INQUIRY RE MINISTRY OF
HEALTH INFORMATION
ROBERT MACMILLAN
CONTENTS
Tuesday 11 February 1992
Inquiry re Ministry of Health information
Robert MacMillan
STANDING COMMITTEE ON THE LEGISLATIVE ASSEMBLY
Chair / Président(e): Offer, Steven (Mississauga North/-Nord L)
Vice-Chair / Vice-Président(e): Miclash, Frank (Kenora L)
Bisson, Gilles (Cochrane South/-Sud ND)
Christopherson, David (Hamilton Centre ND)
Conway, Sean G. (Renfrew North/-Nord L)
Eves, Ernie L. (Parry Sound PC)
Harnick, Charles (Willowdale PC)
Hope, Randy R. (Chatham-Kent ND)
Mills, Gordon (Durham East/-Est ND)
Murdock, Sharon (Sudbury ND)
Owens, Stephen (Scarborough Centre ND)
Scott, Ian G. (St George-St David L)
Substitution(s) / Membre(s) rempliçant(s):
Kormos, Peter (Welland-Thorold ND) for Ms S. Murdock
McGuinty, Dalton (Ottawa South/-Sud L) for Mr Conway
Wood, Len (Cochrane North/-Nord ND) for Mr Bisson
Also taking part / Autres participants et participantes:
MacMillan, Robert, Ministry of Health
Page, S. John, Cassels, Brock and Blackwell
Clerk / Greffier: Arnott,Douglas
Staff / Personnel:
Jackson, Patricia, Committee Counsel
McNaught, Andrew, Research Officer, Legislative Research Service
The committee met at 1007 in room 228.
INQUIRY RE MINISTRY OF HEALTH INFORMATION
ROBERT MACMILLAN
The Chair: I would like to resume the meeting of the standing committee of the Legislative Assembly. Yesterday we were in the midst of questioning Dr MacMillan. Good morning, Dr MacMillan. What I would like to do is resume the questioning by Ms Jackson.
Ms Jackson: Thank you, Mr Chairman. Dr MacMillan, just before we proceed, one correction that I would like to elicit from you arises from some specifics I gave you about the timing of the e-mails yesterday. I incorrectly asked you, Dr MacMillan, to confirm that the third of the series of e-mails that emanated from your office on the 13th came at 3:55. We subsequently marked the e-mail that came at 3:55. That was the one that was generated in Toronto and that was copied to you from Denise Allen and others. In fact, sir, can you confirm for me that the third e-mail that came from Kingston to Toronto was at 2:48?
Dr MacMillan: Yes.
Ms Jackson: Thank you. Yesterday, Dr MacMillan, there were three matters that were outstanding. I understand that you are in a position to address those this morning and perhaps just to keep things moving we could deal with that.
First of all, you had indicated that you would endeavour to find out to what extent billings information had passed from your office to Dr LeBlanc's office for reasons other than to deal with a particular doctor with respect to his affairs.
Dr MacMillan: Yes. There were none. There were several cases in which the doctor had approached Dr LeBlanc's office wanting assistance, where we agreed to assist the doctor on the understanding of his threshold impact. Information was sent with respect to billing patterns to Eugene LeBlanc for the purposes described.
Ms Jackson: So has somebody reviewed every instance in which billing information was sent to Dr LeBlanc's office?
Dr MacMillan: I reviewed with persons in both offices verbally in order to attempt to, from their memory, recall instances. I was only able to establish two other cases where information was given that was used solely for the purpose of dealing with the individual doctor concerned, to their satisfaction.
Ms Jackson: So based on people's memories, they can only recall two other cases where specific billing information went from your office to Dr LeBlanc?
Dr MacMillan: Yes.
Ms Jackson: The next thing, Dr MacMillan, was that you were going to attempt to ascertain how long a deleted e-mail could remain in the electronic waste-basket of OHIP's mainframe computer and whether and how anyone could have access to it.
Dr MacMillan: Yes. Any document that has been placed in the electronic waste-basket, and the waste-basket is subsequently emptied, can be retrieved, but the retrieval must be through a computer program with Ministry of Government Services, one that none of us has ever attempted to use. I am told, again verbally, quickly, that that opportunity is usually wiped out in a week or two as well. So essentially, when something is put into the electronic waste-basket it is not retrievable easily, and then only for a week or two.
Ms Jackson: Is the difficulty of retrieving it due to simply the fact that some people may not have the technical expertise, or because there is any security clearance required in order to be able to retrieve it?
Dr MacMillan: I am not certain of the answer to that.
Ms Jackson: Then, Dr MacMillan, you were going to endeavour to determine how many hard copies and electronic copies of the e-mail remained in the hands of, or accessible to, people in the Kingston office after November 13.
Dr MacMillan: Let me preface by saying that I was obviously more concerned about the memos outside of my office, inasmuch as we have all that information available to the staff who had hard copy anyway. But in the office of the provider services branch, Bill Teatero, Bob McBride, Dr Simon Kovacs and Peter Quinn were in possession of copies. I might say that on December 11, when the newspaper raised the issue of such a document, our coordinator for freedom of information, Andrew Parr, requested that no one destroy any documentation because of the anticipated subsequent examination of this matter by the freedom of information commissioner that had been requested by the deputy minister.
Ms Jackson: And therefore the copies that Mr Teatero, Mr McBride, Dr Kovacs and Mr Quinn had were retained?
Dr MacMillan: Yes.
Ms Jackson: And did you have or retain a copy of the e-mail?
Dr MacMillan: I subsequently got one from them. I actually got one from them the evening of the telephone call from the reporter suggesting there was a copy outside the ministry.
Ms Jackson: Okay, we will come to that in a minute. Then may I return, Dr MacMillan, to the November 30 visit to Sudbury by yourself, Dr LeBlanc and Mr Belyea that we were discussing yesterday? Mr Chairman, the note of that visit is exhibit 16.
The Chair: Just for members of the committee, we are going back to refer to exhibit 16 as handed out yesterday.
Ms Jackson: Dr MacMillan, you made reference to discussions with Shelley Martel before and after the meeting with the Sudbury cardiologists. In your discussions with Ms Martel, did she seem well-informed about the details of the thresholds and their impact on physicians?
Dr MacMillan: I think, as with most people who had any interest in this, they had the generic overall recognition that the main component of the agreement provided for the reduction of fees over $400,000, and further reduction over $450,000. I do not know whether she understood as well the technicalities of what would be deductible from that or excluded from calculations of the threshold, such as the underserviced area program -- when they started, when they ended -- such as the technical fees that were already in the schedule of benefits, and ones that we had recently decided upon that would be technical fees to help physicians.
So this is a very complex agreement. Even those of us who are involved with it are still working out the ramifications of it. So I think it is fair to say she had a cursory knowledge of the agreement but did not understand all of the issues that were being raised by physicians, both in the press, directly to her, and of course that morning in detail by the cardiologists.
Ms Jackson: I take it from what you said yesterday, how the underserviced area program worked and its impact on some of these doctors was something that was generically discussed in these conversations?
Dr MacMillan: Yes.
Ms Jackson: Now, I had asked you yesterday, Dr MacMillan, whether anybody from the ministry provided any information with respect to individual physician's billings in those conversations. I would like to turn that around this morning and ask you whether Shelley Martel said to you or to anyone else, in your hearing, anything specific about Dr Donahue's billings at all.
Dr MacMillan: No, and I am quite emphatic about that, because I am sure if that had been mentioned I would have been amazed and it would be registered in my memory to this day. I have no memory of anyone at those two meetings or during the morning talking about any physician's billings in any detail, any precise figures -- nothing coming from anyone else to us, nothing coming from us to them.
Ms Jackson: Well, there was some information about Dr Donahue's billings in general terms already in the press. We saw that yesterday.
Dr MacMillan: What is your question?
Ms Jackson: Do you remember that?
Dr MacMillan: Do I remember seeing some press clippings?
Ms Jackson: There was some specific information about Dr Donahue's billings in the press that would have been available.
Dr MacMillan: Oh, you mean information that Dr Donahue had given to the press?
Ms Jackson: Yes. We saw for example an article in the Sudbury Star on November 29 that says, "Donahue estimates that he needs a billing allowance equal to 2 to 2.5 times the $400,000 cap, or $800,000 to $1 million." Are you aware of that information appearing in the press?
Dr MacMillan: Yes. I mean, I did not identify particularly which of the numerous engagements of the press that you are referring to. I recall now that he did make that comment, and others were alleged to have made those comments, in the press. I do not recall anybody, including Minister Martel, specifically pulling out figures that she had read in the press and discussing them with us.
Ms Jackson: So there was no discussion of billing figures where they were publicly available or otherwise?
Dr MacMillan: Not that I recall, no.
Ms Jackson: Now that is with respect to Shelley Martel. Was there any indication from any of the other members whom you indicated were at those meetings, namely Mr Laughren and Ms Murdock, that they were aware of any specific billing information concerning Dr Donahue?
Dr MacMillan: No. The only recollection I have, and I think others may recall this, is a request from Mr Rodriguez. Mr Rodriguez, and I am not sure whether he was referring to the cardiologist or to Dr Donahue, but he wanted to know how much they were billing the public plan. And I said, "Well, I can't tell you," and he said, "Well, I'll have you know I'm a member of the federal house and I'm asking it of you," and I said, "Too bad; you're not getting it." I said, "That information is protected and I can't give it to you." People were of course a little humoured by this interchange between Mr Rodriguez and me and my denial to offer him any kind of indication of billings by any physician.
Ms Jackson: You said yesterday that neither you nor anyone in your hearing gave any information to any of Ms Murdock, Ms Martel or Mr Laughren concerning specific physician's billing information. Were there conversations during the course of those several hours between Ms Martel and either Dr LeBlanc or Mr Belyea that you were not party to, or might there have been?
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Dr MacMillan: No. I was at the short breakfast meeting in which we were all at one table and there was general conversation. Although with that many people you might not hear everything at the other end of the table, Dr LeBlanc was sitting right across from me, I think Minister Martel was two seats to my left and Mr Rodriguez I believe was next to me. So from the bureaucrats' side the only information would be from Dr LeBlanc or me, especially me, and there was no conversation with any of the people we were conversing with about any particular doctor's billings.
Ms Jackson: That was at breakfast.
Dr MacMillan: Yes.
Ms Jackson: What about the lunch meeting?
Dr MacMillan: I will try to review what I told you already yesterday, and that is that it was a short luncheon and --
Ms Jackson: Sorry, just so you understand, Dr MacMillan, I am not asking you to revisit what you told us about it, but at the lunch meeting, did in fact Shelley Martel speak to either Mr Belyea or Dr LeBlanc when you were not immediately present? Or do you know?
Dr MacMillan: No. I do know. We were all together all the time, for about half an hour or a little bit more maybe.
Ms Jackson: All right. Let's continue, if we can, with your note. On page 3 you move on to discuss a meeting in Sudbury on December 5, 1991, and on that occasion, I understand from your note, you, Dr LeBlanc and the deputy minister, Mr Decter, attended in Sudbury.
Dr MacMillan: Yes.
Ms Jackson: And the purpose of that attendance was what, sir?
Dr MacMillan: I want to straighten out, because I think there may be a bit of confusion about what these two meetings were, if you give me one minute. The first meeting, the one we have been talking about, was to go to Sudbury because the Sudbury Memorial Hospital had called a meeting to present its case, with its physicians, to the local MPPs. I received a call from Dr LeBlanc saying, "We've been asked to go to Sudbury," and I said, "When?" They said, "On Saturday," and I said, "Oh, no." I tried to see whether the meetings could be combined, because I knew already that the meeting the following Thursday was already set up, but my efforts were not successful because the MPPs were, of course, in the House and unavailable other than on the weekend. So the first meeting we were asked by, I presume, Shelley Martel's office to assist and be there.
On the second occasion it was the pre-arranged meeting I had tried to make with Dr De Blacam, the president of the Sudbury and District Medical Society, in which, after the meeting in Sudbury the first time, I became aware of the hostility and aggressive opposition to this agreement. I contacted the deputy and said that I would like some friends to go with me and I would particularly like it if he would come with me because I felt this was a bigger issue than we in the south were tagging into. He agreed to come, and we by that time knew that this was not simply a mutual dialogue. It was more of a mass presentation. We heard that it was going to be public. It was in the council chambers. They had extended invitations to apparently the Premier, the Treasurer. They had yellow nametags down in almost a bull pit in the front of the council chambers with all these names of these various people there, all of which ended up being empty, because even we did not want to be sort of on display.
We received a very cold recognition. In fact, no one came up to us officially and welcomed us. We sat in the audience and for several hours listened to various speakers, including a large number of physicians, give their views with respect to this agreement and in particular the threshold. There were various local politicians and other persons who spoke as well. Finally, I would guess a couple of hours, after these various speeches, the deputy was asked to speak. In spite of an overhead projector being requested, apparently none was made available. The deputy proceeded to present the position of the government and the details of the agreement, in a very empathetic way, I thought. He was heckled somewhat and there were comments from the audience and so on. Following his presentation, a number of physicians returned to the microphone to continue the, I guess, government bashing, so to speak, and we were all, I think, at 11:30 rather exhausted from this, did not feel that it had achieved anything in the way of mutually looking at issues, as most of the profession does with us, and retired back to the hotel for the evening. The only MPP at the meeting was Sharon Murdock. Mr Laughren apparently had missed several flights because of the weather, and Minister Martel was, of course, in Thunder Bay.
Ms Jackson: Was Dr Donahue at the meeting?
Dr MacMillan: Yes, he was. It is my understanding that he also happens to be secretary of the Sudbury and District Medical Society.
Ms Jackson: Was there any discussion by anyone at the meeting of Dr Donahue's particular situation?
Dr MacMillan: No.
Ms Jackson: Did you have any discussions with Dr Donahue on that occasion?
Dr MacMillan: It was only a brief one in which I leaned forward and he came over and I asked him if the committee planned on listening to us any time during the evening. He went up to the president, who was chairing the meeting, and shortly thereafter Mr Decter was allowed to speak.
Ms Jackson: And that is the only interchange you had with Dr Donahue on that occasion?
Dr MacMillan: On that occasion.
Ms Jackson: Yes?
Dr MacMillan: Yes.
Ms Jackson: And apart from that occasion and the one or two telephone conversations you told us about earlier, are those the only conversations you have had with him?
Dr MacMillan: Yes.
Ms Jackson: You said, both in your evidence and in your note, that Ms Murdock was in attendance and you say in your note that prior to attending the meeting you had a brief dinner meeting with Sharon Murdock. Who was there? Well, in fact you say in your note. You say the three ministry officials, that being yourself, Mr Decter and Dr LeBlanc, and Esko Vainio, who is who?
Dr MacMillan: He is the CEO of the Sudbury Memorial Hospital.
Ms Jackson: Was there any discussion during that dinner meeting of the specific financial circumstances of any physician?
Dr MacMillan: No, that was a very brief meeting. I mean, it was just to get some supper and get on to the general meeting. There was no discussion whatsoever. Obviously the people there would not be privy to the information, and none was passed either way by anyone.
Ms Jackson: After the meeting, you make reference to a short get-together which occurred between Sharon Murdock and the three ministry officials and Mr David Sword, a member of Ms Martel's staff. David Sword's position is what?
Dr MacMillan: I am not certain. You had better ask someone else. I would imagine he is the communications officer, but I am not certain.
Ms Jackson: During that brief get-together, did Mr Sword say anything to you that indicated a knowledge of any of the specifics of Dr Donahue's practice?
Dr MacMillan: No, not a bit, and I do not recall talking about Dr Donahue with Mr Sword. Again, I am sure I would remember if he had startled me with inside information about Dr Donahue's billings. I am sure I would have remembered it.
Ms Jackson: Did Ms Murdock say anything to you about Dr Donahue or his situation?
Dr MacMillan: No.
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Ms Jackson: You make reference in this note, Dr MacMillan, to a media package that was handed out by ministry officials. Can you just confirm, sir, that that is the document we marked as exhibit 8 yesterday?
Dr MacMillan: Yes.
Ms Jackson: When did you return from Sudbury?
Dr MacMillan: Very early. I think it was a 7 am flight, because both the deputy and I were speakers at a Canadian Institute of Law and Medicine conference at the Royal York Hotel, the deputy being the keynote morning speaker. I recall because we were 15 minutes late getting there, getting there about 9:15. I was also a subsequent speaker speaking on confidentiality of patient records and planning for legislation in that respect. Then I was on a panel thereafter.
Ms Jackson: When did you first become aware of a controversy surrounding Ms Martel's visit to Thunder Bay the prior evening?
