December 5, 2011

October 1, 2011 Speech

by: Roland Wong MD

Today marks the first day of the month where I will be entering a fight on my right to work as a physician.

Compassion and altruism forms the foundation of Practice of Medicine; my action in filling the Special Diet form fulfills those fundamental requirements of being a good physician. Thousands upon thousands saw positive changes in their health and their lives. Yet I am being punished by being called before the Disciplinary Panel of the College of Physician and Surgeon. What is driving this urge to punish me?

It began with then councillor, now Mayor Robert Ford who believed that I had committed fraud and he reported me to the College in 2009. Perhaps assistance to the poor falls into his "gravy" train ideology. He left the picture in my persecution after the complaint. Instead of the gravy train he is now stuck in a "mud" train.

The Minister and the bureaucrats in the Ministry of Social Services were mean. They set the Ministry of Health and the Ontario Provincial Police after me beginning in 2007 alleging that I had committed fraud. They send reams of documents to the OPP. The OPP wrote in April 2010 to the Ministry of Health that after their investigation " criminal charges could not be substantiated" . The decision did not satisfy McGuinty's government. In February 2011 Social Services wrote to the College again to prosecute me.

Now moving forward...... Recently, Nikki Bozinoff a medical student from McMaster University medical school interviewed me on a radio show; she asked me what is the difference of being an advocate versus an activist ?

An advocate by talks and writes letters. Activists act in the form of direct action.

I filled a lot of forms because I believed I was fulfilling my function as a physician. I must have made many bureaucrats and McGuinty's Minister of Social Services very angry at me. I am now called an activist.

One of the criteria of being an activist is that you are fighting against Goliath.

The huge opponent usually possess incredible powers to change injustice into laws and rules; in turn they say that you have broken the law and they can haul you into a court of law .

The list of medical conditions in the Special Diet form is a list of unfairness. It is an insult to poor people because everyone deserves to have food not just does with specific health conditions.

I had to stop filling forms for the masses or risk not working as a physician because the College of Physician and Surgeon says so. You would think that the Ministry of Social Services would leave me alone. I continued to fill Special Diet forms for my regular patients but did not bill or charge for my services; I knew they were tracking me according to my billing submission, I felt that they had no right in knowing my treatment of my patients;. I was wrong.

The Ministry of Social Services set up a system where all the forms were sent to a central office. They isolated my forms and checked off what I had filled in each of the form. That is meanness of the first degree; the OPP had closed their case one year ago and Social Services continues to hunt me down.

They try to humiliate me by highlighting the large amount of money that I had billed. Do I deserve the money? Do medical specialists making many more times than the average worker deserve their money? Do baseball players or hockey players deserve their money whether they shine or skid on the field or rink? What they deserve depends on a set of conditions before they are paid. Each of them must have the necessary training and qualifications and each of them must complete the work that they set out to do. I did my job of seeing the Special Diet applicants, took a history and did the required examination. Money in the form of taxes pay the salaries of Social Services and Health officials, the money helps to pay for food and opportunities for the poor and money allows me the time and expenses to defend myself before the Disciplinary Panel..

My legal team will be entering a fight for my right to work next week. We will fight the following week and the next week and so on until we win. Please continue to stay with us through my struggle.

Thank you all.

November 8, 2011

Special Diet Allowance Forms

There are three versions of the Special Diet Allowance (SDA) form:

• 2004 version of the Special Diet Allowance form (click here for SDA forms)
  
• 2005 version of the Special Diet Allowance form (click here for SDA forms)
  
• 2011 version of the Special Diet Allowance form (click here for SDA forms)
  

The 2004 version is based upon a series of dietary conditions such as calcium needs, diabetic needs and so forth (click here for SDA forms). The Ministry of Community and Social Services (MCSS) became alarmed when poor people began to apply for the Special Diet in large numbers. The form was replaced according to the MCSS because "Ontario Medical Association informed the Ministry that many of its members had raised concerns about strong pressure from patients to complete the special diet allowance form where the patient's medical condition did not justify it" (Ball v. Ontario (Community and Social Services), 2010 HRTO 360 ). The 2005 form was developed very quickly to quell the hordes of poor people applying for the benefits. "Each dietician was authorized to spend a maximum of three hours on the project without further authorization, and required to respond within three days." Furthermore, " according to Dr. De Marchi [the then MCSS Chief Medical Officer of health], there was no consensus among the consulted experts about whether certain medical conditions required a special diet" (Ball v. Ontario (Community and Social Services), 2010 HRTO 360).

