The proposed legislation tabled at Queen’s Park on Monday would change the rules health-care professionals must follow when reporting their patients to the Ministry of Transportation
Independent MPP Michael Mantha tabled a private member’s bill to reform a contentious provincial program that suspends driver’s licences based on alleged health conditions, even when drivers pose no risk to road safety.
The proposed amendments to Ontario’s Highway Traffic Act come in response to an investigation by the Investigative Journalism Bureau (IJB) and the Toronto Star that found many safe drivers are having their licences suspended without any advance warning.
“Your licence is your (lifeline). Your licence is what you need to work … what you need to get to medical appointments, to get your groceries,” says Mantha, who was recently removed from the NDP caucus amid an ongoing investigation into alleged workplace misconduct.
“We do need to make sure that our roads are safe across the province, but let’s make sure that the ability for a patient having a discussion with their doctor is respected as well … This is definitely hurting a lot of people.”
The IJB/Star investigation uncovered a road-safety system that automatically takes drivers off the road based on forms known as medical condition reports, or MCRs. Some health-care professionals must submit MCRs to the Ministry of Transportation (MTO) whenever patients have certain health conditions—whether or not the medical professionals believe their patients pose a risk on the roads. The ministry then automatically suspends their driver’s licences.
It is a practice that some experts have decried as overbroad and draconian.
Mantha’s bill aims to give health-care practitioners greater discretion by only requiring them to report patients they believe could pose a threat to road safety and who continue driving after being warned of the danger.
In cases where patients are assessed by medical practitioners who may not see them again—such as in emergency departments—Mantha says the intention is to allow health-care professionals to either report them or refer them for further assessment.
“The key rule that we have here is the discretion that the doctor will have. Let’s not take away their ability to determine how an individual may or may not affect … the safety of our roads.”
A spokesperson for Transportation Minister Caroline Mulroney said “the current medical reporting system has allowed Ontario’s roads to be among the safest in North America.”
The ministry will be doing “due diligence to review [the bill] at the earliest opportunity,” the spokesperson said. “We will continue to work with all elected members to keep Ontario’s roads safe.”
While the NDP has removed Mantha from the party amid the investigation, it will support his bill.
“The current system administered by the MTO is causing medically competent drivers to lose their licences due to administrative inconsistencies or arbitrary decision-making,” said a party spokesperson in a written statement Monday.
“The changes proposed … will prioritize the safety of all road users and ensure that the system is not arbitrarily suspending people’s licences and causing undue disruption to their lives and livelihoods.”
‘More humane’
The province’s program is vulnerable to medical misjudgment and a lack of scrutiny by health practitioners and ministry officials that can ruin livelihoods, the IJB/Star found. An analysis of appeals filed by drivers challenging licence suspensions resulting from MCRs showed that roughly a third overturned their suspensions. In about a quarter of those cases, it was because the MTO could not prove they ever had the condition.
Suddenly unable to drive to work, medical appointments, and run out for errands, Ontarians who are safe drivers can lose their jobs, their ability to care for loved ones and suffer intense psychological distress. Many also lose trust in the health-care system, vowing never again to be honest with their doctors.
Currently, health professionals do not have to notify patients that they are being reported, though both the MTO and the College of Physicians and Surgeons of Ontario recommend doing so.
Many drivers interviewed for the investigation said they only learned of their suspension when a letter arrived from the MTO informing them their ability to drive had already been taken.
That is a “big problem in this province,” says Kendra Naidoo, former counsel for the Centre for Addiction and Mental Health (CAMH). “It comes as a huge shock.”
Dr. David Gratzer, a physician and attending psychiatrist at CAMH, says he supports the proposed change.
“Moving away from a policy of report first and ask questions later is important,” Gratzer says. “It shifts over to the physician’s judgment.”
The proposed changes are “more humane and reasonable,” says Toronto family physician and coroner Dr. Zoe von Aesch, and will have “positive impacts on the relationships that are so valuable in family medicine.”
“The reporting process for patients with medical conditions deemed unfit to drive is an important mechanism to ensure road safety,” said the Ontario Medical Association in a statement responding to the bill. “However, this reporting process should balance road safety with considerations for the impact and unintended consequences on patients, as well as the obligations placed on providers.”
‘Without notice’
The bill is a “step in the right direction” in the eyes of Peter Amodeo, a 27-year-old whose licence was suspended after he forgot about a doctor’s appointment for his sleep apnea.
Despite his condition, Amodeo says he does not feel sleepy when driving. During more than 10 years of daily driving, the only blemish on his driving record is a speeding ticket, he says.
Amodeo was prescribed a CPAP machine. After a few weeks, he stopped using it, he says. He heard nothing from the sleep clinic for eight or nine months, until the clinic set up a check-in appointment with him to be had over the phone.
He missed the call from the doctor. “I had totally forgotten about it,” he says. The doctor also called from a number with no caller ID and did not leave a voicemail, Amodeo says.
A few weeks later, Amodeo recalls, he received a letter from the MTO that his licence was suspended in the mail.
The suspension came as a complete shock. “I am still floored that it can happen that quickly and pretty much without notice,” he says. “I have never got that much anxiety from anything.”
Amodeo began using the CPAP machine again. The machine kept a record of whether or not he was using it that was accessible to his physician.
“I’m being monitored,” Amodeo says. “I’m at this guy’s mercy.”
Without a car, the Scarborough resident could no longer earn extra money by picking up overtime shifts at different locations of The Beer Store, where he works. He was forced to rely on between 10 and 15 people for rides at various times, he says.
And he was also no longer able to drive his grandmother, who relies on him to go shopping and attend doctor’s appointments.
Amodeo got his licence back after about 3.5 months, but he has not regained trust in the health-care system.
“What better way to discourage somebody from going to seek treatment?”