Dr MacMillan: During the panel questions a woman got up to the microphone whom I did not know and I believe introduced herself -- or I later found out -- identified herself as Evelyn Dodds from Thunder Bay, who recorded that she had had a conversation the previous night with Minister Martel, and if the ministry was so concerned about patient confidentiality, why was it not interested in physician confidentiality and why did I allow the release of confidential information on this Dr --
Ms Jackson: Rather than ask you to try and reconstruct it, as you know, we have obtained a transcript of that question and answer and I would ask that that be the next exhibit.
The Chair: That is now going to be handed out and be marked as exhibit 17.
Ms Jackson: Could you take a look at that, Dr MacMillan, and confirm that that was the series of questions that were put to you on that occasion and the answers you gave?
Dr MacMillan: Yes, I have read this before and this seems to be a true transcript of what I said and what Ms Dodds said.
Ms Jackson: Have you ever had occasion to discuss the incidents she describes there with Shelley Martel?
Dr MacMillan: No.
Ms Jackson: Have you subsequently learned whether or not Ms Martel received any confidential information, as Ms Dodds suggests there?
Dr MacMillan: No.
Ms Jackson: In the note that you made which we marked as exhibit 12 yesterday, you note on the second page that -- I am not putting my finger on the specific point, but at some place in one of these notes, Dr MacMillan, you have indicated that, with the approval of the Deputy Minister of Health, you responded to press calls following this incident.
Dr MacMillan: Yes.
Ms Jackson: Your counsel is going to help me as to where we find that in the note.
Dr MacMillan: Yes. Let me say I think there is something missing in there too.
Ms Jackson: Can you just remind us where it is in the note?
Dr MacMillan: Yes, it is right in the middle of the page, just after the start of the paragraph under Tuesday, December 10: "Dr MacMillan, with the approval of the Deputy Minister of Health, was given leave to respond to press calls."
Ms Jackson: Thank you. And you were going to augment that?
Dr MacMillan: Yes. Because this was heated up and I have often been the spokesperson for issues related to OHIP and out-of-country payments and the other responsibilities we have, I felt that it was just a matter of time before someone was going to be phoning OHIP to determine whether or not we did have a tight ship. So I wanted to be able to give in general terms our track record and what we had generally in place to prevent this sort of thing. I subsequently did receive press calls.
Ms Jackson: Did you speak on December 10 to a reporter from the Toronto Sun?
Dr MacMillan: Yes, I spoke to at least two or three reporters that day. I think the first one was Derek Ferguson of the Toronto Star in which I said exactly what I just told you, that we were quite proud of our record, and we had various checks and balances, that we were not aware of any information ever going out from OHIP that would get in the wrong hands. That interview went fairly straightforward. The second call was about 5:20. There were two people in my office at the time, because we were having a meeting: Bob McBride and our legal counsel in Kingston, Laurel Montrose. I was in the process of a very routine interview with Sun reporter Anne Dawson and suddenly she of course proposed a question to me which rather shocked me.
Ms Jackson: What was that question?
Dr MacMillan: As I recall it, the best I can recall it, it went something like this. She said: "Dr MacMillan, I want you to listen to this question. Are you aware, do you recall, a memo that was sent by e-mail from your office to the office of Dr Eugene LeBlanc in Toronto that contained detailed information about a physician's billings?" She went on to say, "You came in the next morning to Dr LeBlanc's office and got excited and made efforts to retrieve the document because you felt that the detail went beyond what was necessary. Are you aware of that impropriety?" -- or something to that effect.
I think I sat in stunned silence for a minute, wondering whether to deny it or whether to acknowledge it. I did not want to lie about it, and I did not think there was anything done illegally, and I did not want to dig a hole for myself. So about 30 seconds later I said, "Yes, I recall a document that I did retrieve in the course of my job that went beyond the detail that I felt was necessary going out of the division." She tried to go on to insinuate that something terrible had been done and that this was totally incorrect. I tried to, obviously, tone her down and not agree with her that anything at that point was incorrect. The only incorrect thing was the fact that she either had the document or she knew of the awareness of the document.
Both at the time when I was speaking to her and since then, I have tried to analyse whether I felt she ever had the document or whether she was just told about the document by someone who was obviously aware and maybe even witnessed me getting excited. To this day, I do not know whether that document ever did leave the ministry, but certainly the contents in generality were known by her enough that I knew for certain that she was giving me a correct analysis of the existence of that document.
Ms Jackson: All right. Dr MacMillan, I am going to ask you to look at an article that appeared in the Toronto Sun the next day, December 11, which appears to be based on the conversation that you described. Is the conversation you described the only one you have ever had with Ms Dawson concerning this matter?
Dr MacMillan: Yes.
Ms Jackson: Do you have a copy?
The Chair: It is being exhibited as exhibit 18.
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Ms Jackson: Dr MacMillan, can you look at the second column of that article, in the second paragraph: "MacMillan, who is responsible for maintaining confidential information on doctors' billings, said an error was made by his staff in sending out data that was `sensitive.'" As far as your recollection goes, is that accurate?
Dr MacMillan: No, it certainly is not. I would not be silly enough to acknowledge to a reporter an error even if an error had occurred, I do not think. The fact of the matter is also, though, that the lead line says, "Confidential records on a Sudbury doctor." I made no reference to any physician in the conversation. I only acknowledged the existence of a document that was retrieved. The details of the contents of that document were never discussed by me, but obviously she seemed to be aware of some of the detail.
Ms Jackson: In the second-last paragraph of that story she reports: "Sources told the Sun the information went to at least two other health offices." Did she give you any indication of that fact?
Dr MacMillan: I think she knew whom they went to, yes. I cannot recall for certain. I have not read that for a while, but I think she knew not only the offices but I think she knew the names of the two people. I believe she was referring to Maurice Jones and Denise Allen, the communications officials who are used in the preparation of briefing notes.
Ms Jackson: Did she refer to any other health offices where the information was sent?
Dr MacMillan: No.
Ms Jackson: Did she indicate who the sources were?
Dr MacMillan: No. I do not know whether I asked her. I figured she would not tell me anyway.
Ms Jackson: After that conversation with Ms Dawson, did you have occasion to discuss the e-mail with anyone or to obtain a copy of it?
Dr MacMillan: You recall that the next morning when I went to Toronto -- no, wait a minute.
Ms Jackson: This is December 10.
Dr MacMillan: Yes.
Ms Jackson: Just to put you in context, Dr MacMillan, I believe earlier this morning you indicated you may have around this time received a copy or copies of the e-mail?
Dr MacMillan: I think that very evening, Mr McBride, who is in my office -- I said, "Go get me that e-mail; I want to read it again." Some things that the reporter told me were not very detailed and in fact one thing I believed was incorrect: the date of the memo. That led me to believe that if the document was right in front of her, why would she not relate -- it says here on line 3 that the contents were vague. They were true enough that I knew she knew of the document, but it made me doubt that she had the document in front of her.
Ms Jackson: Do you know whether additional copies of the e-mail were generated for purposes of this discussion or review?
Dr MacMillan: That was the only one. I retrieved the document and reviewed it. I will just give you, if I can, the sequence of events. I went home that evening. The next morning I almost knew that I should come to Toronto to talk with the deputy or the minister and, sure enough, I got a call asking if I could come.
I made arrangements for a flight that morning, but just as I was leaving the office -- I would like to comment about falling off my chair, if you give me leave -- Toronto Star reporter Derek Ferguson called me and said, "You lied to me yesterday; you told me everything was squeaky clean at OHIP." I said, "I didn't lie; I didn't know about that document." He said, "Well, you told the Sun all about it." I said, "The Sun told me all about it." I finally said: "Listen, I didn't. I was so surprised I almost fell off my chair." I responded to her positively, and that is how that article of course came out.
I went to Toronto --
Ms Jackson: All right, Dr MacMillan, you have jumped ahead. So that we have this in context, let's --
Dr MacMillan: I am still talking about the e-mail.
Ms Jackson: I understand that, but since you made reference to the Star article and what was in it, let's put that in front of the committee members so we can put in context the comments you have just made. That is the Toronto Star article of December 12, Mr Chairman, if that could be --
The Chair: Marked as exhibit 19.
Ms Jackson: In the middle of that article in the second --
Dr MacMillan: This is not the article. I think the one that most people know and that was raised in the Legislature is the noonday edition of the Star. That is written slightly differently.
Ms Jackson: The quote that you are referring to, I think, occurs in this article in the middle of the second column. Can you take a look at that?
Dr MacMillan: Yes.
Ms Jackson: As far as you recall, is the quote in the article you are referring to the same?
Dr MacMillan: Yes.
Ms Jackson: I think all that has happened is there are probably two editions in which the same story is repeated. I take from what you have said that it is not your recollection that you said, "I almost fell off my seat when I learned someone had broken their oath of allegiance."
Dr MacMillan: Yes. I said that.
Ms Jackson: Did you think anyone had broken their oath of allegiance?
Dr MacMillan: I immediately jumped to that conclusion, that somebody who had access to it, among the people whom I had understood at that time had access to it, either gave it or expressed the details about it to someone else that they should not have.
Ms Jackson: So the breaking of the oath of allegiance, is that in your view sending the information to Toronto or releasing it to the media?
Dr MacMillan: Oh, no. It was releasing it to the media. It is interesting that the Sun article the next day attributed the leak to one of my staff, which was rather poor reporting and upset my staff member considerably.
Ms Jackson: Which article are you referring to now, Dr MacMillan?
Dr MacMillan: I am sorry; the article I am referring to came later, on January 27. But throughout some of this, the media reporting has had some inaccuracies.
Ms Jackson: All right. Let me then return to the disclosure of this information. So far as you know, did anyone other than yourself, Dr LeBlanc, Maurice Jones, Denise Allen, Helen Ambrose or Diane McArthur know of your meeting with Dr LeBlanc on November 14?
Dr MacMillan: I do not know the answer to that. I told you, I believe, that I do not recall any of the minister's staff who are on those floors in the Hepburn Block being there, but I do not think I was satisfied at that point that one of them did not have the e-mail and the material.
Ms Jackson: No. But, Dr MacMillan, you have indicated and the story clearly indicates Ms Dawson knew about the meeting.
Dr MacMillan: Right.
Ms Jackson: Do you know of anyone else who knew about the meeting, other than the people I have listed?
Dr MacMillan: I would not know that. I mean, if someone told someone about the meeting, how would I know that?
Ms Jackson: I am not saying, Dr MacMillan, nobody else did know. But do you know of anybody else who knew of that meeting --
Dr MacMillan: Oh, I see.
Ms Jackson: -- other than the people I have listed?
Dr MacMillan: No.
Ms Jackson: Thank you. Did Ms Dawson mention the doctor's name in the course of your conversation with her?
Dr MacMillan: I cannot remember.
Ms Jackson: I am sorry; I interrupted you. You were saying you then went up to the ministry.
Dr MacMillan: I went to the ministry. You are aware of the order by Andrew Parr, our freedom of information coordinator, not to destroy any documents. A meeting was held in the minister's boardroom, with the minister chairing the meeting, with a number of people from her staff, and the deputy minister, a number of people from his staff. I gave a briefing verbally to the deputy and the minister with respect to the issue.
Ms Jackson: All right. You have made reference to an order by Mr Parr under the Freedom of Information and Protection of Privacy Act. Can I put before you that directive and mark it as the next exhibit? Can I ask you to take a look at a directive that we will put in front of you now from Andrew Parr of December 11 and ask you to confirm that that is the directive you are referring to?
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Dr MacMillan: Yes, that is the document.
The Chair: I would ask if members could mark that interoffice memo as exhibit 20.
Mr Kormos: Mr Chair, could Ms Jackson wait until we get the exhibit before she goes on?
Ms Jackson: Certainly. Dr MacMillan, can you review those instructions and confirm that from the perspective of the health insurance division they were carried out?
Dr MacMillan: Yes, they were. They were reviewed by my staff, my executive assistant, and we took steps to follow through.
Ms Jackson: I am now going to put before you, Dr MacMillan, the article of January 26 in the Toronto Star because you made reference to that in your remarks a few minutes ago. I think you said there was something in there that was inaccurate and I am going to ask you to identify what that is.
Dr MacMillan: I am sorry. It was the Sun on the 27th. The article in the Star the day before was fairly accurate and fairly well done.
Ms Jackson: Mr Chairman, I think we will be getting to this article eventually, so perhaps we should mark it as exhibit 21 in any event. That is the article of January 26.
The Chair: The Toronto Star article of January 26, 1992, will be marked as exhibit number 21.
Mr Kormos: Mr Chair, while we are speaking about these articles, Dr MacMillan spoke of yet another edition of the December 12, 1991, Star, the same article that is in the exhibit but altered to reflect a later edition. The doctor somehow seems to think there are some significant changes between the two editions. I would appreciate it if those could be made available to us too.
Dr MacMillan: I am not sure.
Mr Kormos: How significant they are, who knows? But let us take a look. It is always interesting, the evolution of a story during the day compared to during the week.
The Chair: Thank you very much, Mr Kormos. Dr MacMillan, if you could make that article available we will make photocopies of that and distribute them. Thank you very much.
Ms Jackson: Dr MacMillan, I am going to ask to have placed in front of you an article of January 27, 1992, in the Toronto Sun.
The Chair: For members of the committee, that article is now being distributed and I would ask if you could mark that as exhibit number 22.
Ms Jackson: Dr MacMillan, in the third-last paragraph of that article it says you admitted last month that, "a senior OHIP official in Kingston broke their oath of allegiance and sent a briefing note on Donahue's billing practices to the Health ministry." Is that accurate?
Dr MacMillan: No, it is not, and that is what I was raising earlier. I wish to correct that impression. I did not at any time, nor do I now, admit that anyone in Kingston broke their oath of allegiance. The sending of the briefing note to Toronto I see as an entirely separate incident to the fact that the media were in receipt or had knowledge of the document. I have not determined the source of the document the media received.
Ms Jackson: Then can I take you back to exhibit 19? There is reference there to a statement from Dr Jack Hollingsworth, and I am looking at the middle column in which it is alleged that Dr Hollingsworth said, "She knew statistics about me that I must say I didn't know myself."
I am going to show you a copy of a transcript from the ministry's files of an interview on CBC on December 11 and ask if you can identify that as a transcript of a CBC broadcast obtained from the ministry's files.
The Chair: Members of the committee, that transcript is now being distributed and marked as exhibit number 23.
Ms Jackson: On the telecopy number in the lower right-hand corner it is page 9. I am going to ask you to assume that although this broadcast says "Hallingsworth" it is in fact the Dr Hollingsworth who is referred to in the article.
Dr Hollingsworth is said to say: "Could I just make one more comment with respect to files. You know, I didn't realize this but -- I didn't realize that the politicians were entitled to have our files, but Mrs Martel did have my file. She told me she'd seen my file when I met with her and this question about a doctor's -- she wasn't referring to me in that conversation with Mrs Dodds, but she did have access to my file and Dr Kosar's file and she said that to both of us in her -- "
The interviewer asks, "Now, was that because you authorized that access?"
"No," Dr Hollingsworth says, and then he goes on, "I'm saying she told me she'd seen my file. She knew when I entered the underserviced area program."
Stopping there for a moment, Dr MacMillan, assuming this is the same Dr Hollingsworth who was the specialist on the underserviced area program on the list I took you to yesterday, would I be correct in understanding that the fact that Dr Hollingsworth was on the underserviced area program was public knowledge?
Dr MacMillan: Yes.
Ms Jackson: And the period in which he would be on that program was public knowledge?
Dr MacMillan: Yes.
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Ms Jackson: But would any other specific information about Dr Hollingsworth be public -- specific knowledge about Dr Hollingsworth's billings or billing practices?
Dr MacMillan: No.
Ms Jackson: Would there be any file on Dr Hollingsworth which should be available to Ms Martel?
Dr MacMillan: I do not even know whether there is a file that exists on Dr Hollingsworth. It is not an issue with the threshold. No communication has ever been made to us that I am aware of asking information by Dr Hollingsworth or from anyone else for that matter. I have never seen a file on Dr Hollingsworth. I am not certain whether there is one that exists.
Ms Jackson: In any event, if there is any file with respect to Dr Hollingsworth and, in any event, any information that your division has with respect to Dr Hollingsworth concerning specific billing information should not be available to Ms Martel?
Dr MacMillan: Most definitely.
Ms Jackson: And the same answers would apply with respect to any file or billings information with respect to Dr Kosar?
Dr MacMillan: The same answer: It should not, obviously unless the physician allows the person to be their agent in some way, but that does not seem to enter this argument.
Ms Jackson: Have you had any occasion to speak to Shelley Martel since the meeting you had with her in Sudbury on November 30?
