Psychotherapy 101/Ontario

Jonathan Sher | QMI AGENCY

 

LONDON, Ont. -- Seven years after Ontario passed a law to protect vulnerable people from unscrupulous and untrained psychotherapists, the law is not in force and anyone can claim to be a therapist.

The lack of action has placed at-risk people suffering a litany of emotional ailments, from a bad marital breakup to recovering from the trauma of sexual abuse, experts say.

"You can be a high school dropout and say, 'I'm a psychotherapist’, and you're not breaking the law," Nicole Maurice of the Canadian Counselling and Psychotherapy Association said.

Ontario passed a law in 2007 to regulate those who hold themselves out to be psychotherapists. But the law hasn't taken effect because the health ministry has struggled to forge regulations that meet the demands of the many professions affected, from psychologists and marital counsellors to therapists who use art or music to heal emotional wounds.

That's left Ontario a Wild West for psychotherapy -- broadly defined as the treatment of a mental disorder by psychological means -- in which the therapist with the biggest online presence or lowball prices draws patients desperate to find help.

Some patients lose their savings. Some lose hope they'll find help. Others get worse with bad consequences. Psychologist Jack Ferrari has sometimes been left to pick up the pieces.

"You get some nasty stories," said the London-based Ferrari, who has had a practice for 33 years.

In the absence of a regulatory college that sets standards, fields complaints and punishes therapists for misconduct,  some health professionals have created voluntary associations but they don't have a stick to wield, only a carrot -- certification for those who meet their standards.

Just who's certified and by whom is unclear: Consider a family doctor-turned psychotherapist in London, Dr. Peter John Brown, who's been accused by the Ontario College of Physicians and Surgeons of sexually abusing a patient, having intercourse and oral sex with her. His disciplinary hearing is scheduled in July.
Brown's website says he's certified as a counsellor and in the treatment of those who are bisexual, but which organizations certified him is a mystery and he didn't respond to voicemails left by QMI Agency.

Even if a doctor is found guilty of abusing a patient and loses their medical licence, they could continue providing psychotherapy, said Ferrari, whose many positions of leadership include serving as president of the Ontario Psychological Association.

The province needs to take a final step to make into law the Psychotherapy Act by seeking royal assent, something Ferrari knows well -- he's on a transitional council that's worked with the health ministry trying to craft regulations that work.

"I don't think the ministry of Health quite understood how complex it is," Ferrari said.

Among the stumbling blocks:
-- How to define psychotherapy.
-- Getting support from diverse professionals with varied training.
-- Fear of cutting off patients from good care by therapists who might not qualify under the new law.
-- Creating separate regulatory colleges for psychotherapy and mental health therapy; the latter has been put off until the former is done.
The health ministry promised to enact the law more than two years ago, then again earlier this year.

Now, it's looking at the fall, but not everyone is convinced it will happen.
"I'm not holding my breath," said Sharon Ramsay, president of the Ontario Association of Registered Marriage and Family Therapists.

Marriage therapists in many American states have been regulated since the 1980s and Ontarians deserve the same protection, Ramsay said.
"It's been delayed and delayed and delayed."

New Ontario Health Minister Eric Hoskins, asked about the delay, issued a statement: "It's important that we take the time to ensure all components of the new governing framework will appropriately protect the public . . . The ministry is working with the transitional council to ensure that this occurs as soon as possible."

Source: http://www.sunnewsnetwork.ca/sunnews/canada/archives/2014/06/20140629-163844.html
 

Ontario's workers' compensation system is under attack

To save money, the fairness at the core of Ontario's workers' compensation system is being undermined.

YouTube screen grab 

If WSIB President David Marshall succeeds, he will save the workers' compensation board money, but at what cost? asks Oduardo Di Santo.

By: Odoardo Di Santo Published on Fri Jun 27 2014

 

I had the great privilege to serve as chair of what is now called the Workplace Safety and Insurance Board (WSIB) in the early 1990s. As an immigrant from Italy and then a member of Ontario’s Provincial Parliament, I had observed firsthand the difficult circumstances of injured workers and the important role of the board in helping them get back on their feet.

As chair, I did my best to strengthen the WSIB’s support to those workers, especially around rehabilitation and return to work. So I have a personal stake in the changes now underway at the board — changes that are undermining decades of progress and that all Ontarians ought to oppose.

These changes were well illustrated by two recent articles in the Star. One showed that many of the criteria used by WSIB to justify surveillance of inured workers unfairly target those who are new immigrants or whose injuries seem to be taking too much time to heal.

Another recounted two cases of injured workers who were denied compensation because the WSIB maintained that x-rays found evidence of degenerative disc disease (a “pre-existing condition”) in their spines. Never mind that both of these workers had been able to work for many years before their workplace injuries.

These stories represent a historic and unfortunate departure from established WSIB practice.

The board has no policy or legal authority allowing it to deny benefits because of pre-existing conditions. In fact, current policy and many years of appeal decisions make clear that the board should pay benefits to workers who were able to work before their injury and unable to work afterwards.

Recently, the WSIB proposed a policy to overturn the long-standing approach, which, if approved, would undermine the basic principle upon which the system was based.

Ontario’s workers’ compensation system has always required balance between the contribution of the employers and the benefits paid to the injured workers. It was built with fairness at its core.

And yet, since the 1970s, successive governments have kept employers’ contributions artificially low, allowing an “unfunded liability” to develop. The WSIB doesn’t have the money to fund likely future benefit claims.

In the early 1990s, the board concluded it needed to raise employers’ contribution to 3 per cent of payroll to eliminate the unfunded liability by 2014. Unfortunately, when Mike Harris took power, his government lowered the contribution to 2 per cent. And though it also reduced payouts to injured workers, the unfunded liability skyrocketed.

To deal with this problem, the McGuinty government appointed as WSIB president David Marshall, an accountant, who was granted a stipend of $400,000 a year plus a performance bonus of 20 per cent.

In 2010, Marshall told the legislature he had to cut costs. He said he would develop a plan that would have “some tough, tough proposals in it. I mean you can’t recover this amount of money without … pain somewhere in the system … I don’t get any bonus unless I can meet this target.” Not one word about the revenue side.

Instead, under Marshall’s watch, denied claims increased by 50 per cent. Benefits to injured workers have been reduced by $631 million; the rehabilitation program has been decimated; long-term wage loss benefits have been reduced by 28 per cent; hundreds of WSIB employees have been laid off; and injured workers’ pensions have been reduced by 31.3 per cent.

This is not only having a devastating impact on injured workers; it is also downloading costs onto our social assistance and health care systems. And the workers’ compensation system has been brought to a stall, with thousands and thousands of appeals and lengthy and unacceptable delays in dealing with them.

That’s not all. In 2011, Marshall was granted the unprecedented authority to change autocratically most WSIB policies without board approval.

The Star has documented how Marshall is exercising this power. If he is allowed to implement the infamous policy on “pre-existing conditions,” this will allow the WSIB to deny benefits because of, say, age.

In fact, the board has already begun illegally implementing the policy. The WSIB routinely writes to workers, warning them: “please be aware that … the WSIB may determine that the current condition is more likely related to the natural aging process or to the progression of an underlying pre-existing condition.” So the worker is zapped despite the long-standing policy that compensation will be granted if the injury is a significant factor in causing the worker’s disability.

