Dave's great big disquisition

It was on the agenda as Private Member's Notice of Motion Number 15.

Sault MPP David Orazietti succeded today in convincing the Ontario Legislature to review the Northern Health Travel Grant program.

Here's the wording of Orazietti's resolution:

"I move that in the opinion of this House, the Legislative Assembly of Ontario should examine the northern health travel grant (NHTG) with a focus on reviewing the criteria and improving the services associated with receiving support from the NHTG, as well as enhancing the administration of the NHTG by simplifying its processing formula."

And here's the full text of the speech delivered by Orazietti on the subject today in the Legislative Assembly, which resulted in unanimous consent:

*********************** It's certainly my privilege to rise in the House today to speak to a resolution which is very important to the residents of Sault Ste. Marie and also to residents across northern Ontario.

This resolution concerns the northern health travel grant.

Mr. Speaker, several of my northern colleagues will also be speaking to this resolution: the member for Thunder Bay-Atikokan, Mr Mauro; the member for Thunder Bay-Superior North, Mr Gravelle; and the member for Algoma-Manitoulin, Mr Brown.

I want to thank my northern colleagues for their support of this resolution and for speaking to it this morning.

We have some veteran MPPs who know very well the issues related to the northern health travel grant and who have done an excellent job in past years advocating for this program, and this resolution continues to reinforce those efforts.

Before I begin discussing some of the more specific issues relating to the northern health travel grant, I want to thank Minister Smitherman for his support of this resolution and the Ministry of Health and Long-Term Care staff for meeting with me to discuss this issue.

I sent all members a letter briefly outlining this resolution on April 26, and I hope that members from all parties support this resolution, because it is truly a non-partisan issue. It's about access to health care.

What is the northern health travel grant?

It's a program that was created under the Peterson government to help reduce transportation costs to individuals who reside in northern Ontario and must travel long distances within Ontario or to Manitoba to receive medically necessary, insured specialty services that are not available in their local communities.

This program is absolutely essential to northerners.

It exists because of the incredible shortage of specialists in northern Ontario, and we have a shortage of family physicians as well.

Certainly in parts of southern Ontario and rural Ontario those difficulties are present as well, but when you look at the GTA and the shortages there, the shortages in northern Ontario are much, much worse.

It also exists because we must have equal access to health care for northern Ontario residents.

I don't think we need to spend much time arguing the merits of this program, because they are self-evident to anyone who has any understanding of issues facing northern Ontario residents when it comes to health care.

The northern health travel grant requires residents in the north to be referred by their doctor, dentist, optometrist, nurse practitioner, chiropractor or medical specialist to a health care facility that is at least 100 kilometres away from their residence.

The referral must be for services provided for under the Health Insurance Act, and the referral must be to a specialist certified by the Royal College of Physicians and Surgeons of Canada.

In northwestern Ontario this is a concern because many residents face the difficulty of traveling to a specialist in Manitoba, and the certification of foreign-trained physicians is such that they may be able to practise their medical specialty in Manitoba but may not be registered by the Royal College of Physicians and Surgeons of Canada, so it compounds the problem.

This is one of the issues we would like reviewed if this resolution carries, and perhaps some of the members from northwestern Ontario would care to speak to that this morning.

The northern health travel grant budget is approximately $25 million, and through this program each year approximately 161,000 applications are processed for medical services where individuals have had to travel over 100 kilometres for necessary medical treatment.

To put that in perspective, you're looking at a population in northern Ontario of 750,000 to 800,000 people.

If this were on a per capita basis, on a per visit basis -- now, we know that's not quite the case, because some of the 161,000 applications may have been by the same person multiple times.

But if it were on a per person basis, this would equate to about 20% of people in northern Ontario having to travel over 100 kilometres for necessary medical treatment. It's a significant number.

Of these 161,000 applications, about 100,000 trips are by northerners living in more isolated rural communities who have had to travel to larger northern Ontario communities for medical treatment.

Almost 24,000 of these trips are by northerners to southern Ontario destinations for specialty medical services.

About 15,000 of these trips are by residents living in northwestern Ontario to Manitoba. They can't even get the medical service they need in this province.

What are northerners accessing the northern health travel grant for?

The top five areas of referral for the northern health travel grant patients were ophthalmology, facility-based programs such as MRIs, internal medicine, orthopaedic surgery, and therapeutic radiology or cancer treatment.

So 161,000 visits, and these are people who are facing extreme health care challenges travelling over 100 kilometres.

The number of people applying for this grant is rising as the demographics in northern Ontario are changing rapidly, and a significant number of physicians in northern Ontario are attempting to retire from their practices, so we have an aging physician population in northern Ontario.

There are some key issues we need to address.

The northern health travel grant requires an individual to access a specialist who is the closest to their residence.

If we're talking about wait times - and our government is very committed to reducing wait times for essential care and treatment - it's very important that northern residents, and all residents of Ontario, see a specialist as soon as they are able to.

If the wait time to see the closest specialist is six months, and there is a specialist slightly farther away but the wait time may be a month or two, it simply makes sense to have that individual travel a little farther to see someone a little sooner.

It's in their best interest; it's in the interest of their health. This is an issue that needs to be reviewed in terms of the travel grant.

There are program eligibility requirements as currently set out - without getting into specifics about eligibility; I don't want to prejudge the review process and unfairly set expectations about the process - that need to be reviewed.

The northern health travel grant also requires individuals to meet the 100-kilometre limit or threshold.

To read the conclusion of Dave's Big Disquisition, please click here.