Thursday, April 01, 2010

On wrongful disclosures

All indications to date were that the Wall government's attacks on Saskatchewan's health care system would be aimed mostly at the public delivery of services, no matter how obviously flawed a move to privatize might prove. And sure enough, there's more news on that front today. But just to make sure nobody recognizes the health-care system by the time they're done with it, the Sask Party also seems to have decided to do away with patient confidentiality.

Here's Don McMorris' gratuitous shot at a patient who dared to speak up about his government's decision to stop funding chiropractic care:
Ms. Junor: — I can’t believe this minister can stand in his place and talk about prudent. If we’re talking about what’s prudent, they have no leg to stand on — last year’s budget, this year’s budget, absolutely ridiculous.

Mr. Speaker, from the time the minister announced the delisting of the . . . The implementation date was one week, seven days. Chiropractors today don’t know if they can refer patients for X-rays or to a specialist. That’s absurd. Mr. Speaker, chiropractors have agreements for services with SGI [Saskatchewan Government Insurance], WCB [Workers’ Compensation Board], and private insurance companies that end tomorrow and have to be renegotiated. Well we understand what he knows about negotiation, so perhaps he missed this.

Mr. Speaker, Ontario allowed a 6-month transition period, and Alberta allowed a 3-month transition period. Will the minister at the very least move the implementation date to July 1st to allow for a smoother transition?

The Speaker: — I recognize the Minister of Health.

Hon. Mr. McMorris: — Mr. Speaker, this question was asked a number of days ago regarding referral. The only thing that has changed, Mr. Speaker, is our government is no longer subsidizing a portion of the visits. If chiropractors referred in the past, they will be able to continue to refer into the future, Mr. Speaker. That doesn’t change.

What changes is the portion of subsidization that our government covers, Mr. Speaker. And it’s interesting. Some of the cases we’ve seen come forward, the one just recently in the media, the person was at the chiropractor about 130 times. There isn’t a province or state in the country that would cover that many visits, Mr. Speaker. We will cover, what we will cover . . . 12 visits, Mr. Speaker, for low-income as in Alberta and 10 in British Columbia, Mr. Speaker.
Now, presumably McMorris would be familiar with the fact that in addition to general principles of patient confidentiality, Saskatchewan also has a law making clear that personal health information generally can't be used or disclosed except with consent or for a valid purpose. And not surprisingly, "political gain" isn't included among the permitted grounds for breaching a patient's expectation of privacy.

And there are multiple points in yesterday's disclosure which raise reason for concern. McMorris' statement itself makes for a problematic disclosure of personal health information by the person ultimately responsible for the Ministry of Health. But there's also reason for question as to who found out about the patient's treatment history and how before passing it along to McMorris for public airing.

Meanwhile, in case anybody was wondering: no, the fact that McMorris didn't actually use the patient's name doesn't make matters any better. Personal health information is protected just as thoroughly when it's "identifiable" (i.e. can be linked to the patient's identity) as when it's actually identified by name. And that's for obvious reasons, as a statement that "the provincial Minister who deals with questions related to chiropractic care has a raging case of foot-in-mouth disease" reveals just as much information about the subject as one which mentions a patient by name.

In sum, we now know that under the Wall government, your personal health information is shared between you, your health care providers, and your Minister of Health and his political hacks to the extent it can be used to further the Sask Party's agenda. (Or at least, that seems to be the applicable standard for anybody who dares to criticize the government's policies.) Which may do wonders to help Wall's long-term agenda by undermining confidence in the public health care system - but surely makes for a reckless abuse of power on the Sask Party's part.

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