Injured workers, the medical profession, community groups, and many others have decried the absurdity and unfairness of what the WSIB is doing. So far, to no avail. If Marshall succeeds, he will surely reduce the unfunded liability, but at what cost?

The destruction of our workers’ compensation system will create bitterness and polarize workers and employers. After a century of progress, we will once again have thousands of injured workers desperate and deprived of justice and the means to support their families. Rather than going down this harmful path, we ought to work together instead on the prevention of workplace injuries and diseases, and the re-employment of injured workers.

Odoardo Di Santo is a former Ontario MPP and chair of the workers’ compensation board.

Source: http://www.thestar.com/opinion/commentary/2014/06/27/ontarios_workers_compensation_system_is_under_attack.html

 

Social Security Tribunal struggling with massive backlog: documents

Information regarding the Canadian Pension Plan is displayed on the Service Canada website
 in Ottawa on Tuesday, January 31, 2012. (Sean Kilpatrick / THE CANADIAN PRESS)

Lee-Anne Goodman, The Canadian Press
Published Friday, August 15, 2014 4:38PM EDT
Last Updated Friday, August 15, 2014 9:23PM EDT 

 

OTTAWA -- Ailing, disabled and unemployed Canadians seeking benefits have been facing increasingly long waits to have their appeals heard, even as full-time positions on the government's woefully backlogged Social Security Tribunal have remain unfilled.

Documents obtained via the Access to Information Act suggest there won't be any new hirings on the tribunal until March, despite a backlog of thousands of cases and the Conservative government's assurances earlier this year that the jobs would soon be filled.

The government, meantime, says only two of the 12 vacancies that were still open as of July 18 remain to be filled. New employees were hired this summer and two more will be hired this fall, said a spokesman for Employment Minister Jason Kenney.

The Social Security Tribunal was created in 2013 with the aim of providing a more efficient and streamlined appeal process for employment insurance, Canada Pension Plan and old age security decisions.

It replaced a board of hundreds of part-time referees who heard appeals. The government said the new tribunal would save Canadian taxpayers $25 million a year.

The tribunal, which has fewer than 70 full-time members, took over more than 7,000 appeals of income-security cases from the old board, most of them involving Canadians who were denied CPP disability benefits.

As many as 6,000 still haven't been heard, and there are generally about 3,000 new appeals every year. Among the documents is a memorandum from the head of the tribunal, Murielle Brazeau, alerting Kenney that the tribunal is struggling to manage the caseload.

Under federal regulations, the tribunal must make a decision on the cases or schedule an appeal after 365 days.

"Given the magnitude of the backlog, the tribunal will not be able to assign all those cases without delay," she said of cases reaching the 365-day mark.
Nick Koolsbergen, a spokesman for Kenney, said the tribunal is "implementing a plan to deal with these cases in a timely way." The tribunal did not immediately reply to a request for comment.

Jinny Sims, the NDP's employment critic, was harshly critical of the government.
"They took a system that needed improvement and they've broken it," she said in an interview Friday. "And it's the most vulnerable in society who are impacted."
Sims had harsh words for Kenney, saying not only is he neglecting to authorize the hiring of part-time employees to deal with the backlog, but he won't even fill all the allocated full-time positions.

Sims suggests that's because the Conservatives are consumed with pinching pennies -- often at the expense of downtrodden Canadians.

Allison Schmidt, a Regina-based disability claims advocate and consultant, decried the swelling backlog of cases and lengthening wait times, saying the delays have resulted in financial ruin, poverty, emotional distress and a lack of access to medication and treatment for many of her clients.

"If this system existed in the private sector it would be out of business and held accountable," she said. "They're doing this on the backs of the most vulnerable people; that's what's so disgraceful about it."

Rather than creating a more efficient system, appeals are now being heard at a far slower pace, she added.

"I've been doing this work for 16 years, and since the implementation of the tribunal on April 1, 2013, I think I've had maybe six appeals," Schmidt said. "Prior to that, it was 50 a year."

Schmidt passed along an email she recently received from a longtime IT worker for a municipal government in western Canada who was diagnosed with a brain tumour a year ago.

Despite paying into CPP for 25 years, he was denied CPP disability benefits in June and is awaiting his appeal.

"Basically, I have become a loser with no pride, extreme fear/anxiety and no hope," he wrote.

Source: http://www.ctvnews.ca/politics/social-security-tribunal-struggling-with-massive-backlog-documents-1.1961824#ixzz3AZPslj4Y

Social Justice: Courts should relent on recording defence medical examinations

Monday, 07 July 2014 08:00 | Written By Alan Shanoff

 It seems odd that we continue to debate the recording of litigation-related medical assessments while video and audiotaping become a staple of society.

The latest skirmish in this debate arises in Alladina v. Calvo, a May 6 decision of Superior Court Master Benjamin Glustein allowing a defence motion to compel the plaintiff to attend a medical assessment before a psychiatrist and dismissing the plaintiff’s motion to conduct the assessment by a different practitioner or, alternatively, to record it.

In doing so, Glustein followed pre-2010 decisions holding that recording defence medical assessments shouldn’t be routine and is only warranted on the basis of “substantial and compelling reasons.” More significantly, he refused to follow the more modern approach exhibited by Master Donald Short in Bakalenikov v. Semkiw.

Short considered the amendment to Rule 53.03 that says experts must not be advocates for either side. He noted a Superior Court judge had previously criticized the psychiatrist chosen by the defence to conduct an assessment of the plaintiff for providing his evidence as “an advocate for the party calling him as a witness” and who had his opinions “disregarded by the court for bias and advocacy for the defence” on at least three occasions.

Short took those judicial findings seriously when he stated: “If a judge of the court has made a finding with respect of an individual expert in the past, that is the finding of the Superior Court.
How can the court abdicate any responsibility to audit the performance of such experts in light of the expressed intent of the amendments made to Rule 53?”

Accordingly, Short concluded the psychiatrist’s “objectivity needs to be demonstrated” and ordered that the examination be audiotaped.

Glustein had before him similar evidence concerning the doctor proposed by the defence. Evidence disclosed that the plaintiff had found 66 cases in a Westlaw search that considered psychiatrist’s evidence. In 11 of these cases, courts or tribunals didn’t accept parts or all of the doctor’s evidence. In doing so, they made comments that the doctor’s “evidence had a flavour of advocacy,” “smacks of partiality” or wasn’t “balanced.”

Of course, that isn’t evidence of bias or that the doctor is incompetent. But with 11 negative remarks in 66 cases, shouldn’t we require proof of the doctor’s objectivity? Glustein didn’t think so, concluding there were no “substantial or compelling reasons to require videotaping or audiotaping to ensure fairness.”

Glustein found that any taping of the defence examination would provide an unfair advantage to the plaintiff since there was no recording of the plaintiff’s examination. The reasoning appears to run through other cases denying similar motions. But what would the harm be in allowing a recording of the defence examination given that the introduction of the tape would be at the discretion of the judge?

