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Cheryl Stadnichuk

Allen v Alberta: The Sound and Fury of Section 7 and Health Care - TheCourt.ca - 0 views

  • The pain became so disabling that Dr. Allen was forced to sell his dentistry practice in July 2009. In desperation, Dr. Allen underwent surgery at his own expense in December 2009. The surgery was successful, relieving his pain and signalling a return to health. The cost of the surgery was $77,000.
  • Dr. Allen argued that section 26(2) of the Alberta Health Care Insurance Act, RSA 2000, c A-20 prevented him from obtaining private health care insurance and covering the cost of his surgery. The section in question prohibits insurers from issuing private health care insurance for basic health care already covered under the Alberta Health Care Insurance Plan. It gives the public Plan a monopoly on health care insurance for basic health care services. Dr. Allen argued that this was unconstitutional, infringing his section 7 Charter rights
  • The chambers judge held that the unconstitutionality of section 26(2) was dependent on whether Dr. Allen could demonstrate that this particular restriction on private health insurance in this specific context offended section 7. In his view, the connection between state-caused effect and the harm suffered by Dr. Allen had not been satisfied. This was because there was no evidence indicating either that the prohibition caused Dr. Allen’s wait time in the Albertan health care system, or that private health care insurance would have been available for this type of surgery anyway.
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  • Justice Slatter clearly had issues with the majority judgment in Chaoulli. He highlighted that section 7 is a notoriously unsettled and controversial Charter provision, and the “drafters of the Charter never intended it to be applied to the review of social and economic policies” (para 33).
Govind Rao

Change Day comes to Canadian health care - but will it make a difference? - Healthy Debate - 0 views

  • by Vanessa Milne, Joshua Tepper & Jill Konkin (Show all posts by Vanessa Milne, Joshua Tepper & Jill Konkin) March 24, 2016
  • It was part of her pledge to wear a hospital gown for one day for Alberta’s Change Day – an initiative that asks health care workers and others to think of one positive change they can make to the system. “When Change Day was introduced, I thought I should look at every strategy through the eyes of my patients,” says Patenaude, a registered nurse and project director with Integrated Quality Management at Alberta Health Services. “To make that more concrete, I made a pledge that I would wear a patient gown to get that sense of vulnerability.”
  • Practitioners have pledged to remember to introduce themselves to patients or to shadow another doctor for a day, and the public have vowed to walk more or to help prevent bullying. 
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  • Saskatchewan began having a Change Day in 2014, and BC followed in 2015.
Govind Rao

CEO refutes safety concerns - Infomart - 0 views

  • North Bay Nugget Sat Apr 2 2016
  • The president and CEO of the North Bay Regional Health Centre disputes the results of a poll about employee safety released Friday. In a prepared statement, Paul Heinrich said he is "disappointed in the relentless nature of the Canadian Union of Public Employees/Ontario Council of Health Union's efforts to position our organization and our staff negatively." Heinrich said the campaign "is not based on fact and is harmful to our staff and their care of our patients."
  • The CUPE/OCHU poll indicated that 67 per cent of hospital staff who took part in the Union Calling poll this week do not believe the hospital is doing enough to protect employees from violence in the workplace, and that 72 per cent have experienced physical violence in the past year. Heinrich said the health centre conducts an "organizationwide staff survey" annually, with 75.5 per cent of staff reporting "my organization takes effective action to prevent violence in the workplace," while "73.7 per cent of staff report my workplace is safe."
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  • He said 555 employees participated in the most recent survey. "The health centre is committed to ensuring the safety of staff and patients and has numerous programs and processes in place in order to ensure a safe workplace and to deal with any safety issues, including workplace violence that might arise," Heinrich said.
  • "Further, the North Bay Regional Health Centre supports a blame-free culture of reporting of safety issues, including issues of workplace violence. As per the Occupational Health and Safety Act (OHSA) under no circumstances will any person who in good faith reports an incident of workplace violence /harassment or assists in its investigation be subject to any form of retribution or reprisal as a result of this action."
Govind Rao

