Some young people who have grown up in a mix of broken families, foster homes and group homes deliver a report to the Ontario legislature Monday. Their lives often don’t turn out as well as those of other youth. They think legislators should know that.

About 15 years ago, I received money from a youth charity to give to a youth charity of my choice. I might have given it to groups I had already worked with or knew. But this was a chance again to ask the most basic question: Given all the kids who have needs, who needs help the most?

I asked the advice of people in foundations and other community groups. The most “disadvantaged” of the “disadvantaged,” they agreed, were kids from foster homes and group homes. What these kids needed was a chance, in their words, to “break the cycle” of a family history of poverty and abuse that often went back generations. Their best chance to do this? To go to university or college.

We’ve given out more than 140 scholarships in the years since.

Even when you know these young people’s stories, they strike you with surprise. Not so much the details of parents who have mental illness, alcoholism or drug abuse, but what the day-after-day, year-after-year implications of living with someone with those problems feels like. Yet many of these youth somehow — almost never without big setbacks — reach their last year of high school. Now they are thinking, hoping, dreaming, of university and a future that never was to be. This is their one-way ticket out.

We talk a lot now about the cost of post-secondary education. Imagine as a student trying to meet that challenge if your parents can’t help you out. If they aren’t around to use their contacts to get you a summer job. If there’s no home to return to in the summer even if it’s only not to have four additional months of room and board to pay for. But these youth find a way — big student loans, scholarships — because to them if they’ve made it this far, they’re not not going to go to college or university! This is their chance.

But for them things take longer. Switching foster homes and schools eight times in three years sets them back a year. To pay for college, they need to work a part-time job 20 hours a week, not 10. So they take one fewer course — this year, and next year too. They take a year off to work to save money. Their mother has a relapse. Even though their mother has brought to them little more than misery, she’s the only mother they have. So they leave school for a term to take care of her.

For these youth, without much beneath them to brace their fall when things go wrong — and they do in every kid’s life — the slide is farther, steeper and harder. If gap years and changing majors have made 25 the new 21 for many youth, real life has made it this way for them.

This is what their report speaks of. But first they had to go through some process. They decided if no one else was going to hold hearings for them, they would hold them for themselves, and tell their own story — and they did: for two days last November in the Ontario legislature. In doing so, they were supported by the office of the provincial advocate for children and youth. Their report rarely sounds overdramatized, almost always authentic — exactly what any legislator needs to make the right decisions.

Perhaps most remarkable are the group’s recommendations; or more accurately, their recommendation. In-care youth experience things at a young age things that many others never do until they’re much older, if at all. They make decisions for themselves — about what to eat, what to buy, when to go to bed — that only adults usually make. Yet the big decisions in their life — whether they need to stay with their parents or be put into care; who their foster parents will be; or when they are ready to fly on their own, finally and forever — none of these decisions they make themselves. They’re all made by others.

So their recommendation:

The Province of Ontario should recognize that the current system needs to fundamentally change to better prepare young people in care to succeed. [It] should work with young people in and from care and other stakeholders to complete an ACTION PLAN FOR FUNDAMENTAL CHANGE by November 2012 that addresses our concerns and goals.

The six other “In the meantime” recommendations, as they put it, are all written in smaller print. They talk, among other things, of raising the age for which youth receive extended care and maintenance from 21 to 25, and allowing youth to stay in foster care until they decide themselves when they’re ready to leave. I don’t know if these have merit, or their counter-arguments, or the best way to achieve the goals that need to be achieved. But I do know that the first recommendation, the only one written in big print, is right. Sometimes, it’s not just what you do, but howyou do it.

These youth created their own hearings, wrote their own report, and told their own story better than anyone else could. Now they need to be part of a working group that includes parliamentarians to write an action plan for their future. It’s theirlife.

Ken Dryden served as federal minister of social development under prime minister Paul Martin from July 2004 to February 2006.

< http://www.thestar.com/opinion/editorialopinion/article/1177432–mpps-should-heed-advice-from-youth-who-survived-the-care-system >

Ontario’s child welfare system needs fundamental change to address the isolation, vulnerability and abandonment experienced by too many children in foster care and group homes, says a groundbreaking report written by youth about their plight.

The report, based on unprecedented legislative hearings last fall by youth from the child welfare system, calls on the province and others to work with them to produce an action plan by November.

