Ontario’s controversial plan to expand the private delivery of public health care raises “legitimate concerns” about whether diverting millions of taxpayer dollars into for-profit clinics could erode equitable access to public health services, says federal Health Minister Jean-Yves Duclos.
Speaking to reporters in Prince Edward Island on Tuesday, Duclos said that Ottawa has no intention of “micromanaging” provincial and territorial hospitals and health systems and that he believes all health ministers across the country want to uphold the principles of the Canada Health Act.
However, he says conversations are needed to ensure moving more public health services into the private sector doesn’t erode the right that all Canadians have to equitable health care access, which is enshrined in that federal legislation.
“There has to be a discussion as to whether investing in the private provision of health care services weakens the public provision of public health-care services, and that’s an important discussion to have,” Duclos said.
The federal health minister was reacting to a three-step plan announced Monday by the Doug Ford government to spend millions to move more health procedures to private clinics in Ontario as a way to tackle long waiting lists.
Initially, the initiative will see simple, non-invasive procedures handled by some 900 privately operated surgical and diagnostic clinics currently operating in Ontario. Future steps of the plan will see hip and knee replacements also handed over to for-profit clinics.
This move alone could provide a windfall of over $500 million annually to private health clinics, based on figures from the Canadian Institute of Health Information that show Ontario performs roughly 32,000 knee replacements and 25,000 hip replacements every year, at an average cost of between $8,000 and $10,000 per procedure.
Ford stressed all surgeries and tests will be paid for by the taxpayer-funded Ontario Health Insurance Plan (OHIP) and that no one will pay for these procedures with their credit cards.
The Ontario plan follows initiatives that have been or are being enacted in Saskatchewan, British Columbia, Quebec and New Brunswick, where some public health services are provided by private clinics or operators but funded by the province.
Duclos acknowledged Tuesday that urgent action is needed to relieve significant pressures in health systems across Canada due to staffing shortages and long wait lists for care — all of which have been exacerbated by the COVID-19 pandemic.
But he says part of his role as federal health minister is to uphold the Canada Health Act, which includes principles that stipulate all Canadians should have equitable access to health care services and that medically necessary care must be provided based on need, not a person’s ability to pay.
“There are obviously conversations around whether the measures that were announced (Monday) in Ontario and similar measures that may be put into place and have been put into place in other places in Canada — (whether) these measures will keep ensuring equitable access,” Duclos said.
“These are legitimate concerns that people are expressing.”
Duclos added that these concerns extend to the question of whether privatization of health-care delivery “may weaken the public system and that if that were to happen, that it would indeed create issues of equitable access to health care services in this country.”
Critics and health-care advocates argue Ontario’s plan is a not-so-stealthy step toward privatizing health care and they worry it — and other initiatives like it across the country — could siphon nurses and other specialists away from already chronically under-staffed public hospitals.
“For-profit health care is never the answer. Doctors and nurses know this,” NDP Leader Jagmeet Singh said in a tweet Monday.
“Will the prime minister stand up for public health care or let Doug Ford cannibalize the system and give taxpayers’ money to profiteers?”
Five major Ontario health care unions issued a joint statement opposing Ontario’s plan Monday, saying they believe patients will wait even longer for care under the proposed plan after front-line public staff are lured to private clinics, where they are often paid more by companies whose primary responsibility is to their shareholders.
“Rather than divert funding from public hospital care to privatized clinics, the government must invest in our cherished public health care system, implement a substantive public hospital staffing retention program and fund its public hospitals at least at the rate of the Canadian hospital average to deal with population growth, ageing and inflationary pressures,” the unions said in a joint statement Monday.
While Duclos acknowledged these concerns Tuesday, he stopped short of saying whether he thought it was appropriate for taxpayer dollars to be used to fund for-profit clinics.
Meanwhile, he said he has been working closely with provincial and territorial health ministers on a deal to increase the Canada Health Transfer in exchange for more “tangible results” from the provinces in a number of key areas.
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Those areas include: better access to family doctors; reducing backlogs to diagnostics and surgeries; enhanced retention programs for health-care staff; more funding for mental health; and providing more access to shared health data.
Ottawa’s attempts to reach an agreement with the provinces comes amid ongoing demands from all 13 provincial and territorial premiers to increase health care funding with no strings attached.
On Monday, Prime Minister Justin Trudeau hinted that “positive steps forward” on a health-care deal would be announced “in the very near future,” but on Tuesday, Duclos threw cold water on the notion such a deal was all but finalized.
“Lots of work still needs to be done before we come to an agreement on the importance of those results and how we’re going to achieve them over the next few weeks,” Duclos said.
“We are all looking forward to a final agreement at some point, but we are all very mindful that there is still a lot of work to do before we get there.”