Совет пациентов в северной Онтарио требует реформы программы компенсации расходов на поездки к специалистам

For many people in northwestern Ontario, seeing a specialist begins with a road trip. It can mean hundreds of kilometres behind the wheel, an overnight hotel stay and meals away from home — sometimes while the patient is undergoing cancer treatment or dealing with a different life-threatening illness. A group of northern patient advocates says Ontario’s Northern Health Travel Grant (NHTG) helps but too often leaves patients paying costs the program doesn’t cover, while also navigating a complicated application process despite being sick. Now, the Community Patient Advisory Council of the All Nations Health Partners Ontario Health Team is calling for changes to the program, beginning with reimbursement rates, and eventually giving patients a formal voice in how the grant operates. “We were aware that there were improvements made in 2024, but they really didn’t go far enough,” council co-chair Rita Boutette said in an interview with Kenora Miner & News. The council began examining the issue in May 2025 after hearing stories from people struggling with medical travel and their grant applications. What began as a local discussion soon expanded as members heard similar concerns elsewhere across the northwest. “We realized that this was a broader issue for all of Northern Ontario,” Boutette said. The Northern Health Travel Grant helps eligible residents of Northern Ontario with travel costs when they must travel long distances for specialized medical care. For patients in the Kenora area, geography can and often does make that trip unavoidable. The council’s briefing material notes a trip from Kenora to Thunder Bay for oncology or other specialized services can approach 1,000 kilometres round trip. Fort Frances residents routinely travel about 340 kilometres each way to Thunder Bay, while patients elsewhere in the North face similarly long trips for care. Boutette said Kenora has some visiting specialists and now has MRI and CT services, but patients still frequently must leave the area for specialized care. “Anything heart-related, cancer-related, eye specialty goes to Winnipeg now,” she said. The distance is only part of the problem. Boutette said winter roads can be dangerous, with stretches where cell service and places to stop are limited. Then there is the cost. She said the current mileage reimbursement does not reflect what patients spend on medical travel, particularly once vehicle costs and overnight accommodation are considered. “You can’t find a hotel room for $150,” Boutette said, describing the difference between the accommodation allowance and what patients can expect to pay near major medical centres. The council is recommending that the province review the per-kilometre reimbursement rate and increase accommodation limits when an overnight stay is medically necessary or a same-day return is impractical. Its briefing note argues medical travel is different from ordinary government travel because patients generally cannot choose when or where they need treatment. Appointments can be time-sensitive, leaving patients with little flexibility to find cheaper accommodation or change their travel dates. Boutette has experienced some of the administrative difficulties herself. She recalled booking a hotel through Expedia while travelling with her husband for his medical care. The reservation was in her name, and she said the accommodation expense was initially not accepted because her husband was the patient. Boutette eventually found a parking tag bearing his name, confirming he had been there. “If you’re not in the know, you’re not in the know,” Boutette said. The council also wants to make the system easier to navigate. Its proposed 2026-27 action plan includes working with 211 and Health 811 to improve information on medical travel supports and exploring a community-based navigator to help patients understand applications, documentation and other available programs. The proposal is particularly aimed at people who may have difficulty navigating the system due to illness, literacy or language barriers, limited digital access, mobility issues, or other circumstances. Council co-chair Kathy Kishiqueb said awareness itself can be a barrier. She said she had not previously known much about the Northern Health Travel Grant and believes many others may not know what assistance is available to them. “There’s just not enough exposure out there in terms of what the Northern Health Grant is about and how you may be able to utilize it,” Kishiqueb said. She also raised concerns about language barriers, noting that some patients may need help understanding program information and completing the application process. Elder Advisor Eleanor Skead also spoke about the challenges patients can face when they have to travel away from their communities for medical care. Their comments reflect concerns identified in the council’s briefing material about language, literacy and digital access, which make an already complicated process more difficult for some patients. The council’s planning documents call for stronger connections among the provincial travel grant, 211, Health 811 and other programs. Some First Nations patients may also be eligible for separate supports through programs such as the federal Non-Insured Health Benefits program. The proposed navigator would help patients determine which programs and supports may apply to them. But navigating the system can be difficult even for people who know health care well. Dr. Jillie Retson, a family physician who has worked with All Nations Health Partners, described her own experience with the travel grant in a video produced by the organization. Retson was diagnosed with stage 4 colorectal cancer and had to travel repeatedly for care, including to Thunder Bay and Toronto. “I did not have any positive experiences using the travel grant,” she said. “It was extremely onerous and difficult during a very hard time in my life.” Retson said she travelled more than 500 kilometres to Thunder Bay, at times during difficult winter conditions, and recalled having four MRIs within two months. When the specialized treatment she needed wasn’t available there, she also travelled to Toronto, where she underwent four surgeries within a year. Getting to Toronto could involve a three-hour drive to Winnipeg, a flight and then ground transportation, on top of accommodation that could run several hundred dollars a night. “The costs were astronomical,” Retson said. Her story was among several collected by All Nations Health Partners as the council documented what medical travel looks like from the patient’s side. Those accounts helped shape a three-stage proposal. In the short term, the council wants reimbursement levels and overnight accommodation limits reviewed. Over the next 6 to 12 months, it proposes improved navigation support for patients applying for the grant. Longer term, it wants Ontario to establish a formal patient advisory mechanism specifically for the Northern Health Travel Grant. Kim Elke, a project manager working with the council, said there is currently no patient advisory body at the provincial level that specifically informs the program. The council’s briefing note says patient advisory groups connected with three northern Ontario Health Teams have reported similar concerns, including out-of-pocket expenses exceeding reimbursement, difficulty navigating applications, and, in some cases, delayed or missed appointments due to upfront costs or administrative barriers. The group is not proposing that every change happens at once. Instead, its plan calls for changes to be introduced and evaluated in stages, including examining whether navigation services are reaching rural and remote communities, whether patients are successfully connected with available supports and whether better travel coordination reduces missed appointments. The council also intends to seek support from other Ontario Health Teams and patient advisory groups and continue discussions with elected officials and the province. For Boutette, the issue comes back to a reality northern residents have little control over: if the care they need isn’t available at home, travelling for it isn’t optional. For someone already dealing with a serious diagnosis, she said, figuring out how to pay for the trip and navigate the paperwork can become another burden at precisely the wrong time. The council wants the travel grant to recognize that reality — not only in what it reimburses, but in how patients are helped through the process.