The goal is to make Ontario a better parent to roughly 8,300 children and youth in its care and make their transition to adulthood more secure.

The report being released Monday at Queen’s Park, says the government should act immediately to raise the age of financial and emotional support from 21 to 25; allow youth to stay in foster care beyond age 18; and declare a “Youth in Care Day” to raise awareness and reduce stigma.

The province should also develop ongoing health and education plans for every child and youth in care; collect and publish information on their experiences during and after they leave care; and create an online clearing house of information and resources for them, the report says.

“Every child and youth deserves to feel and know that we are loved and cared for,” says the report, based on almost 200 submissions from young people during two days of hearings last November. “We are vulnerable youth and need more than a system of policies for this to happen.”

The hearings arose from the youth’s need for “our parent — the province — to listen and to understand the struggles around leaving care.”

The trauma of their young lives, coupled with frequent moves in foster care leave too many ill-equipped for adulthood.

Just 44 per cent complete high school. As adults they are more likely to experience poverty and homelessness, suffer mental health problems and become involved with the criminal justice system.

Youth are counting on Ontarians to listen and act, said Wendy, 20, one of the hearing’s four youth leaders.

Her support from Durham Region Children’s Aid ends in August when she turns 21.

(As with the legislative hearings, only first names are being used to protect the youth and respect the often harrowing nature of their experiences.)

“I think people who read the report will begin to understand what the struggles are and how it can get better,” Wendy said in an interview.

“We were focused on the issue of leaving care (at age 18 and 21), but there are a lot of things that happen during care that affect what happens to you after,” she said. “It really starts from the day we enter care.”

Wendy, who was removed from her substance-abusing parents when she was 13, said she was “lucky.” She was only moved twice and is still living with her current foster parents who treat her like a daughter. Unlike most youth who leave the system at age 18 or 21 with no permanent family, she knows the love of her foster parents is unconditional and forever.

“I have not moved out, nor will I have to when I turn 21,” she said. “When I do move out, I always have them as a safety net to go back to if times get rough, or just to spend the night on the holidays.

“We need to look at how I got here,” she added. “For me it was a stroke of luck. But we can’t rely on a stroke of luck.”

The report, entitled My REAL Life Book, reflects six main themes of youth who addressed the hearings, including feelings of vulnerability, isolation and being “left out” of decision-making about their lives. The unpredictability of foster care and group home arrangements, the struggle when care ends, and the lack of one meaningful adult relationship to carry them into adulthood are also highlighted.

Lindsay, 20, who entered foster care with her younger sister in New Liskeard, Ont. when she was 14, said she is often overwhelmed by loneliness and isolation.

Initially, she thought life away from her addicted and abusive single mother would be better. And in many ways it was: Her foster parents provided love, stability and the expectation that she would go to university and become a successful adult.

But she said it felt odd to be excluded from her foster family’s vacations. And restrictions such as needing her Children’s Aid approval to go on sleepovers or ride in a car driven by adults other than her foster parents, always reminded her of her Crown ward status.

Like most youth in care, Lindsay moved out on the day she turned 18 when the province’s legal responsibility for her ended and her foster parents no longer received funding to support her.

“On my 18th birthday I woke up in my foster home and that night I went home to a completely different place,” she recalled of the student rooming house where she rented a room with the help of a modest monthly allowance from Children’s Aid.

Suddenly she was living on her own and juggling a part-time job while trying to complete Grade 12. Her grades slipped and she didn’t graduate that year. Her delayed transition to college wasn’t any easier and she dropped out after first semester. Although she is back in college now, her shaky start means she may not finish by next May when she turns 21 and loses all financial and emotional support from Children’s Aid.

Lindsay, one of seven youth who wrote the report, longs to go to university after college, but doesn’t know how she will manage unless the government acts on the report’s recommendation to raise the age of support to age 25.

As she says in the report: “All we’re asking for is for four more years. Four more years of care to find people who matter to us, who don’t fall into the circle of the unhealthy lifestyle we’ve been born into.”

Ontario’s Provincial Advocate for Children and Youth, Irwin Elman, released a research report earlier this year that showed the $26 million annual price tag to extend support to age 25 for youth in the child welfare system would be more than recouped through reduced jail and social assistance costs and increased tax revenue as they are better able to complete their education and get good jobs.

Over 40 years, the return on this investment would amount to $132 million in current dollars, the report said.

