Ombudsman Ontario

Ombudsman Ontario

July 23, 2009 12:32 ET

Ontario Ombudsman Comments on Province's PET Scan Announcement

TORONTO, ONTARIO--(Marketwire - July 23, 2009) - Ontario Ombudsman Andre Marin today welcomed the government's announcement that it will make positron emission tomography (PET) scanning a publicly insured health service for some cancer and cardiac patients.

The announcement is based in part on the Ombudsman's advice, following his investigation into the government's PET scan program evaluation process.

Mr. Marin launched his investigation in September 2007 after receiving numerous complaints from doctors and patients that the evaluation had gone on too long and Ontario was lagging behind other provinces in the provision of publicly funded PET scans. It has been seven years since the government decided to conduct clinical trials to determine whether it should fund PET scans for specific indications.

The investigation was conducted by the Special Ombudsman Response Team (SORT) and involved in-depth research into PET scan technology, the accessibility of PET scans in other provinces and interviews with about 50 physicians as well as patients and other stakeholders. It was completed in December 2008.

At that time, the Ombudsman provided a copy of his preliminary report to the Deputy Minister of Health and Long-Term Care for a response, as required under the Ombudsman Act. After a number of meetings with senior Ministry officials, the Ombudsman determined that the issue could be resolved without need for a published report.

"Our investigation determined that this is a very complex issue, nowhere near as black-and-white as it is sometimes made out to be," Mr. Marin said. "It quickly became clear to us why the evaluation process had taken so long. However, that was no justification for not taking action, which we urged the Ministry to do. I recommended that PET scans be expedited for those patients who already qualified for them under the cancer and cardiac registries. I'm gratified that the Ministry has taken my advice and finally moved forward."

The announcement notes that PET scans will be available for cancer and cardiac patients under specific conditions where they have proven to be clinically effective. Patients with conditions that are not covered may still be eligible for PET through the PET Access Program. The Ministry has assured the Ombudsman that requests through the PET Access Program will be processed in a timely manner.

"As a result of our recommendations, physicians will now be made aware of the avenues available to get approval to have patients who are not covered under the new regulations provided with PET scans," Mr. Marin said. "That is a safety net that should catch those who fall through the cracks of today's announcement. This existed before, but the Ministry did very little to let doctors know about it until several years into the evaluations. The Ministry has indicated that future technology assessments will be more open and transparent, which is encouraging. I'm convinced that this resolution is a much-needed step forward by the government that will benefit many people in need."

While it is relatively unusual for the Ombudsman to choose not to publish a report, he has chosen this course a number of times in recent years. In 2007, a cancer patient was reimbursed $76,000 in medical costs and the province's out-of-country program was overhauled in the wake of an Ombudsman investigation, without need for a published report. That same year, mental health services for the children of Ontario-based soldiers were increased by the province after the Ombudsman's investigation quickly resolved the issue, also without a published report. The Ombudsman also resolves thousands of individual complaints every year.

Mr. Marin noted that, as with all SORT investigations, his team will continue to monitor the province's progress on the PET scan issue, with the potential to re-investigate if evidence warrants.

"I also recommended to the Ministry that it establish a process so that when the next new technology comes along, it will be assessed as quickly as possible. Bearing in mind what they can mean to people with life-threatening conditions, these kinds of assessments should be properly researched, planned and implemented - and the Ministry should be accountable throughout."

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