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Govind Rao

Physicians and climate change policy: We are powerful agents of change - 0 views

www.cmaj.ca/...307

from heather environment doctors cma

shared by Govind Rao on 16 Mar 15 - No Cached
  • CMAJ March 17, 2015 vol. 187 no. 5 First published February 17, 2015, doi: 10.1503/cmaj.150139
  • Kirsten Patrick, MBBCh DA
  • In December 2014, the World Medical Association (WMA) issued a statement1 urging governments to commit to an ambitious and binding climate agreement when the Sustainable Innovation Forum reconvenes in Paris in December 2015. The WMA also urged that the health sector be “fully integrated” in the current global debate and action on climate change. But what action can physicians take to influence meaningful global action on climate change?
  • ...8 more annotations...
  • The latest Intergovernmental Panel on Climate Change report, released in 2014, outlined more clearly and with greater certainty than ever before how both climate change and pollution from the combustion of fossil fuels have killed thousands of people and will threaten the lives of many more.2
  • In 2010, a position statement from the Canadian Medical Association3 called for physicians to take action, but it focused largely on developing strategies to deal with the impending effects of climate change on health and health systems. In 2013, a CMAJ editorial4 discussed the role of physicians on the front line of climate change and examined how they can make a difference at the political, professional and individual levels. These recommendations remain pertinent.
  • Prompt action on reducing fossil fuel emissions in the near term, to prevent irredeemable downstream effects, is just as important as responding to current and imminent threats. An emergency medicine physician based in Yellowknife summed it up well when she likened the relatively small window for action to the urgency following a myocardial infarction or the onset of sepsis. “We either get the job done in the next decade or so or we prepare for palliative care.”5
  • Yet achieving international binding agreements seems to be happening at a slower pace than that of receding glaciers. When world leaders convene, issues related to saving the world from economic collapse, terrorist threats and oil crises seem to come before those related to saving the world from the threat of climate change. However, things are changing at the macro-economic level. The World Bank has made strides in coordinating international efforts to develop renewable energy, develop globally networked carbon markets and “enhance the flow of finance toward the ongoing effort to limit global warming.”6 One can perhaps see the influence of the current president of the World Bank, who is a physician and social anthropologist, in these recent actions.
  • Humans are bad at envisioning or appreciating the long-term consequences of behaviour. Behavioural scientists call the phenomenon “delayed reward discounting.” In short, we need salience now. In developed countries such as Canada, many of the adverse effects of climate change will only affect future generations. Although we may believe the science and many of us may support our government in making binding agreements to reduce carbon emissions, changing our personal behaviours may be costly, inconvenient and difficult. How do we galvanize to combat global warming?
  • Health promotion campaigns are most effective when delivered on multiple levels at once, combining information on the health benefits of a behaviour change with modelling of the behaviour, reduced barriers to its adoption, a good system of social support for those who adopt it, and person-to-person promotional initiatives and media campaigns.7
  • We need such a multipronged campaign to drive real action on climate change. Physicians are agents for change at all levels, and we can do more to bring climate change to the forefront of people’s consciousness. With our unique comprehension of stages of change and skill at intervening to help individuals make lifestyle changes at whichever stage they may find themselves, we can make a big impact.
  • We have managed to effect social change regarding smoking despite the power of industry, and we are beginning to turn the tide against the anti-vaccine lobby. Our approach to overcoming the stalling tactics of climate-change deniers should be no different. A few years ago, it was unusual to ask patients about how much physical activity they engaged in or how much sitting their job demanded. Now, we counsel about the risks of being underactive and write exercise prescriptions. It is time for physicians to talk about the effects of climate change routinely in daily practice. We should not forget that we are respected, influential advocates.
Govind Rao