Elman says Monday’s report is an opportunity for the province to “do right by its kids.”

“We can move when we want to. I don’t think 60 days to appoint a panel and another 60 or 70 days to create a blueprint is too much to ask,” he said.

In a statement, Minister of Children and Youth Services, Eric Hoskins, called the hearings and the report “without precedent,” “groundbreaking” and “brave.” He will respond formally on behalf of the government Monday.

* Almost 17,000 of Ontario’s 3.1 million children are in the care of Children’s Aid Societies

* Of these children, the province is legal guardian to more than 8,300 Crown wards who have been permanently removed from their parents due to abuse or neglect.

* The average annual cost of maintaining a child in foster care is $45,000

* Just 44 per cent of youth in care graduate from high school

* 81 per cent of all Ontario youth graduate from high school

* 43 per cent of homeless youth have been involved with the child welfare system

* 68 per cent of homeless youth come from foster homes or group homes

* 82 per cent of children in child welfare have diagnosed special needs

Source: My REAL Life Book, Report from the Youth Leaving Care Hearings

< http://www.thestar.com/news/article/1177881–ontario-s-youth-leaving-care-hearings-call-for-fundamental-change-to-child-welfare-system >

Remember that warm and fuzzy ad campaign depicting doctors in white coats, sporting stethoscopes and smiles?

Doctors aren’t smiling any more.

That feel-good branding exercise, part of a year-long charm offensive by the Ontario Medical Association just ahead of fee negotiations, has faded from bus shelters. Now, doctors find themselves sheltering from a perfect storm that is branding them as the fall guys.

It’s not just the governing Liberals taking a hard line, but the opposition Tories demanding a blanket freeze and New Democrats wanting to make the rich pay. With public servants taking a hit, the healing profession is feeling everyone’s fiscal pain.

This time, the writing was on the wall before both sides even sat down at the table. Cabinet approved its final negotiating “mandate” in February for doctors — and teachers: No spending increases.

Doctors are paid about $11 billion; factor in teachers and other public servants with contracts up for renewal, and about $25 billion is at stake in negotiations this year — nearly one-quarter of total government spending. That’s why retreat is unlikely, lest the government’s deficit-reducing fiscal plan crumble.

Read more:How Ontario’s doctors get paid

Outgunned, the OMA deployed a secret weapon of its own: It hired the government’s guy.

As deputy minister of health in the last negotiations, Ron Sapsford helped craft the government line. After leaving in the wake of the eHealth scandal, he joined the OMA, rising to CEO last year.

Sapsford has changed chairs, but times have also changed.

Last time, the government was flush with cash and keen to win OMA support in a highly politicized drive to reduce surgical wait times and increase the supply of family physicians.

This time, doctors can’t complain of falling behind: payments have increased by 75 per cent since the Liberals took power in 2003. They remain the best-paid in the country (despite quibbling from the OMA and others, the data suggest our docs are tops when all payments are included for 2011).

This time, threats of another brain drain are contradicted by the quiet return of émigré doctors from the once-promised land of America, describing how private insurers won’t authorize treatments, patients don’t pay their bills, and malpractice premiums are punishing. Also, medical school slots have recently doubled with a clutch of new schools across Ontario, plus a surge in foreign-trained doctors.

This time, technological advances have bolstered the government’s case for fee reductions. Exhibit A is cataract surgery, which takes 15 minutes today compared to two hours in the past.

This time, expert opinion — and a strong all-party political consensus — is pushing to reallocate spending to long-term care and home care, freeing up acute care beds.

And this time, the government is being goaded by outside experts to hang tough. In his high-profile reported last February on public spending, economist Don Drummond warned, “Aggressively negotiate with the Ontario Medical Association for the next agreement.” In his annual report, Auditor General Jim McCarter complained that Ontario may not be getting value for money from special incentives for doctors.

Against that backdrop, Sapsford hasn’t been able to deliver any medical miracles for the doctors he once bargained against, but now bargains on behalf of. In frustration, the OMA walked away from the table last month.

Sapsford also faces a formidable opponent in Deb Matthews, the health minister whom he served for a few months before taking his leave. Matthews is not above demonizing doctors in public. She has artfully sugar-coated the freeze, which in reality amounts to cuts for some (since more than 550 new doctors every year will compete for that fixed pie).

