Ontario is turning to private clinics to reduce wait times, just as Saskatchewan did in 2010..Premier Doug Ford and Health Minister Sylvia Jones announced Monday more cataract surgeries, knee and hip replacements, foot surgeries, and medical scans would be done in private and independent clinics..Such facilities already provide about 26,000 procedures covered by the Ontario Health Insurance Plan each year. The first step in Ford’s new three-phase plan would see an additional 14,000 cataract surgeries done through new partnerships with clinics in Ottawa, Kitchener-Waterloo, and Windsor. An additional $18 million to existing clinics would fund 49,000 more hours of magnetic resonance imaging (MRI) and computerized tomography (CT) scans..Colin Craig, president of think tank SecondStreet.org, welcomed the announcement..“It's a step in the right direction when you have more people working on healthcare, and there's even a little bit of competition for services. That can be very good because it can lead to innovation, and a rethinking of how to do things. And often that can be done more efficiently than what you see in the government,” Craig told the Western Standard..“If you're saving money for a procedure, well, then you can do more procedures too. So that's an added benefit that can lead to shorter wait times for patients.”.Last November, Craig’s organization corresponded with the Saskatchewan Ministry of Health regarding the Saskatchewan Surgical Initiative. When the SSI was launched on March 31, 2010, 15,234 surgical patients had waited longer than three months for surgery, and 1,587 waited more than 18 months. By March 31, 2015, those numbers dropped to 1,751 and 52, respectively. .Since 2010, about 15% of Saskatchewan surgeries have been done privately, though complications from the pandemic bumped this number to almost 20% in 2021-22..“[A]ll procedures were performed below the cost of the public system,” a spokesman for the ministry wrote. “[A]ssessments showed the difference between per-procedure costs in public hospitals and private surgical centres are roughly 35% in plastic surgery and general surgery day procedures, and up to 45% in orthopedic day procedures.”.An analysis of public health data by SecondStreet.org found the number of people who died while waiting for an MRI or CT scan in Ontario more than tripled from 2015 to 2019. From April 2021 to April 2022, almost 2,000 Ontarians died waiting for an MRI and about 5,400 died waiting for a CT scan. Craig said that doesn’t have to be..“They've got these long waiting lists in different areas. And by partnering with the private sector, that's one way they can help reduce wait times,” Craig said..“These clinics have to compete and work hard to earn business and then earn a profit while they figure out ways to do things much more cost effectively, than what you see in government.”.Craig said people are ahead of the politicians when it comes to a greater role for the private sector in health care..A survey conducted by Leger last fall on behalf of SecondStreet.org found 64% of Canadians thought governments should pay private clinics for surgeries and scans to reduce wait times, with just 20% opposed. A more robust 72% thought Canada should act like the E.U. and pay for surgeries in other jurisdictions, with only 14% opposed. They also found 51% of Canadians supported allowing Canadians to pay out of pocket for health care expenses..Janice MacKinnon a professor at the University of Saskatchewan’s school of public health, told Western Standard she finds it frustrating to watch the resistance against private health care in this country..“It's just such an insular debate. Only in Canada do we debate these things,” MacKinnon said in an interview..“What commentators should be focusing on is, is the government doing a good job? Are they signing the right contracts? Let's make sure the contracts are right. And the other job of the government is to ensure all the regulations are enforced, the health regulations, the medical criteria for people who work there. That's what we should be focusing on..MacKinnon, who was Saskatchewan’s finance minister in the 1990s under the NDP government of premier Roy Romanow, said the Saskatchewan government made sure the public sector was not getting pillaged by private clinics because applicants had to submit an HR plan. .“The only 'losers,' the only group that is worse off with private clinics, are unions, because it means there will be more and more jobs in healthcare that are not union jobs. And so yes, they will not have it,” she said..Many clinic staff come out of retirement due to better hours, even though some benefits received by unionized employees are absent, MacKinnon said..“The wages are good. They wouldn't have the same benefits, earned days off, double overtime — they probably don't have overtime. But the advantages to the workers, why it's attractive, think about a nurse getting a nine-to-five, Monday-to-Friday job. If you know nurses, that's one of the big things they have to grapple with, right? Working weekends, working nights, being called in for emergencies, those things.”.Backlogs for surgeries and procedures are nationwide. There were 600,000 fewer surgeries in English Canada during the first 22 months of the pandemic compared to the calendar year of 2019, according to the Canadian Institute for Health Information (CIHI). Over 200,000 Canadians are still waiting for surgical procedures. Even so, Ontario expects its surgical waitlist to shrink to pre-pandemic levels by March..Orthopedic surgeon Dr. Brian Day opened the private Cambie Surgery Centre in Vancouver in 1996 because he was dissatisfied with public facilities. For a decade, he has been embroiled in a legal battle to allow B.C. to have private health insurance — a battle now headed for the Supreme Court. In an interview with Western Standard, he welcomed the Ford government’s decision..“There's the economic advantages that these freestanding centers have built without taxpayer funding. If they work out, they generate revenue for the government. If they fail, the government doesn't lose anything. And, the data shows, again, that procedures he would be contracting out have been done at a lesser cost,” Day said in an interview..“The other thing that's irritating to me how [some people] say this will draw nurses and doctors away from the public system. Nurses and doctors have been drawn away from the public system because of government policies. They'll come back if you get them a good workplace and a good wage. That's what the private sector can do….“Specialists can't get hospital operating times. So it's a lot of misinformation out there that the self-interest groups like the nurses union and leaders [present] … to keep the monopoly. Name me a monopoly that serves the consumer. Well, there is no such one.”.Day, a former president of the Canadian Medical Association, said patients at private clinics are less likely to encounter “superbugs” and complications and preventable deaths. He said the Cambie Surgery Centre has not had a single incident of complications or preventable deaths despite treating 85,000 patients at his clinic..“Everything in the public hospitals is expensive. I go on about this, but Canada has 11 public health bureaucrats for every one that Germany has, and they probably have 30 or 50 for every one that a private clinic has. These administrative salaries are very high, they consume a large percentage of the provincial hospital budget,” Day said..“I used to have a slide that said, ‘Why does the Vancouver General Hospital need nine vice-presidents when the United States can get by with one?’ And guess what they did? They changed the titles of the vice-presidents to corporate directors, [with] only one vice-president.”.That change, made 20 years ago, has been forgotten, something Day complained about on Twitter last September..“Vancouver Coastal Health has 14 Vice-Presidents serving approximately 1.25 million people. The governments of the United States and China have one Vice-President each. Extrapolating, the US needs 264 more, and China needs 1,160 more,” Day joked.