Nurses need PTSD protection too, union says - Infomart - 0 views

  • Toronto Sun Tue Apr 5 2016
  • Ontario nurses face many of the same dangers and horrors as first responders but are excluded from new legislation designed to strengthen protections for workplace Post-Traumatic Stress Disorder, their union says. "Nurses walk into situations, or run into situations, they don't run away from them," Vicki McKenna, of the Ontario Nurses' Association, said Monday. "We have nurses that go into people's homes, we have nurses working on the street, working along with police and paramedic teams."
  • Bill 163 - to be voted on in the legislature on Tuesday - would deem PTSD a workplace-related illness for paramedics, firefighters and police officers, as well as nurses and officers working in jails.
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  • But McKenna argued nurses in the long-term sector have gone into rooms where a homicide has occurred, and those in emergency rooms constantly deal with victims of violence and horrible accidents.
  • "You shouldn't exclude particular workers because they might not be the first one to step their foot into a vehicle accident setting," she said. The legislation would mean first responders could access Workplace Safety and Insurance Board (WSIB) benefits far more easily than they can now.
  • The presumptive legislation, if it passes third reading as expected, is slated to be proclaimed into law Wednesday. It had been long sought and has now been widely lauded by first responders.
  • In a statement issued on behalf of 8,000 Ontario paramedics, the Canadian Union of Public Employees (CUPE) said the bill will help lessen the stigma associated with PTSD and help first responders get treatment "before it's too late."
  • "Research shows that because of frequent exposure to traumatic situations, paramedics and other first responders are at least twice as likely to suffer PTSD than the general population," the CUPE statement says.
  • Craig MacBride, spokesman for Labour Minister Kevin Flynn, said the government is committed to workplace safety for nurses, creating a leadership table on violence in health care and also amending the Occupational Health and Safety Act to help prevent workplace violence and harassment.
  • It's also important to remember that nurses, like all Ontario workers, are covered for PTSD through the WSIB. Bill 163 simply creates a more responsive process for those who are most likely to face traumatic experiences on a regular basis," MacBride said.
Govind Rao

DRUG DIVERSIONS: the dirty little secret everywhere in health care | Vancouver Sun - 0 views

  • February 15, 2016 |
  • Drug diversion – a more polite term for theft of narcotics by hospital employees, nurses, doctors, pharmacists and other health professionals – is the dirty little secret hospital administrators and health leaders prefer not to talk about.
  • The problem is so pervasive that a new non-profit organization has sprung up in the U.S. to help hospitals outsmart their internal thieves. It’s called the International Health Facility Diversion Association (IHFDA) and its inaugural international conference will take place in Cincinnati, Ohio in September.
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  • As I have since learned, drug diversion can occur in most, if not all, hospitals, nursing homes and other medical facilities where highly addictive narcotics like morphine are dispensed.
  • The overdose death of a care aide at Vancouver General Hospital proves the need for better methods to detect and prevent theft and abuse of hospital medications, coroner Timothy Wiles said in his report Wednesday.
  • Wiles said Kerri O’Keefe, 36, who had worked in the emergency room for about 15 years, died in her Surrey condo last summer from respiratory failure after injecting a stolen hospital anesthesia drug.
  • As well, nurses and doctors will be expected to squirt leftover medications into a slush pail that’s a mixture of all drug residuals instead of using sharps containers. “We are looking to make these (remaining) drugs un-usable,” she said. Drug wasting is the term used in health care for discarding partly used medications. Some medical centres squirt leftovers into a bin filled with Kitty Litter to deter anyone from stealing the contents.
Govind Rao

Project will see restrictions on advanced-care paramedics lifted - Infomart - 0 views