Difficult task ahead for hospital in trying to balance budget - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|pgca|20150219|214798655

from heather Ontario cupe hospital budget cuts

shared by Govind Rao on 20 Feb 15 - No Cached
  • Campbellford EMC Thu Feb 19 2015
  • After realizing a surplus of $200,440 in 2013-2014, and now facing a small deficit in its current fiscal year, Campbellford Memorial Hospital might have to resort to layoffs to balance its budget for 2015-2016. President and CEO Brad Hilker raised that possibility in his report to the board of directors last week, warning balancing the budget will be "a difficult task with ongoing inflationary pressures" and the need to invest in services "that meet the needs of our communities." As a result, the hospital will need to "continually review" its staffing levels. "We are working with the union [CUPE Local 2247] to determine the impact on individuals and will work to minimize the number of involuntary exits," Hilker stated.
  • Board treasurer Pat Sheridan told directors the hospital will "probably end up" with a deficit of about $20,000 on an $18.6-million operating budget by the time the 2014-2015 fiscal year comes to an end March 31. "We're still in pretty good shape," he said. There's "not too much concern around the financial side." Hospital GAINs approval Campbellford has been given the goahead to create a Geriatric Assessment and Intervention Network (GAIN) program in Trent Hills.
  • ...3 more annotations...
  • The Peterborough Regional Health Centre has been providing the service locally once a month. It involves a multidisciplinary team that includes a nurse practitioner, a physiotherapist, an occupational therapist, and a pharmacist, among others, who provide comprehensive assessments and plans of care for frail seniors. "It's been very beneficial to our patients," in addressing their complex needs, president/CEO Brad Hilker told the hospital's board of directors last week.
  • "Recruitment is under way with the program to be up and running in the next few months," he said in his report. The new program is being made possible "through the generous support of the Central East Local Health Integration Network (LHIN). Changes to make CMH more senior friendly, and secure Hilker also reported a number of renovations will be carried out in the next two months to make the hospital environment "more senior friendly." The work, to be done with one-time funding provided by the LHIN, includes making an accessible washroom and installing better handrails.
  • Security cameras have been installed along with signage "to let everyone know" of their presence. "Policies and procedures are being developed based on protocols at other hospitals," Hilker stated.
Govind Rao

2015 Share BC Pension Forum | Hospital Employees' Union - 0 views

www.heu.org/...2015-share-bc-pension-forum

from heather pensions cupe bc hospital

shared by Govind Rao on 17 Feb 15 - No Cached
  • Friday, February 27, 2015 Location: Empire La
  • 11th annual pension forum (hosted by SHARE and the B.C. Federation of Labour) Join Canadian pension leaders to learn and exchange views about solutions to improving retirement security in today’s complex and dynamic public policy and capital market environment.
Govind Rao

Robust health-care stocks reaching new highs; Sector's offerings are attractively priced, and demand grows as the population ages - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150324|217036932

from heather privatization corporation profit

shared by Govind Rao on 24 Mar 15 - No Cached
  • The Globe and Mail Tue Mar 24 2015
  • Investors remain obsessed with the slowing global economy and its effects on commodity prices while U.S. health-care stocks - with little sensitivity to worldwide growth - are hitting new highs with blowout performance well ahead of the S&P 500. Digging deep into health-care subindexes, we also find that despite dramatic outperformance, most areas within the industry are trading at valuation levels close to historical average forward-price earnings ratios. There are 10 major equity subsectors in the U.S. health-care sector and eight of them outperformed the S&P 500's 15-per-cent appreciation over the past 12 months (upper chart). The best performers - managed health (health-care benefits planners), health-care facilities, biotechnology and health-care distribution - generated returns more than double the broader benchmark.
  • Only health-care supplies (a onestock index consisting of Dentsply International Inc.) and the S&P Life Sciences Tools & Services Index (which includes companies such as Thermo Fisher Scientific Inc. and Agilent Technologies Inc.) underperformed. The market success of health care is based on high levels of sales and profit growth in a broader environment where improvement in these areas has been remarkably rare, even with the help of widespread share buybacks. In the most recent quarterly earnings season, the S&P 500 Health Care Index showed the second-best yearover-year improvement in terms of revenue growth (technology was first) and profit growth of 21.6 per cent that outdistanced every other major industry sector in the market.
  • ...1 more annotation...
  • Health stocks are hot for a reason - the longer-term profit outlook is bright. With hundreds of attractively priced ETFs to choose from, the sector offers a compelling investment opportunity for Canadian investors. Scott Barlow, Globe Investor's inhouse market strategist, writes exclusively for our subscribers at ROB Insight and Inside the Market online. Subscribe to Globe Unlimited at globeandmail.com/globeunlimited.
Govind Rao

