BY ROGER ANNIS
MONTREAL - Another provincial government in Canada has lost an attempt to place restrictions on women's right to abortion. The Alberta government announced on October 10 that it was abandoning plans to restrict public funding of abortion.
The government had declared on September 22 that it would seek to limit state funds to abortions deemed "medi cally necessary." The plan, it said, depended on the cooperation of doctors in coming up with a definition of what constituted "medically necessary."
The doctors refused to go along. The Alberta College of Physicians and Surgeons, the governing body of doctors in the province, took just 15 minutes to unanimously reject the government's request at a meeting on October 5.
The Alberta Medical Association took a similar stance one day later. "Decisions about what types and levels of [health] care should be funded are societal decisions," stated the association president, Dr. Guy Gokiert. "It's a moral issue, it's an ethical issue, it's not really a medical issue," he said.
"They (the doctors) have in effect set one broad guideline," said Dr. John Dossetor, who teaches medical ethics at the University of Alberta. "It's a decision between a woman and her doctor. It's hard to think of what other guideline one could use." About 9,000 abortions were performed last year in Alberta.
The government's plan ran into a wall of opposition from supporters of a woman's right to choose abortion. Additionally, the government was wary about entering into a dragged-out dispute on a health care issue at a time when there is growing dissatisfaction with its cutbacks to health care funding.
Victory in New Brunswick
Women's rights supporters won another victory on August
17 when the Supreme Court of Canada refused a request from
the government of New Brunswick for help in obstructing an
abortion clinic operated by Dr. Henry Morgentaler in the
provincial capital, Fredericton.
Following the opening of the clinic in June, 1994, the New Brunswick College of Physicians lifted Morgentaler's license to practice medicine in the province. It did so at the urging of the provincial government. The college threatened similar reprisals against any other doctor performing abortions outside of hospitals.
A New Brunswick Supreme Court decision struck down the provincial law which gave the college that power. The federal court refused to hear an appeal of that decision. It gave no explanation for its decision.
In New Brunswick only three hospitals offer abortion services - in Fredericton, Moncton, and Bathurst - and there are many restrictions, including limits on the number of procedures performed and the requirement of written approval by two doctors. No abortion service is available in Saint John, the largest city in the province. Despite the court decision, the provincial government is continuing to deny funding of abortions performed outside of hospitals.
The government in the neighboring province of Nova Scotia, meanwhile, announced on October 25 that it was ending all funding of facility fees at a Halifax abortion clinic, the only clinic in the province. Henceforth, the government-run health plan will pay only doctors' fees at the facility. Patients will have to pay from $300 to $600.
Currently, only the health plans in British Columbia and Ontario cover the full cost of abortions performed in clinics. Quebec covers a portion of facility fees as well as doctors' fees.
Ottawa wants to control cutback pace
The issue of facility fees at private health clinics has
emerged as a dispute between Ottawa and the provincial
governments. Federal Health Minister Dianne Marleau
announced in September that, as of October 15, services at
private health clinics must be funded either entirely by
provincial health-care plans or not at all. After that
date, provincial governments would lose health care funding
by amounts equivalent to any facility fees paid by clinic
patients.
The Nova Scotia decision on abortion fees, for example, will cost the province approximately $130,000 in withheld federal money. Marleau's directive has been sharply criticized by most provincial governments.
At issue is who will control the pace and scope of health care cuts. Under the government-run health care system in Canada, provincial governments administer health care. Funding is provided from general tax revenues of both federal and provincial governments. The Canada Health Act empowers the federal government to establish national standards if it so chooses.
Ottawa has cut billions of dollars from health care funding (so-called "transfer payments") to the provinces in recent years. The provincial governments have been carrying out their own funding cuts.
Ottawa wants a hand in the pace and scope of the cuts because it shares the repercussions of cutback decisions in any one province.
Cutbacks are putting wind in the sails of capitalist forces that advocate allowing private health care services to expand. They argue demagogically that private clinics will free up resources in an increasingly burdened public system.
A dual health care system - public and private - is proposed in the program of the rightist Reform Party, the third largest party in the Canadian Parliament.
Ottawa is posturing as a defender of the public system. On October 17, Marleau mused that she might even outlaw altogether the operation of private clinics. But her government's cuts are actually undermining public health care and converging with the Reform Party position.
Marleau's directive on private clinics is a threat to the abortion clinics in Canada because these constitute most of the private clinics currently in operation. The private facilities exist because only one third of hospitals in Canada offer abortion services.
Abortion clinics and health care
Any move against the abortion clinics would be a blow to
health care because they have played an important role in
making abortion safer and more accessible in Canada.
Statistics Canada reported in March that the number of second-trimester abortions had declined from 21 percent of all abortions in 1974 to 10 percent in 1991. The complication rate of second-trimester abortions compared to first-trimester ones, according to the agency, is a whopping 13 times higher.
Wayne Millar, a co-author of the study, attributed the improved safety of abortions to easy access to clinics and women's greater knowledge about complications caused by later abortions.
Thirty percent of abortions in Canada in 1992 were performed in clinics. In 1994, there were more than 100,000 abortions in the country.
An historic victory for women's rights was registered in 1988 when the Supreme Court of Canada ruled as unconstitutional a law that restricted access to abortion. The ruling followed years of mass struggles by supporters of women's right to choose. A subsequent attempt by the federal government to recriminalize abortion fizzled out in the Canadian Senate in 1991.
The 1988 ruling meant that abortion became a decision between a woman and her doctor. Subsequent court decisions have ruled that governments must treat it as a medical service to be funded through the public health care system.
Roger Annis is a member of Local 841 in Montreal of the Communications, Energy, and Paperworkers Union of Canada.