Dr MacMillan: Yes, on two occasions.
Ms Jackson: When?
Dr MacMillan: The day I was giving the briefing to the minister and the deputy, someone came in and said a call had been placed to me from Minister Martel --
Ms Jackson: This is the meeting you were telling us about earlier.
Dr MacMillan: On December 11.
Ms Jackson: Yes?
Dr MacMillan: I believe I asked both the minister and the deputy, "Should I take this?" I was obviously not very eager to engage in any conversation with the minister. I believe I went into Tiina Jarvalt's office. She may have been there.
Ms Jackson: Who is Tiina Jarvalt, again?
Dr MacMillan: The executive assistant to the deputy minister. I made a brief phone call and there was some innocuous request from Minister Martel. I have tried to remember what it was. It was some simple thing. My conversation did not last more than a couple of minutes. It was for pure information and I cannot remember whether it was, "What was in the paper was true?" or "Did that happen?" -- something to that effect. It was not something that stuck in my mind. It certainly was not anything requesting any kind of detail or discussing any previous conversations or meetings with her.
Ms Jackson: Have you spoken to her on any other occasion?
Dr MacMillan: She phoned my office and I cannot remember the date because I cannot record incoming calls, but presumably from her office. She phoned to find out about the underserviced area program and, was indeed the information that we gave out as to names of physicians who had received grants under the underserviced program public knowledge? I confirmed for her that indeed we had had an opinion from the freedom of information coordinator in the ministry and that that would be like any other bursary or research grant that the Ministry of Health issues. That is public knowledge and can be made available to anyone in the public who requests it. That was the recollection of that conversation and no other topics were discussed.
Ms Jackson: Thank you. Mr Chairman, I have one short remaining area of questions for Dr MacMillan that would elicit information that is in a protected category under the freedom of information act, and I would suggest that be deferred because it would need to be dealt with, as you have indicated earlier, in camera.
The Chair: Thank you very much, Ms Jackson. As the subcommittee has discussed and decided and as was indicated yesterday on the advice of counsel in response to that particular type of information pursuant to number 10 of our terms of reference which reads: "If there shall be any objection to the disclosure of information based upon the Freedom of Information and Protection of Privacy Act, the committee may continue the proceedings in camera," we will do so on that basis.
I would like to thank you, Dr MacMillan. At this point in time, per agreement with the members of the committee as agreed to by members of the subcommittee, we will open up questions by members of the committee on a rotating basis on the information provided by you to this point in time. On that basis I would ask and inform members of the committee that, is as per an agreement by the subcommittee, we will allow members of the official opposition to commence questions, to be followed by members of the third party and to be followed by government members.
We have agreed that this type of process will rotate each and every witness before the committee. We have suggested that a time frame of approximately one hour per caucus be allocated, to be used if they so wish. On that basis I would open it up to members of the official opposition, if there is any question that they would like to pose to Dr MacMillan at this point in time. Mr McGuinty.
Mr McGuinty: Thank you, Mr Chair. Dr MacMillan, I am going to go back to the business of the three e-mails. I want to deal with the requests, the issue as to the propriety of such requests, the issue as to the propriety of the information sent, the propriety of transmittal by e-mail, the group of people who obtained the information directly in addition to the group of people who may have obtained it, and then I am going to touch on the meetings in Sudbury.
Let me begin by asking you about the requests for the information. As I understand it, it came originally from a D. McArthur in Dr LeBlanc's office. Is that correct?
Dr MacMillan: Yes.
Mr McGuinty: Do you know who or what prompted this request?
Dr MacMillan: I have heard of it second hand recently, but I do not know whether you want me to give that type of hearsay evidence or whether you want to get it directly.
Mr McGuinty: It is certainly acceptable to me.
The Chair: It certainly is up to you, Dr MacMillan, if you wish to provide that information.
Dr MacMillan: I just give it with the knowledge that the details may be a bit sparse. It was always my impression that it was for a priority briefing. When I asked that question just a couple of days ago of Diane McArthur, she said that the minister's office had several inquiries about the issue because of it being raised in the press and wanted a briefing note prepared. I was led to believe that the Treasurer also wanted details of the matter, and that is why, in part, apparently there was a degree of urgency felt by staff in getting the information and preparing it.
Mr McGuinty: Thank you, Doctor. I gather you cannot provide us with any more detail in terms of who specifically within the minister's office?
Dr MacMillan: No. I believe there are memos, e-mails again, that will satisfy that question.
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Mr McGuinty: This request by Diane McArthur was made by telephone, according to your notes, I understand. Is that usual?
Dr MacMillan: Yes. It is common to call back and forth.
Mr McGuinty: It is considered acceptable?
Dr MacMillan: Yes.
Mr McGuinty: And the information that was requested, was that properly entitled to be answered by the provider of services branch? Did it fall within that list of limited circumstances we reviewed yesterday?
Dr MacMillan: Yes.
Mr McGuinty: The additional calls that were received from a D. Allen and M. Jones, why did those come? Do you know? It seemed to me we had a call initially from a Diane McArthur and that the office was acting on that request. Then we had additional calls.
Dr MacMillan: I am not privy to evidence that has been heard here about those calls. Maybe you have read it in something. I know several calls were made back and forth. It is important for the committee to understand that the communications department serves, as I see it, two roles with two different hats on there, to serve in public communication and dealing with the media, but they are also writers and they assist internally with editing briefing notes and making them readable for priority briefings for the minister. It was my understanding, as it was of the persons involved in the transactions that day, that the two media people were involved in the preparation of the priority briefing.
Mr McGuinty: I see. Was that considered usual?
Dr MacMillan: Yes, very usual.
Mr McGuinty: The information provided now, if I might deal with that, with respect to the first e-mail. Of course, respecting the restrictions imposed upon you by the operative legislation, Dr MacMillan, the information in the first e-mail, was that factual in nature only? Was there any editorializing?
Dr MacMillan: Well, let me say just in general terms that there was factual information in there, I suppose with some subjective opinion.
Mr McGuinty: Opinion was offered?
Dr MacMillan: Yes.
Mr McGuinty: All right. The factual information was relating to billings, as I understand. Is that correct?
Dr MacMillan: Yes, essentially.
Mr McGuinty: All right. Was there any reference to any --
Mr Page: This is a concern we have. We have worked through with committee counsel how to deal with these questions. Again, we are in public. You start asking questions about the content of the e-mail. It was our understanding that it was going to be generically identified and that committee counsel would ask certain questions about it.
We are just treading a very thin line on the questioning. I am not objecting, but I want to put kind of everyone on notice that when you get into this area it is very hard to reply to a question about a document that contains a lot of confidential information without slipping into discussing the confidential information. If we can put that on the record and express our serious concerns about questioning on the e-mail, because again, it was not our understanding that that level of detailed questioning would occur on it. I just want to raise that question with the Chair. We can proceed with that caveat.
The Chair: Thank you very much. As we have already noted, there will be a point in these proceedings where we will be going into an in-camera session pursuant to the terms of reference.
Mr McGuinty: Thank you, Mr Chair, and I appreciate the point you make, counsel. I am going to ask this question notwithstanding. If you think I am overstepping that line, then please advise me.
Just generically speaking, it contained information with respect to the billings. Did it contain any information with respect to charges or the potential of such charges under the Medical Review Committee?
Dr MacMillan: No, it did not.
Mr McGuinty: All right. Thank you. With respect to the second e-mail, can you tell me how that differed from the first one generically?
Dr MacMillan: I have to understand which second e-mail you are referring to.
Mr McGuinty: The one that I understand was sent at 2:20.
Dr MacMillan: It was just brief additional information, a line or two of some further figures.
Mr McGuinty: All right. And the third e-mail, which I understand we originally thought was at 3:55, but actually it was sent at 2:48 --
Mr Christopherson: On a point of order, Mr Chair: I am one of the subcommittee members and -- I apologize for interrupting Mr McGuinty -- I know that in subcommittee we agreed we would go through all the questions, then we would go in camera and then we did not deal with the issue, but then I guess we could go into further public questions if we wanted after that. I want to suggest to the Chair and the other members of the subcommittee that we consider going into camera and hearing that information. Then we will have it out of the way and then we can come back and ask all the questions we want without interruption.
The Chair: Thank you very much, Mr Christopherson. Unfortunately that very point has already been decided at subcommittee. Certainly, if you would like to bring that back up at a subcommittee meeting, I would be more than pleased to discuss it. The process as to the questioning by committee members of Dr MacMillan has already been discussed. I would be very wary of changing that outside of the subcommittee, but I thank you for raising that.
Mr McGuinty: The third e-mail, Dr MacMillan, generically speaking?
Dr MacMillan: The third e-mail was simply a copy sent to Denise Allen and Maurice Jones, which had earlier been sent to Diane McArthur with a covering sheet just saying: "Here is the requested material."
Mr McGuinty: All right. I understand, Dr MacMillan, that normally when information of this type is prepared it is subject to review by yourself or Ms Fleming or possibly Ms Heath?
Dr MacMillan: When we prepare what we are responsible for as a priority briefing, yes, that is the proper process. In this case, and you will ask other witnesses, it seems to be the understanding that Dr LeBlanc's office was responsible for preparing the information. We were a part, probably a major part, in the passage of information in order that that priority briefing be prepared.
Mr McGuinty: Right. Had this been drawn to your attention at the outset, you would have provided different information -- less detailed information, I think you indicated in your notes.
Dr MacMillan: Yes, I would have.
Mr McGuinty: Okay. The third e-mail was sent in the afternoon. Had Ms Fleming returned by then?
Dr MacMillan: I believe she had.
Mr McGuinty: I just wonder why this was not brought to her attention and why she was not involved.
Dr MacMillan: I think for the reason I just stated, that at the time we were simply supplying information for the preparation of a briefing note. It happens very frequently on many issues where we might have only a small role to play. Abortion clinics might be an example. There might be an issue at a hospital or something where a physician component may have been involved.
It was not unusual to be a partner in preparing a briefing note, but we were not, through the usual process, through my office, asked to prepare a briefing note. In fact, the information that was being transmitted between the staff in my branch on this matter was not even copied to me. I guess it was felt by them to be in the usual course of one of the numerous pieces of information being sought with respect to the whole issue of the OMA agreement and the billing as it was affected by the thresholds.
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Mr McGuinty: I am a bit confused then, Dr MacMillan, as to whose responsibility it is to vet or okay the information that is being released. Was it Dr LeBlanc or was it your office?
Dr MacMillan: No, it would have been primarily, in that case, Dr LeBlanc having the responsibility for the briefing of his office. It would normally be signoffs and checks that he would have carried out, and he would have followed the same rules had I had the primary responsibility. I would have sent it to the executive assistant to the assistant deputy minister. In his case, I believe at that time he was still reporting to Mary Catherine Lindberg, an assistant deputy minister, and that signoff would have gone through that process.
Mr McGuinty: I thought you said in your testimony yesterday that Mr McBride -- I think these were your words -- took responsibility for what happened.
Dr MacMillan: Yes. I had said that when I had called back from Dr LeBlanc's office to Mr McBride and said, "Why did this e-mail come up to Toronto from Bill Teatero?" I said: "It contained far too much detailed information on this physician and I want it pulled back. Who did this?" Mr McBride immediately took responsibility, saying: "I was involved with that. I knew that the e-mail had been prepared and I sent it on to Toronto, as requested." I mean it was sent by Mr Teatero's machine, but the approval of the branch acting director had been given.
Mr McGuinty: So it was Mr McBride's responsibility then? I do not like to use the word "blame," but if we were to assign blame for providing too much information, that would lie with Mr McBride?
Dr MacMillan: Mr McBride acknowledged immediately that he authorized the transmission of the information.
Mr McGuinty: Fine. I will move on to something else here. The information that was provided, was there anything wrong with the amount of information provided?
Dr MacMillan: That is a good question, and one that we have already been through probably in more depth than any other ministry because of Minister Gigantes. Following the resignation of that minister, the information and privacy commissioner did a thorough investigation of the various steps of transmission of such information. As you recall, in that case it was detailed information on a patient, not detailed information on a physician. We have a copy of that investigation report that the Chairman may wish to introduce as an exhibit, because that very question was asked in that matter, and while in the end it seems that a judgement call may have not been prudent, it was not in breach of the freedom of information. Indeed, in that particular instance, information went to the minister, as you know, and it was determined that the minister did have the right to know, the need to know.
The judgement call was whether or not someone should expose a minister to that type of information that even inadvertently might slip out. Almost all of us, I thought, were so knowledgeable and so experienced in what happened on the previous occasion and we were so sensitized to it that I had never seen information since that time go that I was not happy with. So this came as a surprise and was obviously demonstrated by my immediate reaction.
Mr McGuinty: The information that was provided in these e-mails -- back to my original question, Doctor -- the mere transmittal of this information to the intended parties who received it, was that proper and lawful?
Dr MacMillan: I still believe, although there may be further investigations and this committee may make other decisions, that staff did not act with prudence, but I do not believe they did anything, to my knowledge, in breach of the three pieces of legislation that I have referred to.
Mr McGuinty: At one point in your notes, Dr MacMillan, you indicate that Mr Teatero consulted with a medical consultant in the branch and then prepared the document. Who was that medical consultant? I am referring to exhibit 12, the last paragraph.
Dr MacMillan: I believe the physician's name was Dr Robert Ecclestone.
Mr McGuinty: And what is his role?
Dr MacMillan: He is a medical consultant. That is his title.
Mr McGuinty: Why would Mr Teatero consult him?
Dr MacMillan: Why?
Mr McGuinty: Yes.
Dr MacMillan: The physicians in the branch are there for advice for piecing together information and putting it in some perspective. I know of no other reason than that. The person in charge of that department where most of the information would have been retrieved by Mr Teatero is normally Dr Simon Kovacs, who was on holiday that week.
Mr McGuinty: That brings up another matter. I understand a hard copy of the third e-mail was sent to -- is it Drs? -- Kovacs and Quinn?
Dr MacMillan: He is asking why?
Mr McGuinty: Yes.
Mr Page: Mr Chairman, frankly I think that will get into an area which would require a response in camera.
The Chair: Mr Guinty, if you could make a note of that for another venue.
Mr McGuinty: We have the list of names, Dr MacMillan, of people who received the various e-mails. You indicated yesterday that there is a group -- perhaps it was the Kingston office -- you had greater confidence in the Kingston office's ability to deal with confidential information. Is that accurate?
Dr MacMillan: Yes.
Mr McGuinty: All right. Now, if we remove those people from the picture and we deal with the others, ministry staff, can you here today limit for us in any way, or circumscribe, the group of people who may have had access to that information that was forwarded under cover of the e-mails?
Dr MacMillan: I personally, my office not being in Toronto, can only give you the names that are on the e-mails that I have assumed -- and have some evidence to know -- that they received the document. I have various scattered pieces of information that Larry Corea received the document. I have never talked to Larry Corea and looked at him and said, "Did you receive the document?" I have not done any personal investigation to determine who may have seen or been in receipt of the document. I would expect that a secretary or two might obviously have seen the document if a person had converted it from the electronic media to paper, so if they printed the document, as we know it was printed, in Denise Allen's and Maurice Jones's office, because they walked around the copy attached to the media report and a covering memo, as you are aware.
So I think the only names I have, I have given. I do not have any knowledge of anybody who I would be surprised had the memo. I only knew of people who would normally and properly, in my view, be in receipt of the material in order to prepare a briefing note, but I have not obviously information beyond that.
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Mr McGuinty: Can you provide us with any kind of assurance that those persons who would deal with this kind of information in the normal course of business did not disclose this information, either advertently or inadvertently, to others?
Dr MacMillan: Could you repeat the question, just so I am certain?
Mr McGuinty: Can you provide us with any kind of assurance as to specifically who it was received this information? Can you offer any guarantees?
Dr MacMillan: I cannot give you any names other than I have already given in my evidence. I have no idea whether anybody else received the information, factually and in hard copy or electronically. I only have the evidence that either the contents of it or the awareness of it was in the hands of Anne Dawson. That is all I know.
Mr McGuinty: If I were to give you names, could you provide me with the names which you have not listed as those people who have received this information? Could you tell me for certainty that that person did not receive the information?
Dr MacMillan: No, I could not tell you for certain.
Mr McGuinty: For instance, the Minister of Northern Development -- you could not assure me that she did not receive that information?
Dr MacMillan: No, I could not do that.
Mr McGuinty: What about the Minister of Health?
Dr MacMillan: No, I could not do that. I know that -- or I presume, I do not know that either -- I presume when the note was properly edited and the system worked in effect, to my knowledge, the proper note was received by the minister. But I have no knowledge whatsoever of whether the minister had access to or saw the more detailed information.
