INQUIRY RE MINISTRY OF HEALTH INFORMATION
CONTENTS
Monday 9 March 1992
Inquiry re Ministry of Health information
Susan Majkot
Jean-Pierre Donahue
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):
Cunningham, Dianne (London North/-Nord PC) for Mr Eves
Elston, Murray (Bruce L) for Mr Scott
Kormos, Peter (Welland-Thorold ND) for Ms S. Murdock
Wood, Len (Cochrane North/-Nord ND) for Mr Bisson
Clerk / Greffier: Arnott, Douglas
Staff / Personnel: Jackson, Patricia, Committee Counsel
The committee met at 1021 in room 151.
INQUIRY RE MINISTRY OF HEALTH INFORMATION
The Chair: Good morning, members of the committee. As some members already are aware, there have been some scheduling delays this morning which will require this committee to stand adjourned until 11 am, at which time those who were to appear before us will be able to. There have been some delays and difficulties in getting before the committee, and I think in fairness to all members of the committee and to all in the room, we should and will adjourn until 11.
However, prior to doing so, members of the committee and the subcommittee will know that there is now going to be distributed the transcript of an in camera proceeding with the Minister of Health. It deals with her responses to questions posed in an in camera proceeding on a matter that was not of a confidential but rather of a private nature, and the subcommittee last week decided to release it to the public. That exhibit is now marked as exhibit 90.
Having said that, this committee shall be adjourned until 11 am.
The committee recessed at 1022.
1103
The Chair: We will call to order this meeting of the standing committee on the Legislative Assembly. I would like to thank everybody for their patience in the one-hour recess. It was unavoidable, but we are now ready to resume. For members of the committee, you will note on your agenda three witnesses we will be calling today. We will be calling witness number 2, Susan Majkot, first. Depending upon when the committee has completed its questioning, it may be that Dr Donahue will be called thereafter, but it is still a little much for decision at this point in time, but I just wanted to give members of the committee and others some prior information on how the witnesses for today may be called.
SUSAN MAJKOT
The Chair: Having said that, I would invite Miss Susan Majkot to the table. Good morning, Ms Majkot.
Ms Majkot: Good morning.
The Chair: Ms Majkot, it has been the practice of this committee that prior to questions and answers of the committee, witnesses are administered an oath. I understand that has been explained to you earlier. I would like to invite the clerk to administer the oath at this time.
Susan Majkot, sworn.
The Chair: Thank you very much. Ms Majkot, again, as a warning that has been provided to all who have come before the committee, in the event that you are asked a question which you cannot properly answer without divulging information which you feel is of a confidential nature, then could you please advise the committee and if an answer cannot be given without divulging such confidential information, then we can proceed in camera so that this information can be elicited. Having said that, I would invite our counsel, Patricia Jackson, to commence questioning.
Ms Jackson: Thank you, Mr Chairman. Ms Majkot, I understand that you are a resident of Sudbury.
Ms Majkot: That is correct.
Ms Jackson: Where you have lived all your life.
Ms Majkot: Basically, yes.
Ms Jackson: And that you have at the moment at least two jobs, one working as a communicator with the Sudbury regional police and in the evenings in a local movie theatre.
Ms Majkot: That is right.
Ms Jackson: And you are a parent?
Ms Majkot: Yes.
Ms Jackson: And you have two children?
Ms Majkot: That is correct.
Ms Jackson: An older son and a daughter who is 15 years old.
Ms Majkot: That is correct.
Ms Jackson: And as I understand it, your daughter has been a patient of Dr Donahue for some period of time.
Ms Majkot: Since Dr Donahue came to Sudbury, yes.
Ms Jackson: And as a result of your daughter being a patient of Dr Donahue, did you become aware in November 1991 that Dr Donahue might be closing his office?
Ms Majkot: Yes. She came home from the doctor's office with a letter stating that he would be closing his office.
Ms Jackson: Now, I said I was not going to ask you to look at any exhibits; I am going to just ask you to look at one, if you could. In the black volumes in front of you, could you look at the exhibit that is at tab 48?
Ms Majkot: Can I get my glasses, please?
Ms Jackson: Oh yes, I am sorry. If you would take a minute and read that, Ms Majkot, then I am going to ask you if that was the letter or the kind of letter your daughter brought home.
Ms Majkot: I cannot say that it is the exact content, but it is the type of letter she brought home.
Ms Jackson: All right. When you learned that, did you do anything as a result of learning of the prospect of the closure of Dr Donahue's office?
Ms Majkot: Not at first. I believe it was about two days later when I did make a phone call to Shelley Martel's office.
Ms Jackson: Why did you call Shelley Martel's office?
Ms Majkot: My daughter attends at Dr Donahue's office as often as three times a week and the closure of his office was going to cause a lot of stress to her and a lot of problems. I was quite concerned that we would have no dermatologist in northern Ontario.
Ms Jackson: Had you ever called Miss Martel's office or any politician's office about anything ever before?
Ms Majkot: No. I am the most unpolitical person you want to know.
Ms Jackson: Do you remember what day it was that you made this telephone call?
Ms Majkot: It was the Friday.
Ms Jackson: Do you remember what time of day approximately you made the call?
Ms Majkot: I believe -- I am not sure if it was just before lunch or just after lunch.
Ms Jackson: Who did you speak to, do you know?
Ms Majkot: At first I spoke to the receptionist.
Ms Jackson: And what did you say?
Ms Majkot: I told her that I wanted to speak to someone regarding the closure of Dr Donahue's office, "I want to speak to Shelley Martel." She told me Shelley Martel was not in; Miss Martel was not in, she was in a meeting and could not be reached. I said, "Well, I would like to speak to someone," and she stated, "Would the administrative assistant be of help to you?" and I said, "Sure, I'll talk to her."
Ms Jackson: Did she tell you who the administrative assistant was?
Ms Majkot: She may have given the name and I am sure when the lady came on the phone she gave her name, but I am sorry, I do not remember it.
Ms Jackson: Do you know the name of the receptionist to whom you spoke at the --
Ms Majkot: No, she never introduced herself whatsoever.
Ms Jackson: When the administrative assistant came on the line, what did you say?
Ms Majkot: I was quite adamant that I thought it was really wrong that Dr Donahue was closing his office and we would be without any dermatologist, and she stated it was Dr Donahue's doing that he closed the office, and I said, "I understand it has something to do with OHIP," only became my daughter had heard a rumour previous and came home and told me about it. She kind of chuckled and she said --
Ms Jackson: Can I just ask you, you say your daughter had heard a rumour. What rumour had your daughter heard?
1110
Ms Majkot: That it had something to do with OHIP billing, but she did not know and I did not know.
Ms Jackson: You mentioned that to the administrative assistant, and what did she say?
Ms Majkot: She chuckled and she said -- I do not know the exact words she said, but something to the extent that Dr Donahue had been practising illegal billing procedures. I said, "Pardon?" and she said, "Dr Donahue is billing illegally and we have the documentation to prove it." And she asked me if I would like a copy of the documentation.
Ms Jackson: Did she say anything else?
Ms Majkot: I said yes, I wanted a copy of the documentation, and she took my name and my address and everything. Then I said: "I still don't think it's right. I think something should be done because of the area that he services." She said, "Well, when the public becomes aware of what he's doing, they won't be so supportive towards him."
Ms Jackson: Did she say anything else?
Ms Majkot: That was it.
Ms Jackson: You have used the words "billing illegally" and that his practices were illegal. Were those words used?
Ms Majkot: Definitely, because I could not believe she was saying that to me. In fact, the first time she said it I took the phone and looked at it and thought, "I don't believe she's saying this."
Ms Jackson: Did you ask her what she meant by the fact that he was billing illegally?
Ms Majkot: Not really. I asked her to repeat it, because I do not understand a lot of the billing practices. Truthfully, that is not my concern. I was just concerned about the care of my daughter.
Ms Majkot: Was anything else said in that telephone conversation?
Ms Majkot: No. She would send me documentation when they had compiled it all.
Ms Jackson: Did she ever send you any documentation?
Ms Majkot: No, I never received anything.
Ms Jackson: Did anybody ever send you any documentation?
Ms Majkot: No, nothing.
Ms Jackson: Did you ever contact the office again?
Ms Majkot: No.
Ms Jackson: Did you ever speak with anyone from Shelley Martel's office in any other context again?
Ms Majkot: No, I did not.
Ms Jackson: Did you ever speak to any other political office about this issue?
Ms Majkot: No, I did not.
Ms Jackson: Did you do anything as a result of this telephone conversation?
Ms Majkot: Not at first, because I am very busy and I am very seldom at home. It was kind of coming more news media, and then I was trying to follow it as much as I can to see what was happening. I did not know where she was coming from when she told me that he was billing illegally. So I was just waiting to see what would happen and what would come from that.
Ms Jackson: Did anything happen that caused you to remember this conversation later on?
Ms Majkot: Yes. Actually, I saw the newscast with the lady from Thunder Bay. I was sitting there with my son and I said that she heard almost word for word exactly what I had heard and I thought it was rather strange.
Ms Jackson: After you made that observation or that connection, did you do anything about the conversation you had had earlier?
Ms Majkot: No, I still did not.
Ms Jackson: Did you mention it to anybody?
Ms Majkot: Just people at work, you know, just that we were following the case, and basically my family.
Ms Jackson: Did you have occasion, ultimately, to speak to Dr Donahue about this conversation?
Ms Majkot: The next time I got in, because of my job, with my daughter, was in February.
Ms Jackson: You mean that is the next time you saw Dr Donahue?
Ms Majkot: That is correct.
Ms Jackson: Your daughter continued to go, but he --
Ms Majkot: Yes, she goes. I cannot always go because of my job.
Ms Jackson: Just so we have it, for a period in there, as I understand it, Dr Donahue's office was closed?
Ms Majkot: That is correct.
Ms Jackson: But when he reopened, your daughter resumed going to him?
Ms Majkot: That is correct.
Ms Jackson: On one occasion in February, you went with your daughter?
Ms Majkot: That is right.
Ms Jackson: Did you have occasion to speak to Dr Donahue about this conversation when you went?
Ms Majkot: I asked to speak to Dr Donahue. I wanted him to know, because I did not feel that -- I did not know what the circumstances were, but I did not feel that anybody had the right to say that about another person, especially at the time that I had heard it.
Ms Jackson: And did you speak to Dr Donahue?
Ms Majkot: I just told him basically the three sentences I told you about billing illegally and public support would not be with him.
Ms Jackson: What did he say?
Ms Majkot: He thanked me and said, unfortunately, unless I was willing to repeat it to somebody else, there was nothing much that he could do about it. I told him I was willing to repeat it, because I did not think it was right.
Ms Jackson: Was there any suggestion made as to what you should do about it then?
Ms Majkot: No. He told me that he would give my name, if that was all right, to someone who would get in contact with me.
Ms Jackson: And ultimately did somebody contact you?
Ms Majkot: Yes.
Ms Jackson: Who was that?
Ms Majkot: Robin Smith.
Ms Jackson: Do you know who she is?
Ms Majkot: She is -- I cannot remember his name, I am sorry, that I believe she is the assistant to.
Ms Jackson: Mr Elston?
Ms Majkot: Thank you, yes.
Ms Jackson: Did she speak to you about this conversation?
Ms Majkot: Yes. She called me on a Friday night. She called me originally at my place of employment and stated that she would call me at home, and that was fine. She called me and asked me the information I had. I told her, and she said Mr Elston would be calling me Saturday morning.
Ms Jackson: And did he?
Ms Majkot: He called me Saturday, approximately 11 o'clock.
Ms Jackson: And you repeated what you have told the committee.
Ms Majkot: That is correct.
Ms Jackson: Subsequently, then, someone from my office contacted you.
Ms Majkot: That is correct.
Ms Jackson: And you repeated what you have told the committee again.
Ms Majkot: That is right.
Ms Jackson: In any of those conversations, Ms Majkot, did anybody ever suggest to you any wording in terms of what you had been told by Shelley Martel's office?
Ms Majkot: None whatsoever. They did not give me any encouragement whatsoever.
Ms Jackson: So what you have told the committee here today is your own recollection of what you were told.
Ms Majkot: Yes.
Ms Jackson: Not prompted by anyone.
Ms Majkot: No, not at all.
Ms Jackson: Can you explain why you did not raise this with anyone other than sort of in coffee conversation at work until you raised it with Dr Donahue in February?
Ms Majkot: I was kind of watching as much as I could to see what proceeded, I guess to see if there was any fuel to the fire or what was happening.
Ms Jackson: To see if there was any which?
Ms Majkot: Fuel to the fire. I felt if there was something illegal being done, somebody would be looking into it. I really did not want to get involved. Part of the reason is I am really a busy person. It sounds awful, but I work 16- and 18-hour days and I am very seldom home. I am not always able to follow what is going on.
Ms Jackson: I realize I have neglected to get your best recollection of the particular day. You said this telephone conversation was on a Friday.
Ms Majkot: That is correct.
Ms Jackson: Are you able to link it to any event that would assist in determining which Friday it was?
Ms Majkot: The only reason I remember which Friday it was is that I had seen on the 6 o'clock news that Dr Donahue -- I believe it was the day he closed his office and he and all his employees were present at a meeting at Civic Square in Sudbury. I think Shelley Martel was there, but I am not sure, and I thought, "Gee, that must be the meeting they were referring to," when she was not available to come to the phone.
Ms Jackson: That is something you saw on television that night.
Ms Majkot: On the 6 o'clock news.
Ms Jackson: After you had had this conversation.
Ms Majkot: That is correct.
Ms Jackson: From what you saw on television, you knew there was a meeting and it was in Civic Square.
Ms Majkot: Mm-hmm.
Ms Jackson: And Dr Donahue was there.
Ms Majkot: Yes, and all his employees.
Ms Jackson: All his 14 staff.
Ms Majkot: That is right.
Ms Jackson: Thank you, Ms Majkot. Those are my questions.
The Chair: I look to government members. We will limit the questions to 15 minutes per caucus. Mr Christopherson.
Mr Christopherson: Ms Majkot, could you please repeat for me the conversation you had with the administrative assistant?
Ms Majkot: I stated that I was upset that Dr Donahue was leaving Sudbury and there would be no dermatologist in the northern Ontario region, particularly Sudbury, and she stated that it was not their doing, that he chose to close up his office and leave.
I said, "But you must realize we are not going to have any dermatologist," and she said, "Dr Donahue has been practising illegal billing," or "has been billing illegally." I said, "Pardon?" and she said, "He has been practising illegal billing and we have the documentation to prove it, and we can send you a copy if you like." I said, "Yes, I would like to see the copy." Then she stated that when the public becomes aware of this, they will not be so supportive towards him.
Mr Christopherson: How long do you recall the conversation was?
Ms Majkot: It was not really very long. It was longer trying to get through their receptionist to the administrative assistant.
Mr Christopherson: Did the administrative assistant suggest to you in any way that the information or the comments that -- was it a she?
Ms Majkot: It was a she.
Mr Christopherson: -- that she was making were sort of off the record or on the QT? Sometimes by a tone of voice you can get a suspicion that someone is trying to send you a message of, "Look, I just wanted to tell you something." Did you get the feeling that this was the kind of conversation, or was she very forthright about what she was saying?
Ms Majkot: She came right out and said it. I did not get the impression that it was off the record. It might have been meant to be, but I did not get that impression.
1120
Mr Christopherson: So your impression was that she was not reticent about offering up the information at all --
Ms Majkot: No.
Mr Christopherson: -- and that this was straightforward?
Ms Majkot: I was shocked, because I asked her to repeat it and she repeated it.
Mr Christopherson: And was any of this consistent with anything else you had heard? Apparently there was a fair bit floating around Sudbury. Was this consistent with anything else you had heard on TV or on the radio?
Ms Majkot: Not when I first made the phone call, no. There was very little. I did not realize why he was closing his office until -- I am guessing -- it was about two days previous to this phone call when my daughter came home and said, "It has something to do with OHIP."
Mr Christopherson: Could I move you to your discussion with Dr Donahue in his office? Again, could you please recall that for me?
Ms Majkot: My daughter went in for treatment and I asked the receptionist if I could see Dr Donahue and she said he was very busy. I said, "I have something to tell him about the Shelley Martel inquiry," and between patients he saw me. I was in and out of the office, I would say, in about two minutes. I told him basically what she had said. He thanked me. He took my name and my address, asked if I would repeat it, and that was it.
Mr Christopherson: You mentioned to him the words you say you heard: "illegal billing." Did the doctor make any comment when you mentioned that to him? Did he respond in any way, shape or form? So those few lines were the only discussion you had with Dr Donahue about that particular issue and anything else would have been perhaps about your daughter? Any other conversation you had with Dr Donahue would have been about --
Ms Majkot: We did not even discuss my daughter. I was in and out very quickly.
Mr Christopherson: And did you ask where you could take your comments, or did Dr Donahue offer to assist in putting you in touch with someone?
Ms Majkot: I assume you would call it an assist. He asked if I would be willing to repeat it for somebody else and I said yes.
Mr Christopherson: Did the doctor happen to mention to you why he would even suggest that there would be a benefit to having it repeated?
Ms Majkot: No.
Mr Christopherson: Did you question that at all? Did it occur to you why he might make that statement?
Ms Majkot: No, it did not. I think I could see a reason.
Mr Christopherson: And what did you think the reason was?
Ms Majkot: I hesitate to use the word "slanderous" because I am not that sharp on the law, but when she said the comment, I thought: "This doesn't sound right. Basically, she's telling me, who's just basically a nobody, somebody off the street." I do not know why I was picked out.
Mr Christopherson: Did Dr Donahue suggest that anybody else had come to him with the same type of call or discussion with anybody else attached to Ms Martel?
Ms Majkot: Actually, he did say, "Several people have come forth with information."
Mr Christopherson: Come forward to him?
Ms Majkot: Yes. I assumed.
Mr Christopherson: I am sorry?
Ms Majkot: I assumed it was to him.
Mr Christopherson: So that was another part of the conversation.
Ms Majkot: Yes. I am sorry.
Mr Christopherson: And did he mention what he recommended or advised or suggested to those folks?
Ms Majkot: No.
Mr Christopherson: So you had no sense in your discussion with him whether or not you were doing something that others were doing too or whether it was just you? There was no sense of that in your mind?
Ms Majkot: No. I certainly did not feel I would end up here. Let's put it that way.
Mr Christopherson: Okay. Could I take you to your discussion with Mr Elston's assistant -- I am sorry, I did not get the name -- Miss Smith? You received a call from Ms Smith?
Ms Majkot: That is correct.
Mr Christopherson: And that was on a Friday also, you said?
Ms Majkot: The first call I received -- I believe it was the night before. I was working at the theatre; I am a projectionist. She could hear the machines running and knew I was very busy. She said she would call me at home.
Mr Christopherson: And how long was this since you had been at Dr Donahue's office?
Ms Majkot: I believe it was about two weeks ago. Was it a week or two weeks ago?
Mr Christopherson: Sorry, weeks ago or weeks in between? I just did not hear the word.
Ms Majkot: I am trying to remember if it was one week or two weeks ago.
Mr Christopherson: Ago?
Ms Majkot: Yes.
Mr Christopherson: So there was some -- so what would the time lag be between when you were in Dr Donahue's office to when you got the call?
Ms Majkot: It would probably be not last Friday, the Friday before, and I believe I was in approximately -- I think she saw him on February 13, right around that time.
Mr Christopherson: Okay, so we are talking a week, two weeks? I am trying to get a sense, from when you were in Dr Donahue's office as opposed to to from now, of when you got the call.
Ms Majkot: I believe my daughter's appointment was the 13th, and this is the 9th, and that was the 7th -- approximately two weeks, March 1.
Mr Christopherson: About two weeks. Could you again recall that conversation for me? She called up, identified herself --
Ms Majkot: That is right.
Mr Christopherson: And what did she ask you?
Ms Majkot: She said, "I understand you made a phone call to Shelley Martel's office," and I said yes. She said, "Could you relay the conversation?" and I did. She asked me if I had ever called any political office and I said no. She asked me why I called Shelley Martel's office. I said: "It kind of just was a name I recognized. There was no particular reason." I thought she was our member. I still do not know, I am sorry to say. Her name was on the list and I just picked her name.
Mr Christopherson: The list?
Ms Majkot: This letter that --
Mr Christopherson: The letter that Dr Donahue put out.
Ms Majkot: What else did she ask me? I do not think there was much else she asked me. She asked me if I had -- she told me then that Murray would be calling me Saturday to ask me. She said this is, uh -- "I think somebody else should know about this information"; I think that is basically what she said.
Mr Christopherson: And then Mr Elston called?
Ms Majkot: Yes.
Mr Christopherson: Can you tell me about that conversation, please?
Ms Majkot: It was almost a repeat of the one the night before. He asked me about the phone call and what was said. Oh, Robin Smith did ask me if I remembered the lady's name, and I said no, and she named one name and I said, "I couldn't tell you if that was the name or not." And the next day he called and asked me to repeat the conversation, and asked me if I had spoken to anybody else. That is basically it. He said somebody from Ms Jackson's office would be getting in touch with me.
Mr Christopherson: Somebody from whose office would be in touch?
Ms Majkot: Ms Jackson's office.
Mr Christopherson: And then that is right, and you received the call from Ms Jackson's office?
Ms Majkot: Yes.
Mr Christopherson: And then what happened?
Ms Majkot: A lady -- Lillian Dodds, is it? Sorry. Lillian called me from your office and basically asked me the same questions. I have been asked the same questions a number of times.
Mr Christopherson: And now you are getting them all again today, right? Yeah.
Have we established for sure -- through you, Mr Chair, to Tricia -- the name of the administrative assistant?
The Chair: One moment.
The short answer to your question is, conclusively, no.
Mr Christopherson: Thank you. I think that clarifies, and I understand what will happen in terms of subcommittee business --
The Chair: Yes.
Mr Christopherson: -- and my colleague Mr Kormos has a question.
The Chair: Thank you very much. Mr Kormos.
Mr Kormos: Thank you, Chair. It was the news reports of Ms Dodds, when she was down here at this committee hearing -- was it the news reports of that occasion that sort of triggered your memory?
Ms Majkot: No, it was the news reports, I believe, from Thunder Bay.
Mr Kormos: Yes.
Ms Majkot: She appeared on our TV stating that Miss Martel had told her this. I do not believe it was from here; I think it was still -- it was right after it happened, a few days after, so I believe she was still in Thunder Bay.
Mr Kormos: Again, because even though I have been here for a few weeks now, I am having a hard time keeping the time frames straight, around when would that have been?
Ms Majkot: Whenever Miss Martel was in Thunder Bay; shortly after.
1130
Mr Kormos: The news report containing Ms Dodds's comments, the ones that sort of triggered your recollection?
Ms Majkot: No, I remembered all along what they had said, but I did not think much of it other than I did not think it was right that they were said. But when she repeated almost --
Mr Kormos: You did not think it was right that this was told you?
Ms Majkot: No, I did not.
Mr Kormos: You found that a little -- what? -- offensive, I would think.
