Bill 87: Violates Basic Human Rights
I thank you for the opportunity to address the Standing Committee about Bill 87 today on behalf of Concerned Ontario Doctors (COD) — a grassroots, not-for-profit organization representing thousands of community and academic family physicians and specialists in every corner of this province. We advocate for a patient-centred, sustainable, accessible and quality healthcare system.
Recently, COD members were elected to over 100 positions on the council of the Ontario Medical Association (OMA). I am the newly elected Chair of OMA’s District 5 which encompasses the Greater Toronto Area and the counties of Dufferin, Muskoka and Simcoe. I am also a community physician, a medical educator and the President and Co-Founder of Concerned Ontario Doctors.
Bill 87, the Protecting Patients Act — is legislation that will directly impact not only Ontario’s 29,000 physicians, but it will affect the healthcare access and delivery of Ontario’s nearly 14 million patients.
Ontario’s doctors have grave concerns over Bill 87, an Act that violates basic human rights of physicians. It has left thousands of frontline physicians — family doctors and specialists alike — fearful. It is unfathomable that the government has introduced this legislation without any consultation with Ontario’s physicians. Effective healthcare reform requires meaningful and respectful engagement of all stakeholders, including physicians. It requires genuine collaboration. None of this has occurred with Bill 87.
As a pediatrician, I wish to address the new reporting requirement that those who administer immunizations provide information to the local medical officer of health. This imposes a greater administrative burden, especially given that physicians already spend over one hour on paperwork for every hour spent providing patient care. This is a breach of the Representation Rights Agreement between the Ministry of Health and the OMA. Under article 3, all discussions about physician work and compensation must occur via those negotiations channels.
78% of Ontario’s physicians report burnout. 86% of these physicians cite the ongoing abuse and vilification by this Liberal government as the cause. Burnout very quickly leads down a road of depression, compassion fatigue, substance abuse and suicide. There is still much stigma surrounding the mental health of physicians. Most suffer in silence while attempting to continue to provide care for their patients, until it becomes unbearable. Physician suicide rates are already twice that of the general population; this is a growing public health crisis. Patient outcomes are worse under the shadow of physician burnout with a rise in medical errors, injury and illness. As a society, we must not only take care of our patients, but also take care of our caregivers.
Sadly, Bill 87 will make the stigma of mental health worse. It will grant the Ministry of Health unprecedented access to the personal and private health records of Ontario’s doctors. Access without the consent of physicians and without the requirement to demonstrate a concrete need. Each January, this government advocates and supports Bell’s Let’s Talk day. Why then are barriers being created for physicians to open up about their own mental health challenges with their family doctors? We need to be creating bridges, not building walls around mental illness. This invasion of privacy not only contravenes the privacy principles of the Personal Health Information Protection Act, but it also represents a constitutional violation of the Canadian Charter of Rights and Freedoms under section 7 (the right to life, liberty and security of the person) and section 8 (the right to be free from unreasonable search and seizure).
Bill 87 goes further in violating the basic human right of the presumption of innocence and physicians’ right to procedural fairness and natural justice. It makes the College of Physicians and Surgeons (CPSO) into a kangaroo court while denying physicians the right to due process granted to all other Canadians. Once Bill 87 passes, CPSO will publish all patient complaints publicly on their website and have the ability to both temporarily and permanently revoke a physicians’ medical license before a committee hearing ever occurs and before any evidence is ever presented. The livelihood and public reputation of the physician, the physician’s family, their staff and their staff’s family can be forever tarnished without a hearing having ever occurred. This is unjust.
Without consulting with patients, CPSO has recommended physicians hire chaperones in their practices to be present for all clinic visits. This is an immense burden on physicians who are already struggling to keep their clinics afloat. The very idea of having a chaperone implies there is no trust between the patient and physician. The patient-doctor relationship is the core of medicine. Having a chaperone for every patient visit runs counter to this principle and erodes the very foundation upon which we practice.
Doctors are fearful about putting themselves in harms way without having due process protections in place against baseless patient complaints. In a survey of all Ontario physicians and trainees last week, 81% reported feeling threatened by Bill 87, while nearly 50% already report plans to make changes to how they deliver patient care and 12% plan to leave the province or retire earlier once Bill 87 passes. Many family doctors have already stopped performing breast, prostate, pap and pelvic examinations and are now instead ordering ultrasounds or other diagnostics, or referring onto specialists at academic centres. If Bill 87 passes, more and more physicians will take such measures to protect themselves against the violation of their Charter rights. This will lead to more fragmented care and longer wait-times for specialists and diagnostics while increasing healthcare costs in an already burdened system.
Ontario doctors strongly believe that those who commit criminal acts should be prosecuted. And we advocate for harsher and more severe penalties through our judicial system to ensure patients are protected. It is wrong to create a kangaroo court out of CPSO to address the failings of our court system. It is wrong to punish and strip all 29,000 Ontario physicians of their human rights and freedoms to address a serious problem seen in less than 1% of college complaints.
Many of Ontario’s physicians are themselves immigrants and refugees who fled other countries that violated their fundamental human rights. They find it unfathomable that those very human right violations will now occur here in Ontario — a province in a country that internationally prides itself on promoting the protection of human rights and freedoms. Bill 84 just passed yesterday making Ontario the first jurisdiction in the democratic world to strip anyone of their conscience rights. Collectively Bills 84 and 87 violate Sections 2, 7, 8, 11, 12 and 15 of the Canadian Charter of Rights and Freedoms. These Bills violate Articles 1, 2, 3, 7, 11, 12, 18 and 23 of the United Nations Universal Declaration of Human Rights.
If this government cannot respect and provide a humane and dignified working relationship with Ontario’s doctors, who will be left to care for the most vulnerable? On behalf of Ontario’s doctors, I plead with this government to protect the fundamental human rights of physicians and ensure that patient care is not further compromised.
I will end with the words of our Prime Minister, Justin Trudeau, which are even more poignant now as we commemorate the 35th anniversary of the Canadian Charter of Rights and Freedoms: “The spirit and substance of the Charter are at the heart of Canada’s success, and should inspire us all as we work toward a fairer, more just and compassionate society. Today, I remind Canadians that we have no task greater than to stand on guard for one another’s liberties. The words enshrined in the Charter are our rights, freedoms, and — above all — our collective responsibility.”
Dr. Kulvinder Gill is the President of Concerned Ontario Doctors. The above is the presentation she made concerning Bill 87, the Protecting Patients Act, to the Standing Committee on the Legislative Assembly at Queen’s Park on May 10, 2017. Follow her on Twitter @dockaurG.