Many poor with nutrition needs looked at the form and shook their heads; those with mental illness, the blind and the deaf were ignored. The new rules took on a form of injustice and unfairness that they have never imagined. Health professionals such as physicians who have to fill the forms now have to fulfill the contrived rules.

The Government invented a "Special Diets Expert Review Committee" chaired by its own employee, the MCSS Chief Medical Officer. The purpose of that report in 2008 was to provide the background for a new form.

By 2009, the poor were perceived to have received too much money through the Special Diet Allowance. According to the Income Security Advocacy Centre (ISAC), the reason the Special Diet Program changed was because (SDA Why the Program is changing):

1. In February 2010, the Human Rights Tribunal of Ontario said the Special Diet program was discriminating against people with certain medical conditions. They ordered the government to fix the problem.
2. In December 2009, the Auditor General said it seemed like the program wasn?t being used properly by some people, and that government should make sure there is no fraud.
3. The budget for the Special Diet program had increased a lot - from $6 million in 2006 to almost $250 million last year. The government said this increase was "unsustainable".

Someone forgot to ask the poor why hunger was also "unsustainable"

On April 1, 2009 Premier McGuinty's government announced in the legislature that they wanted to take away the Special Diet program. There were mass demonstration against the cut. In November 2009, the government changed its mind and an abbreviated version was brought in starting July 2011. The new version was glaring in its removal of medical conditions usually associated with additional food such as Iron deficiency anemia that frequently affects poor women and children and constipation (more fibre). Many lost or had reduced benefits.

There are now more contrived rules. There is one set of rules for Bay Street and another one for Poor Street. The list of medical conditions in the Special Diet form is a list of unfairness. It is an insult to poor people because everyone deserves to have food not just does with specific health conditions.

October 3, 2011

Day 1: In front of The College of Physicians and Surgeons in support of Dr. Wong and the Raise the Rates Campaign. (Picture Above)



Dr. Wong interviewed by Fairchild on OMNI TV (Picture Right)

Join The Stop Community Food Centre and the campaign to Put Food in the Budget and help us reduce poverty. START HERE by taking the survey and Do the Math. What would you need to make ends meet if your situation changed and you had to rely on social assistance?

October 2, 2011

In the next few weeks, I will be at the College of Physicians and Surgeons fighting for my right to work as a physician. A schedule of the discipline committee hearing can be found here.**Please note: discipline committee hearing has been postponed until further notice**

Please see below for more recent information and generous words from my friends.


From: Health For All

Dear members and supporters,

Support Dr. Wong! Let's pack the hearing room!
Stop the Special Diet Cut, Raise the Rates Now!

Please join us in supporting Dr. Wong's courageous anti-poverty work by filling the seats at the College of Physician and Surgeons of Ontario (CPSO) hearings over the next few weeks.

*Pre-hearing rally outside the CPSO*
Monday October 3, 8:00 AM
80 College Street

*Hearings at 80 College Street, starting at 9 AM*
**Please note: discipline committee hearing has been postponed until further notice**

RSVP at: http://www.facebook.com/event.php?eid=123190907784515

We know that income determines people?s health and access to essential needs, such as nutritious food. People living on social assistance have higher rates of diabetes, heart disease and high blood pressure.

Roland Wong is a doctor who recognizes this link between income, proper diet and health. This is why Dr. Wong helped his patients by filling in Special Diet forms that enabled them to receive additional income for food. However,instead of being rewarded for improving the health of his patients, the College of Physicians and Surgeons of Ontario (CPSO) is holding a disciplinary hearing that threatens his ability to practice medicine. Our very own Mayor Rob Ford, who laid the complaint to the CPSO during his time as councillor, stated that "a doctor is there to be a doctor, not to advocate for the poor...". This politically motivated charge by Rob Ford directly contradicts the guidelines of the Royal College of Physicians and Surgeons of Canada, which explicitly state that being an advocate is a key role of a physician. For more information about this case, check out the Health Justice Radio interview with Dr. Wong.

