History of the Medical Reform Group: 1979 - 1996
The Hall Commission
The short-lived Clark government had appointed Justice Emmett Hall to
head a commission to evaluate the state of medical care in Canada, and to
make recommendations for changes in the system. While considerable energy
within the MRG was being spent on the occupational and environmental disease
areas, and a working group was active in the area of women's health, a major
initial focus for the MRG was preparing a brief for the Hall
Commission. Mike Rachlis, Philip Berger, Bob James, Joel Lexchin, Nick
Kates, and Ellen Buchman all made major contributions to the brief, which
was presented to Justice Hall in April, 1980, and crystallized our positions
around economic issues. The brief included recommendations that were highlighted
in the Hall Commission's final report, including ending user fees and health
care premiums.
The provincial meeting that followed the presentation of our
brief was notable for a change in steering committee members. John Marshall
resigned and left shortly thereafter to take up
surgical training in the Maritimes, while Brian Gibson and Bob James
joined the steering committee. Until he left the steering committee
more than three years later, Bob took on a central leadership role, providing
major direction for the steering committee, chairing the biennial provincial
meetings, and serving as an articulate and well-informed leading spokesman
for the group in our media contacts.
This early period of intense MRG activity was also characterized
by high profile educational work around occupational health with unions
in both Toronto and Hamilton. In the latter city, a group of MRG members,
including Ken Burgess, Annalee Yassi, Clyde Hertzman, John Chong, and
Ted Haines, were instrumental in the formation of the first workers' occupational
health clinic in Canada. While in many ways extremely successful, the
clinic's life was cut short before its second anniversary due to a cutback
in funds from the Stelco union. However, the clinic was resurrected in
1984 and, due to the efforts of MRG members John Chong and Ted Haines (as
well as the clinic director Stan Gray) proved spectacularly successful in
the number of referrals, in the outstanding quality of the clinical care
delivered, and in their championing of a safe workplace for all Ontario
workers. The clinic was subsequently the focus of political battles that
eventually led to its demise. John and Ted have continued to take important
leadership roles in occupational medicine in Ontario.
In addition to the occupational health work, the MRG was also
acting on its policy of working with allied health groups by becoming
an active member of the Canadian and Ontario Health Coalitions. The
most exciting educational event during this period was a visit by Vincente
Navarro, author of "Medicine Under Capitalism", in October, 1980.
A Period of Crisis
The initial burst of energy and enthusiasm that followed the public
appearance of the MRG sustained itself for well over a year, but was
followed by a period of difficulties that threatened the existence of
the group. A gradual decline in the number and productiveness of the
working groups, and the lack of dramatic growth in the membership, contributed
to a sense of lack of direction. Attempts to address the issues included
provincial meetings devoted in part to examining "whence the MRG", and
a newsmagazine that failed because of lack of funds. A split in the group
was identified between those who believed that abuse of technology and
environmental contamination were problems that could be corrected by
a change in the social system (Fred Freedman being a leading exponent),
and those who felt that technology and industrialization were damaging
however they were used (the position espoused by Trevor Hancock). A bigger
threat was posed by the group's administrative problems. The immense job
of keeping records, preparing and sending mailings, and keeping track
of the membership and its dues had been taken care of by Gordon Guyatt
during the MRG's pre_history, and subsequently by John Marshall. Although
Debby Copes and Brian Gibson had made a monumental effort to keep up with
these chores, the steering committee was finding that all their time and
energy was being devoted to administrative matters, and despite this the
situation was deteriorating. It became clear that hiring a part-time executive
secretary was imperative, and the decision to hire Howard Cash was made
at a provincial meeting at the South Riverdale Community Health Centre in
October 1981. Funding this job required a major increase in income, and with
considerable reluctance dues for graduate physicians were increased to
$100 per year.
Following this change, the MRG's fortunes improved. The membership
lists were reorganized, and regular mailings were established. Most
of the membership paid the higher dues, and this assured financial solvency.
At a number of meetings members acknowledge the importance of the MRG
as a support system for progressive physicians was acknowledged, our common
goals recognized, and our significant political voice appreciated.
When considering the resolution of the crisis, the accomplishments
of the MRG's first five years are worth bearing in mind. Education of
the group was served by regular meetings in Toronto and Hamilton discussing
issues such as health care in other countries, occupational medicine,
and what we mean by progressive private practice, and by educational sessions
at the biennial provincial meetings (with speakers such as health economist
Greg Stoddart, political scientists Robert Chernomas, Malcolm Taylor,
Vincente Navarro). Invited speaking engagements with a wide variety of
community groups allowed the MRG to fill its external educational function.
The MRG provided a public service to groups such as occupational health
committees in the workplace, and a Hamilton group called the Pro Hospital
Committee fighting for improved health facilities in the city's east region.
The MRG formed effective alliances with other individuals and groups working
for positive change in the health care system, groups such as the Ontario
and Canadian Health Coalitions, pro-choice groups in Toronto including the
Physicians for Choice, and the Committee for Responsible Marketing of Pharmaceuticals,
as well as broader_based groups including the Coalition Against the Death
Penalty.
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