Legal Expense Assistance Plan (LEAP) from the Manitoba Nurses Union, is this worth the cost for Manitoba Nurses?
Shortly after the COVID-19 hysteria started to subside around the summer of 2021, a group of former nurses who left the nursing profession and those who prematurely retired due to the “exhaustion, burn-out and the impossible working condition,” somehow connected with each other on social media network and through the close-knit community.
It became apparent, as what nurses do best, is to “assess, figure it out, what went through during the pandemic” and how many of them somehow got connected and shared a common experience of the demands of delivering the health services and the demands of the complex health needs of the public.
Some realized after retiring prematurely or who left in a haste found themselves needing some support post-retirement, for wellness support, others needing financial assistance due to their unique circumstance, as well, a really troubling one, particularly accessing legal representation.
And because of these shared experiences, it begun to unravel some of the flaws of the Manitoba healthcare system particularly how the dynamics between the healthcare employers, i.e., five Regional Health Authorities (“RHA”s) under the purview of the Manitoba provincial government), nurses, Manitoba Nurses Union (“MNU”), Association of Regulated Nurses of Manitoba (“ARNM”), College of Registered Nurses of Manitoba (“CRNM”) regulatory body, some law firms in Manitoba who represent most of these entities health employers/regulators who at the same time represent nurses for legal defense (perceived conflict-of-interest), Canadian Nurses Protective Society (CNPS) for liability insurance for nurses while on active duty is enshrined within the Regulated Health Professions Act.
Another particular situation of significance is around the nurses’ experience around the structure of local Union Representative for each employer who they represent for their colleague’s best interests but somehow has its own limitation. This is where Union reps have to “tread lightly” as they can’t push the envelope further because they share the same employer for the colleague that they are advocating for. Of course, you do not want to rock the boat, if you are a union rep. There are some subtleties about preferential advocacy for the Union rep based on the racial origin, although this is just an anecdotal account (but shared within the group) but no further exploration done on this subject. But always at the back of the minds of these health workers from the visible-minority- that’s that for now!
Another experience shared is how these entities, i.e., Health regulators/health and Safety Department and compensation claims, makes the determination about decisions for reports of health and safety issues by the low-hanging fruit civil servant(s) without any healthcare background making healthcare decisions for claims. Or policy-analysts providing healthcareThis might be vague for many, but the idea is about the subjectivity and their expert knowledge on subjects, on mental health, PTSD, anxiety and depression and many other claims that are not visible to the eye.
Further, another deeply troubling experience shared is around the legal representation for nurses, post-retirement that their cases dragged on after they prematurely retired due to “legal wranglings” while on active practice.
The Manitoba Nurses Union have this “Legal Expense Assistance Plan or LEAP” That offers legal representation at an astonishing miniscule amount. But no legal defense fund that nurses can tap into when the case goes for litigation, etc. The nurses are literally left for “dead” once they stop paying their union dues and/or their License Fees to CRNM & membership fee to ARNM, plus the CNPS liability insurance only covers while nurses are on active duty with specific coverage/clauses.
This brings to light the recent article by the Winnipeg Free Press, “Medical Legal coverage raises flags: Tax-payer supported organization that protects physicians comes under scrutiny in wake of sex assault trial.”
— February 10, 2024.
See article here or access via Free Press Online Access.
The article highlights the parallels between legal defense for doctors that is tax-payer funded versus non-existing legal defense fund for nurses post-retirement. As of this writing, most of the nurses in the group are unaware of any existing legal defense fund for retired nurses in Manitoba– none to our knowledge!
These are some of the experiences that nurses are coming into the realization of what is happening within the Manitoba healthcare system. Or nurses’ encounter of these situations and are beginning to realized, as one nurse puts it, “how rotten-to-the-core” or how “fucked up” the healthcare system in Manitoba.
So in the fall of 2023, the “Institute for Healthcare Integrity of Canada”– a not-for-profit organization that is incorporated in Winnipeg, was established by these former and retired Manitoba nurses.
With the idealistic goal of being an “advocate, oversight and providing long-term support.,i.e., financial and Wellness for fellow nurses.” As we are just at the very early stages of our existence, expect that Manitoba will be the place to look up to for years to come.
The article of Kathrina Clarke, “Medical Legal Coverage Raises Flags,” dated February 10, 2024, from the Free Press is found below.
— Genaro Guevarra
Millions of Manitoba taxpayer dollars subsizide doctor’s membersip in an organization that covers their legal costs – mainly for lawsuits, hospital complaints and Professional discipline – but also for certain criminal matters.
KATRINA CLARKE
The Winnipeg Free Press
However, the organization is refusing to say if it is paying for the legal defence of a former Manitoba physician recently convicted of sexual assault.
The Canadian Medical Protective Association describes itself as a “mutual medical defence organization” for Canadian doctors that protects their “professional integrity” and “advances patient safety and compensates patients harmed by negligent care.
” It has assets valued at $5.4 billion, according to the CMPA’s 2022 annual report. The organization makes clear it is not an insurance company – it does not require doctors to pay deductibles and premiums don’t go up.
In Manitoba, doctors pay thousands of dollars in dues annually to the CMPA. and are then partially reim-bursed by the province through a re- bate program. In turn, they get access to legal help and advice- including in cases involving a lawsuit, or threat of a lawsuit, a regulatory body complaint or criminal matter stemming from their work-plus information on im- proving patient safety and a range of other services.
A total of $108.5 million from tax- payers went to doctors via Manitoba’s CMPA. rebate program in the last 10 years, including $12 million in 2022-23, according to the province.