  • The Daily Gleaner (Fredericton) Wed Apr 6 2016
  • Representatives from the Department of Health and stakeholders across the provincial ambulance service are busy completing the work needed to launch an advanced-care paramedic pilot project, which would finally lift regulations that prevent these highly trained paramedics from using all of their skills in the field.
  • New Brunswick is the only province in Canada that doesn't use some form of advanced-care paramedic within its pre-hospital emergency system. It has legislation that mandates Ambulance New Brunswick use primary-care paramedics throughout the province. Advanced-care paramedics have completed more training than their primary-care paramedic colleagues, which allows them to administer certain types of medications and perform advanced, potentially life-saving interventions at the scene of an accident or in a patient's home.
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  • Stakeholders throughout the province's health-care system have been lobbying successive provincial governments for at least a decade, urging them to lift restrictions that force the province's roughly 35 advanced-care paramedics to work below their full scope of practice. In February, the provincial government announced it had set aside $580,000 for a new pilot project, which will help New Brunswick figure out how best to make use of these valued health-care providers.
  • Health Minister Victor Boudreau said two committees have been formed to complete the behind-the-scenes work that is needed to introduce them to the existing ambulance service. So far, he said, things are going well, though he's not sure when advanced-care paramedics will be ready to use their skills on the streets. "We're still trying to put a pilot project together, making sure that we're respecting all the different moving parts to this," he said. "The money is still in the budget for this year. It's just sometimes these things prove to be a little more difficult than you'd like to put together. But it's certainly still on the table."
  • Chris Hood, executive director of the Paramedic Association of New Brunswick and a participating member of the committee tasked with sorting out the clinical issues around such a change, said that work is progressing nicely and he expects to see advanced-care paramedics in use within the provincial ambulance service soon. "I know the meetings have been happening and, by all indications, we're getting close," he said.
  • "The committees are still meeting. I've missed the last two meetings, but we had a representative there. They're getting into discussions about the protocols for practitioners, what they'll be following. From what we hear, it sounds like full-steam ahead. They accelerated the meeting times and it seems like everything is on the right track ... All of the prep-work that is necessary is, I would say, probably 80 per cent done, 85 per cent done." Ambulance New Brunswick is also completing some preparatory work, said Hood.
  • "They're looking at curriculum - refresher programs and things like that. From the clinical side of the business, which is what we're concerned with, that stuff is almost complete," he said. "If form follows function, we should be moving forward rather quickly."
  • When asked if the province's advanced-care paramedics are excited they'll finally be able to put all of their training to use in this province, Hood said many are still frustrated from the long struggle to lift these restrictions on their scope of practice. "I think many ACPs are still a bit, 'I'll believe it when I see it.' But some are very excited about it. We've had a couple of people enquire about attending ACP school and I know that the requests for enrolments in ACP classes both in New Brunswick and in the state of Maine are increasing," he said.
  • People are starting to feel more comfortable in spending the money to upgrade their skills, to take the education they need. But with the existing practitioners, I think, it's a wait-and-see mentality." Judy Astle, president of paramedics' union CUPE Local 4848, said she's anxious to learn what the pilot project may look like and how advanced-care paramedics will be used alongside primary-care paramedics across the province.
  • It's going to be a positive," she said. "But we're still waiting to find out the details."
Govind Rao

Poll finds assisted-dying limits wanted; Canadians feel minors and those suffering from... - 0 views

  • The Globe and Mail Thu Apr 7 2016
  • A majority of Canadians do not want minors or people with mental illnesses and psychiatric conditions to be given access to doctor-assisted dying, a new Nanos Research/Globe and Mail poll has found.
  • The poll suggests Canadians would prefer that the federal government follow a restrictive path as it decides which patients have the right to end their suffering in a medical setting. While there is no doubt that doctorassisted dying will become legal, there is a continuing debate about exactly who will have access, and under which conditions.
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  • The government's proposal will be tabled in "coming weeks," she said, adding "there are many elements that need to be considered as we work to achieve the best possible solution for Canada on this highly sensitive and complex issue." The Supreme Court of Canada struck down the Criminal Code ban on doctor-assisted death in February, 2015, and suspended the ruling's effect for one year.
  • Both ideas were promoted by a recent parliamentary committee into the matter, which will influence the government's coming legislation. "Our government is committed to developing an approach that strikes the best balance among a range of interests, including personal autonomy, access to health-care services, and the protection of vulnerable persons," said Joanne Ghiz, a spokeswoman for Justice Minister Jody Wilson-Raybould.
  • The poll of 1,000 adult Canadians found an overall disagreement with the idea of giving access to doctor-assisted dying to people suffering from mental illness or psychiatric conditions. The proposal was opposed by 51.8 per cent of respondents, while 42.4 per cent of respondents agreed with it. The opposition was even greater to granting access to assisted dying to 16- and 17-year-olds. The proposal was opposed by 58.8 per cent of respondents, while it was supported by 36.2 per cent of respondents.
  • The Trudeau government asked for an extension after last year's election, and must now bring in a law by June 6. In February, a committee of MPs and senators recommended to provide assisted dying to Canadians suffering from both terminal and non-terminal medical conditions that cause enduring and intolerable suffering. More controversially, the committee opened the door to assisted dying for youth under 18, calling on the government to address the issue of "mature minors" within three years of the initial law. The committee added that patients with mental illnesses or psychiatric conditions should not be excluded from eligibility as long as they are competent and meet the other criteria set out in law.
  • The Conservative MPs on the committee argued the proposals went too far at the time, and now feel vindicated by the poll's findings. Conservative MP Gerard Deltell said his group followed the example of Quebec where the government, after six years of consultations and studies, opted to restrict the right to doctorassisted dying to consenting adults. "The issues of minors and people with mental illnesses raise major problems," Mr. Deltell said in an interview. "At what point does someone suffering from a mental illness offer his or her full and complete consent? It's impossible. ... Same thing for minors."
  • Still, committee chair and Liberal MP Robert Oliphant said the proposals included "huge safeguards" to prevent any abuse against vulnerable persons who do not want to die. He added that on minors and people with psychological issues, the committee wanted to avoid setting arbitrary criteria and decided to leave clear powers in the hands of doctors. "Will two physicians confirm competency, that the person has capacity, and that the illness is irremediable and grievous, and that the suffering is intolerable to the individual?" Mr. Oliphant said in an interview. "We felt that was the appropriate way to go." The poll also found that 75 per cent of Canadians agreed that doctors "should be able to opt out of offering assisted dying," compared with 21 per cent who disagreed.
  • The Nanos Research random survey, conducted by telephone and online between March 31 and April 4, offers a margin of error of plus or minus 3.1 percentage points, 19 times out of 20.
Govind Rao

