Fact vs. Fiction: Rona Ambrose's laughable claims about Conservative 'evidence based policy'
In a recent speech to the Canadian Medical Association, Health Minister Rona Ambrose said something no cabinet minister ought to have to say out loud: that her boss, Prime Minister Stephen Harper, and his government are firm believers in evidence-based policy.
Ambrose claimed that “at the end of the day, for policymakers like me, it’s the medical science and data-based evidence that must guide our decisions on health sector regulation and allocation of resources.”
The fact that Ambrose felt the need to assert publicly that her government drafts policy based on facts — not on hunches, hearsay or blind ideology — highlights the Harper government's essential problem when it comes to getting Canadians to sign on to its program: It does not believe in fact-based policy and seldom feels the need to behave as if it does.
The Conservatives believe in ideology over evidence. They believe in belief. For proof, look no further than Ambrose’s own portfolio.
In October, Ambrose announced that government would no longer allow doctors to prescribe medicinal heroin (to a very limited group of specialized patients) under Health Canada’s Special Access Program.
Ambrose claimed that there was no proof that the treatment is effective. Here's what she had to say in a CBC interview:
There is no evidence at this point that heroin ... giving heroin to heroin addicts ... is any way an effective treatment ... As I said, there is no evidence that this is an effective, safe treatment ... no clinical evidence ... There is no clear evidence to suggest that this a safe treatment and it’s not a good idea for Health Canada to be supporting giving heroin to heroin addicts when there’s no scientific evidence that this is a safe treatment ...
And so on. Ambose’s position was repeated in the Harper government’s speech from the throne:
Canadian families expect safe and healthy communities in which to raise their children ... Our Government will ... close loopholes that allow for the feeding of addiction under the guise of treatment.
Because there's no evidence it works, right? Actually, there's copious evidence supporting the use of medical-grade opiates to treat addiction. The European Monitoring Centre for Drug and Drug Addiction released a 176-page study on the use of doctor-supervised medicinal heroin. Here's what the study found:
Over the past 15 years, six RCTs have been conducted involving more than 1,500 patients, and they provide strong evidence, both individually and collectively, in support of the efficacy of treatment with fully supervised self-administered injectable heroin, when compared with oral MMT, for long-term refractory heroin-dependent individuals. These have been conducted in six countries: Switzerland (Perneger et al., 1998); the Netherlands (van den Brink et al., 2003); Spain (March et al., 2006); Germany (Haasen et al., 2007), Canada (Oviedo-Joekes et al., 2009) and England (Strang et al., 2010).
That's science. Inconvenient science, from the government's point of view. And so it suffers the fate of all inconvenient facts in the Harper universe: it's ignored.
In May, the The Supreme Court of British Columbia granted an injunction against the Conservative government policy and restored patients' access to the treatment. Here's what the court had to say:
I am not prepared, at this juncture, to accept the view of Dr. Kahan (note: the evidence relied on by the Conservative government) that, as the personal plaintiffs have not received what are in his view optimal doses of methadone, they are not refractory, or that they do not necessarily face the risks described by Drs. Wood and Buxton.
I find that the risks identified by Dr. Woods and Buxton are risks faced by the personal plaintiffs, and by those on whose behalf they apply, which will be reduced if they receive injectable diacetylmorphine treatment from Providence physicians. These potential harms are clearly irreparable in nature.
Translation: The court — a place where only the evidence matters — found that Ambrose’s position contradicted the facts and could result in irreparable harm.
But let's not pick on Ambrose. Her department isn't the only one with standing orders to ignore reality if it clashes with ideology. Take a look at the Department of Justice — where the Conservatives, not content with dismissing the facts, actively work to suppress them.
In May the federal government cut Justice's research budget by $1.2 million. According to an internal government report, the Justice Department's research budget was slashed just as an internal report for the deputy minister was warning its findings “may run contrary to government direction” and have "at times left the impression that research is undermining government decisions" and is not "aligned with government or departmental priorities."
In August, another internal government report indicated that staff at the criminal law policy department had been cut by 51 per cent since 2008 and that the “work environment is beginning to have a negative impact on staff morale”.
That report says almost all government counsel were reporting that short timelines were crippling their ability to provide high-quality legal policy advice; 81 per cent of employees indicated that the quality of their work was suffering because of unreasonable deadlines.
Here's how David Daubney, a former senior bureaucrat in the Justice Department, described the climate in a Globe and Mail interview:
(The government does not) want to encumber their minds with the facts. We always at Justice prided ourselves as being ‘stewards of the criminal law.’ We were seen as the go-to place for the facts and research on criminal policy, justice and corrections. That’s certainly no longer the case.
None of this should surprise. When you're pursuing policies at odds with science and sociology, facts are the enemy. From sex offender registries to mandatory minimum sentences), the federal government's policy agenda is shot through with shaky theories and weak arguments.
Which is why this government's most serious setbacks always seem to happen in court — a place which has little patience with sweeping statements and good intentions. Last year, minimum sentences were struck down, judges were in open revolt over mandatory victim fines, injunctions were granted against prohibitions on medicinal marijuana and heroin and the country’s top court declared Canada’s prostitution laws to be unconstitutional.
We like to say justice is blind. Maybe it is — but governments can't afford to be.
This article first appeared in iPolitics.ca - check out the site - well worth the subscription!