Quebec Medical Specialist Moves his Struggle to the Political Level - Advocating for Academic Freedom and a Safe, Ethical, “Speakup” Environment in the Health Care Workplace

Sherbrooke, September 3, 2023 

Minister Christian Dubé 

Ministry of Health and Social Services 

Catherine-De Longpré building 

1075 Sainte-Foy Road 

Quebec (Quebec) G1S 2M1 

Subject: Law 15, Health Insurance Law, Law 32, protection of whistleblowers and rules of inclusion in Health 

Dear Minister, 

In light of recent articles published in The Guardian concerning the protection of whistleblowers in the British public health sector, it would be appropriate for your Bill 15 to take into account the critical issues of whistleblower protection in the public health system as well as academic freedom in the university medical training setting. These articles highlight problems similar to those afflicting our Quebec health care system (our underlining): 

NHS whistleblowers need stronger legal protection to prevent hospitals using unfair disciplinary procedures to force out doctors who flag problems, the British Medical Association has said. Doctors are being “actively vilified” for speaking out, which has resulted in threats to patient safety, including unnecessary deaths, according to the council chair of the doctors’ union, Phil Banfield. Despite a series of scandals in recent years, it is becoming more common for hospitals to use legal tactics and “phoney investigations” to undermine or force out whistleblowers rather than address their concerns, he warned. Banfield said: “Someone who raises concerns is automatically labelled a troublemaker. We have an NHS that operates in a culture of fear and blame." That has to stop because we should be welcoming concerns, we should be investigating when things are not right. “Whistleblowers are pilloried because some NHS organisations believe the reputational hit is more dangerous than unsafe care,” he added. “Whereas the safety culture in aviation took off after some high-profile airplane crashes in the 70s, the difference is that the aviation industry embraced the need to put things right and understand the systems that led to the disaster – the NHS has not invested in solving the system, it’s been bogged down in blaming the individual instead of the mistake”. Whistleblowers could be afforded greater protection through changes to the law as well as through cultural change in hospitals, including putting an end to many hospitals’ hierarchical “command and control” management style, which prevent more junior staff from airing concerns, he said. 

The calls were echoed (…) by the hospital doctors’ union (HCSA), which is asking for an independent national statutory body to be established outside the health service to protect whistleblowers and those who report safety concerns. “The intolerable cover-up culture by managers that we still see in corners of the NHS is bad for patients and bad for doctors,” said the HCSA president, Dr Naru Narayanan. “For too many doctors, the brave, professionally obligated and morally correct step of reporting safety concerns is rewarded with attempts to silence and force out the individual who reports problems by managers focused on protecting reputations.” The union, which said it had dealt with “a string of cases affecting members” – with some reporting being left on the verge of suicide after raising safety alarms – has also called for a law to be created making it a criminal offence to cause detriment to people who have made protected disclosures. 

In Quebec, the prevention of harassment is governed by section V2 of the Act respecting labor standards. However, this law does not apply to health professionals, as provided for in article 19 of the Health Insurance Act: 

The provisions of the Labour Code (chapter C‐27) and of the Act respecting labour standards (chapter N‐1.1) do not apply to a health professional to whom an agreement made pursuant to this section applies who provides insured services in a facility maintained by or on behalf of an institution.

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Un médecin spécialiste québécois passe au niveau politique - Plaider pour la liberté académique et un environnement éthique dans le secteur de la santé

Sherbrooke, le 3 septembre 2023 

Ministre Christian Dubé Ministère de la Santé et des Services Sociaux Édifice Catherine-De Longpré 1075, chemin Sainte-Foy Québec (Québec) G1S 2M1 

Objet : Loi 15, Loi sur l'assurance maladie, Loi 32, protection des lanceurs d’alerte et règles d’inclusion en Santé 