Minister Lake: Ban for-profit plasma collection | BC Health Coalition - 0 views

  • A private company is going to move to B.C. and profit off of our blood unless we stop them now.
  • Tainted blood infected 30,000 Canadians with HIV and Hepatitis C in the 1980’s during one of the worst preventable health crises of our time.
Heather Farrow

Caution For Employers Dealing With Employees Exhibiting Suspected Mental Health Issues ... - 0 views

  • Mondaq Wed Aug 24 2016,
  • In Passamaquoddy Lodge v CUPE Local 1763 2016 NBQB 056 the Court of Queen's Bench upheld an original arbitration decision condemning an employer for suspending an employee pending the outcome of a psychiatric evaluation. The Facts
  • Mr. Lister worked in the maintenance department at a nursing home in St. Andrews, New Brunswick and was represented by CUPE, Local 1763. The employer had become concerned for Mr. Lister's mental stability, contending he was acting "erratic" and "non-predictable". The grievor also had a history of "causing trouble" for the employer and was the object of a police investigation for a non-work related incident.
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  • In February 2012, Mr. Lister raised concerns with his employer and alleged the presence of asbestos on pipes in the nursing home. The Lodge brought in environmental consultants, but Mr. Lister questioned their qualifications and made statements challenging the accuracy of the expert advice they provided as to health and safety.
  • In March 2012, Mr. Lister attended a general staff meeting where he reportedly made inappropriate gestures and fell asleep. The employer then sent a warning letter to him, which was placed on his personnel file. A few months later, in the summer of 2012, Mr. Lister brought a tomahawk axe to work and, for this action, was suspended for 1.5 days as "progressive discipline." In
  • the Fall of 2012, Management called a meeting with Mr. Lister for which he declined union representation when offered. Mr. Lister was instructed by the Employer that he would not be permitted to return to work until he had a psychiatric evaluation. He was immediately suspended, indefinitely, without pay, and escorted from the property. Mr. Lister was ultimately assessed by a psychiatrist, who determined that he did not pose a danger to himself or others; however, he missed over twenty (20) days of work without pay before being cleared.
  • CUPE filed three (3) grievances, two of which were the subject of the judicial review, these were: (1) alleging that the employer violated the collective agreement by not having a union representative present at the suspension meeting; and (2) that the employer had violated the collective agreement by suspending the grievor pending a psychiatric evaluation, without valid reason and without pay. The (3) third grievance concerned the 1.5 day
  • suspension of Mr. Lister for bringing a tomahawk axe to work. On the third issue, the arbitrator concluded that the suspension was reasonable and the Lodge did not seek judicial review. The arbitrator held that the Lodge had violated the collective agreement by not ensuring a union representative had been in attendance at the meeting with Mr. Lister. He had been told that he did not need such representation, but he clearly did. The Lodge had also violated the collective agreement by suspending Mr. Lister without cause and for over 20 days, which was contrary to the collective agreement.
  • The Decision On judicial review, the New Brunswick Court of Queen's Bench upheld the arbitrator's refusal to accept the employer's argument that the suspension, due to mental health concerns was a "medical leave", and not a disciplinary action. The
  • employer argued it did not intend to punish Mr. Lister and fully expected a psychiatrist would find him unfit to return to work; however, since Mr. Lister had no sick days left, he was simply "suspended" without pay, pending the evaluation.
  • However, there was significant evidence that the suspension was, in fact, disciplinary. Letters had been issued by the employer previously warning Mr. Lister of further "disciplinary action", Mr. Lister was escorted from the premises and Union representation had been offered at the meeting. Further, the suspension resulted in the grievor suffering a financial penalty,
  • as he was unable to access sick benefits and received no pay. Ultimately, the Court of Queen's Bench concluded that the arbitrator was justified in finding that the employer had disciplined Mr. Lister by suspending him and prohibiting his return to work pending a clear psychiatric evaluation, and that this was a violation of the collective agreement.
  • What This Means For Employers With the exception of certain safety-sensitive industries where a bona fide occupational requirement can be established, employers cannot discipline, suspend or dismiss employees suffering from a mental illness or disability. Employers have a legal duty under human rights legislation and/or collective agreements to accommodate all disability, up to the point of undue hardship. Unions, where applicable, also have legal duties within the
