A senior Progressive Conservative government source told The Globe and Mail the province will increase the number of surgeries and procedures being done at the province’s existing private clinics, using only existing staff.Chris Young/The Canadian Press
Ontario will immediately ramp up the number of surgeries done at private health care clinics while assuring critics that a further expansion of these facilities won’t siphon personnel away from the short-staffed public system, according to plans set to be unveiled early next week.
A senior Progressive Conservative government source told The Globe and Mail the changes include an initial increase of the number of surgeries and procedures being done at the province’s existing private clinics, using only existing staff – meaning there could be no effect on scarce hospital resources.
The source also said the government will outline a further expansion of the role of what it calls “community clinics” and “independent health facilities” to do even more surgeries. However, the government will include “specific measures,” which the source did not detail, meant to protect staffing in public hospitals. The Globe is not identifying the source as they were not authorized to speak publicly about the plans.
Premier Doug Ford and Health Minister Sylvia Jones have repeatedly said all patients would still have their procedures covered by the Ontario Health Insurance Plan – and not their credit cards. Many publicly-funded health services in Ontario, such X-rays, blood tests and ultrasounds, are performed in private-sector facilities, while a small number of other specialized private facilities do some OHIP-covered surgeries.
But critics charge that allowing more surgeries in private clinics can only worsen the crisis in the province’s hospitals, where staff shortages amid waves of COVID-19 and other respiratory illnesses have made wait times explode and even forced the temporary closing of some emergency rooms in recent months.
Opposition politicians and health care activists have warned that new private clinics will lure nurses and other staff away from the public system, where they are needed most. The College of Physicians and Surgeons of Ontario, which would inspect any new private health clinics, issued a statement this week saying the idea would worsen staff shortages and lengthen wait times for more urgent hospital care.
Proponents say moving more low-risk surgeries out of hospitals and into smaller, specialized and more efficient facilities – whether for-profit or not-for-profit – is a key way to dig out from under Ontario’s massive backlog in procedures that multiplied during the pandemic. The Ontario Medical Association has called for a similar scheme: Its plan would see the new clinics operated as non-profits affiliated with hospitals.
The government has already been boosting the number of surgeries performed at the handful of these facilities in the province that currently do outpatient surgeries, such as knee replacements, in the wake of the pandemic. And Mr. Ford and Ms. Jones have signalled in recent months that more changes were coming.
In August, as part of the province’s “Plan to Stay Open,” Ms. Jones pledged to increase the number of publicly funded procedures done in “existing private clinics,” as well as to “consider options” for doing more at “independent health facilities.”
John Yip, president and chief executive officer of SE Health Care, a non-profit home care provider, says shifting more surgeries to community clinics – either for-profit or non-profit – is a much needed step, one he has been pitching to government officials for years.
A former head of Toronto’s Kensington Eye Institute, a not-for-profit, standalone clinic that does eye surgery, Mr. Yip told The Globe in an interview that SE Health could be interested in setting up a surgical centre under Ontario’s new model.
He said surgical centres that do non-urgent and simple procedures would be a “pressure valve” for overstretched hospitals that must care for a wide variety of much sicker patients, including people suffering from heart attacks or injured in car accidents. As many as half of procedures done in hospital don’t need to be performed there, he said.
Mr. Yip dismisses the argument that such clinics would poach scarce hospital workers, saying only improved working conditions in hospitals can alleviate the problem of staff who, burnt-out by the pandemic, are leaving demanding front-line jobs.
“It’s a myth that we’re cannibalizing hospital staff,” Mr. Yip said. “Staff have already left the hospitals. … If you are going to stem that loss, change the work-life balance.”
Ross Sutherland, chair of the Ontario Health Coalition, a group backed by health care unions, said the government should spend more in the public system rather than moving surgeries into private clinics.
“Private clinics don’t grow staff on trees, what they do is they take staff from the public system,” Mr. Sutherland said in an interview with The Globe. “They’re better off to use hospitals and increase funding.”
The Opposition NDP’s health critic, France Gélinas, said private clinics are more likely to charge patients for “add-on” services above those covered by OHIP – a problem previously identified by the province’s Auditor-General.
And she warned the move would open a door to more privatized care, as companies that invest millions of dollars in new clinics seek healthy returns.
“You ask any Canadian, we are proud of Medicare. We don’t want to be like the States. We’re proud of what we have,” she said. “There is a lot of money to be made in health care.”
With a report from Dustin Cook
Editor’s note: An earlier version of this story misidentified John Yip as a doctor.