TORONTO - Ontario hospitals may soon be required to release information to the public about how they're run, but the governing Liberals are turning a blind eye to new rules that will muzzle doctors from speaking out, critics charged Wednesday.
Under proposed bylaws drafted by the Ontario Hospital Association, doctors can't engage in any conduct that would adversely affect a hospital's "reputation or standing in the community" and must raise any concerns through proper channels.
Failure to do so can be grounds to suspend a doctor's hospital privileges.
"It is absolutely a gag order on doctors," said NDP Leader Andrea Horwath.
"At this point in time, what we want is more transparency. What we want is more accountability in the health-care system."
The controversy over the proposed rules comes as the government entertains the idea of making hospitals more accountable by subjecting them to Ontario's freedom-of-information laws.
Dr. Mark MacLeod, president of the Ontario Medical Association, raised the alarm about the new rules in a letter Tuesday to the province's doctors, saying the rules will "minimize physician input and influence" in hospital decisions.
It's the first set of bylaws in 60 years that weren't produced in collaboration with doctors, said MacLeod, an orthopedic surgeon in London, Ont.
"Hospitals are finding themselves under a whole new set of pressures, and we think it's important that physicians continue to have input into how hospitals are run and how hospital decision-making occurs," he said in an interview.
"It's not only that we feel that from a physician perspective, we know that that's something that our patients expect of us."
The OHA fired back Wednesday, noting the specific provision applies to all board-appointed professional staff at the hospital, not just doctors. It added there's nothing new in the bylaws that would supersede a doctor's ethical duties to patients.
"The OHA believes that it is reasonable for hospital boards to request that in return for the ability to access hospital resources, physicians should be asked to agree to a reasonable and balanced set of accountabilities," it said in a statement.
Health Minister Deb Matthews refused to wade into the debate over the OHA bylaws, saying it's up to hospitals to decide if they want to adopt them.
"I'm going to leave that to the OHA and the hospitals and the doctors," she said.
"This is the work of the Ontario Hospital Association. This is not the work of government or my ministry."
Given the public uproar over untendered contracts and expense abuses at eHealth Ontario, it's "absolutely outrageous" that hospitals are trying to imposed new bylaws that will silence physicians who could blow the whistle on waste, Horwath said.
The scandal over eHealth rocked the governing Liberals last summer after it was revealed that $1 billion was spent to develop electronic health records with very little to show for it.
"It is unacceptable, it is inappropriate and I certainly hope that the government's clear with hospital boards that they should not be implementing bylaws that put gag orders on docs," Horwath said.
Premier Dalton McGuinty said he wasn't familiar with the new rules, but will take a "good look" at including hospitals under FOI legislation.
"I think that in an era of heightened accountability and transparency, as part of an effort to ensure that our precious health-care dollars go as far as possible, we think there might be some real value to doing that," McGuinty said.
"So that is now something that we'll seriously consider."
The province's privacy watchdog has been pushing for the change since 2004, and the OHA came out in support of the idea last year.
"I don't know what the delay is," said Progressive Conservative critic Lisa MacLeod.
"Increasing transparency has not been the strong suit of this government when it comes to health-care dollars."
Universities were included in Ontario's freedom-of-information laws in 2006. Children's Aid societies were not and McGuinty said Wednesday he's not sure if he would include them in any future legislative changes.