Ms Majkot: I found it odd. I do not know if I would say offensive, but I found it very odd.
Mr Kormos: Peculiar?
Ms Majkot: Okay. Strange.
Mr Kormos: Strange, sure. We could run through the whole thesaurus.
Ms Majkot: I did not know the reason why it was told me. Let's put it that way.
Ms Kormos: Okay, but you had been calling to register your protest --
Ms Majkot: Yes.
Mr Kormos: -- in accordance with the mailout or the sheet that Dr Donahue's office had provided, I presume in your mind to a number of people.
Ms Majkot: That is right.
Mr Kormos: The names of MPPs on the bottom of it, huh?
Ms Majkot: That is right.
Mr Kormos: Did you call any others, just by the way?
Ms Majkot: No. I probably never will call again now.
Mr Kormos: Well, you never can tell.
Ms Majkot: No.
Mr Kormos: Did you call Ms Martel's office? Again, I appreciate you said you were not entirely sure she was your MPP, but she was the one you figured was your MPP.
Ms Majkot: Most visible to me, most familiar.
Mr Kormos: You called the person a receptionist. That is the person who answered the phone, I trust.
Ms Majkot: Yes.
Mr Kormos: And that person identified themselves as the receptionist?
Ms Majkot: No.
Mr Kormos: Okay. You asked for Shelley?
Ms Majkot: Yes, I asked for Miss Martel.
Mr Kormos: And that person said: "Shelley's not available. She's in a meeting."
Ms Majkot: That is right.
Mr Kormos: If you ever do call again, you will notice that is the standard line used for almost all MPPs in all MPPs' offices.
Mr Harnick: Speak for yourself.
Mrs Cunningham: Speak for yourself, Peter.
The Chair: Order, please. Mr Kormos.
Mr Kormos: Often times you have to push a little to get down to the nitty-gritty.
Ms Majkot: You see, that's the difference. When you call my house and I am not home, they say I am at work.
Mr Kormos: Exactly.
The Chair: Mr Kormos, if I can just give you some notice. I have added another minute as a result of Mr Christopherson's question. There are two minutes left.
Mr Kormos: Thank you. So I have two minutes left.
The Chair: Yes. So if you could please --
Mr Kormos: The receptionist, the person who said to you, "Shelley's not available," suggested you talk to this other person, the administrative assistant?
Ms Majkot: That is correct.
Mr Kormos: You do not remember the name of that person?
Ms Majkot: No, sorry, I do not.
Mr Kormos: If indeed that person was identified to you.
Ms Majkot: No. I would not like to accuse somebody, you know.
Mr Kormos: Fair enough. What time of day are we talking about here?
Ms Majkot: It seems to me I feel it was about 11 o'clock.
Mr Kormos: Roughly. Again, I appreciate --
Ms Majkot: I do not know why that time -- it was either 11 or 1, but 11 seems to stick in my mind.
Mr Kormos: It was some time before you had a chance to see Dr Donahue again, because you just did not have occasion to visit his office with your daughter.
Ms Majkot: That is right. My daughter goes usually by herself.
Mr Kormos: And you tell us you raised the matter with Dr Donahue. Since then, of course, you have been called by Mr Elston and his office, and I trust by Ms Jackson or her -- I was going to call it high-priced Bay Street law firm, but I do not know whether it is on Bay Street or even necessarily high priced.
The Chair: Mr Kormos.
Mr Kormos: Since then, this has been put down in writing for you now, huh?
Ms Majkot: No.
Mr Kormos: Nobody has ever written it down, would it be fair to say about this? Nobody has ever --
Ms Majkot: All my contacts have been by telephone. I do not know if they are writing it down.
Mr Kormos: Oh, I see. So you never met with Ms Jackson or her office?
Ms Majkot: No. Today was the first day I met her. And I could never remember Mr Elston's name. You can see how good I am with names.
Mr Kormos: That may well explain some recent provincial history.
Ms Majkot: But I do remember your name.
Mr Kormos: Bless you. There may be some caucus members of his who are in a similar position; I am not sure. In any event --
The Chair: Mr Kormos, just --
Mr Kormos: Wrap it up.
The Chair: Thank you.
Mr Kormos: Has anybody told you since then that you may well be called upon not only to tell us what you are telling us today, but that this may be important down the road, perhaps in litigation or other matters that might develop?
Ms Majkot: Miss Jackson's office -- Lillian was the first lady that said I may be called.
Mr Kormos: To be here today?
Ms Majkot: To be here today. Nobody said anything else.
Mr Kormos: Okay, thank you.
Ms Majkot: Do you mean I am going to come back?
Mr Kormos: Have a good visit here and a good trip back.
The Chair: Thank you very much. Mr Conway.
Mr Conway: Thank you very much, Mr Chairman. Ms Majkot, I would just like to go back to one of the last questions Ms Jackson asked you about, and that was trying to tie down the date in November when you called Ms Martel's office. You indicated it was a Friday, you thought. Would I be right in saying that might have been Friday, November 15?
Ms Majkot: I believe that was November 15.
Mr Conway: Thank you very much.
The Chair: Are there any further questions? Mr Harnick.
Mr Harnick: Very briefly, you indicated you did not have a long conversation with Ms Martel's office, but was it obvious to you that the person who came on to the phone to discuss this matter with you was a person well conversant with the issue?
Ms Majkot: Yes.
Mr Harnick: Was it clear to you that the kinds of things they were saying were the stock answers that they were providing to everyone who called on this matter, or could you not tell?
Ms Majkot: I could not tell.
Mr Harnick: All right. The other thing you said when Mr Christopherson was asking you some questions was that up until this time you had not heard rumours about these issues in the community generally. Is that correct?
Ms Majkot: That is right. About the OHIP? Definitely.
Mr Harnick: And about Dr Donahue generally?
Ms Majkot: I do not remember the time frame; just that he was planning to close his office. They had given my daughter warning.
Mr Harnick: Other than that you had not heard any other rumours running rampant through the community?
Ms Majkot: Total surprise.
Mr Harnick: All right. One other question that has nothing to do with this: I think you said you were a projectionist.
Ms Majkot: Yes.
Mr Harnick: Are you a member of the projectionists or the film handlers union?
Ms Majkot: The International Alliance of Theatrical Stage Employees and Moving Picture Machine Operators of US and Canada, yes.
Mr Harnick: I used to be a member of that union. Okay, thanks.
Mr Hope: They kicked you out.
Mr Owens: There goes your career with the Tory caucus.
Mr Harnick: It was just a summer job; they made me do it.
The Chair: Order.
Mrs Cunningham: I have a question with regard to a comment you made when you were describing either the telephone conversation with the receptionist, or perhaps your remarks were related more to what you had heard down the road with regard to what Ms Martel had said. You used some interesting words, I think, as a person who picked up the phone and called an office for the first time. You intrigued me. You said, "I didn't think anybody had the right to say that." What were you referring to when you said that? Were you referring to the receptionist or to what you read in the newspaper or what you saw on TV or perhaps the whole thing?
Ms Majkot: Basically what the administrative assistant had said to me, because I had no inkling that there was a problem there. I always go by the precept that you are innocent until proven guilty, and it just seemed to come totally out of the blue. I did not realize that he was, or if he was, under any type of scrutiny. I did not know what the problem was other than my daughter coming home and saying, "It's got something to do with OHIP." I thought maybe we would have to pay some extra money. That was fine.
Mrs Cunningham: But your remarks really did refer to the billing illegally --
Ms Majkot: Yes.
Mrs Cunningham: -- and the public awareness. They would be less supportive coming from the person who worked in an MPP's office?
Ms Majkot: No, no, just anybody who would say that. I am not sure what the law for slander is, but I got off the phone and said to my mother: "That's not right. What was said is not right."
The Chair: Seeing no further questions, I would like to thank you very much, Ms Majkot, for coming before the committee today.
1140
JEAN-PIERRE DONAHUE
The Chair: To the members of the committee, the next witness we are going to be calling is Dr Jean-Pierre Donahue. Good morning, Dr Donahue.
Dr Donahue: Good morning.
The Chair: Again, prior to entering into questions and answers it has been the custom of this committee that the clerk administers an oath for every witness, and at this point I would like to invite the clerk to do so.
Jean-Pierre Donahue, sworn.
The Chair: Thank you very much. Dr Donahue, as we go through the questions and answers, both by counsel and by each respective caucus, I would like to remind you -- and I have given this warning to all witnesses coming before the committee -- that in the event you are asked a question which you cannot properly answer without divulging confidential information, could you then please advise the committee? If there is not a way to disclose this information without divulging confidential information, then this committee can address the matter in an in camera proceeding.
Having said that, I would like to invite counsel Jackson to commence questioning.
Ms Jackson: Dr Donahue, I understand that you are originally from Montreal, sir?
Dr Donahue: Yes, that is right.
Ms Jackson: And that you attended university initially at McGill in Montreal?
Dr Donahue: Yes.
Ms Jackson: And then went to medical school at McMaster University, from which you graduated in 1981?
Dr Donahue: Yes, that is right.
Ms Jackson: You then went into an internship program at the University of Western Ontario, where you were from 1981 to 1982?
Dr Donahue: Well, actually, the medical internship that I attended was at the Toronto Western Hospital --
Ms Jackson: I am sorry.
Dr Donahue: -- which is part of the University of Toronto system.
Ms Jackson: All right. And thereafter you attended McGill again for three years, studying to become a specialist in dermatology?
Dr Donahue: That is right.
Ms Jackson: And you in fact obtained your fellowship in dermatology in 1985?
Dr Donahue: That is right.
Ms Jackson: Thereafter you attended the University of Colorado for three years and, as a result of that, obtained a fellowship in dermatopathology?
Dr Donahue: It is dermatopathology; it is a difficult one to pronounce. It would have been two years, actually, in Colorado, not three, because I came back in 1987. So that is about two years.
Ms Jackson: Fine. And when you finished your fellowship in dermatopathology, you had to determine where you were going to go to practice, and indeed you decided to go to Sudbury?
Dr Donahue: It was a difficult decision, but Sudbury was one of the choices, yes.
Ms Jackson: And that was in part because you were quite actively recruited by the city of Sudbury and with the assistance of the underserviced area program?
Dr Donahue: Yes, that is right.
Ms Jackson: And you moved to Sudbury, sir, as I understand it, in the summer of 1987?
Dr Donahue: Yes.
Ms Jackson: And as you understand it, began on the underserviced area program some time in the summer of 1987?
Dr Donahue: That is right.
Ms Jackson: Now, Dr Donahue, you were -- well, let's talk about the fall of 1991. In the fall of 1991 you were practising dermatology in Sudbury?
Dr Donahue: Yes.
Ms Jackson: And you in fact were running a dermatology clinic?
Dr Donahue: Office, clinic, yes, whatever term you want to use.
Ms Jackson: With, as you have told me, 14 employees?
Dr Donahue: That is right.
Ms Jackson: Six of whom were nurses?
Dr Donahue: Yes, registered nurses.
Ms Jackson: Four were secretaries?
Dr Donahue: Yes.
Ms Jackson: And four were technologists?
Dr Donahue: Yes, that is right.
Ms Jackson: Were the last four electrologists?
Dr Donahue: Yes.
Ms Jackson: And at your clinic you did then, and do now, treat a number of dermatological illnesses, including serious diseases of the skin like cancer?
Dr Donahue: Yes, that is true.
Ms Jackson: You also, for a period of time, had an epilation component to your practice?
Dr Donahue: I still do.
Ms Jackson: In the fall of 1991 and in the months leading up to that, the average portion of your practice devoted to epilation, if we were to take it as a percentage of billings, was approximately 25%?
Dr Donahue: That would be a reasonable approximation.
Ms Jackson: Now, the committee has heard, Dr Donahue, that the question of how epilation should be treated in terms of the OHIP schedule of benefits was the subject of some discussion and debate among the Ministry of Health and practitioners in the period leading up to November 15, 1991. That is your understanding as well?
Dr Donahue: I would say that the question was probably under active discussion for two or three years prior to then.
Ms Jackson: And the result of that discussion was a decision by the ministry to delist epilation as an OHIP service effective November 15, 1991?
Dr Donahue: Yes, that is right.
Ms Jackson: During the period where this was all the subject of some active discussion, Dr Donahue, were you a participant in that public debate?
Dr Donahue: Yes, to some extent.
Ms Jackson: I would just like you to turn up two exhibits that reflect that. If you could look at the black volumes, Dr Donahue, that are in front of you, the two I am going to look at are exhibits 70 and 71; 71 first, if you would not mind.
Dr Donahue: I have 70.
Ms Jackson: If we could go back to 71, somewhat peculiarly it is earlier in time. It is a quick note of October 26, 1990, in the Toronto Star which makes reference to your involvement, and you make reference to a letter-writing campaign on the issue. There was a letter-writing program that went on at that time and you had occasion to comment on it?
Dr Donahue: Pretty well. There were many women who were receiving electrolysis under medical supervision for some very necessary reasons. They were quite concerned that their treatments would be terminated and they essentially began to express their concerns to their MPPs as well as to the Ministry of Health. In support of their points of view with regard to the importance of continued service I made some public statements and I wrote a letter to the ministry as well.
Ms Jackson: Briefly stated, Dr Donahue, what was your position on this issue and what was your reason for it?
Dr Donahue: Electrolysis is a service that unfortunately has been, well, maligned both here and unfortunately prior to that. What had been happening over the past two or three years, meaning as far back as 1990, was that a professional association of private electrologists had in fact been lobbying the government to delist it, to remove it. The overall reason for their wish to have it delisted was that they essentially wanted access to those patients.
What in fact was happening was that the patients who were being treated medically or by medical practitioners who essentially hire electrologists to provide this treatment -- these women have very significant medical problems, meaning glandular imbalances and a variety of other medical conditions that involve glands. It is perhaps a little bit too complex to get involved here. Thyroid glands and pancreas in terms of diabetes and Cushing's disease are syndromes you may be familiar with, but there are a multiplicity of very sophisticated metabolic imbalances and enzyme disorders as well as benign and malignant tumours that can produce abnormal changes in people, and in women some of these are facial hair growth.
So the subset of women who were getting electrolysis in medical offices had to undergo a very complex series of medical, biological and biochemical tests to prove that they in fact had these abnormalities. Once these were proven, the results, along with an application, then had to be sent to the Ministry of Health, which had established its criteria for medically supervised epilation to begin with. Once it was approved at that stage, the physician was authorized by the Ministry of Health to proceed with treatment.
Ms Jackson: All right. Just to finish off this area, I had asked you to take a look at exhibit 70 as well. Exhibit 70 is an article on this discussion and debate. On the second page there are references to your involvement in this issue and references to some of the statements you have made to the press. You had occasion to review this in my office yesterday?
Dr Donahue: Mm-hmm.
Ms Jackson: And those are approximately accurate, as far as you can recall, what you said to the press?
Dr Donahue: Sure, yes.
Ms Jackson: Okay. Then, Dr Donahue, I am going to ask you to take a look -- let me then turn to the question of the threshold agreement that was negotiated between the OMA and the Ontario government. You were of course familiar with that agreement?
Dr Donahue: Yes.
Ms Jackson: I understand that in the period, in 1991, you were one of the officers of the Sudbury branch of the OMA. Is that correct?
Dr Donahue: Yes, that is right.
Ms Jackson: In that capacity, I suppose you had a particular interest in following the development of that agreement and its terms.
Dr Donahue: Yes.
Ms Jackson: And reviewed those terms when the agreement was signed.
Dr Donahue: Yes. The Sudbury branch did not have any direct involvement in the negotiation process. That was done primarily by the OMA directly. As a branch society we more or less simply stood aside, if you will, or stood back while the negotiations by the OMA executives were in fact going on.
Ms Jackson: Once the agreement was signed, there was a question of a ratification vote by the various sections of the OMA.
Dr Donahue: Yes. There was a great deal of concern by certain physician groups that the memorandum of agreement would cause particular hardship for residents of certain parts of the province.
Ms Jackson: I understand that if for no other reason, in the context of deciding how the Sudbury OMA and how you would vote on this issue, you did review the agreement.
Dr Donahue: Oh, indeed.
1150
Ms Jackson: All right. During the summer of 1991 and into the fall of 1991, did you become concerned about the impact of the agreement on your practice?
Dr Donahue: Yes, I was very concerned.
Ms Jackson: Can I ask you to turn up exhibit 85, which contains a number of documents, but I am going to ask you to turn in it to a letter of October 22, 1991, which is about five pages from the back, Dr Donahue. See that?
Dr Donahue: Could you identify the letters by --
Ms Jackson: It is October 22, 1991, apparently from you to Ms Sharon Murdock.
Dr Donahue: Oh, I see.
Ms Jackson: Do you have that?
Dr Donahue: Yes, I see the letter.
Ms Jackson: That is a letter that you sent to Ms Murdock?
Dr Donahue: Yes.
Ms Jackson: And it included the attachment that is entitled Cost Saving Through Local Service.
Dr Donahue: Yes, it does.
Ms Jackson: Indeed, I understand you sent that letter to a number of politicians and others with involvement and interest in this issue.
Dr Donahue: Yes, I did.
Ms Jackson: You say on the second page of that letter, Dr Donahue -- and I am looking in the big paragraph in the middle of the page -- "The imposition of the `cap' would render my office financially untenable." Do you recall when you came to that conclusion?
Dr Donahue: I do not know that there is a particular date, but during the process of negotiation of the memorandum of agreement certain sections of it would become common knowledge or it would be leaked out, you might say, to the membership. So overall there was sort of a growing impression that a billing cap might be established, and little by little that level was identified as probably being somewhere around $400,000.
Ms Jackson: That was certainly known by the beginning of the summer, was it not?
Dr Donahue: Yes, that is right.
Ms Jackson: And once you knew that, did you become concerned?
Dr Donahue: Yes, I became very concerned.
Ms Jackson: And is that what prompted this letter?
Dr Donahue: Yes.
Ms Jackson: Can you describe in general terms for the committee why you thought this was going to cause a problem for your practice -- as you say, render it "financially untenable"?
Dr Donahue: Well, the answer to that may be a little long, but if I can sort of shorten it, I have a very large service area of probably over 600,000 people. To provide service to this very large group of people I have slowly developed the necessary services to render those that are necessary for the large numbers of patients that are referred to me, because the truth of the matter is that if I, as a dermatologist, cannot provide for these services, these people essentially have to travel to Toronto. I think that my cost analysis of treatment per visits to Toronto show that the cost to the public to have people transported to Toronto for services are just enormous, so local service is always less expensive.
So I developed a practice that needs the services of six qualified registered nurses and of course the administrative staff necessary. Even the simplest of arithmetic -- even if you exclude electrolysis and you look at my staff of 10 people I need just to provide barebones service to northern Ontario -- shows you that with a $400,000 cap, the office simply could not continue. It just cannot.
Ms Jackson: Because if you take the salaries of 10 people at -- what ballpark figure would you use to make that calculation?
Dr Donahue: Well, I think you can take any figure you want, but the average industrial wage, I think, in Ontario is somewhere around 30 or 35 and I think the average wage for a family is somewhere around 44. These are just figures that I remember from newspaper articles. So even on the basis of salaries alone the practice is untenable, but once you throw in other costs, such as -- there are a whole raft of them. Anyone who has been in business knows what they are. They just go on and on and on and on. Even rent for office space is just enormous. So, as I say, it just did not take a lot of imagination to figure it all out. It was just transparent. It was just obvious that I simply could not continue that office.
Ms Jackson: On page 2 of your letter still, in the bottom paragraph you say, "In closing, I would like to point out that the consultation fee for dermatology is...$49.60." I take it from the context in which you are making that point that you are making that point for the purpose of contrasting it with what it would cost if you had to provide that service from Toronto.
Dr Donahue: Yes. I thought it was very important that I make that quite clear to the ministry as well as to the local MPPs and anyone else who may be reading this, to understand the context in which I had concerns about the cost of the provision of service as well as the inconvenience it would have had to the patients in Sudbury.
For example, the travel grant system, as outlined in this letter, is $130 to Toronto. So if a patient has a dermatological consultation in Sudbury, the ministry, you might say, is out of pocket $49.60. But if dermatological services are not available or are not readily available, meaning, say, the wait is too long, that patient will likely have to be sent to Toronto, or perhaps Ottawa or Hamilton, but the travel grant is $130. So what that really does is it effectively quadruples the cost of the provision of that service, because the dermatologist in Toronto or Hamilton will be paid that same fee as well. I just thought it completely unreasonable that you would quadruple the cost of provision of services when, if you could maintain local service, it would be so much more cost-effective.
Ms Jackson: So I take it you are in effect making two points. You are saying, one, your costs, because of the number of people you have to serve and the number of staff you have to have to do that, are so high that the cap makes your operation financially untenable. That is one point.
Dr Donahue: Yes, that is right.
Ms Jackson: And then you are saying: "And look at what the alternative is. If I go out of business, the replacement cost of this kind of service will be much higher than the amount of money you're already paying me."
Dr Donahue: Well, actually I was not referring to replacement cost. That is actually another point as well. But, for example, if I should have had to close my office completely, it is not to say that I could not actually continue practice, but I could not continue to provide the service needed, because, as I say, I am providing service to a population of half a million people, and by way of example, there are over 100 dermatologists in Metropolitan Toronto, so the ratio in the Toronto area is one dermatologist per 40,000 people. So I am looking after a population 10 times the size.
Ms Jackson: So your conclusion from this is not that you would necessarily have to close your practice but that you would have to scale it down dramatically?
Dr Donahue: And on this basis what would happen is I could only --
Ms Jackson: Is that right, though, Dr Donahue?
Dr Donahue: Pardon?
Ms Jackson: Your conclusion was not that you would have to close your practice but that you would have to scale it down dramatically.
Dr Donahue: To the point that I could not actually provide services for the people who needed them and what I would actually have to do is continually turn people away from my office, saying, "Well, I can't see you, or for that matter, I can't provide you with a complex blend of services I've been providing." So on this basis what would have to happen is that my staff and I or the referring physicians would have to continually sign travel grants to send these people to Toronto. Obviously, the alternative is to have other dermatologists there, either in Sudbury or in the vicinity, but that was never forthcoming.
Ms Jackson: Now, in trying to describe the impact of this cap program on a practice such as yours, and in particular some of the cost considerations, you had occasion in late October and through November to speak to a number of media people and some government people about the impacts on your practice, did you not?
Dr Donahue: Yes, I did.
Ms Jackson: I am going to ask that we put -- I was going to put something in front of you, Dr Donahue, that will take --
The Chair: There is one document that counsel would like to distribute as an exhibit now, which would take approximately 10 minutes to complete. It would be my intent that we could through that particular document, at which time we would recess until 2:00 pm.
Ms Jackson: Mr Chairman, could we put in front of Dr Donahue and the members of the committee the memorandum of October 31, 1991, from Nuala Doherty, and this is the memorandum, Dr Donahue, that you had occasion to review in my office yesterday, which apparently records a telephone conversation between Ms Doherty and yourself. Do you recall speaking to Ms Doherty, the assistant --
The Chair: Just one moment. Members could mark this as exhibit 91.