The reluctance of defence lawyers and experts to allow taping of assessments has always puzzled me. The tape protects the doctor from allegations of wrongdoing by the patient. Why wouldn’t an expert want irrefutable evidence of what was said and the examinations conducted during an assessment? Further, as stated in Moroz v. Jenkins, “The ability to review the defence examination and compare it to the report should in most instances promote settlement by demonstrating to both sides the correlation between what the psychiatrist saw and heard and his or her conclusions.”

Yet doctors resist recording their examinations. Their arguments ring hollow, however. For example, we hear patients may perform in front of the camera. But if doctors can’t adequately deal with performing patients, surely we can leave that to the judge or jury to sort out.

Patients may not be forthcoming knowing there will be a recording. Yet it’s the patient who has requested the recording, so how can that be a valid consideration? Could it be that defence experts don’t want an accurate record of their examination so as to make it more difficult for plaintiffs to dispute their findings?

Common sense dictates recording defence examinations when plaintiffs reasonably ask for it.

Source: http://www.lawtimesnews.com/201407074065/commentary/social-justice-courts-should-relent-on-recording-defence-medical-examinations
 

Tribunal can deny in-person appeals in disability benefits cases

Some Canadians who believe they have been wrongly denied federal disability benefits are being told, under new rules, that they have no right to plead their case directly to the adjudicator of the new Social Security Tribunal who will decide their appeal.

A lawyer who handles Canada Pension Plan disability cases says his clients will be stripped of their right to basic justice if they cannot appear before the tribunal. And a retired doctor who heard appeals under the previous system says he could not have made fair decisions without meeting claimants face to face.

“I can tell you there were a couple of times when you would say to yourself, ‘This is a slam dunk for denial,’ until the human walked in,” said George Sapp, who lives near Halifax. “Then you would see the person that’s attached to the file. And sometimes it took you back. And you listened.”

CPP disability benefits are available to people who paid into the pension plan and cannot work because of a serious and prolonged ailment. Until the spring of last year, anyone who was told by the government that they were not entitled to collect them, had the right to tell a three-person review tribunal why that decision was wrong.

But, in April 2013, the Conservative government eliminated the roughly 350 part-time members of those panels, including Dr. Sapp.

They were replaced by 35 full-time members of the new Social Security Tribunal (SST) which, despite inheriting a backlog of 7,224 cases, managed to hear just 348 appeals in its first year of operation. By last month, the backlog had grown to nearly 10,000, some of them dating back several years.

New rules introduced when the SST was created allowed adjudicators to hear cases by teleconference, video conference, in person, or by written question and answer. But the adjudicators could also decide, unilaterally, that the written material given to them by the claimants and the government was sufficient and that no further live input was necessary.

In the first 13 months of the SST’s operation, 57 cases were decided on the basis of the existing written record alone. In the same period, 173 appeals were heard by teleconference, 52 by video conference and 123 were done in person.

Dominique Forget, the senior director of the tribunal, said in a telephone interview on Friday: “It’s a question of flexibility and efficiency.” Appellants can express their preference, she said, but “we’re trying to move files and to be as quick as we can.”

Ms. Forget said the tribunal does not keep statistics to show the relative success of appellants who are permitted to present their case in person versus those who are not.

Allison Schmidt, a Regina-based consultant who helps people appeal denials of CPP disability benefits, said it has only been in recent weeks that her clients have been told that an adjudicator would make a decision without hearing directly from them.

“It appears that the way the Social Security Tribunal is going to manage the enormous accumulation of backlogged appeals is to unilaterally deny Canadians the right to be heard in an in-person hearing,” said Ms. Schmidt. “By denying this right to this type of appeal, the federal government has found another way to tilt the playing field in their favour.”

One of Ms. Schmidt’s clients who was told he would not get a hearing was Stu Lang, a British Columbia man who had to quit his job building airplanes after a catastrophic shoulder injury. He was denied CPP disability benefits and launched an appeal in 2011.

Mr. Lang, who does not yet know what the adjudicator will decide in his case, said he was “a little peed off” to be told three years later that he would not be able to explain, in person, why he believes he is owed the benefits.

Richard Fink, a Toronto lawyer who handles CPP disability cases, said none of his clients have yet been told they will not get a hearing. On the other hand, said Mr. Fink, there is such a backlog at the SST, none of his clients have received a hearing of any kind in recent months.

But “the rules of natural justice say you are entitled to an oral hearing if there is some value in having it,” said Mr. Fink. “There is judicial precedent that where your rights are being decided, you are entitled to appear before the party making the decision.”

Source: http://www.theglobeandmail.com/news/politics/ottawa-guts-already-overloaded-tribunal/article19485258/#

Fewer claimants successful when appealing disability benefit denials

Canadians with long-term and debilitating illnesses who believe they have been unfairly denied federal disability benefits are finding it increasingly difficult to get those decisions overturned.

In 2005-06, nearly 60 per cent of claimants were successful when they appealed the rulings of federal bureaucrats who said they did not qualify for payments under the Canada Pension Plan disability program.

But that success rate has declined year over year for the past eight years, with one slight upward tick in 2009-10. And, by 2013-14, just 43.4 per cent of appellants were able to convince an adjudicator of the new Social Security Tribunal (SST) that they had been wrongfully denied.

Coupled with the backlog of nearly 10,000 appeals that are waiting to be heard by the tribunal, and new rules that allow adjudicators to accept or deny appeals without actually hearing from the claimants, critics say many ill and disabled Canadians are being left in desperate straits.

“For many people, it’s heartbreaking,” said Peter Beaudin, an advocate with the B.C. Coalition of People with Disabilities. “They have been working to support their families all their lives, and suddenly they are facing the loss of their homes – their marriages are in trouble because of the stress.”

It is a problem even for sick and injured people who have private disability insurance through their employers. The payout of the private insurers is reduced dollar-for-dollar by the amount paid by CPP’s disability program, so the insurers generally insist that their clients also apply for the federal benefits. If the government benefits are denied, the private benefits are often terminated.

In recent years, bureaucrats within Employment and Social Development Canada and its predecessor, Human Resources and Social Development Canada, have refused about 60 per cent of initial applications for CPP disability benefits. Large numbers of those rejections are overturned when claimants request that their cases be reconsidered.

If the claim is again denied, it can be appealed to the SST. That is often enough for the government to seek a resolution. But, if that does not happen, the case will be decided by one of about 35 full-time adjudicators of the SST who were appointed last year to replace a system of three-person review panels drawn from a pool of 350 part-time members.

It is not clear why the success rate for appeals would have declined over time. A spokesman for the department said in an e-mail he is not in a position to comment on the decisions of the previous review panels. And the senior director of the SST said decisions are made on the basis of evidence.

But “the numbers are pretty stark when you see the number that have been refused tracked back to 2005,” said Rodger Cuzner, the Liberal critic for employment and social development.

Jinny Sims, the NDP critic, said the reduction in successful appeals has been dramatic. “For there to be that kind of a shift that quickly shows that the adjudicators may be looking at the files with a different set of directions.”

Ms. Sims also said it seems “highly irregular and highly unfair” for the SST adjudicators to be able to decide, unilaterally, that they will not hear directly from claimants who have launched an appeal. It is important, she said, for appellants to be able to tell their story.

