Important child-health bill died with Ontario’s election call

Posted on May 15, 2014 in Health Policy Context

TheGlobeandMail.com – News/Politics/Politics Insiders
May. 15 2014.   André Picard

When elections are called – as happened recently in Ontario – legislation that is under consideration dies on the order paper.

For the most part, this is appropriate: Government initiatives die with the government. In many cases, it doesn’t matter: The winning party can table a new budget and deliver on its campaign promises through the legislative process.

But sometimes stuff that really matters gets blown away in the political whirlwind, and risks being forgotten.

That is the case with Bill 135, also known as Ryan’s Law (Ensuring Asthma-Friendly Schools).

Ryan Gibbons, a 12-year-old student at Straffordville Public School, died on Oct. 9, 2012 after suffering an asthma attack during recess.

(Asthma is a disease of the lungs in which the airways become blocked or narrowed causing breathing difficulty. During a severe asthma attack, airways can be blocked completely, stopping the flow of oxygen to the heart and brain. People with severe asthma carry puffers that contain steroids to help control inflammation and beta2-agonists to open up airways when they have trouble breathing.)

The Grade 7 student did not have his puffer – potentially lifesaving medication – because it was locked in the school office. The family said teachers had repeatedly confiscated Ryan’s puffer, as per school policy.

This ridiculous policy – not allowing students to carry essential medications like asthma puffers, Epi-Pens, insulin, blood products, anti-anxiety meds and so on – is all too common in Canadian schools.

This wrong-headed “safety” measure is patronizing and sometimes deadly, as the Ryan’s tragic case underscores.

Let’s be clear: No child has ever assaulted or otherwise harmed another with an asthma puffer.

Ryan’s Law, a private member’s bill sponsored by Elgin-Middlesex-London Conservative MPP Jeff Yurek, called on schools to adopt “asthma-friendly” rules, including minimizing exposure to asthma triggers like dust, mould and animals, providing training to teachers to help them spot asthma symptoms and, of course, allowing students to carry their puffers.

The approach is very similar to Sabrina’s Law (An Act to Protect Anaphylactic Children), named in honour of Sabrina Shannon, who died in 2003 of a severe allergic reaction after eating fries in her school cafeteria in Pembroke, Ont. Among other things, that legislation allows students to carry their Epi-Pens.

Yet, puffers are still a no-no in many schools. That’s simply wrong.

Nicola Thomas, a professor in the health science faculty at St. Lawrence College in Kingston, Ont., has studied this issue for a long time. She notes that responding promptly is the number one factor in surviving an asthma attack that causes respiratory failure. That can’t happen if puffers are locked up, and if school staff don’t have adequate training.

More than 15 per cent of Canadian children have asthma. It’s the number one cause of school absence, and the leading cause of pediatric emergency room visits.

Asthma is largely perceived as benign but it can be debilitating, and deadly. About 250 Canadians a year die of the condition, many of them children.

It’s an issue that has to be a priority for schools. And given that they seem to lack the common sense to act on their own, it is quite appropriate for elected officials to bring about change through legislation.

Ryan’s Law had the support of all three Ontario parties but it was stalled in committee as members bickered over wording. (The proposed legislation calls on every child with asthma to have a treatment plan and there is disagreement about who should oversee this process, given that most schools no longer have nurses on-site.)

Surely, these bureaucratic quibbles can be resolved. After all, the 50 U.S. states have asthma-friendly school policies in place, and they work well.

In Canada, we seem to have forgotten that the health of children comes first. Policies vary wildly between school boards and even between schools. Legislation would ensure some consistency and minimum standards – at least in Ontario.

The real tragedy here is the foot-dragging that has gone about this issue for a generation.

Back in 1999, high school student Joshua Fleuelling died en route to hospital after suffering an asthma attack. The coroner’s inquest that followed generated a lot of media attention because it focused on how long it took for help to arrive. But the jury’s recommendations were wide-ranging and placed a lot of emphasis on prevention.

In response, the Ontario government convened an expert working group that drafted an Asthma Plan of Action, including making schools asthma-friendly.

The province even conducted a pilot project in 170 schools, and it showed the initiative helped students better control their asthma symptoms and, as a result, they missed less school and had lower healthcare costs. A win-win in public policy terms.

But, as is the case with so many health-related pilot projects in Canada, the program was never scaled-up. Instead the budget was cut and it died.

So children are dying. Again.

Surely, making schools asthma-friendly is an initiative on which all the parties can agree. They should all pledge to re-introduce and swiftly pass Ryan’s law when the next session of the provincial legislature resumes – regardless of who wins the election.

Schools can – and should – be made safer for the one in seven children with asthma, and it should happen promptly, before the return of classes in September.

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