Open Letter to Auditor General of Ontario

Re: Ministry of Health and Long-Term Care Misuse of Public Resources
June 7, 2016

Ms. Bonnie Lysyk, CPA, CA, LPA, MBA
Auditor General of Ontario
20 Dundas Street West
Suite 1530
Toronto, ON MSG 2C2

Dear Ms. Lysyk,

The Ontario Association of Cardiologists (OAC) is calling on you, as the chief observer of provincial government fiscal accountability, to immediately undertake a review of the Wynne government’s cardiac care spending, through the Ministry of Health and Long-Term Care (Ministry), and to report on what we consider to be the serious misuse of public resources.

As physicians and taxpayers, we are turning to you as a measure of last resort, having exhausted all avenues of reasonable discourse with Ministry officials. Our message to these officials has been clear and consistent. The Ontario government’s unilateral actions of 2012 and 2015 have resulted in a lower quality of care at higher cost and increased utilization. These actions threaten the long-term viability of the health care system.

We are asking you to examine two issues involving cardiac tests. These are the most glaring examples of poor management, having been left completely unregulated for decades, despite persistent calls by cardiologists to regulate them.

1. We believe that certain ambulatory cardiac rhythm monitoring tests were, and are being, inappropriately over-billed to OHIP. They have been paid for without question for a number of years, costing the system millions of dollars. This continues despite cardiologists’ urging the Ministry in July 2015 to put a stop to this practice. The government’s inactions have encouraged the proliferation of these inappropriate billings, wastefully increasing the cost of cardiac care while eroding its quality.

2. In October 2015, the Ministry unilaterally decided to waive the longstanding requirement for a qualified physician to be present during the performance of cardiac ultrasound services. Quite predictably, this action has boosted the profits of commercial labs almost overnight. These labs provide services without a physician being present, and without regard to the appropriateness of these tests. Worse still, this Ministry decision has unleashed a flurry of new commercial interests whose sole goal is to drive-up utilization and maximize profits, further burdening the limited provincial health care budget.

The people of Ontario need to be concerned that the Wynne government’s mismanagement of health care is resulting in higher costs and lower quality care. We therefore request that you review these ill-conceived decisions that endanger lives and the sustainability of cardiac care in Ontario.

Respectfully,

James Swan, MD,F.R.C.P.(C) F.A.C.C.
President
Ontario Association of Cardiologists

c.c. Hon Kathleen Wynne, MPP, Premier of Ontario
Patrick Brown, MPP, Leader of the Official Opposition
Andrea Horwath, MPP, Leader of the NDP