Ontario tables health-care bill to expand role of private clinics

The Doug Ford government has tabled a bill meant to reduce surgical backlogs by allowing more private clinics to open and conduct OHIP-covered surgeries, while also designating organizations to provide further oversight.

Health Minister Sylvia Jones introduced the bill—titled Your Health Act—Tuesday afternoon.

“With the Your Health Act, Ontario is boldly breaking with a status quo that has stifled innovation, and struggled to respond to growing challenges and changing needs,” Jones said in a statement.

“Instead, our government is being bold, innovative and creative. We’re making it easier and faster for people to connect to convenient care closer to home, including and especially the surgeries they need to maintain a high quality of life.

Many of the details of the legislation were slowly released over the last month as part of the province’s newest health-care plan, titled “Your Health: A Plan for Connected and Convenient Care.”

Elements of this plan include expanding the role of private clinics to allow them to conduct cataract surgeries, MRI and CT scans, minimally invasive gynecological surgeries and, eventually, knee and hip replacements.

Health-care experts and advocates expressed concern about oversight, staffing, and upselling when the plan was originally introduced. The legislation appears to try and address some of these apprehensions, although the details are still vague.

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Under the bill, new community surgical and diagnostic centres will need to show how they will “promote connected and convenient care” by improving wait times and the patient experience. They will also have to provide a description of health-system partners, apply for a licence, and prove they have a staffing model that won’t detract from other facilities, such as hospitals.

It is unclear how long it will take to go through the application process or how many new clinics will obtain a licence under this new system.

Speaking with reporters after introducing the bill, Jones said there would not be a cap on the number of clinics allowed to open.

‘BUSINESS MODEL’ ALLOWS FOR LACK OF TRANSPARENCY: NDP

Jones said there will be elements of the application process and the agreements that will be kept private due to the “business model nature.”

It is unclear as to what this will include.

The minister did say, however, that the standards clinics must adhere too will be made public.

“What I know is that people should not have to wait for months for diagnosis, and if necessary, surgeries,” she said.

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The province will designate “expert organizations” that will work with Ontario Health and the Ministry of Health to ensure quality and safety standards are met.

In a statement, the province said they are working with front-line partners to determine what organizations are best positioned for the job.

When asked by reporters who the potential regulators may be, Jones would only say “there are a couple options on the table.”

NDP Leader Marit Stiles said their party has concerns about the lack of oversight and the impact that could have on the health-care system as a whole.

“We don't know, and we won't know, what the cost is for the services that are being provided versus how much the ministry is actually paying them. That's because, as the minister said, this is based on a business model,” she told reporters.

“We're getting signals here that we're not going to have all the information and we won't have the transparency and accountability that this system needs.”

The bill also follows through on Premier Doug Ford's pledge to let Canadian health-care workers registered or licensed in other provinces to immediately start to practice in Ontario.

These workers will not need to wait until their registration with a regulatory college is complete before starting their jobs.

“These changes will help health-care workers overcome bureaucratic delays that have made it difficult to practice in Ontario,” officials said.

‘A SIGNIFICANT PIVOT’ FOR HEALTHCARE

Ontario Liberal Health Critic Dr. Adil Shamji said that while there may be a role for not-for-profit clinics in the province’s health-care system, it isn’t the solution to the health-care crisis.

He said there is “no ambition” by the Ford government to address root causes of the crisis.

“I'm not trying to be absolutist or ideological, but to make a massive pivot, particularly to one which is very clearly been signaled a move to for-profit healthcare, without addressing the root causes that are handicapping our health-care system, is disingenuous.”

Shamji provided examples of how patients could be upsold, which included the purchase of more expensive and higher-quality lenses for cataracts surgery, which may be available quicker than the OHIP-covered item.

There may be other diagnostic tests or pre-surgery interactions that could cost patients money.

Under the Your Health Act, the clinics will be required to allow patients to use their Ontario Health Insurance Plan (OHIP) card to pay for services.

“If passed, no centre will be allowed to refuse service to someone because they choose not to purchase upgrades, such as an upgraded cataract lens, and people cannot pay an additional fee to receive services faster than anyone else,” the government said.

However, it does not specify that the clinics cannot also offer alternatives.

Each centre will also be required to have a process for complaints that patients can use if they do not believe they received the highest level of care.

“If patients are not able to have their complaints addressed at the centre, they will be able to seek help from the patient ombudsman.”

Jones said the amount of time it would take for the patient ombudsman to review complaints depends on the “complexity of the complaint.”

The ombudsman will, Jones added, share the information of the complaint as well as the results publicly.