Ms Jackson: Do you recall speaking to Ms Doherty, Mr Laughren's assistant, in or around this time?
Dr Donahue: I do not remember the conversation. I have sort of a vague memory of speaking to somebody from Mr Laughren's office, but it is fairly vague.
Ms Jackson: And in terms of the kind of information you were using to make the points you have been describing this morning, is the information that is set forth in here consistent with the kind of information you would give in this conversation and in others about your practice?
Dr Donahue: When pressed, yes.
Ms Jackson: All right. At the bottom of the page, there is an indication that, "Dr Donahue's financial statements have been sent to the joint management committee." Did you have any personal knowledge of that, Dr Donahue?
Dr Donahue: No. Actually, when you showed it to me yesterday it came as a complete surprise.
Ms Jackson: All right. Notwithstanding the prospect that I said would take 10 minutes, Mr Chairman, I am pleased to report it took two. I am ready for the next item, and perhaps we should do that after lunch.
The Chair: Thank you very much, Ms Jackson. We will recess now until 2 pm.
The committee recessed at 1200.
AFTERNOON SITTING
The committee resumed at 1415.
The Chair: Good afternoon. We will call the afternoon session of the Legislative Assembly committee to order. At the end of the morning our counsel, Patricia Jackson, was in the midst of questioning Dr Donahue and I would invite Dr Donahue back up to the table. Good afternoon, Dr Donahue.
Dr Donahue: Good afternoon.
The Chair: For members of the committee and for those watching, I would like to indicate that the rest of today's questioning will be with Dr Donahue, and we will commence tomorrow with Mr Harfield. So there is a slight change to our agenda, but that is done with the concurrence and the agreement of members of the subcommittee, and we just wanted to say that so those members who are interested in the agenda will know of that at this point in time. Having said that, I would invite Ms Jackson to continue questioning.
Ms Jackson: Dr Donahue, we were dealing with the events of the fall of 1991, and I would like to take you, sir, to November 15, 1991, when I understand there was a meeting in Civic Square between yourself, Ms Martel, Mr Laughren, members of the regional government and some other people.
Dr Donahue: There were about a dozen doctors as well.
Ms Jackson: All right. Members of your staff were there, as I understand it, as well?
Dr Donahue: Yes, my staff was present.
Ms Jackson: And a number of members of the regional government?
Dr Donahue: Yes.
Ms Jackson: What was the purpose of that meeting?
Dr Donahue: It was an information meeting for Ms Martel and Mr Laughren with regard to the issues and just how important and vital they were to the community. Moreover, from a physician's point of view, it would also give us an opportunity to hear what the government policy was going to be if it had reached a decision with regard to helping the residents of northern Ontario obtain better access to medical services. So it was sort of give and take.
Ms Jackson: The meeting was chaired, as I understand it, by Dr de Blacam, was it?
Dr Donahue: I guess it could have been, although my memory is that it might have been chaired by Mr Tom Davies, who is the regional chairman.
Ms Jackson: In any event, sir, were you the first person to present information to that meeting?
Dr Donahue: I might have been, but I cannot remember the order of speakers. In fact, perhaps I was not. I just do not remember whether I was first, second or third.
Ms Jackson: You do not remember in what order, but do you remember that you did give the meeting information about your practice?
Dr Donahue: We discussed it rather briefly, yes.
Ms Jackson: Can you give the committee your best recollection of what you told that meeting, please.
Dr Donahue: My presentation had more to do with dermatology than my practice as such. Overall I think there is a grave and considerable misunderstanding of exactly what dermatology is. It had been related to me that there was a misunderstanding with regard to the true importance of dermatology as it pertains to medicine generally speaking, and it was my intention to point out that dermatology is a subset of internal medicine, and beyond treating rather simple diseases such as acne there are a whole variety of very important, severe and difficult-to-diagnose conditions of the skin that often times have internal medical ramifications. That was more or less what we were talking about.
Ms Jackson: As I understand it, you did a slide presentation of some of those diseases?
Dr Donahue: Yes, that is right.
Ms Jackson: Then you told the people who were assembled something about the financial strains you felt you were under as a result of the threshold?
Dr Donahue: I do not remember specifically, but it was pretty brief. It was just a synopsis, if you will.
Ms Jackson: Do you recall telling the people at the meeting that you had exceeded the threshold in August of that year, as you understood it?
Dr Donahue: I do not remember saying that.
Ms Jackson: Would that be consistent with the kind of thing you were saying around that period of time?
Dr Donahue: Yes.
Ms Jackson: And when you made that statement, Dr Donahue, were you taking into account the fact that you were on the underserviced area program, or had been on the underserviced area program?
Dr Donahue: No, not really. The underserviced area program was a bit of a blur as far as I was concerned.
Ms Jackson: So when you made that statement you were not making any allowance for the possibility that some of your income for part of the year was not subject to the threshold because of the underserviced area program.
Dr Donahue: No. No.
Ms Jackson: Now, when you made that statement, Dr Donahue, were you taking any account of the -- well, first of all, did you know that epilation income was not going to be subject to the threshold?
Dr Donahue: Not at that time.
Ms Jackson: When did you learn that, do you recall?
Dr Donahue: I do not have a very special day. Actually, it was actually quite late that I -- as I understand it, in discussion the ministry had with the OMA in deciding how the memorandum of agreement would be applied, it was decided that it would not be. I cannot remember exactly; it was actually fairly late. I do not think it was on the 14th. I think it would be after that.
Ms Jackson: Are you sure of that or is that --
Dr Donahue: No, I am not sure.
Ms Jackson: It could be some time in around that period.
Dr Donahue: Mm-hmm.
Ms Jackson: In any event, when you made that statement you were not making any allowance for the fact that on the basis of the number you gave us this morning, 25% of your income would not be subject to the threshold.
Dr Donahue: I was not making allowances for the fact that some decisions may or may not have been made with regard to technical fees or UAP allowances, no.
Ms Jackson: In other words, you were assuming all your epilation income would be the subject of the threshold.
Dr Donahue: That all my income, sure, including epilation.
Ms Jackson: All right. Now, at that meeting you had your accountant present, I understand?
Dr Donahue: Yes, that is right.
Ms Jackson: With a view to giving some further information about the financial strains you considered you were under.
Dr Donahue: Not really. There had been up to that point, in around that point, a great deal of interest in my personal finances, and frankly, I resisted any attempt to lure me into discussions of specifics, and I brought my accountant and my staff to show Ms Martel and Laughren that I really did have a staff of 14 people and that I had not just hired them from some theatrical company and were there, and to lend an air of respectability to my comments with regard to the presence of my employees, my accountant was there.
Ms Jackson: Do you recall whether you or your accountant told the members of the meeting that you had a $150,000 line of credit?
Dr Donahue: I do not know if that was actually my accountant who said that. There was a bank manager who was there, or it could have been my accountant, either one of them.
Ms Jackson: I think you indicated at the meeting as well that you, on that line of credit, owed about $138,000.
Dr Donahue: Something around there.
Ms Jackson: And at that meeting as well you had cheques for your employees?
Dr Donahue: I did.
Ms Jackson: And you delivered them to the Treasurer?
Dr Donahue: I did.
Ms Jackson: Why?
Dr Donahue: I was deeply concerned about the fact that I would have to lay off 14 people. My employees are near and dear to me; they are almost like friends. I spent a great deal of time selecting them. I liked them a great deal. I would dearly love to keep them going and keep them with me, but it was becoming impossible for me to actually keep them there.
There had been some suggestions coming from the ministry that I really did not have a financial problem when in fact I really did, and so I had wanted to present to Mr Laughren and Ms Martel at least proof in some fashion that I did have a large office, that I had many expenses, without actually having to go into detail. So I had wanted to show Mr Laughren that this really was my payroll, that I do have all these people there, and if I were to be able to maintain my service to the community and in the region, then the billing cap simply would not allow me to do that. It was just --
Ms Jackson: The cheques that you gave to the Treasurer were the last salary cheques for your 14 staff members?
Dr Donahue: Yes, they were.
Ms Jackson: And did you invite the Treasurer to give them to your staff?
Dr Donahue: I did.
Ms Jackson: For the reason you have indicated?
Dr Donahue: Yes.
Ms Jackson: Now, I would like to ask you a little bit about the impact of the underserviced area program on your situation and the threshold as you understood it. You said this morning that you had studied the threshold agreement, correct?
Dr Donahue: Mm-hmm.
Ms Jackson: That agreement is exhibited, Dr Donahue, as I indicated to you yesterday when we met, in exhibit 8 of the volumes in front of you. It might be helpful, as much for committee members as for you because you will be familiar with this, to turn up exhibit 8. I am looking about a third of the way into that document, a document entitled Interim Agreement on Economic Arrangements.
Dr Donahue: Is there a page number?
Ms Jackson: Unfortunately there is not. What you will see as you go through the document, Dr Donahue, is it starts with remarks by Mr Decter, then there is a copy of the agreements reached between the government of Ontario. That is a document that goes on for some 26 pages. The document I am looking for is immediately after that.
Dr Donahue: I am afraid you will have to give me a page number. I do not know, I cannot find it as such.
The Chair: We will have some assistance provided so that you might be able to find that part of the exhibit.
Ms Jackson: It is after the 26-page agreement, immediately after that.
Dr Donahue: Interim Agreement on Economic Arrangements?
Ms Jackson: Exactly. On page 4 of that there is a clause dealing with -- this section deals with the threshold payment adjustments. Clause 10, subparagraph (a), subparagraph (i) provides that, "The threshold payment adjustments set out do not apply to: (i) physicians working in underserviced areas by arrangement with the Ministry of Health under the Ministry of Health underserviced area program." You were familiar with that provision in the agreement, Dr Donahue?
Dr Donahue: Yes.
Ms Jackson: We covered the fact this morning that you were on the underserviced area program. When did you understand your entitlement, or your enrolment, under that program came to an end?
Dr Donahue: It was my understanding, at least at the time, that it would likely be in June of 1991.
Ms Jackson: When did you have that understanding?
Dr Donahue: It was always my understanding that it was June.
Ms Jackson: Do you know why you came to the conclusion that your enrolment was over in June?
Dr Donahue: Probably because I arrived in Sudbury somewhere in early summer, so the assumption was June.
Ms Jackson: So you just assumed it was four years later that you were up.
Dr Donahue: Yes, right.
Ms Jackson: At lunchtime you were able to locate a document, and I would ask that that be distributed to members. You will have your original which is, as I read this, the most recent annual contract in respect of an incentive grant agreement. Do I take it, Dr Donahue, that this is with respect to the underserviced area program?
Dr Donahue: Yes.
Ms Jackson: Mr Chairman, could we mark that as the next exhibit?
The Chair: This incentive grant agreement is going to be marked as exhibit 92.
Ms Jackson: That document appears to say that the life of the agreement -- I am looking at the upper right-hand corner -- is from August 31, 1990, to July 30, 1991. What does that suggest to you about when your underserviced area program enrolment was up?
Dr Donahue: It suggests that the enrolment is up on July 30, 1991.
Ms Jackson: In any event, whenever the underserviced area program enrolment was up, you understood, I take it, from the threshold agreement, that so much of your income as was earned until your enrolment was completed would be exempt from the threshold?
Dr Donahue: I beg your pardon?
Ms Jackson: Having read the threshold agreement, you would understand that so much of your income as was earned by you up until the date when you finished on that program would not be included in the threshold calculation.
Dr Donahue: I think in and around that time there was a certain degree of confusion as to whether or not the memorandum of agreement would supersede that or not; that is to say, my UAP designation. I did not spend a lot of time thinking about my UAP designation because I was really planning for the future.
Ms Jackson: Did you make any efforts to find out what your status was in respect of the threshold as a result of being on the UAP?
Dr Donahue: No, I simply presumed that my UAP designation was up in June and that was that.
Ms Jackson: Having assumed your UAP designation was up in June, would you not therefore assume that the income that you earned till the end of June would not be subject to the threshold?
Dr Donahue: If I had given it a great deal of thought, I guess so.
1430
Ms Jackson: I assumed you did, from what you said. You were giving a great deal of thought to your future financial situation.
Dr Donahue: True, but as my UAP designation was literally up anyway, from my perspective, it was not all that relevant to my long-term plans.
Ms Jackson: So you did not make any effort to determine whether your assumption that your UAP designation was up in June was correct or not.
Dr Donahue: No, it just did not seem pertinent to my long-term plans.
Ms Jackson: Are you saying you made no effort to determine whether or not your enrolment in the underserviced area program had anything to do with whether or not you would be exempt under the threshold?
Dr Donahue: My UAP designation was up and I was told it would not be renewed, so the UAP designation was meaningless.
Ms Jackson: Did you make any effort to determine whether, for any other reason, you were exempt under the threshold?
Dr Donahue: You are referring to 10(a)(ii), I guess?
Ms Jackson: I am just inquiring if you made any steps to determine whether you were exempt under the threshold.
Dr Donahue: Not specifically. I cannot remember.
Ms Jackson: All right. Did you have occasion at some point in time to discuss with Dr MacMillan whether or not your previous status on the underserviced area program had anything to do with the threshold issue and how much money you had made that would be subject to the threshold?
Dr Donahue: Yes. He actually gave me a call on that issue.
Ms Jackson: Do you recall when that was?
Dr Donahue: Some time in November. I guess maybe mid to late November.
Ms Jackson: Did he indicate what had prompted the call?
Dr Donahue: No, he just essentially said, "By the way, did you know," and --
Ms Jackson: What did he tell you?
Dr Donahue: He told me that my underserviced area program designation actually expired at the end of August. When he told me that, I said, "Oh, well, that's news." Then I went back to my file and that is when I retrieved this contract, and the contract says it is up in July. I called him back and said: "Okay, well, what's what? Is it June? Is it July? Is it August?" He said, "It's August, but there is a mistake." I said: "Oh, okay. That explains the confusion."
Ms Jackson: Having told you that your underserviced area program enrolment went on till the end of August, did he also tell you that therefore your income up to the end of August was not subject to the threshold?
Dr Donahue: Yes, he did.
Ms Jackson: As I understand it, you, having received that information, wrote a letter confirming that you had received it from him on November 15.
Dr Donahue: That is right.
Ms Jackson: Could I ask that that letter be placed in front of you -- and given to committee members, Mr Chairman, and perhaps marked as exhibit 93.
The Chair: Yes, that will be marked as exhibit 93.
Ms Jackson: This is the letter that you wrote on November 15.
Dr Donahue: Yes, it is.
Ms Jackson: I think you have said you had two telephone calls with Dr MacMillan, one where he made this point and another after you checked the date on which you completed your enrolment in the underserviced area program.
Dr Donahue: I think I have had two or three. I remember this one, with regard to this issue.
Ms Jackson: All right, and that call clearly would have been in advance of November 15, 1991.
Dr Donahue: Yes. I would think maybe a few days before or something like that.
Ms Jackson: I asked that because I checked Dr MacMillan's evidence over lunchtime and I noticed that his recollection -- and I do not believe he had any document to prompt him -- was that you and he had this conversation later on in November. But if this letter is accurately dated, it would clearly have to have been in the early part of November, the first two weeks.
Dr Donahue: I have no reason to doubt that the letter is inaccurately dated.
Ms Jackson: Therefore it would follow from that, Dr Donahue, that by November 15 you knew that none of your income up until the end of August was subject to the threshold.
Dr Donahue: That is true.
Ms Jackson: And it would follow from that, would it not, sir, that you could not have exceeded the threshold in August?
Dr Donahue: Agreed.
Ms Jackson: Therefore the information you had from Dr MacMillan was at odds with the statement you made in the meeting of November 15.
Dr Donahue: Yes, I would have to agree with that.
Ms Jackson: Once you knew that your income to the end of August was not subject to the threshold, that had profound ramifications for the financial survival of your practice.
Dr Donahue: No, not really, because what it really suggested was that I could eke out or keep my practice alive for about another two or three months, but the finances thereafter would be no different. Like most small business people or physicians that have to sign many long-term commitments, whether I could survive for another month or two or three was not really much of an issue from my point of view or, for that matter, from my staff's point of view. The big question was, could I keep them employed for another four or five years.
Ms Jackson: That might go to what happened in the following years, but in the immediate term, the implication of the information Dr MacMillan had given you had profound ramifications for the immediate financial survival of your practice.
Dr Donahue: Yes, that is true.
Ms Jackson: All right. Having received that information, did you take any steps to correct the impression that had previously been given that you were being immediately forced out of business by the threshold?
Dr Donahue: No.
Ms Jackson: Why not?
Dr Donahue: Because the issue at this point in time was so complicated even in my own mind, and for that matter even with Dr MacMillan, with regard to when I was on UAP, when I was not on UAP, what was applicable, what was not applicable, what were technical fees, what were not technical fees. It would be essentially impossible to try and correct this unfortunate misunderstanding.
Ms Jackson: There was no question by this time what the implication of the UAP was on your threshold situation, was there?
Dr Donahue: I beg your pardon?
Ms Jackson: It was clear after you had your conversation with Dr MacMillan that any income that you earned to the end of August was irrelevant for threshold purposes. There was no doubt about that.
Dr Donahue: No, none.
Ms Jackson: From about the middle of November, or some time in November, it was equally clear that your epilation income would not be subject to the threshold.
Dr Donahue: Some time in November, yes.
Ms Jackson: The remaining question was what, if any, portions of your costs would be categorized as technical fees, correct? That was not clear.
Dr Donahue: No, it was not clear to me.
Ms Jackson: The implication of costs being characterized as technical fees is that they would be deducted from your income for threshold purposes.
Dr Donahue: That is true.
Ms Jackson: So it would be important to know what costs you had that might be categorized as technical fees.
Dr Donahue: Yes.
Ms Jackson: And that was uncertain?
Dr Donahue: That is right.
Ms Jackson: But the other matters were not by November 1991.
Dr Donahue: Exactly.
Ms Jackson: In the course of your conversation with Dr MacMillan, do you recall him making a suggestion that you and he should meet when he was next in Sudbury to review your situation?
Dr Donahue: I believe he made that suggestion.
Ms Jackson: He indicated, I think, that he was coming to Sudbury some time that month, probably near the end of the month.
Dr Donahue: He may have, yes.
Ms Jackson: Did you agree to meet him?
Dr Donahue: No. I said I would think about it.
Ms Jackson: Did you in the end meet him?
Dr Donahue: No.
Ms Jackson: Why not?
Dr Donahue: I had very grave reservations about meeting with any senior bureaucrat with regard to my situation.
Ms Jackson: Why?
Dr Donahue: I have a certain mistrust of bureaucrats and bureaucracy and so forth. There were comments that were emanating out of the ministry's offices that I felt were a little biased, so I just did not feel safe meeting with any bureaucrats or any senior people.
Ms Jackson: Is it fair to say you never intended to meet with any senior bureaucrats to discuss your practice?
Dr Donahue: No, actually that is not quite true. I did agree to meet with Dr MacMillan on the morning of December 6th, which would be the morning after the December 5th meeting, as long as I was not alone with him, as long as I could bring other people.
Ms Jackson: A moment ago I thought you said you did not agree to meet with Dr MacMillan.
Dr Donahue: That is to say, before the December 5th meeting.
Ms Jackson: You did agree to meet with him afterwards?
Dr Donahue: Afterwards, yes.
Ms Jackson: Did you tell him that?
Dr Donahue: Yes.
Ms Jackson: When did you tell him that?
Dr Donahue: I think I got a call back shortly before the December 5th meeting, probably the week before, but I cannot remember.
Ms Jackson: From whom?
Dr Donahue: I got a call from David Sword. Actually, he called me a couple of times.
1440
Ms Jackson: David Sword is Ms Martel's assistant?
Dr Donahue: I understand.
Ms Jackson: Let me follow the chronology that gets us to that point. In the November 15 meeting with Ms Martel and Mr Laughren, did Ms Martel make a request of you that you meet with representatives of her office and the ministry to discuss your situation?
Dr Donahue: Yes.
Ms Jackson: Was there any discussion about whether that meeting would be in private or in public?
Dr Donahue: It was very quick. She was running out of the meeting and just stopped by my chair.
Ms Jackson: Was there any discussion as to whether it would be in public or in private?
Dr Donahue: I do not remember that we discussed it in detail. She just said, "Meet in the office," or, "Meet with them."
Ms Jackson: There was no suggestion then that the meeting would be in public?
Dr Donahue: No. I think the suggestion was that the meeting would be in my office, so I guess the understanding would be that it would be private but not necessarily confidential.
Ms Jackson: What did you say to her in response to that suggestion?
Dr Donahue: That I would give it some thought.
Ms Jackson: After giving it some thought, what did you then say to her or her office about that meeting?
Dr Donahue: I did not actually call her back on that. The next thing that happened was I got a few calls from her office.
Ms Jackson: David Sword?
Dr Donahue: I think that somebody else from her office called me as well, but I cannot remember. I think there was more than one. I think David Sword was not the only one who called me from her office trying to set up a meeting.
Ms Jackson: In the end you agreed to meet, you say, on December 6?
Dr Donahue: David Sword had been very, very pressing, if not insistent, that I meet with them before the December 5 meeting. He was almost desperate to get me to meet with them before December 5 or on the afternoon of December 5. Finally, trying to be agreeable about all this and trying to be a good guy about it all, I said, "Okay, okay, well, we can have a meeting after the December 5 meeting, but not before."
Ms Jackson: This was to be a meeting with Mr Sword and somebody from the ministry, was it?
Dr Donahue: I think the idea was MacMillan would be there as well.
Ms Jackson: You said earlier you were inherently very distrustful of meeting with senior bureaucrats?
Dr Donahue: Yes.
Ms Jackson: Why then would you agree to this meeting?
Dr Donahue: I think I felt that my back was up against the wall and at some point or other I would. What I had decided at that point in time was that I would not have a private meeting with them, that I would insist that my attorney would be there and that representatives from the Sudbury and District Medical Society would be there.
The other point here as well is I felt there was a high probability that the meeting on the 6th would not really be necessary because the meeting on the 5th was really to decide the issue. So if the issue was decided on December 5, the meeting would be irrelevant.
Ms Jackson: The meeting on December 5 was to decide what issue?
Dr Donahue: The billing cap as it applied to physicians in northern Ontario.
Ms Jackson: You understood that the ministry was going to decide on December 5 whether the billing cap would apply to northern Ontario?
Dr Donahue: We had hoped that we would have some decision from the ministry at that time.
Ms Jackson: There had never been any such indication from the ministry, though, had there?
Dr Donahue: Not publicly, but there were a lot of private discussions. There was no guarantee that it would be decided, but there was very little reason to hold a meeting if in fact a decision would not be forthcoming.
Ms Jackson: One reason to hold a meeting, Dr Donahue, would be to find out whether you were in fact threatened by the threshold in the fashion that you seemed to fear you were.
Dr Donahue: The December 5 meeting?
Ms Jackson: Sorry, a reason to hold the meeting between the members of the ministry and yourself was to determine whether you were in fact threatened by the threshold in the way you seemed to assume you were.