Mr McGuinty: Just on that point, Doctor, while I think of it, in the House I think the minister indicated in response to a question on December 9 that, and I am going to quote: "I have very specifically asked and received assurances from my deputy minister, who has heard directly from the director of OHIP, that no confidential information with respect to doctors' files and their billings and their incomes has been shared with anyone outside the OHIP department which has proper access to that information. I have not seen it, the Minister of Northern Development has not seen it and no other MPP has seen it."
Dr MacMillan: Yes?
Mr McGuinty: The information that was sent to the minister's office, either the first, second or third e-mail or the cleaned-up version which was sent the following day, November 14, did any of those contain confidential information?
Dr MacMillan: I think you will have to substantiate with witnesses in the minister's office who saw what. My information is secondhand at best. I presume, if the system worked properly, that anybody in the minister's office who gave any detailed information such as was in the initial memo would have been a fool, having been through the Gigantes episode. I would be absolutely flabbergasted if I heard somebody had sent the initial memo to the minister. The preparation of the second document to my knowledge was finalized, signed off and approved and sent for purposes of the ministry and the minister.
Mr McGuinty: I am just going to go back to this quotation, Dr MacMillan, where the minister specifically says, and again I quote, that "no confidential information with respect to doctors' files and their billings and their incomes has been shared with anyone outside the OHIP department." It seems to me that the e-mails which reached the minister's office and came into the hands of some of her staff did contain confidential information.
Dr MacMillan: Yes, it would appear that that statement is not entirely correct. I have to emphasize the close working relationship that I told you of Dr LeBlanc's office with our office. There is no other analogy to that with OHIP. It is almost a part of OHIP. I can only surmise and conclude that the minister might have said that, assuming that to be the truth. To my knowledge the minister did not have knowledge of this document with the details of a doctor's billings. At that time -- what date did you say? December 9?
Mr McGuinty: The 9th, yes.
Dr MacMillan: I seemed to be the first one to know that someone had provided a member of the press with that information on the 10th.
Mr McGuinty: Taking this a bit further, Doctor, she says here at the outset, "I have very specifically asked and received assurances from my deputy minister, who has heard directly from the director of OHIP," and that is you.
Dr MacMillan: This is again on the 9th?
Mr McGuinty: On the 9th.
Dr MacMillan: Yes.
Mr McGuinty: You are the director of OHIP.
Dr MacMillan: Yes. I am the executive director of the health insurance division.
Mr McGuinty: Would she be making reference to you here when she says "the director of OHIP"?
Dr MacMillan: The term gets bandied about. The proper term is the one I have given you, yes.
Mr McGuinty: Is that correct, then, when she said that you advised that "no confidential information with respect to doctors' files and their billings and their incomes has been shared with anyone outside the OHIP department"?
Dr MacMillan: I did not know about that until you have told me now. I believe I might have been asked. Again, the knowledge of the document was in the back of my memory. I mean, it was three weeks earlier. I might have given that assurance. Not recalling the particular document, it became a dead issue with respect to that individual physician. So I may have given that assurance or may have led them to believe that I felt our system was secure.
Mr McGuinty: I am just going to read this quote one more time. The minister, in response to a question from Mr Harris, replies -- this is only part of the response; there is a paragraph above dealing with another matter -- "I have very specifically asked and received assurances from my deputy minister, who has heard directly from the director of OHIP, that no confidential information with respect to doctors' files and their billings and their incomes has been shared with anyone outside the OHIP department which has proper access to that information. I have not seen it, the Minister of Northern Development has not seen it and no other MPP has seen it."
The minister stated that, of course, unequivocally, and you are telling us here today, Dr MacMillan, that if you provided such an assurance you may have misled the minister or you may have forgotten about the e-mails. Is that correct?
Dr MacMillan: Certainly it is important that on the 9th of December, or earlier, had I been asked, I would have inferred to them that I was happy with the security of information. Whether or not I specifically said nothing went out of OHIP, I cannot remember. I might have said that and therefore misled them.
Mr McGuinty: It is possible you did not say it?
Dr MacMillan: But I also might have said that to my knowledge nothing has gone out of the ministry and the proper people who have this information to the outside. I cannot recall that. I would have probably answered at that time that I was quite happy about the security and not aware of any information that was in improper hands.
Mr McGuinty: Do you recall any conversation dealing with this matter specifically that you had with the deputy minister?
Dr MacMillan: No, I do not. I converse with the deputy frequently and I report directly to him now, but I cannot recall the specific day or time when he may have asked me that specific question.
Mr McGuinty: Is it possible that you never had that conversation?
Dr MacMillan: I think at that time the issue had become very public. You recall that I was confronted with it on December 6 and I immediately phoned the deputy and told him what I had been confronted with. Over the next week, I am sure that I had been talking with him about the potential of any file which was allegedly seen, any information that was allegedly available to Minister Martel that might have come from OHIP. I certainly reassured him that I had no knowledge of anything and I did not believe that there was any information out there.
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Mr McGuinty: When I come to the matter of the meetings that you had in Sudbury, Dr MacMillan, in particular there was a breakfast and a luncheon meeting on Saturday, November 30, 1991. During those meetings, who raised the subject of Dr Donahue? Do you recall?
Dr MacMillan: Can I ask for a piece of information I need? The Sudbury Star, I believe, had a front-page article with Dr Donahue's picture. This is what was in the paper the night I went to Sudbury. This was the hot topic of the day, a physician who was going to be packing it in and the big concern about patients who needed dermatology services, and what would happen. There was another practising dermatologist in Sudbury, but even with the two of them, the patient load was significant.
I cannot recall exactly who said what about this article and Dr Donahue in particular, because it does focus in on him. I really cannot say for certain that his name was even mentioned at the morning breakfast meeting, but I did recite for you the questions of Mr Rodriguez, and that may have referred to him. But I do remember Dr Donahue's name being mentioned, along with the major subject, still, of cardiology services, at the noonday luncheon meeting between the three civil servants and Minister Martel.
The Chair: Just for information to committee members, the press clipping referred to by Dr MacMillan is in your exhibit 9.
Mr McGuinty: Dr MacMillan, I want you to tell me if you can, if you can describe it for me, the nature of the Ministry of Northern Development's interest in Dr Donahue. Maybe you can categorize it as follows: Was it a passing interest? Was it a keen interest? Was there no interest?
Dr MacMillan: This is at the --
Mr McGuinty: During the breakfast and luncheon.
Dr MacMillan: All three members, MPPs, who represented Sudbury and Nickel Belt, as I understand, around Sudbury -- I knew, because I was told, that we were getting all kinds of letters and cards and opposition. Obviously it is easy for physicians to generate that type of response, seeing so many people per day. So they were genuinely concerned, I guess, as politicians, but they seemed to portray also a genuine interest in the health care of their own community that was being threatened. They all seemed committed to maintaining the integrity of the OMA-government agreement. After all, it was a bilateral agreement; it was not government's imposition of something.
The physicians in the province have a lot to gain by curtailing excessive or very, very high earnings by some of their colleagues as well. That seems to be well understood by the rest of the province. But certainly in many individual cases, and a rather prevalent view by the medical community in Sudbury, the threat of physicians leaving the north, where, as you know, it is difficult to attract and keep people -- that is why we have had the incentive grant program -- the danger and the threat was pretty great. I must say that their greatest concern was by far the cardiovascular services, where suddenly a service might be necessary on an urgent basis. It did not seem to have the same threat to the community as the treatment of warts and acne and skin lesions, and that is true. So I do not recognize or remember that there was much prevalence on Dr Donahue. The reason for the meeting, the whole reason for us going up there, was because Sudbury Memorial Hospital had precipitated a meeting chaired by Shelley Martel, the minister, and we were requested to go as civil servants to provide necessary and proper information for the understanding of the very hot issue at hand.
Mr McGuinty: Can you recall whether the Minister of Northern Development ever talked about Dr Donahue?
Dr MacMillan: We talked about Dr Donahue at lunch; I have made that clear. I recall definitely talking about the impact of his closing down. It was in the newspapers. We talked about what would happen with regard to patients who would no longer have access to services there. I think we talked about epilation. I believe Dr Donahue had gone on record with the media saying he had set up a doctor's studio next door to his office or something and that part of his practice at least was going to continue, in which he would presumably bill the public and hire the electrologist himself. So that general conversation did take place.
Mr McGuinty: Do you recall, Doctor, what Ms Martel may have said in relation to Dr Donahue?
Dr MacMillan.: No. I simply remember, again, a concern, although less of a concern, about that particular service, but a concern that it was erupting into cessation of service, something that I guess as a member she would have to deal with with her constituents and was dealing with. I just do not recall anything more than that. But I do specifically recall that there was no discussion about detailed billings, profiles, charges, inspections or any of that.
Mr McGuinty: Is it fair to say that Dr Donahue's matter was causing problems for the minister?
Dr MacMillan: I do not think it would be causing a problem as much as the threat of cessation of cardiovascular services would have, and that was a very serious threat. A dermatologist would see far more patients than a cardiovascular surgeon, and it is my understanding that there was quite a campaign to pressure the politicians into amending or changing the exemptions to allow for physicians to continue in the north without the encumbrance of a threshold arrangement.
Mr McGuinty: Is it fair to say that a number of Dr Donahue's patients were writing to the Minister of Northern Development or to the ministry?
Dr MacMillan: I just said that it was my understanding; I do not remember whether anybody told me that or whether I just heard it. It is just that it was my understanding that this doctor, who was obviously going public frequently, would probably be, naturally, turning to his patients for support.
Mr McGuinty: This was a fairly big issue in the grand scheme of things in terms of medical treatment at Sudbury, though. Very topical.
Dr MacMillan: Very topical.
Mr McGuinty: Did anyone during those meetings, luncheon or breakfast, try to elicit information from anyone else at the meeting, which information would have been confidential?
Dr MacMillan: Only the episode I told you about, which was almost humorous. There was no serious request for any information, any files; nothing I recall.
Mr McGuinty: Were you present at all times during breakfast and lunch?
Dr MacMillan: Yes.
Mr McGuinty: You never left the table.
Dr MacMillan: No, I do not recall that I did.
Mr McGuinty: Was all conversation that took place overheard by you?
Dr MacMillan: I told you that in the morning meeting the length of the table -- I might not have been able to hear. I think Mr Laughren was at the end with his staff member and Sharon Murdock, so I might not have heard everything they said. Mr Belyea, who did not know anything about physician billings anyway -- he was a hospital coordinator -- I think he was down more to their end of the table. I may not have heard everything, but I am certain that no information was transmitted, because the major person who knew the information was me. Dr LeBlanc would know some information because of the threshold arrangements.
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Mr McGuinty: Doctor, I understand you had files containing information of a confidential nature in your briefcase. Is that correct?
Dr MacMillan: Yes.
Mr McGuinty: Did you have a file in that briefcase on Dr Donahue?
Dr MacMillan: Yes.
Mr McGuinty: Can you describe Dr Donahue's file for me? First of all, the colour.
Dr MacMillan: It was, I believe, just several sheets of paper with figures.
Mr McGuinty: Was it inside a file folder?
Dr MacMillan: I think it was inside one of the plastic, clear-coloured envelopes.
Mr McGuinty: What size paper?
Dr MacMillan: Normal-size paper.
Mr McGuinty: Eight and a half by 11? How thick was this file, so to speak?
Dr MacMillan: I had, you know, a fair amount of information in there. I had information about cardiology services in the north. I had the files of some of the cardiologists. Several of these physicians I had been in communication with on the phone. My records do not indicate the dates because they phoned me. In fact, the major doctor who was giving the major part of the presentation, the head of the department of cardiovascular services in Sudbury, Dr Abdulla, I had his file, I recall, because of his expression of concerns about the whole department and how they would be affected.
Mr McGuinty: Dr MacMillan, with respect to Dr Donahue's file specifically --
Dr MacMillan: Yes?
Mr McGuinty: -- how thick was it?
Dr MacMillan: I said several pages.
Mr McGuinty: What does that mean?
Dr MacMillan: About two or three pages. I have it here, but the committee may not wish to have it as an exhibit.
Mr McGuinty: Perhaps you could tell me, just generally speaking, what percentage of physicians on an annual basis are investigated by the MRC?
Dr MacMillan: What percentage?
Mr McGuinty: Yes, practising physicians.
Dr MacMillan: I believe there were about 60 to 70 cases referred per year in the last couple of years.
Mr McGuinty: Out of?
Dr MacMillan: We told you there was a backlog of about 130 --
Mr McGuinty: Right.
Dr MacMillan: -- and taking, on average, 23 to 26 months to finally get the decision of the MRC.
Mr McGuinty: That is 60 to 70 cases out of how many? Each case deals with one physician?
Dr MacMillan: Yes, out of about 20,000 physicians.
Mr McGuinty: So a very small percentage really.
Dr MacMillan: Very small.
Mr McGuinty: There have been references to a leak in the media. There has been reference to a leak by the minister in the House, the Minister of Health. Are we talking about the same leak? Are we talking about information relating to Dr Donahue or is there another leak?
Dr MacMillan: I have no idea.
Mr McGuinty: Do you have any information that would lead you to believe that there is another leak relating to --
Dr MacMillan: No, I do not.
Mr McGuinty: Do you have any inkling as to how -- was it a Toronto Sun reporter who had contacted you, Dr MacMillan -- that reporter would have gained access to any of the information in the e-mail?
Dr MacMillan: No, I have no idea.
Mr McGuinty: I am through, Mr Chair. Thank you, Dr MacMillan.
The Chair: Thank you very much. For members of the official opposition there is still some time. Mr Conway.
Mr Conway: Thank you very much, Mr Chairman. Dr MacMillan, very good to see you again. I have really enjoyed your testimony. I regret I was not able to hear it all.
I am anxious to explore one area briefly, trying to understand the context, the environment in which the so-called Martel affair is evolving. Pardon me if in fact you have dealt with some of this while I was not present. You yourself have referred to the unfortunate circumstances surrounding the release of information that caused the resignation of the previous Minister of Health. I would like to just briefly ask you a couple of questions about the environment, to the extent you can talk about that.
Would I be correct in stating that there had developed in the weeks leading up to the unfortunate incident that caused the resignation of the former Minister of Health, the member for Ottawa Centre, something of a difference of opinion between very senior officials in the Ontario Ministry of Health and the Minister of Health's office around any protocols that may have in fact been in place regarding the availability of very confidential medical information?
Dr MacMillan: No, I do not think that there was any difference in the transmission of information for briefing notes or whatever to the minister's staff. Maybe I am misreading your question.
Mr Conway: You are not aware of any tension or any rather significant difference of opinion that had developed in the Ministry of Health -- that is, the bureaucratic side of the Ministry of Health -- regarding protocols which may have been in existence having regard to, for example, the availability of names in the minister's briefing notes?
Dr MacMillan: My office, as you know, is in Kingston and I am, I guess, a little more insulated from the interaction between ministry staff and bureaucrats. I am aware of a change in policy with respect to how a briefing note was constructed with the last minister that has since been changed back to a way that would add protection of a minister from giving out sensitive information. I am looking to the Chairman to see whether we are still under the terms of this hearing. I want to be cooperative but it seems like we are talking about issues at the time of Minister Gigantes rather than the time of --
Mr Conway: I am trying to understand. You yourself have raised, I think quite appropriately, the Gigantes matter on a couple of cases. I am trying to understand the environment in which this case took place. I can well imagine the trauma around the place after the so-called Gigantes affair. I have a very keen appreciation for just how traumatic that would have been. You indicated, though, a moment ago that there had been a change that has since been changed back to the way it had been before the so-called Gigantes affair. Could you elaborate a bit as to the cause and the nature of the first change in protocol, having regard to how it is sensitive medical information may have gone forward to the Minister of Health's office?
Dr MacMillan: Yes. It is fairly simple. With Minister Gigantes, where information was being sent any sensitive information had an asterisk beside it. The previous way, under the previous government, had been to put a sheet at the back, "Confidential to the minister." Following the investigation of the privacy commissioner and the inadvertent release of a patient's name, any confidential information that is necessary now and since that time has been added as a final sheet, "Confidential to the minister." That is where there is confidential information to the minister. I think the majority probably of briefings do not have anything other than the general information that presumably the minister takes into the House.
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Mr Conway: Having heard that then, I want to just conclude by asking again for a quick summation of what I believe happened then, according to what you have already indicated in the case of the e-mail matters: that on request of the office of Dr LeBlanc, an office that is very closely associated with the office of the ministry, for the reasons that you have given in terms of the flow back and forth of information -- stop me at any point if I am misstating what I believe you have either said or left an impression of -- on the request of the office of Dr LeBlanc, someone in OHIP at Kingston prepared and caused to be sent to Dr LeBlanc's office e-mails which contained information, some of which was subjective, having to do with certain kinds of medical information involving practitioners in Ontario, and that information somehow came into the possession of at least, among others, the exempt political staff working in the office of the Minister of Health.
