TORONTO, QUEEN’S PARK –
NOTE: NO reporters were present at the committee hearings. All documentation can be provided.
Canada’s hospital insurance company has successfully lobbied the Ontario Liberals and Tories to keep information about medical errors and quality of care from patients and the public.
Both political parties quietly tabled amendments in support of the medical lobby on Friday afternoon and will be voting on them in a committee meeting Monday. Once the government wording passes, it will likely become law before the next election.
Injured patients who want to find out if there have been similar cases to theirs, academics who want to learn from medical error, and journalists who try to uncover holes in our medical system have all been stymied until now by the fact that hospitals haven’t been included under Freedom of Information legislation.
A recent report by the Auditor General on Local Health Integration Networks (LHINs) lambasted the government for lack of transparency and the use of taxpayer funds by medical lobbyists.
This bill, the Broader Public Sector Accountability Act, was supposed to address the Auditor General's concerns by improving access to information and banning taxpayer-funded medical lobbyists. But the spirit and language of the Act has been undermined by this recent amendment.
Excludes “Quality of Care” information
The medical lobby proposed the amendment to exclude "quality of care information" and "risk management" (a term that means risk of being sued) information from Bill 122, which brings hospitals under Freedom of Information (FOI) legislation and bans taxpayer-funded healthcare lobbyists.
The Ontario Hospital Association (OHA) says that sharing information will harm "patient safety culture" and that doctors will be reluctant to come forward if they are vulnerable to embarrassment and accusation.
The Conservative Party amendment, tabled by accountability critic Lisa MacLeod, used the exact wording suggested in the last-minute proposal by HIROC, the Healthcare Insurance Reciprocal of Canada (which represents the majority of hospitals in Ontario), the OHA and the Ontario Medical Association (OMA). The Tories put the amendment forward on behalf of the insurance company.
The Liberals also put forward an amendment on behalf of the medical lobby, to limit public access to information about quality of care from hospitals. Although they used more watered-down language, the effect is the same. Two of the Liberal members of the committee voting on the amendment Monday are doctors, and Dr. Kuldip Kular has been a member of the Ontario Medical Association (OMA), one of the groups lobbying to keep the information hidden.
Medical error affects many people
According to the Canadian Institute of Health Information (CIHI), more Canadians are dying from preventable adverse events in hospitals than from breast cancer, motor vehicle accidents and HIV combined. Many injuries and deaths are not reported in adverse event statistics, because they are attributed to the patient’s underlying medical condition.
Surveys of medical error and adverse events show that the problem is bigger than is publicly recognized. In a CIHI survey in 2003, one in four Canadians said they or a family member experienced a preventable adverse event during treatment and more than half of those had serious health consequences. A tiny fraction of people hurt by preventable adverse events ever get to court, and even fewer receive compensation.
Patient safety problems cost the system time and money, by extending hospital stays, over-using precious medical resources and reducing economic productivity through extended illness.
Public scrutiny of hospital practices which contribute to injury and death is an essential part of efforts to improve patient safety, as it would allow us to independently assess the gaps in the quality of our healthcare system and find out what the biggest sources of medical error are.
Patient Safety Culture Needs Patients
The medical lobbyists told the committee that keeping “quality of care” information from the public would encourage doctors to come forward with problems they identify, and that they will be reluctant to admit to error if they are vulnerable to public embarrassment and accusation. The insurance company said that even basic information, such as whether a hospital has "fever protocols", is too personal to doctors and shouldn't be shared.
The Ontario Hospital Association claimed that releasing information to the public would undermine patient safety culture.
"I object to this,” Cybele Sack of ImPatient for Change, a new patient rights group, told the committee. “Patient safety culture needs patients." Sack says she is not included in hospital adverse event statistics, even though she waited nearly six months for surgery after her appendix burst. “In 2008 it was me,” she said about falling prey to medical error. “Tomorrow it could be your mother, sister, son or grandchild.”
There is a growing opposition to this amendment. The Ontario Health Coalition, the Registered Nurses Association of Ontario, and service employees union are all concerned that hiding medical information which could save lives and prevent injuries is against the public interest.
Releasing “quality of care” information to the public would not compromise private patient information, as this is already protected under privacy rules.
Lobbyists did not ask to protect the identity of doctors who release information, they asked that the information not be made public at all.
Public hearings about this legislation in Ottawa were cancelled by the government without notice.
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ImPatient for Change is a new patient rights organization whose goal is to exchange information about patient safety and to advocate for medical reform in the public interest. We believe that Every Patient Matters.
For more information or for copies of relevant documentation for this original news story, please contact: impatient4change@gmail.com