Health care, infrastructure top budget priorities for Canadians: Nanos survey | CTV News - 0 views

www.ctvnews.ca/...nadians-nanos-survey-1.2802857

from heather federal budget

shared by Govind Rao on 04 Mar 16 - No Cached
  • Thursday, March 3, 2016
  • Canadians want health care and infrastructure to be the top priorities in the Liberals' first federal budget this spring, according to results of a survey from Nanos Research. In a survey asking respondents to rank their top two budget priorities, 43 per cent of respondents said health care should be the No. 1 priority in the budget, while 28 per cent said infrastructure spending should be prioritized above all else. Eight per cent of respondents said the economy/jobs/stimulus efforts should be the top priority, while seven per cent chose public safety spending. The military and the environment were each ranked No. 1 by only four per cent of respondents, respectively.
Govind Rao

Suicide shouldn't be an occupational hazard for doctors - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20151124|234361264

from heather mental health doctors

shared by Govind Rao on 24 Nov 15 - No Cached
  • The Globe and Mail Tue Nov 24 2015
  • On Nov. 17, 2014, the inanimate body of Emilie Marchand was found in a parked car in the north end of Montreal. The 27year-old medical resident at the University of Montreal died by suicide, from an overdose of the painkiller hydromorphone. Unlike most suicides, Ms. Marchand's death garnered a lot of media attention. It occurred at a time when the dysfunctional administration at University of Montreal-affiliated hospitals was under scrutiny, and came on the heels of a damning report by the university's ombudsman about another medical student's suicide. Now Quebec coroner Jean Brochu has weighed in, pointing a finger at the University of Montreal for sitting idly by while a sick, troubled student was "slipping slowly and solitarily toward a dead-end of desperation."
  • While his report looked at a specific case, the coroner noted that it was part of a much larger problem - astronomical rates of depression among medical students and residents, coupled with the troubling reality that as many as one in seven had seriously contemplated suicide. Suicide is now considered an occupational hazard for physicians: About 400 doctors take their own lives in the United States annually, as do a few dozen in Canada. And the problems begin early: Medical students face significantly higher rates of burnout, depression and mental illness than those in the general population. Medical students - and residents in particular - face tremendous pressure, including punishing exams, a cutthroat atmosphere and gruelling hours.
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  • But stress is not the sole explanation. As both the coroner and the ombudsman note in their reports, the medical classroom and workplace are brutal: Bullying and psychological harassment are commonplace in hospitals, and the stigma about mental illness is pervasive in the medical profession. In short, medical education is too often imbued with a macho attitude that learners have to be broken down and toughened up and that those who can't take it are weak and unworthy.
  • Perversely, many physicians take pride in this boot-camp mentality. When efforts were made to eliminate the insane 100-hour workweeks of residents, old-timers quietly (and sometimes not so quietly) dismissed the younger generation as wimps. Even Quebec Health Minister Dr. Gaetan Barrette, when asked about medical-school suicides, reacted dismissively, saying: "The pressure they are dealing with is a lot less than it was 15 years ago." In fact, what's different today is not that young people are weaker, it is that expectations are so much higher and isolation is so much greater, in spite of (or perhaps because of) so-called social media. Medical students and residents are also headed into a world of uncertainty, not one in which they are guaranteed a life of privilege.
  • There is also an open recognition of the problem; when residents and doctors killed themselves before, it was hushed up - now it is at least talked about. But while the system has become adept at collecting data on depression and suicide, it has done little concrete to offer help and invest in prevention. Emilie Marchand, like all her classmates, had stellar marks and, from the time she was in high school, dedicated herself heart and soul to the goal of becoming a doctor - in her case a specialist in internal medicine. When she was in medical school she was diagnosed with a personality disorder and, in residency, suffered from bouts of depression so severe that she had to be hospitalized. She also had a previous suicide attempt, using the same drug, hydromorphone. But Ms. Marchand continued her studies full bore and - her friends testified later - lived in mortal fear that her illness would be exposed and her career derailed.
  • Increasingly, research is showing that so-called superperformers (such as those attracted to medical school) are particularly vulnerable. Paradoxically, the very qualities that make someone a good doctor - empathy, caring, perfectionism - make them vulnerable to burnout, depression and suicide. The students attracted to medical school are among the best and brightest of their generation. They are smart, talented and driven. But many are also anxious, overwhelmed and lost - sick, not weak.
  • We cannot simply respond to the wounded healers with the age-old admonishment, Cura te ipsum (Physician, heal thyself). We must create an environment in which our future doctors can learn to heal, beginning with caring for themselves.
Govind Rao