As a community, we cannot accept the bullying of doctors who advocate for the poor. We need to let the CPSO know that poor people, and their allies, including those in health care, will not stay home when one of our community members comes under attack. Dr. Wong's legal team has requested that we assemble peacefully and remain respectful during the hearings. Come show your support for Dr. Wong for his commitment to his patients. Come show the CPSO that advocacy is to be applauded and not attacked!

For further information on the Special Diet, check out this video by the Ontario Council of Hospital Unions and the Ontario Coalition Against Poverty. Also see the 2010 article on this case from the Canadian Medical Association Journal (CMAJ).

For any questions, or to post to the group, please email us at healthforalltoronto@gmail.com. And see our website: health4all.ca.

April 6, 2010

Poverty and The Provincial Budget 2010
Speech delivered at OPIRG
by: Roland Wong MSc, MD, FRCPC

Since 2004 there have always been two budgets: one for Bay Street and one for Poor Street. While corporation tax cuts proceeded on schedule in Ontario?s 2010 Budget, the increase in social assistance benefits was a mere 1%, which is still more than 40% below 1995 rates. In 2007, McGuinty's government reported that :

"Ontario has seen continued strong job creation and business investment. Incomes are on the rise and the standard of living is one of the highest in the world. Ontario?s economic growth continues to exceed expectations." Whose standard of living is McGuinty's government referring to? Certainly not those living on Poor Street. The majority may be fooled, but not the poor. Poor people's standard of living under Harris's regime remained the same under McGuinty's regime every budget year from 2004 to 2010.

When poor people found the Special Diet Allowance program could put food on their table in 2004, the government became alarmed; they decided to tightened the noose on the flow of funds to the poor in 2005. They changed the form to require specific medical conditions in order to get the allowance. The poor knew that is nothing "special" about having food to eat.

The government's strategy to change the form did not stop the people from applying to Special Diet Allowance. They stepped on my fingers to stop me from working in 2009. That did not stop the flow of forms either. Physicians and health professionals have now gained greater insight into the living conditions of the poor. In the 2010 budget, the government proposed to scrap the program.

On April Fool's day 2010, the Ontario legislature debated on the Special Diet Allowance issue. The Premier insisted that he had to eliminate the program after weighing his choices. He said he had to strike a balance between those with Special Diet needs and being accountable to the tax-payers of Ontario. He had to run the province efficiently and effectively. McGuinty spoke of Ontarians as "at their best are kind, caring, considerate and compassionate". I assume when he spoke these words he was also referring to his own government, a government which just eliminated a program so desperately needed by the poor of Ontario.

Some many think, "The poor do not need any more money, they get enough already", let me explain to you how much "more" money they are getting. Just say the welfare rates were NOT cut 21.6% by Mike Harris and McGuinty's caring and compassionate government HAD restored the rates to pre-Mike Harris days and today's inflation rate was taken in to account, these two governments would have had to paid over 2 billion dollars a year to the 800,000 poor on assistance. The $200 million Special Diet Program is a mere 10 per cent of what was taken from the poor. That money which was taken away from the poor meant no food for mothers until their kids were fed, no fresh fruits or vegetables, empty food banks, living on the streets and living in starvation; yes, starvation in a province that claims to have a "standard of living that is one of the highest in the world".

On the economic side, I have met many teenagers who said that they don't have to work at their second part time job to supplement their families meagre income. They were delighted to spend their extra time studying. I have met many of these young people through the years that I have seen them complete their high school and College degrees. These are the future tax payers of Ontario. Will the tax payers of Ontario complain that these new tax payers are now joining them? Isn't investing in human resources an excellent way to run the province efficiently and effectively? Not only will the Province be able to meet their economic objectives, but also their moral objectives of their three C's- caring, considerate and compassionate. Not one of these young people has ever said they wanted to make a career of staying on social service assistance. As a doctor, I have made the solemn oath to "Do no harm", I only wish I had a government who would do the same, to not harm our young people, but to step forward and help them.

On the other side of the economic equation there are those Ontarians who were laid off from work and those Ontarians injured on the job. They too were tax payers until not long ago. Companies have failed them and Worker's Compensation have denied their claims or deemed them to be able to do jobs that in theory make sense, but in reality do not. Indeed many part time workers and their families and those on minimum pay are one or two pay checks from ending up on social assistance. They too may emerge from their misery and pay taxes in the future.