Source: http://www.theglobeandmail.com/news/politics/fewer-claimants-successful-when-appealing-disability-benefit-denials/article19501881/

Gloria Galloway

The Globe and Mail

Published Monday, Jul. 07 2014, 8:51 PM EDT
Last updated Monday, Jul. 07 2014, 8:51 PM EDT

Ontario will miss target of cutting auto insurance rates 8 per cent by August

Despite falling short, Finance Minister Charles Sousa says the government is ‘still going to be on track’ for 15 per cent cut by August 2015. 

Darren Calabrese / THE CANADIAN PRESS

Ontario Finance Minister Charles Sousa blamed the Progressive Conservatives and NDP in the last minority parliament for stalling efforts to pass the first proposed bill. 

By: Rob Ferguson Queen's Park Bureau, Published on Tue Jul 15 2014

 

Ontario will fall short of its promise to cut auto insurance rates 8 per cent by next month, Finance Minister Charles Sousa acknowledged Tuesday as average premiums inched 0.22 per cent higher in the second quarter.

Premiums are now down 5.44 per cent since the government improved efforts to tackle fraud and promised a larger 15 per cent cut by August of 2015, Sousa said as he reintroduced legislation to cut costs for auto insurance companies and crack down on price gouging in the towing industry.

That 15 per cent cut would be worth an average of $225 annually.

Sousa advised motorists feeling the pinch of higher rates to “shop around” and blamed the Progressive Conservatives and New Democrats in the last minority parliament for stalling efforts to pass the bill first proposed last winter.

“It’s unfortunate the opposition delayed it and delayed it and delayed it,” the finance minister told a news conference.

“We’re still going to be on track for the 15 per cent. We have to pass the legislation as soon as possible.”

Progressive Conservatives support the legislation but want amendments to improve the dispute resolution mechanism between motorists and insurers, said Nipissing MPP Vic Fedeli, accusing Sousa of going too far in the blame game because not enough has been done to combat insurance fraud.

“It was everything but the dog ate my homework…they have nobody to blame but themselves.”

The Financial Services Commission of Ontario reported Tuesday that five companies with a total market share of 14.5 per cent had new rates approved with an overall impact of 0.22 per cent across the system for the province’s nine million motorists.

Two companies lowered costs for drivers by one percentage point but another, Security National Insurance Company, boosted premiums 4.19 per cent.

Ralph Palumbo of the Insurance Bureau of Canada said that was likely to make sure Security National has “enough money to pay the claims” and Sousa suggested its rates were “well below the cost of other companies.”

New Democrat MPP Jagmeet Singh for Bramalea-Gore-Malton said many drivers are still seeing increases or won’t see promised reductions for months when their new billing periods begin.

“Claiming that there’s a 5 per cent reduction is ludicrous,” he told reporters. “People are feeling pinched…we’re paying the highest rates in the country.”

He said Sousa has a long way to go to meet the 15 per cent target, set in the spring of last year as a condition for NDP support of his budget.

“I think this will be another promise made, promise broken.”

The proposed auto insurance legislation, aimed in part at settling disputed auto insurance claims faster to reduce administrative costs and licensing of accident rehab clinics, is being combined with another bill to regulate towing and vehicle storage, giving consumers — who have often just been in car accidents — more rights in dealing with tow truck operators.

Towing companies would have to post prices, accept credit cards for payment, provide itemized bills and notify motorists immediately where vehicles have been towed.

“We’ve had concerns raised,” said Consumer Minister David Orazietti.

Palumbo said the measures will help cut costs for insurance companies and make lower premiums possible in an industry where a number of firms have already posted average rate reductions.

“We’re months behind.”

Source: http://www.thestar.com/news/queenspark/2014/07/15/ontario_will_miss_target_of_cutting_auto_insurance_rates_8_per_cent_by_august.html

Liberals revive bill to cut auto insurance rates

TORONTO – Ontario’s governing Liberals insist they can still reach their target of cutting auto insurance rates by an average of 15 per cent across the province, even though they’re only a third of the way there with just a year to go.
Rates have dropped an average of 5.44 per cent since the government started to take measures aimed at combating insurance fraud last year, Finance Minister Charles Sousa said Tuesday.

He acknowledged that recent filings showed the provincial regulator approved rate changes over the past three months that resulted in an overall 0.22 per increase, with one company receiving approval for a 4.19 per cent hike.
“There are some companies that have already priced themselves below market and now they’re trying to figure out how to best compete,” Sousa said.
About a dozen companies have reduced their rates by over 10 per cent since the government started addressing the issue, he said. More should follow once a bill aimed at tackling insurance fraud and inflated towing costs passes in the legislature, helping the government reach its goal by August 2015.
“We’re taking every action necessary to try to meet that target and we recognize that in order to do so, we have to pass the legislation as soon as possible,” Sousa said.

His advice for drivers who keep seeing their premiums go up? Shop around.
“It’s up to consumers to choose the best possible rate that they can get,” he said.
The Liberals introduced two bills in the spring dealing with auto insurance and towing rules, but they were scrapped when the June 12 election was called.
Sousa’s merging them into a single bill that’s all but certain to pass since the Liberals now have a majority of seats in the legislature.

Among other measures, it would move the dispute resolution system for injured drivers from Ontario’s insurance regulator to an existing tribunal run by the Ministry of the Attorney General, which he says will help resolve disputes more quickly.

It also proposes more oversight of the billing practices of health clinics and allow only licensed service providers to be paid directly by insurers. Insurance agents or adjusters who abuse the system could also see their licences suspended immediately.

There are measures to cut down on the amount of time vehicles can be stored after an accident, so owners and insurers won’t be squeezed for more money.
The proposed law would also force tow truck operators to register their vehicles, get permission from a driver before charging for towing and storage services, post their prices and provide itemized invoices detailing all charges.
In an interview with AdvocateDaily.com, Toronto critical injury lawyer Patrick Brown says the measures are a step in the right direction.

“It’s about time that we see people trying to streamline the system and save costs without the knee-jerk reaction of reducing people’s benefits as we’ve seen in the past” says Brown, partner with McLeish Orlando LLP. “From an access to justice standpoint, I think this plan and the changes they’re making to the dispute resolution system (DRS) will allow people to receive treatment in much more expedited fashion and reduce unnecessary procedural costs presently in the system.”

When it comes to the law’s focus on health clinic billing practices and tow truck operators, Brown says, “I think there’s good and bad in any industry, whether it be the health clinics, tow truck industry, legal industry or insurance industry– there’s the good, the bad and the ugly. Any attempt to remove the ugly and bad out of the system is a good thing that will hopefully curtail future abuse ”
One drawback to the plan, says Brown, is its move to streamline all cases through the DRS process.

“There are certain benefit cases that do require court review.  To take away an individual rights to access the courts on significant claims can lead to unfair and unjust results.  Certain decisions regarding benefits can have a long term and dramatic impact on person’s life.  If the person chooses to have that decided by a court, they should maintain that right. ” says Brown.

Sousa may claim that fraud is at the root of high premiums, but insurers are still racking up record profits, said NDP critic Jagmeet Singh.
The Liberals are “bending over backwards” to cut costs for insurance companies, rather than pressing ahead to reduce insurance rates for consumers, he said.

“This is a gift to the insurance companies, this is a way of reducing their costs once again but there’s absolutely no guarantee that this will result in a reduction in rates for drivers,” he said.