Farm-to-Table Dining Hits the Retirement Home | TakePart - 0 views

www.takepart.com/...elder-care-farm-table

from heather ltc food environment continuing care

shared by Govind Rao on 26 Nov 15 - No Cached
  • Green beans are a “touchy” subject at the Virginia Mennonite Retirement Community, where preferences fall on either side of the Mason-Dixon: soft-cooked Southern-style for some, crisp sautéed Northern-style for others. But diners are united in just how good they’ve been this summer.
Govind Rao

CIHR spurns Aboriginal researchers' call for reconciliation - 0 views

www.cmaj.ca/E75

from heather aboriginal research

shared by Govind Rao on 15 Mar 16 - No Cached
  • CMAJ March 15, 2016 vol. 188 no. 5 First published February 8, 2016, doi: 10.1503/cmaj.109-5232
  • Laura Eggertson
  • Aboriginal health projects received less than 1% of the funding awarded by the Canadian Institutes of Health Research (CIHR) in its first major competition since restructuring — an outcome Aboriginal researchers say illustrates the need to reconcile the new system with the vast inequities in Indigenous health.
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  • CIHR’s decision-making style, which resulted in it going ahead with changes to funding despite objections from Indigenous and non-Indigenous researchers, “is not consistent with the recommendations of the Truth and Reconciliation Commission,” says Rod McCormick, a Mohawk researcher and co-chair of the Aboriginal Health Research Steering Committee.
  • There is no recognition or provision for the fact that systemic policies, when applied across the board, can have damaging impacts for groups that are different,” McCormick told an emotionally charged meeting at the Wabano Centre for Aboriginal Health in Ottawa on Jan. 25.
  • In 2014/15, funding for Aboriginal health research was $31 million, down from $34 million at its annual peak 2004–2008, the Aboriginal Health Research Steering Committee reported.
  • McCormick and co-chair Frederic Wien, the principal investigator for the Atlantic Aboriginal Health Research Program, urged CIHR to revisit its changes and rebuild what Wien called “a respectful relationship with First Nations, Métis and Inuit people.” Given the crisis in the health and well-being of many of these communities, the researchers want CIHR to prioritize Aboriginal health research.
  • We have gone through major changes at CIHR. I do not deny that,” Beaudet said. “But I would deny ... that these changes are affecting particularly the Aboriginal community.”
  • Marlene Brant Castellano, co-director of research for the Royal Commission on Aboriginal Peoples, believes CIHR is out of step with the Truth and Reconciliation Commission’s recommendations.
  • Beaudet made the remarks just three days after the shootings at La Loche, Saskatchewan. The murder of two teenagers, a teacher and a teacher’s aide in the largely Dene community underscored for some attendees the crises in suicide, lack of mental health support and poverty that affect many Aboriginal youth and families.
  • Beaudet said Aboriginal health research is “extremely important” for CIHR, and its strategic investments will reflect that. CIHR has been working with the Aboriginal Health Research Steering Committee for 14 months and, according to the institute’s media specialist David Coulombe, is committed to “co-building research initiatives” that “will improve the health of Canada’s First Nations, Inuit and Métis peoples.”
  • While Beaudet acknowledged both the magnitude of the recent changes and the fact that the Aboriginal health research budget has “flatlined,” he said it has done so parallel to CIHR’s overall budget. CIHR’s billion-dollar annual federal budget has not increased since 2009, meaning that its spending power has declined by roughly 25% since then.