Dr MacMillan: I have told you to the best of my knowledge that someone in the minister's staff received it, but I still do not accept the fact -- and others will judge -- the total impropriety of such a person assisting in the development of a briefing note.
Mr Conway: My point in raising the question, having spent years of my life as a cabinet minister, I am trying to understand the flow of this information. I was led to believe when Mr Harris asked the question in the Legislature on December 9 that the minister, who could not have been more categorical -- we were led to believe that that was a very closed circle.
I will not take you through the testimony again, but I carefully listened. I certainly respect the minister and I know how these things can happen, but I took her answer to mean that there was no breach in a very tight circle that essentially incorporated only the OHIP office. Now I understand that a series of e-mails had been asked for and sent with a variety of information that, believe me, I can well imagine the contents of, and that e-mail information was circulated, among other places, in the office of the Deputy Minister of Health, and more important, from my point of view, it found its way to some of the exempt political staff working for the Minister of Health, among others.
Dr MacMillan: I do not know what you mean by "exempt."
Mr Conway: That is the minister's personal staff. Mr Corea --
Dr MacMillan: What are they exempt from?
Mr Conway: They are the minister's personal staff. I am talking about --
Dr MacMillan: Non-civil servants.
Mr Conway: -- non-civil servants, political aides to the minister. My point in asking that question is that I had initially been led to believe that that kind of information was tightly controlled, and it did not breach the OHIP circle. Now I know, apparently -- correct me if I am wrong -- that those e-mails found their way into the hands of the political assistants to the Minister of Health.
Dr MacMillan: At the time when I was making efforts on December 11 to retrieve the documents I had no knowledge of anyone on the minister's staff having received it.
Mr Conway: I appreciate that, Doctor.
Dr MacMillan: No, wait a minute; let me finish. I believe I would have been especially interested in that, and I do not believe anybody led me to believe that someone had it. I cannot remember for certain, though. The first time I knew that someone in the minister's office might have had it was when I read it in the Toronto Star in January. I have not approached Mr Corea to interview him or to discuss the matter with him, so, still, my knowledge about the possibility of someone in the minister's office having it is no better than yours.
Mr Conway: Listen, I do not think you should feel defensive about anything. I am not questioning your testimony or your motivation. All I want to conclude with is that, on the basis of what you have now told us and what we now know, there came a point in time in December 1991 when the minister's personal staff had access to that e-mail information, which my colleague from Ottawa South has raised more extensively.
Dr MacMillan: I do not know. It would appear to be the case, but I do not have any direct knowledge.
Mr Conway: Thank you.
The Chair: Thank you, Mr Conway. That brings to an end the 60-minute allocation to the opposition caucus. It also, being cognizant of the time, brings us to 1207. I would like to adjourn until 2 pm, at which time the third party shall commence questioning.
The committee recessed at 1207.
AFTERNOON SITTING
The committee resumed at 1405.
The Chair: We will reconvene for the afternoon session. When last we left, the official opposition had completed its questioning of Dr McBride. It would now be for the third party to commence its questioning. I remind all members of the committee that it was the intention, and still remains the intention as per the subcommittee, that the questioning per caucus would be limited to an hour or thereabouts. On that basis I will open this up to Mr Harnick.
Mr Harnick: Doctor, I was interested in your discussion with Mr McGuinty, particularly when he asked you what prompted the request for the preparation of the e-mail. Your answer to him was that the e-mail was being prepared for a priority briefing, and because there had been inquiries from the minister's office. In addition, you said that the Treasurer wanted the details and because of that there was a degree of urgency. Does that reflect accurately what you said?
Dr MacMillan: No, not accurately. I said that my knowledge of what it was required for was a priority briefing. That knowledge did not go beyond that, other than the fact that I was aware of a morning interview that had been made on CBC in Sudbury with Dr Donahue, and we subsequently received a transcript of that interview. I had no knowledge as to who was making the request, other than it was for priority briefing, and indeed subsequent evidence may contradict what I am saying because I am telling you what my impression was. I only recently found out, as I indicated in my evidence this morning, that -- secondhand knowledge, hearsay, I was told -- that there were calls being made to someone from the Treasurer's office or his constituency riding, because of numerous calls and letters and so on that the Treasurer, representing that riding, was apparently getting. That is all I know. I did not see any memos. There may be some, but I have not seen any directly.
Mr Harnick: It is fair to say, I gather, that once all this started to happen you made certain investigations and certain inquiries. One of those inquiries led you to the belief that the Treasurer wanted details, and that is one of the reasons the e-mail was prepared. That is what you told us this morning now.
Dr MacMillan: I just found that out a couple of days ago. I did not know at the time who was requesting the information.
Mr Harnick: That is right. But all I am asking is to confirm that in fact the Treasurer wanted the details that were contained in the e-mail. That is what you told us this morning.
Dr MacMillan: If we are going to argue about it, I would like you to read my testimony, because I did not know anything about the Treasurer wanting information. At the time I only told you that I had found out incidentally, in the last couple of days, that someone told me the Treasurer had been eager to have information about the issue because it was in his riding. That is all I know.
Mr Harnick: That is all I want to know. I do not care whether it was the day of, or the day after, or two days ago, you subsequently found out the Treasurer wanted the information and you are now confirming that that is so.
Dr MacMillan: I think I have explained it, Mr Chairman, to the best of my abilities.
Mr Harnick: As well, because the Treasurer was requesting the information, you indicated that there was a degree of urgency, or more urgency than would usually be the case.
Dr MacMillan: No, I am not going to let you put words in my mouth.
Mr Harnick: Well, that is what you told us.
Dr MacMillan: Well, let me tell it again then, because if that is exactly how I said it, I erred.
Mr Harnick: If you want to change what you said, I am giving you the opportunity to do that.
Dr MacMillan: It is your opinion about what I said, compared to my opinion about what I said.
Mr Harnick: Is there any way, Mr Chairman, that we can get a copy of --
The Chair: We have requested that there be Hansard of these on an A-priority basis. That order and request has already been made and we already do that. I would just caution all members of the committee that in their posing of questions to witnesses they should wait for the response from those witnesses.
Mr Harnick: Doctor, we know that through your investigations the Treasurer had an interest in this and he wanted the details and that the e-mail was prepared. However, in the list of people whom the e-mail was sent to, I do not see the Treasurer listed. When was this material sent to the Treasurer?
Dr MacMillan: I have no idea whether it was sent to the Treasurer or not.
Mr Harnick: Can you undertake to make some inquiries for us, because if your inquiries indicated the Treasurer wanted the material, I suspect that somewhere along the line, because you were doing it promptly to fulfil his request, the information would have ultimately been provided to the Treasurer.
Dr MacMillan: I was not doing anything to promptly --
Mr Harnick: Well, you were away that day, but your people were there and they were preparing the e-mail.
Dr MacMillan: Yes.
Mr Harnick: And your information is they were preparing it with a sense of some urgency because the Treasurer made certain requests for information.
Dr MacMillan: No, you are wrong again. My staff did not know, to my knowledge, that the Treasurer was wanting some information about this matter. My staff who were preparing the e-mail were preparing it, I believe, on the assumption that it was a routine priority briefing because of increasing media discussion about Dr Donahue and the thresholds.
Mr Harnick: Can you tell me then who told you that the Treasurer wanted the details?
Dr MacMillan: I believe it was Dr Eugene LeBlanc.
Mr Harnick: And would the Treasurer, to the best of your information, have requested the information from Dr Eugene LeBlanc?
Dr MacMillan: No, I do not know who requested it of Dr LeBlanc or his office or his staff. I have not seen, I told you, any e-mail or know of any e-mail, but apparently Dr LeBlanc's office at some time was made aware that in addition to the minister, I guess, the Treasurer or someone from the Treasurer's office had phoned to get information about this issue.
Mr Harnick: Do you know what was sent to the Treasurer?
Dr MacMillan: No, I told you already I do not know whether anything was sent to the Treasurer. I presume something must have been sent to the Treasurer, but I do not know.
Mr Harnick: All right. Now, doctor, this whole episode really began when Dr Donahue said he was about to close his practice, and I think that was on November 8, 1991, on MCTV. Is that correct?
Dr MacMillan: I would have to look it up. I will accept your date if you have it before you.
Mr Harnick: All right. Then, as well, there was a radio broadcast on the 8th or 9th that basically involved Dr Donahue and said the same thing. Is that your information?
Dr MacMillan: If I can just have a moment, Mr Chairman.
The Chair: Yes, doctor. Mr Harnick, I believe Dr MacMillan wants to just refer to some of the exhibits to make certain as to the dates.
Mr Harnick: Sure.
Ms Jackson: I think exhibit 10 and exhibit 11.
Dr MacMillan: The correction is that on the 8th there was an article about epilation on MCTV channel 4 Sudbury. Several days later on November 13 at 7:35 on Morning North, CBC Sudbury, there was an interview with Dr Donahue.
Mr Harnick: That is really when the whole incident began as far as you were aware. Is that correct?
Dr MacMillan: No, I think there was earlier press that I was aware of, where Dr Donahue was threatening to close his practice. I cannot recall the dates. I can look them up.
Mr Harnick: All right. Then it was after that that the e-mails were prepared on November 13, pretty much in response to what Dr Donahue had been saying.
Dr MacMillan: Yes.
Mr Harnick: My list indicates that they were distributed to McArthur, LeBlanc, Allen, Jones, Quinn, Kovacs, McBride, Teatero, Dave McNaughton, Larry Corea, the reporter at the Sun and a reporter at the Star. Is that essentially where you found out all of the e-mail copies had gone to?
Dr MacMillan: Some of that I knew to be a fact and some of it you concluded that I heard by rumour or newspaper article to be the case. I have no proof of several of the people you have named there that were in receipt of the document.
Mr Harnick: Because I got all these names based on the information you gave us yesterday.
Dr MacMillan: Well, I know you got all the names. But you did not get them all in that tone: that I had proof that every one of those persons had it. I have been quite clear on that, that I knew whom it was sent to and I talked to some of them. I immediately made efforts to retrieve the document. I felt I had fulfilled my duties and felt the information had been contained. It is only subsequently that people are coming forward either alleging or agreeing that they have had further knowledge of the memo.
Mr Harnick: Well, at any rate, you do not quarrel with the fact that you gave us that list yesterday?
Dr MacMillan: I gave you those names yesterday in various contexts.
Mr Harnick: That is fine. And it was after that that you in your confidential notes respecting Sudbury visits -- I guess it is exhibit 16 -- made mention of physicians in Sudbury becoming vocal and that you really had a significant concern at that stage.
Dr MacMillan: Yes.
Mr Harnick: On page 1 of that document that you prepared -- just let me digress for a moment. You prepared that document yourself?
Dr MacMillan: Yes.
Mr Harnick: I wonder why in the course of the preparation of that document you keep referring to yourself as Dr MacMillan. Why not "I" and "me"? "Dr MacMillan did this, Dr MacMillan recalls that." Why do you not just say "I recall" or "Somebody spoke to me," as opposed to "Dr MacMillan"?
Dr MacMillan: I do not know. I just put it in as the impersonal, so all the facts and all the names were known.
Mr Conway: Past presidents of the OMA have certain prerogatives, Charles.
Dr MacMillan: There was no particular reason. I prepared the notes entirely myself. In fact, the first notes I remember preparing and assimilating on the airplane coming to Toronto. That is why they are dated December 11. The other notes I wrote down later around December 21 and signed them. That was simply because I know from my experience that memory serves you better closer to the events.
Mr Harnick: Well, I am interested -- on the first page, you talk about: "Dr MacMillan recalls having read some of the media statements attributed to Dr Donahue in which certain allegations and views were expressed about his own personal situation. As a result of this erroneous material, Dr MacMillan phoned Dr Donahue to correct his understanding of the impact of the threshold on his income and offered to meet with him." So I gather that after you had heard what Dr Donahue had been saying, you then did some work on your own to determine that what he was saying was erroneous?
Dr MacMillan: To determine whether or not the statements he was making about how he was affected were correct. I found out, by virtue of retrieving data, that he was in error as to how the threshold would affect him. Very significantly in error.
Mr Harnick: And the data that you would have been retrieving would have been data pertaining to his income?
Dr MacMillan: Yes.
Mr Harnick: And his billings?
Dr MacMillan: Yes, and his coverage for a portion of the year under the underserviced area program.
Mr Harnick: Which I gather was ending that very year, I think, in around November or December.
Dr MacMillan: September 1.
Mr Harnick: Or September 1.
Dr MacMillan: That is right.
Mr Harnick: Whom did you discuss this erroneous information with, once you determined that the information was erroneous?
Dr MacMillan: I discussed the interpretation of the data with staff who had prepared them for me. I am not certain. It would probably be Dr Kovacs. I think I got probably from Dr LeBlanc's office his coverage under the underserviced area program, and I called Dr Donahue to give him the information I felt he was not in receipt of or had misinterpreted.
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Mr Harnick: From the very outset, from the day you determined that the information Dr Donahue had been speaking publicly about, to whom have you explained that this information was erroneous? With whom have you discussed the fact that his information was erroneous?
Dr MacMillan: I would have probably, in generalities, discussed it with the deputy minister when we went to Sudbury.
Mr Harnick: How could you discuss something like that in generalities?
Dr MacMillan: I am discussing it with you in generalities.
Mr Harnick: Except that would you not have had to sit down with the deputy minister and explain to him what the figures were and why it was erroneous? Would he have not been interested in that?
Dr MacMillan: It is interesting you should ask, because it would certainly be proper for me to do so, but I chose not to and Mr Decter chose not to ask me. I would protect that information from the deputy minister, just as I would from directly to the minister, in order that inadvertently they not release it. So I did not discuss details of Dr Donahue's billings with anyone other than Dr Donahue and the staff that had prepared it for me.
Mr Harnick: So you never told the deputy minister why the things Dr Donahue was talking about were erroneous.
Dr MacMillan: No, not in detail.
Mr Harnick: I gather the next stage of this was when you spoke to Dr De Blacam and the first meeting was arranged, which I gather was on the Saturday morning.
Dr MacMillan: Yes. That meeting had nothing to do with Dr De Blacam.
Mr Harnick: But you had been speaking with him and you had the first meeting arranged and you tried to combine them.
Dr MacMillan: Yes.
Mr Harnick: But the meeting with Dr De Blacam really came about a week or so later.
Dr MacMillan: Yes, the following Thursday.
Mr Harnick: In order to attend the first meeting, what preparation did you do in terms of files you prepared? What documents did you prepare to take to that meeting?
Dr MacMillan: I have already indicated that I took several physicians' billing information because of the desire for me to be of assistance in explaining their situation. There was a fair amount of hype that I thought they were in some cases misinformed. In some cases they were going to be very severely affected by this alteration in cash flow. For those physicians who were affected to a great degree, the first withdrawal of payments would have been made on their mid-December cheque, and therefore I took information relating to when the threshold would be reached, to what extent we would be withdrawing money from their normal flow of cash and being able to be, as head of the billing agency and the dealings with physicians, in an intelligent way of assistance to them. That was the only purpose and the only documents I had.
Mr Harnick: This information you had, was it confidential?
Dr MacMillan: Yes.
Mr Harnick: I gather you went to this meeting, which was a public meeting in nature -- there were many doctors there, there was --
Dr MacMillan: Are you talking about the --
Mr Harnick: The Saturday meeting.
Dr MacMillan: The Saturday meeting was not a public meeting, no.
Mr Harnick: The Saturday meeting was the meeting at the hospital?
Dr MacMillan: Yes. There were, I said, about 17 people there, who were either physicians on staff, hospital personnel, the MPPs and a few staff people I have already indicated, plus the three of us from the ministry.
Mr Harnick: And you had the confidential information with you at that meeting.
Dr MacMillan: Yes.
Mr Harnick: But you did not make use of it at the meeting.
Dr MacMillan: No.
Mr Harnick: And you never used that information prior to the meeting in your breakfast with the MPPs?
Dr MacMillan: No.
Mr Harnick: And you never used it after the meeting with your lunch with Miss Martel.
Dr MacMillan: No.
Mr Harnick: But you took it with you anyway.
Dr MacMillan: Yes, and I have given the reason for that is because I was on the phone to several of these doctors on several occasions. In fact I believe Dr Donahue even phoned me back. I cannot prove that, but it is in my memory that he did.
