in most cases, an issue between a woman and her doctor.
Globe and Mail, August 26, 1989
Lawsuit seeks to free fetus from prison
A lawyer has filed suit in Missouri contending that the state is
illegally imprisoning the fetus of a pregnant female inmate. Missouri
has an anti-abortion law which states that life begins at conception
and that fetuses have "all the rights, privileges and immunities
available to other persons." The suit contends that the fetus
has been imprisoned without having been charged with a crime, allowed
to consult an attorney, or sentenced.
Globe and Mail, August 4, 1989
AIDS carrier jailed
An Alberta man who had unprotected sex with two women without telling
them he is carrying the HIV virus has been sentenced to one year
in jail. The man pleaded guilty to a charge of being a common nuisance
after charges of aggravated assault were withdrawn when both women
refused to testify in court. Both women have since tested positive
for the HIV virus. A spokesperson for the Alberta Civil Liberties
Association said the ruling would keep AIDS victims from seeking
help. "I think the message is, `If you suspect that you are
HIV positive, be very circumspect about seeking help with it because
you don't know what you'll open yourself up to,"' said association
president Tony Managh. In another case in Halifax, a man pleaded
guilty to a charge of criminal negligence causing bodily harm for
passing on the AIDS virus to a pregnant woman.
Globe and Mail, August 11, September 9, 1989
AZT to be more widely available
About 1,000 Canadians infected with the HIV virus, but who do not
yet have AIDS, will be able to start using the drug AZT, federal
health officials have decided. About 2,000 Canadians are presently
receiving the drug in clinical trials. The decision comes in the
wake of a U.S. study which suggested that AZT slows the development
of AIDS if given to people with early symptoms. The manufacturer,
Burroughs Wellcome Co., charges patients about $10,000 a year for
the drug. The government will pick up the tab, estimated to be an
additional $10 million per year. Some doctors questioned whether
there was enough scientific evidence of the drug's effectiveness
to justify its expanded use. "No reputable scientist could
defend these guidelines," said Dr. Philip Berger.
Globe and Mail, August 11, 19, 1989
Public health won't warn wife
Ontario public health authorities have decided not to warn the wife
of a bisexual man that she may be at risk of contracting the HIV
virus because he has engaged in unsafe sex. The decision was criticized
by Dr. Philip Berger, who treated the man between 1986 and 1988.
According to Berger, the man "was having unsafe sex with men
and with his wife during the time I was his doctor...This woman
needs protection." The man has refused to be tested for the
AIDS virus, but according to Berger showed two possible symptoms
of HIV infection. Berger acknowledged that the man's "whole
life could collapse if the information about him was revealed to
his wife -- he could lose everything." He said his decision
to report the man's name to public-health authorities "is the
most difficult situation I've ever found myself in in 15 years."
Public health officials decided not to inform the wife partly because
they did not believe there were reasonable grounds "at the
moment" to assume the man has the virus, and partly because
he has said that he is now using condoms during sex with his wife.
Globe and Mail, September 20, 1989
Quebec dumps called health danger
At least 66 toxic waste dumps in Quebec pose a risk to human health
and the environment, according to a provincial agency, GERLED, which
has been studying the problem. GERLED has identified 372 toxic waste
dumps in Quebec. It says that Quebec produces more than 350,000
tonnes of toxic waste a year, about one-third of which is dumped
directly into the St. Lawrence River.
Globe and Mail, August 22, 1989
College endorses patients' access
The College of Physicians and Surgeons of Ontario (CPSO) is supporting
proposals that patients be allowed access to their medical records.
At present, doctors are under no legal obligation to show patients
their records. A poll commissioned by the CPSO indicated that 60
per cent of doctors were in favour of the move, as were 88 per cent
of the general public.
Toronto Star, September 19, 1989
Lesbian/Gay Challenge to OHIP
A court decision earlier this year which upheld OHIP's refusal to
deny family coverage to lesbian or gay couples is to be appealed.
The test case involved Karen Andrews, who has been trying since
1985 to get family OHIP coverage for her partner of ten years. Andrews'
employer is willing to pay the family premium but OHIP refuses to
accept it.
Anti-apartheid activists target hospitals
The South African anti-apartheid movement is targeting segregated
white hospitals in its campaign to abolish race laws. Scores of
black patients presented themselves at white hospitals for treatment,
which in most cases they were given.
Globe and Mail, August 3, 1989
Independent health facilities
Legislative hearings have been continuing on Bill 147, the Independent
Health Facilities Act. The legislation would regulate independent
health facilities performing a variety of procedures such as eye
surgery, abortion, and arthroscopic knee surgery. An MRG
delegation consisting of Mimi Divinsky, Bob Frankford, and Philip
Berger appeared before the committee on August 16. The MRGers expressed
concern that "facility fees" under the proposed legislation
might be a step towards the reintroduction of extra-billing, and
that the legislation would lead to a greater privatization of the
health care system. They also expressed concern over the amount
of discretionary power being given to the health minister, and about
the inspection and assessment provisions of the act. Others also
expressed concerns to the committee. Dr. Henry Morgentaler said
that the legislation as framed would threaten the existence of free-standing
abortion clinics, or would let them exist only at the pleasure of
the health minister. Dr. Nikki Colodny of Choice in Health Clinic
said that the bill as it stands would force her clinic to close.
The Ontario Medical Association expressed fears that the bill would
lead to risky cost-cutting as clinics bid against each other to
get licenses, and that it would endanger the confidentiality of
patient records.
Cancer treatment backlog
Toronto's Princess Margaret Hospital, Canada's largest cancer treatment
centre, has placed a six-week moratorium on accepting new patients
for radiation therapy, and is giving patients believed to be curable
priority over those needing palliative care. Emergency patients
will still be accepted, but the hospital will turn away an estimated
400 new patients who will be sent to other cancer centres in Canada,
if possible. The major reason cited is a shortage of radiation technologists
at a time when the number of cancer cases is growing rapidly. Other
hospitals, including ones in New Brunswick and British Columbia,
are reporting similar problems.