Sousa said rates would have gone down further if the opposition parties, who collectively had a majority of seats in the legislature, had allowed the legislation to pass before the election was called.

The Progressive Conservatives say they’re cautiously supportive of the measures, but that Sousa is looking for a scapegoat.

“Look, they have nobody to blame but themselves,” said Tory finance critic Vic Fedeli.

“Quite frankly, these guys look for any excuse to pass blame on every single issue … it’s always somebody else’s fault.”

Source:  http://advocatedaily.com/2014/07/liberals-revive-bill-to-cut-auto-insurance-rates/

New Policy for Reduced/Fair Auto Insurance Premiums in GTA/Ontario

This plea is on behalf of Nine Million Canadian Drivers in Greater Toronto Area who continue to be robbed by the Auto Insurance companies in the GTA. We pay twice as much as the Maritime. GTA has the highest Insurance rates not just in Canada but in the whole of North America. Are these Insurance companies implying that Toronto is the most dangerous city in North America? Or everyone who lives in Toronto is a fraud and will scam them? This is the only reason for them to justify these premiums.

Even the biggest of US cities like NYC have a fraction of the insurance costs compared to ours and majority of the Insurance companies operating there have a completely different premium policy for GTA residents. Is it because they feel they can get away with it as the Ontario Provincial Government doesn’t care if their residents pay an arm and a leg for their insurance or they admit to being the most dangerous city in entire North America, full of unethical residents as the insurance companies make us out to be? That is an insult to all the people living in GTA and the people who work hard to protect these cities.

Free Health care means nothing if you end up paying so much for the Auto Insurance as you are still burdening people with large insurance costs.

A substantial portion of the people don’t have adequate money for their retirement in Ontario and it will not be unreasonable to say that a large portion of their money that they could have contributed towards their retirement was taken away in these heavy insurance premiums over their lifetime.

We do not want a 10-15% discount for our insurance but we want FAIR and HONEST rates which are legitimate and comparable with other cities in North America(which should be atleast half of the current rates). The same Insurance companies operating in the other markets charge much lower premium rates.

 If someone has committed insurance fraud you penalize that person and not punish the entire city/province for it.

So it is our urgent request to form a Powerful Action Committee that studies the rates across comparable cities in North America and compare them with the rates being charged here.

Also, audit the books of the insurance companies operating out of GTA to see how much their earnings are in GTA versus the other regions that they are operating in and then come up with a strong policy on Insurance Premium Rates.

It is very important and essential for you to take action to keep the trust of your residents who continuously feel let down and disappointed when it comes to their Auto Insurance.

Sincerely,

To:

Stephen Harper, Kathleen Wynne, Elizabeth Dowdeswell, Jim Wilson; Mayors of GTA & MPPs of Ontario

New Policy for Reduced/Fair Auto Insurance Premiums in GTA/Ontario 

 

Sincerely,
[Your name] 

Source: http://www.change.org/p/stephen-harper-kathleen-wynne-elizabeth-dowdeswell-jim-wilson-mayors-of-gta-mpps-of-ontario-new-policy-for-reduced-fair-auto-insurance-premiums-in-gta-ontario

 

Bill 15 – New Auto Insurance Legislation

Bill 15, introduced in the Ontario Legislature on July 15, 2014, is a combination of two earlier bills which died with the spring election call. You can read Bill 15 in its entirely at:

http://www.ontla.on.ca/web/bills/bills_detail.do?locale=en&Intranet=&BillID=3007

It is divided into 5 areas, being amendments to the Consumer Protection Act, the Highway Traffic Act, the Insurance Act, the Repair and Storage Liens Act and the Financial Services Commissions Act.
Key points are:

• the right to sue for disputed Statutory Accident Benefit Schedule claims will be eliminated
• both insured persons and insurers have the right to apply to the Licence Appeal Tribunal to resolve disputes
• much will still be left for regulations to be drafted at a later date, including transitional rules and opting out rules for the arbitral process
• there are provisions to “grandfather” the existing Financial Services Commission of Ontario mediators and arbitrators as it relates to pending disputes, even once Financial Services Commission of Ontario is disbanded

Bill 15 was introduced at the same time as auto premium rate announcements were made and the news wasn't good for the Liberals who had promised an 8% reduction in auto insurance premiums by August of 2014. Premiums are only down 5.44% since the government promised the 15% reduction. One insurer, Security National, was just approved for a rate hike of 4%...not the direction the government wants to see.

With the Liberal's now enjoying a majority, extreme pressure to fulfill the promise of a 15% rate reduction by August of next year, and much of this having been previewed and debated a few months ago, don’t look for a lot of debate on this legislation. This bill will likely be fast tracked, without public hearings. It is possible this bill will be pushed through by Labour Day, depending on how long the legislature sits this summer.

Source:  http://www.jdsupra.com/legalnews/bill-15-new-auto-insurance-legislation-03753/

Canadian Insurance Companies Can Legally Practice 'Genetic Discrimination'

July 18, 2014 // 04:05 PM EST

Right now, in Canada, there's a battle going on for its citizens' genes, as health insurance companies are using genome sequencing to assess risk (read: increase rates) for patients who are predisposed to certain diseases. 

The country's privacy commissioner issued a policy statement last week saying that the government would really appreciate if health insurance companies left genetic testing out of whatever actuarial algorithms they're using, but hasn't banned the practice outright. 

While Canada has universal health care that's highly subsidized by (and often free for consumers), there are still plenty of private insurers. And, right now, the country's health insurance industry has instituted a voluntary moratorium on asking people to specifically undergo genetic testing when they apply for coverage. But that doesn't mean it never happens—it just happens in a different way. If a person has already undergone genetic testing in the past, insurance companies will regularly request that data from a prospective client's doctors.

"If genetic testing has been done and the information is available to the applicant for insurance and/or the applicant’s physician, the insurer would request access to that information just as it would for other aspects of the applicant’s health history," the Canadian Life and Health Insurance Association stated as its official policy on the issue. 

The practice sets a pretty scary precedent that some have worried about for years—what happens when and if a baby is genetically tested at birth and is determined to be a risky investment for an insurance company? Some countries, including the United States have (sort of) already banned the practice, but there's still no law against it in Canada. 

“Some of these tests—as time goes on, and now—are important indicators with respect to risk,” Frank Zinatelli, a lawyer with the CLHIA, told Canada's Globe and Mail. “So yes, we feel it’s important to be able to have access to those types of information.”

An insurance company flak would say that. There's no denying that knowing whether someone is predisposed to having Alzheimer's or Parkinson's or certain types of cancer is valuable information for an insurance company. It's, perhaps, the most important thing an insurance company can learn about a person, from a business standpoint. 

It's also why the United States, a country that seemingly protects its citizens' privacy much less than Canada does passed a ban on genetic discrimination back in 2008. There are loopholes in that law, sure (it only covers health insurance and employment, not life insurance), but it's better than any sort of "voluntary moratorium," especially when the industry is champing at the bit to expand the practice. Meanwhile, a bill that would actually ban genetic discrimination has been sitting in Canadian parliament since October, with little indication that it's going to move forward.

