While initially billing it as a way to deal with a surgical backlog worsened by the COVID-19 pandemic, Ontario Premier Doug Ford has confirmed the expansion of publicly funded medical procedures at private clinics will be permanent.
Ford and Health Minister Syliva Jones announced the three-step plan on Monday that will allow public health services such as surgeries and MRI and CT scans to be delivered by for-profit facilities.
"Ontarians are still waiting too long for treatment and surgery and more needs to be done," said Jones. "Community and surgical diagnostic centres have been valuable partners toward our pandemic response and addressing the surgical backlog. That is why we are taking further action."
The first step of the phased-in approach will add 14,000 cataract surgeries a year through "new partnerships" with community surgical and diagnostic centres in Windsor, Kitchener-Waterloo, and Ottawa. That represents roughly 25 per cent of the province's current wait list for the procedure, according to Jones.
Ontario will also add over $18 million into existing centres for MRI and CT scans, ophthalmic surgeries, minimally invasive gynecological surgeries, and plastic surgeries such as hand soft tissue repair.
The second step will "further reduce wait times", by expanding the scope of community surgical and diagnostic centres to include more non-urgent, low-risk and minimally invasive procedures like colonoscopies and endoscopies. The third and final step will grant these clinics with the capability to conduct hip and knee replacement surgeries as early as 2024.
"This plan will boost the availability of publicly-funded services in Ontario, ensuring that Ontarians currently waiting for specialized service will have greater access to world-class care where and when they need it," said Jones. "Bold solutions are necessary to improve the health care system as we know it today."
Both Jones and Ford stated all of the procedures in the three-step plan would be covered by the Ontario Health Insurance Plan (OHIP). However, neither took a hard line when asked about clinics trying to upsell patients on items such as enhanced lens for cataract surgery. Jones said a patient concerned they were forced to pay for an item or procedure that is covered by OHIP can file a complaint which could result in a refund. Ford simply stated the main goal of expanding these procedures is to tackle surgical backlogs without outlining how upselling will be prevented.
When asked whether the allowance to perform these publicly funded surgeries would be removed from private clinics once the backlog is cleared, Ford clarified the legislative changes would be permanent.
"The reason being, we have an aging population. Baby boomers like myself, eventually get up there and we need more care. We have newcomers coming into Ontario to a tune of about 300,000 a year for the next ten years," said Ford. "So we are going to be creative and take the best ideas from around the world, from around our country. Look at B.C., look at Alberta, look at Quebec. They're delivering it a little differently and they're being successful."
At present, there are about 900 privately operated surgical and diagnostic clinics located in Ontario. Jones confirmed additional licences are likely to be granted for more such clinics in the province going further. She added that "strengthened oversight" for these clinics will be introduced with new legislation next month.
Meanwhile the chorus of voices objecting to the province's privatization of the health-care system is growing. Five major health-care unions issued a joint statement against the plan on Monday. The unions argue this move will further starve the public system of both funding and frontline staff. They call it a "risky venture that will cost Ontarians dearly and damage access to public care.”
The Ontario Health Coalition said Ford's move to shift more surgeries and procedures into for-profit centres is a “fatal threat” and “terrible blow” to public hospitals.
"If they turn over a significant portion of our public hospitals’ surgeries to for-profits, we will not be able to protect patients against extra charges of thousands of dollars for needed care and from manipulative extra upselling," said Natalie Mehra, the coalition's executive director. "The fact is that no one has been able to control the private for-profit clinics where they have sprung up in Canada, and Ontario has done a particularly terrible job of controlling for-profit healthcare companies in long-term care and other sectors.”