Funding of patient organizations - Ontario specific

[A Former User]

I have copied in about 3 pages from the 314 page report. Maybe the language and sentiments can be helpful to us.

The phrase that led me there was "patient advocacy - a crucial accountability mechanism for patient safety in Ontario - has been starved "nigh unto death," and that the imbalance is "systemic discrimination"

Report from the SATF Sexual Abuse Task Force hearing in Ontario

http://www.health.gov.on.ca/en/common/ministry/publications/reports/sexual_health/taskforce_prevention_of_sexual_abuse_independent_report.pdf

Concerns About the Current System Under the RHPA

We could find no evidence that the oversight of health regulatory colleges delegated by the Ontario government via the RHPA over a number of decades has led to significant reductions in the number of instances of sexual abuse of patients by members of those colleges. However, as discussed in more detail in Chapter 2, accurate data that allow for meaningful comparisons from year to year have not been gathered consistently, and information that the task force received from colleges allowed us to reach few firm conclusions based primarily on data. This unfortunate reality is the foundation for our emphasis on implementing our recommendations through sustainable transparency and accountability built upon mandatory reporting.

When the first task force on the sexual abuse of patients in Ontario held hearings in 1991, non-governmental organizations (NGOs, also known as civil society organizations, or CSOs) addressed the work being done to address the sexual abuse of patients by regulated health professionals.

Similarly, the second task force, in 2000, heard from patient advocacy organizations and patient advocates working actively on this issue. Yet the current task force - held 24 years after the first one - did not hear from even one organization or patient advocate that received any government funding to work on any aspect of the sexual abuse of patients by regulated health professionals, and none came to our attention during our mandate. This imbalance generates numerous deficiencies in our civil society, including greatly reduced accountability on issues of patient safety, particularly the sexual abuse of patients.

Put more bluntly, patient advocacy - a crucial accountability mechanism for patient safety in Ontario - has been starved "nigh unto death," in significant contrast to the robust legal defence schemes available to regulated health professionals and institutions.

This entrenched imbalance can now be characterized as systemic discrimination, and generates many unfortunate and unfair consequences that affect the health and dignity of Ontario patients. The previous task force reports in 1991 and 2000 also noted that this damaging imbalance needed recalibration through public investment in patient safety and accountability to patients. Yet the situation has deteriorated significantly in the past 15 years. Feedback we received during consultations suggests that many patients are not aware of the existence of the colleges or of their disciplinary roles, or they are afraid to venture into a process that they fear could render them even more vulnerable. The Ontario landscape for patient advocacy and public accountability is parched, and patients are often lost in the desert of the current regulatory health system.

In light of this situation, our multisectoral recommendations are intended to:

1. provide protection and assistance to patients who experience sexual abuse and exploitation by regulated health professionals;

2. ensure that the disciplinary process protects the rights of the accused regulated health professional as well as the patient(s);

3. increase access to justice for patients; and

4. shed light on the objectives and processes, including public tax support of defence insurance for regulated health professionals.

Access to justice is essential for preventing the sexual abuse of patients and improving health outcomes, particularly for patients who are found in vulnerable populations.

Chapter 1: Introduction and Recommendations 9 In a legislated complaints system, such as the one that exists under the RHPA and that we have been asked to assess, there are some checks and balances available through administrative tribunals such as the Health Professions Appeal and Review Board (HPARB)12 and courts at different levels, depending on resources that determine how far parties are able to take their appeals. It is impossible to participate fully in any of the aforementioned decision-making fora, however, without significant resources of time, expertise and money. Regulated health professionals in Ontario deservedly can access these resources because they are insured through a variety of protective plans, ranging from the Canadian Medical Protective Association (CMPA) for doctors, to individual insurance plans that regulatory colleges such as the Royal College of Dental Surgeons of Ontario (RCDSO) require their members to carry.

Patients have no access to any such legal defence plans, however. Patients are seldom granted party status to be able to participate fully in most of the college processes or appeals by regulated health professionals against college findings of sexual abuse by patients. In the absence of the needed resources that would help patients to participate in a meaningful way, therefore, access to justice is greatly reduced or non-existent.

Judicial Interpretations of the RHPA Provisions

To understand our emphasis on access to justice as a crucial component of implementing the zero tolerance standard on the sexual abuse of patients, it is important to look more closely at how colleges, tribunals and courts have interpreted the RHPA provisions on sexual abuse that have been enacted since the first independent task force report, which was commissioned by the College of Physicians and Surgeons of Ontario (CPSO) and released in 1991.13 Later in this report, in Chapter 5 and in Appendix G, we examine more closely recent college decisions that have added to our high level of concern about the lack of parity for patients, which reduces access to justice in the self-regulatory health college system under the RHPA.

While there is some variance among lower court decisions since the RHPA sexual abuse provisions were enacted in 1994, we see considerable acceptance of the zero tolerance standard and consistency in the judicial interpretations of what is required under the RHPA to protect patients. More than 20 years after it was decided by the Supreme Court of Canada in 1992, the case of _Norberg v. Wynrib,_14 for example, stands as an authority on setting a clear standard of responsibility in protecting patients from sexual abuse.

[A Former User]

Here's an excerpt from recommendations of the Sex Abuse Task Force

19. Minister's Implementation Council

I. The Minister of Health and Long Term Care (MOHLTC) should immediately establish the Minister's Implementation Council for an initial renewable five year term, to make an annual public report to the minister, who in turn should report to a standing committee of the Ontario Legislative Assembly. Reports should include a detailed summary of cases, patient evaluations of processes and responses, an audit of decisions, evaluation of OSAPPA and suggestions for more effective procedures and educational initiatives for preventing the sexual abuse of patients

in the public interest. Membership in the Minister's Implementation Council should include one Ministry of Health and Long Term Care employee/appointee at the assistant deputy minister level (or equivalent) and one at the director level in the ministry, one member of the Premier's Permanent Roundtable on Violence and one member of the Aboriginal Roundtable on Violence, two experienced executives from health regulatory colleges, one health care administrator with extensive community based care experience, at least two survivors and two advocates working in the field of abuse prevention and/or victim support, one executive officer of OSAPPA - taking into consideration those recommended by separate letter from the task force for the minister's consideration.

To succeed, each member of the Minister's Implementation Council needs to be able to interact critically with every other member in a way that protects the integrity of each; thus, all members should receive the same level of remuneration for this public service - at the level of chair - as a clear indication of the respect and need for the equivalency of the range of expertise needed for effective collaboration and implementation of this major reform.

The Implementation Council should encourage, receive and respond to reports on educational and research initiatives undertaken, as per relevant recommendations made herein...