Source: www.parl.gc.ca/LEGISInfo/BillDetails.aspx?Language=E&Mode=1&billId=6257110

 

Shielding doctors from the consequences of their actions isn’t fair to patients and won’t improve health care

By Alan Shanoff, Toronto Sun

First posted: Saturday, July 19, 2014 07:00 PM EDT 

 

The use of so-called “black boxes” to document surgical procedures is long overdue.

A 2012 study estimated about 40,000 Canadians die each year due to medical errors.

The actual number of medical-error induced deaths is likely much higher due to a lack of adequate reporting.

Almost 50% of all hospital adverse events take place during surgery, according to a 2007 study.

So it is comforting to see Toronto’s St. Michael’s Hospital has installed and is using video and audio recording equipment to document surgical procedures.
Other hospitals should follow suit.

This will allow analysis of surgical techniques and permit hospitals to take steps to avoid errors.

Clearly, this has great potential provided hospitals are willing to take the time to analyze the recordings and educate surgical teams on best practices.
Doctors are concerned the recordings may be used as evidence in malpractice lawsuits.

The doctor who introduced the recording system to St. Mike’s has been quoted as saying, “If we choose to use it as a tool to place blame and to point fingers at surgeons for litigation, I think this will never take off.”

That is a misguided view.

If there’s an adverse event during a surgical procedure why shouldn’t we use the best possible evidence to assess liability?

Why should we force courts to rely on notes and recollections, often faulty and incomplete, to determine what took place when we have an accurate recording?
Using a recording as evidence should simplify matters and make it easier to determine fault, thereby reducing trial duration.

Better yet, if the recording makes it clear someone made an obvious error there’s no reason why the hospital shouldn’t enter into an early settlement, thereby saving everyone a great deal of money.

It seems our laws are set up in an effort to insulate hospitals and doctors from adverse publicity and lawsuits

While we pass laws superficially intended to enhance patient safety, the reality is the laws protect hospitals and health care professionals from litigation and shield them from having to disclose embarrassing information.

The best example of this is the Quality of Care Information Protection Act.
This legislation places restrictions on the release of any information collected by or prepared for a hospital’s quality of care committee.

This is the legislation that allowed Humber River Regional Hospital to keep secret information on how a baby was wrongly declared dead in February, 2013.
It is also being used to throw a cloak of secrecy over the June suicide of Prashant Tiwari, while under 24-hour surveillance at Brampton Civic Hospital.
Quality of care information is not available under freedom of information legislation and even if disclosed is not admissible in any court proceeding.
Hospital administrators attempt to justify such secrecy legislation, arguing that without assurances of confidentiality candid reviews would not take place.
But what does that say about hospitals and doctors?

That they are more interested in protecting themselves and their colleagues and would compromise on honesty and patient safety?

We also have section 36(3) of the Regulated Health Professions Act, which bars the use of any information obtained as a result of a complaint to the College of Physicians and Surgeons.

Even findings of wrongdoing are inadmissible in court proceedings, making it difficult for victims of malpractice to pursue civil claims.

These laws portray hospitals and health professionals in the worst possible light.
They send the message it is more important to hush up malpractice than to provide justice or improve patient safety. We have a fault-based system of civil liability for medical errors.

We hold hospitals and health care professionals accountable for their negligence, believing such accountability will lead to behaviour modification to improve patient safety.

Yet we have created laws to shield hospitals and health care professionals from being held accountable.

These shield laws must be eliminated.

All hospitals should be forced to use black boxes to record surgical procedures, regardless of how the recordings are used.​

Source: http://www.torontosun.com/2014/07/19/shielding-doctors-from-the-consequences-of-their-actions-isnt-fair-to-patients-and-wont-improve-health-care

Toronto-area rehab clinic convicted of fraud, fined $200,000 plus restitution

A Toronto-area rehabilitation clinic has been convicted of several auto insurance fraud-related offences and has been fined $200,000.


Ontario Rehab Centre was charged following co-operative investigations involving the Financial Services Commission of Ontario (FSCO), the Insurance Bureau of Canada, multiple insurers, and the Toronto Police Service.
The conviction resulted from an investigation into a staged accident ring called “Project Whiplash.” According to IBC, insurers paid out an estimated $4 million in fraudulent claims as a result of the scam.

The clinic was charged with two offences under the Insurance Act including:

• Knowingly making false representations to State Farm to obtain payments for services provided to auto insurance claimants; and 
• Charging amounts to State Farm for the payment of services that were not provided.

The Ontario Court of Justice found the clinic guilty on both counts and imposed the maximum fine of $100,000 on each of the charges, for a total of $200,000 in fines, FSCO reported in a statement Wednesday.

The court also ordered that the clinic provide restitution to State Farm for amounts that were proven to have been falsely billed and paid, totalling $609,112, FSCO noted.

In a separate statement Wednesday, IBC noted that Justice of the Peace Mark Conacher commented that it was “particularly egregious” that the clinic used of the names and credentials of practitioners long after they had left the company, because of the potential to hurt the reputation of the health care providers.
“These are fraudulent acts that jeopardize the integrity of our healthcare system, drive up premiums, take valuable time from emergency services, tie up the courts and cost everyone,” Rick Dubin, vice president of investigative services at IBC said in the release.

“Criminals need to be brought to justice. The cooperation between police, IBC investigators, individual insurance companies and FSCO helped make this possible.”

Source:  DAILY NEWS Jul 23, 2014 1:11 PM http://www.canadianunderwriter.ca/news/toronto-area-rehab-clinic-convicted-of-fraud-fined-200-000-plus-restitution/1003171496/?&er=NA

Anti-fraud bill a mirage

Ontario government’s latest auto insurance legislation doesn’t do what it’s supposed to do

 By Alan Shanoff, Toronto Sun

First posted: Saturday, July 26, 2014 12:57 PM EDT | Updated: Saturday, July 26, 2014 09:13 PM EDT

Ontario has made significant changes to the auto insurance system

 - capping benefits and streamlining the process - 

but it’s not yet clear what impact that’s had on limiting fraudulent claims.

 

Ontario’s Bill 15 has a strange title.

The title, Fighting Fraud and Reducing Automobile Insurance Rates Act, 2014, is strange because this proposed legislation doesn’t refer to fraud anywhere in the body of the bill save in references to the title of the proposed legislation.
Then again why pass up the opportunity to propagandize?

Upon introduction of the bill earlier this month the Ministry of Finance announced, “Ontario is moving forward with its plan to help reduce auto insurance rates, by introducing legislation that would, if passed, protect the province’s nine million drivers and fight fraud in the auto insurance system.”
But there’s nothing in the bill that fights fraud in the insurance system.
Worse, there’s little in the bill that would protect drivers.

Indeed, there’s much in the bill that would harm drivers, especially those injured in auto accidents.

Let’s start with the manner in which no-fault accident benefits disputes are handled.

Currently such disputes may be dealt with via arbitration or through court action.

Bill 171 will remove the option of court action.

It’s hard to see how removing the right to pursue claims before a judge will help drivers.

Paradoxically, this move will cause legal costs to increase as claimants are forced to pursue two separate claims.

Ontario drivers are subject to a hybrid or dual auto insurance system.

Those injured in auto accidents may pursue a tort or negligence claim (although that right has been curtailed as a result of previous legislation), as well as a claim for no-fault accident benefits.

Currently, lawyers often combine both in one lawsuit.