Dr Donahue: In so far as the 6th is concerned, I presume you are referring to?
Ms Jackson: Whenever the meeting took place.
Dr Donahue: The meeting on December 5 did not pertain to me specifically. There were well over a dozen doctors who were affected and actually made presentations, so the idea was to have a policy decision. You see, the Sudbury and District Medical Society and the physicians in northern Ontario were not looking for personal exclusions from the billing cap. This essentially was a province-wide problem, and it required a policy decision. So we were looking for a policy decision.
It had been decided long ahead of time that the physicians individually were not looking for individual exclusions. Individual physicians may have talked about their individual situation, but it was quite clear that the society in Sudbury was looking for exclusion for all doctors in northern Ontario. So my personal situation was really quite irrelevant to the issue because the issue required a policy decision from the ministry. So that is why we held the meeting.
Ms Jackson: But it would be a fair interpretation of the events of November, Dr Donahue, that you had put your personal situation as being an example of the problem.
Dr Donahue: Yes.
Ms Jackson: Having put that forward, it is not unreasonable, is it, to find that people want to test whether indeed the example being proffered presents a problem? Is that not reasonable?
Dr Donahue: Yes, I think it is reasonable, although it was never actually spelled out to me that any of these meetings would be a test as such.
Ms Jackson: I take it from what you are saying there never was very specific discussion about exactly what would be discussed at this meeting or on what basis?
Dr Donahue: Agreed.
Ms Jackson: Notwithstanding that it was never really talked about, you were very reluctant to have such a meeting?
Dr Donahue: Yes.
Ms Jackson: You were not prepared to have one before December 5 at all.
Dr Donahue: That is right.
Ms Jackson: I am going to suggest to you, as to what would happen after December 5, you said you might be prepared to meet under certain conditions but you did not commit to such a meeting.
Dr Donahue: Actually, I did commit to a meeting on the 6th, sure.
Ms Jackson: To Mr Sword?
Dr Donahue: Mm-hmm.
Ms Jackson: Did you tell him you wanted to meet with all the people you indicated you insisted be there, the district health council, your representatives and others?
Dr Donahue: I do not think the district health council. I guess the Sudbury and District Medical Society. Pardon me if I said district health council.
Ms Jackson: All right. Did you tell them those people would have to be there?
Dr Donahue: I cannot remember specifically whether I insisted that these people would be there, but in my own mind, I had decided that it would be necessary for them to be there.
Ms Jackson: When was that meeting to be held?
Dr Donahue: The morning of the 6th.
Ms Jackson: At what time?
Dr Donahue: I think around 10 o'clock.
Ms Jackson: Who was to attend from the ministry?
Dr Donahue: I believe it was supposed to be Dr MacMillan.
Ms Jackson: Anyone else?
Dr Donahue: Well, I got the impression David Sword would be there.
Ms Jackson: Dr Donahue, the difficulty with that is that Dr MacMillan was for quite some period of time scheduled to be at a conference on December 6, in the morning. It is hard to understand, given the evidence we have heard, that anyone would have agreed for him to attend a meeting in Sudbury that morning. Is it possible that what you are suggesting was a fixed commitment was in fact just the possibility of a meeting?
Dr Donahue: Yes, sure. The thing here is that David Sword was trying to set up the meeting. I was not talking directly to Dr MacMillan, so as I say, whether he was going to attend or not was --
Ms Jackson: So it may well be that while there was discussion of a possible meeting on December 6, no such meeting was ever committed to?
Dr Donahue: Mm-hmm.
Ms Jackson: Again during that meeting on November 15, was there a suggestion from Mr Laughren that there be a review of your situation?
Dr Donahue: Yes. He was quite outspoken about demanding that I open my books publicly.
Ms Jackson: Did he say "publicly"?
Dr Donahue: Yes, "Open your books."
Ms Jackson: Well, he said, "Open your books." Did he say "publicly" or did you infer publicly?
Dr Donahue: I inferred publicly, because all the publications and newspaper articles essentially had quoted these people as saying, "Open them publicly." So I presume it was publicly.
Ms Jackson: Did you respond to that suggestion from Mr Laughren?
Dr Donahue: No. The chair actually did not recognize me, so I had no opportunity to address that.
Ms Jackson: Can you look at exhibit 73 in those black books, Dr Donahue. It is a letter of November 19 addressed to you from Mr Decter. Did you receive that letter?
Dr Donahue: Yes, I did.
Ms Jackson: Did you respond to it?
Dr Donahue: I wrote a reply but I never sent it.
Ms Jackson: So you may have considered a response, but you did not in fact respond to Mr Decter?
Dr Donahue: No.
Ms Jackson: Why did you not?
Dr Donahue: It scared me.
Ms Jackson: Why did it scare you?
Dr Donahue: Because it is a threat.
Ms Jackson: Where is the threat?
Dr Donahue: They are asking my permission to investigate and publicly discuss my practice patterns.
Ms Jackson: You are looking at the third paragraph?
Dr Donahue: Sure. Who essentially wants to give somebody permission to be publicly investigated and to have all of this discussed publicly? It is a threat. We all have legitimate rights to a certain element of privacy. To have somebody who is the Deputy Minister of Health write you on all this gold-embossed paper to say -- it is frightening. I was just scared out of my wits.
1450
Ms Jackson: Was there anything else in the letter that you considered amounted to a threat, apart from the reference that you have already made to the third paragraph?
Dr Donahue: The entire tone of the letter; it just chilled my blood. For example, it starts off by saying that I have made repeated threats to shut down my clinic. I was not threatening anything. How can one doctor essentially threaten the ministry? It is ridiculous.
I was a doctor who felt that I had a financial problem, and I had a major, large commitment to providing services in northern Ontario and I would not be able to continue doing it. So my public comments and the comments I made to the MPPs and other people were cries for help. That is what it was: "Help. I am in trouble. If you want me to continue providing services, then give me a break, help me. I can sort of function as a small, little office, but the needs of the community are so enormous that I need my staff."
Ms Jackson: Was there anything else in the letter that you took to be a threat?
Dr Donahue: The suggestion here that I was putting services in the north in jeopardy. It is almost flattering for these people to suggest that I am so important, but I am just one doctor. There are hundreds of dermatologists in Ontario, so I do not know.
Ms Jackson: But it would certainly be your view that the departure of your clinic was putting dermatological service in northern Ontario in jeopardy.
Dr Donahue: I would think that I should be easily replaceable. I am not that important.
Ms Jackson: If your economic analysis is right, you are not that easily replaceable, are you?
Dr Donahue: I would think so. There are hundreds of dermatologists in Ontario, so why not just send someone else up, or give him a contract, or bring him up?
Ms Jackson: So you are suggesting the threshold is not inherently a problem for dermatologists in northern Ontario.
Dr Donahue: I think the suggestion here was that if you are going to replace me, whoever you bring up, you are going to have to give that person an exclusion because that person is not going to be able to do what I was doing, because I cannot continue doing it.
Ms Jackson: So as long as the threshold applies to dermatologists in northern Ontario, dermatological service in northern Ontario is in jeopardy.
Dr Donahue: Sure. Whether they essentially decide to remove the cap for me or whoever would replace me -- that is all they really needed to at least have some service continued.
I did not just read this letter with a sort of excessive sense of paranoia. I took this letter and I looked at it. It just scared me. Moreover, the day before, or two or three days before I got this letter, I got a fax. Now I do not have a fax machine, but it was sort of sent over to me by the local OHIP office. I got a fax and then I got the letter following up, so I got the impression that somebody was trying to give me a message in no uncertain terms. It is not as if I just got a letter; I got a fax and I got this letter. So I went and spoke to my private attorney, who read it, and he said --
Ms Jackson: You do not have to disclose your legal advice, if you do not want to, Dr Donahue. You may if you want to, but you are not obliged to.
Dr Donahue: As I say, there was not a lot of legal advice. I sought my attorney because he is level-headed, he is calm, he is not prone to paranoia. He just could settle me down and say, "Now hold on." So I showed it to him. He said it was a threat. I discussed this with Dr de Blacam, who is president of the local medical society, and he interpreted it the same way. I do not think my interpretation, under the circumstances, is all that erroneous. That is how I saw it.
Ms Jackson: Just so we have the nature of the threat, you understood the threat to be that the ministry wanted to investigate and publicly discuss your practice. Right?
Dr Donahue: Yes, that is right.
Ms Jackson: But clearly this letter is saying the ministry cannot do so without your consent.
Dr Donahue: Yes, that is right.
Ms Jackson: So as long as you do not consent, the threat is not very prejudicial.
Dr Donahue: Let's just say that as long as they do not go out and release the information on their own.
Ms Jackson: There is no suggestion in this letter that they are going to do that, is there?
Dr Donahue: I think my distrust of government is sufficient that I figured, if I do not play ball, they are probably going to do it anyway.
Ms Jackson: That is what you read between the lines.
Dr Donahue: Yes.
Ms Jackson: All right. Dr Donahue, I have given you already, and I would like to ask that it be put back in front of you now, a bundle of press reports that run through this period in which reference is made to your situation. Could I ask that those be distributed to members as well? Mr Chairman, could that be exhibit 94?
The Chair: Yes, those will be marked as exhibit 94.
Ms Jackson: Just so you and members of the committee know, Dr Donahue, this is a compilation of press reports involving your practice. They are, by and large, in chronological order, although because of the late delivery of some documents there are some press reports near the end that are out of chronological order. For purposes of referring to them, they have been assigned page numbers in the upper right-hand corner.
May I just, before we move on, clarify one thing with you. There appears to be some uncertainty about what it was that was faxed to you. You made mention a moment ago of a fax to your office. I took you to be saying that the November 19th letter from Mr Decter, which also came by ordinary mail, was as well faxed to some nearby office and delivered to you.
Dr Donahue: No. The letter I received from Mr Decter is an original letter signed by him which was sent by, I presume, regular mail.
Ms Jackson: But it was also faxed to some other place and delivered to you, was it?
Dr Donahue: There was a fax of that letter that arrived in my office a day or two or three prior.
Ms Jackson: When you spoke of a fax coming to your office, it was a fax of the letter that was subsequently delivered to your office?
Dr Donahue: Yes, that is right.
Ms Jackson: Let me take you back then to this package of newspaper articles, exhibit 94. In preparation for giving your evidence today, you had an opportunity to review this package of press reports with your counsel, right?
Dr Donahue: Yes.
Ms Jackson: I understand your recollection and position to be that while you do not always recall the specific interviews that generate these press reports, the statements that are attributed to you in the press reports do reflect accurately what you said, so far as you can recall it.
Dr Donahue: Yes, I would agree with that.
Ms Jackson: I want to ask you about a few specifics in there. First, on page 3, and this is in the interview you gave on November 8th dealing with the epilation issue on MCTV in Sudbury, you are reported as saying, in the middle of the page, that: "The billing is approximately forty-some-odd dollars. It actually dropped ten dollars from what it was originally." Is that something you said?
Dr Donahue: Yes, I believe so.
Ms Jackson: The billing we are talking about there is the dermatological consultation fee.
Dr Donahue: No. That is actually the fee for providing epilation for one hour. It is a procedure fee, I guess.
Ms Jackson: All right. Then you note that for that fee, electrolysis specialists net less than $30 per hour. That is noted at the top of page 4. Is that accurate?
Dr Donahue: Yes.
Ms Jackson: In fact, you point out there are a number of costs and --
Dr Donahue: -- that we do not make $30 an hour.
Ms Jackson: Yes. Then on page 5 you indicate that you, as a result of the delisting of epilation, plan to open an electrolysis clinic that would be, I take it, independent of your medical practice. Is that right?
Dr Donahue: Yes, that is right.
Ms Jackson: And you did in fact do that.
Dr Donahue: Yes.
Ms Jackson: On page 6 you apparently gave an interview to CBC Sudbury on November 13th concerning the closure of your office. Do you recall that?
Dr Donahue: Yes.
Ms Jackson: The host is saying, "Unless something breaks this week, Dr Donahue plans to close the doors to his office on Friday." Given the timing of this -- that would be Friday, November 15th -- was that your position at that time?
Dr Donahue: No. Actually my office was closed on November 29th. What essentially happened, as far as the closure is concerned, is that it was a progressive closure.
1500
Ms Jackson: What do you mean by that, Dr Donahue?
Dr Donahue: Well, I think you have asked me this when we had a chat previously, and I am trying to figure it all out. I stopped accepting new referrals or consultations about two or three weeks before I actually closed, and so the idea was to stop seeing new patients but to continue seeing those patients I had a commitment to see or provide a service to.
Ms Jackson: All right. And so you stopped seeing new patients when?
Dr Donahue: Probably this is in around the date 15th, 18th or something like.
Ms Jackson: And you stopped seeing all patients on what date?
Dr Donahue: I believe the 29th of November.
Ms Jackson: All right. And then you say on page 7, in the middle of the page, "My operating expenses are at the upper limit of the cap. So on this basis alone, it is actually financially impossible for me to keep my office going, even if I wanted to." That is an accurate quote of what you said?
Dr Donahue: Yes, it is.
Ms Jackson: And that would be without taking account of the effect of the underserviced area plan exemption till the end of August?
Dr Donahue: Yes.
Ms Jackson: And without taking account of the fact that you have income of an epilation nature that is not subject to the threshold?
Dr Donahue: That is right.
Ms Jackson: If both of those things were taken into account, it would not be accurate to say that it was financially impossible for you to keep your office going at that time.
Dr Donahue: Yes, I guess so, at that time.
Ms Jackson: And then, on page 8, you are reported as saying, "Now, once I'm capped, I'm essentially unemployable in the province and must in fact leave the country." That was an accurate quote?
Dr Donahue: I think it is.
Ms Jackson: Then could I ask you to turn over to page 13, an article in the Sudbury Star on November 15, 1991.
Dr Donahue: What page is that?
Ms Jackson: Page 13, Dr Donahue. It is the Sudbury Star article of November 15. You are reported there as saying -- and I am looking in the left-hand column -- "Donahue said he is personally in debt over the issue because he continued to treat patients, even though he knew he was over the billing limit.
"`Right now I personally owe the bank $129,000 and there is a payroll sitting in my office to be signed. Once it is signed I will owe the bank $150,000,' he said at a press conference Thursday evening called by the Sudbury and District Medical Society." So far as you know, is that an accurate quote?
Dr Donahue: I would think so.
Ms Jackson: Then on page 41, just to stick with the chronology, although it is a little bit out of order in terms of pages, there is a reference made by a Mr Chapman in a CBC radio program: "Dr Donahue is the only dermatologist for more than 500,000 people in northern Ontario. He reached his $400,000 limit three months ago." That would make it back in August, and that was consistent with the kind of thing you were saying at that time?
Dr Donahue: Yes. Yes.
Ms Jackson: On page 18 there is an article of November 29, 1991, in the -- I think it is the Sudbury Star. Yes, it is the Sudbury Star. You are quoted as saying, on the left-hand column, Dr Donahue, in the fifth paragraph down, "I was assured that in no way was I to be affected by the cap." It is indicated that you said that after talking with Ministry of Health officials. Were you given that assurance?
Dr Donahue: Yes, I was.
Ms Jackson: When?
Dr Donahue: In midsummer.
Ms Jackson: By whom?
Dr Donahue: By Dr Claude Renaud.
Ms Jackson: And who is he?
Dr Donahue: At the time he was head of the underserviced area program for the Ministry of Health.
Ms Jackson: And how did he come to give you that assurance? Were you just --
Dr Donahue: I never actually asked him. My assumption was that, given who he was and his position, he was in a position to make those determinations.
Ms Jackson: I am sorry. It was a bad question. How did the subject come to be the matter of discussion between the two of you?
Dr Donahue: Oh, I called him.
Ms Jackson: And what did you say?
Dr Donahue: I told him I had heard or was under the impression that a billing cap would be applied to all doctors in Ontario, and I said, "Well, you know my situation here," because he is actually originally from the Sudbury area. I said, "You know my situation here; I am looking after half a million people." I said, "The billing cap is not going to allow me to continue providing the same level of services I had over the past five years." I said, "Are there not going to be any exclusions?" I said, "It only makes sense."
Ms Jackson: What did he say?
Dr Donahue: He said, "I know your situation very well," because he worked actually in Sudbury when I was there. He said, "There's simply no way that the billing cap will apply to you or, for that matter, cardiology."
Ms Jackson: If you received that assurance in the middle of the summer, what was it that caused you, as we have seen you did, to come to believe by October that you were affected by the threshold?
Dr Donahue: Because the comments that were being made by the Ministry of Health were such that no exclusions would be forthcoming.
Ms Jackson: In fairness, Dr Donahue, I do not think there was any such announcement from the ministry until November 13. You clearly had a concern at an earlier point. Do you recall what prompted that?
Dr Donahue: Well, as I say, I am not entirely certain when my specific concern about it developed, but I mean to say during the summer as the memorandum of agreement was ratified and we talked to the OMA and tried to get some idea as to whether or not the ministry would bring into effect that clause to --
Ms Jackson: The one that provides for an exemption by district and by speciality.
Dr Donahue: Yes. The overall word was that in all probability that would not in fact be happening.
Ms Jackson: That clause, just so we have it, is the second clause under 10(a)(ii).
Dr Donahue: That is right.
Ms Jackson: We looked earlier at 10(a)(i), which provides for an underserviced area plan exemption. So you became concerned that there were no exemptions going to be granted under that section to you?
Dr Donahue: Or to any other doctor.
Ms Jackson: Just sticking then with this November 29 article, on the right-hand column, you are reported as saying: "To maintain a viable practice, Donahue estimated he would need a billing allowance equal to two or two and a half times the $400,000 cap, or $800,000 to $1 million." Do you recall making that statement?
Dr Donahue: I do not actually recall making that statement specifically. I think that this was Mr St Pierre's guesstimate and I probably said, "Well, sure."
Ms Jackson: All right. Then it is noted that, "He" -- that would be you -- "said he has between 10,000 to 15,000 new referrals a year, not counting repeat visits by existing patients." Is that a statement you made?
Dr Donahue: I could have, sure.
Ms Jackson: It sounds about right?
Dr Donahue: Yes.
Ms Jackson: As well, if you look at the box, "Quick Facts," in the middle of the page, it says, in the last paragraph: "The only full-time dermatologist in northeastern Ontario, Donahue says he may have to repay the government about $60,000 because he already has surpassed the OHIP billing cap this year." Did you make that statement?
Dr Donahue: I believe I did.
Ms Jackson: You certainly knew by November 29 that the underserviced area program exempted you till the end of August?
Dr Donahue: Yes, that is right.
Ms Jackson: Which would make this statement likely inaccurate.
Dr Donahue: I actually have not done the calculations, but it is possible. I would have to sit down and do the arithmetic.
Ms Jackson: Then could you turn to page 20, which is an article that apparently appeared in Northern Life on December 1, and you are reported there as saying, Dr Donahue, that you would be better off running a Mac's Milk store. Do you recall making a comment to that effect?
Dr Donahue: Yes, I do.
Ms Jackson: In this article, in the far right-hand column, you say that you see up to 12,000 patients a year. Is that a statement that you made?
Dr Donahue: Sure.
Ms Jackson: If you would see 12,000 patients a year and 10,000 to 15,000 new referrals a year, well, are those two statements not inconsistent?
Dr Donahue: No, not really. As I say, most of my comments to the press and to other people who asked were primarily statements made to give examples of what a busy practice is. These were just my best guess at the time. As I say, most of the calls from the press usually happened to me during my busy office days, so you can imagine with five or 10 or 15 patients waiting for me in the office, and my office late by an hour or two hours, that I was in a pretty big hurry to get off the phone with these people.
Ms Jackson: I take your point, that every time a reporter called you did not call your accountant and say, "Tote up the number of patients I saw last year."
Dr Donahue: That is right, sure.
Ms Jackson: But what you did do was give your best estimate of what you thought your situation was.
Dr Donahue: That is right.
Ms Jackson: And is not the best estimate of 12,000 patients a year a bit inconsistent with the best estimate of 10,000 to 15,000 new patients a year?
Dr Donahue: Yes, I agree with you.
1510
Ms Jackson: So on reflection, one or both of those statements are substantially inaccurate?
Dr Donahue: Agreed.
Ms Jackson: You are also quoted as saying there that you buy $8,000 worth of disposables a month and write $1.5 million worth of prescriptions. Are those statements you believe you made?
Dr Donahue: Yes.
Ms Jackson: And that 30% of your workload is skin cancer. Is that accurate as far as you know?
Dr Donahue: Yes, that is accurate, I would believe.
Ms Jackson: I think you say in here somewhere -- and I am just trying to find it -- that more than half your revenues go to expenses. Do you recall making that statement?
Dr Donahue: I think I have made statements like that in the past.
Ms Jackson: It is at the bottom of the fourth column of that page.
Dr Donahue: Yes.
Ms Jackson: Then over in the article of December 2, which is page 22, you are quoted as saying, in the first column, about two thirds of the way down, "In an interview with Ontario Medicine, Dr Donahue said that approximately 60% of his gross income goes towards covering his overhead expenses." Is that a statement you think you probably made?
Dr Donahue: Sure.
Ms Jackson: In dealing with this question of media coverage, the last thing I would like to do with you, Dr Donahue, is skip ahead to January 1992. I am going to ask you to turn up the article that is exhibit 21 in the black book before you. That is the article by Kevin Donovan of January 26. Do you have that?
Dr Donahue: Yes, I do.
Ms Jackson: Were you contacted by Mr Donovan?
Dr Donahue: He did call me.
Ms Jackson: Did you discuss with Mr Donovan whether or not your practice was or was not under review by the Ministry of Health or the Medical Review Committee?
Dr Donahue: I did not.
Ms Jackson: I would like to move to a totally separate event. I understand in late November 1991, you attended some kind of meeting with a group of businessmen at which you met a Mr Keith Harfield.
Dr Donahue: Yes, that is right.
Ms Jackson: When was that?
Dr Donahue: I do not actually have a specific date, but it could have been the 29th of November. I seem to remember it was a Thursday night, but maybe it was a Friday night.
Ms Jackson: What was the purpose of the meeting?
Dr Donahue: I had actually been invited -- somebody called me from the small businessmen's association, and because I in fact run a small business, asked if I would be willing to buy a ticket. I guess they were actually looking for money and asked me if I would bring along other members of the district society such as Dr de Blacam. I thought, "Well, why not?" It seemed reasonable. We do run small businesses. So I called a few people in town to see if they would be able to make the meeting, but apparently not. So they asked me to attend as secretary of the society.
Ms Jackson: Did you have a conversation with Mr Harfield?
Dr Donahue: Yes, I did.
Ms Jackson: Had you ever met him before?
Dr Donahue: No.
Ms Jackson: Who is Mr Harfield?
Dr Donahue: I understand he is a management consultant in Sudbury.
Ms Jackson: Does he have some position of officership with the small businessmen's association, do you know?
Dr Donahue: To be honest, I do not really know.
Ms Jackson: You had a conversation with him that night?
Dr Donahue: Yes, towards the end of the meeting.