Income level is the best predictor of health. Life-style health predictors such as smoking and cholesterol level pale in comparison with how income level predicts health status. For every 3 babies belonging to rich families that survive to their first year, only two babies belonging to poor families will live to be one year old (Infant Mortality Rate). For every rich person to die from suicide, three times the amount of poor people will commit suicide. For every rich person with diabetes, about 2.6 poor people will have diabetes. Large number of people die needlessly because of misguided provincial policies. More will die as McGuinty's misguided policies continue to suffocate the poor.

If the government cannot spare the compassion then look at the hard economic facts; every day of hospital stay will cost about $1000. An average heart attack case will cost about $8000 and an average complicated case will cost over $11,000. The many years of inadequate food, housing and opportunities have left the poor in a weakened state of health and they will have no choice but to fill those hospital beds. Based upon these economic facts, I believe that the tax payers will thank the Premier for running the province efficiently and effectively by paying attention to Poor Street. Hopefully the Ontario's Auditor General will also respect poor people's life as much as broken bridges and roads.

The Minister of Social Services has recommended that 2300 poor people who received the Special Diet Allowance be charged because they have committed fraud. Mr. Sid Ryan, President of Ontario Federation of Labour (OFL) on February 1, 2010 in an opinion article in the Toronto Star complained why Ontario has not charged employers and directors of company for killing their workers. Protective guards were removed and fingers were amputated. There are two types of justice; one for Bay Street and one for Poor Street. On February 9, 2010, a frail 63 year old man with cancer came to my office and cried that his social worker at Ontario Disability refused to take his form. Why? Because I had completed the form for him. He was told to take a new form and to have it completed by another doctor. He was also told to look for a job. He told the social worker that he did not have another doctor and that I have been his doctor for 5 years. This fragile man is now on chemo-therapy. Mr. Glen Murray (his MPP) and the Premier's office were kind to him and helped him and with that gesture I feel there is hope. I have six other patients whose forms have been rejected. No reasons were given; just that the social worker doesn't want to approve the form. Only the powerless people of Poor Street receive this form of unjust treatment. Natural justice was not rendered to the poor. Being kind, caring, considerate and compassionate to the poor makes economic sense. But it all begins with restoring the social benefits rates to allow mothers, fathers, sons and daughters to eat. Ontarians can then proudly lay claim to having one of the highest living standard in the world!

February 21, 2010

The Honourable Dalton McGuinty
Legislative Building
Queen's Park
Toronto ON M7A 1A1
Fax: 416 325 3745


Dear Premier:

Special Diet Allowance Follow-up

Thank you to you, your staff and Mr. Glen Murray for helping my patient. He phoned me up with his happy, excited voice. The good news made our office staff smiled. Your help to him means that he will have access to nutritious food for the next 12 months. He may still have a poor appetite because of his illness but we find other ways to help. Thank you again.

Yours sincerely,

Roland Wong, M.Sc., MD., FRCPC

February 14, 2010

The Honourable Dalton McGuinty
Legislative Building
Queen's Park
Toronto ON M7A 1A1
Fax: 416 325 3745


Dear Premier:

Special Diet Allowance

On Tuesday, February 9, a frail 63 year old man with cancer came to my office and cried that his social worker at Ontario Disability refused to take his form. Why? Because I had completed the form for him. He was told to take a new form and to have it completed by another doctor. He was also told to look for a job. He told the social worker that he did not have another doctor and that I have been his doctor for 5 years. This man had taken his old form to the new MPP for Toronto-Centre, Mr. Glen Murray. I know him from Winnipeg in the mid-80s where we fought an epidemic of phobia and discrimination. The patient was told to return to me to forward his case to the Ministry. Perhaps Mr. Murray has too much confidence in me! So the patient trudged heavy- hearted to my office. I told him the best I could do was to write a note for him to show all those in power who can change his fate. Those in power set rules whether it's fair or not. The heads of Ontario Disability and Ontario Works issued a memorandum on December 18, 2009 to their departments that social service workers can decide on their own that a person does not have a health condition. So precisely the social worker has acted according to that memorandum.

He went for a procedure for his cancer on February 12 2010 and he was given an anesthetic for the procedure. The clinic staff asked him if there was anyone taking him home and he said he was alone in the city. What about a taxi? He said "I don't have money for taxis". He fell outside the clinic and injured his shoulder. He hobbled onwards to your office to deliver his note. He found that the front office staff at your office was kind to him and accepted his note. He felt very relieved to meet pleasant people. Luckily for him, he has no broken bones just stiff shoulders.

