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Health News Briefs
January 1987 - December 1991

Compiled by Ulli Diemer

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

 

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