Every so often a government policy comes to the public’s attention that is so totally backwards, so obviously dangerous and wrong, that when it is inevitably overturned the celebration is dampened by a residual bewilderment at the lunacy that was.
So it is with the rules governing safety oversight and reporting at Ontario’s private health clinics, which received a desperately needed overhaul by Health Minister Eric Hoskins on Monday. Yes, we welcome the end of life-threatening government-enabled secrecy. But how could it ever have been otherwise?
Over the past several weeks, the Toronto Star’s Theresa Boyle has uncovered a series of grave safety failures at private clinics in the province, which both Toronto Public Health and the Ontario College of Physicians and Surgeons were aware of but did not report.
This is astounding when you consider the breadth and severity of the cases.
At a Toronto pain clinic, nine patients were infected with staph bacteria after receiving spinal injections in late 2012. Four developed meningitis, a potentially deadly condition.
No wonder: a Toronto Public Health inspection from that year revealed 170 deficiencies in infection control at the clinic, and yet patients were allowed to continue visiting the facility without any knowledge of the danger. Even the affected patients were kept in the dark; one woman learned the source of her debilitating epidural abscess only after filing a freedom-of-information request for the THP investigation results.
Meanwhile, three Toronto colonoscopy clinics have seen hepatitis C outbreaks since 2011, likely the result of tainted sedative injections. Both oversight bodies were aware that 11 patients contracted the liver-damaging disease, but neither said anything.
After all, they were not required to do so. Instead, until this week, the province’s absurd policy mandated the disclosure of health-code violations at restaurants and tattoo parlours, but not at health clinics, where the safety precautions are inordinately more complex and the dangers more diverse.
Finally, that unfathomable rule is no longer. Hoskins announced that he has told Ontario’s health-regulatory bodies that all investigation and inspection reports must be made public, part of a larger slate of well-judged changes to improve oversight and reporting at Ontario’s clinics.
“I see my top priority as minister as protecting the safety and well-being of Ontarians,” said Hoskins during his announcement. “An important part of that is them having access to information which is going to allow them to make the right decisions for their health and well-being.”
It was ever thus, but never more urgently than now. As our aging population places increasing demands on Ontario’s health-care system, the province will have to develop new tools, including out-of-hospital facilities, to bear the burden. But this will not work if patients don’t trust these facilities, or indeed, if clinics have no external incentive to become trustworthy.
Our health-care system will have to evolve along with our changing demographic reality. In the process, if Ontarians are to feel safe, and to be safe, transparency is the only way. Hoskins’ new measures close a despicable chapter in the history of Ontario health care — one that holds an increasingly important lesson about the profound cost of secrecy.