Ms Jackson: Was this a conversation just between the two of you or were others present?
Dr Donahue: I think the discussion was between both of us. There were obviously people nearby, because it was a fairly small meeting, but it was between both of us really.
Ms Jackson: So it was a private conversation between the two of you?
Dr Donahue: As private as it gets in a business meeting where there are people closer than the members here are to me.
Ms Jackson: In that conversation, did he report something to you about your billings?
Dr Donahue: Yes, he did.
Ms Jackson: What did he say to you?
Dr Donahue: He said that he knew what my OHIP billings were.
Ms Jackson: Did he say how he knew?
Dr Donahue: Well, he gave me a figure which was to two decimal points. It sounded so accurate that I was just stunned for a minute, because if you guess what somebody's income is, it is rarely to the decimal point. So I asked him, "Where in God's name did you get this stuff?" and he said he had called friends or called somebody in the ministry or something along that line.
Ms Jackson: Was this in the ministry or in the government or did he say?
Dr Donahue: As I say, I thought he said ministry, but maybe it was government. I got the impression that he had some direct access to someone who had some very specific information about me.
Ms Jackson: Did he tell you anything else he had learned from that person or people?
Dr Donahue: My memory is just a little vague on it, but I got the impression he gave me some figures or breakdowns in terms of percentage of what epilation is. But as I say, I cannot be sure about that.
Ms Jackson: Do you recall, without knowing what percentages he gave you, whether you were struck by the accuracy of those percentages in the way you have indicated you were struck by the accuracy of the total billing number?
Dr Donahue: Yes, I was astounded, because to be honest with you, on a day-to-day basis, even I do not know what those percentages are. It is not the kind of information I tend to carry around with me in my head.
Ms Jackson: We will not know the dollar number of that, at least not in the public sessions, but in terms of the percentage you have given the committee earlier for the epilation proportion of your practice, I take it if you were struck by the accuracy, the number he gave you was something in the order of the number you gave the committee earlier this morning.
Dr Donahue: Yes, that is true.
Ms Jackson: Did you do anything as a result of that?
Dr Donahue: I took a big breath because I was shocked. You just do not walk into a meeting or something along that line and somebody walks up to you and says, "Hey, I know how much money you make." The numbers were so specific I had to go back the following day and call my accountant and say, "Hey, what did we bill last year?" I had to check it out.
Ms Jackson: When you checked it out, did it check out?
Dr Donahue: It checked out, sure.
Ms Jackson: Was there any indication from Mr Harfield that he had given this information to anyone other than yourself, to whom it clearly related?
Dr Donahue: No. As I say, we did not spend a great deal of time talking about it. There was a number of other people I had wanted to talk to at the meeting, and I was pretty upset about the discussion. I just wanted to get away.
Ms Jackson: The thing you were upset about, I take it, was not that he was telling you this information, but that he had received it from someone else who presumably knew it.
Dr Donahue: My conclusion was that if he can obtain this information, obviously other people who have sources in the government can get it too. It just seemed a little strange.
Ms Jackson: Once you had confirmed that not only had he information, but that it was accurate information, did you do anything as a result?
Dr Donahue: No.
Ms Jackson: Did you contact anybody to express any concern about that?
Dr Donahue: No, not at that point.
Ms Jackson: Later on did you contact anyone?
Dr Donahue: Later on, after the events of Thunder Bay, I did, yes.
Ms Jackson: Do you remember whom you contacted?
Dr Donahue: Yes, after the events of Thunder Bay, I got to thinking about everything that had been happening to me and all these strange things. I did not know what was going on, but I did know that seemingly at least one person had access to information about me, so I got in touch with Mr Ian Scott.
Ms Jackson: Did you tell him how he might get in touch with Mr Harfield?
Dr Donahue: Yes.
Ms Jackson: Turning to the events of Thunder Bay and their aftermath, when did you first hear about the conversation in Thunder Bay between Ms Martel and Mrs Dodds?
Dr Donahue: Sunday night, which I guess would be the 8th.
Ms Jackson: How did you hear of it?
Dr Donahue: She called me.
Ms Jackson: Who called you?
Dr Donahue: Ms Martel did.
Ms Jackson: Do you remember when she called you?
Dr Donahue: It was late in the evening, somewhere around 10 or 10:30, although I am a little vague on that.
Ms Jackson: What is your best recollection of what she said?
Dr Donahue: She said she had made some public comments about me and about having seen my file and that there were charges against me.
Ms Jackson: Did she say anything else?
Dr Donahue: She said they were not true and that she had made it up.
Ms Jackson: Did she express an apology?
Dr Donahue: She said she was sorry.
Ms Jackson: Do you remember if she said anything else?
1520
Dr Donahue: Perhaps. I was trying to get some information out of her. I mean, this was like an atom bomb. It was 10:30 at night and I was just sitting around my apartment and someone calls me and says, "Oh, by the way, I'm a senior minister in government, and I just publicly said that you have charges against you." I was just devastated. I was just stunned.
She mentioned that she had called the other people involved and she felt it would not be going anywhere. Because, when she called, I said: "You just ruined my life. You just destroyed my professional reputation, my integrity. You have just ruined me." Because a minister cannot make a statement like that against a citizen and not be believed by at least some people. I mean, there are a lot of people willing to believe the worst about anyone.
She said, "You know, I've retrieved. I've called everyone and they are not going to go any further." Then she said she had called someone in one of the newspapers. I think she said the Globe and Mail or something like that. I said: "This is impossible. If the reporter has got this, then the story has gone. This story is going to flash right through Ontario. You're not going to stop this. You can call these people, but believe me, this is not the kind of story that just becomes overlooked, not when it comes from a minister."
Ms Jackson: You said you were trying to get some information from her. Do you recall what that was?
Dr Donahue: When she called and said she had made this statement, that she had seen my file and there were charges pending, I said: "Your story is just incredible. How can I believe it? Is there such a file? Where do you get this information?" I said: "You know, you are a senior minister of the crown. You've got a reputation for being pretty sharp and you don't go around making these things up right on the spot. What's your source? Where did you get this?"
What I was desperate to find out was, was there such a file? There are files on all of us. There are credit reports, files in banks, personnel files and files everywhere. You do not know what people say about you, so I want to know: "My God, is somebody saying rotten things about me? Where? What source?" I said: "Did you see a file? If you did, let me know. I've got to know. I've got to see this file because it's obviously wrong and so if it is wrong, I want to correct it."
It is like finding out that your neighbour hears you went bankrupt because some credit company has gone around doing a credit check on you and your neighbour says, "Ah, you're bankrupt." And you say, "Hold on a second. Who gave you that information?" "Oh, the credit company." So you call the credit company and they say: "Oh, I'm sorry. There's a misunderstanding. This is what we meant."
Ms Jackson: When you pressed her to find out who had the file and where it was and what it was, what was her response?
Dr Donahue: She just kept saying that she had made it up.
Ms Jackson: I am going to put before you some notes that will be identified by Ms Martel in her testimony as notes of a conversation with you. Could I ask that those be circulated to members of the committee?
The Chair: They are being distributed and they will be marked as exhibit 95.
Ms Jackson: Dr Donahue, you have had a chance to review those notes.
Dr Donahue: Mm-hmm.
Ms Jackson: Is there anything in there that is inconsistent or at odds with your recollection of the remarks you made in the conversation?
Dr Donahue: No, I think it is pretty accurate. There is a question here that I would want to talk to Dr MacMillan, I do not remember, but overall I cannot disagree.
Ms Jackson: At the top of page 2, you are referencing the note that, "Should talk to Dr MacMillan." You do not recall making a comment of that sort?
Dr Donahue: No, but as I say, the information here is a bit more specific than I would have personally remembered.
Ms Jackson: But is the general tenor of these comments the same as the kind of thing you recall saying?
Dr Donahue: Oh, yes.
Ms Jackson: There is nothing in here that strikes you as inaccurate.
Interjection.
The Chair: Order, please.
Mr Conway: Just for clarification, what exactly is this we are looking at?
Ms Jackson: This is a typed version of Ms Martel's notes of this conversation, which I expect she will indicate are generally Dr Donahue's comments.
Mr Conway: Say that again so I am clear. This is Ms Martel's --
Ms Jackson: Typed version of Ms Martel's handwritten notes of this conversation.
Mr Conway: This Sunday evening conversation with Dr Donahue?
Ms Jackson: Yes.
Mr Conway: Thank you.
Ms Jackson: Dr Donahue, last I would like to ask you to identify a letter of December 9, 1991, and I will ask that it be distributed to committee members as well.
The Chair: Distributed as exhibit 96.
Ms Jackson: This is a letter from Ms Martel apparently to you, dated December 9th, in which she notes she is repeating the apology she made in her conversation last night, as of the date of this letter. Did you receive this letter?
Dr Donahue: Yes, I did.
Ms Jackson: The committee heard this morning from a woman named Susan Majkot.
Dr Donahue: Yes.
Ms Jackson: She has a daughter who is a patient of yours.
Dr Donahue: Yes.
Ms Jackson: Do you recall a visit from her in February of this year?
Dr Donahue: I do.
Ms Jackson: Do you recall what she said to you?
Dr Donahue: In vague terms, sure.
Ms Jackson: What did she say?
Dr Donahue: She said she had called Ms Martel's office at some date, she was not quite sure at the time, and the comment that had been given to her was something about irregular billings or something along that line.
Ms Jackson: Are those the words she used?
Dr Donahue: I cannot quote her because I honestly do not really remember.
Ms Jackson: Did you respond to those remarks when she made them?
Dr Donahue: I was stunned. I was in the middle of my office and my secretary came back and said somebody wanted to talk to me about the Martel affair. Frankly, I did not want to talk to anyone about the Martel affair or anything, so I told my secretary: "Just forget it. There is no way." Then she said, "It's a patient's mother." So I thought, okay, I will take a minute out, but I am not talking to anyone about this. When she came in and told me that, I was really upset. I said: "I don't want to hear this. I just don't want anything to do with this." I said: "Thanks for telling me, but you really should find someone else. You should be telling this to someone else" -- like yourself, or somebody on the committee or something like that.
Ms Jackson: Had you heard those kinds of remarks from anyone before, or was that the first report you had had of them?
Dr Donahue: That was the first report.
Ms Jackson: Did you assist her in making contact with someone connected with this hearing process?
Dr Donahue: I called Dr de Blacam, who is president of the local medical society, and discussed it with him and said, "Now one of my patients just came in and said something like this." He said, "Will she testify?" I said: "I think so. She talked to me." So he said, "Okay, give me her name and number and I will see to it that the committee gets in touch with her."
Ms Jackson: Apart from the fact that she is the mother of one of your patients, do you know Ms Majkot?
Dr Donahue: No.
Ms Jackson: Is she a particular friend of yours at all?
Dr Donahue: No. I do not know her at all.
Ms Jackson: All right. Thank you, Dr Donahue.
Dr Donahue: Thank you.
Ms Jackson: Those are all my questions.
The Chair: Thank you, Ms Jackson. Keeping in mind the time and the amount of questioning that has gone on, we will recess for 15 minutes.
The committee recessed at 1528.
1549
The Chair: We are back in session for the afternoon meeting of the Legislative Assembly committee. Before opening it up to questions by rotation, our counsel would like to ask just a few further questions of Dr Donahue.
Ms Jackson: Actually, just one, Dr Donahue. I had you describe that you did indeed close your office on November 29, and I had you describe that somebody came into your office in February 1992, but I neglected to ask you when you reopened your office.
Dr Donahue: On January 13.
Ms Jackson: Why?
Dr Donahue: The Minister of Health, Frances Lankin, made an announcement in very early January -- I cannot remember the date; maybe the 3rd or whatever it was -- that the difficulties with the billing cap in so far as physicians in underserviced areas are concerned would be resolved to the physicians' satisfaction.
Ms Jackson: And you opened your office as a result.
Dr Donahue: On that basis, yes.
The Chair: We will now open for questions, first by the official opposition, Mr Elston. I have allocated 45 minutes per caucus.
Mr Elston: Just 45? Thank you very much, Mr Chair. Dr Donahue, just a few questions. I was interested, you are the only permanent dermatologist in northern Ontario. Is that true?
Dr Donahue: There is a dermatologist, Dr Rinne, who has been there for an extremely long period of time. He is past retirement but is still working, so he is a factor. But I understand from comments made to me that it has become a bit of a hobby for him.
Mr Elston: In fact exhibit 91, the Nuala Doherty memo to Floyd Laughren which mentions Dr Rinne, a retired doctor, speaks fairly clearly to his status in Sudbury. He is basically retired but has a few patients. Is that how you describe him?
Dr Donahue: I do not have any intimate knowledge of Dr Rinne's practice, but the understanding from people who do see him or other physicians is that he is still partially active.
Mr Elston: The other person mentioned in that memo, Dr Hradsky -- do you know of that person?
Dr Donahue: I do not know her very well, but she is a dermatologist in Toronto who flies up to Sudbury to do clinics.
Mr Elston: Did you know that Dr Hradsky, via a letter introduced by the Deputy Minister of Health, was used to suggest that your practice somehow was improper because you employed 14 staff and she employed only two to carry on her business? Did you know that?
Dr Donahue: I was made aware of those comments.
Ms Jackson: I do not think it was a letter.
Mr Hope: No, it wasn't.
Mr Elston: It was a memo, then, that Dr --
Ms Jackson: A transcript of an interview.
Mr Elston: A transcript of an interview? I am sorry, my apologies. It was a transcript of an interview which is an exhibit here and was introduced by Mr Decter when he was going through. He actually gave testimony on behalf of Dr Hradsky through the able counsel of one Mr Kormos at the time.
Dr Hradsky's transcript -- the interview, I guess it was, with Morning North or whatever -- suggested or alleged that your practice somehow was improper because she employed two people but you employed 14. Do you have an opinion about why she would happen to want to suggest that you were not carrying on a quality practice?
Dr Donahue: No. As I say, all of this is sort of third hand, so I am not entirely certain what Dr Hradsky may or may not have been intimating. But I think what you have to understand is that --
The Chair: That is exhibit 76, if you would like to refer to that.
Mr Elston: Yes, an interview on Morning North, CBC, Peter Williams, host, of Dr Nadine Hradsky.
Dr Donahue: Well, as I say, I am not entirely certain what the overall intent was. I am obviously rather aghast, if not a bit surprised. As I say, I have very little contact with Dr Hradsky and I have never discussed my practice with her. She has never asked me any questions about my practice. She has never been in my office, as such, so I think it is a little unfair -- I think you would agree -- to draw these conclusions. I guess she is asking questions about things she does not really know very much about.
Mr Elston: Just to go over your staff complement again, there are how many registered nurses?
Dr Donahue: I have six registered nurses.
Mr Elston: And they perform delegated acts with patients on behalf of you under your supervision. Is that partly what they do?
Dr Donahue: They assist me in many ways, such as in facilitating the consultative process by obtaining histories beforehand and teaching my patients how to use a variety of different medications and drugs. They assist me in providing or rendering certain services that would be unavailable in northern Ontario otherwise.
My basic problem in northern Ontario is that unless I can provide the care and service the patients need, they must necessarily travel to Toronto. On this basis, if I am actually going to provide good medical care, I must unfortunately assume the responsibility and cost of employing these people.
I do not want to go on too long but, for example, in terms of a disease called psoriasis where people develop large, red, scaly plaques on the body, this actually, biblically speaking, is the modern-day equivalent of leprosy. These people oftentimes will only respond or clear with phototherapy, meaning special light cabinets, special wavelengths, and this of course should be performed under the supervision of a qualified dermatologist.
In Toronto there is no need for a dermatologist to have photo treatment because it is available in all of the teaching hospitals. So what tends to happen, if you open a practice as a dermatologist in Toronto, is that your operating costs are really very low. You do not really have to assume responsibility for any sort of complex investigation or technologies.
Be that as it may, I have unfortunately had to assume this responsibility; otherwise those services simply would not be provided to the people in northern Ontario. This really is why I need my staff. I like them all and they are all wonderful people, but I think, as anyone who has run a small office would realize, the fewer people you have, the fewer headaches. But as I say, I have no problems with my staff. If they are watching, I am glad they are all with me and I certainly hope they will stay with me for a long time to come.
Mr Elston: You are a highly qualified specialist in dermatology. You actually took the extra training in the United States for some time.
Dr Donahue: Yes. I did special training in dermatopathology, primarily because of my interest in oncology or cancer. I had done some research in cancer prior to entering medical school and I have continued my interest in cancer. Dermatopathology is the founding science upon which dermatology is subtended, so by being able to review microscopic slides I have a far better understanding of the pathologic process of disease in any one patient that I see. I would like to think it gives me a leg up on most dermatologists.
Mr Elston: Your work in the pathology of dermatology, if that is the correct way of describing it, then, can take you into other disciplines as well, as a physician in Sudbury.
Dr Donahue: Yes. The truth of the matter is I practise both as a dermatologist, which is a clinical practice, as well as a dermatopathologist. In that sense I have a referral practice. I accept slides or difficult cases from pathologists from the province or different regions and I assist them in making difficult diagnoses because of my experience in reading out dermatologic slides. I also teach dermatopathology.
Mr Elston: Your work as a dermatologist in Sudbury is more than what would be experienced by a southern Ontario dermatologist like Dr Hradsky, for instance.
Dr Donahue: As I say, I have never actually seen her practice. I do know that she practises in Toronto where there are well over 100 dermatologists and essentially one per 40,000. You have a number of teaching hospitals where there are residency programs. So you might say that I have a much broader practice than the average dermatologist in Toronto for those reasons. Unless I can actually perform the service or do the investigation, the patient will necessarily have to come to Toronto, not that Toronto is all that bad a city, but for the average patient, to have to travel the distance is an enormous inconvenience and a costly one as well.
Mr Elston: I am interested quite a lot in the memo, exhibit 91, Nuala Doherty to Floyd, October 31, 1991. It starts off, "Dr Donahue would like an exception." Had you been talking with people in Mr Laughren's office? Had you been talking with Ms Doherty at all at this stage?
Dr Donahue: My understanding is that they called me one day. They had called me.
Mr Elston: Out of Mr Laughren's office?
Dr Donahue: I do not have specific knowledge of exactly who had called me, but I have some vague recall that somebody from Mr Laughren's office had called me.
1600
Mr Elston: But by the 31st of October it is clear they knew that you were quite concerned about this issue, and you think you remember a call from his office?
Dr Donahue: Well, let's just say I would not deny having had a call.
Mr Elston: Okay, but you are not precise that it was somebody out of that office. I am taken by the fact that as of October 31, 1991, under a clause called "Present Appeal," Nuala Doherty asserts, "Dr Donahue's financial statements have been sent to the joint management committee." Can you advise what the joint management committee is in your understanding?
Dr Donahue: The joint management committee is a committee that was set up under the terms of the memorandum of agreement that was signed between the Ministry of Health and the OMA. It is supposed to be a body involving six or eight representatives from both sides. It is understood by the OMA to represent its ability to influence government policy, sort of a joint management committee. The truth of the matter is, from the government's perspective, from statements made by the deputy minister, it is perceived by the government to be little else than a mechanism by which to negotiate or settle disputes with regard to fees and so on. So the different groups have a fairly different idea of what the ultimate use of the JMC is going to be. But it is supposed to be the ultimate body for negotiation between government and the OMA.
Mr Elston: That is under the general agreement, which is, I have been advised, exhibit 8. Can you tell me if you had asked the OMA or the Ministry of Health to take your financial statements, so described, to the joint management committee?
Dr Donahue: Absolutely not.
Mr Elston: You had not given permission for any of this material to go to this body for review?
Dr Donahue: No, I certainly did not, and when I saw this statement, which I think I saw first in print last night or this morning, I was really taken aback.
Mr Elston: I found it extremely surprising myself since we have just been told by Mr Decter in testimony that they are just making arrangements now to share bulk information with the OMA under some agreement that they are about to negotiate. But this looks like somebody has advised -- other than yourself, in any event -- that your files were going to go to the joint management committee. Do you know any of the members of the joint management committee? I can tell you Mr Decter is one, but after that I am not sure.
Dr Donahue: I do not actually know them personally. I mean, I know one or two names. I think Dr Dixon is one.
Mr Elston: From the College of Physicians and Surgeons of Ontario?
Dr Donahue: No. I think there are two Dixons; they are different. We are talking about the president of the OMA.
Mr Elston: Okay.
Dr Donahue: The other person I perhaps know a bit better is Dr Wendy Graham, because she is a general practitioner in North Bay and so she sends me patients. So her name is familiar to me, and I had heard she was on the JMC.
Mr Elston: Have you ever been told by anyone that the joint management committee actually did study your financial statements?
Dr Donahue: Yes. Dr de Blacam, who is president of the Sudbury and District Medical Society, told me that subsequent to a conversation he had with Dr Wendy Graham she admitted that my file had been reviewed in detail by the JMC and that no exclusion for my practice was forthcoming.
Mr Elston: This was told to you by Dr --
Dr Donahue: By Dr de Blacam.
Mr Elston: And his status?
Dr Donahue: He is a general practitioner in Sudbury, but he is also president of the local medical society in Sudbury.
Mr Elston: He advised that he had had this contact with Dr Graham?
Dr Donahue: Yes, that is right.
Mr Elston: Would it surprise you to hear that Mr Decter has denied that they talked about your medical materials, your financial statements, at the joint management committee?
Dr Donahue: The truth of the matter is, I do not know what was discussed at JMC and what was not. All I do know is that someone whom I trust and have a great deal of faith in, that is Dr de Blacam, told me that my file was discussed. Moreover, some time during the summer I was in conversation with Dr Graham, and she said she would do her best. So the fact that they discussed my file probably would not surprise me, but the fact that they did not, given Dr de Blacam's statement, I guess would surprise me.
Mr Elston: Bearing in mind that Mr Decter sent you a letter on November 19, 1991, asking to publicly discuss your financial -- I guess publicly discuss your open books would be more particularly like it -- was it your feeling that you were under a great deal of not only scrutiny but pressure from the government because of your vocal opposition to this program?
Dr Donahue: I guess the question -- what date do you mean? The 19th of November?
Mr Elston: The 19th of November.
Dr Donahue: These are just impressions. Remember, they can be coloured a little bit by looking at the issue retrospectively. I got the general impression, because I mean journalists were calling me and from the tenor and tone of the conversations they were asking me, that they had a certain spin on the issue. It was sort of difficult for me to try and convince them otherwise. They were looking for a lot of personal information about me. I just simply told them that the issue was one of underservice that applied to 700 doctors in Ontario and that perhaps they should start contacting some of these 700 to find out just how big a problem it really was.
Mr Elston: Have you had any contact from the OMA to assist you in this issue, in resolving the underserviced area program, the cap -- or I think it is called a threshold -- by the government people? Have they provided you with assistance to mount your discussions?
Dr Donahue: No. I think the OMA has been severely criticized, not by myself publicly or for that matter even privately, but it has offered me absolutely no help at all, which I do not understand. They have never really explained.
Mr Elston: Those are all the questions I have for the moment. Thanks.