Monsieur le Ministre, 

À la lumière de récents articles publiés dans The Guardian et concernant la protection des lanceurs d’alerte (whistleblowers) dans le milieu de la Santé britannique, il serait approprié que votre projet de Loi 15 prenne en ligne de compte les enjeux essentiels de la protection des lanceurs d’alerte dans le système de la Santé ainsi que de la liberté académique dans les milieux de formation médicale universitaire. Ces articles mettent en évidence des problèmes similaires à ceux affligeant notre système de santé québécois: (nos traduction et soulignés): 

‘Les lanceurs d’alerte du National Health System (NHS) ont besoin d’une meilleure protection juridique pour empêcher les hôpitaux d’utiliser des procédures disciplinaires injustes pour expulser les médecins qui signalent des problèmes’, a déclaré l’Association médicale britannique. ‘Les médecins sont activement vilipendés parce qu’ils s’expriment, ce qui a pour conséquences menaces à la sécurité des patients et nombre de décès inutiles,’ selon le président du conseil du syndicat des médecins, Phil Banfield. ‘Malgré une série de scandales ces dernières années, il est de plus en plus fréquent pour les hôpitaux d’avoir recours à des tactiques juridiques et des enquêtes bidon pour discréditer ou expulser les lanceurs d’alerte plutôt que de répondre à leurs préoccupations,’ a-t-il prévenu. Banfield a déclaré : ‘Quelqu'un qui fait part de ses inquiétudes est automatiquement qualifié de fauteur de troubles. Nous avons un NHS qui fonctionne dans une culture d’intimidation et de reproche. Cela doit cesser parce que nous devrions accueillir les préoccupations des lanceurs d’alerte, nous devrions enquêter lorsque les choses ne vont pas. Les lanceurs d’alerte sont mis au pilori parce que certaines organisations du NHS estiment qu’une atteinte à leur réputation est plus dangereuse que des soins dangereux’, a-t-il ajouté. ‘Le NHS s’est enlisé dans le blâme de l’individu plutôt que la correction de l’erreur. Les lanceurs d’alerte pourraient bénéficier d’une plus grande protection grâce à des modifications de la Loi ainsi que par un changement culturel dans les hôpitaux, notamment en mettant fin au style de gestion hiérarchique command & control de nombreux hôpitaux qui empêche le personnel subalterne d'exprimer ses préoccupations’, a-t-il déclaré.

Ces appels ont été repris (…) par le Hospital Consultants and Specialists Association (HCSA) qui demande la création d’un organe statutaire national indépendant en dehors du service de santé pour protéger les lanceurs d’alerte et ceux qui signalent des problèmes de sécurité. ‘La culture intolérable de dissimulation de la part des gestionnaires que nous observons encore dans certains coins du NHS est mauvaise pour les patients et mauvaise pour les médecins’, a déclaré le président de la HCSA, le Dr Naru Narayanan. ‘Pour trop de médecins, la démarche courageuse, professionnellement obligatoire et moralement correcte, consistant à signaler les problèmes de sécurité est récompensée par des tentatives de réduire au silence et d'expulser la personne qui signale des problèmes par des gestionnaires plus enclins à protéger leur réputation’ Le syndicat, qui a déclaré avoir traité une série de cas affectant des membres – dont certains poussés au bord du suicide après avoir lancé des alertes de sécurité – a également demandé qu'une loi soit créée qui érigerait en infraction pénale le fait de causer un préjudice aux personnes ayant fait des divulgations protégées. » 

Au Québec, la prévention du harcèlement est encadrée à la section V2 de la Loi sur les normes du travail. Or, cette loi ne s’applique pas aux professionnels de la santé, tel que prévu à l’article 19 de la Loi sur l’assurance maladie:

« Les dispositions du Code du travail (chapitre C‐27) et de la Loi sur les normes du travail (chapitre N‐1.1) ne s’appliquent pas à un professionnel de la santé visé par une entente conclue en vertu du présent article qui rend des services assurés dans une installation maintenue par un établissement ou pour le compte d’un établissement. »

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Sask Seniors Continue Fight for Justice and Correction of Apparent Tax "Irregularities" With Appeal to 400 Officials

Date - May 2, 2023

Good day Members of Parliament and the Saskatchewan Legislature,

400 of you will receive this letter, on a good day perhaps 10 will read it. During the past eight years, many of you have heard from us, few have responded.