  • CIHR’s president denied any need for the federal agency to engage in reconciliation. “I would like to bring my personal views, not only those of CIHR, about the stormy weather we have been experiencing lately,” Dr. Alain Beaudet told attendees at the January meeting. “But not in the spirit of reconciliation, because I don’t think anything has been broken.”
  • The Aboriginal Health Research Steering Committee contends that CIHR disadvantages researchers working in Aboriginal health through recent changes such as scrapping an Aboriginal-specific peer review process, requiring matching funds for several granting programs, and reallocating almost half the open competition funding for stellar emerging and establishing scholars.
  • But Beaudet said the changes promote more “out-of-the-box” research that will enable Canada to achieve more international success. He also suggested that those critical of the new system are afraid of change, and advised researchers that “looking back doesn’t work.” Learning from the past is a critical Indigenous value. CIHR is starting to analyze the
  • results of its initial investments, but it will take seven years for the new system to take full effect and before “meaningful” figures result, Beaudet said. “We’ll work as quickly as we can, but we need the data. I’m saying ‘Yes, trust us,’ because if you look at CIHR’s record, we’ve done a lot, and we’ve done it in good faith.”
  • Most of the researchers and representatives of Aboriginal political organizations at the meeting did not seem inclined to trust Beaudet’s reassurances.
  • You’re really saying to this group, ‘Trust us.’ And I just want to remind you that there’s very little basis for trust,” said Scott Serson, a former deputy minister of Indian Affairs and Northern Development, now with Canadians for a New Partnership, a group working for a new relationship between Indigenous and other Canadians.
  • The Aboriginal Health Research Steering Committee asked CIHR to set aside half a day at the June meeting of its governing council to address these issues. In an online statement, Beaudet acknowledged the request for an in-depth discussion at “a future meeting” of the governing council. He also urged Indigenous health researchers and community members to apply as members of the new Institutes Advisory Board on Indigenous People’s Health and a new College of Reviewers.
  • Marlene Brant Castellano, co-director of research for the Royal Commission on Aboriginal Peoples and the Mohawk elder who closed the meeting, described Beaudet and CIHR’s response to the committee’s requests as “disconnected” from the prevailing political environment.
  • Castellano, who is revered as the first Aboriginal full professor at a Canadian university, brought many in the audience to tears. Instead of recognizing the need for a new relationship between Canada and its Indigenous peoples, Beaudet’s remarks echoed a too-familiar demand that Aboriginal researchers “get with” CIHR’s program because, eventually, they would discover it was good for them, Castellano said.
  • “We have 400 years as Indigenous people trying to make things work in other people’s agendas, and that is where we’ve gotten to the place now, where we still are, of watching our children dying,” she said, tears streaming down her cheeks.
  • Beaudet had already left the meeting before Castellano went to the podium, and the two CIHR vice-presidents who had stayed for most of the discussion left as she began to speak, citing prior commitments. Only Malcolm King, scientific director of CIHR’s Institute of Aboriginal Peoples’ Health and a member of the Mississaugas of the New Credit First Nation, remained for the duration of the meeting.
  • According to Coulombe, Beaudet had a phone conversation with Castellano on Jan. 29, and “agreed to continue working collaboratively with community representatives and leaders in the future.”
Govind Rao

North Bay hospital staff report staggeringly high workplace violence rates: Poll - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|nxbg|20160401|243817284

