Doctors repeatedly disciplined for sexual abuse need stricter oversight, critics say

WARNING: This article contains graphic descriptions of child sexual abuse and may affect those who have experienced​ ​sexual violence or know someone affected by it.

Some health-care critics and legal experts are calling on the Ontario government to review its medical oversight system after CBC News uncovered a fourth alleged victim tied to Eleazar Noriega, a disgraced pediatrician who stayed employed for nearly 40 years in Toronto through multiple suspensions and disciplinary hearings related to child sexual abuse.

Noriega's lengthy file, and others like it, point to a need for systemic reform, according to the province's NDP health critic.

"The physicians that have maliciously hurt patients continue to go scot-free … it has to change," said France Gélinas, MPP for Nickel Belt in northern Ontario. 

Gélinas, along with a Liberal MPP and two legal experts, points to three main issues: the self-regulatory nature of the College of Physicians and Surgeons of Ontario (CPSO), the role of the Canadian Medical Protective Association in shielding doctors, and the limited liability that hospitals face for physicians' actions on their premises.

"People that have been hurt by physicians are not getting their day in court and are not being compensated the way they should," said Gélinas.

The Noriega case

Susanne Barrow, a woman from the Ottawa region, is the latest complainant to come forward. She alleged Dr. Eleazar Noriega penetrated her vagina with his fingers to check her "internal heat" at Toronto's Hospital for Sick Children in 1980.

She was 12 at the time, and said for years she didn't know the name of her doctor. 

In 2015, she began investigating her case and eventually hired a legal team to obtain decades-old hospital records that revealed Noriega was the attending physician on the day she was admitted to SickKids for food poisoning.

It turned out he was already well-known within medical circles, having been hauled five times before a professional tribunal to face allegations, including three cases of alleged sexual abuse involving girls as young as eight.

The allegations span from incidents between 1979 to 2008.

Of his five tribunal appearances, four were related to the three sexual abuse cases — one of the cases came before the tribunal twice.

"Shocking, disturbing. How, how could somebody continue practising after so many allegations?" Barrow told CBC. "I mean, they're all kids, they're all young."

Regulators revoked Noriega's medical licence in 2011, which he appealed. His licence was finally revoked in 2015.

He was found guilty in two of the three sexual abuse complaints and one was dismissed.

Doctors regulating doctors

The CPSO — the main regulatory body overseeing doctors in Ontario — is tasked with balancing the rights of both physicians and patients. But that can create conflicts of interest, according to Paul Harte, a Toronto-based lawyer specializing in medical malpractice.

"People who went to medical school are now acting as regulators. They weren't trained to be regulators," Harte said.

On the various panels judging four of Noriega's five professional hearings, the majority of panel members were doctors. Out of the 18 panellists only seven were non-doctors. CBC could not obtain the details of one of the panels.

Harte argues the college's self-regulatory nature often prioritizes protecting of the profession over public safety, as it's primarily composed of physicians elected by their peers.

The college's current board structure is composed of 21 physicians and 13 public directors appointed by the Ontario government, said CPSO spokesperson Laura Zilke in an email to CBC. 

"CPSO is constantly working to ensure the objectivity and independence of the Board and its committees," Zilke wrote. 

The college said it has recently made some improvements to modernize its governance, including requiring members to disclose conflicts of interest and undergo training.

In 2021, the CPSO's discipline committee, which oversaw Noriega's hearings, restructured and renamed itself the Ontario Physicians and Surgeons Discipline Tribunal, partly to signal its neutrality from the college.

Legislative amendments by the government in 2017 also granted the college the power to suspend a doctor's licence at any point during the complaint process, even before the tribunal hearing, if patient safety is deemed at risk — an authority it did not have during Noriega's time practising.    

But the tribunal continues to rely on the CPSO to build cases against problematic doctors. For Harte, this perpetuates the problem of doctors regulating doctors.

He argues the college should only appoint professional regulators with core expertise in regulation and public administration, rather than in medicine. He says these regulators could then consult medical experts when needed.

Unlimited legal assistance 

When doctors in Canada face accusations of wrongdoing, they are backed by the Canadian Medical Protective Association (CMPA), a national organization dedicated to defending physicians.

