It was bad enough when one of their town's few doctors left to take a new job. But when Dr. Thomas MacKey's patients in Perth, Ontario learned their medical records were also gone -- and they'd have to pay to get copies -- they were outraged.

"Our medical records are being, I guess you could say, held hostage," former patient Sandra MacGregor told CTV News.

When Dr. MacKey left Perth to take a new job in nearby Smith Falls, he had no other doctor to take over his practice -- a growing problem across the country, brought on by Canada's doctor shortage. MacKey put an ad in the local paper telling his 3,500 patients their records were now with a medical file storage company in suburban Toronto. But when they call the company, patients are told if they want their records photocopied, and sent to them, they will have to pay a fee.

The storage company, Green and McQueen, is only five years old, but it's quickly become Canada's largest medical file storage company. It now holds thousands of patient files for more than 500 Canadian doctors from six provinces. Green and McQueen told CTV News they charge patients a maximum of $300 per file for photocopies.

"I can't afford it," Perth resident Pauline Wilson said. "I'm a waitress. I don't make a lot of money. That's more than a week's salary for me."

MacGregor told us a specialist needs to see her records next month -- but she also can't afford the fee. Green and McQueen quoted her a reduced family rate of 15 per cent off for her and her two grown children.

"It's (still) over $700 for myself and my two children to get our medical records, which is outrageous," said MacGregor.

Wilson said even her 23-year-old son was told he would have to pay more than $100.

"For him especially, $117 is awfully unreasonable for what it would be. (His file) would probably fit in a small envelope," Wilson said.

MacGregor added that "I think there's no way it would cost $300 to photocopy the information."

Green and McQueen's Director of Operations, Gwen Watts, told CTV News the fees cover more than just photocopying. "It's actually the locating of the records, the copying of the records and the administration cost."

Every province in Canada holds doctors responsible for storing their patient's records - for up to 10 years. Legally, the record does not belong to the patient, it belongs to the doctor. That system worked fine when retiring doctors had other doctors to replace them, but it doesn't work that way anymore. Green and McQueen offers retired doctors two years free file storage -- then charges them for storage beyond that time.

"The patient says to me, why should I pay?" Watts told CTV News. "Well, who should pay for it? We are a private business."

Watts said she would welcome government subsidies to cover the cost she passes on to patients. She also gets a lot of questions about confidentiality, she said -- and stressed the company has very strict rules about who gets to see what in the patient files.

"We run an extremely tight ship," Watts said. "It would be detrimental to our business if we had a (privacy) breach."

The whole problem of storing paper medical records could be solved, though, if all of Canada's doctors just used computers instead of paper to store their records. Ottawa has tried to make that happen, but so far it hasn't been all that successful. Since 2001, Canadian taxpayers have poured $1 billion into a national plan to convert medical information to electronic formats, called "Canada Health Infoway." Despite that investment, Canada Infoway told CTV News approximately 80 per cent of Canada's physicians are still not keeping records online. The goal is to get 50 per cent of the system computerized by 2010, but according to the province's health ministers, that will take even more money.

"We're very hopeful that the federal budget forthcoming will make a greater contribution to Canada Health Infoway, which is at the point where it is pretty much out of capital," George Smitherman, Ontario's Minister of Health, told CTV News.

"This is an area where all provinces have worked hard, but it's certainly an area that does call for greater investment in terms of building the electronic health record capacity," Smitherman said.

"Just do it," MacGregor said, when CTV News told her about Smitherman's comments. "Then there wouldn't be this paper trail and photocopying to be done."

Wilson's answer was just as direct.

"If you can't get the files electronically and you've got (Ottawa) spending a billion dollars trying to do it -- just give me 300 bucks so I can get my file."

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