Access to Information Orders
Decision Information
• Meeting minutes and Agreements relating to provincial government reimbursement of fees paid by physicians for professional liability insurance
• Section 65(6)3 applied to exclude records from ambit of Act, but Records 4 to 6 brought back under the Act by application of section 65(7)1
• Section 17 (third party information) not applied to Records 4 to 6 - Ministry ordered to disclose Records 4 to 6
• Reasonable Search - Ministry ordered to conduct new search
Decision Content
BACKGROUND
In three related requests, the requester sought records from the Ministry of Health and Long-Term Care (the Ministry) about the Ministry’s relationship with the Ontario Medical Association (OMA) and the Canadian Medical Protective Association (CMPA). The requester was specifically interested in records describing formal arrangements between the Ministry, OMA and CMPA for government reimbursement of professional liability insurance premiums paid by physicians.
The OMA is the entity that “represents the political, clinical and economic interests of the province's medical profession.” According to the OMA website, practicing physicians, residents, and students enrolled in an Ontario medical school may be members. The OMA currently represents approximately 24 000 physicians.
The CMPA is an organization that provides legal defence, indemnification, risk management, educational programs and general advice to Canadian physicians. Founded in 1901, the CMPA was incorporated by federal statute in 1913. The CMPA website notes that “[it] is funded and operated on a not-for-profit basis ...and its membership of more than 66,000 comprises about 95 per cent of the physicians licensed to practise in Canada.”
This order disposes of the issues raised in three appeals (PA-020278-3, PA-040078-2 and PA-040080-2) that resulted from the Ministry’s refusal to disclose records responsive to the requests.
NATURE OF THE APPEALS
Appeal PA-040078-2
The requester made a request under the Freedom of Information and Protection of Privacy Act (the Act) as follows:
By article 4 of the Memorandum of Understanding (MOU) dated July 20, 2000, made between the Ministry, [the CMPA] and [the OMA], a Medical Malpractice Coverage Committee (MMCC) was established.
The mandate of the MMCC is in Appendix 2 to the MOU. Please advise:
i. The dates on which MMCC has met, and the locations.
ii. What recommendations have been made by MMCC.
iii. What actions have been taken as a result of the recommendations, advice or activities of MMCC.
iv. What has been done to carry into effect the principle stated in paragraph 4 of Appendix 2, that is, “balancing the interests concerning professional reputation with those concerning sensible management of resources available.”
Please note that Article 4.01 mentions Appendix 3, but it is obvious that Appendix 2 is meant.
The Ministry responded by advising the requester that the request did not furnish sufficient detail to determine whether any responsive records exist. The Ministry asked the requester to provide additional information to clarify the request and he did so. The Ministry then located one record responsive to the request and denied access to it, in full, pursuant to sections 12(1)(c), (d) and (e) (Cabinet records), and 17(1)(a), (b) and (c) (third party information) of the Act.
The requester (now the appellant) appealed the Ministry’s decision. In addition to appealing the Ministry’s access decision with respect to the responsive record, the appellant raised the possible application of section 23 (public interest in disclosure) to the responsive record. The appellant also expressed the view that the Ministry had not addressed all parts of his request.
During mediation, the mediator requested that the Ministry conduct another search for responsive records and issue a revised decision letter. The Ministry’s subsequent search identified the following additional records responsive to parts 1, 2 and 3 of the request:
- Meeting schedules and locations for 2003 and 2004; and
- MMCC meeting minutes dated April 14, 2003, July 2, 2003 and November 25, 2003
The Ministry also indicated that the record originally identified was responsive to part 4 of the request. The Ministry then issued a supplementary decision letter to the appellant denying access in full to the original record and the additional records pursuant to sections 12(1)(a), (b), (c) and/or (d) and 17(1)(a) and (b) of the Act.
The appellant again raised reasonableness of search as an additional issue. He stated that the original record located by the Ministry’s first search is a report titled “[MMCC] Interim Report, June 2002,” and that the existence of this document suggests that meetings prior to 2003 occurred and that records relating to those meetings should exist.
Further mediation was not possible and the file was moved to adjudication.
This office sent a Notice of Inquiry to the Ministry, the OMA and the CMPA, seeking the representations of these parties with respect to the application of sections 12, 17 and 23, and the search for responsive records.
The events following the issuing of this initial Notice of Inquiry in Appeal PA-040078-2 are described in the section titled “Further Developments in Appeals PA-040078-2 and PA-040080-2”, which appears after the following section.
Appeal PA-040080-2
The Ministry also received the following request under the Act from the appellant:
I understand that the Government of Ontario, for several years, has rebated to physicians a significant portion of the fees they pay to the [CMPA], and continues to do so.