  • accommodation process and can be of assistance in navigating "difficult" employee behaviour, including mental health issues where such employees may pose a risk not only to themselves, but the broader workplace. Occupational health and safety legislation also requires employers to provide a safe working environment for their
  • employees. Under certain conditions, with the proper evidence and context, employers may need to remove an employee with a confirmed mental illness to protect against harm to others or themselves. In such specific circumstances, an employer might be justified in preventing an employee from returning to the workplace until medical clearance is confirmed. The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances. Ms Leah Ferguson
  • Cox & Palmer Suite 400 Phoenix Square 371 Queen Street Fredericton NB CANADA Tel: 902421 6262 Fax: 902421 3130 E-mail: kbehie@coxandpalmer.com URL: www.coxandpalmerlaw.com
Heather Farrow

CMA head vows to act on climate change; President says physicians have heard MSF founde... - 0 views

  • The Globe and Mail Tue Aug 23 2016
  • Climate change is the "greatest global health threat of the 21st century," so it is incumbent that physicians take a stand to protect their patients, one of the world's leading human-rights advocates says. "Responding to climate change is not just a scientific or technological issue," James Orbinski, a founding member of both Medecins sans frontieres (Doctors Without Borders) and Dignitas International, told the general council of the Canadian Medical Association in Vancouver on Monday. "It's time for the CMA to step up and step out, to be genuinely courageous on climate change," he said.
  • Cindy Forbes, president of the CMA, said the message was heard loudly and clearly by physicians. "We heard clearly about the absolutely critical need for action to address the very real and growing effects of climate change," she said. "As a nation and as a planet, we cannot ignore climate change." Dr. Forbes said the CMA has a long-standing concern about the impact of climate change on health both globally and domestically but, given the seriousness of the issue, needs to do more.
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  • She said a lot of work is already being done by Canadian physicians but the CMA "is committed to finding the best way to support efforts that are taking place from coast-to-coastto-coast." Dr. Orbinski presented delegates with a grim catalogue of the health impacts of climate change, including a rise in infectious disease, drought and rising water levels that cause mass displacement, and even violent conflict. But, worst of all, he said, "climate change is a threat that magnifies other threats." Dr. Orbinski cited the example of the Darfur region of Sudan, where tensions between farmers and herders over disappearing pasture and evaporating water holes have degenerated into violent clashes and civil war.
  • "You will do anything to feed your children, even if it means going to war," he said. Darfur is often described as the world's first climate-change war, but there could be many more to come, Dr. Orbinski warned. He noted that the world is in the midst of an unprecedented refugee crisis - with 60 million people worldwide displaced - and increasingly those mass movements are driven by drought and climate change. For example, 29 million people are now on food assistance in southern Africa. "The No. 1 health issue there is no longer AIDS; it's drought." Dr. Orbinski, who currently holds the research chair in global health at the Balsillie School of International Affairs in Waterloo, Ont., said that while climate change disproportionally affects developing countries, especially the poor and marginalized, even wealthy countries such as Canada are not immune from the devastation wrought by climate change.
  • The rate of increase in temperature in Canada is two times higher than the global average," he said, and that will have dramatic impacts, especially in the Far North and the country's coastal regions. "There are real questions about the viability of Vancouver as a city due to rising sea levels in the coming decades," Dr. Orbinski said. A study published in 2008 by the Canadian Medical Association estimated that 21,000 Canadians die prematurely each year due to air pollution. (Worldwide, there are eight million preventable deaths attributed to bad air.)
  • The rise of carbon dioxide emissions, caused largely by the burning of fossil fuels, is one of the principal drivers of climate change. With the global population increasing by one billion people every 13 years, "we're going to see massive increases in CO2 emissions unless we take radical action," Dr. Orbinski said. The Canadian Medical Association, which represents the country's 83,000 physicians, is holding its 149th annual general council meeting in Vancouver this week.
Heather Farrow