We are Busted Trust Working Group, a creation of your behaviour.

Let us get straight to the point. We find ourselves in circumstances so desperate that we must now do the unthinkable. We are asking everyday citizens of Canada to give us money for legal fees so that in a court of law, we can attempt to protect ourselves from you, you who are supposed to help citizens.

The Story In a Nutshell

Here is the short story. A Regional Park Authority in Saskatchewan is a creature of Government that enjoys the benefit of Government funding. Through a convoluted bureaucratic process, they have direct influence on property taxes. Provincial and Municipal. A group of cottage owners in a Park identified a tax dodging scheme administered by the Park Authority. The scheme shortchanged the Government of Education Property taxes due.  The offending Park Authority sued the cottage owners in a contrived process designed to hide an incompetent and dishonest administration.

The amount at issue used to launch the initial suit was a only a few hundred dollars. Prior to the first Queen’s Bench action even making it to court it was shown that claims of tax irregularities by the group were correct. The action went forward anyway.

Seven lawsuits and hundreds of thousands of dollars later, the battle continues. Cottage owners have been self-representing in every case. To date the Applicant has won nothing.  After they tried seven times, using same law firm, we are now seeing the beginnings of related actions number eight and nine. The law firm spearheading the efforts is proud of their tactics; they created handbook (available online) that explains how to defeat financial weaklings in the courts.

Minor Local Argument?

While SaskGov has consistently tried to paint this as a minor local argument, the Premier of Saskatchewan accidently informed us that he knew we were being sued before we did. This was after an agency of his own government had already corrected the specific tax problem at the heart of the issue.

Respondents to the most recent lawsuits are three pensioners and a grandmother not yet of pension age. A fifth Respondent also a senior, dropped out and moved away. After Queen’s Bench efforts and Provincial Court actions against him (none were successful) he had enough and left his home of  over 20 years. It remains unoccupied and is now in a state of disrepair.

Three different Justice Ministers in Saskatchewan have ignored the fundamentals of Justice: the wife of one of those Ministers worked as a legal assistant for the law firm behind every court action taken thus far; the second , after we advised him that an agent of his government was cheating them on taxes, told us to get a lawyer; and the third has not even acknowledged receipt of our information.

After receiving a very complete description of events dating back to 2016, The Minister of Justice for Canada informed us he could not interfere. He recommended we contact the Saskatchewan Ombudsman. We did that, had a nice chat and we’ve not heard from them since. The Federal Justice Critic for the NDP did not bother acknowledging receipt of the same documents. The Committee Chairman (Liberal) for the Justice and Human Rights House of Commons (Bill C9) has ignored the information. An independent member of the Senate has also ignored correspondence. In Saskatchewan, the Official Opposition accepted our information, then ceased communications twice, once in 2018, then again under new leadership in 2022.

The Federal Conservatives ranks were bolstered when two SaskParty MLAs moved from Premier Moe’s government over to Mr. Poilievre’s federal camp in time to get their pictures taken with people on the wrong side of an attempted insurrection.  Then we saw video from Commons hearings regarding Bill C9 where Conservative MP Larry Brock thought it was a good idea to intimidate invited witnesses before they had a chance to speak; we haven’t received any help from that quarter and have no reason to expect any.

While all this was going on and we were predisposed by court actions, the Government of Saskatchewan was working to clean up the very mess we had identified regarding tax irregularities. What we learned one day before Justice Lyle Zuk delivered his decisions was the mess was at least 20 times the size of what had been discovered initially. In the court decisions delivered a day later, however, it said our allegations (about tax irregularities) were based on the weakest of circumstantial evidence…ooops, that was wrong.

It should be noted that since 2016 Respondents have tried several different times to initiate mediation or open discussions to resolve this matter long before it got to court and again after the first two rounds of lawsuits. Every effort was denied.