But following passage of Bill 15 lawyers will be forced to pursue two different proceedings, a court proceeding for the negligence claim and an arbitration proceeding for the accident benefits claim, thereby resulting in higher costs.
At the same time accident benefits claim disputes will no longer be handled by the expert arbitration staff at the Financial Services Commission Ontario.
Bill 15 would see the elimination of all mediators and arbitrators employed by FSCO.

Disputes will be handled by Ontario’s Licence Appeal Tribunal, a body that currently decides cases with no relation to the complex accident benefits issues seen daily by FSCO arbitrators.

FSCO arbitrators have many years of experience handling accident benefit disputes.

They are full-time, unionized public sector employees who are seen to be independent and are highly respected.

LAT members are part-time (other than the Associate Chair), appointed for temporary terms, receive per diem rates (other than the Associate Chair), and are government appointees.

Reappointment is at the pleasure of the Ontario cabinet, so they cannot be seen as independent.

While there’s nothing to stop cabinet from appointing some former FSCO arbitrators to the LAT roster, there’s also nothing to stop cabinet from cherry-picking from among the FSCO arbitrators to eliminate arbitrators whose decisions have displeased the insurance lobby.

Prejudice

Bill 15 contains two other provisions that will prejudice those injured in auto accidents.

Currently arbitrators have the power to penalize insurers who act unreasonably in withholding or delaying benefits.

They can award a lump sum of up to 50% of the amount withheld or delayed along with interest at the rate of 2% compounded monthly.

Bill 15 eliminates that power.

In addition, Bill 15 would reduce the amount of interest insurers are required to pay on money owed to accident victims.

That surely won’t serve to speed up settlements, with insurers given an incentive to delay payments.

Let’s not kid anybody.

Bill 15 is mainly about saving money for insurance companies to help them reduce premiums, so as to assist them in achieving the government’s promised 15% rate reduction.

But even if we achieve this 15% savings in auto insurance rates there’s nothing to stop insurers from increasing premiums on their other products, including property insurance, which is not subject to government regulation.

If you don’t believe me, just take a look at your next property insurance bill.

Source: http://www.torontosun.com/2014/07/26/anti-fraud-bill-a-mirage?token=9667a0c820d1bcf13e1e96439ef93b68
 

Make all complaints about Ontario doctors public: trial lawyers

Only the most serious grievances are made public by medical watchdog CPSO. The Ontario Trial Lawyers Association believes that making all information available will allow patients to make informed choices.

Medical malpractice lawyer Paul Harte would like to see information on all complaints to the CPSO made public. 

By: Theresa Boyle Health, Published on Wed Jul 30 2014

 

All complaints against doctors should be made public after they have been dealt with by the province’s medical watchdog, according to the Ontario Trial Lawyers Association.

“Patients should have as much information as possible about who they want to go to for their health care. The problem with the current system is that the patient isn’t being given the information to make her own choice,” said Steve Rastin, president of the association, members of which include lawyers representing patients in medical negligence cases.

The College of Physicians and Surgeons of Ontario makes public on its online register only complaints that end up being referred to the regulatory body’s discipline committee.

These are the most egregious complaints, dealing, for example, with allegations of serious medical error or abuse. They can lead to findings of misconduct or incompetence and in some cases doctors can lose their licenses.

But last year, they represented only 2 per cent of the 2,294 complaints investigated by the college.

Medical malpractice lawyer Paul Harte said information about the remaining complaints should be made public as well, once the CPSO has decided what action to take on them.

Other actions the college can take include “cautioning” doctors, ordering them to take continuing education and entering into agreements that would see, for example, doctors restrict or cease practising.

Hospitals aren’t even automatically informed of complaints made to regulatory colleges about health professionals and the Ontario Hospital Association wants that changed. Currently, it’s up to health professionals to annually self disclose to hospitals where they work if they have run into trouble.

Dr. Ved Tandan, president of the Ontario Medical Association, which represents the province’s 25,000 doctors, said the OMA is participating in an ongoing “transparency project” with the CPSO on how much information should be made available to the public and hospitals.

“There is always room to re-evaluate the level of transparency and we are happy to have those conversations,” Tandan said.

But he said that complaints found to have no merit by the CPSO should not be passed along to hospitals: “There are many complaints that don’t move forward that have no bearing on patient care, on quality or on safety and we are not clear on how that information is going to help hospitals provide safer high-quality care for their patients.”

Harte, on the other hand, said the public should also be made aware of those complaints that the CPSO decides to take no action on because it deems doctors’ conduct or care to be appropriate. These category of complaints amounted to 59 per cent of all those investigated last year.

“If there is a doctor who has got 50 complaints and all of them resolved without any kind of negative disposition, it is still useful information to the public. Here is somebody who evidently has problems dealing with patients,” Harte charged.

But Harte agreed that those complaints that the CPSO doesn’t even investigate because it finds them frivolous or vexatious should not have to be made public.

CPSO registrar Dr. Rocco Gerace said legislation introduced last week by the province, the Safeguarding Health Care Integrity Act, would go part way to making it easier for the college and hospitals to share information about doctors, but he said it does not go far enough and he would like to see amendments made.

On Sunday, the Star reported that the CPSO has ordered the former chief of Humber River Hospital Dr. Jack Barkin to be orally cautioned “to avoid future difficulties” in caring for patients like an elderly man who died after being under his care last year.

Hospital officials said Barkin was forthcoming about the caution, but did not answer repeated questions about whether he had told them about a history of complaints that saw the college previously take action against him.

Source: http://www.thestar.com/news/gta/2014/07/30/make_all_complaints_about_ontario_doctors_public_trial_lawyers.html

 

Hospitals want to know about all complaints against MDs, nurses

If patients complain about health professionals to regulatory colleges, hospitals want to be informed, the Ontario Hospital Association says.

By: Theresa Boyle Health, Published on Tue Jul 29 2014

 

Hospitals should be automatically informed when health professionals working there have been the subject of complaints to their respective regulatory bodies, the Ontario Hospital Association says.

Currently, health professionals are required to self-disclose to hospitals whether their self-regulatory colleges have taken action against them in response to complaints.

But the province’s medical watchdog, the College of Physicians and Surgeons of Ontario, has acknowledged that doesn’t always happen.

Michael Green died after a minor, elective surgery at Humber River Hospital, triggering a complaint to the College of Physicians and Surgeons of Ontario and an oral caution to the physician in his case. 

The OHA, an umbrella group for the province’s 145 hospital corporations, isn’t just interested in knowing when regulatory colleges take action; it wants to know about complaints even before findings have been made.

And it wants this information for all regulated health professionals working at hospitals, including doctors, nurses and pharmacists.

“Regulatory colleges, including the CPSO, should notify hospitals when a complaint has been lodged against one of the hospital’s regulated health professionals, and inform hospitals as to the outcome or decision as it relates to such a complaint,” said an OHA statement emailed Monday by Akilah Dressekie, a public affairs specialist with the organization.

“Hospital leaders are always looking for ways to improve quality and one way to do that is to enhance the reporting mechanisms in place for both doctors and hospitals …. Access to this information is necessary in protecting patients, and ensuring quality of care,” the statement continued.

