A surgery is performed in the operating room in Toronto's Hospital for Sick Children in November 2022.Chris Young/The Canadian Press
The Ontario government has passed a landmark health bill to shift more surgeries out of hospitals and into new or expanded private clinics, despite warnings from opposition politicians and advocacy groups that the move threatens the public system and will siphon away scarce nursing staff.
The Progressive Conservatives approved Bill 60 on Monday, legislation the governing party says is needed to speed up wait times for cataracts, knee and hip operations and to clear up backlogs exacerbated by the COVID-19 pandemic.
Opposition NDP Leader Marit Stiles called the bill the “one of the greatest threats to the right to public health care that we’ve seen in our province for generations” and vowed to repeal it if her party wins power in the next election, which is not scheduled until 2026. The Liberals said the new bill needs more “guardrails” and that all of the clinics should be non-profits.
Premier Doug Ford rose to defend the bill in the legislature, pointing to endorsements for his plan by the Ontario Medical Association (OMA), which represents doctors, and the Ontario Hospital Association (OHA), which speaks for hospital administrations.
Mr. Ford said little about Bill 60 itself, but accused both the Opposition NDP and the former governing Liberals – whom he first defeated in 2018 – of neglecting the health care system. He also pointed to his government’s increases in health care spending and the record number of new nurses registered in the province last year.
“We’re fixing health care,” the Premier said. “We’re ending this hallway health care that you created, and we’re bringing health back to the standards of a world-class health care system, the best in the world.”
Ms. Stiles said the ability of the new clinics to lure burned-out nurses will mean more emergency room closures, of which Ontario has seen many, as its hospitals face personnel shortages. She also warned of a “two-tier” health system, saying the bill will see U.S.-owned private clinics “upsell” patients on enhanced procedures or charge them extra to skip waitlists.
The NDP Leader said B.C. and Quebec have “curtailed their use of private for-profit clinics.” While B.C. recently purchased two private clinics, Quebec is still going ahead with plans for new private mini-hospitals while pledging a crackdown on private nursing agencies.
Neither Mr. Ford nor his Health Minister, Sylvia Jones, took questions from reporters on Monday. Both have said all of the procedures moved to private clinics will be funded by Ontario Health Insurance (OHIP), and that no one will pay out of pocket. Ontario already has more than 800 private clinics, most of which do diagnostic tests, as well as a small number of private facilities that do other outpatient procedures.
Anthony Dale, president and chief executive of the OHA, said in an interview that he was confident the government will consult hospitals as regulations are rolled out for the new system. The government has said the new clinics must have connections with hospitals and that staffing in the public system must be kept stable.
“So far our engagement with the ministry suggests they’re very alive to these considerations,” Mr. Dale said.
Meanwhile, the OMA has called for this kind of specialized surgical centre, but it had previously said they should be non-profits. The association’s president, Andrew Park, said allowing for-profit facilities was not a deal-breaker – as long as no one is denied access or forced to pay for publicly insured services, which would be illegal under the federal Canada Health Act.
“Your family doctor’s office is a for-profit business,” said Dr. Park, an emergency room physician in an interview. “It’s a private business within a publicly administered health care system. The priority is universal access.”