Honest Public Servant Tells the Truth – Tax System Had Loophole

It all sounds preposterous, doesn’t it?  It would be a hard sell had if not for the integrity of a senior civil servant who happened to be the Chief Executive Officer for Saskatchewan Assessments Management Agency (SAMA). He thanked us for exposing a weakness in their system (that had allowed tax dodging). He also lamented how unfortunate it was that we were subsequently treated the way we have been because we exposed the truth. There were over 200 email exchanges between our working group and SAMA regarding this series of events yet our claims were discarded out of hand by Government and the courts. One Deputy Minister called us vexatious and frivolous, and keep in mind it was the agency under her oversight that sued us seven times.

We know Premier Moe and his Ministers of the day were aware of the weakness that allowed tax dodging and who exposed it; they were included on the mailing list when the CEO thanked us.  Just for the record, after 40 years of service, he doesn’t work there anymore. 

If these circumstances are not bungled enough, consider this: Regional Parks in Saskatchewan are governed under the Saskatchewan Regional Parks Act; the Saskatchewan Regional Parks Association gets a sizeable amount of direct funding from SaskGov to provide guidance and distribute grant funding to individual Parks.

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Submission to the Standing Committee on Justice and Human Rights

This is the story of a few Saskatchewan Seniors who attempted to report to the proper authorities improper taxation in what they believed was one Saskatchewan Regional Park Authority. Their attempts to get this corrected resulted in years of retribution and eventually the wrong-doing was discovered to be much wider than initially believed. The retribution was in the form of legal tactics, threats,  law suits, Judges and conflict of interest, and stone-walling by political authorities with responsibility for dealing with the situation. They are in jeopardy of losing their homes and saw no other option but to appeal to Canada’s Parliament.

Good day Honourable Chair Sarai and Standing Committee members, 

We understand the Standing Committee is generally focused on broad and evolving issues that affect the lives of everyday Canadians. Perhaps our issues will not resonate within your group because every day Canadians do not usually find themselves in civil court defending themselves against well-funded agents of government. “You can’t fight City Hall” is a saying at least 200 years old. Its origins are founded in the belief that bureaucratic structures spending public money will always fight to the bitter end rather than admit a mistake or deliberate wrongdoing. It’s the same theme that prompted US satirist Will Rogers to say the country was being run by the best politicians money could buy. 

In a terrible example of “progress”, it is now accepted that politicians will lie and will do so without consequence. Lying by misdirection, by omission or by flat propagating false statements are among the broad unspoken approvals in our world of sound byte politics.   

What should be of great concern is that lying in the courts of Canada now come with their own unspoken approvals. The very cornerstone of everything we have been taught since childhood centers around the concept of honesty. This is especially true in courts of law where not too many years ago, those testifying in a court of law did so with their hand on a bible, another cornerstone of our would be “just society”. 

However, in our own circumstances we have been told by a member of the Supreme Court that in court perjury is addressed at the discretion of the judge. The everyday citizen hearing that, has to immediately wonder about the discretion of a judge who would allow perjury. It is especially troubling if you are on the side of the courtroom equation facing the perjury. 

We have been in contact with numerous Canadians who have been on the wrong end of judicial discretion regarding perjured statements. We have witnessed it up close and personal three times in two years, all under the same judge. In a 2021 Canadian Judicial Council review, Chief Justice for the Supreme Court of British Columbia, Christopher Hinkson, stated it was within a judge’s discretionary right to ignore perjury. 

In our case the line between justice and politics became very blurred and, in applications seven and eight, perjury prevailed and court decisions were made based on the falsehoods. This was not alleged perjury that might be claimed by a disappointed loser in a court battle; this was material fact perjury verified by Freedom of Information documents received from Municipal Government which disproved the often-used perjury contained in the sworn statements of another agent of Government. 

In practical terms we are helpless to act to protect ourselves simply because we don’t have access to public funds to freely spend on the litigation industry that is always at the center of these disputes. 

If this trend continues it will soon, if it’s not already, be a matter of whoever has the best Liar, wins. 