from heather cupe Ontario hospital violence poll nursing nurses pn lpn

shared by Govind Rao on 04 Apr 16 - No Cached
  • Fri Apr 1 2016
  • NORTH BAY, ONTARIO --(Marketwired - April 1, 2016) - A poll of North Bay Regional Health Centre (NBRHC) staff conducted earlier this week shows "staggeringly high rates of workplace violence with virtually no resolve from the hospital," said Michael Hurley president of the Ontario Council of Hospital Unions (OCHU) that commissioned the poll.
  • The poll shows that registered practical nurses (RPNs) and personal support workers (PSWs) doing direct patient care, are dealing with disproportionately higher rates of workplace violence. 86 per cent of the nurses and PSWs polled experienced incidents of physical violence such as pushing, hitting or having things thrown at them in the last year.
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  • What's more said Hurley at a media conference to release the poll findings, "it's a grim and concerning reality that despite the fact incidents are happening almost daily, workers fear reprisal and incidents are under-reported". The majority of respondents said that in the last year, in the workplace they had experienced at least one incident of physical violence, but many said they had experienced nine or more occurrences.
  • 59 per cent of the poll respondents are RPNs or PSWs. Of those respondents 73 per cent are women. 41 per cent of respondents provided other important support services at NBRHC. A high number, 81 per cent also indicated they witnessed incidents of physical and non-physical violence toward co-workers in the last year.
  • 40 per cent of respondents had experienced sexual harassment or sexual assault either physical or non-physical in the last year. "These workers are largely women. This is violence against women that's being allowed to happen here. In what other workplace would sexual harassment and sexual violence, at this level be tolerated?" Asked Sharon Richer, OCHU north eastern
  • Ontario vice-president. The poll also points to a climate of intimidation in the workplace and an under-reporting of incidents. 51 per cent responded that they are afraid of reprisal if they speak up about an incident of violence. The poll shows that there are far-more incidents of violence experienced by respondents than are actually reported. "The findings show violence is pervasive in this workplace. It's an unsafe work environment where something is standing in the way of workers reporting incidents. There is a fear of reprisal if you report. There is also under-reporting, which is linked to reprisal. There is no doubt people are afraid to speak out," said Hurley. FOR FURTHER INFORMATION PLEASE CONTACT: Michael Hurley OCHU President 416-884-0770 Sharon Richer OCHU, Vice-President North Eastern Ontario 705-280-0911 Stella Yeadon CUPE Communications 416-559-9300 Source: Ontario Council of Hospital Unions (OCHU)
Govind Rao

'Disturbing' poll results out today; North Bay Regional Health Centre staff polled - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|245142|nbng|20160401|243776734

from heather poll cupe Ontario hospital violence pn lpn nurses nursing

shared by Govind Rao on 04 Apr 16 - No Cached
  • North Bay Nugget Fri Apr 1 2016
  • A poll of North Bay Regional Health Centre staffthat measures incidents of workplace violence will be released this morning. The poll is the pilot for a provincial survey the Ontario Council of Hospital Unions (OCHU)/CUPE plans to conduct with its 30,000 hospital and long-term care members across Ontario.
  • Government data shows that health-care staff are the most likely to experience work-related violence and the incidents are rising. The poll conducted earlier this week asks how many incidents of physical and non-physical violence staffexperienced in the workplace in the past year.
  • ...4 more annotations...
  • Several of the questions focus on how many incidents workers have reported and whether they are afraid of reprisal if they speak up at work about violent incidents. The poll also asked how many times in the last year staffhave experienced sexual harassment or assault either non-physical or physical. "The results of personal experience with violence are very disturbing and suggest a profoundly unsafe environment," says OCHU
  • president Michael Hurley. "But for us, the most unexpected and unsettling finding is the measure of sexual harassment or sexual assault. "The number of staffafraid of reprisal if they report violence in North Bay is also very concerning, if not unexpected, given the firing of a nurse who raised the issue in January."
  • In January, nurse Sue McIntyre was fired by the health centre after she spoke on a workplace violence panel. In her comments, McIntyre had zeroed in on the issue of reprisal against health care staffwho report. Others on the panel stressed that there are fewer staffto deal with more aggressive
  • patients. Ontario has the lowest hospital and long-term care staffing levels in the country. Delegates attending the conference asked the provincial health minister to take the following actions: Enact legislation, to protect health-care workers from violence Provide health care workers with the same rights to refuse unsafe work as other workers in the public sector Charge patients and family members under the Criminal Code who are violent with staff Fund and staffOntario hospitals and long-term care facilities to the Canadian average.
Heather Farrow

