Social Policy in Ontario

Ontario ready to overhaul health secrecy law

Posted on July 1, 2015 in Health Policy Context

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TheStar.com – Life/Health & Wellness – Legislation will no longer let hospitals leave grieving families in the dark over what happened to their loved ones, health minister vows
Jul 01 2015.   By: Olivia Carville, Staff Reporter

A controversial law allowing Ontario hospitals to investigate medical errors in secrecy is about to be overhauled by the government.  The act will no longer grant hospitals the power to leave grieving families in the dark over what went wrong with their loved ones’ care, Health and Long Term Care Minister Dr. Eric Hoskins told the Star on Tuesday.

Changes to the Quality of Care Information Protection Act (QCIPA) include involving families in reviews of medical errors, giving families the right to call for an independent investigation into a medical mistake, and creating a public registry of all critical-care incidents that occur in Ontario hospitals.

Following a series of Star investigations into hospital secrecy under QCIPA, Hoskins last August called on an expert panel to review the act. The panel highlighted serious holes in the system and called for significant legislative changes.

On Tuesday, Hoskins told the Star the government would be implementing “every one of the 12 recommendations” made by the panel.  “I can’t imagine what individuals and their loved ones go through when a critical incident occurs in a hospital environment,” Hoskins said.  “If this government can help them understand what did happen, if we can respect them by involving them in the process, if we can do the absolute maximum in terms of sharing information to give them confidence that hopefully it will never happen again to anyone else, that’s the least we should be able to do for people in such tragic circumstances.”

Hoskins said he was seriously concerned by several issues raised in the review, such as the huge variation in how hospitals have been using the act, with some invoking it after every critical incident and others never using it at all.

He was also shocked by the patients’ perspective of the use of QCIPA and the “genuine feeling” that hospitals were not being transparent over medical errors or intentionally leaving them “outside the [review] process.”
There is a need to be “open and honest and human about admitting when mistakes happen, and they do,” Hoskins said.

“When we are honest about them and work hard to correct them, you get a better result. In the midst of a tragedy, that’s a better path to take. That’s what this is all about — it’s about finding a way to both be human in a tragic circumstance, but be responsible and accountable.”

Hoskins said he felt compelled to launch a review of the act after the Star exposed the plight of grieving families who have had to fight hospitals to discover the truth behind their loved one’s deaths, such as Rakesh Tiwari, whose 20-year-old son hanged himself under active suicide watch at Brampton Civic Hospital one year ago Friday.

Tiwari, who says he is still waiting for answers about what happened on the day his son died, told the Star he welcomed the minister’s announcement.  “This is a very good step in the right direction,” Tiwari said.

The quality-of-care act was brought into force in 2004 to allow health professionals to speak freely about medical errors in a closed environment, in the hope of preventing future incidents.

Last year, the Star revealed several internal hospital investigations that had been kept secret under the act — among them, cases involving a baby girl who was wrongly pronounced dead, a 33-year-old woman who died after being admitted to hospital with a toothache, and the Tiwari case.

Hoskins said the government owed it to these families and all Ontarians to implement these recommendations and strengthen QCIPA.

“We owe it to them to make sure we have created a process where they are provided with detailed information that not only allows them to understand what went wrong, but the steps that will be taken going forward,” he said.
Some of the changes were already underway with relevant health-care associations, Hoskins said, but recommendations requiring legislative amendments would not be in place early until next year.

“I have instructed the ministry to move as responsibly, but as expeditiously as possible on all this,” he said.

TOP FIVE RECOMMENDATIONS
The most significant changes that will come:

1. Develop clear guidance on when and how hospitals should use QCIPA to avoid the large variation in how the act is currently used.

2. Amend the act to ensure appropriate disclosure to patients and families following a critical care incident so they are fully informed about the results of a hospital investigation, including what happened and what measures would be taken to prevent future incidents.

3. Establish an appeal mechanism for the investigation of critical incidents so in circumstances where patients or families are not satisfied with a hospital review, they can request an investigation from an independent body, possibly the Office of the Patient Ombudsman.

4. Establish a publicly available database or registry that contains information about all of the critical incidents investigated in Ontario hospitals, including the type of incident, the causes and the recommendations to prevent future incidents.

5. Patients and families must be interviewed as part of the process of investigating critical incidents and then be fully informed of the results.

< http://www.thestar.com/life/health_wellness/2015/07/01/ontario-ready-to-overhaul-health-secrecy-law.html >

Tags: Health, ideology, mental Health, standard of living

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