History of the Medical Reform Group: 1979 - 1996
1990 and After
MRG and the Ontario Government
The election of the NDP government in 1990 meant a sympathetic ear for
the group in the provincial parliament. The MRG, in meetings with Health
Ministers Evelyn Gigantes (December 1990) and France Lankin (December
1991) and Deputy Minister Michael Decter (autumn 1992) emphasized positions
worked out by the Resource Allocation group. These included the dangers
of excessive cost cutting, the need for decisions to be made democratically,
and on the basis of evidence, and the areas in which costs could appropriately
be constrained (excessive physician use of diagnostic tests, in part through
increased use of independent health facilities and getting diagnostic
test facilities out of physicians' offices; licensing of health technologies;
and restriction of funding for unproven procedures). The MRG, represented
by Phil Berger, had a positive influence the method in which the new
health cards were introduced at the beginning of 1992. At the invitation
of the government, the MRG participated in a National Conference on Physician
Management in June 1992. Through contacts with Frances Lankin's Executive
Assistant Sue Colley, the MRG provided comments on a number of the Health
Minister's speeches, and made a number of nominations to Ministry working
committees. Mimi Divinsky and Rosanna Pellizzari were able to represent
the MRG position concerning proposed delisting of procedures -- that delisting
be done only after careful consideration of the underlying principles,
public debate, and with provision for services still being covered where
legitimate -- directly to Ministry personnel. The were able to reinforce
the Ministry's understanding that delisting will not help deal with the
province's health care problems.
MRG Internal Matters
In June of 1990 the CMAJ published an article which presented a rather
unflattering picture of the MRG searching for a purpose. Ralph Sutherland
was particularly negative about the group. However, many took the view
that such major publicity was better than no publicity at all, and the
steering committee had a chance to reply in a letter to the editor.
In February of 1991 the MRG sent a letter to the Prime Minister,
noting the heroic action of steering committee member Robbie Chase in participating
in formation of the international peace camp in Saudi Arabia, and suggesting
that war was not the best response to the crisis. The steering committee
was subsequently criticized for not including wider consultation with
MRG members, though there was a split in the group on the appropriateness
of the steering committee's action. The incident led two long-standing
active MRG members to not renew their memberships.
In August of 1991 the MRG decided to change the format of semi-annual
meetings. Recognizing the increasing competing demands in the lives of
the members, semi-annual meetings were subsequently held on weekday evenings
and were seen as opportunities for members to participate in debate on
the most relevant current issues, rather than educational sessions which
would require a large attendance to be successful.
One issue addressed in the first such meeting, in October, 1991,
was whether, in response to the OMA and the Ontario government agreeing
to Rand formula for Ontario physicians, the MRG should become a section
of the OMA. The decisions was to reject this course, and to continue to
stand on our own.
Steering Committee members at the beginning of 1990 included Bob
James, Mimi Divinsky, Rosanna Pellizzari, Haresh Kirpalani, Bob Frankford,
Don Woodside, and Robbie Chase. Jim Sugiyama, although not attending steering
committee meetings, was in charge of membership. Bob James stepped down
from the Steering Committee after his second stint in April of 1990. Gordon
Guyatt began a second tenure on the Steering Committee in June, 1990, and
Murray Enkin joined for the first time in November, 1990. John Frank started
a second stint on the steering committee in January 1991 and stayed active
for over a year. Bob Frankford resigned from the Steering Committee after
being elected as an NDP member of parliament. Don Woodside left the committee
in the summer of 1991, Andy Oxman in the summer of 1992, and John Frank
at the end of 1992. Vera Tarman and Chris Jinot joined the steering Committee
in August, 1992, while medical students at McMaster. Chris remained active
until finishing medical school and moving to Montreal for his interneship
in June, 1994. Ian Scott, then acting as a junior faculty member in the
Department of Family Medicine at McMaster and soon to be a Community Medicine
resident at McMaster, joined the Steering Committee in September, 1993.
Martha Wilson joined the steering committee in November, 1994.
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