PERJURY:  a Criminal Code of Canada indictable offence; but go ahead and lie in your affidavit, turns out addressing perjury is a matter of judicial discretion NOT law. 

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The Cost of the Attack on Truth in Medical Research and Bullying Of Medical Professionals in Canada

Here is the story of a medical specialist in a university health centre in Quebec, a story that is repeated in other provinces and experienced by other professionals and which affects many people in harmful ways.

It is reasonable to think that if a committee were formed that included a person with a master’s degree in Aerospace Science, another with a PhD in Mathematical Physics, another with a Medical Doctorate and specialist credentials who was capable of highly specialized research and applications, another that was a University Professor and collectively they had received numerous awards; that committee would be considered very credible and well anchored in professional terms.

What if, instead of it being a committee holding all these stellar qualifications and abilities, it was just one man? A man whose credentials and accomplishments encompass all that and more? Most of us would think this is an extraordinary person obviously functioning at a stratospheric level of intelligence with broad scientific and medical understanding.

Just such a man lives in Quebec. He is Doctor Richard Le Blanc, a man who has dedicated his life to learning, teaching and to helping people, some of whom were truly in life and death situations. 

What did he get for all his efforts and dedication? He was bullied by colleagues and unofficially blacklisted by those in positions of authority above him. 

It has taken two full decades for Dr. Le Blanc to make inroads against those in the medical, scientific and academic communities of his province who set out to ostracize him both professionally and socially.

Dr. Le Blanc has never been officially charged or disciplined for any wrongdoing, yet he was treated as if he had broken all the rules of a just society. What was his crime?

He is a qualified scientist who questioned the opinions of a colleague who held a more senior management position. He also questioned the practice of large pharmaceutical corporations funding University research and review of new products – the potential for bias is obvious even to those of us well outside the scientific and medical worlds.

Dr. Le Blanc has worked at the very highest levels of medical research and physical science.  His professions demand that all things that affect humanity at the very core be questioned in the most stringent way. When he attempted to do that, Dr. Le Blanc was not officially chastised in any way.  Instead, he was bullied by his peers and mentors in the very same way a child faces attack and ostracization in the school yard. We are often told “the bullies are always the weak ones”. Perhaps the weakness is not physical but rather weak in self-esteem and maybe also intellect?

If Dr. Le Blanc was deserving of all the harm that landed on him, why didn't "they" attack him in public and make an example of him? Instead, they constructed a wall of silence around the real concerns and discredited him literally beyond belief. The apparent reason - his insights - were valid and damaging to other reputations and financing. Keeping that quiet was job number one so rather than embrace the well-informed considerations of a dedicated man, who raised valid, ethical and scientifically sound questions, a concentrated effort was made to render him as ineffective as possible.  This was apparently aimed at ensuring that reasonable employment, recognition and the ability to have a public voice were denied Dr. Le Blanc.  Colleagues in the Quebec Medical establishment created a self-fulfilling prophecy by first discrediting Dr. Le Blanc, refusing to provide letters of recommendation, restricting access to his own scientific writings and ultimately designing circumstances in which they could assess him unemployable in his chosen fields.

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Ignoring Whistleblowers and Not Enforcing Laws Cause Avoidable Deaths.

The recent CTV -W5 documentary “The Problem with Pills” illustrates in horrific detail, what happens when whistleblowers – often experts in their fields - are ignored and not protected, laws to protect the public are not upheld and policies are diverted from the public interest towards a specific interest.  These actions have led us to a place where 22,000 or more innocent Canadians die a year from adverse reactions to legally prescribed drugs.

One W5 participant noted Health Canada had “backed down” from enforcing the many extra powers the Protecting Canadians from Unsafe Drugs Act (Vanessa's Law) gave it. The Food and Drugs Act and Vanessa’s Law are part of criminal law in Canada.  And Health Canada does not uphold it?  The main message from the participants was – do not trust Health Canada to protect you from unsafe drugs.  How have we arrived at such a dark place? 