You have to understand these were collegial conversations, I am sure you will be able to prove, that demonstrated a willingness on my part, as a physician understanding how severely certain doctors were going to be affected, to discuss with them their billings. I mean, I had in my possession information that I realize in this province is extremely confidential, and I was holding it for use only to talk with the individual doctors.
Mr Harnick: Did you speak with individual doctors on the Saturday morning that you were there?
Dr MacMillan: Yes, but never on a one-to-one basis.
Mr Harnick: That is what I mean. You never intended to go there and meet with individual doctors privately and review their files?
Dr MacMillan: Yes, I did. I went --
Mr Harnick: Did you do that?
Dr MacMillan: I was not requested by any of the doctors I met to do so.
Mr Harnick: I see. So you took that material but you made no use of it?
Dr MacMillan: That is correct.
Mr Harnick: All right. Doctor, in your note you talk about "looking for viable solutions to prevent withdrawal of services by Sudbury physicians." That is what the mission was really all about.
Dr MacMillan: For my part, it was certainly looking to assist in the evolution over this difficult period for certain physicians, yes. I had been charged with administering this new agreement with the thresholds, and it was fine to adopt the general policy, but I was the one who of course ended up dealing, as Eugene LeBlanc did, with the numerous phone calls and letters and discussions with physicians into the most intricate detail into their billings, how they would be affected, how they could be helped and so on.
Mr Harnick: Your biggest concern was that the doctors were very upset, and it would have been a very major problem if they began to withdraw their services?
Dr MacMillan: Yes.
Mr Harnick: That would impact very much on the Ministry of Northern Development, would it not?
Dr MacMillan: I never thought about that. How would it -- it would affect the health care of the people in the north.
Mr Harnick: Would that not be something that would be of very great concern to the Minister of Northern Development?
Dr MacMillan: I presume it would be, yes.
Mr Harnick: That is why she was involved in the discussions with you.
Dr MacMillan: I think it was also her riding.
Mr Harnick: It was her riding and it was also the responsibility she had for the whole of northern Ontario.
Dr MacMillan: Yes.
Mr Harnick: And in fact she was more intimately involved with dealing with your ministry than either Mr Laughren or Ms Murdock would have been because she had a greater responsibility in her role as minister.
Dr MacMillan: Yes.
Mr Harnick: You had a second meeting, I gather early in December, that would have been on December 5, and your first meeting, I understand, was November 25, one dealing with the cardiologist, the second one dealing with doctors generally?
Dr MacMillan: The 29th.
Mr Harnick: The 29th?
Dr MacMillan: And 30th. The meeting was on the 30th.
Mr Harnick: Up to this time, had you ever spoken with Miss Martel, Mr Laughren or Ms Murdock?
Dr MacMillan: The morning at breakfast was the first time I ever met them or spoke to them.
Mr Harnick: That would have been the Saturday morning when you had breakfast with the three of them.
Dr MacMillan: That is right.
Mr Harnick: Can you tell me what discussion you had at that breakfast with Miss Martel? What were her concerns as put to you?
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Dr MacMillan: My recollection, as I have tried to indicate, was that the sole topic of discussion that I can recall was about the access to services, the threat of withdrawal of services and in particular, in the majority of the conversation, dealing with the cardiovascular surgeons and the cardiologists, who had publicly and of course to us in more detail expressed their grave displeasure about the threshold and how it would affect their program and I guess their incomes.
The whole discussion that morning, as I remember it, was simply in preparation for these three MPPs, who I guess had certain amounts of information about the issue but had never, to my knowledge, sat down with people who were experienced and charged with administering the agreement and the threshold. It was simply a natural meeting that I saw with politicians who were responsible for programs in the government position, and the bureaucrats have the information.
Mr Harnick: In the course of that discussion -- and you told me some of it dealt with the concern about withdrawal of services or access to services -- was Dr Donahue mentioned at the breakfast meeting?
Dr MacMillan: I have been asked that question several times. I hope I am making it clear to you that I have indicated that I do not recall his name being mentioned at the breakfast. It may have been. I said that it most definitely was at noon. The night before was the big newspaper articles, front page in the Sudbury newspaper. If someone suggested his name was mentioned in the morning, I would not be surprised, but I do not recall it.
Mr Harnick: You had with you at that breakfast the confidential documents?
Dr MacMillan: Yes.
Mr Harnick: But they were never --
Dr MacMillan: They were never taken out of my briefcase.
Mr Harnick: All right. You then attended at the meeting, and you have told us about the meeting. Can you recall anything at all about anything Miss Martel said at that meeting?
Dr MacMillan: I cannot recall anything specific. I was with Dr LeBlanc, who tends to speak quite a bit, and Dr LeBlanc seemed to dominate the conversation. In fact, I remember saying that his eggs were getting cold. I cannot remember --
Mr Harnick: No, I am talking about the meeting now.
Dr MacMillan: I am talking about the meeting --
Mr Harnick: No, the meeting itself.
Dr MacMillan: Oh, the meeting at the hospital?
Mr Harnick: Yes.
Dr MacMillan: Minister Martel was chairing the meeting. The most part of the meeting was a presentation. There was some written material that was handed out. I do not have that, but I am sure it could be obtained. It generally described the cardiovascular program in the north, which is the only cardiovascular program in a non-teaching centre --
Mr Harnick: I just want to know what she may have said.
Dr MacMillan: Oh. Well --
Mr Harnick: Other than moderating the meeting.
Dr MacMillan: I cannot remember.
Mr Harnick: All right. Now --
Dr MacMillan: I cannot remember specifically. It was all about cardiology and the Sudbury Memorial Hospital. No other topic was discussed.
Mr Harnick: Generally, in terms of disclosure of confidential information, can cabinet see doctors' billings if they request it?
Dr MacMillan: The Minister --
Mr Harnick: Is there anything wrong with cabinet, if they are having a cabinet meeting, saying: "We would like the billings of all these doctors. Deliver them so we can review them at our next cabinet meeting"?
Dr MacMillan: The Minister of Health can request that, but I am not an authority and I have never experienced such a request. My opinion would be that I would have to probably have the Premier phone me before I would release anything.
Mr Harnick: Would there be anything wrong with the Minister of Northern Development seeing the health files if it would relate to her portfolio?
Dr MacMillan: Yes, there would. She has no authority, any more -- any other minister, to me, would have the same status as a person coming in off the street.
Mr Harnick: What if the Minister of Health said that it was proper and it related to the other minister's portfolio?
Dr MacMillan: If the Minister of Health asked me for something, I guess I would not question, although I would advise the Minister of Health, but my advice would be that she would be probably improperly providing information if it went beyond her.
Mr Harnick: I gather that you had lunch with just Miss Martel and the three ministry officials.
Dr MacMillan: Yes.
Mr Harnick: What discussion did you have at that time with Miss Martel? Specifically, what did she tell you?
Dr MacMillan: I will relate that I recall a general, continued discussion about the cardiology services. We informed her how the threshold agreement would impact on them. We explored potential government policy changes that could reduce the problem, reduce the risk and the very specific and serious problem that we were facing. Indeed, one of the options that was discussed at that luncheon, among others, was eventually adopted, and that was to expand the notion of the underserviced area program to include any physician who was in that designated underserviced specialty.
I recall then talking about what we could do, what possible things we could take back for discussion in our ministry, and we assured the minister that we were going to do that. For her part, providing us with information, I think it was more questions in general about the issue, her demonstration of what I believed a very sincere wish to assist in reducing this access problem.
Mr Harnick: From what you told us earlier, this is the first day that you met Miss Martel. At that luncheon, in your memo on page 3 you specifically state, "His plight was discussed," meaning Dr Donahue.
Dr MacMillan: Right.
Mr Harnick: Obviously you were talking about the things that Dr Donahue had been saying, and I suspect you may have had some discussion with Miss Martel about the validity of the things Dr Donahue was saying if you were discussing his plight. Is that not correct?
Dr MacMillan: I might have indicated that it was not as bad as was being portrayed in the press and that I was hopeful that even though his office was closing we would be able to assist him and not have him leave town, which of course he had threatened to do. I did not provide any detailed information. I did not pull out any figures or facts from my briefcase. I was not asked nor was there any probing by anybody, in particular by her, about what he made or his particular status. We talked about dermatology services in Sudbury in general, and the impact of his leaving, what would happen, how the underserviced area program could help and so on.
Mr Harnick: Did you not explain to her why the things he was talking about were erroneous?
Dr MacMillan: I do not recall, but if I did, it would not have been any more than I have explained; that is, he was on the underserviced area program till September and apparently did not recognize that -- certainly the information in the newspapers did not seem to acknowledge that -- and that the epilation issue I have told you about which --
Mr Harnick: But in a general way, would you not have had to tell her --
Dr MacMillan: I just want to finish because you have asked me, and I want to say that the epilation issue was also possibly discussed and the fact that, with the Ontario Medical Association, we had determined to make that a technical fee. Therefore, he would have immunity from that portion of his income made from his epilation services. That is the extent to which --
Mr Harnick: So you did speak about his income in that sense?
Dr MacMillan: I spoke about just what I told you I spoke about. I did not mention his income.
Mr Harnick: You did not need the files to know what the numbers were. I suspect that you were well acquainted with Dr Donahue's situation.
Dr MacMillan: I was aware of -- I might not have been precise in the numbers. There are a lot of numbers: how much are technical fees, how much are gross fees, how much is going to be deducted on whatever month, what is the eventual total amount of money that would be deducted by the end of the year. There is more than one figure. I would have had those available if I had met with Dr Donahue, which I did not.
Mr Harnick: Some time later you told us about your encounter with Evelyn Dodds. I suspect it would not be wrong to categorize her getting up at that meeting and her discussion with you as being somewhat shocking to you at the time. Is that correct?
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Dr MacMillan: Yes.
Mr Harnick: The things she told you were things you had heard before. Is that correct?
Dr MacMillan: No. That is the first I had heard of that. On the morning of December 6, when she related her conversation with the minister, I had no knowledge of that conversation until she got up and announced it.
Mr Harnick: How much similarity was there between what she told you and what was contained in the e-mail?
Dr MacMillan: I hesitate giving an opinion on that. It was not exactly similar; it was not exactly different. I think the committee is going to be reviewing the contents of the e-mail and it might be better that it make its own judgement on that.
Mr Harnick: Is it safe to say that some of what Mrs Dodds related was contained in the e-mail?
Dr MacMillan: Only to the extent that it was no secret that the doctor was --
Mr Hope: Excuse me, Steve --
The Chair: Mr Hope?
Mr Hope: Is this not getting into something that may be pertaining to the confidential information? You are asking somebody to convey something and I guess we are all waiting to see what is there.
The Chair: No, I think it is clear, as we went through in the morning, if there is a --
Mr Hope: You are trying to compare two documents, public information and private information.
The Chair: Thank you very much, Mr Hope. Dr MacMillan has counsel and as we discussed earlier this morning, in the event there is a concern with respect to any release of information which is of a confidential nature, that will be taken up in the proceedings in camera, if it is determined that we will be going in camera. As I understand it, we will in fact be moving in camera.
I recognize in the morning a question was posed by, I believe, Mr McGuinty where there was a concern as to the content of the answer. It was indicated at that time that the question could again be posed when the proceedings move in camera. Seeing that there was no concern raised by Dr MacMillan and counsel to the committee, then certainly Dr MacMillan and counsel are quite prepared to provide whatever information they can on a non-confidential basis.
Mr Page: I should say that I had similar concerns that the member just raised about getting into this questioning about the e-mail in specifics.
The Chair: If there is a concern, as we know, there will be opportunity to proceed in camera. I would then ask Mr Harnick to make note of the question he was prepared to ask and we will ask that question on an in camera basis.
Mr Harnick: I am still prepared to ask that question, because I am not asking for any details; I am asking, were there elements of what Mrs Dodds told you at the meeting in Toronto that were similar to what was contained in the e-mail? It is a yes or no answer.
Dr MacMillan: Could I ask you what elements you are talking about?
Mr Harnick: No.
Dr MacMillan: I cannot comment. The only similarity that I recall is that --
The Chair: It may very well be that, without taking away from the question and answer, if there are concerns with respect to the response, then the matter could be referred to the in camera proceedings.
Mr Harnick: There is another way I can come at that, Mr Chairman.
The Chair: Thank you, Mr Harnick.
Mr Harnick: Were you particularly surprised by the content of what Mrs Dodds said, or had you heard those things before?
Dr MacMillan: I cannot answer that question because I would have to divulge my knowledge of what is in the e-mail and other matters that are still confidential.
Mr Harnick: No, I am just saying --
Dr MacMillan: I cannot answer that question.
Mr Harnick: You cannot just say whether "I was surprised" or "I was not surprised." I mean, that does not divulge the contents of anything.
The Chair: Mr Harnick, I think you will recall in subcommittee that in the event that there is a question posed that might in its response divulge confidential information, that matter would be set over to the proceeding in camera.
Mr Harnick: I was quite content with that as long as I really believed there was something that was going to be divulged. What I am asking this witness does not divulge anything of a confidential nature.
Mr Page: Surely that is a matter of what the answer is.
Mr Harnick: I am not going to push it.
Interjection.
Mr Harnick: I am somewhat surprised that a question like that cannot evoke a response.
Dr MacMillan: Mr Chairman, he is asking me for an opinion.
Mr Harnick: Those are all the questions I have.
Dr MacMillan: The document will be before him and he can form his own opinion when he sees the similarity. I do not think I have an answer.
Mr Harnick: With respect, there are a limited number of people who are going to see that document. There are a whole lot of people in this room who might be interested in your answer.
The Chair: Mr Eves.
Mr Eves: First, to clear up the point about the Treasurer's request, I think it is appropriate to read into the record what you said about the Treasurer's request on page 1105-2 of this morning's transcript. You indicated that you had just received this information a couple of days ago as a result of talking to Diane McArthur, I believe, and you go on to say, "I was led to believe that the Treasurer also wanted details of the matter, and that is why, in part, apparently there was a degree of urgency felt by staff in getting the information and preparing it."
Dr MacMillan: Yes, thank you.
Mr Eves: I would like to pursue a few general areas, and I will try to make this as organized as possible. How many physicians in Ontario are affected by the billing cap, in general numbers?
Dr MacMillan: Originally it appeared as if there were about 600, but as we have been able to obtain more information about the particular physician's practice, to the degree to which the traditional technical fees would be deducted or exempted and the degree to which the new and added technical fees that were determined would be exempted, I believe we are down now to something less than 400 physicians.
Mr Eves: How many of those would be in northern Ontario roughly?
Dr MacMillan: I know the figures for the Sudbury area. There are about 17 physicians that would be affected in the Sudbury area with the original plan at that time. As I have indicated to the committee, there has been a subsequent expansion of the definition of "underserviced area," but originally there were 17 doctors in Sudbury and maybe from Thunder Bay another similar number.
Mr Eves: To your knowledge were there any memos, e-mails, briefing notes, letters, reviews of any kind done on any other physician in northern Ontario or the Sudbury area besides Dr Donahue?
Dr MacMillan: We are doing it on every physician in the province to determine -- and we must do that to program the computer as to when the physician, by virtue of his billings, will reach the threshold. So that type of analysis is done by my staff all the time, but I have no knowledge of any of that information leaving my department.
Mr Eves: Were there any MRCs or reviews done on any other physician in northern Ontario other than Dr Donahue?
Dr MacMillan: What do you mean by MRC?
Mr Eves: Medical review committee.
Dr MacMillan: We traditionally use the letters MRC for the medical review committee of the College of Physicians and Surgeons which I described yesterday. To my knowledge, no one from OHIP, the health insurance division, which is privy to that information, has released any information on any physician who is before the medical review committee other than to the authoritative people within the ministry or to the medical review committee itself.
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Mr Eves: At any of the meetings that you attended in Sudbury, be they in November or December, at any time were files containing specific information on physicians passed around or shared during the course of the meeting?
Dr MacMillan: No. None.
Mr Eves: You are absolutely certain of that.
Dr MacMillan: I am absolutely certain.
Mr Eves: The meetings in Sudbury on November 29, I believe it was -- there has been some discussion as to whether Dr Donahue's name came up in the course of conversation or not, and there has been some discussion of whether a physician's billings and the cap were mentioned. You have indicated, I believe, that Mr Rodriguez, the federal member, was the only individual who requested such information --
Dr MacMillan: Yes.
Mr Eves: -- or wanted that specifically. That is correct?
Dr MacMillan: Yes.
Mr Eves: I want to talk a little bit about the conversation you had with Mrs Dodds at the conference that she was attending, and about your conversation with Mr Ferguson and your conversation with Anne Dawson.