The Chair: Thank you very much, Mr Elston.
Mr Conway: Dr Donahue, I want to just go over some of the comments you made this morning. I was taking notes as you spoke. I just want to clarify a number of things, but before I do that -- prior to the events of the fall of 1991 you had been in Sudbury practising medicine for a little more than four years. I think you told us you came to Sudbury in the summer of 1987. Am I right in calculating that you would have been in your fifth year of practice in Sudbury by the time November 1991 broke?
Dr Donahue: Going into the fifth year, yes.
Mr Conway: In the course of the previous four years and some months, had you ever been involved in what I might call any sort of public debate or political issue as it might have related to this government, this provincial government, its predecessor or the local government?
Dr Donahue: I had acted as a patient advocate because of my concerns that certain patients, particularly females, with very severe hirsutism and metabolic abnormalities would have their benefits removed. At that time it seemed a little unfair because, while some people had branded the procedure cosmetic, the fee schedule which had contained that code for years also contains numerous other codes for other procedures that could be deemed to be cosmetic.
I do not want to give you a long litany of it, but if you have a little bit of acne scarring from your adolescence, the ministry will pay for dermabrasion. If your nose is a little crooked, they will straighten it out for you. If you got a tattoo and you want to get rid of that, they will pay for that. If you have something called a birthmark or a strawberry hemangioma or a port wine stain -- you know, Gorbachev has one on his head -- I mean, they will pay for a laser abrasion. The list goes on and on and on. It just seems to me a little unfair that these women would be, you might say, picked on and have their benefits removed. I knew some of these women personally. It was pretty heartbreaking that they would not be able to continue.
1610
Mr Conway: This patient advocacy to which you make reference is an advocacy that, I take it, in terms of the public domain, developed in the last year around the whole epilation issue.
Dr Donahue: In the summer of 1990. The fact of the matter is, the ministry had been thinking or talking out loud about delisting that probably for two or three years.
Mr Conway: My point in asking the question is, if I were a Sudbury area MLA, what, if any, reason would I have to know about you, assuming I was not one of your patients?
Dr Donahue: Actually, there are probably two or three. In so far as epilation is concerned, I felt that the decision to delist was probably not fair to women generally speaking, because it is really only women who get treated, so I wrote a letter to all the local MLAs, including Ms Martel, Ms Murdock and so on, and they sent letters of support on this issue to continue that. The MLAs, in that sense, would have known me.
The other way I guess they would have known me is that I am a very strong believer in preventive medicine and public education. I hold cancer-screening clinics throughout Ontario on a regular annual basis and I do this in a variety of towns. It tends to attract a fair amount of attention because skin cancer is becoming a very significant problem in our society. It tends to generate a lot of publicity and a lot of people come to these clinics. These are free clinics. I do not do any OHIP billings or anything like that. The public have been very supportive of these clinics. They really feel that they are very beneficial in public education and in screening people who, for the most part, would tend to avoid going to the doctor's office. I guess on that basis I am relatively well known.
Mr Conway: I appreciate that. You said earlier in response to Ms Jackson that by late summer you were becoming increasingly concerned about what the framework agreement between the Ontario Medical Association and the Ontario government would and could mean to your practice and that by the early fall of 1991 that concern was increasing in your own mind.
Dr Donahue: Yes, that is right.
Mr Conway: You said something as well this morning that I was very interested in, and I will try to quote you and I would like you to just respond. In talking about the November 15, 1991, meeting at Civic Square with the local MLAs, the representatives of the Sudbury medical association and municipal politicians regarding the framework agreement, I think I quoted you correctly that you said, "Up until that time there had been a great deal of interest in my income." Do you want to just clarify that? I may have not captured the full essence, but do I take you to be saying that throughout a good bit of November there was a fair bit of interest in your income?
Dr Donahue: Pretty well, because even the deputy minister, Decter, had gone -- it may be in one of the exhibits and it was quoted in the Globe and Mail -- "Let's know what's real, what's not real; let's get them to open their books."
I noted in one of the exhibits that when one of the journalists called the ministry and spoke to Paul Howard, he said something to the effect of, "Well, if you knew what we knew, then you wouldn't feel the same way." I think when comments like that are made to journalists they get the impression there might be something really dirty, there is some story there, and on that basis they go after it.
Mr Conway: At any point through November 1991, did any of the provincial members -- Ms Martel, Ms Murdock or Mr Laughren, to be specific -- or any of the officials representing the Ontario Ministry of Health, ever say to you, directly or otherwise, that they were very unhappy that you were mixing up, accidentally or otherwise, the delisting of epilation, the exemption being provided to people under the underserviced area program and the cap that was part of the framework agreement?
Dr Donahue: No. None of them actually came to me and said, "You have got a misunderstanding." I certainly do not remember them. They certainly never sent any letters like that and they certainly did not call me. There was no attempt to explain.
Mr Conway: So you had no indication whatsoever that there was a frustration on the other side of this argument, accidentally or otherwise, that a lot of things in the Donahue case were getting all mixed up together.
Dr Donahue: No. No, I did not. I mean, it is a complex issue: memoranda of agreement, exclusions, caps, epilation. It is difficult for people -- it is easy to understand how people in the general public would be confused about all of these facts and figures.
Mr Conway: Again, just to go through this morning's testimony and the exhibits, I was very struck by exhibit 93 and I just want to confirm that exhibit 93 suggests dates actually. It is a letter from you to Dr MacMillan dated November 15, "Your recent phone call to me underscores a misunderstanding about the application of the ministry `thresholds' as it pertains to physicians such as myself." This makes plain that by the middle of November, Dr MacMillan was actively involved in your case.
Dr Donahue: Yes.
Mr Conway: That you had had a phone call some time prior to November 15 and that you were corresponding by the 15th.
Dr Donahue: Mm-hmm. Yes. True.
Mr Conway: I am also struck again by the fact that you said this morning, and correct me if I am wrong, but that November 15 meeting, I have you quoted here as saying that Treasurer Laughren was quite outspoken in his request that you, Dr Donahue, open your books publicly. I fairly represent that?
Dr Donahue: Yes. Yes, that is my recall.
Mr Conway: Do you recall anything else about Mr Laughren's demeanour or his comments of that day?
Dr Donahue: I do. I guess my staff and I were struck by certain things. It is true.
Mr Conway: The reason I ask that is that you may not have had the opportunity, but we have a number of exhibits, and I am going to make reference to, and of course it is not -- I have got exhibit 28 and exhibit 49, to mention but two. There are others where it is quite clear.
Exhibit 28 is from Larry Corea, who is a special political assistant to the Minister of Health. He is corresponding with, among others, Michael Decter, the Deputy Minister of Health, saying, "Nuala Doherty of Floyd Laughren's office called to indicate that they have been inundated with calls regarding Dr Donahue."
A little bit later, the next day, November 13 -- this is exhibit 49 -- we have the Treasurer's executive assistant, Ms Notar, corresponding with Ms Colley, executive assistant to the Minister of Health, stating, and I quote, "We would like to request briefing notes on Dr Donahue's actual position and a political response from the Ministry of Health."
It is quite clear that by mid-November you are certainly attracting a very significant amount of ongoing attention in very high places in the Ontario government, and you were quite aware of that, surely.
Dr Donahue: Well, they never really told me. I mean, to be honest with you, when I sort of reviewed proceedings, I was somewhat stunned at what in fact was sort of transpiring in the background. I mean, the problem as far as the billing cap is concerned, the physicians in northern Ontario, I thought was a problem that could be solved with 15 minutes of sort of reasoned discussion. It did not seem terribly complex.
Mr Conway: Well, you see, I am trying to understand what ultimately happens around Ms Martel's speech on December 5, 1991, at Thunder Bay, and I just want your help. As I look at this, I have got to believe, though, that you felt that, as the month of November went on -- we have all of the media exhibits. You are very much front and centre in this attack on a major piece of government policy.
Dr Donahue: Let's just say that it was never my intention to be front and centre, because I was at pains in all my conversations with everyone, be it journalists or members of the Parliament, that I was simply not the issue -- I never was, never am and hopefully never really will be -- that the issue was service to people who deserve it in northern Ontario. There are not enough doctors, there are many other doctors -- yes, I agree with you that for whatever reason, the media were focusing in on me and I was inundated with calls. I did my best to try and expand the issue to let them know just, you know -- I mean, I hate to say the word -- just get off my case.
Mr Conway: I am not asking you to apologize for any of this, I just want to understand, and I presume that you must have begun to feel that you were at the centre of this controversy.
Dr Donahue: Yes, agreed, I was at the centre of a whirlwind.
1620
Mr Conway: You mentioned as well that in response to Ms Jackson that -- and I think again, I have tried to quote you -- you were concerned some time, I forget when it was -- in mid to late November -- you were concerned about "biased things" that were coming out of the ministry in connection with your case. Do you recall having said that this morning and could you elaborate?
Dr Donahue: Yes. As I say, these are impressions. I do not know that I could actually give you the exact figures. But when journalists would come to my office, they most often had the opportunity of discussing the issue with -- from the ministry, and they would say, "The ministry says you should open your books, and the ministry says -- " I just got the impression that they were focusing uniquely on me, and things were just getting out of control.
Mr Conway: Did you have, in any of your discussions with Dr de Blacam or any of your colleagues in the Sudbury, northern Ontario medical community -- did you ever throw out October, November, prior to December 5 -- did you ever have any inclination from any of your medical colleagues that they were beginning to know things about you that you were surprised to learn?
Dr Donahue: No. Doctors tend to be pretty close-mouthed, so I cannot remember any conversation as such. If there was, I just cannot remember specifically.
Mr Conway: You said as well that towards the end of November you were beginning to get, and I think your phrase was -- you were getting a number of calls from Mr Sword from Ms Martel's office -- nearly desperate, I think you said at one point. Mr Sword seemed to be nearly desperate to get a meeting between yourself, representatives of Ms Martel's office, and Dr MacMillan, or some other representative from the Ministry of Health/OHIP.
Dr Donahue: That is right.
Mr Conway: Could you help me understand, from your recollection, what seemed to be, or what you thought might be, fuelling the near desperation of Mr Sword?
Dr Donahue: I do not know. I just got the feeling that somebody told him, "Get a meeting with that guy and get it before December 5."
Mr Conway: Did you have any reason to think about what the importance of a meeting before December 5 was from Ms Martel's office point of view?
Dr Donahue: Not specifically. I discussed this with the president of the district medical society to find out why the urgency was with meeting with me specifically. It was an important issue that related to at least 17 doctors in Sudbury, 35 in northern Ontario, and why they would want to meet with me just seemed a little silly because I had no intention of cutting a separate deal.
You see, there had been a situation in Peterborough involving a number of cardiologists and apparently Dr MacMillan was able to resolve that to the satisfaction -- as I understand it, anyway -- to the satisfaction of the cardiologists there. But this was a separate -- you might say, like a separate deal.
The truth of the matter was that the people and the physicians in northern Ontario recognize that there is a fundamental problem in providing services to northern Ontario; not as it pertains to dermatology uniquely, but as it pertains to a variety of other medical specialties. There were hundreds of doctors in Ontario affected by this. So we felt that there had to be a policy decision where the ministry would decide that for physicians working in underserviced areas where they are in short supply, the cap should be removed. There was a feeling among the physicians in Sudbury that private meetings with ministry officials could only end up with secret deal negotiations that may be satisfactory to one physician, but would not address a fundamental problem, and that was service.
I never wanted to be perceived as cutting a deal for myself. I was not in it for myself. I know people may not believe this, but the reason for even my involvement was I really felt that it was fundamentally unfair that so very little health care dollars were being spent in northern Ontario when compared to southern Ontario. The figures are just shocking.
Mr Conway: You mentioned that when you saw or got Dr Decter's letter of November 19, 1991, which I think is exhibit 73 -- Dr Decter's letter which essentially asked you to open up your books "chilled your blood," I think was your phrase.
Dr Donahue: Yes, it scared me all right.
Mr Conway: Did you connect Dr Decter's request with the rather outspoken attitude of the Treasurer a few days before at the meeting at Civic Square?
Dr Donahue: Yes. I thought they had gotten together. As I say, I do not know, but it just --
Mr Conway: You saw some connection in your own mind?
Dr Donahue: Well, they were all after me for the same reason. Whether they decided that collectively or individually, it just was a little curious that they all were asking me the same thing.
Mr Conway: I want to go to what I think is a very serious business and that is the meeting you had with Mr Keith Harfield. I am correct, am I not, in saying that you met -- was it socially -- on November 29? Or you were at a meeting of some sort.
Dr Donahue: I was at a meeting of the small businessmen's association. I had been invited to go. I guess they just wanted more people in attendance, for whatever reason, and I just happened to attend. While I was in attendance, they were discussing the funding of the health care system and the manner in which the business health tax would be impacting on the cost of running a small business. So I spoke to the meeting on how the billing cap would actually increase the cost of medical care for northern Ontario, because the alternatives to the provision of local service were to fly doctors in at enormous cost or fly people down at enormous cost. After my brief comments on that, that is when Mr Harfield came up to me.
Mr Conway: Did you know Mr Harfield?
Dr Donahue: No, I had never heard of him before.
Mr Conway: If you could quickly summarize the encounter with Mr Harfield again. You had never met him before. You meet at this meeting. You have undertaken to give your view on what the threshold cap is going to do to northern Ontario medical practices.
Dr Donahue: Yes, what it will actually do for businesses, because that was really the key, because businesses ultimately would have to pick up the tab.
Mr Conway: So Mr Harfield comes over and introduces himself?
Dr Donahue: Mm-hmm.
Mr Conway: Quickly tell me again what he did.
Dr Donahue: Well, he introduced himself. He said, "Thanks very much for very enlightening comments." He said he is a business consultant in the area and he is often asked to make comments or studies on things like that. I mean, do not quote me. As I say, it is just my impression. He said: "You're not going to get a lot of sympathy. You know, you make this amount of money." The figures were so precise, it was not a guess. He was not bluffing me. It is not as if he had worked it out out of newspaper clippings and a little calculator. The man was not kidding; he knew. Boom, these are the figures.
I just stopped with an open mouth and said: "Where did you get these? How did you get these things?" He said he had contacts in the ministry or government, I was not sure. Ms Jackson asked me whether it was the ministry or government. I thought he said ministry. So he got information like that about me and he said, "It is easy to get." And I thought, boy. Then I believe he said, "X amount is for epilation." I cannot be sure. That may be sort of a bit of a biased statement, but I seem to remember he said that. But it just reinforced in my mind that this man had a pipeline to someone or somewhere.
Mr Conway: You then subsequently called your accountant?
Dr Donahue: I called him the next day to say, "Listen, what did we bill OHIP last year?" He gave me the figure and I was pretty amazed to realize that the figure was accurate.
Mr Conway: So he specifically alleged a certain amount that you billed OHIP in the year, presumably, 1990-91?
Dr Donahue: Well, whatever it was. It was for the preceding year.
Mr Conway: When you checked those OHIP billings, they turned out to be very precise?
Dr Donahue: Yes.
Mr Conway: What did you think? Did you connect any of that back to what Mr Laughren had said or Mr Decter had said in his November 19 letter?
Dr Donahue: Well, it seemed as though, what is the expression, the hen was coming to roost. I get this letter -- and maybe I am wrong -- which I interpret as a threat. Information about me was going to get out whether I agreed to it or not.
1630
Mr Conway: We heard last week that staff in Ms Murdock's office were telling some people who called what they estimated your billings to have been. Did anybody ever report that that kind of guesstimation was going on?
Dr Donahue: Not to me directly. You have to understand that the people in Sudbury are well brought up, if I can use that term; they are nice, polite, quiet people. If they had heard that, they would not confront me directly; they would just sort of whisper something maybe to my staff or something like that.
Mr Conway: But you were not being very polite and quiet about the cap. You were really raising the roof, were you not?
Dr Donahue: I was very concerned. The cap is unfair. It is not necessarily unfair to the doctors, but it is unfair to the citizens who work in that area and by virtue of the fact that these doctors have got to see these patients. They have a responsibility to provide treatment for these people. It just did not make any sense.
As I say, the issue of the billing cap is something that two sensible people can sit down, discuss over 15 or 20 minutes or half an hour and come to a decision on. The figures in regard to underservice in northern Ontario have been published and discussed ad nauseam. It is just obvious that the area needs an exclusion.
The Chair: I want to just remind you there are five minutes remaining.
Mr Conway: Late on the night of December 8, around 10 or 10:30, you got a call from Ms Martel in which she apologized and indicated what she had said was without foundation etc etc. Just one question: Did you accept her apology?
Dr Donahue: I do not see how I can. How can you trade a reputation for an apology? My life has never been the same since. I cannot go anywhere any more. If I go to a professional meeting, I am accosted by people asking me, "Is it true?" or "What about this?" I cannot appear publicly. As I told her that night, my life is ruined, and there is no going back.
Mr Conway: I took you to say this morning that when she explained her version of what happened at Thunder Bay you found it to be incredible, that did not square with your knowledge of her previously.
Dr Donahue: I did not know her very well, but I think most people who are selected to be ministers tend to be at least of average if not better intelligence and capability. It is just not the kind of thing someone makes up. It is just not the kind of thing you make up off the cuff; it is not the kind of comment you make from hunches or suspicion. It is the kind of thing you are prepared to say; you have got this information and you are going to use it.
Mr Conway: My final question has to do with what Ms Martel said. I am now working from exhibit 17, which is Mrs Dodds's reporting of what she says Ms Martel said: "`I have seen his records. You will lose sympathy when you see the charges that we lay against him' and she used the word `criminal.'"
This morning we had the mother of one of your patients say in testimony on page 1110-1 the following things about what an administrative assistant in Ms Martel's office said. I think we estimated the date roughly to be Friday, November 15. According to Ms Majkot this morning, this administrative assistant in Ms Martel's office said, and I quote from the Hansard on that page, "Dr Donahue is billing illegally and we have the documentation to prove it." Later she says, "Well, when the public becomes aware of what he's doing, they won't be so supportive towards him." You had never heard that testimony until this morning.
Dr Donahue: Mrs Majkot's?
Mr Conway: Yes.
Dr Donahue: She had mentioned it very briefly but not in detail. I mean, the minute she started to talk to me I said: "Hey, I don't want to hear this. I don't want anything to do with this. I have just had it." I said: "Don't tell me this. If you think it is important, if there's some substance to it and so on, if this kind of thing happened, please just talk to someone else. There are some very important people you should talk to about this, but not me."
Mr Conway: Because it seems to me that there is an amazing degree of similarity between what Ms Martel said in Thunder Bay on the night of December 5 and what her office was telling people in your city three weeks earlier.
Dr Donahue: That is true.
Mr Conway: You had never heard this from anyone until Ms Majkot brought it to your attention a couple of weeks ago?
Dr Donahue: No. No one else told me that.
Mr Conway: And you had never heard anything like this?
Dr Donahue: No.
Mr Conway: Thank you very much.
The Chair: Time has expired at this point.
Mr Harnick: Doctor, just so we can clear up something dealing with the threshold, the cap and the delisting of epilation services: You have indicated, through the examination by our counsel, that as of November 1991 the threshold, the cap and the delisting of epilation services would not have put you over the cap because you were part of the underserviced area program. Is that correct at that time?
Dr Donahue: I think the estimates we have done subsequently would tend to confirm that, yes.
Mr Harnick: All right. Was there some concern that you had about what would happen over time?
Dr Donahue: That was really the key. I think anyone who runs a small business knows you can have temporary cash flow problems. That is what the bank is there for, to sort of see you through them. But I have an expensive practice to run and I have a lot of liabilities and I have a lease actually that is coming up for renewal this August. It is renewable for five years, so I have to make decisions for five years down the road. Making decisions for the next two or three months or five months or six months is not really the key.
I mean, my employees are very nice people. They have families. Some of them are single parents. Some of them have bought homes. Some of them have bought cars. When I talk to my employees I have to tell them, "You've got a job and you've got a job on a long-term basis. It's really on the basis of yes, we'll be in business for five years. I've committed myself to this lease. I've bought this equipment. It's going to be okay."
Mr Harnick: What would be the effect of the cap and the delisting of epilation on your practice if you wanted to continue to run that practice at the scale you had been?
Dr Donahue: Well, as far as delisting of epilation is concerned, it would actually have very little on my practice, because I was going to continue it anyway, but as a private business. My patients, in essence, would become clients now. It is regrettable that there are some people, even at a discounted rate, who cannot afford to do that. But from my discussions with my accountant, the delisting of epilation would have very little ultimate effect on the long-term basis on my practice, so it really was a non-issue.
The real key was -- my medical practice, which consists of six registered nurses and four secretaries -- even if you eliminated epilation, I still could not continue on that basis because the costs were still there. The only way -- well, I simply could not continue my style of practice. I simply could not continue to provide the kinds of services needed for that community. If three or four other dermatologists came up, then I would have no problem. In fact, on December 5 -- this is the option, choice or suggestion I gave to the deputy minister: that I would not complain about the billing cap if he could bring up 11 more dermatologists for northern Ontario. But if he could not bring up 11 more to rectify the situation, then obviously the billing cap had to come up for some people.
So the choice was that I could not continue my medical office, and that the only way I could actually continue providing service would be to dismiss all my 14 employees, or most of them -- say, dismiss 12, keep one nurse, keep one secretary, get rid of my office, get rid of literally hundreds of thousands of dollars' worth of equipment and just find another small, little office and just sort of mind my business and do my job and keep turning people away.
I could not look people in the eye and say: "Listen, I know what you've got. I know the medical condition you have. Six months ago I used to have the equipment to treat it, but sorry, I can't here. Go to Toronto." I just could not do that.
Mr Harnick: If that cap were in place, you would have gone over that cap and it would all have gone towards your expenses, I gather, plus the money you would have lost?
Dr Donahue: Yes, if I continued, sure.
1640
Mr Harnick: All right. We have heard evidence, as Mr Conway indicated, from the office which Sharon Murdock ran in Sudbury that they had come up with some assumptions based on inaccurate information and they were advising people who phoned their office what your income was. We have also heard evidence today that in the office of Shelley Martel in Sudbury, people were phoning and being told that your billing practices were illegal and that there would be no sympathy when the public became aware. In terms of what was going on in that community between November and December 1991, what was the significance of these rumours being circulated and being on the street?
Dr Donahue: The significance? I am not quite sure.
Mr Harnick: How extensive were the rumours out in the community?
Dr Donahue: I honestly do not know. As I say, I put in 12 or 14 hours a day. Rumour is not the kind of thing I like to listen to. I honestly do not know. I cannot answer your question.
Mr Harnick: Especially when they are being promoted by government offices, I suppose.
Dr Donahue: All I know is that when the journalists came to ask me questions, they had sort of a unique spin on me as an individual and on my practice, and it seemed a little biased.
Mr Harnick: What has been the effect of these incidents in terms of your reputation in the community. Can you tell us that?
