Private clinics ruining public health care

Maude Barlow
The Chronicle-Herald (Halifax)
May 7, 2008

Private clinics are spreading like bad weeds across the country, welcomed by a federal government that is content to look the other way while these for-profit ventures offer health care for a price.

Last weekend, health coalitions, citizens’ groups and other organizations that support public health care confronted the federal government’s abandonment of the public health care system. People across the country raised a united voice to say that these private clinics continue to pose a real threat to the future of public health care in Canada.

It may seem easy to dismiss the clinics merely as service providers, filling a niche where people can pay money if they want to access surgeries, medical procedures and even family doctors. If people have the extra money, why shouldn’t they be able to pay for something as personal and essential as health care?

The fact is that Canada does not have enough trained doctors, surgeons, specialists, nurses or other health care providers. The professionals who practise in private clinics are spending their time away from the public system where there are arguably more people with greater needs – including the elderly, the disabled and the chronically ill. Private clinics may be able to help some, but they are the advantaged few. Everyone else is left with even longer waiting times or without access to family doctors.

Examples across the country show how health care privatization is moving forward with the blessing and encouragement of provincial governments and the laissez-faire approach taken by the Harper government, which refuses to acknowledge blatant violations of the Canada Health Act.

The recent release of the Canada Health Act Annual Report shows just how much the federal government is willing to turn a blind eye to private clinics that violate the letter and the spirit of the Canada Health Act. In 2006, British Columbia was the only province to be fined for violations – at a sum of $29,019. B.C. Health Minister George Abbott quipped that the fine levied for private surgical clinics would fund the province’s health care system for about 65 seconds.

There are clear examples across the country of the growing surge of private clinics. Canadian Medical Association president Dr. Brian Day has publicly admitted to taking people’s money for surgeries at his Cambie Surgery Centre in British Columbia. The B.C. government has done nothing about it. Businessman Donald Copeman has been operating a medical centre in Vancouver that requires people to pay an enrolment fee before they can see a doctor. The B.C. Medical Services Commission has ruled it legal, although the details of the findings have not been released to the public. Other Copeman clinics are planned for Calgary and Toronto.

In Quebec, the recent Castonguay report has opened the door to increased privatization, as recommendations include the use of private clinics to reduce waiting lists and allowing doctors to work in both private and public systems. Similarly, the Nova Scotia government recently announced it will be spending $1 million to get the private, for-profit Scotia Surgery clinic to perform surgeries.

Why public, not private?

There is no dispute that there are problems with wait times in Canada, particularly for non-life-threatening surgeries like hip and knee replacements. But there are many examples of how wait times can be reduced through publicly funded and publicly delivered models. Streamlining waiting lists, offering multiple services under one roof, and providing dedicated operating room times are all ways the public system can deliver better and quicker health care.

A public system is better for everyone because it means health care dollars are spent on patient care rather than private clinic profits, and services are provided in accountable facilities rather than ones that are not nationally regulated.

Consistently, polls have shown that Canadians’ support for a public medicare system never wavers. Public health care is seen and respected as a foundation for our society. The federal government has a duty and responsibility to protect and enhance the public health care system – and not let private clinic owners fuelled by profits systematically dismantle it.

Maude Barlow is the chair of the Council of Canadians and author of Profit Is Not the Cure: A Citizen’s Guide to Saving Medicare