Private Deals, Proven Failures - 0 views

  • PREVENT THE PRIVATIZATION OF NOVA SCOTIA'S HOSPITALS
healthcare88

BC refutes Charter challenge of medicare - 0 views

  • CMAJ October 18, 2016 vol. 188 no. 15 First published September 19, 2016, doi: 10.1503/cmaj.109-5327
  • Steve Mertl
  • It was the British Columbia government’s turn Sept. 12 to rebut a Charter challenge barring doctors from operating both inside and outside the public health care system. However, anyone who came to the BC Supreme Court expecting an impassioned defence of medicare was disappointed. Instead, lawyer Jonathan Penner attacked the legal underpinnings of the case filed by Cambie Surgeries Corp., which operates a Vancouver private clinic, and its co-plaintiffs.
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  • The law prevents physicians from operating both inside and outside of the provincial Medical Services Plan. The restriction on so-called dual or blended practices violates Section 7 of the Charter of Rights and Freedoms guaranteeing “right to life, liberty and security of the person,” Gall said.
  • The strains on the public system, such as waiting lists to see specialists and for surgeries, are “indisputable facts,” Penner told Justice John Steeves. But the remedy proposed by the plaintiffs — a hybrid system where doctors can deliver private and medicare services and patients can buy insurance for services already covered by medicare — will not solve the problem. In fact, said Penner, it could make things worse by disrupting the public system and diverting resources from it.
  • Penner warned that if the Cambie plaintiffs win their challenge, the implications will extend outside British Columbia. Other provinces have similar restrictions on physician practice and private insurance that, like BC, are tied to federal transfer payments under the Canada Health Act. The trial opened Sept. 6 when Peter Gall, acting for Cambie, an affiliated clinic and several patients, argued BC’s Medicare Protection Act handcuffed both doctors and those seeking timely care.
  • Penner’s argument addressed core questions in the closely watched case: Does the law infringe doctors’ freedom to provide and patients’ right to receive timely medical care and, if it does, are those restrictions reasonable under the Canadian Charter of Rights and Freedoms?
  • Orthopedic surgeon Dr. Brian Day of Cambie Surgery Centre says provincial laws limiting private care have resulted in rationing and long waiting lists.
  • The law also keeps residents from using private insurance to pay for treatment for things covered by the public system, despite the fact that some groups, such as those covered under WorkSafe BC injury claims, get expedited private care. That violates the Charter’s equality provisions under Section 15, argued Gall. The arguments echoed long-held positions of orthopedic surgeon Dr. Brian Day, Cambie’s co-founder and the visible face of the case. He contends provincial laws limiting private care have resulted in rationing and long waiting lists.
  • The alleged Charter violations are far from clear cut, said Penner, as he reviewed previous Charter decisions. A key test, for instance, is whether legislation violates the principles of fundamental justice under Section 7. Past rulings have specifically warned against applying it to social policies, he pointed out. Gall noted that the Supreme Court of Canada’s 2005 decision in the Dr. Jacques Chaoulli challenge affirmed Quebecers’ right to use private medical insurance to pay for publicly insured services when the public system was inadequate.
  • But Penner said the wording of the Canadian and Quebec charters differ on fundamental freedoms and only three of nine Supreme Court justices found the Quebec law violated the Canadian Charter in Chaoulli. The evidence in the Cambie case is not the same, he added. “It will tell a very different story.” Even if evidence points to Charter violations, he said, such violations are legal under Section 1 of the Charter, which allows “reasonable limits prescribed by law as can be demonstrably justified in a free and democratic society.”
  • The justification here is government’s ability to ensure universal access based on need, not ability to pay, said Penner, adding courts have deferred to legislatures on social policies such as those covering housing. Granting the plaintiffs’ application would reverse that by putting patients with money or insurance ahead of those without, said Penner.
  • Penner was expected to take two days to present the government’s defence, with intervenors on both sides of the case presenting separate arguments later in the week. The trial is scheduled to last six months and hear from dozens of witnesses, including experts, historians and patients. Steeves’ decision is expected to end up being reviewed by the Supreme Court.
healthcare88