Last week, Matthews went ahead with nearly 40 unilateral fee changes that achieved most of the government’s targets for this year. Now, she is inviting them back to the table to address the unfinished business for the next three years.

As for Sapsford, his OMA sought a private meeting with Premier Dalton McGuinty. But it was seen as an end-run around Matthews, his former boss. In the end game, the meeting never materialized.

And doctors aren’t smiling any more.

< http://www.thestar.com/news/canada/politics/article/1177718–cohn-why-ontario-s-doctors-won-t-win-fight-on-fees >

Every generation updates and renews the values that make us who we are. I once found it hard to truly understand what those in my grandfather’s generation meant when they spoke of making the ultimate sacrifice in wartime to allow their loved ones back home to live in a democracy.

Until, that is, I myself almost lost it all in a remote village in Afghanistan on behalf of the values that make us Canadian, values that I now see as under threat not by a foreign force, but by a domestic one.

Compared with others who did make the ultimate sacrifice in Afghanistan, like my friend Bill Turner, who took my place in the field, my story has been well publicized.

On March 4, 2006, I was part of the 1st Battalion PPCLI battle group in the tiny village of Shinkay, when during a meeting with local elders to discuss their needs for water, housing and education, an insurgent sneaked up behind our group and buried a crude axe in my skull.

Unconscious, I was taken to the base hospital in Kandahar, where I was stabilized for the flight to a U.S.-run hospital in Germany. Fast forward through 10 hospitals and today I am back living in Canada with the goal of proving wrong those doctors who said that I’d never walk again.

Every morning, I also wake up and count my blessings, as we all should, that I get to spend another day with loved ones. My wife Debbie has stood beside me like a rock, and my young daughter keeps giving me that jolt of energy that only kids can give their parents, and I need it more than most. We now have a son on the way.

Frequently, however, the newspapers bring clouds to my day. The Canada I went overseas to fight for was a tolerant and open society, always striving to do the right thing, and to bring to the world a sense that tomorrow can be better than today.

Today, though, the government in Ottawa seems to want to throw all that out the window. Stephen Harper’s vision of Canada seems to begin, and end, in the tarsands, and everything else be damned. Tolerance is redefined as applying only to anyone who agrees with that vision. Everyone else is “radical,” an “extremist,” or even included in his government’s new program battling terrorism.

This is an insult to those of us who have fought, and sacrificed for our country, against real radicals, real extremists and real terrorists.

When I read about ministers of the Crown attacking and smearing heroes like David Suzuki, who are trying to put us on a more sustainable pathway, I wonder what’s happened to Canada. I fear for the kind of world my daughter and son stand to inherit should we cave in to this oil-driven agenda. Not a good one, I am certain.

If my own story gives inspiration to others, and I hope it does, then it’s about exactly that — hope. I was given little chance of surviving, let alone thriving, and I’ve already half proven that wrong.

With determination, we can overcome all manner of adversity, and reclaim who we are both as individuals and as a people. We face this challenge now with Ottawa, with a government that is taking our country in the wrong direction, undermining the values that make us who we are. I am loath to have to admit to my children that the irreversible degradation of their planet continued on my watch.

Capt. (ret’d) Trevor Greene now lives in Nanaimo, BC with his wife Debbie and daughter Grace. They are expecting a son in June. The Greenes run a foundation to educate Afghan girls as teachers.

< http://www.thestar.com/opinion/editorialopinion/article/1177442–trevor-greene-from-one-battlefield-to-another >

Does anyone recall Stephen Harper’s pledge in the first line of the Conservative election platform Stand up for Canada back in 2006? “The time for accountability has arrived.” That became the Tory mantra in the dying days of the discredited Liberal government.

Harper used the words “accountable” and “accountability” no fewer than 10 times on the first page of the manifesto.

But 6 ½ years into Conservative rule even Harper fans have reason to feel queasy, looking back. The gap between promise and delivery grows by the day, along with secrecy and manipulation.

The Tories are still taking a beating for keeping Parliament in the dark on the F-35 fighter’s cost, which is closer to $25 billion than the $16 billion advertised. Meanwhile on Friday, Defence Minister Peter MacKay was again under fire for lowballing costs. He told CBC News last year that the nearly completed Libya mission had cost “under $50 million” by Oct. 13, but didn’t say the final tab would be $100 million.

This slipperiness with numbers is bad enough. But the Tories are also under fire, justly, for abusing the parliamentary process to push forward their agenda.