You have indicated -- and if I am paraphrasing you incorrectly, please correct me. I believe that you have generally indicated to the committee that in your conversation with Mrs Dodds -- and we have a transcript of those questions and answers -- you had no reason to suspect that any such information got outside of parameters of OHIP and the ministry.
Dr MacMillan: Yes.
Mr Eves: And again, from your transcript this morning on pages 1035-1 and 1035-2, you indicated that when you were talking on December 10 to Derek Ferguson of the Toronto Star, "in which I said exactly what I just told you, that we were quite proud of our record, and we had various checks and balances, that we were not aware of any information ever going out from OHIP that would get in the wrong hands." Although I think that you were aware of the fact that the e-mail went to several people who were not connected with OHIP, such as, for example, Mr Howard, who was a member of the minister's staff in her communications department, why would you make such a statement to Mr Ferguson?
Dr MacMillan: Well, that was, I think, what, about three weeks earlier? There are many decisions made during the course of the day, with lots of sensitive information. I just did not recall immediately, I guess, that incident, nor did I have any knowledge of it having gone astray. It was information for a briefing note. The briefing note was subsequently prepared. I have indicated to the committee that Mr Howard was away and did not receive it, I understood, but I am not sure when I remember -- whether I knew that right at the time or not. That was not uppermost in my mind. I really thought that I had stopped the flow of information that could be seen by people that it be best not seen by.
Mr Eves: But in fact, on December 10, 1991, you were aware that some of that information had gone out from OHIP.
Dr MacMillan: Yes.
Mr Eves: And you said in your conversation with Anne Dawson, "Yes, I recall a document that I did retrieve in the course of my job that went beyond the detail that I felt was necessary going out of the division." Just, I guess, making the point that the conversation that you had with Anne Dawson came to a rather different -- or you made a different statement to her than you made to Derek Ferguson of the Star and than you made, I would suggest, to Evelyn Dodds a few days before that in her conference. You suggested to Mrs Dodds and you suggested to Derek Ferguson that none of this information ever went out of OHIP, and you admitted to Anne Dawson that it did.
Dr MacMillan: Well, I would agree with you, Mr Eves. Technically, I should have not said "out of OHIP," I guess. I obviously erred. It is not that I forgot all about that document, but I told you before that we work with Dr LeBlanc's office every hour of the day in doctors and their incomes and their impact on the threshold, so information transmitted back and forth between Dr LeBlanc's office was fairly customary. This, I have already explained, demonstrates more detail than had been transmitted before that, so maybe that is partly why I took it back.
Mr Eves: Okay. With respect to the Anne Dawson interview, you say on page 1035-2 of this morning's transcript, and I quote, "To this day, I do not know whether that document ever did leave the ministry," end of quote. You have indicated earlier, I believe, that -- despite the fact that Anne Dawson seemed to know some information, for example, names of two particular people who had access to the e-mail, why would you not ask her where she obtained her information and what she knew about the ultimate distribution of the e-mail, seeing as how you are so concerned that you get all copies of the e-mail back and nobody outside of OHIP find anything out about what was in it?
Dr MacMillan: I do not recall asking her. Maybe I should have. I said this morning that I doubt, if I asked, that she would have given it to me. But maybe I should have asked it. I did not.
Mr Eves: Larry Corea -- now, to be fair, you indicated that you did not know about Mr Corea gaining access to the e-mail in place of Mr Howard until some time later. Is that correct?
Dr MacMillan: I believe so.
Mr Eves: When you knew that at least it appeared on the face of the document that a copy of the e-mail went to Mr Howard, did you make any attempt to retrieve it from his office or the minister's office?
Dr MacMillan: I did not make any attempts to retrieve it directly myself. I instructed and requested my equal person, Dr LeBlanc, to undertake that. He was responsible for the preparation of the notes. I trusted that it would be done, and indeed, until December 10, I had assumed it was done. I did not phone around and do an investigation on my own. It might be that I should have, but I did not.
Mr Eves: So you regarded that as Dr LeBlanc's responsibility?
Dr MacMillan: And I also believed that he would do it because he shared with me, as I said, the observation that this went beyond prudence to be giving this kind of information to people in the ministry.
Mr Eves: Has anybody on the Premier's staff ever contacted you to discuss this matter or any aspect of it?
Dr MacMillan: Anybody --
Mr Eves: Anybody on the Premier's staff ever contacted you to discuss this matter --
Dr MacMillan: No, never.
Mr Eves: -- in any way, shape or form?
Dr MacMillan: No.
Mr Eves: To your knowledge, has any member of the Premier's staff discussed this matter with any other person in the ministry?
Dr MacMillan: I have not heard of that happening, no.
Mr Eves: You have indicated that you had two fairly short telephone conversations with Ms Martel about this matter.
Dr MacMillan: Yes.
Mr Eves: Or since then, I guess is a more accurate way of putting it.
Dr MacMillan: Yes.
Mr Eves: Have you had a conversation with anyone on Ms Martel's staff?
Dr MacMillan: Yes. Let me try to recall who. The afternoon of the question to me by Ms Dodds, I notified, I have already said, the deputy's office. And I called someone in Ms Martel's office, on her staff -- I do not think it was her direct executive assistant, but one of her assistants -- to just report what I had seen. I said to the staff person that "I felt I should inform your office about this accusation." But I said also -- I remember saying -- "I think it's best that if there are any further inquiries, you make your own calls, but I would prefer and think it proper that Ms Martel not call me."
Mr Eves: Do you recall who you had that conversation with?
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Dr MacMillan: I think if I saw a list of her staff, I would recognize it. I cannot remember right now.
Mr Eves: But you could get that information for us?
Dr MacMillan: I think so.
Mr Eves: Okay.
Dr MacMillan: Then -- sorry.
Mr Eves: It is all right.
Dr MacMillan: To complete your question, I believe before the meeting I went to in Sudbury, I may have had a conversation with David Sword of her office, who, as I have recalled, attended at the Thursday night meeting on December 5. I may have called to arrange the media distribution or whatever. I cannot remember the exact -- it was simply very straightforward. I could try to look up my telephone index to see when, but it does not stick in my memory as being anything important.
Mr Eves: Those are the only two occasions or two individuals?
Dr MacMillan: Yes.
Mr Eves: You did not discuss any information with respect to the subject matter of the meetings in Sudbury or particulars with respect to individual physicians?
Dr MacMillan: No, I did not.
Mr Eves: Have you had any occasion to talk to any other MPPs or their staff with respect to the Sudbury meetings in November and December, either before or since? If so, on what occasions and what did you discuss?
Dr MacMillan: No, I do not recall ever speaking to any other MPP or their staff.
Mr Eves: To the best of your knowledge, has anybody in the minister's office, any of her staff or any ministry personnel, discussed this matter with Ms Martel or any of her staff?
Dr MacMillan: No, I have no knowledge --
Mr Eves: You have no knowledge?
Dr MacMillan: -- of conversations, no.
Mr Eves: What have you done, if anything, since the middle of December about retrieving the e-mail and trying to ascertain where in fact it had or may not have gone, and what action have you taken, if any, since that time?
Dr MacMillan: Well, I have indicated this morning that when the Sun reporter brought this apparent leak to our attention, directions came in through the deputy to the coordinator for freedom of information, Andrew Parr, who sent out a document -- I believe it is an exhibit now -- asking us to do a number of things, one of which was to follow the e-mail, put it in a sealed envelope, contain it but do not destroy it. I was also, and still am, under the impression that an investigation was to be done by the freedom of information, privacy commissioner.
Mr Eves: Okay. I just have one small area I want to pursue in addition, Mr Chairman, and then I will be finished.
The Chair: I would remind you of the time as you do that, that there is approximately five minutes.
Mr Eves: That is fine. With respect to the medical review committee, and Dr Donahue in particular, do you have any idea when that review on Dr Donahue was commenced?
Dr MacMillan: I do not want to talk about any particular doctor as it relates to the medical review committee.
The Chair: There is a concern that the divulging of that information -- I would ask Mr Eves to make a note of that question.
Mr Eves: Okay, we will save that one.
The Chair: Are you complete, Mr Eves?
Mr Eves: I have finished.
The Chair: Thank you very much. Mr Christopherson.
Mr Christopherson: Thank you, Mr Chair. Dr MacMillan, you have testified that you do not recall at all any information that might come under the purview of the freedom of information act being relayed at the breakfast meeting or the lunch meeting that you had in Sudbury with ministers and MPPs and an MP, I believe.
Dr MacMillan: Yes, I am quite confident of that.
Mr Christopherson: Okay, you have also testified -- and I am reading from yesterday's Hansard, 1715-1 -- just to reiterate: "I am so sensitive to that" -- meaning the release of any information -- "having gone through personally the Evelyn Gigantes release of information. I am above that. I just do not believe that I could have inadvertently even slipped out something about an amount of income or any other matter relating to Dr Donahue." Is that still perfectly accurate?
Dr MacMillan: Yes.
Mr Christopherson: In today's Ottawa Citizen there is a quote from an opposition member that states, "It stretches one's credulity to believe that this particular doctor's practice, the size of his billings were never discussed at any of these meeting with ministry officials." I would ask how you would respond to that.
Dr MacMillan: I think I have responded fairly clearly with respect to --
Interjections.
The Chair: Order.
Dr MacMillan: I believe that I have described to the best of my ability the discussions about what happened during those two meetings and the conversations that took place.
Mr Christopherson: Okay. The day that you were in Dr LeBlanc's office, first of all, who was in the meeting in that room at that time? Do you recall?
Dr MacMillan: No, I indicated yesterday I did not recall everybody precisely. I do recall precisely that Eugene LeBlanc was there. I believe Diane McArthur was there, I believe Maurice Jones was there and I told you that I believed I saw Helen Ambrose at the door. I do not recall whether anybody else was in there at the time or thereabouts, but that is the best of my recollection. It is not firm, and you may find that not to be case, but that is my recollection.
Mr Christopherson: Okay, that is fine. We will leave that. Can you recall any individuals who returned to you directly a hard copy of any of the e-mails?
Dr MacMillan: Yes, I also indicated that, that the very first thing that morning when I first found out about it Maurice Jones came to me. I believe I was in Dave McNaughton's office. He had that three-piece package for me with my name circled in pencil on it and he was walking that around, as I understood it, to the people whose names it was addressed to with copies to two other people. When he walked it into me I had the same reaction that I had later in Dr LeBlanc's office, saying: "Who sent this? Why was this sent? There's too much detail here. Why do they need this?" I was mad.
Mr Christopherson: Again, I would just like to make sure that we are crystal-clear that it was testimony you gave yesterday to your questioning from Ms Jackson that there were three e-mails and that none of the e-mail -- I will use the correct language -- "There's no reference to the medical review committee in the document." Is that correct? In all three documents there was no reference to the medical review committee as that committee is described earlier in your original testimony?
Dr MacMillan: That is correct. You are talking about the three stapled together?
Mr Christopherson: Yes.
Dr MacMillan: The coverings --
Mr Christopherson: The follow-up and the one that was really just the two of them.
Dr MacMillan: Oh, I am sorry. The answer is the same -- no.
Mr Christopherson: In all, there was nothing in any of them that referred to, and I do not want to use any wrong language, the medical review committee in any way as we have talked about it earlier in questioning, as to what it is and how it exists and what it does, no reference to it?
Dr MacMillan: No reference to it.
Mr Christopherson: Fine. I believe a couple of my colleagues have some more questions, Mr Chair.
The Chair: Yes, we have Mr Owens on.
Mr Owens: In terms of the testimony around the Treasurer and the document, in your experience is it unusual for an MPP, whether as part of the government or as part of the opposition, to request a briefing note on a particular issue within his or her riding?
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Dr MacMillan: No, it is certainly not unusual to have a constituent request, either directly from the MPP or the staff, especially when the issue relates to that particular riding. I am not familiar with the processes of briefing notes' transmission between ministers' offices, but certainly we get direct requests or requests in the form of letters that we have to respond to, put the information on, back for the minister's signature to send to the particular MPP or minister. In this case, because of the morning broadcast presumably, there would be a more urgent request than the usual form of transmission of information through a signed letter.
Mr Owens: Without going into the details contained in that briefing note, do you have any reason to believe that would be the information that the Treasurer would request in terms of dealing with the situation as it was occurring in the Sudbury area?
Dr MacMillan: He certainly was extremely interested in the cardiology services, being there on a Saturday morning in a spot that was not his riding, as I understand it, so I guess he would be as interested in the withdrawal of dermatology services and the comments being made by the particular doctor affected. I guess when you look at it, the cardiologists represented a group, including cardiovascular surgeons. In this particular case it represented one physician. Therein lies some of the dilemma of providing information that did not relate. We do not have anything else about doctors other than their billing. That is all my staff could send and that is what they sent.
Mr Owens: Thank you, Mr Chair.
The Chair: Mr Mills?
Mr Mills: Thank you very much, Mr Chair. Doctor, my question centres around the process one goes through when one finds an errant doctor. I am interested to hear exactly the steps that happen to come to grips with the shortcomings.
Dr MacMillan: Okay, let me start again at the local level. We have district medical consultants out close to the providers' practices in order that customer service, so to speak, can be enhanced. Indeed, for the most part it works well and the local medical consultant is seen as an agent for the physician in dealing with the billings and for the most part is assisting the physician in adjudicating claims, complex claims that have to have sometimes an individual consideration, problems in billing and so on. So the staff of the district office receiving the claims and the physician who is in my division assist in that process.
They also have the other hat. The other hat is of course to detect people who are abusing billing privileges or who may be innocently charging for things in an improper way. Therefore it is the duty of the local medical consultant to bring those inequities to the attention of the physician with the expectation that they be corrected. If the expectation does not come to fruition and the physician ignores the advice of the medical consultant, then the local medical consultant will undoubtedly contact head office in order to possibly have a further review of the doctor's practice.
For our part, in reviewing a doctor's practice that is only one source of our attention to a doctor. The computer program will identify aberrant profiles, someone who has an excessive cost per patient, someone who sees four times as many patients as someone else, does or has repeat visits or inappropriate charges. We receive calls from the public at times. I have described, I think, for the committee various ways in which a doctor comes to our attention. Obviously doctors who are high-income earners, high billers, have more attention paid than someone who is not billing to a high degree. Those are almost routinely analysed and indeed a high percentage of the cases that do eventually go to the medical review committee and are deemed to be inappropriately billing are people who are at the high end of the income scale from OHIP.
My staff do all that work without my direct supervision. I do not interfere with their ability. Sometimes I personally phone them and ask them to have a look at someone because it has come to my attention. But for the most part, routinely, about once or twice a week, I will get a package on my desk which contains a covering letter for my signature, and eventually the assistant deputy minister's signature, that contains all the information that we wish to report to the medical review committee of the college for its adjudication of the matter.
I have told you that when we send them we do not know that they have erred, but we suspect they well may have, and I am told that in approximately 70% of the cases that do go there is a recovery subsequently made. I have described for you the process then after it leaves my office, with the medical review committee. I think I may have failed to say that if the physician does not agree with the final judgement of the medical review committee, he or she has access to the Health Services Appeal Board, and indeed in many cases an appeal is made there and the issue, I believe, is opened to public scrutiny in that forum.
Mr Mills: Thank you. So the ultimate is that there is a recovery process for the slippage, shall we say?
Dr MacMillan: Yes.
Mr Mills: At any time in your experience has there ever been a doctor charged with any criminal offence?
Dr MacMillan: I believe there have been about 20 doctors charged with criminal offences relating to OHIP over the past 10 years. I am not certain of the number that might emanate from the MRC, if any. It would seem apparent that they could pick up information, obviously with having an inspection in place to find information, that would lead to the feeling that outright fraud had occurred, and in those cases of course the police force having jurisdiction in the area of the practice would take over the whole matter.
Mr Mills: My next area of question is that I just wonder if there has been any request for information for Dr Hollingsworth at any time.
Dr MacMillan: No, I have never had any request that I have heard of on Dr Hollingsworth.
Mr Mills: If I may, Mr Chair, I would like to go to exhibit 23. It is the CBC interview with Dr Hollingsworth and a CBC reporter by the name of, I think, Ruth Reed. During that interview it goes on to say:
"Dr Hollingsworth: No, there was no authorized access. And the other point about our files is that --
"Reed: You're saying she had those files without you authorizing them?
"Dr Hollingsworth: I'm saying she told me she'd seen my file. She knew when I entered the underserviced area program. She knew statistics about me that I must say I didn't know myself."
Would it be fair for me to assume that the document that Dr Hollingsworth is talking about is the public document exhibit 8 whereby there are all kinds of statistical detail about the date the support started and things like that? Would it be fair for me to assume that the document Dr Hollingsworth is talking about, having heard what you said, your freedom of information, how you look after the documents, that in fact the document that Dr Hollingsworth said is the one that the minister had is in fact this public document?