Provinces, Ottawa spar over health transfers; Ontario warns cuts will lead to 'declinin... - 0 views

  • Toronto Star Wed Oct 19 2016
  • Provincial and territorial health ministers are imploring Ottawa not to diminish its role as a funding partner in health care any further. Ontario Health Minister Eric Hoskins, who co-chaired a meeting of his counterparts from across the country on Tuesday, said funding from Ottawa will be "inadequate" if the federal government proceeds with its plans to cut the annual increase in health transfers next year.
  • "(It) will result in a declining partnership," he told a news conference at the King Edward Hotel in Toronto. "What we are asking as provinces and territories is that the federal government ... not withdraw further, that we want them to sustain the level of partnership that traditionally has been there," he said. Canadians have seen that partnership "very seriously erode" since medicare was created about a half century ago when the federal government footed half the bill, Hoskins said. Today, Ottawa is paying only 20 per cent of the tab, a share that will decrease further if Ottawa next year cuts the annual increase in the Canada Health Transfer to 3 per cent from 6 per cent.
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  • Federal Health Minister Jane Philpott, who co-chaired Tuesday's talks, tried to steer the conversation away from money and toward system improvement, innovation and accountability. She repeatedly pointed out that Canada spends more on health care than many other developed countries that have superior health systems. She expressed disappointment that planned system improvements that Ottawa funded in the 2004 health accord did not materialize. Philpott indicated that she wants new funds to be targeted to such areas as mental health and system innovation. She also reiterated an earlier commitment to provide $3 billion for home care, including palliative care.
  • I have made it clear to them that we would love, for instance, to invest in innovation," she said. "I want to know how they want to use those investments in innovation. I have told them that I am very interested in mental-health care." Hoskins said his provincial and federal counterparts are on board with that, but that they need a boost in the annual increase in health funding as well just to maintain the status quo. "You can transform and we have to transform, but you have to do that in a way which respects and understands that you need to sustain the existing system," he said. Hoskins cited a Conference Board of Canada report that found that a spending increase of 4.4 per cent is needed "just to keep the lights on, just to keep the existing services working" because of pressures from a growing and aging population. Quebec Health Minister Gaétan Barrette said Ottawa's current plans for health spending will amount to $60 billion less over the next decade for the provinces and territories.
  • "It says to Canadians, 'We will not provide up to the level of $60 billion.' That's what's at stake," he said. The 2004 health accord - which includes annual funding hikes of 6 per cent - expires next spring. The former Conservative government decided unilaterally that annual health spending will increase at a lower rate of 3 per cent after that. The provincial and territorial ministers are hoping Prime Minister Justin Trudeau will reconsider that when the first ministers meet later this year. Hoskins said a 50-per-cent cut in the annual funding increase will translate to $1 billion less for the provinces and territories next year. Ontario alone stands to lose $400 million. Philpott apologized about confusion over comments she made earlier on accountability for funds. Some provincial and territorial ministers expressed anger over an insinuation that health transfers were not being spent on health. Philpott said that was not what she meant.
  • I apologize if people misunderstood," she said. "There is certainly no intention to make accusations." Philpott said the Canada Health Transfer, which stands at $36 billion, will increase by about $19 billion over the next five years. "It's really important for Canadians to know that we are going to continue to contribute to the Canada Heath Transfer," the federal minister said. Philpott said that over the last five years, $9 of every new $10 spent on health in Canada came from the Canada Health Transfer. "We are contributing he largest part to spending." In addition to the Canada Health Transfer, extra funds will be provided for targeted priorities with strings attached to ensure transformation goals are met, she said.
  • This is Canadians' money ... We want to find a way that we can work together so that as we agree to make new investments, that we have already got a sense of plan," Philpott said. In elaborating on why Ottawa should fund new, more efficient ways of providing health care while at the same time provide sufficient funding for the current health system, Hoskins offered the example of dialysis for kidney failure. The ministers discussed how it would make more sense to monitor blood pressure to prevent kidney failure and thereby lessen the need for dialysis, he noted. "That's great and we are all working toward that end, but you still have to provide dialysis today because that individual who needs it will be dead in three weeks without it," Hoskins said.
healthcare88

