Dear Colleague:                                                          October 17, 2006.

‘Ontario's sad legacy of failure…'

- Dr. Douglas Mark, President, Coalition of Family Physicians of Ontario

A Prescription for Disaster:

During the past few weeks here in Ontario, we have witnessed the bizarre spectacle of a Premier telling the media that he was ‘caught off guard' by the ER crisis and a Minister of Health and Long-Term Care blaming everyone else he could think of for the failures of the Government of Ontario's ‘transformation agenda'. None of this comes as a surprise to us, however, for the sad reality is that the Coalition of Family Physicians of Ontario has been warning of the consequences of bad healthcare planning for over a decade. It is only now that many people finally seem to be waking up to the news that our healthcare system is in crisis. Obviously, with an election on the horizon, the Government of Ontario cannot afford to pretend anymore that everything on the healthcare front is under control and proceeding according to plan. Or, to put it another way:

‘The era of procrastination, of half-measures, of soothing and baffling expedients, of delays, is coming to its close. In its place, we are entering a period of consequences.'

- Sir Winston Churchill, November 12, 1936

A Brief History :

1987: The Government of Ontario bans ‘Balanced Billing' by doctors, an act which results in a wave of doctors leaving the province.

1991: The authors of the Barer-Stoddart Report convince governments all across Canada that the best solution to deal with increasing healthcare costs is to decrease medical school enrolment by 10 per cent. This short-sighted action dramatically cuts the supply of new doctors and sets the stage for our current doctor shortages.

1996: The Government of Ontario passes Bill 26, the Savings and Restructuring Act , a piece of legislation giving it unilateral powers to audit and punish doctors without due process. Angry and frightened doctors choose to leave Ontario in droves.

1997: The Government of Ontario gets the Ontario Medical Association to agree to the geographic redistribution of new medical graduates. This plan fails miserably and results in many new graduates again fleeing Ontario.

2000: Family Medicine withers under Primary Care Reform, a payment scheme advanced by the Government of Ontario in cooperation with the Ontario Medical Association, resulting in a huge drop off of medical students – as few as 25 per cent – choosing to train as family doctors.

2004: The Government of Ontario passes Bill 8, the Commitment to the Future of Medicare Act , which turns out to be the most offensive and coercive universal Medicare scheme outside of North Korea. Twenty per cent of Ontario's doctors seriously consider moving their practice out of the province as a result.

2005: Family Health Teams are announced for 150 sites amidst great fanfare by the Minister of Health and Long-Term Care, despite the fact that they appear to open the door to two-tier medicine in the province. A year later, many will refer to these as ‘Fictitious Health Teams' when they fail to materialize. While all this is going on, the Government of Ontario buries its head in the sand and effectively ignores the manpower crisis in ER departments across the province.

2006: The Government of Ontario passes Bill 56, the Emergency Management and Civil Protection Act , which threatens doctors with conscription in the event of a pandemic without any protection or compensation, as well as fines of $100,000 and a year in jail for every day that they fail to report for duty. And finally, after a long hot summer, ERs across the province announce one by one that due to inadequate pay and poor working conditions, many will have to consider closing their doors, thereby depriving the 1.5 million Ontarians without a family doctor of their last medical safety net. The Premier claims to be surprised at this latest turn of events, while the Minister of Health and Long-Term Care desperately engages in yet another exercise in damage control.

Our Prognosis :

Doctors and patients in Ontario have now entered that ‘period of consequences' Sir Winston Churchill alluded to, mainly because of the persistent mismanagement of our healthcare system by the Government of Ontario. And while the Coalition of Family Physicians of Ontario does not believe in playing the ‘blame game' the way the Minister of Health and Long-Term Care does, it is clearly time for those responsible for creating the present mess to accept the consequences of their ill-advised actions and do something about Ontario's sad legacy of failure in managing our healthcare system before it is too late. Otherwise, we will be left with little choice but to make the following prognosis:

‘When it comes to the actions of the Government of Ontario in dealing with our healthcare crisis, the doctors of Ontario can only say that it was…

Too little…too late…too bad!'

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