I request particulars of the program under which this is done, including existing and expired agreements, the amounts paid, and how the amounts are calculated.
Without limiting the generality of the foregoing, I request copies of:
1. The 1996 [OMA/Ministry] Agreement;
2. The [OMA/Ministry] Agreement for the term [April 1, 2000 to March 31, 2004];
3. The 5 Year memorandum of understanding (MOU), effective January 2004, negotiated in February 2003, between [the Ministry], OMA and CMPA;
4. Particulars of the “Procedure” mentioned in Article 6.02 and appendix 4 of the 2000 MOU between [the Ministry], CMPA and OMA; and
5. The report issued by the Medical Professional Liability Committee [MPLC] (formerly the Medical Malpractice Coverage Committee. The report is mentioned in a bulletin by OMA to members and is recent.
In addition, I request the total amounts paid under the program in each year since it began, showing for each year the beginning and end of the fiscal period.
Please advise also whether the government has knowledge of Ontario physicians who obtain malpractice insurance from a carrier other than CMPA, and in that case whether the government pays any part of those premiums. If so, please provide particulars of the program, similar to those requested in respect of CMPA subsidies.
Pursuant to Section 24(3) of the Act, this request continues to have effect for two years. With regards to documents 1, 2, 3, 4, and 5, mentioned, access is requested even if Ministry officials are of the view that they are not involved in the malpractice insurance subsidy program.
The Ministry sent a decision letter to the appellant which identified four records as responsive to the request:
1. The 1996 [OMA/Ministry] Agreement;
2. The 2000 [OMA/Ministry/CMPA] [MOU];
3. The 2004 [OMA/Ministry/CMPA] [MOU]; and
4. Annual Report from the [MPLC] to the Ministry and the Physician Services Committee [PSC].
The Ministry denied access in full to Records 1 and 3 pursuant to sections 17(1)(a), (b), and (c) of the Act and informed the requester that Record 2 had already been released to him in a previous appeal (PA-020278-2). The Ministry remarked that a separate decision on access to Record 4 had been made through appeal PA-040078-2, as it was the same record as the one identified as a result of the Ministry’s original search in that appeal.
The Ministry also provided information responding to other parts of the request, specifically:
• That the total amounts reimbursed by the Ministry to physicians in each of the 2000/2001, 2001/2002, and 2002/2003 fiscal years was previously released to the appellant in Appeal PA-020278-2.
• That the Ministry had identified no records responsive to the part of the request relating to the government’s knowledge of Ontario physicians who obtain malpractice insurance from a carrier other than CMPA, the government paying any part of those premiums, or the particulars of such a program.
• That the records are not produced on any scheduled or foreseeable dates and, therefore section 24(3) of the Act does not apply since it is not intended to provide ongoing access to the kind of record of which only one edition is produced, as in the present case.
The Ministry also noted that the name of the MMCC was changed to MPLC in the 2004 MOU.
I would note that while the name of that committee was formally changed in the 2004 MOU, as stated by the Ministry, the use of the name MPLC, instead of MMCC, seems to have occurred in mid-2003. Both names are used throughout this order, with an effort to apply the name in use at the time the document or record was created.
The appellant appealed the Ministry’s decision based on the following:
• Reasonable Search: the [OMA/Ministry] Agreement for the term [April 1, 2000 to March 31, 2004] (part 2 of the request)
• Exemption Claim: the application of section 17(1)(a), (b) and (c) of the Act to exempt the 1996 [OMA/Ministry] Agreement (part 1 of the request) and the 2004 [OMA/Ministry/CMPA MOU] (part 3 of the request)
The appellant also asserted that “even if there were exempt information in the appendix, it would be severable under section 10(2).”
• Reasonable Search: Annual Reports from MMCC
The appellant submits that further annual reports should exist as the MMCC was established under the 2000 MOU.
• Non-answer: Amounts paid since 1986
The decision letter refers only to totals for the last three years and fails to identify the fiscal periods.
• Non-answer: the “Procedure” mentioned in the 2000 Ministry/OMA/CMPA MOU
The appellant indicates that this is part 4 of his request and that no responsive record is mentioned in the list of records found by the Ministry
• Compelling Public Interest: possible application of the “public interest override” at section 23 of the Act.
During mediation, the appellant emphasized that the record he is seeking in part 2 of this request is a two-party agreement between the Ministry and the OMA, which is a separate and distinct document from the three-party MOU that he received as the result of appeal PA-020278-2.
With regard to the document referred to as Record 4, the appellant noted that because the record is being withheld, he had no way of knowing whether it is indeed the same record located by the Ministry through its search in appeal PA-040078-2.