Funds would come with conditions: feds - Infomart - 0 views

  • Winnipeg Free Press Wed Oct 19 2016
  • OTTAWA - Provinces may get additional money for health care but only for specific initiatives such as home care or mental health, federal Health Minister Jane Philpott signalled at the end of a meeting with her provincial counterparts in Toronto. The tensions from the meeting spilled into the post-event news conference, as provincial ministers talked about federal cuts to health care and Philpott fought back, saying provinces never delivered promised health-care innovations when the 10-year health accord was signed in September 2004. That accord guaranteed six per cent annual increases in health care for a decade, and that formula was extended for two more years. The provinces argue Ottawa's plan to cut the annual increase in health transfers to the provinces from six per cent to three per cent will result in $60 billion less in federal cash going to the provinces over the next 10 years. They call that a "cut" to health care. "We are being asked to do more with less," said Quebec Health Minister Gaétan Barrette.
  • "All provinces and territories will have to make difficult choices." Philpott disagreed with his assessment. "There will be no cuts," she said. "There will be increases." Canada transferred $36.1 billion to the provinces for health care this year. A six per cent increase next year would be $2.2 billion more. The previous Conservative federal government announced intentions to reduce the increase in health transfers to three per cent, and the Liberals have taken up that plan. Additional funds will be available for health care but in targeted ways, such as for home care or mental health. During the election, the Liberals promised to spend $3 billion on home care over four years, money that has yet to materialize. "Canadians want to see their health-care system get better," said Philpott. Developing a new multi-year health accord with the provinces was the first task assigned to Philpott in her mandate letter in November 2015. Philpott said when the previous accord was signed, it put a lot of money on the table and it was negotiated in good faith by all parties involved that "there would be the changes that needed to take place."
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  • Those changes included cutting wait times, improving home care, electronic records and telehealth, better access to care in the North, a national pharmaceuticals strategy, improvements in prevention in public health and accountability and better reporting to Canadians. Philpott's assessment Tuesday was the provinces had intended to live up to their commitments but that it hadn't happened. "The transformation to the system didn't follow," she said. Philpott said Canadians want to be able to measure where new money is going, such as the number of hours of therapy delivered in a mental health program or the number of additional home care visits added. Manitoba Health Minister Kelvin Goertzen said in a later conference call he agrees there needs to be more reform and innovation, particularly when it comes to accountability and meeting specific performance targets. "I would take exception that there hasn't been any innovation," he said. "Could there have been more? Sure."
  • Goertzen said Manitoba will be announcing more health-care targets shortly, with plans to better account for the dollars spent. He said additional funding for home care or mental health would be welcome but Ottawa needs to be a better partner on the day-to-day business of health-care delivery, and the three per cent increase isn't enough. The provinces have long complained Ottawa was to contribute half the cost of medicare but its contribution is now around one-fifth. They want the accord to move Ottawa to contributing 25 per cent. "We didn't get that commitment today," said Goertzen. The provinces want to discuss the health accord with Prime Minister Justin Trudeau when they all meet in Ottawa in December. Trudeau called that meeting to discuss climate change and the new carbon price he is requiring all provinces to impose. Health care is not currently on the agenda. mia.rabson@freepress.mb.ca
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