Opposition parties say a new bill that would allow some surgeries to take place outside of hospitals could open the door for multinational health-care companies to operate in New Brunswick.
An Act Respecting Surgical Facilities will allow regional health authorities (RHA) to enter into agreements with health-care providers to provide surgeries in private clinics, in order to free up operating rooms for more complicated procedures. A pilot project providing cataract surgeries in a Bathurst clinic is already underway.
But the wording of the bill doesn’t limit who an RHA can enter into an agreement with, meaning they could theoretically strike a deal with a multinational health-care company to open a for-profit clinic in the province.
“I feel that it’s open-ended and they can still go down the slippery slope of privatization and bringing in outside corporations,” said Liberal house leader Rob McKee.
The bill allows “a person” to enter into an agreement with the RHAs to provide surgical services. As Green Leader David Coon points out, that’s a wider definition than it might initially appear to be.
“The legal definition of a person includes an individual like you and me and a corporation the size of Amazon, so that’s the problem with the way it’s defined and the nub of the problem with the bill,” he said.
Health Minister Bruce Fitch said that’s not the intent of the bill and that plenty of safeguards to prevent a health-care corporation from operating in New Brunswick already exist. He says anyone, or any entity, entering into an agreement with an RHA must have a billing number and be licensed to practise in the province.
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“There are many safeguards that are in place right now that will prevent a multination coming in and setting up wherever they want,” he said.
But both opposition parties say that isn’t made clear by the bill or the legislation it will amend.
Coon tried to amend the bill to ensure that clinics providing surgical services are owned publicly, but that was defeated by the government. The Liberals tried to add that a person providing the services must be registered by the New Brunswick College of Physicians and licensed to practise in New Brunswick, but that, too, was unsuccessful.
Fitch said the Liberals’ amendments would make the bill unworkable and get in the way of its stated purpose, to allow for surgeries to take place outside of hospitals.
Ultimately, the opposition wants the bill to explicitly rule out multinational corporations providing health-care services in the province. McKee said he wanted to work with the government, and its lawyers, to try and make that a reality.
But in its current form, he worries there is nothing to stop the RHAs from entering into agreements with out-of-province corporations down the road.
“They’re giving us indication that the RHAs will not enter into agreements with foreign international types of companies, but like I said, we’re signing a blank cheque, we’re giving blind faith to the RHAs to not overextend their power,” he said.
“They will, as it stands, be able to go out and make those agreements, even though the minister says they won’t.”
The government defeated another amendment to the bill that would have allowed surgical abortions performed outside of hospitals to be covered by Medicare. As part of the changes introduced by the bill, radiology clinics will now be covered under Medicare, and Coons’ amendment would have done the same for surgical abortions.
New Brunswick is the only province that doesn’t fund out-of-hospital surgical abortions through Medicare. The government has maintained that it is meeting demand and access is adequate.
Surgical abortions are available at three hospitals in the province: one in Bathurst and two in Moncton. Medical abortion is also available, with doctors authorized to prescribe Mifegymiso, the so-called “abortion pill.”
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