Dr Donahue: I do not really know, because frankly I just do not want to hear. Many physicians have come to me and have been very supportive. I have gotten calls from as far away as British Columbia and Toronto, people telling me that I should stick up for my principles and that I should not back down. Most of my patients essentially are very sympathetic to me and they have been very helpful. They have written hundreds of letters and made phone calls.
I know very well that there are people who like to believe the worst about people. That is why that newspaper the National Enquirer does so well: People love dirt, they love a rotten story. These events, from my perspective, have tarnished my personal and professional reputation, and no matter how hard I scrub, I will not be able to rid myself of that stain. There are people who want to believe the worst, and they will, and they will talk about it. It just makes my life a living hell.
Mr Harnick: Has your relationship with your patients been affected, and your ability to treat them?
Dr Donahue: Maybe not. The one thing that happens is that, day in and day out, dozens of time during the day, I have to go over the story in some way. I obviously do not want to discuss it, but they say, "Oh, by the way." It is really very distressing to have to go over this. To be honest with you, I would just rather forget the whole thing. It is just upsetting.
Mr Harnick: At some stage, did you become aware of any particular strategy that seemed to be developing regarding just Dr Donahue?
Dr Donahue: No, I do not think so. When I was getting these phone calls or these requests, I got the overall impression that they wanted me in some way to authorize them to sort of investigate, open my books and literally discuss every personal thing about me publicly, because they figured they could embarrass me in some way.
Mr Harnick: When did you first become aware that that was in fact what you thought was happening?
Dr Donahue: I think it was signalled by the deputy minister's comments. It was reported in the Globe that they wanted doctors to open their books. I just felt that you can resolve this issue without discussing people's books publicly. The ministry has these computers that can pump out a profile on a doctor that would shock you. It is 150 pages long and it can tell you how many patients you saw for colds over the past 10 years and give you the dates. The ministry is not lacking for information.
There is no reason whatever at all to discuss the issue on the basis of physicians' incomes or billings or net incomes. That is not really the issue.
The issue is a policy one with regard to how you are going to provide the necessary incentives to bring medical specialists up to northern Ontario. They are not predisposed to go, and when they do, they do not stay. They do not stay because the workload is horrendous, they are alone, they have no backup, and ultimately they crash. The life expectancy of the average male medical specialist in northern Ontario is five years, and after that they are gone.
Mr Harnick: Doctor, I bet it will be a long time before you are willing to take on a government again. Is that a fair assumption?
Dr Donahue: I think that when I reflect on this philosophically in my sort of quiet moments, this is what I think I regret the most. Everyone complains that citizens tend to be apathetic and do not get involved in the political process and they do not stand up and they do not make comments. You can get politicians complaining about apathy, but the events that happened to me seem to be a lesson to virtually every physician in Ontario and every citizen. It is chilling. What essentially the doctors are going to say now is they will never stand up, because otherwise they will get their heads shot off.
Mr Harnick: Doctor, one last question. Have you ever, at any time, disclosed your income to anyone?
Dr Donahue: No. I am pretty close-mouthed about that. In fact, my girlfriend is in the audience and even she has never heard it.
Mr Harnick: Thank you, doctor.
The Chair: Thank you, Mr Harnick. Mrs Cunningham.
Mrs Cunningham: Thank you, Mr Chairman. Dr Donahue, you mentioned earlier, as you were describing some of your awareness around issues and health care in Ontario, something that happened with regard to cardiologists in Peterborough. I am just wondering how you first heard about that issue and whether there were any individuals involved. Could you just fill me in on that a little more extensively?
Dr Donahue: It was in the paper briefly, and in some of the medical meetings I attended it was discussed by people who actually had direct knowledge about the problem of cardiology in Peterborough.
Mrs Cunningham: Were you ever aware of any public accounts of this or newspaper articles or it being discussed at the Legislative Assembly in any way?
Dr Donahue: No.
Mrs Cunningham: So this one did not make headlines, at least to your knowledge?
Dr Donahue: No, not to my knowledge, no.
Mrs Cunningham: There was some discussion a couple of summers ago about independent health facilities, and the group of physicians who were discussed at that time with regard to billings were radiologists. Were you aware of any of the discussions -- it happened to be the Liberal government's legislation at the time -- with regard to independent health facilities and the billings of radiologists at that time?
Dr Donahue: No. The idea of independent health facilities had been sort of discussed for a while, and it was a way in which the government wanted to direct certain services to be carried out. These things are reported in the medical press on a regular basis as to what the policy may or may not be, or the ideas. I did not follow it very closely because the idea of an independent health facility did not relate really very directly to me as such.
Mrs Cunningham: Are you aware of the discussions at this point in time with regard to the -- I do not know the correct terminology, but perhaps the government's intent not to support the in vitro fertilization programs in the province of Ontario? One, I know, is at the University of Western Ontario's University Hospital. I represent London, so I am aware of it. Are you aware of any discussions with physicians in that regard?
Dr Donahue: Yes. Actually, that probably, from my recall, was one of the first sort of public discussions about how the billing cap would affect a physician. I am not sure whether we are talking about the same clinic or not, but there is a pretty well known clinic that does this, and the physician has essentially expressed publicly that there is simply no way that he can carry on because his expenses are just enormous.
I am not sure whether he has closed, but I would be pretty surprised if he has not. He, I know, discussed this with the ministry and tried to find some way or some solution, but I think the last I recall of it is that he actually did not. I would hope that under the terms of the new agreement in some way he apparently will be able to carry on, because I hear he has done some amazing work.
1650
Mrs Cunningham: The point of my questioning is that, in my position as an elected representative, I depend on the front-line workers to let me know of their concerns. In this regard, I am hopefully on top of the issue, but certainly not in a position to discuss it in any public way. The reason I am raising it is to let you know that in my life down here there have been many individual physicians who have talked to me about their work and their concerns and their billing, and they have also done this publicly. Are you aware of the Premier's conflict-of-interest guidelines for members of cabinet?
Dr Donahue: No.
Mrs Cunningham: You have never been told anything about them.
Dr Donahue: No.
Mrs Cunningham: Were you curious as to whether they even had conflict-of-interest guidelines? Would that be something you would wonder about?
Dr Donahue: One reads about this in the lay press from time to time, particularly when scandals develop, but beyond that I have no interest in legislation.
Mrs Cunningham: I would like to read to you the purpose of the guidelines. I think it would be interesting to you, since you have taken the time to come here, not of your own will I suppose, but certainly to help us out. The purpose is, "To increase public confidence in the integrity of government, the following guidelines impose upon cabinet ministers and parliamentary assistants more stringent standards of conduct than those imposed by existing conflict-of-interest legislation and policies." There are a number of fundamental principles. I am just going to read two short ones.
"Ministers shall at all times act in a manner that will bear the closest public scrutiny." The second one I would like to read to you is, "Ministers shall perform the duties of office and arrange their affairs in such a manner as to maintain public confidence and trust in the integrity of the government."
These guidelines, at least from our point of view, were part of the reasons for this public hearing. You have already remarked in a positive way, certainly with your attitude towards Ms Martel until these hearings were necessary, and certainly until December 4. Now that you have heard them, I am just wondering if you have any information you would like to share with us with regard to the purpose of these guidelines, or perhaps to all of us as politicians. None of us here is in cabinet, but I consider these my responsibility even though I am not a cabinet minister. I would like you to tell us, as a citizen, how these guidelines should be helpful or otherwise to elected people and whether or not you believe they have been followed in this instance.
Dr Donahue: I do not want to be accusatory and I certainly do not want to be judge and jury, because that is not my intention. To a certain extent, this is the responsibility of this committee. As a citizen, and one who has become the subject of unnecessary speculation and slanderous statements, there are some people in society whose standards of behaviour and standards of practice are necessarily higher than other people, and that includes physicians. A physician is liable for many things that the average citizen could essentially get away with.
In our form of parliamentary democracy, what we call a participatory democracy, I think those people who aspire to high office or who are fortunate enough to achieve high office -- regrettably, if you will, or not -- must necessarily demonstrate to the citizens that their decisions and their behaviour are beyond reproach. If that is not forthcoming, then you create a situation where the citizens have absolutely no faith in the democracy. Expressing democratic principles should be done more often than just once every four years at election time. Citizens must become involved in the stuff of government on a regular, daily basis and they have to feel safe that the kinds of statements they make or actions they may become active in will not necessarily be used against them.
For example, just a few days ago I became involved in a discussion with someone with regard to these overall concepts. This person said: "Last year, whenever it was, I got a census form. I got the long one which requires you to put down enormous amounts of personal information." This person said, "Boy, I sure hope I never get that again, because I am not sure what can happen to it."
I think citizens have to be assured they can carry out their lives in a free, democratic society in the knowledge that the weight of government or bureaucracies will not be turned against them if they should have a dissident view. I would essentially encourage you to take this mandate very seriously, because while people may want to laugh or to minimize the events as they have in fact transpired, there are events in our lives that require us to assume a far greater responsibility than we may have ever had.
In American folklore, you have an example of this. You have the story of George Washington who, as a boy, said, "Yes, I chopped down the cherry tree." I think the reason for the folklore is the implication that there is honesty, truth and integrity in government, and if that cannot be proved, if the citizens ever believe that is not forthcoming, then we do not have a democracy.
Mrs Cunningham: Because you are here today and because the purpose of these hearings is known, that the standing committee on the Legislative Assembly shall meet for the purpose of an inquiry, which members of the public quite readily think may be in fact a waste of time, given the number of dollars we are spending here, I think you should know what the terms of reference are. The first is "an investigation into the disclosure of confidential information emanating from the Ministry of Health, including documentary and viva voce evidence." The second one is an investigation into the conduct "of the Minister of Northern Development and Mines in Thunder Bay, Ontario, on December 5, 1991, and the events leading up to her attendance in Thunder Bay." The third one is "an investigation into the dissemination of information obtained from the Ministry of Health."
I asked you if you wanted to comment, and I do not want to quote you incorrectly, but I think you inferred that you did not want to be part of the judge and jury. Yet you said to us that your life is ruined and that there is no going back and that you feel that citizens such as yourself should feel safe and that statements you make should not be used against you. I am probably giving you the opportunity, and this will be my last question, to tell us how you feel about this inquiry with regard to the opportunity that you have had today in so far as to clarify certain facts is concerned.
Second, perhaps you could also tell us about the spins, as you refer to them, that the journalists had when they called you, because you are talking about public attitudes. Their obvious responsibility is to ask you the kinds of questions people may be wondering about in their own living rooms. Certainly from my personal point of view I would like to think there will be some justice at the end of this inquiry, and since we are looking at the conduct of a minister, I will probably have an opportunity to talk about that at the end of this inquiry. So you have an opportunity here to talk to conduct and you have an opportunity to talk to spins of reporters, where sometimes one is judged by the questions, and you have an opportunity to talk about how safe you feel or would feel in the future.
Dr Donahue: I do not quite know what to say. I did not feel safe then, I do not feel safe now and I do not think I will ever feel safe again. I think that more or less sums it up. I just do not feel safe any more. I am not sure whether other citizens in Ontario feel similarly, but I know that some people have expressed that to me, other doctors who have come up to me and -- people just do not feel safe. I think that more or less says it all. I think I have said a lot: I just cannot trust government any more; I just do not feel safe; I never will feel safe again.
The Chair: Are there any further questions? We will now move to the members of the government. I would just like to remind all members of the committee that after the complete questioning here, there will be the need for an in camera session. Mr Mills.
Mr Mills: Dr Donahue, I want to just go back to December 5. We had a meeting in Sudbury, the ill-fated meeting, where Miss Martel was engaged in some sort of argument with Mrs Dodds.
1700
The Chair: Excuse me, it was Thunder Bay.
Mr Mills: Thunder Bay. I beg your pardon. We have been up and down so many times, I get confused. Thank you, Mr Chair.
The Chair: To help the witness.
Mr Mills: From that meeting, Mrs Dodds journeyed to Toronto, I think the next day, on some sort of seminar about freedom of information. Before she went to Toronto, did she call you and tell you what she had heard at the meeting?
Dr Donahue: No.
Mr Mills: I have heard you say at least two or three times here this afternoon, hey, your life has been destroyed with this thing. Do you not agree and think that by going to Toronto without asking you, Mrs Dodds got on a roll about what happened in Thunder Bay and that she has contributed in fact to the position you find yourself in? Do you not agree with that?
Dr Donahue: I could not disagree with what you say. I guess Mrs Dodds called it the way she saw it. I think Mrs Dodds was acting in an ethical fashion. I guess she felt that these were the kinds of behaviours from a minister that were essentially unacceptable. There are, I guess, certain costs that may be engendered. I guess she felt as a citizen that she had to. I guess to a certain extent maybe I was the sacrificial lamb or something like that.
Mr Mills: I think it is fair, Dr Donahue, to say that in the circumstances and what she said down there, you would have had to have left the planet not to identify with what went on and you. I am just thinking that if you look at that scenario, it would appear to me, as a decent, upright citizen, that the least I could do would be to call you and say, "Listen, I'm sorry if I've spoken." You are telling me that never ever has she ever taken this issue up with you and apologized for what she said, which has contributed to your situation, or said nothing to you about this?
Dr Donahue: Well, Mrs Dodds did call me about a week ago.
Mr Mills: She did?
Dr Donahue: Yes, she called me about two weeks ago or something like that.
Mr Mills: And what was the gist of that conversation?
Dr Donahue: We just chatted briefly about the events. I think she more or less intimated that the events as they occurred were regrettable but that -- I think overall she felt it was regrettable that everything that had happened essentially had become public, but I think what she felt was that there were things happening hidden away in the bowels of government and so on, and if left alone actually would tend to suppurate and be a far greater cancer than might have been otherwise.
Mr Mills: It is just thinking out loud, doctor, and I am musing here that Mrs Dodds had the opportunity. She found the leader of the third party, Mr Harris, and I believe she had the opportunity for some conversation with Mrs Cunningham about this matter. It just puzzles me that she had all kinds of time to do that but never had time to call you. However, I am going to move on to something else.
We heard this morning from the mother of one of your patients about the letter that came, so I would presume there was considerable concern up in Sudbury, and to put it rather bluntly, there was some panic being created up there through your office and yourself about the lack of doctors such as you that might happen. I think in a documentation here somewhere you said that you had threatened to go to the United States. Is that right?
Dr Donahue: No, I really never issued any threats. I explained my situation to people as to what my situation was. No, I am a Canadian first. I came back to Canada after some US training and I certainly would prefer to stay in this country.
Mr Mills: I think it fair to say that somewhere in the news media you were quoted as saying that you were going to the United States if this could not be resolved, so that leads me into my next point. I believe the very point in time that you were announcing you were closing your office and that you were through in fact you were opening up a doctor's clinic. Is that right or not?
Dr Donahue: I beg your pardon?
Mr Mills: The very time when you were announcing that you were through, you were closing your office, in fact you were opening a doctor's clinic in Sudbury. Is that correct or not?
Dr Donahue: No. I think there is a bit of a misunderstanding there. I think what you are referring to is a discussion I had had with a journalist with regard to epilation and the fact that epilation was being delisted. What I was explaining to the journalist at the time was that regrettably epilation was being delisted but I would continue to provide this service on a private basis by virtue of having a studio.
Mr Mills: I see. I have the Yellow Pages here where it says "The Doctor's Studio, Dr J.P. Donahue, Dermatologist, Certified Electrolysis." That is the --
Dr Donahue: That is the studio in question.
Mr Mills: That is the studio that you are talking about, so in fact you remained in business in Sudbury. I have heard counsel for the committee say that on January 13 you reopened your clinic as it was with all the people again. Is that right?
Dr Donahue: Let me just -- so there is no misunderstanding. I closed my office completely, so the studio you are referring to was not operational. It just did not exist. Everything was shut down. I did not have any private business. Everything was closed. Subsequently when the minister announced that a resolution would in fact be forthcoming, it was in fact being negotiated between the Ontario Medical Association and the ministry, I mean, on this basis I reopened the office. When I reopened the office, because epilation was still of course delisted -- there was never any suggestion it would ever be relisted -- then the studio came into existence. But the studio as such, the one you refer to, was not operated or open during the period of November 29 to January 13 when in fact I reopened my medical office.
Mr Mills: I see. Some of my colleagues want to follow up so I am just going to ask you a last, very basic question that concerns me, that you have said many times you are destroyed. I am going to go back to December 9 in the Legislature here when Mr Harris rose and read a letter from Mrs Dodds relating to the comments made on December 5 by Miss Martel and made some statements which allowed, in my opinion, you to be readily identified.
My question, sir, is this: Did Mr Harris contact you in advance of making that announcement in the House, seek your approval, and through the process the public of Ontario, that these disparaging comments have been made about you at a reception in Thunder Bay? What I am saying to you is, did the leader of the third party, before he got up in the House and made all these statements about the letter from Mrs Dodds, call you?
Dr Donahue: No. I have never spoken to Mr Harris.
Mr Mills: So really, when we are looking at your situation when you are saying that you are destroyed all over the place, there are several factors in here that I think contributed to that, and really that statement, to me, is raised in haste and no one even asked you if it is all right to do it. Is that true, no one asked you, they just did it?
Interjections.
Dr Donahue: Well, certainly --
The Chair: Order, please. I am not hearing from the question that you are suggesting any name was mentioned in the Legislature, but I do wish to remind all members of the committee that when a member is asking a question, he should be allowed to pose that question and give the witness the opportunity to respond free from any interjection. Mr Mills.
Mr Mills: Thank you. That is my question, Dr Donahue.
Dr Donahue: As far as the two people you had mentioned, no, neither one of them ever asked my permission to proceed or discuss or whatever.
Mr Mills: Thank you very much, doctor. Thank you, Mr Chair. My colleague Mr Kormos has something to say.
1710
Mr Kormos: Please, Chair, help me with exhibit numbers, because I want to talk to the doctor about the Kevin Donovan article in the Toronto Star of January 26, 1992. If somebody could tell the doctor what exhibit number that is, he can take a look at it.
The Chair: That is exhibit number 21.
Mr Kormos: You have seen and read this at least once, because it is a fascinating collection of journalistic effort. You are quoted under "Heated Discussion" --
Dr Donahue: Where would that be?
Mr Kormos: -- under the subtitle "Heated Discussion" as saying: "Confidential information is used in the political process on a daily basis. If you can get something on your opponent, then you use it." I trust that is an accurate quote.
Dr Donahue: Yes, it is.
Mr Kormos: Prior to that you said legal reasons prevent you from discussing certain details of the case. Is that accurate as well?
Dr Donahue: Yes, it is.
Mr Kormos: You go on to say that you are not surprised that sensitive information was both released and used. Is that correct?
Dr Donahue: Yes.
Mr Kormos: So Donovan correctly reports that. I trust Donovan spent a considerable amount of time with you.
Dr Donahue: No. Actually, I have never met him.
Mr Kormos: Well, you had a conversation with him, huh?
Dr Donahue: It was a brief conversation.
Mr Kormos: He is preparing material. He identifies himself as a Toronto Star reporter. Is that correct?
Dr Donahue: Yes, that is right.
Mr Kormos: And you knew he was in the course of collecting information to write an article or articles or a column or something to that effect, did you?
Dr Donahue: Yes, I got that impression.
Mr Kormos: When you read it, were you surprised to see Donovan refer to billing approximately $1.25 million a year?
Dr Donahue: When Mr Donovan called me he wanted to discuss the issue, and I told him that frankly I had no interest in discussing with him, or never had any interest in discussing with anyone, anything personal or confidential about myself. So it was just totally out of the matter and to just forget about it. He asked me if I would discuss the issue in generalities and I said, "Well, ask me a few questions, but frankly, I have no interest in discussing anything with you."
So the three comments you made are probably more or less the substance of my telephone conversation with him. The point you are asking me is -- yes, when this story came out I was shocked. I was so shocked that I just sort of skimmed it and I put it away for two weeks. I did not want to read it. I just did not want to read it.
Mr Kormos: Were you shocked by the apparent access to information that Mr Donovan from the Toronto Star had had?
The Chair: Mr Kormos, if I can just remind you that matters of a private and confidential nature are areas that can be addressed on an in camera basis, and that certainly would surround the issue of billings and the like.
Mr Christopherson: Mr Chair, Mr Kormos asked for the information. I think he was asking, was he surprised that the information was there?
Mr Harnick: The question is the source of the information.
The Chair: Order, please.
Mr Harnick: That is what the question is.
The Chair: Excuse me, Mr Harnick. Thank you very much. The question calls for a comment on the accuracy of the information. That I believe is one which would fall within the area of private and confidential and is certainly an area that is open for questioning on an in camera basis.
Interjection.
The Chair: Would members of the third party please come to order. I think Mr Kormos is well aware that this is certainly an area that may be addressed, if he so desires, on an in camera basis, but certainly questions calling upon the accuracy of information which is of a private and confidential nature are ones that should not be brought forward in public.
Mr Kormos: I regret hitting a nerve, Mr Chair.
Let's move right on to the part of that article that deals with Keith Harfield. Donovan describes him as having been contacted by you, Donahue, to assist you in your battle with the government. Were you surprised to read that?
Dr Donahue: Where is this in the article?
Mr Kormos: Well, it is in the final column, actually the fifth or sixth to last paragraph:
"In another instance, management consultant Keith Harfield, who had been contacted by Donahue to assist him in his battle with the government, telephoned a person he will only describe as a `health official.'"
Dr Donahue: I am sorry for being at a loss here, but exactly -- oh, all right. Last column, middle, is that right? Okay, I have it. What was your question?
Mr Kormos: You read that, and when you read that the first time -- unless you are reading it for the first time now.
Dr Donahue: In fact, I am. As I say, this is not an article -- I mean, this kind of -- there are a lot of things I would just not even bother reading. Mm-hmm. Yes, so I have read it.
Mr Kormos: Is that accurate?
Dr Donahue: No, it is inaccurate.
Mr Kormos: And if Donovan had determined that by talking with Keith Harfield, I trust then you would dispute very much what Keith Harfield would have to say about his relationship, that is, Harfield's relationship, with you?
Dr Donahue: Well, I am not sure what you are going to say, so I cannot dispute what you are going to say ahead of time.
Mr Kormos: Quite right. If Harfield told Donovan that you had retained Harfield to work for you in the course of your work with the ministry, would that be accurate?
Dr Donahue: No.
Mr Kormos: Would that be close to accurate?
Dr Donahue: No, it would be completely inaccurate.
Mr Kormos: If you had been confronted by Donovan during the course of this interview with that proposition, would you have been in a position to correct him?
Dr Donahue: Indeed.
Mr Kormos: And what would you have said to his proposition as it is recorded here?
Dr Donahue: That it is inaccurate.
Mr Kormos: And your only contact with Harfield was, what, when he approached you?
Dr Donahue: I have had two conversations with Mr Harfield. The first conversation was when he approached me on November 29, or whenever the small businessmen's club met.
Mr Kormos: Yes?