The CMPA was initially established to prevent doctors from facing financial ruin when contesting malpractice claims. Over time, it has come to provide such comprehensive protection that it's a selling point for physicians who might otherwise be drawn to the U.S. or other countries with higher pay.

But the NDP's Gélinas says she frequently receives complaints from the Canadian public about this "unfair" legal advantage.  

"[The CMPA] really will go all out at any cost for the physicians to win, and this is at the expense of people that have been hurt, people that have been harmed by physicians that have done things that are unthinkably bad," Gélinas said. "Yet, the CMPA will continue to spend millions of dollars in lawyers' fees to protect that person."

Ontario doctors are required to obtain professional liability protection to ensure they're covered in cases involving negligence, surgical errors or sexual assault.

In 2023 alone, the CMPA spent nearly $225 million to cover legal fees for members facing complaints, according to its annual report. Doctors pay for their coverage, but unlike an insurance company, the CMPA imposes no deductibles or payout limits, essentially offering a bottomless defence fund in eligible cases.

Noriega's lawyers did not answer CBC's questions about whether the CMPA has funded his various legal defences over the years. The CMPA declined CBC's request for interview.

Over the years, Toronto police have charged the now 80-year-old with seven criminal offences. He was acquitted by a jury on four of the charges, and the rest were withdrawn or stayed. CBC was also able to uncover at least one other civil suit against him. 

Although the CMPA does not receive direct public funding, the Ontario government has subsidized approximately 75 per cent of membership fees for Ontario doctors in 2024 through a reimbursement program. Similar contracts exist in other provinces.

"The bottom line is, hundreds of millions of dollars of public taxpayer money is being funnelled to the CMPA," Harte contends.

According to its 2023 annual report, the CMPA sits on assets valued at $6.5 billion, including investments.

Ontario Health Minister Sylvia Jones's office declined CBC's request for an interview, and the ministry did not provide a statement regarding the CMPA reimbursement program or plans to review the current system.

What about the victims?

When a nurse harms a patient in a hospital, the hospital is usually responsible for addressing the issue and providing compensation for the victim. 

But the vast majority of doctors, including Noriega, work as independent contractors rather than employees, according to the Ontario Medical Association. 

"When people go to a hospital, they assume that the hospital is going to be taking care of them, and if something goes wrong, it's the hospital that has to deal with it. But that's not true when it comes to doctors," said Simona Jellinek, a Toronto lawyer specializing in civil litigation over sexual assault cases. 

In Barrow's case, SickKids provided her with $5,000 for counselling services, but said it did so as a gesture of goodwill and not an admission of liability. 

According to court records, SickKids argued the care Barrow received was "provided by or under the direction of an independent physician," absolving the hospital of responsibility.

"There ought to be a whole huge overhaul of how the CMPA works, how hospitals work, how doctors work," said Jellinek, who argues hospitals and clinics should be vicariously liable when physicians commit sexual assaults within their premises.

Ottawa South MPP John Fraser, the Liberal critic for Children, Social and Community Services, says that imbalance of accountability needs to change.

"I think any reasonable, thoughtful person would say that's not right," he said. "There needs to be a better balance, more fairness.

"All organizations … have a responsibility to make sure that that trust is maintained and that vulnerable people are protected as best as humanly possible."

Following CBC's investigation, Fraser is urging the health minister to meet with representatives from the CPSO and CMPA to create a more equitable system for both patients and doctors.

The province did not provide a response to that proposal, and instead issued a statement.

"Ontario has zero-tolerance for the abuse of patients by physicians or other regulated health professionals," the Ministry of Health wrote in an email to CBC. 

NEXT: CBC Ottawa will publish another story exploring why, even in civil court, victims of sexual abuse by doctors face significant challenges in securing compensation

Support is available for anyone who has been sexually abused. Resources for family and children are available through the Canadian Centre for Child Protection. You can also access crisis lines and local support services through this Government of Canada website or the Ending Violence Association of Canada database. ​​If you're in immediate danger or fear for your safety or that of others around you, please call 911.