Globe and Mail, September 13, 1989
Threats to medicare
The Canadian Health Coalition (CHC) is concerned that the free trade
deal and related legislation being pushed through by the federal
government poses increasing dangers to medicare. The CHC says that
massive cuts in transfer payments to the provinces which the federal
government is implementing is bound to mean cutbacks in health services.
The CHC is also unhappy that the free trade agreement entrenches
the right of American companies to manage Canadian hospitals.
U.S. MDs rejecting high-risk patients
The fear of malpractice suits is leading some U.S. doctors to turn
away high-risk patients, according to a Gallup poll. Fourteen per
cent of doctors surveyed said they had denied service to as many
as 10 high-risk patients in the past year because of such fears;
four per cent said they had refused to treat more than 10. Seventy-six
per cent said they did not turn away any patients for fear of litigation.
Thirty-five per cent said there are forms of medicine they do not
practice, despite being qualified, because of high liability insurance
costs.
San Francisco Chronicle, July 7, 1989
Alberta doctors can advertise
The Alberta College of Physicians and Surgeons has passed a by-law
allowing its members to advertise their services for the first time.
The new rules require advertising to be truthful and in good taste.
ONA News, August 1989
Extra-billing
The Canadian Health Coalition is gathering information on ways that
doctors are imposing extra charges on patients now that extra billing
has been legally banned in all provinces. People who have experienced
this are asked to contact the Canadian Health Coalition, c/o 2841
Riverside Dr., Ottawa, Ont. K1V 8X7.
Medicare Monitor, Vol. 5, No. 1
Hostels sue province over funding
Five facilities that provide treatment for alcoholics and drug addicts
are taking the provincial Ministry of Community and Social Services
and the Regional Municipality of Ottawa- Carleton to court over
what they charge is inadequate funding. The five facilities charge
that the funding they are receiving is based on an arbitrary limit
rather than on what is actually need to operate them.
Globe and Mail, August 1, 1989
Rules on gifts by drug companies
The Manitoba College of Physicians and Surgeons has told its members
that it is unethical to accept major benefits from pharmaceutical
companies. Small gifts such pocket diaries are considered acceptable,
but larger gifts such as all- expenses-paid trips to conferences,
are not. Dr. James Morrison, the College Registrar, acknowledged
that the guidelines are general and open to varying interpretations.
Globe and Mail, August 21, 1989
Quebec nurses strike settled
Quebec's 40,000 nurses, among the lowest paid in Canada, have voted
to accept a settlement after a strongly supported illegal strike.
The settlement gives them a four per cent increase in the first
year plus a 2.5 per cent lump sum payment. In the second year, they
will receive increases ranging from 5 to 9 per cent. The agreement
also includes improvements in vacations, training, and shift premiums.
Punitive measures taken by the government to penalize the nurses
for striking will remain in effect. As the nurses went back to work,
95,000 Quebec hospital support staff remained on strike.
B.C. nurses strike ends
B.C.'s nurses strike ended with a two-year contract imposed by a
mediator, but nurses say they are unhappy with the settlement. "Job
action may be over but our dispute continues," said Pat Savage,
president of the B.C. Nurses Union.
Globe and Mail, August 19, 1989
Interim council on midwifery
The Ontario Ministry of Health has appointed an interim regulatory
council to develop standards of practice and establish certification
requirements for midwives. The 13- member council, chaired by Toronto
lawyer Mary Eberts, will serve until a midwifery act is passed and
a statutory College of Midwives is established.
AIDS strategy delayed
Canada's national AIDS strategy will not be ready until the summer,
the government has announced, despite earlier promises by Health
and Welfare Minister Perrin Beatty that the strategy would be ready
by the end of 1989. AIDS community groups expressed their frustration
over the delay.
Supreme Court releases Daigle ruling
The Supreme Court of Canada has released the reasons for its ruling
in the Chantal Daigle case. Daigle's former boyfriend had gone to
court to prevent her from having an abortion. The Court said that
``A fetus is not included within the term `human being' in the Quebec
Charter and, therefore, does not enjoy the right to life.'' The
court said that similar cases in the rest of Canada would also fail.
New abortion legislation under fire
The federal Conservative government has introduced new legislation
on abortion which would make the procedure a criminal offense unless
a woman's physician agrees that her mental or physical health would
be at risk if she doesn't have the abortion. According to Justice
Minister Douglas Lewis, the bill is a compromise which ensures women's
rights to an abortion, but which also protects the fetus through
the health criteria necessary to obtain the procedure. Anti- abortion
groups attacked the bill because it permits abortion at all. Pro-choice
groups called the bill unacceptable because it requires women to
obtain a doctor's permission to obtain an abortion, and because
it does nothing to guarantee equal accessibility to abortion services.
Men for Women's Choice
A new group, Men for Women's Choice, has formed in response to recent
court cases challenging women's right to choose to have an abortion.
The group says that ``no man should be able to force a woman to
bear a child against her will''. It says that ``men should have
equal say and responsibility in a decision to parent. But ultimately,
if there is a dispute, the decision to end a pregnancy must be a
woman's choice -- because it is her body.'' The group has placed
newspaper advertisements signed by hundreds of men supporting this
point of view. It can be contacted at Men for Women's Choice, 555
Bloor St. West, Toronto, Ontario M5S 1Y6, (416) 538-3086.
Anti-abortion MDs lobby CMA
Canadian Physicians for Life, an anti-abortion group, is pressuring
the Canadian Medical Association to change its policy on abortion.
The CMA's policy is that the decision to have an abortion is a medical
one which should be made by a woman and her physician up to the
twentieth week of pregnancy. The group claims that a survey it carried
out indicates that Canadian physicians favour a more restrictive
policy. However, critics of the survey contend that the questions
in it were biased.
Globe and Mail, November 6, 1989
Morgentaler setback in Nova Scotia
The Nova Scotia Supreme Court has granted an injunction sought by
the Nova Scotia government against Dr. Henry Morgentaler. The injunction
prohibits Dr. Morgentaler from performing any more abortions in
his Halifax clinic until charges against him are heard in court
next March. Dr. Morgentaler announced to the media that he had performed
13 abortions at the clinic and challenged the government to charge
him. It did. Nova Scotia's Medical Services Act, passed last June
with the express purpose of stopping Dr. Morgentaler from setting
up a clinic in the province, stipulates that abortions can only
be performed in provincially approved hospitals. The government
maintains that free standing clinics are unnecessary, while Dr.