As the Star’s Tim Harper reports, Parliament Hill is in a lather as opposition MPs decry Tory efforts to push through a vast bill to implement the budget. The “omnibus bill” runs to 425 pages and touches on everything from environmental regulations to border security, employment insurance, immigration law and fisheries. It is so complex that MPs haven’t had time to scrutinize the Tory agenda to make sure it makes sense and is a prudent use of tax dollars. Still, the Tories refuse to break it up into smaller, manageable bills.

At the same time the Star’s Tonda MacCharles points out that trouble is brewing over the government’s tactic of letting individual Tory MPs put forward bills — known as private member’s bills — on hot-button issues. One controversially targets masked protesters, threatening heavy jail terms and fines. Such bills get less scrutiny, analysis and debate than government-sponsored bills. It’s another manipulative trick to spare the government grief.

This is political sleight-of-hand and message control, and it appears to be an accelerating trend. These shabby tactics keep Parliament in the dark, swamp MPs with so much legislation that they can’t absorb it all, and hobble scrutiny. This is not good, accountable, transparent government. It is not what Harper promised to deliver.

< http://www.thestar.com/opinion/editorials/article/1177328–stephen-harper-promised-accountable-government-but-hasn-t-delivered >

Ontario physicians are angered by the provincial government’s high-handed approach to fee negotiations. Perhaps it’s time for both sides to do the obvious: End fee-for-service medicine; put doctors on salary.

Originally, the pioneers of Canadian medicare assumed that doctors would become salaried employees of government. That’s what happened in Britain when its National Health Service was established after World War II.

In Saskatchewan, the storied birthplace of Canadian medicare, an established system of salaried rural doctors already existed when Tommy Douglas’s Co-operative Commonwealth Federation (the forerunner of the New Democrats) took power in 1944.

But Douglas’ CCF didn’t follow the British example. The reason was fierce physician opposition.

Self-employed doctors — and even many salaried physicians — preferred the piecework system known as fee-for-service, one in which practitioners are paid set amounts for each procedure or consultation.

In part, this was because doctors preferred to see themselves as independent entrepreneurs.

But in part, it was because fee-for-service gives doctors great leeway in determining their own incomes. To get more money, a physician need only see or treat more patients.

Eventually, Saskatchewan’s CCF government adopted the fee-for-service variant of medicare. That in turn became the model for the entire country when medicare went national in 1968.

In spite of doctors’ initial misgivings, fee-for-service medicare turned out to be a bonanza. They could still charge piece-work rates. But their payments were guaranteed by government.

Today, however, governments don’t want to pay as much. Over the years, they have gradually eroded physicians’ fee-setting autonomy

Ontario’s government, for instance, began by negotiating overall financial settlements with the Ontario Medical Association,leaving physicians to divvy up the pot.

But that proved unsatisfactory since it allowed the most politically powerful factions within the OMA to reap the bulk of the rewards. This in turn left some areas — particularly general practice medicine — woefully underfunded.

Then governments began to involve themselves in the nitty-gritty. Premier Dalton McGuinty’s Liberals initially used carrots, giving doctors extra bonuses on top of fee-for-service in those areas of medicine where the government wanted more done.

Now, the Liberals are using sticks, threatening to unilaterally remove some of the goodies they introduced in the first place.

In short, the government is doing its best — in a rather clumsy way — to treat doctors as employees, calling upon them to do more for less.

It’s the same message Queen’s Park is giving all of its salaried workers, from teachers to prison guards.

So maybe it’s time for both sides to face what is going on. So-called alternative payment schemes (such as paying doctors on the basis of their patient rosters) have already moved the system away from pure fee-for-service. Why not go the whole way?

Incidentally, salaried docs don’t do that badly. In Britain, a general practitioner can earn up to $131,000 for a 40 hour work week. And that’s just base pay. There’s overtime and merit pay on top.

There’s also a handsome, fully inflation-indexed pension plan and up to six weeks paid holiday annually — perks that Ontario’s self-employed doctors don’t enjoy.

Best of all, the entire pay packet goes to the physician. Overhead and office costs are covered by government.

The advantage for government is that it can manage the system it funds. The advantage for doctors is they can focus on medicine.

And patients? The evidence from Britain suggests they do just fine with salaried doctors.

