Health Canada breaches Indigenous patients' privacy, MDs say

More than 20 doctors in northwestern Ontario say they will stop following Health Canada policy starting Tuesday, because of concerns over their patients' privacy.

For years doctors who provide care for First Nations people in remote reserves have been required to provide Health Canada clerks with detailed diagnostic information about their patients for the patients to access medical travel grants.

The doctors say that is an invasion of privacy and leads to a situation where an anonymous clerk at Health Canada can deny access to care.

"I don't like the fact there could be a list somewhere in Ottawa of all the First Nations people who are medically incapacitated," said Dr. Mike Kirlew of Sioux Lookout.

Health Canada demands details

Health Canada requires the detailed diagnostic information under the federal non-insured health benefits program that covers First Nations people for drugs, dental and vision care and other benefits not covered by provincial health insurance. Health Canada clerks regularly ask for a patient's condition when Dr. Kirlew has requested travel for a patient to see a specialist or undergo a diagnostic procedure, he said.

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"They're not part of the circle of care," Kirlew said. "What are they doing with that data?"

The patients Kirlew and the other doctors serve live in isolated First Nations where there are no hospitals and no resident doctors. Denying travel for them is denying access to health care, Kirlew said.

The Northern Physicians group wrote a letter to Health Minister Jane Philpott on Sept. 30, outlining their concerns and signalling their intention to stop following Health Canada policies as of Oct. 11.

Health Canada is responsible for the health needs of First Nations people living on reserve in Ontario.

Provincial health travel grants in Ontario require only a doctor's signature with no further requirement to reveal private medical information, Dr. Kirlew said. But provincial travel grants would not cover the cost of flights from remote First Nations communities.

Double standard

There is also a double standard when it comes to assistance to pay for prescription drugs — Health Canada requires more private information than the provincial drug benefit system, he said.

The root of the problem, according to the northern doctors, is that First Nations people have fewer protections under the Federal Privacy Act than people covered by the provincial Personal Health Information Protection Act, which has much tighter controls on patient information.

NDP MP Charlie Angus, whose Timmins-James Bay riding includes several First Nations, wrote to the federal privacy commissioner about the doctors' concerns on Thursday.

"It's absolutely unbelievable that we could have a situation where the relationship between a doctor and a patient could be interfered with and undermined and overridden by some bureaucrat in Ottawa who decides they'll save money by just denying treatment," Angus said in an interview with CBC News.

For both Dr. Kirlew and Angus, the privacy issue is just one example of discrimination against Indigenous people within the Canadian health care system.

"How many other provincial safeguards are missing on reserve?" Kirlew asks. "There is so much jurisdictional ambiguity."

A spokesperson for the Health Minister says she is aware of the doctors' concerns and working to address them.