It's extremely curious, Someguy. I'm doing a part-time PharmD, and for the Health Administration course, I read and analyzed Bill 102, the Transparent Drug System for Patients Act, that was passed in 06. That was the bill that brought us Medscheck (a good thing), and changed Section 8 to Section 16.
The huge change brought by this bill was the creation of the position of Executive Officer, public drug programs. This person has the power to list or delist drugs from the ODB Formulary, determine interchangeability, fine pharmacists or manufacturers for non-compliance, and also enter into agreements with drug manufacturers in order to acquire volume discounts.
Previous to Bill 102, the Minister of Health and Long-Term Care had jurisdiction over the Drug Benefit Formulary. Bill 102 handed that power over to the Executive Officer. That person is Helen Stevenson, who subsequently was also made ADM.
About HS, backing up a bit: in 2005, she was picked from the private sector by then-health minister George Smitherman to be Team Leader, Drug System Secretariat, consisting of a team of 6 people who travelled throughout Ontario talking to various stakeholders in the health care system: drs, pts, pharmacists, advocacy groups, groups like Cancer Care Ontario and suchlike. She asked folks questions about how they would improve the drug system in Ontario, and prepared a report for Minister Smitherman. This report provided the foundation upon which Bill 102 was based and has never been made public. I deduced the kinds of questions she asked indirectly, from PDFs put on-line by various groups posting their reports to the Drug System Secretariat.
I couldn't figure out why George Smitherman formed this group in the 1st place. But if you send a couple of people around the province asking them how the government should improve the health care system, it provides the foundation, the impetus for change. Like, "You told us your concerns, and here's what we've done to address those concerns."
So then Bill 102 was written, then passed, the position of Executive Officer was created, and Helen Stevenson was put in that position. The opposition screamed about this (I read the Hansard transcripts) but furious George got his way.
So that's how we have someone who is not a health care professional but an MBA, who has been working for the province for less than five years, and is making $275,000 a year, telling the media that pharmacists are to blame for rising drug costs, and that pharmacists are guilty of collecting "rebates," even though Bill 102 defines professional allowances explicitly.
The reason that she is able to say this and we can't sue her, is that Bill 102 defines certain set purposes for which professional allowances can be used, and if they aren't used for those purposes (eg pt education, blister packing), and if we don't produce the paperwork twice a year proving that we are using these allowances as laid out in the legislation, the Executive Officer then calls our professional allowances "rebates" (it actually says this in the legislation!), and has the power to fine us for the amount of professional allowances we were "improperly" paid.
Also, Bill 102 is exempt from the Statutory Powers and Procedures Act, a technical point missed by many critics. What this means is due process does not have to be followed. So the rulings of the Executive Officer are binding, and cannot be appealed. The only avenue of appeal open is a judicial review, which are very infrequently granted. Apparently if the SPPA is suspended, only the rules of common law apply, and I'm not a lawyer so I don't know all the ramifications of that.
Long post...........