< http://www.thestar.com/news/canada/politics/article/1177014–walkom-why-not-put-all-ontario-doctors-on-salary >

Linda McQuaig makes an important point in her column that high tuition fees for university students are a question of dogma, and not a necessity imposed by the global economy. She cites the example of Norway where tuition is free and students receive a stipend to cover living expenses. She mentions the good fortune of Norway to have “ample oil reserves — almost as blessed as Canada.”

The paradox is that Norway does not use the benefits of its oil reserves to fund the costs of government and of social programs, including education. Norway, like Alberta, has created a Heritage Fund to benefit future generations when the oil dries up, but the comparison ends there.

Norway’s fund, created in 1990 with a contribution of $400 million, is now valued at $573 billion. Alberta’s, created in 1976 with an initial contribution of $1.5 billion, has a puny $15.4 billion. Norway, unlike Alberta, invests its oil profits off shore to avoid the “Dutch disease”: short-term boom, high wage pressure and over-valued currency. Thanks to Alberta, it has become a Canadian disease.

The Norwegian government, with citizen support, has decided to fund its social programs with high levels of taxation. At the same time, as McQuaig indicates, Norway manages “to compete effectively in the global economy.”

Norway, using proportional representation and electing large numbers of women, has good forward-looking government. Canada does not. Norwegian students and citizens benefit, Canadians do not.

Larry French, Toronto

< http://www.thestar.com/opinion/letters/article/1175845–norway-using-oil-money-wisely >

Imagine being refused a job, an apartment or public service due to your race, disability or sex. How hard is it to enforce your human rights? Six years ago, the McGuinty government’s Bill 107 made controversial changes to human rights enforcement. You likely don’t know that a poorly publicized government-appointed independent review has asked the public if these changes make things better or worse.

Before Bill 107, you could take your case to the Ontario Human Rights Commission. Its job was to enforce the Human Rights Code, to investigate human rights complaints, to screen out frivolous or meritless cases and to try to negotiate settlements. If it decided a complaint had merit and couldn’t settle it voluntarily, its job was to publicly prosecute the case at theHuman Rights Tribunal.

Six years ago, to speed up a slow, backlogged system that needed reform, Bill 107 privatized human rights enforcement. It took the Human Rights Commission out of screening, investigating and prosecuting individual discrimination cases. It makes discrimination victims investigate and litigate their cases at the tribunal without the commission’s help.

Does Bill 107 make lives better for victims of discrimination? Far from it.

It created a huge void for discrimination victims by taking the Human Rights Commission out of individual cases. The government promised free lawyers for all claimants. Yet its new Human Rights Legal Support Centre only represents a fraction. Far too many unrepresented claimants encounter respondents (those accused of discrimination) armed with lawyers. The tribunal reports that 81 per cent of respondents have a lawyer at mediation but only 32.9 per cent of claimants have any representative when filing a claim.

The Liberal government promised human rights hearings within one year. The tribunal set a goal to achieve this in only 75 per cent of cases. Its average time to complete cases is 372 days, but most of those never have a hearing.

Individuals can’t themselves investigate and litigate complex systemic discrimination cases. The Liberals pledged that the stripped-down Human Rights Commission would effectively combat systemic discrimination by bringing public interest cases to the tribunal and intervening in individual cases. To date the commission has brought only one public interest case and intervened in only 73 of the thousands of individual cases. Also, the government hasn’t established the promised anti-racism and disability secretariats, ignoring its own legislation.

Liberals also promised more accessible human rights but instead created new barriers. A discrimination victim who wins at the tribunal risks having to pay thousands of dollars in legal costs if their win gets overturned by the court due to the tribunal’s own legal errors. Would a blind person likely take on the TTC today, to force it to call out bus stops, when the new Legal Support Centre is statistically unlikely to take their case, the TTC is ready to spend $450,000 on lawyers, and the applicant could be stuck with a huge court cost order because a win at the tribunal was based on the tribunal making legal errors?

The government said Bill 107 would address the backlog. Yet its transition process unfairly led 885 cases to vanish in the system.

Liberals promised fair hearings. Yet they gave the tribunal power to override legislation designed to ensure fair hearings and allowing it to pass controversial and complicated rules.