Here’s how.  In 1996 the top medical regulator from Health Canada, Dr. Michele Brill-Edwards, tried to warn us that not enforcing the law, deregulation and shifts in priorities taking place at the Department were leading to more deaths from unsafe drugs.  She sacrificed her career to speak out in the interest of public safety but her message went unheeded.   Many knowledgeable others have also tried to warn us:

  • The Auditor General - warned us and Parliament a number of times about the deficiencies in the regulatory body – Health Canada- which included funding and staff cuts among many others.
  • Researchers - starting in 2000 with Wiktorowicz’s work , Shifting priorities at the Health Protection Branch: challenges to the regulatory process. Also, there is the work of 16 researchers in the Fall 2013 issue of The Journal of Law, Medicine and Ethics on the topic of Institutional Corruption and the Pharmaceutical Policy.  They clarify how certain practices have corrupted medical research, the production of medical knowledge, the practice of medicine, drug safety and Regulatory oversight of pharmaceutical marketing.
  • The Media – alerted us over the years with stories of unsafe drugs.

Almost 25 years later, the media and W5 are warning us again, about needless Canadian deaths from unsafe drugs.

The reasons for this are:

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International Conference Discloses Canadian Whistleblowers At Risk

It has been a busy summer.  In June, two of Whistleblowing Canada's Directors, Ian Bron and I, attended a two day Conference organized by the International Whistleblowing Research Network(IWRN) in Utrecht, Netherlands.  The gathering included prominent whistleblowing academics, researchers, whistleblowers and non-profit organizations supporting whistleblowers from around the world.  The sharing of the knowledge and experience of those attending was empowering and confidence-building as it reinforced many of our own findings and future plans.   One of the most memorable (and disconcerting) moments came when one researcher gave a preliminary glimpse of results of research being done by his organization aimed at examining whistleblower protection legislation from some 60 countries to determine how many contained "best practices".  Experts have identified 20 elements considered "best practice".  It was announced at the Conference, for all to hear, that Canada's Federal whistleblower protection law, the Public Servant Disclosure Protection Act (PSDPA) does not contain even one best practice.  In effect it does not protect whistleblowers.  Canadian academics have pointed out that provincial legislation has been largely modeled after the federal legislation.  This does not auger well for whistleblowers or Canadians.  Donald Savoie, a well known expert on Canadian Public Administration, tells us that Canada's democratic institutions are "disintegrating".  In the age of disinformation, the attack on truth, and failure of our Access to Information laws,  whistleblowing is the only way we can know what is really going on in government.  And it is only by knowing what is really going on that we can make informed decisions and take reasonable action to participate in our democracy.   With this in mind Whistleblowing Canada has written to all party leaders regarding recommended (and ignored) amendments to the PSPDA.    

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Welcome

Welcome to Whistleblowing Canada's Blog.  The following is the first post.  I hope it is the first of many that will stimulate discussion and debate on the issues that concern us.

 

Is it Time to Reboot Canadian Democracy?

Recently the media has had a large focus on a number of issues that speak to how Canadian citizens are governed federally.  I refer here to questions raised by the SNC – Lavalin affair around:

  1. the rule of law – which means not only that the law must be obeyed but also that it applies to everyone equally including the Prime Minister and large powerful corporations.
  2. the role of the Clerk of the Privy Council – does s/he represent to his/her political masters the considered, best, impartial opinions/advice of the federal bureaucracy in the public interest or does s/he represent to the bureaucracy the views/preferences of his political masters which they are to support unquestioningly?
  3. the role of a public servant – is it solely to assist the Prime Minister and Ministers implement their policy preferences or does a public servant have a role as guardian of the rule of law and the public trust?
  4. are we governed by democratically elected representatives and an Executive headed by the leader of the party in power and his/her Cabinet who are responsible/answerable to the members of the House of Commons from all parties? Or,
  5. are we governed by leaders (and bureaucrats at their political leaders behest) who are too close to the very large, powerful companies who supposedly “creat jobs” (a wrong assumption) rather than keeping an “arm’s length” relationship with those the government regulates?  

 

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