'A nasty issue that has festered': B.C. pays almost $400M to private clinics

Hundreds of millions in taxpayer dollars have gone to private for-profit clinics in B.C. providing surgical and medical imaging services, according to new report by a left-leaning think tank and an advocacy group – but the province's health minister is disputing the researchers' conclusions.

The study, titled “The concerning rise of corporate medicine” and co-presented by the Canadian Centre for Policy Alternatives and the BC Health Coalition, found in the province’s health authorities shelled out $393 million to the clinics over six years, all but the first under the NDP government, with a 57 per cent surge in annual payments from the 2015/16 fiscal year to 2020/21.

Andy Longhurst, a health policy researcher at SFU and a research associate with CCPA, slammed the NDP government for its increasing reliance on private for-profit companies to catch up on delays for medical imaging and day-surgeries in the public system.

“It is a nasty issue that has festered and we need the provincial government to address the issue head on, of extra billing, and then have a strategy to wean the province off and build that public capacity," he said.

“We're seeing a pretty noticeable upward trend in terms of the contracting to private surgical clinics and we've seen a levelling off of the contracting out to medical imaging clinics – but that said, the overall expenditure to private medical clinics in the province is still larger than what we spend on private surgical clinics."

HEALTH MINISTER RESPONDS

When CTV News raised the report with the health minister and asked whether enriching private clinics provided good value for taxpayers' money, he raised questions about the accuracy of some of the numbers and was adamant that the conclusions were false.

“The suggestion we're silently supporting private health care is wildly inaccurate,” said Dix. “It's always patients first, and the best way to serve patients is to build a public health-care system, that's precisely what we did, what we've been doing and what we'll continue to do."

However, when pressed by reporters, Dix defended the use of private clinics to play catch-up. 

“Having a small number of surgeries that increase our capacity, as long as … there's no extra billing and they follow the Medicare Protection Act, I don't have any objection to that,” he said. “In fact, I think we've continued that.”

As CTV News was first to report in March, $27.2 million was spent in the last fiscal year alone in an effort to catch up on postponed surgeries and medical imaging due to the pandemic, but the Ministry of Health also acknowledged that day procedures at private clinics had accounted for 3.5 per cent of total surgeries in 2018/19, growing to 4.4 per cent in 2020/21.

WHATEVER IT TAKES TO RECOVER

The province’s surgeons are emphasizing that not only is it an emotional and psychological burden for patients waiting months or years for operations, they also deteriorate physically with increased disability, pain and suffering.

“Patients don't care where it gets done they just want that surgery to happen, and if it happens to be down the street at a private surgical centre still paid for by the government, they don't care,” said. Dr. Cassandra Lane Dielwart, president of B.C. Orthopaedic Surgeons. “As surgeons, we don't care, we just want to get those patients treated and off the waitlist.” 

Longhurst pointed to multiple studies showing parallel public-private health-care systems end up with private companies benefiting, since they offer better pay and working conditions, and that further undermines the public system. But Dielwart points out the current working conditions have some staff walking away from medical careers altogether. 

“A lot of nurses are trying to leave the profession and thinking about retail, thinking about the service industry because at the end of the day there's a lot less stress and the pay's not that different,” she said.

“Technically we're running all these operating rooms but they're not running efficiently because we don't have the staff – so on my orthopaedics ward I walk in and the nurse says ‘we've got zero beds available, 12 (patients) on the slate and four nurses short.”

Procedures are cancelled, staff and patients are frustrated and Dielwart says as a result, “the morale is terrible.”