We hope this current Human Rights Code Review will recognize these amply-documented problems, and make strong recommendations to improve Ontario’s troubled human rights system. Many from equality-seeking communities want the government to keep its broken promises about Bill 107. They want the government to require the tribunal to obey legislation designed to foster fair hearings, and to restore the Human Rights Commission as a stronger public interest voice at the tribunal. Discrimination victims should be given the option of asking the Human Rights Commission to investigate and publicly prosecute their case if there’s enough evidence. Discrimination victims want results. They don’t care if they get it through hearings or through mediations.

Do you like the TTC announcing bus and subway stops, even if you’re sighted? Imagine if under this new human rights system, no one wanted to risk taking on big organizations like the TTC without the backing of a public prosecutor to win that and other accessibility measures. Is that the human rights enforcement system we really want?

David Lepofsky is a blind Toronto lawyer, activist for reforms for the rights of persons with disabilities, and twice successfully won human rights cases before Bill 107 to force the TTC to announce bus and subway stop announcements.

< http://www.thestar.com/opinion/editorialopinion/article/1175822–it-s-tougher-than-ever-to-enforce-your-human-rights-in-ontario >

Ontario’s doctors complain of being “deceived” by the Liberal government after several hundred fees paid for services were slashed to save $338.3 million this year.

Health Minister Deb Matthews announced Monday there would be 37 changes to the OHIP fee schedule, targeting hundreds of services provided by cardiologists, radiologists and ophthalmologists.

The doctors claim this will mean longer waits in emergency wards and for test results — and warn that patients could expect a harder time finding a family doctor or a specialist because of fewer physicians.

“Our doctors are the best paid in Canada,” said Matthews, whose gambit comes as the province’s bitter negotiations with the Ontario Medical Association, which represents 25,000 doctors, have stalled.

“Instead of another raise for doctors, we need a real wage freeze so we can invest in more home care,” she told a press conference at Toronto Rehab, a continuing-care hospital. “I was left with no choice.”

Dr. Doug Weir, the new president of the OMA, accused Matthews of not negotiating fairly because she has not moved from her initial bargaining stance yet now wants to slash $1 billion in fees and programs.

“Where I come from, holding your breath until you get what you want is not negotiating,” said Weir, who was on his first day on the job. “This is not a wage freeze, it is a cut.”

Matthews argues the OMA is looking for a $700 million boost and what is the equivalent of a 5 per cent raise for physicians, which works out to about $20,000 per doctor.

The OMA says this is false; they will take a two-year fee freeze and help find another $250 million in savings.

Weir, a Toronto child psychiatrist, said it is clear the government never had any intention of really negotiating with Ontario’s doctors.

“We have been deceived. In doing so, they have chosen confrontation over collaboration.”

The OMA has launched a $1.5 million print, radio, TV and online advertisement campaign in an attempt to arouse public sympathy.

While the doctors have promised not to stage a job action, such as a strike or working to rule, Weir predicted patients would feel the pain of the changes.

“Patients in Ontario, particularly seniors, will suffer from reduced access to medical care for blinding conditions like macular degeneration, glaucoma and diabetes,” he said, adding ultrasound and mammography waits could return to levels not seen for decades.

The changes, which affect several hundred of the 4,500 OHIP services, were filed Monday and are retroactive to April 1, said Matthews.

Insisting that she is choosing “seniors over specialists,” the minister stressed she still wants to work with doctors to hammer out an agreement.

“Our budget was explicit; we were looking for a real wage freeze. This comes as no surprise to doctors. I am hoping they will now come back to the table so we can continue to work.”

Weir’s predecessor, Dr. Stewart Kennedy, angrily denied on Friday that all the doctors want is a raise. They say this is a fight about the future of the health system as the boomer population rapidly greys and demands more services.

With 407 specialists billing OHIP more than $1 million each a year, the Liberals believe vast savings can, and must, be found as the province faces a $15-billion deficit.

Conciliation, first refused by the government but pushed for by the doctors, was agreed to late Friday. However, the Health Ministry placed a 48-hour time limit on talks, saying the OMA had until only Sunday night.

The doctors would not accept this, saying they would talk to Matthews about conciliation Monday.

She responded by regulating fees.

Payments for cataract surgeries will be cut to $397.75 from $441 — surgeries that took two hours in the 1980s now take 15 minutes, thanks to technological improvements. Fees for eye injections for retinal diseases will be cut to $90 from $189 over four years.

“Specialties have seen tremendous windfall profits because of enhanced technology. We need to share in some of those productivity changes. It is only appropriate we update fees to reflect reality,” said Matthews.

