Lorian Hardcastle Profile picture
Sep 13, 2020 7 tweets 2 min read Read on X
Some thoughts on this article, which suggests that the ruling in the BC private health care case is inconsistent with SCC jurisprudence and thus vulnerable to appeal: nationalpost.com/news/canada/b-…
While one of the parts of BC's law was similar to that challenged in Chaoulli (ban on private insurance), the BC case addressed other rules like limits on extra billing.
There are significant differences in Quebec's 2005 health system and BC's 2020 system. For example, while judges in Chaoulli disagreed on how to assess unreasonable waits, the judge in BC relied on benchmarks that didn't exist in Quebec in 2005.
The constitutional jurisprudence has evolved in the last 15 years. Many were very critical of the SCC's approach in Chaoulli. The majority appeared to substitute their own policy choices for those of the government, rather than applying the proper legal test.
The quality of the evidence in the BC case was much better and the judge's analysis of it was methodical. He didn't fall into the Chaoulli trap of failing to appreciate that health policies from one political/legal/social climate cannot be easily imported to Canada.
The $ backers of Brian Day claim that subsequent Supreme Court cases "stand for the same principle: that the government cannot undermine measures that help protect people". This is a preposterous oversimplification of the cases that she cites.
I read the whole 880 pages yesterday and will be posting a blog post on Monday that summarizes the case.

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More from @Lorian_H

Nov 15, 2023
Manning report on covid has dropped. Notably, the panel's mandate wasn't to look broadly into the management of covid, but more narrowly to look at governance in a public health emergency. /1
I'm not going to disparage any specific person, but it is fair to say that the panel's composition seems designed to reach particular conclusions on the issues. /2
Report immediately mischaracterizes who makes decisions in a pub health emergency by putting Cabinet at the top of the list and saying cmoh is merely "highly relevant". Although that's what happened during covid, the law is quite different (for now...see bill 6). /3
Read 30 tweets
Nov 8, 2023
Watching the presser on changes to the health system...

Smith highlights challenges with staffing and surgical wait times, but unclear how their proposed reforms will fix any of this. Says that current system lacks accountability and falls short on putting patients 1st /1
Delivery system will now focus on 4 areas, each with their own organization: primary care, acute care, continuing care, mental health & addiction. Calls current AHS structure "scattered" and "rigid". Will apply province-wide to avoid pre-AHS regional fragmentation. /2
Smith says this new model will be more responsive to issues, better able to mange performance, more accountable, more adaptable to innovation, and responsive to make space for local input. Unclear how the new model will facilitate these goals. /3
Read 20 tweets
Nov 2, 2023
Gov announced forthcoming changes to the Public Health Act today that will give cabinet greater power over decisions during a public health emergency. Some thoughts... /1
First, clarity over the role of the CMOH was much needed. This should have been fixed much, much sooner when it became clear that what was happening during covid (i.e. cabinet making decisions) was out of step with the law (i.e. CMOH making decisions). /2
Two questions required attention. First, who ought to make decisions during a health emergency (CMOH, cabinet, combo)? And second, how much independence should the CMOH have (e.g. a bureaucrat reporting to the Minister of Health or able to disclose recommendations publicly)? /3
Read 10 tweets
Aug 1, 2023
Much anticipated decision in Ingram v Alberta (CMOH) is out! This case addresses the legality of covid public health orders. A summary and some thoughts... /1
As discussed ad nauseam during covid, this decision clarifies that the authority to issue public health orders is that of the CMOH and not cabinet. Despite this, Hinshaw repeatedly said that she was merely an advisor, thereby improperly delegating her power to cabinet. /2
Specifically, the Act "requires that decisions with respect to public health orders must be made by the CMOH" or her delegate. Instead, decisions here "were made by cabinet" or its committees. This delegation was "not permitted" by the Act. /3
Read 19 tweets
Nov 17, 2022
Catching up on the Smith/Copping presser...
Smith commends front line staff and scapegoats AHS. Appoints administrator to replace AHS board. 4 priorities: EMS response times, ER waits, surgery waits, develop long-term reforms through consultation with health professionals. /1
Copping also commends front line staff and talks about the need for more capacity (doesn't address preventing people from needing hospital services in the first place). Claims a temporary administrator is preferable to board because they can work on these issues full time. /2
Administrator will work with CEO and will report to Minister of Health/Premier.
EMS: fast track transfers, use other modes of transport for non-urgent cases, empower EMS to step down calls from 911, empower paramedic to triage and determine need for ER transfer by ambulance. /3
Read 13 tweets
Oct 27, 2022
Hot off the press! The Court of KB releases its decision in the school masking case. Some thoughts to follow... /1
The applicants challenged the chief medical officer's order rescinding masking in schools and the Minister of Ed's direction that schools not impose their own masking requirements. /2
Notably, and as @UbakaOgbogu and I have said many times, the Court finds that the authority to make public health orders rests with the CMOH, not cabinet. Because the masking decision came from cabinet and not her, it was unreasonable. /3 Image
Read 9 tweets

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