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

www.fpinfomart.ca/...254615138

nb mental health arb cupe

shared by Heather Farrow on 25 Aug 16 - No Cached
  • 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 founder's call for the association to 'be genuinely courageous' on threat to public health - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20160823|254466010

cma environment doctors

shared by Heather Farrow on 23 Aug 16 - No Cached
  • 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

Could Trudeau use health care to get carbon deal? - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20160926|256970156

accord

shared by Heather Farrow on 26 Sep 16 - No Cached
  • The Globe and Mail Mon Sep 26 2016
  • Justin Trudeau faces tough talks with provincial premiers to hammer out a national climate-change plan. But he also has a critical tool to get a deal: cash. At first blush, the meeting with premiers seems to be shaping up as a clash. The federal government wants provinces to put a price on carbon, either through a carbon tax or a capand-trade system. And if they don't, Environment Minister Catherine McKenna has warned, Ottawa will slap a federal carbon tax on them. Four provinces have a carbon price now, but some premiers are wary, and Saskatchewan's Brad Wall sounds implacably opposed.
  • Then again, the premiers want something, too: money. Most provinces have high debt, and fear aging populations will mean rising costs in social programs and health care. They're clamouring for Ottawa to provide bigger-than-planned increases in health transfers. In other words, the premiers can probably be bought off. Put that way, of course, it sounds cynical. But it's been a formula for federal-provincial dealmaking for decades. The federal Liberals are already promising $2.9-billion over five years for climate-change measures, including $2-billion in the next two years to start a Low Carbon Economy Fund for projects chosen with the provinces. But money for other things could also be used to grease the wheels. The provinces want bigger streams of health-care money, but so far the federal Liberals aren't promising much. On Sunday, Health Minister Jane Philpott said she's working on the assumption there won't be much change, aside from a $3-billion federal injection for home care.
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  • What if the Prime Minister linked a climate deal to a health deal? That could be politically explosive. But McGill economist Chris Ragan thinks it's a good idea. One reason is that Mr. Ragan thinks the federal government will end transferring more money to the provinces anyway. Although the growth in provincial health spending has actually slowed in recent years, there are forecasts that it will grow by 3 per cent of GDP - by 2040. Mr. Ragan figures Ottawa will eventually give in, and might one day pay a third, that would be about $30-billion in 2027. The feds might as well admit it now and get a climate-change deal out of it, he argues. In other words, mix talks on health and climate together. "The more things you choose to put on the table, of course it becomes more complicated, but it also becomes a lot easier," Mr. Ragan said. "Because one of the things you bring to the table is a bunch of money."
  • There are a few problems. One is that Mr. Trudeau's government already wants something else from the provinces, a deal on home care. Ottawa is offering $3-billion and wants provinces to agree to meet targets for home-care services. Another is that Ottawa might not be ready to concede that it's going to have to transfer more to provinces. The recent years of slower growth in provincial health-care costs is an argument that the provinces don't really need the extra money. But that doesn't mean it will stay that way: Many economists believe those costs will rise sharply again in the near future. Then there is politics. Health transfers are to help the sick. Linking it to something else is likely to be seen as crass. But in the end, health-care transfers are dollars, and no one can really identify which dollar is spent on what. Mr. Ragan suggests they could be spent both on health and a climate deal.
  • Mr. Ragan is also chair of the Ecofiscal Commission, an organization of economists studying climate policy, which argues pricing carbon is the most efficient way of reducing greenhouse-gas emissions, because it will cost the economy less. The Ecofiscal Commission's models indicate that as long as the revenues are pumped back into the economy in the right ways, the costs of carbon pricing will be modest. In other words, if you are going to reduce emissions, a carbon price is the least costly way. In fact, the premiers, including Mr. Wall, agreed last spring to work on carbon-pricing options. Ms. McKenna is now brandishing a federal carbon tax as a stick to demand they seal a deal. But money is the traditional carrot. Mr. Trudeau might find it too politically dangerous to link health transfers to a climate deal. But it would allow him to offer what it usually takes to make a deal: money.
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