In some specialties, new technologies have boosted doctors’ pay to $700,000 a year on average, she said.

Payments for 250 different diagnostic radiology tests, such as X-rays, CT/MRI scans and ultrasound will be reduced by 11 per cent over four years.

Self-referrals — the practice of doctors referring patients back to themselves for additional procedures — will be curbed. Currently $88 million is spent on that, but the government wants that reduced to $44 million.

Matthews noted doctors’ pay has risen an average of 75 per cent since the Liberals were elected in 2003 — from $220,000 to $385,000.

Progressive Conservative Leader Tim Hudak supported her move to impose the fee cuts and to freeze the total compensation package for doctors because “something has to happen.”

But Hudak said he’d go further by introducing a bill soon to impose a mandatory wage freeze on all public-sector workers with “no exceptions, no special deals” instead of waiting for wage freezes to be negotiated.

Premier Dalton McGuinty told Hudak that wage freeze legislation is too provocative, saying “we’re not going out there looking for a fight.”

NDP Leader Andrea Horwath chastised the government for taking the “my way or the highway” approach and not engaging the doctors in a more meaningful dialogue.

“The patients have become the ping pong ball in this high-stakes game.”

With files from Rob Ferguson

• Fee per service for any combination of retinal disease or glaucoma will be reduced to $25 from $63, and service will be limited to four times a year.

• Fees for anesthesia for conscious sedation (colonoscopies, cataracts, etc.) will be reduced to a combined fee of about $60 from $120.

• Electrocardiogram fees are being reduced to $4.95 from $9.90.

• Complete colonoscopy fee is being reduced to $197 from $218.90.

• Payments for cataract surgeries will be cut to $397.75 from $441.

• Fees for eye injections for retinal diseases will be cut to $90 from $189, over four years.

< http://www.thestar.com/news/canada/politics/article/1174205–deb-matthews-slashes-fees-for-ohip-services-to-save-338-million >

Canadians with cancer, heart disease, diabetes and just about every other physical illness don’t think twice about going to their doctor for help. But, when it comes to mental illness just one in three affected adults and as few as one in four children seek and receive treatment.

For some, stigma and fear keep them from getting the medical care they need. Others desperately want treatment but can’t find the appropriate services in their community or face long waitlists. This is why Prime Minister Stephen Harper has called mental illness “a major national public health problem” and, in 2007, created a national agency to tackle it.

This week, the Mental Health Commission of Canada released its blueprint for a national strategy to properly treat and support Canadians with mental illness. The comprehensive document covers every aspect of what needs to change – from how employers and schools handle mental illness to the need for more affordable housing and a reformed justice system that doesn’t criminalize illness.

The danger now, though, is that rather than embracing the challenge, Harper may throw up his hands at the enormity of it all – and the seemingly high price-tag that comes with it. That can’t be allowed to happen. The status quo is not an option when one Canadian in five suffers some form of mental illness every year and it costs our economy more than $50 billion, according to the commission.

If Ottawa needs a manageable place to begin improving the lives of Canadians, why not start with our kids? In many communities, children and youth face the greatest shortage of mental health services. Resources spent on children have enormous impact. Early identification and treatment can save young people from a lifetime of challenges that come with untreated mental illness.

Without proper health services and community support, childhood mental illness can stress families to the breaking point. Children drop out of school, wind up in homeless shelters or, worse still, the prison system. Crown wards and First Nations youth are particularly vulnerable to this downward spiral.

Focusing on children will also teach everyone involved about the extraordinary level of cooperation and coordination that is required. This is not just a health problem. The solutions cross federal-provincial boundaries and run across multiple ministries, including health, education, social services, housing and corrections.

Breaking down those silos will require strong federal leadership. That, unfortunately, is not something this Conservative government has shown much interest in, especially in the health care.

When Prime Minister Harper launched this commission he promised “their work will improve quality of life for Canadians and their families dealing with mental illness.”

Whether that happens depends on what his government does now. So far, it isn’t looking promising. Health Minister Leona Aglukkaq welcomed the report and committed the government – not to action, but to yet more research.

The 6.7 million Canadians suffering with a mental health problem or illness deserve better than that.

< http://www.thestar.com/opinion/editorials/article/1175149–focus-on-children-first-in-tackling-mental-heealth >