It was supposed to be a day of hearings on the provincial budget, but the insertion into the Act of an amendment to the Freedom of Information and Protection of Privacy Act that would exempt hospitals from providing information on quality had many individuals and organizations up in arms. Is the government getting anxious about its decision to open public hospitals to scrutiny? Schedule 15 in Bill 173 would exempt hospitals from divulging “information provided to, or records prepared by, a hospital committee for the purpose of assessing or evaluating the quality of health care and directly related programs and services provided by the hospital.”
Hospitals are to be subject to Freedom of Information beginning January 2012.
This is what some of the April 20 deputations to the standing committee on finance and economic affairs had to say on the issue (from Hansard):
“There’s absolutely no evidence that giving more information to patients means that lawsuit numbers will rise; in fact, the evidence is exactly the opposite. In the United States, where a few hospitals have taken the courageous position that regardless of the circumstances, patients are entitled to know the full details of errors—and the hospital has even assisted patients to file a claim—lawsuit numbers have plummeted, and the amount of money that is paid out per lawsuit is reduced. That’s the truth of what happens. Do you know why? If you think about it, you have a close relationship with the people who are looking after you in a health care setting. You don’t want to sue them. The people who come to me are not chomping at the bit to sue doctors and nurses; they’re doing it because it’s their last option, because they’ve tried other things and it hasn’t helped.”
– Amani Oakley, medical malpractice lawyer
“I sued in frustration as a last resort, so that the truth would be told in the death of my father. Unfortunately, that has yet to happen. I wanted, and am still actively seeking, accountability, justice and transparency in the Ontario health care system in its entirety, and access to information that, in a democracy, must be available to the public.
I was offered the sum of $10,000 by University Health Network and the medical transportation company involved and told that if I took this money, I could never speak of my father’s case again or I would be sued. I refused this money, as I considered any monetary compensation as blood money, because this would not bring back my father and it would not right the wrong that had occurred, especially for people who still put their lives in jeopardy using the Ontario health care system.”
– Lorraine Blue
“We in Niagara want, therefore, to have access to everything that the NHS and the LHINs have discussed under quality of care. Without that, we will not be able to have a full investigation, either under this government or a subsequent government. Without a full understanding of what has gone wrong—and this is not to put blame. I do not believe, and most of us do not believe, that we’re talking about individuals here at all. There has been a system breakdown because of the speed in having to do things and also because of financial constraints on an overly large amalgamated hospital.”
– Fiona McMurran, Welland resident
“It boggled my mind when I saw this amendment, after the government had come so far in terms of opening up hospitals to freedom of information in the first place. No other province does this. All the other provinces open hospitals up to freedom of information. We’re the last province to put hospitals under freedom of information.”
– Rick Janson, OPSEU staff expert on health care
“The hospital industry maintains that FIPPA will undermine patient safety culture, but has presented no data and no concrete example. The facts suggest that whatever is going on behind closed doors now is, in any event, ineffective. Recent data shows that adverse events in hospitals remain frustratingly high. The Canadian Medical Association recently estimated that between 9,000 and 24,000 deaths in hospitals across Canada were preventable.”
– Paul Harte, President-elect of the Ontario Trial Lawyers Association
“Imagine our surprise when a question was put forward regarding schedule 15 and our honourable health minister said that this was added for patient safety. In our opinion, schedule 15 does just the opposite. Patient security and privacy is already covered by the Personal Health Information Protection Act.
The impact that this will have on Ontario’s health care system could potentially be frightening. Hospitals which engage in poor practices will be protected from scrutiny, potentially resulting in numerous victims. Even if your family doctor wants to access information regarding a hospital’s record of quality before he sends you there, access can be denied.”
– Ed Vander Vegte, Niagara chapter of the Association for Reformed Political Action
“I’d like to know more clearly what it is that they’re concerned about. The examples that have been given so far don’t hold weight; they certainly don’t meet a public interest test. If there is something there, then we’d like to know what it is, but we haven’t been given that information. It certainly doesn’t belong in a budget bill and certainly not with the very short period of consultation that we’ve been given to date. There’s only one hearing; it’s only in Toronto. It’s just not the right way to do this properly.”
– Natalie Mehra, Ontario Health Coalition
“RNAO agrees there is a need for protecting the identity of hospital staff when engaged in quality-of-care discussions, as the threat of disciplinary proceedings could indeed hamstring such discussions. On the other hand, it would not inspire great confidence in the hospital or the health care system if hospitals refused to release quality information for fear of litigation.
This approach is very different to the one the Ontario Hospital Association and its members demonstrated when they participated in the important and popular hospital report card series, allowing many facility-level quality indicators to be released publicly. That showed bold leadership. Unfortunately, the public no longer enjoys access to this window on the hospital system, as it was terminated in 2008.”
– Kim Jarvi, Registered Nurses Association of Ontario
“The number one thing I hear about is not lawsuits. It really isn’t. It’s not the money. It’s not even an apology, because with the Apology Act, it doesn’t mean much. It’s not even disclosure; that’s just the first step. What people really want is to know that what happened to them did not happen in vain, that we’re learning from it, that we’re measuring the change and that we’re accountable to that change, so that they know nobody else has to go through what they went through.”
– Cybele Sack, ImPatient for Change
“In my opinion, I believe it is time for Ontario citizens to have full transparency and accountability in all matters related to the health care they receive. I also believe that our health care should reflect the human and democratic right we each have as Canadians to have a quality health care system regardless of age, race, ability or gender.”
– Kim Hessels, “mother of a child with special needs”
“You’re being asked to throw a large blanket of protection of secrecy over anything related to quality within a hospital, and quality care makes up the core, the essence and many of the functions that hospitals perform for the public.”
– Eoin Callan, SEIU
Conspicuous by its absence was the Ontario Hospital Association and the Ontario Medical Association, which had lobbied for the exemption alongside a major malpractice insurance company.
To read the full transcripts, go to: http://www.ontla.on.ca/web/committee-proceedings/committee_transcripts_details.do?locale=en&Date=2011-04-21&ParlCommID=8858&BillID=2475&Business=&DocumentID=25696#P56_3174