The mediator forwarded a copy of the appellant’s appeal letter to the Ministry for review and response. There was no response from the Ministry. As it appeared that no further mediation was possible, the appellant requested that this file proceed to adjudication.
This office sent a Notice of Inquiry initially to the Ministry, the OMA and the CMPA, seeking representations on the application of sections 17 and 23, and the search for responsive records.
Further Developments in Appeals PA-040078-2 and PA-040080-2
After the initial Notices of Inquiry relating to each of these two appeals had been sent to the Ministry, OMA and CMPA, the Ministry issued a new decision letter on November 4, 2004, in which it claimed that section 65(6)3 of the Act applies to exclude the records at issue in both appeals from the Act.
Based on this new decision letter, this office sent a Supplementary Notice of Inquiry to the Ministry, the OMA and the CMPA seeking their representations on the possible application of section 65(6), as well as certain other issues in the original Notice and the supplementary Notice on which representations had not yet been received.
The Ministry, the OMA and the CMPA all submitted representations. This office then sent a Notice of Inquiry to the appellant, along with the Ministry’s representations and complete copies of the representations from the OMA and the CMPA, inviting the appellant to provide representations.
Upon receiving representations from the appellant, this office sent a Reply Notice of Inquiry to the OMA and CMPA, as well as the Ministry, enclosing a complete copy of the appellant’s representations. Reply representations were provided by the Ministry and the CMPA.
The appellant was offered a final opportunity to reply to the Ministry’s and CMPA’s representations through a Sur-Reply Notice of Inquiry and did so.
The appellant also sent in several short letters to clarify typographical errors in earlier correspondence or to bring other matters to the adjudicator’s attention, none of which were construed as requiring further reply from the other parties.
After these stages of the adjudication process in relation to Appeals PA-040078-2 and PA-040080-2 were complete, I assumed carriage of both appeals from the former adjudicator.
Additional Record
In its representations, the Ministry indicated that a renewed search at the Provider Services Branch of the Ministry had located a copy of the OMA/Ministry Agreement (for the term April 1, 2000 to March 31, 2004). The Ministry stated that it was claiming section 65(6)3 to exclude this record from the Act and that, in the alternative, it claimed the exemption at section 17(1) of the Act, relying on the same representations submitted in relation to the 1996 OMA/Ministry Interim Agreement.
A copy of this record (the “2000 OMA/Ministry Agreement”) was not obtained at that time. After I assumed carriage of these appeals, however, I sought and received a copy of the 2000 OMA/Ministry Agreement from the Ministry, since it was responsive to part two of the appellant’s request, as originally framed, in appeal PA-040080-2.
The numbering of the records originally identified as responsive to the appellant’s request in Appeal PA-040080-2 (and as labeled in the original representations provided to this office) had the 1996 OMA/Ministry Agreement as Record 4 and the 2004 MOU as Record 5. This order reflects revised numbering of the records in that although the 1996 OMA/Ministry Agreement remains known as Record 4, I will be referring to the 2000 OMA/Ministry Agreement as Record 5 and the 2004 MOU as Record 6.
Having reviewed Record 5, the 2000 OMA/Ministry Agreement, I concluded that it would be appropriate to seek supplementary representations from the Ministry and the OMA regarding the possible application of sections 65(6), 17 and 23 of the Act. I sent a supplementary letter Notice of Inquiry to the Ministry and the OMA and I received representations from both the Ministry and the OMA in response.
In view of the Ministry and OMA providing representations on Record 5 which were virtually identical to those received earlier in the inquiry process in relation to Record 4, I determined that I did not need to hear from the appellant on Record 5.
This order was being prepared when, on June 13, 2006, the Ministry contacted this office and advised that it wished to withdraw the representations it had provided on Record 5 in May 2006 because it had decided to release the 2000 OMA/Ministry Agreement to the appellant. The Ministry subsequently sent this office a copy of the revised June 19, 2006 decision letter to the appellant under cover of which it had sent Record 5 to the appellant.
The appellant subsequently sent correspondence to this office in which he acknowledged receipt of the June 19, 2006 revised decision letter and a copy of the 2000 OMA/Ministry Agreement.
As previously mentioned, however, Record 4 is an Interim Agreement signed in 1996 between the OMA and Ministry, while Record 5 is an Agreement signed in 2000 by the same parties. My review of Record 4 - over which the Ministry maintains its claims of exclusion from jurisdiction or, alternatively, exemption under the Act - does not demonstrate an adequate or reasonable basis for distinguishing between the two records, in terms of the decision to release Record 5, but not Record 4, to the appellant.