On Sunday, the Star reported that Humber River Hospital’s chief of staff, Dr. Jack Barkin, was ordered by the CPSO to appear for an oral caution following a complaint over his care of an elderly man who died nine days after minor elective surgery.

The 91-year-old patient, Michael Green, suffered a stroke on Aug. 10 last year, two days after Barkin performed a procedure known as a cystoscopy to dilate his urethra and unblock his bladder.

A decision by a CPSO committee that investigated a complaint by Green’s family identified problems with Barkin’s clinical care but did not say the urologist was responsible for the patient’s death.

In this case, Humber chief operating officer Barb Collins said Barkin had been forthcoming about the caution. But she did not answer repeated questions as to whether he was also forthcoming about a “previous history where the college has taken action with respect to prior clinical complaints,” which was referenced in the Green decision.

This history elevated the CPSO’s concerns about Barkin and contributed to its decision to orally caution him, “to avoid future difficulties.”

Humber said Barkin took a medical leave two weeks after the CPSO decision came down. He has also resigned as chief of staff, though it’s not quite clear when that happened.

The CPSO and some other self-regulatory colleges are in the midst of a “transparency project” aimed at giving patients more information about their health professionals. The CPSO is looking at posting on its public online register whether doctors have received oral cautions, have been ordered to take continuing education courses or have signed “undertakings,” for example to cease practising or to abide by practice restrictions.

Some critics — such as NDP health critic France Gelinas and medical malpractice lawyer Paul Harte — say the proposals for more transparency do not go far enough. At the very least, hospitals should be made aware of when doctors have run into trouble with the CPSO.

It would be easy enough to make this happen, they say. When doctors apply annually to renew their privileges to work at hospitals, they must submit proof from the CPSO that they are licensed to work in Ontario. They should also be required to submit to hospitals printouts of their history from the CPSO, Gelinas and Harte say.

(Currently, the CPSO only posts online whether doctors are scheduled for disciplinary hearings and whether those hearings have made findings of misconduct on incompetence. Disciplinary hearings are held for the most egregious of complaints — for example, very serious medical errors or abuse.)

Health Minister Dr. Eric Hoskins said he’s buoyed that the regulatory colleges are looking to make more information about health professionals available to patients.

“I understand that the CPSO is working with other health regulatory colleges on an initiative to make more information — including cautions — available to the public through their website. I have faith that the CPSO will continue to give careful consideration to this difficult question and I will be watching their work on this subject with interest,” he said in a statement.

“Ultimately, we remain absolutely committed to a transparent and accountable health care system and we will work with our partners to closely examine ways to build on this record,” Hoskins added.


Source: http://www.thestar.com/life/health_wellness/2014/07/29/hospitals_want_to_know_about_all_complaints_against_mds_nurses.html

Plaintiff-friendly impairment ruling survives judicial review

Divisional Court rejects insurer’s challenge over Glasgow coma scale

A Financial Services Commission of Ontario ruling that made it easier to prove catastrophic brain injury has survived a judicial review at the Divisional Court.

The insurer was trying to ‘rewrite the legislation,’ says Tammy Ring.

Last year, the Financial Services Commission of Ontario chose a broad definition of brain impairment and a more generous interpretation of the reasonable time period to test for it. The ruling is favourable to insurance claimants seeking a catastrophic impairment designation.

In Security National Insurance Co. v. Hodges, the insurance company argued Goderich, Ont., resident Manos Hodges’ score on the Glasgow coma scale, a tool used to measure unconsciousness, was inaccurate as it occurred after he had received drugs that affected his awareness.

The insurance company also claimed test scores obtained more than 24 hours after the accident were outside the rule requiring them within a reasonable time period.

But on the judicial review application, the Divisional Court made it clear it has no intention to set restrictions based on those factors.

“Security National submits that the legislative intent is to ensure that [Glasgow coma] scores with no prognostic value should not be used to determine catastrophic impairment. We do not agree,” the court said in its July 14 endorsement.  “That would turn a legal test into a medical test.”

The law says a Glasgow coma scale rating of nine or less within a reasonable time period after an accident denotes catastrophic brain impairment. The purpose of the test is to allow a person to make a claim for enhanced benefits, the court said, noting it’s far from a guarantee a claimant will actually get those benefits.

“The person will still need to show entitlement based upon his or her subsequent medical condition and the degree of impairment sustained. The legislative intent in providing [Glasgow coma] scores as a proxy measurement of injury is simply to weed out the weakest claims at an early stage,” said the court in a ruling issued by justices Edward Then, David Aston, and Alison Harvison Young.

“The legislature could not have intended that seriously injured individuals would fail to receive a catastrophic impairment designation simply because their [Glasgow coma] score was confounded by the severity of their other injuries or treatment.”

The insurer in this case was trying to “rewrite the legislation,” says Tammy Ring, the practice group leader of the plaintiff personal injury group at Lerners LLP who represented Hodges in the case.

“This is a legal test set out in the statutory acts and benefits schedule. What the insurer was suggesting was to change it basically into a medical test to impose other conditions, to look at CT scans or to find some other test that they thought was better suited rather than applying what the test was in the legislation.”

The court’s finding in this case is consistent with the way other courts and adjudicative bodies have dealt with the matter, she says.

Linda Matthews, counsel for Security National Insurance, says she can’t comment on the ruling as her clients have not yet made a decision on whether to appeal it. They have until July 28 to make that decision, she says.

Insurance companies may argue the decision will open up the floodgates for similar coverage applications, but that concern “has not been borne out,” says Ring.

“My understanding is that fewer than one per cent of all injury claims fall under the catastrophic test,” she says.

“So we’re not talking about a huge number of people but we’re talking about people who are really seriously hurt. It’s really important that these people get the access to benefits quickly.”


Source:Monday, 28 July 2014 08:00 | Written By Yamri Taddese http://www.lawtimesnews.com/201407284103/headline-news/plaintiff-friendly-impairment-ruling-survives-judicial-review
 

Medical malpractice in the media: the Toronto Star

In November 2013, OTLA submitted recommendations on the Draft Transparency Principles, proposed by the College of Physicians and Surgeons of Ontario (CPSO). In the submission, OTLA expressed the importance of patient safety:

“OTLA feels that the overriding concern in establishing and applying these transparency principles must be, first and foremost, the protection of the public and disclosure of information, not the protection of the physician’s privacy.”

Medical malpractice lawyer and OTLA Past President Paul Harte contributed to two articles recently published in the Toronto Star. Both articles address Ontario hospitals’ desire to be informed when their health professionals have been the subject of complaints. The current system requires these health professionals to self-disclose when their college responds to complaints with a finding of guilt and when disciplinary or punitive action take place. The Ontario Hospital Association (OHA), a group representing 145 hospital corporations across the province, believes that hospitals have a right to “know about complaints even before findings have been made.”

The Ontario Trial Lawyers Association feels that all complaints and findings should be made public on the regulatory colleges’ websites in order to ensure transparency and accountability.

You can read each of the articles here:
Medical watchdog issues secret oral caution to Humber River chief of staff

Theresa Boyle for the Toronto Star – July 27, 2014
Hospitals want to know about all complaints against MDs, nurses
Theresa Boyle for the Toronto Star – July 29, 2014


Source: http://otlablog.com/medical-malpractice-in-the-media-the-toronto-star/