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Ontario’s NDP is pushing for reform of a provincial program that takes drivers off the road based on their alleged health conditions — even in cases where the drivers don’t actually pose any danger.
The move comes after a Toronto Star/Investigative Journalism Bureau (IJB) investigation found that Ontario’s system for reporting potentially unsafe drivers is unfairly stripping many of not just their licences, but also their livelihoods.
NDP MPP Michael Mantha says he will be introducing a private member’s bill that would amend the Highway Traffic Act to address what he sees as serious issues under the current regime.
“People’s livelihoods are being affected by the loss of their licence without proper communication between them and a doctor or the MTO,” said Mantha, who represents the rural riding of Algoma-Manitoulin. “You lose your job, you lose your livelihood, you cannot bring your family to and from activities, to school … to medical appointments.”
Under provincial legislation, doctors and other health professionals must file a medical condition report (MCR) to the MTO when patients have certain health conditions, including some psychiatric problems, motor and sensory impairments, and substance use disorders. The ministry then automatically suspends the licences of drivers reported as having these conditions. MCRs trigger thousands of licence suspensions each year.
But this system is prone to abuse, inaccuracies, and a lack of vetting by doctors and government officials, the Star/IJB investigation has found.
Health professionals are not required to inform patients that they are filing an MCR about them. Once an MCR is filed about a condition that must be reported, there is no opportunity for drivers to challenge the report until their suspension has already been issued.
Not all jurisdictions are so quick to suspend drivers’ licences, nor do they all require health professionals to report patients based on their medical conditions. Ontario’s program is among the most stringent in North America.
Mantha and his team are looking to British Columbia’s legislation, which only requires health professionals to report patients who they believe have a dangerous medical condition but continue to drive “after being warned” not to.
Transportation Minister Caroline Mulroney declined requests for interviews on the investigation’s findings. In a statement, a Ministry of Transportation spokesperson said MCRs are “carefully assessed against regulatory requirements and national medical standards” and the role of the ministry is to “ensure road safety.”
To reinstate a licence suspended through an MCR, drivers must typically arrange for a health-care provider to send medical paperwork showing they are safe to the MTO, or they can file a formal appeal before the Licence Appeal Tribunal (LAT) — a process that costs $106 and can take more than a month to resolve.
The investigation’s review of nearly 200 appeals of MCR-based licence suspensions showed one third were overturned by the LAT between January 2017 and March 2022 because the MTO could not show that the drivers had a health condition likely to significantly interfere with their driving.
In about a quarter of those successful appeals, MTO officials could not prove the drivers ever had any of the conditions that prompted their licence suspensions.
Bob Collings lost his driver’s licence last summer after fainting from suspected heat stroke. He had been working outside in the hot sun all morning. When he went to the emergency room to have it checked out — a move he now calls a “big mistake” — the doctor treating him filed an MCR stating Collings had “syncope/loss of consciousness.”
Collings said he was seen by the doctor for roughly five minutes during the visit and was given no medication or treatment. On his way out, he said, a nurse ran up to him and gave him a pamphlet explaining that he would be reported to the MTO and his licence could be suspended.
The 63-year-old college instructor from Caesarea, Ont., a village about 35 minutes north of Oshawa, said the suspension was a “total shock.”
“I can see it if there’s diagnostic evidence that says you’re a hazard, then sure … But with no evidence whatsoever, they shouldn’t be doing that,” he said. “I would never have thought a doctor who’s supposed to help you would do something like that, that destroys your life.”
For rural residents like Collings, losing the ability to drive can be devastating.
“Where I live, there’s no public transit and I’m driving all the time, so there’s no life if you don’t have a licence out here,” he said.
Collings is the primary caregiver for his elderly parents and was forced to rely on relatives — including his sister who flew in from Winnipeg to help out — to do anything from commuting to work to taking his parents to medical appointments.
Comments collected by Ontario hospitals through patient surveys underscore the serious collateral damage that the current system can wreak.
“The attending doctor contacted the MTO and pulled my drivers license,” reads one comment submitted in 2021 to a Toronto hospital. “The next week my cardiologist informed me that the doctor in emergency did not need to suspend my license. Basically a s——- move … I’m a front-line worker and have been more than happy to work and support my family over the pandemic and now I can’t.”
A patient at another Toronto hospital commented in 2017 that a doctor reported them “immediately before there had been any determination of what was wrong with me.”
As for Collings, he considered selling the “dream home” he built with his late wife and moving to another province after his licence suspension. At the time, he recalls thinking his life in Ontario was over.
Collings was able to get his licence reinstated after about a month, however, after doctors confirmed his fainting spell was temporary and had no impact on his ability to drive.
He said he’ll think twice before going to the hospital.
“I would never go there again,” he said. “I can’t afford to lose my licence.”
The breakdown of trust between patients and health-care providers caused by MCRs can also take a heavy toll on those filing the reports.
“It’s very distressing for patients and physicians,” said Dr. Zoe von Aesch, a Toronto family physician. “Physicians have a great deal of stress doing it and try to avoid it if possible because it has serious repercussions … It’s heartbreaking.”
By requiring health professionals to report patients based on health condition and not on their individual fitness to drive, Ontario is “casting way too broad a net,” said Kendra Naidoo, former lawyer at the Centre for Addiction and Mental Health.
NDP’s Mantha hopes his proposed model will foster better communication about fitness-to-drive issues between health-care providers and their patients, and ultimately, make patients feel less afraid when reaching out for help.
“That relationship is really key and important,” Mantha said. “You have to be able to trust your doctor.”
The Investigative Journalism Bureau is a non-profit newsroom based at the University of Toronto’s Dalla Lana School of Public Health.
With files from Naama Weingarten/Investigative Journalism Bureau