Morgentaler says that many Nova Scotia women travel to Montreal
to have an abortion because abortions are difficult to obtain locally.
Dr. Morgentaler is appealing the injunction.
Toronto Star, Globe and Mail, November 7, 1989
Planned Parenthood to fight right-wingers
The International Planned Parenthood Federation decided at its November
annual meeting to go on the offensive against U.S.-based right-wing
groups which are exporting an anti- choice ideology to other nations.
``We can't bury our head in the sand any more,'' said Sharon Camp,
who works for a family planning agency in Washington, D.C. In recent
years, she said, the U.S.-based groups have been undermining the
development of family planning programs around the world. The groups
have been successful in cutting off U.S. aid to organizations which
advocate family planning.
Globe and Mail, November 10, 1989
More eligible for AIDS drug
Ontario has agreed to provide the drug AZT to about double the number
of people currently eligible. It will provide the drug to anyone
who is HIV-positive and who has early symptoms of the disease. The
decision follows the announcement of a federal policy permitting
AZT to be given to anyone who is HIV-positive and who has a white
blood cell count under 500. This followed U.S. studies which suggested
that early use of AZT might slow the progress of AIDS.
Toronto Star, September 27, 1989
Man fired for AIDS gets damages
The Canadian Human Rights Commission (CHRC) has ruled that it is
discriminatory for an employer to fire someone because they have
AIDS or have tested positive for the HIV virus. The Commission's
made its ruling in the case of a Canadian Pacific employee who was
fired after he revealed that he had tested positive for AIDS. According
to Michelle Falardeau- Ramsay, the CHRC's deputy head, ``AIDS is
not a moral issue. AIDS is an illness. Would you fire someone if
that person had cancer even if that person was able to do the work?
AIDS is not contagious except when you are in contact with blood,
blood-related products or semen. Education is required. Misinformation
on AIDS is rampant all over the place.''
Toronto Star, October 28, 1989
Pharmacists rapped on complaints
The Consumers Association of Canada (CAC) has suggested that the
Ontario College of Pharmacists is failing to investigate public
complaints against pharmacists. According to Jerry Taciuk, a Toronto
pharmacist and a member of the CAC's Ontario health committee, the
College has not properly investigated some complaints. ``If they
don't want you to complain about a certain person, they circumvent
the statute'', he said. The College was heavily criticized in 1986
for turning a blind eye to illegal money-making practices by its
members, including members of the College's governing council. However,
James Dunsdon, the College's deputy registrar, says that ``I think
that our procedures will stand up to scrutiny.''
Globe and Mail, November 27, 1989
Fee deal seems imminent
The Ontario government and the Ontario Medical Association seem
close to an agreement on fees negotiations which would involve binding
arbitration to determine fees. It would be the first time the Ontario
government has relinquished the final authority over the spending
of public funds to an independent body. The agreement would also
involve a disputes settlement panel which could settle contentious
issues such as how many doctors should be allowed to practice in
the province, and the criteria and standards used for medical practices.
Manitoba's government adopted binding arbitration in 1985, but abandoned
it again in 1987, saying the fee increases being awarded were too
high. The Ontario Medical Association says that it is strongly in
favour of binding arbitration.
Toronto Star, November 4, 1989
Mulroney warns medicare cuts coming
Prime Minister Brian Mulroney has told provincial premiers that
the federal government will be cutting funding to medicare and other
social programs as part of its strategy for cutting the deficit.
Globe and Mail, November 10, 1989
CHO for The Toronto Hospital
The province's first comprehensive health organization (CHO) is
to be set up at The Toronto Hospital (Toronto General + Toronto
Western). The establishment of CHOs was recommended by the Premier's
Council on Health Strategy. CHOs are supposed to bring together
``community health care resources'' under one roof, and are supposed
to be non- profit and self-managing, with members of the public
being represented on their boards of directors. The Ministry has
said that it wants to set up six CHOs per year for the next three
years. Feasibility studies are under way in Fort Frances, Wawa,
and Kingston. The unit at the Toronto Hospital would replace the
hospital's three family practice units.
Ministry press release; Toronto Star, September 27, 1989
Heart patients going to Detroit
Windsor doctors have developed a plan to get around long hospital
waiting lists for heart patients by sending patients to a hospital
in Detroit. The St. John Hospital in Detroit would perform heart
bypass surgery on Canadian patients and then bill the Ontario Health
Insurance Plan. The Ontario Health Ministry has not commented directly
on the scheme, but it is ministry policy to pay 75 per cent of the
cost of out-of-province hospital ward costs and 100 per cent of
the OHIP rate for elective hospital admissions. According to Windsor
surgeon Dr. David Wonham, who negotiated the agreement, Windsor
heart patients wind up waiting six to 18 months for a bed.
Toronto Star, September 27, 1989
Cancer centres warns patients to be turned away
A shortage of radiation therapists at the Toronto-Bayview Regional
Cancer Centre, combined with patient overflow at the Princess Margaret
Hospital, is causing the Bayview Centre to delay treatments for
patients or to send them elsewhere. The Centre says that it needs
another 20 radiation therapy technologists to handle the patient
load.
Toronto Star, October 23, 1989
Nurses say new regulations ignored
The Ontario Nurses' Association (ONA) says that hospital administrators
are ignoring new regulations which were supposed to give nurses
more power and responsibility. According to Glenna Cole Slattery
of the ONA, only one hospital has complied with a new regulation
requiring that nurses be put on key hospital committees by the end
of September. Peter Wood of the Ontario Hospital Association denied
the accusation, saying that the majority of hospitals were well
on the way to changing their bylaws to permit the changes. Slattery,
however, charges that the hospitals are deliberately dragging their
feet.
