To the Standing Committee on BILL #41:

Thank you for giving me the opportunity to present my concerns regarding Bill 41, the Patients First Act.  My name is Dr. Rohit Kumar and I have worked as an Anesthesiologist at Trillium Health Partners in Mississauga, Ontario for the past 10 years.  I am currently the Treasurer of the Professional Staff Association at Trillium Health Partners.

I would like to express my concerns about Bill 41 and the effects it will have on healthcare in Ontario.  Creating a better health care system is in the best interest of both the government and physicians as well as our patients.  Input and involvement from both parties is essential for success.  The Ontario Government is trying to transform healthcare delivery without consulting physicians.  Successful health care models ensure engagement from physicians and their expert input is valued in any health care change.  In communication with our Ontario Medical Association it has been made very clear that there has been no meaningful consultation with Ontario’s doctors surrounding Bill 41.  This is not surprising given the unilateral approach the current government has had towards physicians for the past several years.

I urge you to reconsider Bill 41 and stop its advancement until physicians have given constructive input and the necessary changes are made.  Bill 41 gives the Minister of Health and LHINs substantial powers.  Inspection of health service providers is an example of something that is unnecessarily invasive.  The legislation as it is written will permit inspectors to force doctors to provide access to patient records at their request.  This is complete invasion of privacy and if patients understood that their patient-doctor confidentiality could be breached, they certainly would not be in agreement.   There is absolutely no need for the LHINs to have access to patient records in order to manage the healthcare system.

This shortsightedness of trying to push Bill41 through without our input will lead to increased costs in health care without any of it helping doctors or other frontline healthcare workers who take care of patients every day.  It does not address the required funding for hospitals to increase their capacity nor does it reduce wait times for patients to see physicians or time to surgery from their initial consult.  As an anesthesiologist I see this first hand.

The creation of a new layer of sub-LHINs and all associated managers and staff will be very expensive and this money could be better spent to directly help reduce wait times and care at the front line.  The government has made it clear that they cannot increase the healthcare budget.  This implies that paying for the additional bureaucratic layers will come at the expense of direct patient care.  The Auditor General’s reports over the years have found that the LHINs have failed to meet their mandate of better integration of health care services.  Trying to integrate parts of the Community Care Access Centers into the LHINs will no doubt be a messy, complex and expensive endeavor.  Billions have been invested in e-health with no resultant effective system to share information between care settings.

It is very concerning to physicians that Bill 41 will give LHINs the ability to plan and direct where physicians can practice.  The fact that Bill 41 will require physicians to inform the LHIN when they open or close a practice, or take extended leaves or retirement is an unnecessary burden on physicians.

The Ontario Government must change course and once again collaborate with Ontario’s doctors to help tackle the incredible challenges that face our health care system today.   Ongoing unilateral action is disappointing and quite frankly, disrespectful to physicians.

I once again urge the Ontario Government reconsider moving ahead with Bill 41 until they collaborate with physicians and incorporate our expert input.   Ontario cannot afford to risk wasting billions of dollars on changes to our healthcare system that will not directly improve patient care but just create additional layers of bureaucracy.  By the time the impact of Bill 41 is assessed it will be too late.  The drastic reduction of medical school enrollment in the 1990’s had long lasting effects and the recovery from that was slow.   You must put a stop to Bill 41 and design a system that includes physician input and together we can create a system that will improve patient care in Ontario. We have been asking for fair treatment and Ontario’s Doctors would like nothing more than to collaborate in a fair and meaningful way.

Thank you,

Rohit Kumar MD, FRCP(C)

Anesthesiologist – Trillium Health Partners
Treasurer – THP Professional Staff Association
Site Lead – Pre-Operative Assessment Clinic MH/QHC
Lecturer – University of Toronto