Health authority contracts with for-profit surgical and diagnostic imaging clinics topped $393 million between 2015/16 and 2020/21 – with total annual payments increasing by 57 per cent over that period.
That’s according to a new report from the Canadian Centre for Policy Alternatives - BC Office and BC Health Coalition analyzing public financial documents.
“We’ve seen some positive recent moves by the BC government to enhance access to MRIs and reduce surgical waitlists in the public health care system,” says author and health policy analyst Andrew Longhurst.
“But these numbers show a troubling continued reliance on contracting out to for-profit clinics.”
Longhurst says contracting out subsidizes the growth of a for-profit industry that is contributing to staffing shortages in the public health care system.
He also points to the abundance of Canadian and international research showing that private delivery is more costly, is associated with poorer outcomes and fails to reduce wait times over the long term.
Longhurst is particularly troubled to see substantial health authority payments going to private clinics known to have engaged in extra-billing – an unlawful practice that allows wealthier patients to jump the queue by paying privately for medically necessary health care.
“Instead of tackling unlawful extra-billing head on, the province’s strategy has been to increase outsourcing to private surgical clinics but make those contracts subject to compliance with provincial and federal law. In other words, we’re using one form of privatization (outsourcing, or contracting out) to curb another (two-tier health care where those who can afford it pay privately),” he says.
That strategy is reflected in correspondence between the owners of False Creek Healthcare Centre and the Deputy Minister of Health, obtained by Longhurst through a Freedom of Information Request.
In an email exchange following a meeting, the corporate representative expresses his appreciation that the provincial government will provide “long-term, volume guaranteed contracts which will enable us to make an informed decision on the long term sustainability of this business model.”
False Creek Healthcare Centre is one of the largest private clinics in BC and has continued to receive public funding despite a recent BC government audit finding the clinic engaged in unlawful extra-billing.
Longhurst acknowledges that COVID-19 has put extraordinary pressure on public health care across the country, but says governments should resist the temptation to add short-term surgical and diagnostic capacity by funneling public dollars to for-profit corporations.
Longhurst says BC can address wait times more efficiently within the public health care system by further increasing public surgical and diagnostic capacity, scaling up successful strategies like centralized waiting lists and pre-screening by teams of health care professionals and reducing the need for hospital care with more emphasis on primary and community-based care (especially for seniors).
“The provincial government has taken important steps in these areas in recent years, but it needs to put a stop to unlawful extra-billing and ramp down its reliance on for-profit clinics,” he says.