Toronto Star, November 15, 1989
Independent Health Facilities Act passed
The Independent Health Facilities Act passed the Ontario Legislature
last month in a 54-21 vote. The act will regulate clinics and offices
outside hospitals. When the law goes into effect this spring, doctors
who want to operate clinics will have to apply to the government
for a license. They won't be allowed to charge ``administrative''
fees, and will be given money by the government to operate.
Task force calls for crackdown on overbilling
According to a task force reporting to the Ontario College of Physicians
and Surgeons, a few dozen doctors over-charge the Ontario Health
Insurance Plan (OHIP) for more than $1 million a year. The report
urges the college to develop specific standards of practice to prevent
doctors from billing for unnecessary or inappropriate services.
According to the task force, many doctors who over-charge are never
challenged, and many of those who are get off because there are
no specific guidelines as to what is or isn't appropriate treatment.
Toronto Star, November 28, 1989
Multicultural nursing homes being funded
The Ontario Ministry of Health is inviting proposals from multicultural
groups for 600 new non-profit nursing home beds. ``We want to make
sure that elderly people in such institutions can communicate in
their own language and that they can follow their traditional customs
and diet,'' said Health Minister Elinor Caplan.
Ministry of Health press release, November 3, 1989
Quebec nurses' union fined
The Quebec nurses' union and two members of its executive have been
found guilty of contempt of court and fined for defying a government
order to return to work during their `illegal' strike. Diane Lavellee,
president of the Quebec Federation of Nurses, and vice president
Raymonde Bosse, were fined $1,000 each, while the union was fined
$5,000.
Malpractice suits up
Lawsuits for malpractice have tripled in Canada over the last 15
years, according to Robert Pritchard, dean of law at the University
of Toronto, who is conducting a study of the subject. Pritchard
told a meeting of the Ontario Hospital Association that the size
of the average award has quadrupled over the same period of time,
while the proportion of patients who win their cases has doubled.
About 900 suits are launched each year. Most of the complaints are
against hospitals and other health-care institutions, he said. As
a result, doctors and hospitals are now spending $200 million per
year on medical liability insurance and insurance premiums have
increased immensely.
Globe and Mail, October 31, 1989
Nursing homes gave Liberals too much
Two of Ontario's largest nursing home chains gave illegal campaign
contributions to the Ontario Liberal party during the 1987 election
campaign. The two chains, Versa Care Ltd., and Leisure World Health
Care Centres, Inc., each gave more money than the legal maximum.
No charges were laid <196> instead the Commission on Election
Finances simply asked the candidates and riding associations to
return the money. The nursing home industry, once an important supporter
of the Ontario Progressive Conservative Party, has become a major
backer of the Liberals now that they are in power. The homes are
the recipients of over $400 million from the provincial treasury.
Toronto Star, November 20, 1989
Ontario Public Health Association meets
The Ontario Public Health Association adopted a number of resolutions
at its November annual meeting. Among the resolutions adopted were
ones calling on the province to provide condoms free to people who
can't buy them; a call for gay couples to have the same rights as
heterosexual couples; limited anonymous testing for the HIV virus;
and an expansion of home care services.
Toronto Star, November 21, 1989
Anti-car measures
Toronto board of health is proposing measures which would ban polluting
cars from the city. One suggestion is that all cars be required
to pass a test of their exhaust fumes. Only those within the set
levels would be given a sticker allowing them to drive on city streets.
Toronto Star, October 5, 1989
Government backing down on safety bill
The Ontario government is backing away from legislation which would
let workers shut down work places they consider unsafe. ``We had
a breakdown in communication'', said Industry and Trade Minister
Monte Kwinter. ``We were led to believe that there had been consultation
[with business] and that they were onside.'' Business groups have
been lobbying fiercely against the proposed bill, and the government
has now indicated that key provisions will be changed or watered
down. Many labour unions have been supporting the bill, although
some have said that it is too weak. Ross Dunsmore, chairman of the
Metro Toronto Board of Trade labour relations committee, said that
free trade makes it necessary to weaken the legislation. ``We have
to compare the cost of doing business here with Buffalo or Georgia...
The more impositions the government makes... the more it will cost
and more companies will be pushed to the United States.''
Toronto Star, September 28, October 13, 1989
Logger's Death
A B.C. logger who was killed on the job earlier this year was working
for a company that had been under close scrutiny by the Workers
Compensation Board for violating provincial safety regulations,
a coroner's inquest has been told. Rodney Tubbs died on July 27
after being struck by a block of cedar logs that had fallen out
of a sling on a helicopter. He was working for G & R Cedar Ltd.,
an independent contractor working with MacMillan Bloedel. Charles
Burrell, a MacMillan Bloedel manager, told the inquest he is not
particularly interested in finding out whether companies subcontracted
by his firm are in violation of provincial regulations. He suggested
that there may be too many safety regulations in the logging industry.
Mr. Tubbs was one of over 150 people to die on the job in B.C.'s
logging industry since 1984.
Globe and Mail, October 4, 1989
Barrie deaths investigated
The Ontario Ministry of Labour is investigating reports of deaths
and illness said to be linked to a company that operated tanneries
in Barrie, Oshawa, Kitchener, and Coburg. The Simcoe County Injured
Workers Association says that it has received reports of appalling
working conditions at the plants, and the dumping of hazardous chemicals
into city sewers and creeks. The company, Robson Lange Leather Inc.
closed in 1986. Dr. Jim Stopps, chief of health studies services
for the Ministry of Labour, said that 44 reports of death and illness
are being investigated.
Toronto Star, October 12, November 1, 1989
AIDS compensation
Federal Health and Welfare Minister Perrin Beatty has announced
that people who contracted AIDS because of tainted blood products
will received $120,000 each in financial compensation. Beatty characterized
the measure as an action to "ensure public confidence in Canada`s
blood supply". He said that `it's not designed as an AIDS relief
program as such. The Department of Health and Welfare estimates
that 1,250 people in Canada, 950 of them hemophiliacs, were infected
with HIV from receiving blood transfusions from 1979 to 1985.
Globe and Mail, 15 December, 1989
Northern medical school?
