Jerry Ford

Visit Jerry's website at http://www.ehwhat.ca/.

Human Rights Tribunal Update

On Wednesday March 28 I attended a focus group on accessibility for the new Human Rights Tribunal that is being developed.

The initiative seems to be a worthy one but there are a number of caveats that have to be applied. It would be more appropriate to have a lawyer comment on the overall process because of the greater insight into something that is so completely a legal initiative.

There is one glaring deficiency that needs to be broadcast far and wide if this legislation is to have any hope of being effective. The HRT envisions the start of a complaint being full completion of a quite extensive written document, and there is no intake process or support given to make this happen. They actually believe that everyone making a complaint has the ability to get this right.

In reality this process is a major barrier to all but those who are comfortable with this kind of task. There are a significant number of complainants who may react negatively even if assistance is offered, but the overwhelming majority will not be able to cope on their own.

I do not believe development of an intake function at the HRT level is the solution, but I am increasingly skeptical about provincial agencies ability to understand the needs of their constituents. The very fact that these barriers were not anticipated by HRT certainly adds credence to my position.

The real solution is utilization of advocates to assist complainants, which will put a huge burden on the various consumer groups but it is one that will have to be met if the mandate of the HRT is to be achieved. Ideally I would like to see a fee schedule in place so advocates could be hired using HRT funding, justified on the basis that this is merely an accommodation issue.

I do urge you however, to consider this problem and discuss it with a number of people to ensure fairness and equity prevails.

Jerry Ford
Email: jford@eagle.ca

PHYSIOTHERAPY DENIED

In September the Ontario government announced a new emphasis on knee and hip surgery, designed to relieve the backlog and get people back on their feet.

This is an admirable strategy, one that is long overdue. Reducing the queue for these important surgical procedures comes at a cost of course, but the Ontario Ministry of Health and Long-Term Care had the full support of the public in spending the money to achieve this objective.

After knee and hip surgery physiotherapy is incredibly important, and the government rightly decreed that physiotherapy would be made available. What they did not tell us is that the government has no intention of finding extra money for this physiotherapy. The Community Care Access Centres (CCAC's) that coordinate the delivery of healthcare across Ontario have been directed to use their existing physiotherapy resources to provide these needed services.

At first blush it does not seem like an unreasonable approach, until you learn that the waiting list for physiotherapy before this new government initiative was about a year. Now that future physiotherapy resources are going to be devoted almost exclusively to knee and hip replacement patients, everyone else requiring physiotherapy through their CCAC is now on a virtually permanent deferral.

There are two major facts about physiotherapy that need to be highlighted.

1. Physiotherapy is most effective when applied very early in the recovery process, the longer it is delayed the more difficult full recovery becomes.
2. Physiotherapy is not only for those recovering from injury or surgery, it is becoming increasingly evident that significant gains can be made in recovery from damage from stroke and chronic disease if physiotherapy is provided on a timely basis.

The strategy adopted by the Ontario Ministry of Health and Long-Term Care clearly recognizes the need for providing physiotherapy probably after knee and hip surgery. But why should it come on the backs of everyone else who needs physiotherapy from our health system?

This misguided policy has done nothing but change the pecking order of conditions for those people that require physiotherapy. If knee and hip surgeries have a priority and there has been no expansion in the available talent pool virtually every other physiotherapy request has been downgraded. It has done nothing but exacerbate a systemic problem that ensures several tiers of service levels exist within what is supposed to be a single tier health system.

We can only speculate about what the pecking order for service delivery is, but it is very clear to those of us in the queue that it looks something like this. High-profile problems get priority, particularly when they impact large numbers of people under 70 years of age.

The second tier of service delivery relates to lower profile but high-frequency items such as accident recovery, surgery and strokes. In all these cases physiotherapy is necessary to achieve satisfactory levels of recovery.

And then we move to the non-essential service area. Persons with a soft tissue injury or condition that requires physiotherapy for a proper recovery; all people for whom services can be deferred indefinitely while they can learn to live with their condition.

Lastly we have those people who are perceived to have no standing as full members of a modern Ontario; frail seniors and persons with permanent disabilities. These people are tacitly considered to be a burden on our health system and have quietly but effectively been marginalized by most sectors of our society.

What is going on? Using the Ontario health system as a political tool to manipulate public opinion has reached an all-time new low. And the people who carry the can, the people who feel the brunt of the changes, are those least able to protect themselves through alternative action because they lack the resources. They simply cannot afford the luxury of alternative actions.

This of course is not true for the people of the first and second tiers of our service delivery hierarchy. They have the resources (money) needed to develop alternative solutions to their healthcare problems, together with the skills and knowledge needed to make that happen. In short, you can remain healthy if you can afford it but woe to the person that must rely on the terminally ill healthcare system that passes for medical services in Ontario.

Tell us what you think, do you think physiotherapy would have made a difference in your health situation if it had been readily available? You think it can make a difference in your future health, helping you maintain a quality of life? We need to know what you think, send your comments to eh@ehwhat.ca right now!