New rules to shield private clinics from public scrutiny

Posted on April 6, 2023 in Health Policy Context

Source: — Authors: – Opinion/Contributors
April 6, 2023.   By Linda McQuaig, Contributing Columnist

Ontario’s privatization director will have sweeping powers and little public accountability.

As Premier Doug Ford embarks on his privatization blitz of our health care system, there’s a nagging question.

If the purpose of opening a slew of new private clinics is to reduce Ontario’s surgical backlog, why does the enabling legislation do so many other things — things that will dramatically reduce public accountability and leave our precious public health care system vulnerable to corruption?

It’s a question that urgently needs to be answered as Ford plows ahead with privatization plans that are huge in scope and ominous in design.Fullscreen

Of course, what makes his whole privatization project so dubious is that, as a number of doctors have noted, we could deal with the surgical backlog simply through better use of existing hospital operating rooms.

Dr. Michael Warner, medical director of critical care at Michael Garron Hospital, says wait times could be quickly reduced if operating room hours were extended by even just two hours a day. Imagine if they were extended by four or five hours a day!

Instead of working on this simple, low-cost solution, the premier plans to invite in private companies — potentially including large multinationals notorious for driving up U.S. health care costs — to set up clinics where they will perform up to 50 per cent of all surgeries in Ontario (that is, the uncomplicated ones where profits will be easy and large).

These clinics will be funded through our public system and will also be allowed to sell expensive extras to patients at a time when their judgment may not be best.

Ontario already has private clinics. But the government is greatly expanding them in number and function and carving out a whole new zone within our health care system where they’ll be allowed to operate with far less public accountability, scrutiny and oversight than is currently required of private clinics.

A key difference, created by the new legislation, Bill 60, removes the requirement that the director overseeing private clinics be an employee of the Health Ministry and therefore be subject to all the strict rules for conflict-of-interest, public and financial accountability that govern the public service.

This raises the possibility that Ford could appoint a crony, a lobbyist or even a corporation closely tied to the industry.

Bill 60 imposes no financial disclosure requirements on the director, who will have sweeping powers over the awarding of lucrative clinic licences.

This means the director could own stock — or have relatives who own stock — in the very companies being awarded licences and yet there would be no way for the public to know this, says Natalie Mehra, executive director of the Ontario Health Coalition.

The rules governing inspections are also being loosened, even though the Auditor General has already expressed concerns about private clinic inspections. Gone is the requirement that clinics be inspected by the Ontario College of Physicians and Surgeons. No new inspecting authority is identified. Perhaps the clinics will inspect themselves?

Interestingly, the Ford government carefully avoids the term “private clinics,” referring to them instead as “Integrated Community Health Service Centres.”

Why shroud these clinics in such misleading language?

In fact, we already have Community Health Centres, which function as you’d expect a community centre to function — no one makes a profit, they’re run by democratically elected boards and are subject to full public accountability. They’re popular and could have served as a model for an expansion of clinics.

Instead, without any public consultation, Ford is creating a special zone where a large number of new private clinics — performing core functions currently performed only in public hospitals — will be shielded from the prying eyes of concerned citizens and stripped of existing protections that were put in place to ensure high standards and prevent corruption.

Perhaps we can trust Doug Ford to ensure there won’t be corruption, extreme profiteering or diminished standards in these clinics. But then why did he introduce legislation that opens the door to all these possibilities?

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