A task force of the Ontario New Democratic Party has come out in
favour of the creation of a medical school in Northern Ontario,
arguing that this would be a way to keep doctors, nurses, technicians
and other professionals in the North. The proposed school would
also be charged with developing medical care programs more suitable
to the North. The proposal has met with skepticism from the Liberal
government, which argues that there are already too many doctors
in Ontario.
Toronto Star, 10 February, 1990
Transfer payments cut
Michael Wilson's new budget contains extensive cuts to transfer
payments to the province for health care and education. Payments
to Ontario alone will be cut by $378 million per year, nearly all
of it money slated for health care and education.
Budget hits veterans
More than 5,000 aging Canadian war veterans confined to chronic
care hospitals will have to pay more than $3000 each for their bed
and board as a result of the Progressive Conservative government's
new budget. Another 60,000 veterans living at home will lose some
of the home care and help currently being provided to them because
of cuts to the Veterans Independence Program.
New OHIP cards
The Ontario government plans to introduce new OHIP cards for all
Ontario residents this year. Under the new system, each person would
have a new OHIP number, and each child born in the province would
receive an individual `cradle-to-grave' card at birth. The government
says the new cards will improve administration of the system and
make it easier to keep track of health care trends, including billings.
Critics charge that the new system would be a threat to individual
privacy, and that it would open the door to OHIP numbers being used
as a tracking device for unrelated purposes in the same way as social
insurance numbers have become widely used.
Registry for heart patients
The Ontario government has announced a new system of networks designed
to insure that people with urgent problems get heart surgery when
they need it. The networks will be able to refer patients to other
facilities if their own hospital has a waiting list.
Safety law weakened
Ontario's Labour Minister Gerry Phillips has tabled amendments to
the Occupational Health and Safety Code which would weaken the provisions
of the legislation that are supposed to safeguard workers' safety.
The changes reduce the right of workers to refuse unsafe work. Criticism
of the proposed changes came from a number of labour unions. Bob
De Matteo, director of health and safety for the Ontario Public
Service Employees Union, said that if workers do not have the right
to refuse unsafe work, employers find it easy to ignore employee
complaints.
B.C. electrician sues asbestos companies
George Hunt, a retired electrician from Victoria has gone to court
to claim damages from 14 asbestos-related companies and industry
associations. Mr. Hunt's lawyers will try to prove that he is dying
of mesothelioma, and that the disease is associated with his having
inhaled asbestos fibres during his work. His claim alleges that
the health hazards of asbestos have been known to the industry since
1927, but that information about them was deliberately withheld.
-Globe and Mail, 27 February 1990
OHIP curbs payouts to U.S. hospitals
The Ontario Health Insurance Plan is now paying only the Ontario
per diem rate for Ontario residents hospitalized in the United States.
Previously, OHIP had paid the full amount, which is often double
the comparable Canadian per diem rate. OHIP will continue to pay
100% of the treatment in U.S. institutions if comparable treatment
is not available in Canada and if prior approval has been obtained.
Out-of-country health costs have more than doubled in Ontario to
$225 million in 1990-91 from $100 million in 1988-89. The government
said that it would work to reduce the need for the most frequently
used out-of-country services, such as cardiac care, brain-injury
treatment and alcohol and drug rehabilitation be expanding Ontario
facilities and by setting up registries to guide doctors and patients
to them.
Tories want user fees
Delegates to the national Progressive Conservative convention in
Toronto voted in favour of imposing user fees for medical treatments
despite warnings that this would create a two-tier system of medicare.
The resolution becomes party policy, but the government is not obligated
to act on it, and federal health minister Benoit Bouchard said subsequently
that he was opposed to user fees.
Alberta to charge for oxygen
The Alberta government has started charging chronically ill seniors
who use oxygen tanks 25 per cent of the cost of the oxygen, to a
maximum of $500 per year. Previously the tanks were provided free.
Study calls for reduced med school admissions
A study into the question of physician supply commissioned by the
conference of deputy ministers of health is said to urge that the
number of students admitted to Canadian medical schools be reduced
by 10 per cent. The report, prepared by Greg Stoddart of McMaster
University and Morris Barer of the University of British Columbia,
concludes that "the long-term trend of annual increases in
the rate of growth of physician supply in excess of population growth
continues without obvious or compelling justification." The
number of doctors in Canada rose 3.5 per cent per year from 1981
to 1987, while the population increased 1 per cent per year.
Quebec MDs told to solve physician supply problems
The Quebec government has told physicians that they have 18 months
to come up with solutions for the chronic shortage of physicians
in outlying regions. If they are unable to do so, then the government
will impose sanctions to force physicians out of metropolitan areas.
Provincial health minister Marc-Yvan Cote made the announcement
as part of a series of measures he introduced to revamp the province's
health care system. Bill 120 proposes that medicare fees for doctors
in cities be cut until all posts were filled in outlying regions
and that licences be denied for new private practices in urban areas
where there are staffing shortages in emergency rooms and health
clinics. The doctors' proposal is that all physicians with less
than 10 years of service spend a portion of their time working in
clinics, emergency rooms or home care. Those who refuse would face
cuts in their medicare fees. The legislation also calls for the
creation of a medical council of Quebec and of 17 regional medical
commissions.
Abortion clinics funded
The Ontario government has started providing full funding for Toronto's
four free-standing abortion clinics. The funding means that the
clinics will stop charging women a fee of $200 to $300 per abortion.
Insanity law annulled
The federal government has introduced new legislative proposals
to replace the law on criminal insanity struck down earlier this
year by the Supreme Court. The Court ruled this spring that a law
which forced those not guilty of a crime by reason of insanity to
be automatically committed to a mental institution violated a person's
rights under the Canadian Charter of Rights and Freedoms because
it called for indefinite confinement without regard to whether the
person is a danger to society. The court granted the federal government
a six-month period to pass legislation to replace the old law. About
1,000 people are confined across Canada under such warrants. The
federal justice department had new legislation ready since 1986,
but had made no effort to introduce it. Under the new proposals,
in most cases an offender with mental disorders would be given a
detention period with a maximum specified.
Forced drugging struck down
The Ontario Court of Appeal has struck down provisions in the Mental
Health Act that allowed doctors to administer anti-psychotic drugs
to inmates of psychiatric institutions against their wishes.