When it comes to funding criminal cases, the CMPA’s policy is that it will “generally exercise its discretion to assist” by paying for a member’s legal defence in cases where the criminal charge arose from the doctor’s medical work The CMPA. will not say if it paid the legal costs associated with the defence of Arcel Bissonnette, a former Ste. Anne family doctor convicted of sexual assault.
A spokesperson said the organization is “unable to comment on individual members or on matters before the court.” His lawyer, Martin Minuk, said the same.
Bissonnette was convicted last fall of sexually assaulting five patients. Earlier this month, he pleaded guilty to two more sex crimes, avoiding what would have been his third trial. He remains out on bail, with sentencing submissions to be heard in June. He also faces a civil suit from five women whose charges were stayed in the first trial.
His medical licence was revoked following his conviction. Arthur Schafer, an ethics expert, called the CMPA’s refusal to say if it is funding Bissonnette’s legal defence “shabby ethics.”
“The public is entitled to know,” said Schafer, the founding director of the Centre for Professional and Applied Ethics at the University of Manitoba. The CMPA. receives “substantial public dollars” and it has “a moral obli- gation” to be transparent, he said. Two of the alleged victims in the Bissonnette case were shocked to learn taxpayer dollars could have supported his legal defence. “I understand that doctors have in- surance for malpractice, which makes sense because accidents happen, but not in criminal cases where sexual assault has occurred because that’s not an accident,” said one alleged victim who cannot be named. Her charges were among those stayed. Another woman whose charges were also stayed said she was “disgusted” to learn the CMPA. covers legal fees in similar cases.
“It’s just hard to deal with,” she said. “That’s really gross.” The Canadian Taxpayers Federation also takes issue with the use of public funds in criminal cases. “It’s definitely outrageous,” said Gage Haubrich, the organization’s prairie director. Physicians who have been convicted of criminal offences should be required to pay back the cost of their legal fees, Haubrich said. The CMPA. declined to provide a February 10, 2024 3:27 pm (GMT-6:00)
representative for an interview. In a statement, CMPA. CEO Dr. Lisa Calder said the association works with doctors to prevent harm and improve patient safety and that it does not toler- ate sexual abuse. “We understand that sexual impro- priety allegations can be devastating to all involved; but like all Canadians, doctors should be considered innocent until proven guilty,” she said. “As such, where the CMPA. provides assistance, it does so based on the presumption of innocence; and we remain committed to providing doctors with a fair and ethical defence.”
The CMPA. “does not provide further assistance once there has been a crimi- nal finding of guilt in relation to sexual abuse,” Calder said. It also does not pay settlements or awards of costs in cases where there is an allegation or finding that the mem- ber engaged in sexual abuse. Paul Harte, a medical malpractice lawyer based in Toronto, takes issue with CMPA’s position.
“You will note that they are prepared to fund a legal defence to doctors who are alleged to have sexually abused patients, but they do not use their discretion to pay compensation to these victims. As a publicly funded organization, they have their priorities reversed,” he said.
It remains unknown how many crim- inal matters the CMPA. has assisted with in Manitoba. Statistics from its annual report show there were 18 medical-legal cases in 2022 classified as “other,” a category that includes criminal cases but also human-rights complaints, inquests and privacy investigations in the “SMAT” region -Saskatchewan, Manitoba, Atlantic provinces and the Territories. In her statement, Calder stressed the CMPA. is not a taxpayer-funded orga- nization. “Membership fees are paid entirely by members,” she said. That characterization is discounted by critics.
“The notion that this is not public money is simply not correct. In the same way that funding for hospitals and doctors is public, the reimburse- ment program is funded entirely by taxpayer dollars,” Harte said. The CMPA’s key interest is in pro- tecting doctors’ reputations, something it goes to great lengths to accomplish, he said.
Its deep pockets allow it to take a “scorched earth” approach to litiga- tion, dragging out cases and racking up fees, he said. “It doesn’t accord with the public interest. I just don’t understand why physicians are afforded this protection when other professions aren’t,” Harte said. It can be difficult for patients who have suffered harm to even find a lawyer willing to take on their case, he said. Going up against CMPA-funded law yers means costs will be high, he said, adding unless the injury is catastroph- ic, it might not make financial sense to sue.
In response, Calder said the CMPA. assesses each case and seeks settle- ment “when appropriate, as quickly as possible.” Chris Wullum, a Winnipeg medical malpractice lawyer, is less critical of the CMPA’s practices. “(The CMPA.) will put a claimant to task to prove their claim regardless of whether it involves a minor injury or catastrophic one. I don’t fault the CMPA. for playing within those rules and defending the reputation of doc tors,” Wullum said, noting the exist ing legal system presents a potential Winnipeg Free Press “access to justice” issue.
“The issue with the system is the inequity of the cost to litigate versus the amount of compensation that can be recovered where negligent mistakes were still made but the injuries that resulted were more minor,” he said. “In those cases, lawsuits usually don’t get pursued even though negligence may still have occurred.”
Doctors Manitoba, which facili- tates the rebate program on behalf of Manitoba Health, said physicians are “disgusted and horrified” by the Bissonnette case. As for the rebate, spokesperson Keir Johnson said it “covers a portion of the annual liability coverage fees that all doctors must have to practise medicine.” “Our rebate never covers any direct expenses a physician faces in a criminal trial,” Johnson said, adding the rebate helps Manitoba remain competitive in recruiting and retaining much-needed doctors.
Liability insurance rates can reach into the tens of thousands of dollars, depending on the specialty, he said. The funding model is similar in other provinces and is not unique to Manitoba. “The need for doctors to practise in Manitoba with reasonable protections must be balanced against the needs of patients to be safe and to seek justice when they have been wronged,” Manitoba Health Minister Uzoma Asagwara said in a statement in response to a question about the CMPA.
-with files from Dean Pritchard katrina.clarke@freepress.mb.ca
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