Accordingly, and notwithstanding the Ministry’s recently revised decision on Record 5 and its consequent release to the appellant, I have decided to proceed with my analysis and disposition of the 2000 OMA/Ministry Agreement in this order.
Appeal PA-020278-3
The Ministry also received the following request under the Act from the appellant, which pre-dated those described above under Appeals PA-040078-2 and PA-040080-2:
I understand that the Government of Ontario rebates to physicians a significant portion of the fees they pay to the [CMPA]. I am interested in getting particulars of this program, that is, the Agreement or regulations involved and the amounts.
The Ministry advised the requester to forward his request to the Ministry’s Freedom of Information (FOI) office. The requester then asked the Ministry’s FOI office for the following:
(a) A [MOU] signed by CMPA, OMA, and the Ministry. I don’t know the date, but the document is mentioned in the current CMPA website.
(b) The amounts paid by the Ministry under the Memorandum in the years to which it applies. I do not ask for amount paid to or for any individual. I request yearly totals. I also ask for a breakdown by specialties or regions if that information already exists.
(c) Predecessor Agreements or [MOUs] for earlier time periods. My understanding is that the subsidy program for Medical Malpractice insurance began in 1986, but I am not sure of that.
(d) With regard to predecessor Agreements, information similar to that mentioned in (b).
(e) With regard to (b) and (c), I ask how the amounts paid are calculated. I suppose that information is in the Agreements, but if other documents are needed, I ask for those.
As the requester (now the appellant) did not receive a response from the Ministry within 30 days of his request, he appealed to this office and file PA-020278-1 was opened as a deemed refusal file. The Ministry subsequently provided the appellant with a decision letter responsive to his request and that appeal file was resolved.
In its decision letter, the Ministry granted access, in part, to records responsive to the request. The Ministry provided information responsive to part (b) of the request for the years 2000 and 2001, and advised that it does not collect data by specialty or region. The Ministry informed the appellant that the CMPA fee schedule is available on the CMPA website, where it is broken down by specialty and region. The Ministry also provided information responsive to part (e) of the request. With respect to part (e), the Ministry stated:
Under the 1987 [Ministry]/OMA Agreement, the government agreed to subsidize physician malpractice coverage. Since 1987, the government has continued to pay the difference between the 1986 fee and the current fee.
Access was denied to the record responsive to part (a) of the request, in its entirety, pursuant to the third party information exemption found at section 17(1) of the Act. The Ministry also informed the appellant that records responsive to parts (c) and (d) of the request do not exist.
The appellant appealed the Ministry’s decision to deny access to the MOU and also appealed the Ministry’s decision that the records and agreements sought do not exist. The appellant stated his belief that the 1987 agreement must exist based on the Ministry’s response to part (e) of his request. As a result, Appeal PA-020278-2 was opened.
The appeal was not resolved through mediation. During the adjudication stage of the appeals process, the Ministry granted access to the MOU requested in part (a) of the request.
In Order PO-2213, issued on December 11, 2003, Adjudicator Donald Hale dealt with Appeal PA-020278-2 and ordered the Ministry to provide the appellant with a decision letter on access to the 1987 Agreement and the accompanying financial information. In that order, he stated:
In my view, the request as formulated is sufficiently broad to include the 1987 Agreement and the related information outlining the total payments made pursuant to that Agreement. Based on a literal reading of the request, it is clear that the appellant was seeking access to records relating to the subsidy program for malpractice insurance which began around 1986. I find that the Ministry has applied an overly-restrictive interpretation of the request by identifying only records which pertain to a tripartite agreement between the CMPA, OMA and itself. I find that the appellant's request, particularly part (c), is drafted in such a way as to include the 1987 Agreement or MOU, regardless of the fact that it may not have included the participation of the CMPA. I note that parts (b) and (d) of the request also include records pertaining to the amounts paid by the Ministry under the 1987 Agreement.
I will, accordingly, order the Ministry to provide the appellant with a decision respecting access to the 1987 Agreement, and any records relating to the payments made pursuant to that Agreement, using the date of this order as the date of the request.
The Ministry did not comply with Adjudicator Hale’s order within the required statutory 30-day period.
Eventually, the Ministry issued a decision granting access to the MOU; however, the appellant wrote to the Ministry to point out that “there was no financial information, as required by the Order.” In his letter, he also indicated that the financial information he is seeking is set out in paragraphs (b), (d) and (e) of his request.
On April 2, 2004, the Ministry issued a decision on access to the financial information, advising the appellant that a further search in the Operational Support Branch of the Ministry had located no responsive records. The Ministry also advised that records related to the type of payments in question are maintained by the Provider Services Branch of the Ministry and that “... no responsive records were located as retention schedules do not extend for this period of time.”