Tobacco ad ban overturned
The Quebec Superior Court has ruled that the federal ban on cigarette
advertising violates the right of tobacco companies to free speech
as guaranteed in the Charter of Rights and Freedoms. In striking
down the law, the court also negates provisions requiring tobacco
companies to print health warnings on packages.
Drugstore Tobacco ban urged
The Ontario College of Pharmacists has recommended that the Ontario
government ban the sale of tobacco in drugstores by July 1, 1993.
At present, about 24 per cent of all tobacco sold in Canada is sold
in drugstores, a total of $2 billion annually, including $800 million
in Ontario. The recommendation was criticized for delaying too much
by Gar Mahood of the Non-Smokers Rights Association. "The Shoppers
Drug Mart-led pro-tobacco lobby is simply out to delay this measure
for as long as possible," he said, noting that Shoppers Drug
Mart is owned by Imasco, which owns Imperial Tobacco.
Safety agency plans overhaul
The Ontario Workplace Health and Safety Agency, the new agency charged
with overseeing health and safety issues in the workplace, is planning
a major overhaul of the delivery of health and safety services which
are currently provided by 12 separate organizations in Ontario.
The agency has not yet announced what changes it proposes.
AIDS Centre wins reprieve
Federal Health and Welfare Minister Benoit Bouchard has put a halt,
at least temporarily, to plans to close down the Federal Centre
for AIDS. Community activists were alarmed by the plan because they
feared that without an identifiable national body, AIDS issues might
become lost in a bureaucratic maze. The centre was established in
1987, and has come in for repeated criticism for failing to fulfil
all its functions effectively.
Couple jailed for nursing home death
A Muskoka couple have been sentenced to prison for 20 and four months
respectively for failing to provide a resident of their unlicensed
nursing home with "adequate and proper care." The patient
died after suffering burns in a bathtub. The sentence marks the
first time that a nursing home operator in Canada has been convicted
of criminal negligence for failing to provide proper care.
Out-of-country OHIP cut
The Ontario Ministry of Health has announced a new policy on paying
for out-of-country health care services. In most instances, the
Ministry will now pay U.S. hospitals and physicians the same rates
as are paid to Canadian hospitals and physicians. Health Minister
Frances Lankin said that "Ontario taxpayers can't afford to
provide an open-ended subsidy to the profit-driven U.S. medical
system if we want to preserve medicare and improve health services
in Canada." The Ministry will now cover the full cost of out-of-country
hospital treatment only if the service is unavailable in Ontario
and the patient is threatened in terms of life or irreversible damage
to their health.
Inter-provincial committee to look at costs
Canada's health ministers have set up an inter-provincial committee
to look at ways of controlling health care costs. The committee
is to prepare recommendations to be considered at another conference
in mid-1992. Among the issues and suggestions to be looked at by
the committee are reducing enrollments in medical schools by 10
per cent, as recommended in a report by Morris Barer and Greg Stoddart;
alternatives to the fee-for-service system; and reducing the concentration
of doctors in urban areas and increasing services to rural and northern
areas.
B.C. Royal Commission recommends changes
British Columbia's Royal Commission on Health Care and Costs released
its report in mid-November. Among the 359 recommendations contained
in its 400-page report, Closer to Home, were a substantial shift
of resources from hospital care to less costly institutions and
to home care. Specifically, the Commission recommended that 25 per
cent of the province's acute-care budget be cut by 1995. It called
for an immediate increase in provincial welfare rates, a school
meals program, a ban on liquor and tobacco advertising, health warnings
on bottles of alcohol, sharp controls on the province's doctor supply,
a global cap on payments to doctors, monitoring of billing practices,
regular audits of doctors' billings, and mandatory AIDS testing
for pregnant women, health-care staff, and patients undergoing medical
procedures in a hospital. It called for five principles of medicare
to be entrenched in law: universality, accessibility, comprehensiveness,
portability, and public administration, as a way of stopping threats
to medicare such as extra-billing, user fees, and a two-tiered system.
The health minister in British Columbia's new NDP government said
that many of the recommendations were in accord with NDP policy,
but that it would take time to study all the recommendations. The
British Columbia Medical Association said that the report was biased
against doctors.
Cuts coming, Lankin says
Ontario Health Minister Frances Lankin told the Ontario Hospital
Association on November 13 that the government is looking at ways
of reducing wasteful spending in the health care system. Citing
estimates that "25 to 30 per cent of everything we currently
do in the health care system has no proven value", she said
that cholesterol testing, caesarian sections, and in-vitro fertilization
are being considered as areas where costs could be cut.
Lab fees cut
The Ontario government has imposed a five per cent reduction in
fees paid to medical testing laboratories. The across- the-board
cut in fees paid by OHIP to the test labs come into effect January
1, 1992. "We haven't had a fee increase since July 1990",
said John Rogers of MDS Laboratories, which operates 53 laboratories
in the province. "Clearly we are not pleased." Ministry
of Health spokesman Layne Verbeek said billings by commercial laboratories
have increased by an average of 15 per cent a year over the past
decade. For the 1990-91 fiscal year, OHIP paid out about $450 million
in lab fees. There are 173 private testing labs in the province.
Paul Gould, president of the Ontario Association of Medical Laboratories,
criticized the government for taking unilateral action while it
was simultaneously engaged in fee negotiations with the labs.
AIDS drug lawsuits
Burroughs-Wellcome Inc. is suing Apotex Inc. of Toronto and Interpharm
of the Bahamas for patent infringement on zidovadine (sold as AZT)
and acyclovir (sold as Zovirax). Burroughs-Wellcome is seeking an
injunction to prevent the two companies from selling these two drugs.
Meanwhile, Apotex has launched a patent challenge to win the right
to produce the drug. Apotex and another company, Novapharm Ltd.
of Toronto, claim Burroughs-Wellcome should not have been granted
the AZT patent because it did not invent it: the Michigan Cancer
Institute did so in 1964. According to Apotex president Barry Sherman,
Apotex can sell AZT at a price between 25 and 50 per cent less than
Burroughs-Wellcome.
