Hi:

Health  Providers Against Poverty recently sent a letter to the Ontario
ombudsman, Andre  Marin, asking him to investigate the inadequacy of
current welfare rates, and  consider the impacts of poverty on health.  A
number of other organizations  are preparing similar letters.  Apparently,
volume of complaints is one of  the factors considered in initiating an
ombudsman's investigation.  If you  are at all interested in sending a
letter along a similar vein, please  do.

Please  see our letter, attached, for the address, and the arguments we
made.

Thanks,
Gary


Health Providers Against Poverty
[log in to unmask]

André Marin
Ombudsman Ontario
Bell Trinity Square
483 Bay Street
10th Floor, South Tower
Toronto, ON M5G 2C9
May 16, 2006

Dear Mr. Marin:

We are writing to you as health professionals from across the province who
provide
health care, collectively, for thousands of the poorest Ontarians. We are
deeply concerned
about the threat poverty poses to the health, well-being, and lives of
those in our care.
This poverty is preventable and reversible, but a succession of governments
in Ontario
have made cuts to social programs that have resulted in an increase in our
patients.
poverty and a corresponding worsening of their health. It is this
legislated poverty that we
feel falls within your mandate to investigate.

Ontario Works and Ontario Disability Support Plan benefits were drastically
cut in 1995,
and have fallen steadily relative to inflation since then. Welfare
recipients. spending
power is now forty percent less than it was prior to those cuts. This has
left our patients
on social assistance without enough money to pay for even their most basic
needs, such
as food, shelter, and childcare. The Toronto Board of Health estimates that
a single
person receiving Ontario Works benefits receives only about two-thirds of
what she
requires to meet her basic needs. People cannot be healthy when they are
forced to
choose between food and rent and keeping the heat on. We feel this
situation constitutes
an unconscionably under-addressed health crisis.

A recent example of the provincial government.s neglect of Ontarians living
in poverty
occurred with the changes to the Special Diet Allowance application
process. This
Allowance was created to provide a nutritional supplement for people living
on welfare
who require nutritional support for the treatment or prevention of health
problems. In
November, 2005, the government arbitrarily revised the application criteria
in a manner
that cut thousands of deserving people off this lifeline of extra income,
and took millions
of dollars out of the pockets of people living in extreme poverty. The new
application
forms require that medical conditions, including HIV/AIDS, be disclosed to
front-line
social service workers, which we consider a breach of privacy rights. The
amounts that
people receive for each health condition is grossly inadequate; for
example, those with
liver disease or cardiovascular disease only receive $10 per month.
Finally, the new
regulations remove the ability for providers to promote a preventative
approach to health
care. This means that recipients are only eligible for assistance when
significant damage
to their health has already been done. The changes in this process were
made without any
basis in medical evidence, have undermined the purpose of this program, and
have placed
thousands of Ontarians at higher risk of developing, and suffering worse
consequences
from, significant health problems.

The change to the Special Diet Allowance program represents only one small
example of
the way in which our government has the ability to legislate poverty. Every
day in our
practices we see the negative health outcomes that result from living on
social assistance
payments that fall far below subsistence levels. A robust body of research
supports the
link between poverty, ill health, and premature death. People who live in
poverty are at
significantly higher risk for developing, getting sicker from, and dying
from many
diseases, including diabetes, cancer, heart disease, and serious mental
health conditions.
Furthermore, growing up in poverty can mean not growing up at all: a
large-scale British
study recently reported that the poorest children were 40% more likely to
die in their first
10 years than children in the highest socio-economic group. The fiscal
argument, that we
need to .trim. social spending that has grown beyond our means, does not
account for the
inevitable and large increases in health care spending that will result
from these policies.

Your office has consistently acted to protect the rights of our most
vulnerable citizens.
You carefully documented the plight of families who were forced to give up
parental
rights so that children with severe disabilities could access needed care,
you
recommended that government fund cysteamine for Batten.s Disease for
Christopher
Comeau-D.Orsay, and criticized the failures of Ontario.s newborn screening
program
that resulted in as many as 50 children annually becoming disabled or
dying. In all these
cases, government policies and programs caused suffering and harm to
vulnerable
Ontarians. We urgently request that you continue to use the powers of your
office to
protect those who most vulnerable by launching an investigation into
legislated poverty
in this province, especially chronically inadequate (and falling) social
assistance rates.
We would like to meet with you to discuss our concerns about the health
impacts of low
social assistance rates and related programs such as the Special Diet
Allowance. We
would be pleased to provide additional information to support your
investigation into this
threat to the health of the hundreds of thousands of Ontarians living in
poverty.

We look forward to your reply. Please contact Lynn Anne Mulrooney at 416
408-5616
or [log in to unmask] or 158 Pearl Street, Toronto, ON M5H 1L3. Thank you.
Sincerely,

Lynn Anne Mulrooney (for the steering committee)
HPAP Steering Committee:
Gary Bloch, MD, CCFP, St. Michael.s Hospital
Mimi Divinski, MD, Family Physician
Anne Egger, RN(EC), Regent Park Community Health Centre
Kathy Hardill, RN(EC), Regent Park Community Health Centre
Sarah Innis, RN, Street Health
Tara Kiran, MD, CCFP, Regent Park Community Health Centre
Melissa Melnitzer, MD, CCFP
Lynn Anne Mulrooney, RN, MPH, PhD, Registered Nurses. Association of
Ontario
Alicia Odette, RN, Street Health
Neena Prasad, MD, St. Michael.s Hospital
Deborah Phelps, RN, Central Toronto Community Health Centres




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