Dr MacMillan: I have no --
Mr Harnick: How does he know that?
The Chair: Order. Allow Dr MacMillan to respond.
Dr MacMillan: I have no knowledge of any other documents that would be available to which he would be referring. I believed, when I read that, that he was either misinformed or he was just adding fuel to the fire. I did not believe that anybody would have a file on Dr Hollingsworth, since I am the only one, plus the district office, that would have access to obtaining that kind of information. I am not aware, to this day at least, of any file having been prepared on Dr Hollingsworth.
Mr Mills: Is that this public document, with the detail?
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Dr MacMillan: Just the one, of course, where his name is listed with the others in the province on the underserviced area program.
Mr Kormos: You say when criminal changes are being contemplated it is no longer the Ministry of Health that conducts that investigation?
Dr MacMillan: Right.
Mr Kormos: What happens? I do not understand what happens. You say local police. Is it local police or OPP? A police force assumes the responsibility for investigating at that point. How does that transfer of responsibility take place?
Dr MacMillan: I mentioned yesterday how we would flood a doctor's practice with verification letters to patients, saying: "The following is your list of services. This is how much was charged. This is the service that was performed in the name of the doctor." The patient is then asked, "Please contact the ministry if you believe this is in error."
I have never been personally involved in such a referral but, as I understand, when such a determination is made that patients are writing back, saying, "I've never seen this guy," or "I never was there; I don't even know this doctor," that type of thing could come to our attention. Obviously the fraud squad of the OPP might be contacted or, in the Metropolitan area such as this, maybe the Toronto police.
I just indicated that the MRC might do the same thing if they come across what they believe to be criminal behaviour, but that is a very rare thing, as you know from the figures I gave you of 20 physicians over 10 years for 20,000 physicians in the province.
Mr Kormos: I got one of those letters once, around four years ago. I did not fill it out. I did not return it. I am not in trouble?
Dr MacMillan: No, because it probably told you that if you were satisfied you do not have to return it.
Mr Kormos: Okay, it is one thing I do not have to worry about. But I come from a small town -- I come from down in the Niagara Peninsula -- not that much smaller than Sudbury, but still not quite Sudbury. I know that other people have gotten those letters. Are you aware, especially in small towns, of some of the impressions these letters create in people's minds?
Dr MacMillan: I realize it could create the impression we are snooping on a doctor. But you must remember that physicians in this province enjoy a tremendous privilege to be able to decide what to send as a bill to the Ontario government; you are spending 10% of your provincial budget on doctors. It is obviously prudent to be accountable. If I had my way, the patients, at the end of the year, would all receive a receipt for the services rendered on their behalf.
Mr Kormos: My grandmother, an old Ukrainian lady, when she got this letter -- she is insistent that the doctor is already not just being investigated, but just about due either that day or the next to be captured. Have you ever encountered that sort of impression?
Dr MacMillan: I do not think that is a prevalent issue. I often had patients who would come in to me and say: "Doctor, I got this in the mail. What does this mean? What should I do with it?"
Mr Kormos: Dr Donahue is a pretty high-profile doctor in Sudbury -- even before his speaking out on the matter of threshold -- is he not?
Mr Scott: Do you think Shelley jumped to the same conclusion as Peter's grandmother?
Mr Kormos: You never can tell. If you speak ill of my grandmother, Mr Scott, you will have a bigger problem than you ever had.
Mr Scott: I am just comparing her conclusion to Shelley's.
The Chair: Order. Dr MacMillan, would you please respond to the question.
Mr Kormos: Let's talk about Dr Donahue and his profile in Sudbury. He is a pretty high-profile physician, is he not?
Dr MacMillan: I have no idea of that, really. I mean, as the main dermatologist in town, I would think he would be well known.
Mr Kormos: With a lot of patients, and I am talking about medical patients.
Dr MacMillan: Any doctor in the north, where those specialties are limited, is generally busier than a doctor in the south with more competition.
Mr Kormos: Somebody in Sudbury would not necessarily have to talk to you to have the impression that Dr Donahue was a pretty big biller.
Dr MacMillan: I cannot comment specifically on that. The night the deputy, Dr LeBlanc and I drove in from the airport, the taxi driver seemed to know almost as much about Dr Donahue as my two colleagues did.
Mr Kormos: That he had a big practice.
Dr MacMillan: It was news. It was in all the papers. It was the talk of the town. There was a big town hall meeting. The regional council had a great big presentation on the issue of dermatology, I believe, that Dr Donahue presented a night or a couple of nights earlier. It was headline news at that time.
Mr Kormos: The fact that somebody is worried about threshold implies that he or she is near or at the point where he or she is billing that kind of money?
Dr MacMillan: One would expect that, yes. In my experience anybody who has complained about his own particular circumstances -- there are many who complained on behalf of physicians in general. But those who raised with the press their own peculiar circumstances, including and very importantly when they believed they reached the threshold, I think, as I indicated yesterday, it would be fair to -- I cannot say; you would have to ask somebody from the north. But I think it would be a fair impression that an intelligent person would draw from that that if you are reaching your threshold in November, only seven and a half or eight months into the fiscal year upon which the determination was made, there would have to be a general feeling that you were doing pretty well.
Mr Kormos: You were asked questions about being contacted by the Premier's office, by any ministers' offices. I trust you have come here eager to be candid in your responses to questions.
Dr MacMillan: Yes.
Mr Kormos: Of course the impression that is trying to be created is that somehow there is a coverup. You are aware of that effort, are you not? I am talking about the effort to create the impression that there is some sort of coverup.
Mr Harnick: Shelley's answers did that.
Dr MacMillan: I think, Mr Chairman, that is a question I would rather not answer.
The Chair: I understand.
Mr Kormos: Have you come here with any purpose other than to tell what you know?
Dr MacMillan: No, no other purpose.
Mr Kormos: Is anybody influencing what you have to say to this committee this afternoon -- or yesterday?
Dr MacMillan: Not a bit.
Mr Kormos: Could you anticipate what your response would be if somebody were to suggest that you somehow alter your comments to comply with what other people would expect?
Dr MacMillan: No, I have not been approached by anyone who has made any kind of suggestion, not the deputy minister, nor any of the other people who you are going to call whom I know and have worked with. I have not talked to the Minister of Health about this since the meeting I told you about on December 11 when I came to Toronto. I tried, both at the time or shortly after, to document everything I could remember. I made a few errors that I have tried to recognize. I am willing to answer any question as long as I take the only advice I have from counsel: that I do not release here what I have been trying so hard to protect, confidential information.
The Chair: Mr Christopherson is next on the list. I would remind all members that as a result of a subcommittee meeting we decided the rotation of the questions. I hope all members of the committee would, and I expect all members will, respect other members who now have the floor and who will subsequently have the floor to pose questions without any interventions.
Mr Christopherson: Dr MacMillan, the memos that were sent and cc-ed: I have gone through the Hansards and you acknowledged some of the people it was sent directly to and then cc-ed to. Exhibit 13 is referred to in the questioning by Ms Jackson as having the balance of those people. Do you know all those people personally?
Dr MacMillan: Yes, I know them all.
Mr Christopherson: All of the people listed on exhibit 13?
Dr MacMillan: Yes.
Mr Christopherson: Did everyone on that list receive it?
Dr MacMillan: I do not know for certain. I believe they did. My name is circled. It was hand-delivered to me the following morning. It is my assumption that I was probably the last one to get it, since most of the other people probably would have been available the day before at the time the documents were put together.
Mr Christopherson: Obviously because I do not work there, I do not know the relationship between you and these folks. I am just asking if you know each and every one of these people personally in any way, like, if somebody mentioned his name, you would know who he is. I am asking also if that applies to the person who received, if I read the transcript correctly, Paul Howard's copy, which would be Mr Corea. Do you know all of those people personally?
Dr MacMillan: I know Mr Howard because he attended in Sudbury for the second meeting, the town hall meeting, with the physicians. That is the first time I had an opportunity to really get to know him, other than his name and his face. Mr Corea I have not had occasion to work with and I do not know.
Mr Christopherson: So you never met him. But the rest of them you do know?
Dr MacMillan: I may have met him, but I just cannot recall --
Mr Christopherson: If he walked in right now you would not be sure that was Larry Corea?
Dr MacMillan: I do not think so.
Mr Christopherson: The balance of the folks here, though, you would? If they walked in you would know that that is so-and-so, or if somebody said their name when they walked in you would know who was about to sit down?
Dr MacMillan: Certainly, yes.
Mr Christopherson: The other question I have relates to this morning's discussions. I just want to walk through this, page 1045-1, a question from Ms Jackson. It is another reiteration of your quote, "I almost fell off my seat when I learned someone had broken their oath of allegiance." You responded, "Yes. I said that." Ms Jackson asked, "Did you think anyone had broken their oath of allegiance?" You responded, "I immediately jumped to that conclusion that somebody who had access to it in the people whom I had understood at that time had access to it either gave it or expressed the details about to someone else that they should not have." Ms Jackson asked, "So the breaking of the oath of allegiance, is that in your view sending the information to Toronto or releasing it to the media?" You responded: "Oh, no. It was releasing it to the media. It is interesting that the Sun article the next day attributed the leak to one of my staff, which was rather poor reporting and upset my staff member considerably."
Dr MacMillan: Then I went on to correct the fact that it was not the next day; it was January 27.
Mr Christopherson: Do I draw from that that you know with a certainty it was not your immediate staff that divulged that information?
Dr MacMillan: No, I do not know that it was not my immediate staff or anybody in the office that I tried to tell the committee that I thought had access to it, including the secretarial support. Obviously my reaction about the allegiance thing at the time seems to indicate I had forgotten to think about ministerial staff, minister's staff --
Interjections.
Dr MacMillan: I do not even know whether they take an oath of allegiance. I presume they do, or they should. But obviously I know that I took an oath of allegiance. I have since confirmed from everybody I can ask that yes, it is standard routine. It is part of the Public Service Act, in that is a declaration of maintaining confidentiality, both at the time of employment and following any cessation of employment. So that is why I made those comments.
Mr Christopherson: Do you have any reason to believe there were any people outside those who have been mentioned so far who knew the existence of these e-mails prior to the reporter calling you? Do you have any indication that it was outside the known group of people who would normally receive it in the usual course of business? You then retrieved it. It was after the fact, obviously, by virtue of the phone call from the reporter that somebody outside -- that is where I am assuming you felt that someone had broken their oath of allegiance. My question is, do you have any reason to believe that, prior to that, anyone else had that information that should not have?
Dr MacMillan: No, none whatsoever.
Mr Christopherson: Can I ask, in your opinion, and I realize it is your opinion only, why might that document be leaked? What would a motivation be?
Interjection.
Mr Christopherson: Well, the opposition has lots of opinions on it. I thought Dr MacMillan might.
Interjections.
The Chair: Order. Again, I remind members of the committee that a question has been asked of Dr MacMillan. Let us give him the opportunity of responding without any interjections.
Dr MacMillan: I think I can answer it, Mr Chairman, just in a roundabout way. After the events of December 5 became public, the awareness, or indeed the hard copy of that document, became far more newsy and important. Up until that time -- any of us involved can be asked -- we thought it was just one of those decisions you make and one of those judgement calls you make, that you change, and it was not a big event. It was a big event for a few minutes and a morning and that was the end of it.
If someone recalled the knowledge of the document, of course, following the news of December 6 or 7 or beyond, then that document became very valuable as a newsy subject. If in fact somebody had released it earlier, why did they not embarrass everybody by producing it earlier? It would not have meant too much, other than obviously got all the civil servants very worried about their conduct. But the release of it at the time became a totally different matter because of the issues in the House.
So I do not know. I also think that supports my theory that maybe the document is not even out there. The recollection of the contents is out there, and that is why nobody has ever in the press, or anywhere, produced the details in the document. I have never seen them. I have never heard them addressed in any kind of detail. I may be wrong, but that is my opinion.
Mr Christopherson: Thank you, I appreciate that. So it is fair to say then that if there was not the political drama in the Legislature, the most significant factor in this whole episode in your office would have been the fact that there was an embarrassment on your part and on your chain of command, to use that phrase, of information moving that did not follow the way it should have. It would have been something that should not have happened, but other than an embarrassment to you and your people, it had no real relevance, assuming that it did stay contained within people who were already under an oath to keep it quiet.
Dr MacMillan: That is exactly right.
Mr Christopherson: So is it fair to say then that it is possible that the leaking of it could have had some relationship to the dynamic that was playing out in the Legislature?
Dr MacMillan: That is the observation I have made.
Mr Christopherson: So it is possible that it might have been politically motivated.
Dr MacMillan: Might have been I suppose.
Mr Christopherson: Thank you.
The Chair: Thank you very much, Mr Christopherson. There is some available time left to members of the government. If there are no further questions --
Mr Scott: I want to make it clear that I did not leak that information.
The Chair: Thank you very much. If there are no further questions by members of the government, we have completed the rotation as per agreement.
Mr Christopherson: On a point of order, Mr Chair: We have not discussed this in subcommittee that I recall, and it is just a matter of procedure, where I assume you are about to take us into in camera session, but I would ask if it is your intention that as a result of that session, and in light of my colleagues' concern that as much of these proceedings as possible take place in public, that if there are further questions of Dr MacMillan that could take place in public, that you would again ask Dr MacMillan to assume the chair so that we could ask some questions.
The Chair: Certainly, if that be the wish of a subcommittee meeting, that is fine.
Mr Conway: I could not agree with that more completely. No more objection.
Mr Christopherson: Good. Thank you, Mr Chair.
The Chair: Thank you on that point. We will be moving, pursuant to paragraph 10 of the terms of reference, into an in camera proceeding. I would first ask that we recess for 10 minutes while we get the room prepared.
The committee continued in closed session at 1535.
The committee continued in open session at 1747.
The Chair: I would suggest that this be an in camera procedural committee meeting for which Hansard is usually not required. I would suggest at this point that we can dismiss Hansard on this.
Mr Christopherson: We do not see any real need to go into in camera to have this discussion.
The Chair: You do not see the need to go into in camera? Concerns? Proceed.
Mr Christopherson: I do not think there is anything for us to initiate. The subcommittee has made its decision and we are here.
The Chair: The subcommittee made a decision earlier on that if there are matters of a confidential nature, they would be provided but on an in camera basis. I am summarizing that. Is there any concern of that nature?
Mr Conway: It is the view of my colleagues, and of my friend the absent member for St George-St David, that the decisions made by the wise subcommittee should be confirmed.
Mr Harnick: That is my understanding. Obviously Mr Christopherson felt the same way, so I think we can probably conclude this meeting and start this again tomorrow.
The Chair: I think that now has been resolved as per the subcommittee's decision.
Mr Christopherson: I have a question. Do I understand then that all the members of the committee will be complying with the decision of the subcommittee to sign and take the oath?
The Chair: It would be my intention that if a person is not going to sign the oath, then that person would not be able to partake in the in camera proceedings.
Mr Christopherson: I am not at this time going to commit to what our position is. If someone refuses at that point to follow the procedures laid out by the subcommittee, we reserve the right to comment on that at the time something may happen.
The Chair: Certainly you can do so whenever you wish. I think it is very clear from our terms of reference that "members of the committee and/or their counsel shall be permitted, upon swearing an oath of non-disclosure," to take part. That is section 9. I think the terms are very clear. We have discussed these in subcommittee meetings on more than one occasion I think. The oath itself is one which has been prepared by counsel, reviewed by members and, in fact, amended by members, which is now agreeable and acceptable to all members as a condition to being a participant in an in camera meeting.
Ms Jackson: Could I just, in that vein, in order that we can proceed at 10 o'clock tomorrow, ask that all members who are going to sign the oath, do so tonight and we will get that paperwork done with? It has to be sworn in front of someone who is a commissioner, and there are a number of us here.
Mr Christopherson: Yes, I think it would be good for us to know, because it does raise a couple of other questions that we would like to discuss, if indeed someone is going to not take the oath.
Mr Kormos: Let's hear it.
The Chair: Has everyone signed the oath?
Ms Jackson: No, because we have not got around and done it. We will have to administer the oath. I do not think we need to stay in committee to do this. We could administer the oath before people leave, just to deal with it.
Mr Christopherson: Will the Chair then advise first thing in the morning whether we have any inconsistencies?
The Chair: Certainly. I will be able to advise as to any member who has not signed an oath of non-disclosure. We will, I believe, reconvene tomorrow at 10 am. We will continue, or at least, let us say, commence the in camera examination of Dr MacMillan, as per agreement, and we will then enter into questions. The committee is adjourned until tomorrow at 10.
The committee adjourned at 1751.