Globe and Mail, 26 October 1991
Unions target workplace violence
Violence in the workplace is a serious threat to many workers in
the service sector, delegates to a union- sponsored conference on
workplace violence were told in November. Dick Martin, executive
vice-president of the Canadian Labour Congress, said those most
at risk include bus drivers, school staff, prison guards, social
workers, security guards, police officers, medical workers and those
who work alone. "There are angry clients, disturbed patients,
dangerous criminals -- workers come into contact with them every
day as part of their job," he said. "For example, in one
rehabilitation hospital where members of CUPE work, 80 per cent
of the nursing staff suffered injuries due to physical assault over
a 20-month period." According to CUPE president Judy Darcy,
nursing homes often see incidents of violence against staff. She
said that understaffing, poor living conditions, and neglect of
residents' needs raised -frustration levels in nursing homes and
made violence more likely.
-Source: Globe and Mail, 9 November 1991
Injured workers blast government
After a four-year battle to receive compensation for aluminum- and
asbestos-related disabilities, workers at McDonnell Douglas say
they have been betrayed by members of Ontario's NDP government.
At a demonstration at Queen's Park, the workers said that Ontario
Premier Bob Rae and Labour Minister Bob Mackenzie had strongly supported
their cause before coming to power. Nick DeCarlo of the Canadian
Auto Workers union said Mr. Rae and Mr. Mackenzie appeared at demonstrations
and denounced the previous Liberal government for its policies on
aluminum poisoning and asbestosis. Mr. DeCarlo said that several
former McDonnel Douglas workers have been refused compensation from
the Workers' Compensation Board for illnesses related to aluminum
and asbestos exposure. In 1988, tests conducted by researchers at
the University of Western Ontario found that high levels of aluminum
were found in 450 or 1,300 workers tested.
Welfare rights
The Welfare Rights Group, an advocacy organization for people receiving
social assistance, is calling on the government to take steps to
make it easier for people receiving benefits to cash cheques. The
group is calling on the Ministry of Community and Social Services
to stop automatically dating Family Benefits cheques for the last
day of the month. The group wants either the month only or the actual
date of issue to appear on the cheque. This would enable recipients
to cash their cheque on the day they receive it. The groups is also
calling on the government to develop a free, universal form of ID
which would be acceptable to banks. This would lessen recipients'
reliance on cheque-cashing companies which charge fees to cash cheques.
For more information contact Pam Chapman, Welfare Rights Group,
473 Queen Street East, Toronto Ontario M5A 1T9, (416) 863-0499.
Cigarette smuggling
Cigarette smuggling is on the way to becoming a $500-million per
year business, according to the Royal Canadian Mounted Police. The
massive increase in smuggling is linked to high taxes on tobacco
products. It is estimated that the federal and provincial governments
lose $350 million per year in tax revenue as a result of smuggled
cigarettes. A report by the RCMP's customs and excise branch says
that the problem gets worse every time tobacco taxes are raised
because each increase acts "as an additional incentive to smuggle,
as profit margins for smuggling increase in direct proportion to
the amount of the tax increase."
"Granny dumping"
Elderly Americans are being abandoned at hospital emergency departments
in a new phenomenon known as "granny-dumping", according
to the American Association of Retired Persons (AARP). According
to the AARP, the old persons are usually left in the emergency waiting
room by relatives. By the time hospital staff realize that the old
person is not sick, the relatives have disappeared. Some just drop
off the relative from a car and summon staff by sounding the horn,
before driving away. According to Dr. Tom Mitchell, the head of
emergency at Tampa General Hospital, which sees two or three such
cases a week, people dumping relatives "feel overwhelmed. They
have reached the point where they can no longer care for the old
person." Medicare in the United States does not pay for care
in nursing homes, or for long- term care at home, and temporary
help is difficult to obtain.
Manchester Guardian Weekly, 29 September 1991
Health Ministry re-structured
The government announced a series of organizational changes in the
Ministry of Health on January 20. The existing five divisions in
the Ministry are being replaced by four new management groups. They
are the Health System Management Group (covering programs associated
with hospitals, payments to doctors, drug programs, and laboratory
services); the Population Health and Community Services System Group
(covering health promotion, disease prevention, and community services);
the Health Strategies Group (to create policies and plans to shift
toward preventive and community care and away from hospital and
illness-based systems, and to oversee negotiations with the OMA
and other contract negotiations); and the Corporate Management and
Support Group (to provide administrative support to the other three
management groups.
New Ministry strategies
Health Minister Frances Lankin announced a set of strategies and
initiatives which she said were to guide the Ministry over the next
three to five years. The stated aim is to "shift our view of
health away from its emphasis on treatment to a wider vision that
includes communities, living standards, and the personal choices
that people make", while simultaneously creating a system "in
which costs will be brought under tighter control." The Ministry
has adopted five health goals articulated by the Premier's Council
on Health Strategy as the basic of its approach. The goals are:
1) Shift emphasis from treatment to health promotion and disease
prevention; 2) Foster strong supportive families and communities;
3) Ensure a safe, high quality physical environment; 4) Increase
the number of years of good health for the citizens of Ontario by
reducing illness, disability and premature death; 5) Provide accessible,
affordable health services for all. Specific initiatives will include
three major program reviews, of hospitals, drugs, and laboratory
services. Lankin said that the Ministry also intends to implement
the redirection in long-term care with a new emphasis on community-based
programs and services.
Hospitals get 1% increase
Ontario's hospitals have been told that they, like universities
and colleges and other recipients of provincial funding, will be
held to a one per cent funding increase for 1992-93, and increases
of two per cent for each of the following two years. The government
suggested that hospitals should achieve greater efficiency by better
use of existing services; encouraging the shift from inpatient to
outpatient care; better links between hospitals and with community
agencies; elimination of duplication; and better local and regional
planning.