Dr Donahue: The next conversation I had with him was when I phoned him in his office or home in Manitoulin Island, and this is in around -- I think this is after the minister made her comments and everything was just going crazy in the media. I phoned him and I said, "You have talked to me about some confidential information that you had." I said, "Where did you get this?" And he was not really keen on discussing it with me. I said, "Well, you've got to do something." I said: "There's something wicked that's been going on. Where? I mean, who?" You know, I said: "You've got information that's important. Who talked to you? Who did you talk to?" And he was, as I say, quite reluctant. So I discussed the concept, much as we discussed here, of government and the responsibilities of citizens to be forthcoming in important events and not to shy away.
Mr Harfield, I took it from my conversation with him, is a thinking man, and he reflected on my words and thought that perhaps he should be forthcoming, but he was actually very concerned about the manner and mechanism by which this information would -- or could, or who he could in fact talk to. So we -- I forget exactly how it came about, but I think I asked him if he would be willing to talk to someone, because clearly this information had to be brought out, because it was being discussed in the House or something along that line.
And it is on this basis that Ian Scott actually ultimately got in touch with him, and in fact, if my memory serves me right, Mr Scott spoke to him to discuss the issue in the House, brought up his name in the House. In fact, if I remember the circumstances -- I guess you will have to ask Mr Scott about this, but apparently Keith Harfield had some concerns about giving this information to just anyone, but Mr Scott said in the House that Keith Harfield would be willing to give it to the Premier, Mr Bob Rae.
Mr Kormos: Harfield would not give you the information as to how he obtained your earnings?
Dr Donahue: To me?
Mr Kormos: Yes.
Dr Donahue: Oh, no. No.
Mr Kormos: And did you ask him to contact Ian Scott? How did that come about?
Dr Donahue: I am not sure. I think we decided that he obviously should discuss it with someone. So whether he called Scott or Scott called him, I am not entirely certain. I am of the impression that Mr Scott called him.
Mr Kormos: Did you make any contacts after your conversation with Mr Harfield, where, at Manitoulin?
Dr Donahue: Manitoulin Island.
Mr Kormos: What contacts, if any, did you make after that?
Dr Donahue: With Mr Harfield?
Mr Kormos: With anybody. With anybody about your contact with Harfield and his access to information.
Dr Donahue: Well, I think the only contact I made was in some way to get in touch with Mr Scott's office and then that was it.
Mr Kormos: Okay, but did you call Mr Scott's office so as to give Mr Harfield's name and his phone number to Mr Scott, asking Mr Scott to phone Harfield?
Dr Donahue: Yes, I think so.
Mr Kormos: So to the best of your knowledge, you did not rely on -- or not to the best of your knowledge; you did not rely on Harfield to contact Scott? You initiated the contact with Scott?
Dr Donahue: Yes, I think I did.
1720
Mr Kormos: You told Harfield you were going to be doing that?
Dr Donahue: Yes.
Mr Kormos: That was as the result of an agreement with Harfield about who you would call with this information about Harfield having access?
Dr Donahue: Yes, pretty well. In my conversation with Mr Harfield, as I say, initially he had real concerns, the same situation. He said he is a business consultant in town, he relies on contracts, government contracts. He is in the same kind of situation many citizens find themselves in: They do not want to get involved because they have got families, they have got businesses and they have got jobs. They just do not want to be involved. This is what Mr Harfield said, and I think most citizens feel the same way. I just said: "Listen, you have got some information that somebody has got to know. It has got to be brought forward."
Mr Kormos: Did Harfield give you any indication why he, Harfield, would use a contact to get this information about you, you not having retained him, you not having consulted him?
Dr Donahue: I never asked him.
Mr Kormos: Did that not concern you a little bit?
Dr Donahue: No, because when I met Mr Harfield at the small businessmen's club and he came to me afterwards, he said he was a business consultant in town and he did a lot of studies and so on. I got the impression -- in fact, I do not know even if I am right or wrong now -- that in some fashion he was tied in with the district health council. Maybe I am wrong or something like that, but I got the overall impression that as a business consultant he did sort of medical consulting or something like that, but I am not sure. I got that overall impression, so I presumed that that was probably why.
Mr Kormos: During that conversation did he try to persuade you to retain him so that he could use more of these contacts to get more information?
Dr Donahue: No, indeed not. No, not at all.
Mr Kormos: I guess I could see somebody trying to impress you with the fact that they have got connections: He is coming out of the blue, he knows you are involved in the Sudbury medical association and dealing with the Ministry of Health on the issue of capping or threshold. So the impression I first got was that he was somebody who would come to you and try to market himself by virtue of saying, "Look at the sort of stuff I can get out of MOH." That was my first impression. You are saying no, that was not the impression you got at all?
Dr Donahue: No indeed. Frankly, I think your interpretation sounds a little, I do not know, a little off.
Mr Kormos: Well, it is not the first time. So that is not the impression you got at all?
Dr Donahue: No. Actually I am surprised, I am shocked; I never got that impression.
Mr Kormos: You had never met this guy before; you never knew him. Is that right? Am I correct in that regard?
Dr Donahue: No, I had never met him, and his name certainly was not familiar to me.
Mr Kormos: He comes out of the blue at a small business meeting and introduces himself and says, "Hi, I'm Mr Harfield." Is that what he did?
Dr Donahue: Yes, that is quite true. After I had made my presentation, a number of other business people had come up and introduced themselves to me and explained or asked me questions with regard to the impact of the memorandum of agreement or billing cap on the business community. He was just one other, that is all.
Mr Kormos: He gave you his card. I trust he did that.
Dr Donahue: I do not think he gave me a business card. Well, I guess he did; yes, a little something with his name on it.
Mr Kormos: Because you knew how to get hold of him in Manitoulin?
Dr Donahue: Yes, that is right.
Mr Kormos: You relied on that card to get hold of him in Manitoulin?
Dr Donahue: Actually that is not too difficult because he has an office in Sudbury.
Mr Kormos: Okay, but how did you get hold of him in Manitoulin?
Dr Donahue: I called his office.
Mr Kormos: Yes, and asked to speak to him?
Dr Donahue: Yes.
Mr Kormos: They told you: "He is not here. He is in Manitoulin right now. Here is the number. Call him there."
Dr Donahue: Yes.
Mr Kormos: When Harfield is talking to you he is telling you, "Look, I know how much you bill, and not only do I know, but I am going to tell you how much you bill." And he did.
Dr Donahue: Maybe not in that fashion. As I say, we were talking about the billing cap and so on, and I think Mr Harfield struck me as a reasonable businessman. I got the impression he was expressing a certain concern. He was saying, "Well, this is the kind of information that other people can get." I think that is what he was telling me.
Mr Kormos: How did he leave you with that impression?
Dr Donahue: Because he was able to get it so easily. If he were able to get it, why should not someone else?
Mr Kormos: But he does not know you. How did he leave you with the impression that he was trying to tip you off to the amount of information that can be out there? How did you get the impression -- is that what you are telling me: He was trying to tip you off?
Dr Donahue: I got that impression. I think it is a fairly common experience. Someone comes up and says: "Hey, by the way, people are saying things about you. They say you're beating your wife." In common conversation people come up to you and say, "Hey, by the way."
Mr Kormos: Okay, but he told you how much you had billed last year?
Dr Donahue: He told me what my OHIP billings were, yes.
Mr Kormos: And you were not quite sure to the point where you called your accountant to check the figure out, to check the numbers out?
Dr Donahue: The figures sounded so precise that I accepted them as probably being accurate right then and there. But to be sure, someone gives you a very precise number and so you check. Someone says, "Well, you weigh 147 pounds and a half," and you say, "Well, I wonder if they're right," and you go and stand on a scale, because most of us do not know our weight that well. I do not know my billings that clearly, so I had to go and check. I got the impression from my conversation with him that he knew precisely because someone had given him some very precise information. It was so precise that I wanted to check just how accurate it was.
Mr Kormos: This was a shocking bit of information reaching you, was it not?
Dr Donahue: That someone had access to that kind of information, yes.
Mr Kormos: That someone you had never retained or consulted, someone you had never met before, would not only have this information but would have gone out of his way -- perhaps only a little bit, but certainly out of the way to have gotten it. Did that not intrigue you?
Dr Donahue: It shocked me. As I say, it would shock anybody here. It is not an ordinary experience.
Mr Kormos: I trust then you carried on with Mr Harfield and said: "Hey, what gives here? What's going on? How come you went to whatever lengths you did to get my billing information?"
Dr Donahue: I did not ask him why he went through the effort. The conversation just carried on, if I remember correctly, with regard to maybe other information he had with me with regard to the percentage, which may have been epilation. But to be honest with you, the conversation was, from my point of view, getting very, very uncomfortable, and I just did not want any part of it. You have to understand that my conversation with Mr Harfield was at the end of November, and by that time I had already received the letter from Mr Decter, and you understand how I felt about it, so I just wanted to get the hell out of there. Pardon my language, but it just upset me. There were other people there. I just said, "Thanks," and just did not want to carry on.
Mr Kormos: You did not want to know any more about it?
Dr Donahue: No, any more than I want to know any more about this. To be honest with you, I am tired, I am stressed out, I have been humiliated and embarrassed publicly. It was too much for me. I just did not want any more.
Mr Kormos: But some two weeks later, after having reflected on the matter, you decided to call this gentleman?
Dr Donahue: Yes.
Mr Kormos: And it was at that point, I trust, that you made the further inquiries, having calmed after the shock of confrontation at the small business meeting? I trust it was at that point you had a more protracted conversation with Mr Harfield.
Dr Donahue: Yes, that is right.
Mr Kormos: And you asked him why he got your billing information?
Dr Donahue: No, I did not. I did not ask him why.
Mr Kormos: You asked him how many other doctors' billing information he had obtained?
Dr Donahue: No.
Mr Kormos: You asked him who else he had told the billing information to?
Dr Donahue: No, I did not.
Mr Kormos: Did you ask him then why he confronted you with this information the two weeks prior?
Dr Donahue: No, I did not. As I say, during my brief conversation with him on what I presume to be November 29, I just got the impression that he was somehow involved with the district health council and they had been looking into the issue, and because of whatever contacts he had he was sort of looking into it. I just left it at that. I was just really tired of the issue at that time; I just did not want to ask any questions. He had said he had information on me, he gave me some figures that sounded really reliable, so all I said to him was: "Now listen. Don't talk to me. I don't want to hear this stuff. You've got to talk to someone who essentially can make sense of it. I don't want to hear all this nonsense. I just don't want to hear the details. I just don't need any more of this. Just talk to someone who's got some smarts about him."
1730
Mr Kormos: The one single thing that threw you back was the accuracy of the billing figure that he was able to relate to you.
Dr Donahue: Yes, that and my impression that he could fractionate my business.
Mr Kormos: What do you mean? Determine what percentages of your billings or what types of treatments?
Dr Donahue: Yes. We did not get into it. As I say, it is just a recall, and my recall in this is admittedly vague. It is probably deliberate; I just want to forget about it. But I get the impression that he had mentioned an epilation figure or something like that. As I say, it is just an impression, so at that point I just wanted to terminate my conversation with him, because it is not the kind of conversation I have ever engaged in with anyone. This was essentially a stranger who had come up to me and given me these figures. Honestly, I just wanted to turn tail and get the heck out of there. I just wanted to get out.
Mr Kormos: If he had merely a rough idea of what your gross billings were, that would not have shocked you the way his very precise idea did.
Dr Donahue: I think even that would surprise me. It is not the kind of thing that people approach you with. Strangers do not walk up to you on the street and say, "Hey, you paid $250,000 for your house." They just do not have that, and even if they do, they do not tend to give it to you right off the bat. To be honest with you, most people I know mind their own business. Even if they have confidential information about you, they keep it to themselves. They just button up.
Mr Kormos: But a whole lot of what you had been doing in Sudbury with respect to the issue of threshold and seeking exemptions had to do with arguing how unrealistic $400,000 was for you and perhaps other northern doctors.
Dr Donahue: True.
Mr Kormos: It entailed, among other things, your telling publicly what your approximate billings were and should be for you to maintain viability.
Dr Donahue: I beg your pardon?
Mr Kormos: Help me again, Chair: the November 29, 1991, Denis St Pierre article in the Sudbury Star. Do we have that as an exhibit yet?
The Chair: Yes, we do. It is part of exhibit 94. Which article?
Mr Kormos: "Patient Fears Loss of Doctor," Denis St Pierre of the Sudbury Star.
Ms Jackson: Page 15.
Mr Kormos: Take a look at that, please, Dr Donahue.
Dr Donahue: What is the reference here?
Mr Kormos: Page 15.
The Chair: The media excerpts.
Dr Donahue: Oh, it is the media. Would you give me the page number again?
The Chair: Page 15.
Mr Kormos: That is the Sudbury Star, Denis St Pierre, in the final column, second- or third-to-last paragraph. I trust you were interviewed by Denis St Pierre for this article.
Dr Donahue: I presume so, sure.
Mr Kormos: It says: "To maintain a viable practice, Donahue estimated he would need a billing allowance equal to two or two and a half times the $400,000 cap, or $800,000 to $1 million. He said he has between 10,000 to 15,000 new referrals a year, not counting repeat visits by existing patients."
Dr Donahue: Is that page 15?
Ms Jackson: There are two parts to the Denis St Pierre article, and the part that I think Mr Kormos is reading from is on page 18.
Mr Kormos: "Patient Fears Loss of Doctor" and "Specialist Knew Trouble Was Coming."
Dr Donahue: Okay.
Mr Kormos: Final column, right-hand side. "To maintain a viable practice, Donahue estimated he would need a billing allowance equal to two or two and a half times the $400,000 cap, or $800,000 to $1 million." Denis St Pierre says you told him that.
Dr Donahue: I do not have specific recall on all the comments I may or may not have made, but generally speaking the comments I made were illustrative, and in many instances these journalists were coming to me with hypotheses they wanted to test out on me. As I understand, this is a fairly classic approach from journalists, so in all likelihood, he asked me, "Is it reasonable?" and I probably said yes.
Mr Kormos: Okay, so his suggestion in the article that you estimated that you would need two to two and half times is not accurate.
Dr Donahue: I guess it depends exactly how you read it, word for word, but I certainly do not recall providing him with these kinds of things. I may have agreed to them but, as I say, exactly whose idea it was to begin with I think is questionable.
Mr Kormos: Okay, because now I am looking at the December 1, 1991, Northern Life article, "Ministry Challenges Doctors to Open Books to Public," Jim Brown.
Ms Jackson: Page 20.
Dr Donahue: Page 20? Oh, yes, mm-hmm.
Mr Kormos: Now, in the final column there, or the last two columns really, underneath the photo, "Dr Jean-Pierre Donahue says he would be better off owning a Mac's Milk store than operating his practice," the second-to-last column, the final short column under the photo, the last two paragraphs: "Donahue, who bills OHIP as much as $1 million a year, is one of 700 doctors in Ontario who bill $400,000 or more annually. More than half of his revenue goes to operating expenses, he said." Now, did Mr Brown interview you for this article?
Dr Donahue: Yes, he did.
Mr Kormos: I mean, the lead paragraph is the quote that you would be better off owning a Mac's Milk store than running a dermatology practice, huh?
Dr Donahue: That is right.
Mr Kormos: And he did not run the figure of $1 million past you during the course of that interview?
Dr Donahue: He may have.
Mr Kormos: To give you an opportunity to confirm or deny it?
Dr Donahue: He may have, sure.
Mr Kormos: And you confirmed it, did you not?
Dr Donahue: I doubt that I was particularly forthcoming in these kinds of things. I probably would have shrugged and said --
Mr Kormos: Well, you were pretty specific when you carried on, because let's look at the final column there, midway down the page, paragraph, "Donahue said he sees up to 12,000 patients a year, 50,000 over the four years he has been in Sudbury." You told Mr Brown from Northern Life that, did you not?
Dr Donahue: Yes, I did.
Mr Kormos: It goes on, "Donahue said he buys $8,000 worth of disposables a month, including rubber gloves and gauze." Well, that was not something that Mr Brown simply threw out at you and you sort of shrugged, letting him conclude for himself whether or not that was the case. You told him how much you spent a month in disposable gloves and disposables.
Dr Donahue: It was an approximation, sure.
Mr Kormos: And you told him that you write $1.5-million worth of prescriptions a year.
Dr Donahue: Yes.
Mr Kormos: And you told him that more than 30% of your case load involves patients with some form of skin cancer.
Dr Donahue: Yes, that is right.
Mr Kormos: I mean, you were pretty forthcoming with Mr Brown in that interview about your practice and the number of patients that you see and the types of treatments that you participate in, were you not?
Dr Donahue: I had no -- I have no -- I had no problem, then, discussing generalities about my practice but, I mean, I had never had any real interest in discussing my income. I mean, if people want to guess what my income is, well, they are certainly free to do that. But, as I say, in these interviews, the idea is, "What do you do?" you know, "What is your practice?" So in an attempt to provide people with examples, I mean, these are the figures that are utilized. They are for examples only, I mean. You know, if someone asked me, "Is that the exact number?" I would say, "Well, no, it's not the exact number," but these are honest sort of guesstimates at the time.
Mr Kormos: You also at several times made it clear that you had exceeded your cap or threshold, had you not? And we are talking about the latter part of 1991.
Dr Donahue: Yes, that is right.
Mr Kormos: And now the threshold is $400,000?
Dr Donahue: That is right.
Mr Kormos: Then it is incremental after that. There is a formula for the next stage and then the next stage, huh?
Dr Donahue: That is right.
Mr Kormos: And you were off the UAP when?
Dr Donahue: I beg your pardon?
Mr Kormos: You were off the UAP.
Dr Donahue: Ultimately it was decided that my UAP contract terminated as of August 31, but there was actually quite a bit of confusion about that. I mean, I was under the impression that I was off the UAP as of June. The Ministry of Health, in the person of Dr MacMillan, thought it was July -- or thought it was August. The contract said it was July and ultimately when we read it quite carefully we concluded that the contract had been mistyped or something like that and the true date was really August. So there was quite a bit of confusion about that.
1740
Mr Kormos: So in your mind it might have been what, June? In your mind it might have at one point been June that you were off it?
Dr Donahue: I beg your pardon? What was this?
Mr Kormos: The UAP. It might have been June that you were off the UAP?
Dr Donahue: It was my impression, yes.
Mr Kormos: Because even if it were June, in the Globe and Mail of November 19, 1991 --
The Chair: Order, please. Mr Kormos, we have five minutes.
Mr Kormos: The Globe and Mail of November 19, 1991, "Doctors Say Fee Limit Will Threaten Services," Rod Mickleburgh, health policy reporter, Globe and Mail. Have we got a reference to that?
Ms Jackson: Page 14.
Mr Kormos: The same bundle, as I understand it, doctor. In the second column, "Dr Donahue said he can no longer afford to pay his 14-member staff out of his reduced OHIP earnings, having passed the $450,000 limit several months ago." Now, if you had reached the limit several months prior -- not a couple but several -- and even if you left the UAP in June, the cap only applying to post-UAP earnings, it would not be very hard to extrapolate a gross annual figure out of your statement that you had passed $450,000.
Mr Harnick: On a point of order, Mr Chairman: The evidence was quite clear, as lead by our counsel and in questions I asked, that the doctor admitted he was mistaken about that. Surely if you are going to ask these questions, you will accept the admission that he was mistaken. And it follows from that that all the calculations you and the Globe and Mail and Ms Murdock have made are wrong. But at least if you are going to quote the evidence to him, at least quote what he said when he was examined by counsel. Do not leave a blank in the evidence and forget what the response was when counsel went over this much more carefully than you are going over it, Mr Kormos.
The Chair: Mr Harnick, that is not a point.
Mr Harnick: It is a point, Mr Chairman, and --
The Chair: Mr Harnick, with respect, members will attempt to place the questions in the best way which they feel is necessary, being fair to the witness. Thank you very much for your opinion. Mr Kormos.
Mr Kormos: You understand what I am saying, doctor. Even if you believed, as you concede you may have mistakenly believed, that you were off the UAP in June, in mid-November you are telling the Globe and Mail -- or perhaps earlier, because the story is published in midNovember -- that several months prior to mid-November you had exceeded the $450,000. That clearly would have put you in a position where you had grossed $450,000 in the few months succeeding even June, would it not?
Dr Donahue: I guess if you are an enterprising mathematician and you want to make assumptions based on some of these statements, I guess you can reach conclusions, but whether your conclusions are accurate or not actually is based on your source.
Mr Kormos: In this case the source is you, sir, speaking to Rod Mickleburgh from the Globe and Mail.
Let's talk for a minute about your telephone call regarding the so-called consultant who told you what your earnings were. You called him on Manitoulin Island and then you and he agreed that Ian Scott would be contacted. Is that a fair synopsis of what happened there?
Dr Donahue: I am not sure whether we agreed necessarily that it would be Ian Scott, but I think the agreement was that he would be willing to talk to someone who had a dispassionate ability to look into the issue. As I say, I had wanted nothing to do with the issue. I just said: "You essentially need someone who is an attorney or someone in the Legislature. You've got to be forthcoming with this. As I say, you've got some information and it sounds important and you apparently have some access or source. Why don't you tell someone about this?"
Mr Kormos: What is interesting is that Mr Harfield, who shocks you, you sent him to Ian Scott. Now, the letter from the Ministry of Health that asks for your permission to discuss your numbers publicly, that shocked you. You took that to your attorney. Ms Majkot, when she came to your office with her child and shocked you with what she says she was told by Miss Martel's constituency office, heard you refer to who? Dr or Mr de Blacam?
Dr Donahue: Dr de Blacam. He is president of the Sudbury and District Medical Society.
Mr Kormos: Why would you have made those references to those three different people in those three different instances?
Dr Donahue: It just seemed reasonable under the circumstances.
Mr Kormos: Now, you told us that Ms Majkot was identified to you by one of your staff as somebody who wanted to tell you something about the Martel affair.
Dr Donahue: By my receptionist, yes.
Mr Kormos: Yes. And you did not want to hear nothing about what she had to say.
Dr Donahue: No. I did not and I do not. It is something I would much rather forget about.
Mr Kormos: Well, you are involved in preparation for civil litigation against Ms Martel, are you not?
Dr Donahue: I do not think I have ever --
The Chair: I would just inform the witness that with respect to that particular question, you are not compelled to respond to that.
Mr Kormos: Thank you. Because Ms Majkot said that you said --
The Chair: Mr Kormos, there is one minute remaining.
Mr Kormos: Ms Majkot said that you said to her, unless she was willing to repeat it, there was nothing much that could be done about it, and I suggest to you that that was very much in the course of preparing a witness list for a tort action, a slander action against Ms Martel, which is really one of the goals here, is it not?
Interjections.
Mrs Cunningham: And you guys talk about our questions in the House?
The Chair: Mr Kormos, if you have a question to ask of the witness which is pertinent to the terms of reference, I would ask you to do that, but the time has expired, Mr Kormos.
Mr Kormos: Thank you for assuming the balance of it, Chair.
The Chair: I do not think I did, Mr Kormos. I would like to thank you. We will now be moving into an in camera session at which time we will be having a subcommittee meeting, and I would just give us a recess of five minutes so we can get our transcriber in order.
The committee continued in closed session at 1747.