According to media report from December 2009, the Minister of Social Services has recommended that 2300 poor people be charged because they have committed fraud. Mr. Sid Ryan, President of Ontario Federation of Labour (OFL) on February 1, 2010 in an opinion article in the Toronto Star complained why Ontario has not charged employers and directors of company for killing their workers. Protective guards were removed and fingers were amputated. The poor people I serve wonders what your government wants to do with them.

As of January 2010, there was a new addition to the Special Diet Allowance form. Applicants are required to sign at the bottom of the form that they have read the form and understand to their "best of my knowledge, the information given on the form is true, correct and complete". Unfortunately, most applicants probably don't understand at least half the medical and health conditions listed on the form. They probably don't understand the words such as "dysphagia", "mastication", "malabsorption", "microcytic anemia", and "macrocytic anemia". In medicine that would be signing a truly uninformed consent. They also have to vouch for the health professional filling the form. I wonder how the sponsors of the new forms intends to use the information gathered in a court setting. I certainly hope that my patient would not be charged for fraud. One never knows in this rough world.

There is a campaign to raise the pitifully low social service rates from the Mike Harris's days. A group of activist from "Put Food in the Budget advisory group" PFIB)recently met with the Minister of Social Services Madame Meilleur, they were told it was unlikely that their request to increase the rate would be met because according to pubic opinions social assistance "is not on their (the government's) radar". According to the Minister, your government's priorities remain in health and education. In addition, Ontario has an anemic economy and has no money for increasing rates. I remember that not long ago we had a rosy economy in Ontario, but Harris legacy didn?t change even during the good times. We do know that poverty is the number one determinant of health. If I may argue, the poverty belongs in the health equation. Moreover if it helps, transfer the Social Service Ministry into the Health portfolio and we have solved a problem!

So I can only sit on the sideline with my patient and hope the government will help him, shred the toxic memo, get rid of autographs and raise the rates. Thank you.

Yours sincerely,

Roland Wong, M.Sc., MD., FRCPC

February 1, 2010

There has been a great deal of pressure on me to not assist you with the Special Diet from the College of Physician and Surgeon Ontario.

I am sorry I will not be able to complete the forms for you at this time.

In the meantime , please find an "approved health practitioner" such as physicians, dieticians and nurses with extended care qualifications to complete the form. Unfortunately many of you either do not have a family physician or a physician who is willing to fill your form. I wish I can do more for you. The amount of allowance prescribed for each of your medical conditions is described under the authority of Ontario Regulation 564/05. Please study your form carefully before you present the form to the practitioner.

http://www.e-laws.gov.on.ca/html/regs/english/elaws_regs_050564_e.htm

Please pay attention to the table at the bottom of that document. Many poor people have food intolerance and allergies. Only four conditions are recognized in that category: eggs, milk, soya and wheat. The amount paid may vary according to the age of the applicant. Soya and milk intolerance or allergies are also often associated with one of the allowed medical condition called "malabsorption". Women in particular may be low in iron with "microcytic anemia". Poor people generally have bad teeth because of the type of diet they can afford and lack of money to see dentists and so they may have dysphagia/ swallowing or mastication (chewing) problem. Another common problem for those with limited resources is that they cannot afford fresh fruits and vegetables with resulting "constipation". "Gout", an allowed condition results from elevated uric acid that may accumulate in joints used frequently and associated with swollen feet and knees. Older people (and even young ones) may have conditions such as "blocked arteries" with resulting cardiovascular disease (an allowed condition). They may have hypertension (high blood pressure), diabetes (high sugar in the blood) , hypercholesterolemia (high cholesterol in the blood), hyperlipidemia (high triglycerides or fat in blood), osteoporosis (low calcium in the bones), Some may have lost weight because of "malignancy" or cancer including leukemia, HIV, lupus, multiple sclerosis. others may have "liver failure/ hepatic disease " from Hepatitis B and /or C. There is money for those who are pregnant and those breast feeding. Note that blindness, deafness, schizophrenia, depression, bipolar condition, obstructive lung disease and asthma are not "allowed conditions". Study the form if you have other "allowed conditions" and inform the health practitioner.

Please complete the Special Diet Survey: http://www.surveymonkey.com/s/ZR856ZR

I truly wish you all the best.

Roland Wong M.Sc., MD., FRCPC