Health ministers adopt strategy on MD numbers
In a January meeting, provincial and territorial health ministers
adopted a common strategy on `physician resource management'. Measures
include setting up a national co- ordinating committee on postgraduate
medical training; reducing enrollment in medical schools by 10%
starting in 1993; reducing postgraduate medical training positions
by 10%; reducing the recruitment of visa trainee graduates of foreign
medical schools; supporting the development of national clinical
guidelines with emphasis on health outcome research; replacing fee-for-service
"wherever that method of payment aligns poorly with the nature
or objective of the services being provided"; increased utilization
of alternative service delivery models; restructuring and rationalizing
the funding of academic medical centres; introducing initiatives
to improve access to clinical services in rural communities.
Medical schools disagree
Medical school administrators are saying that cutting back on admissions
is the wrong way to curb health care costs. According to John Provan,
associate dean of medicine at the University of Toronto, the association
of medical schools is forecasting a shortage of physicians by the
end of the decade. The projections are based on factors such as
an aging and growing population, and on the tendency for doctors
to reduce their hours of work. There are currently about 1,755 first-year
students enrolled in Canadian medical schools. According to Provan,
the proposal to cut post- graduate positions by 10% would be especially
problematic.
Fund for laid-off workers
The Ontario government plans to set up a fund to assist hospital
workers who are laid off, Health Minister Frances Lankin has announced.
Ontario Hospital Association President Dennis Timbrell has predicted
that 13,000 hospital workers will lose their jobs because of government
spending restraints, but Lankin disputed those figures, predicting
that a maximum of 2,000 jobs would be lost.
Hospital workers laid off
Four Ontario hospitals are laying off about 200 employees in the
wake of funding restrictions. Mount Sinai Hospital is Toronto is
laying off 90 employees, including 51 RNAs and lab workers; Joseph
Brant Memorial Hospital in Burlington is laying off 80 workers.
Sudbury Memorial Hospital is laying off more than two dozen employees,
most of these layoffs are classified as temporary. Sudbury General
Hospital laid off four people, and said that between 75 and 115
might be laid off later.
Lab fees rolled back
Ontario Health Minister Frances Lankin has rolled back fees paid
to privately owned medical laboratories by 5 per cent. This reverses
a trend which saw lab fees rising by more than 15 per cent a year
over the last 10 years. The money paid to the province's 173 private
testing labs has been increasingly dramatically. In 1980-81, the
province paid out $112 million; in 1990-91, the amount had risen
to $428 million. According to Dr. Dennis Psutka, a former Ontario
assistant deputy minister of health, "All the provinces have
the same problem and none of them knows what to do about it. The
attempts to regulate the private lab industry have all been resounding
failures." A number of factors are seen as contributing to
the increase. These include an increase in the number of physicians.
In Ontario, the number of physicians has grown at 3 per cent a year
in recent years, while the population has grown one per cent a year.
Not only are there more physicians ordering tests, but physicians
are ordering more tests: the number of tests per patient has been
increasing at a rate of 4.5 per cent a year.
Health and safety centre faces closure
The federal government is developing a plan to shut down the Canadian
Centre of Occupational Health and Safety (CCOHS). A confidential
Treasury Board document obtained by the Canadian labour Congress
instructs the federal Ministry of Labour to shut down the centre
unless the provinces or the private sector want to take it over.
The CCOHS collects and distributes free information on occupational
health and safety matters. According to Dick Martin, a director
of the centre, the CCOHS receives tens of thousands of inquires
each year from business and labour. Mr. Martin said that "at
a time when health costs are soaring, it is ludicrous to close a
centre that exists to prevent disease and accidents. It provides
life-saving information."
Patent protection extended
The federal Progressive Conservative government has announced that
it will increase patent protection for multinational pharmaceutical
companies to 20 years. The current system gives protection for up
to 10 years. The decision was harshly criticized by Canadian generic
drug companies and by consumer groups, who said that the result
would be increased costs for consumers and government drug benefit
plans. The average price of single-source drugs (drugs for which
there was only one supplier) rose 350 per cent between 1979 and
1988. By comparison, the average price of drugs for which there
was more than one supplier rose by less than 100 per cent. In the
United States, where patent protection has been stronger than in
Canada, prices for name-brand drugs are up to three times higher
than they are in Canada.
Quebec pays more for drugs
Quebec is paying drug companies between 25 and 124 per cent more
than Ontario for identical drugs, a legislative committee has learned.
The price discrepancy adds about $40 million to the $500 million
annual cost of the provincial drug plan. The committee was looking
at ways of reducing Quebec's pharmaceutical costs, which have increased
by more than double the rate of inflation for the past two decades.
Claude Lafontaine, president of the Quebec Order of Pharmacists,
said that costs are increasingly dramatically not because of abuse
but because the province is spending too much money on drugs and
not enough on pharmaceutical expertise. Mr. Lafontaine said that
in the doctor-driven health care system, pharmacists have become
"mere dispensers of drugs."
Toronto Hospital shifts medical priorities
The Toronto Hospital has adopted a new mission statement which narrows
the hospital's focus. The new mission statements emphasizes cardiology,
neurosurgery, cancer treatment, and transplants, while de-emphasizing
internal medicine, women's reproductive health, and mental health.
According to hospital president Dr. Alan Hudson, "The Toronto
Hospital has been at world levels in a whole variety of programs.
That number of programs at which we will be at world level will
be reduced."
Depo-Provera
The Canadian Coalition of Depo-Provera has expressed its concern
about pending approval of Depo-Provera as an injectable long-lasting
contraceptive. The Coalition says that, based on the available evidence,
Depo-Provera should not be released for use as a contraceptive at
the present time. It calls for strict protocols to be followed when
prescribing drugs for unapproved uses, stating that such protocols
should include informing the patient of the drug's status, and of
the concerns about long term safety; and obtaining a signed consent.
The Coalition wants a mandatory reporting system in place to track
the drug's use and allow for follow-up and research. The Coalition
also wants the drug approval process to be made much more public
and open.
All items appeared in Medical Reform, the newsletter of the Medical Reform Group of Ontario, and were compiled by Ulli Diemer.
Related Links:
Health News Briefs 1992- 1994
Medical Reform Group of Ontario - Connexipedia article
Medical Reform Group newsletter online archive
Medical Reform Group of Ontario new releases 1979 - 1995
Connexions Digest Collected News Briefs 1989-1992
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