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U.S. Firms Could Move in on Cdn Health-Care If Private Clinics Used: Expert

Posted on: Monday, 2 April 2007, 18:00 CDT

By KEITH LESLIE

TORONTO (CP) - Relying on private clinics to help deliver on Canada's medical wait-times strategy could result in giant American health-care providers clamouring for access to the Canadian market, former British health minister Frank Dobson warned Monday.

A key plank of the federal Conservative's election platform, wait-time guarantees could see patients who are denied timely care within their own community travel to another city or province, or get care at private clinics.

The problem, as Dobson sees it, is that allowing private, for-profit companies to play a bigger role could eventually weaken Canada's public health-care system to the point where U.S.-based health management organizations would attempt to move in.

"The big companies will start pressing the American government and saying 'under World Trade Organization rules, there should be a free, open international market in health care in Canada,' " Dobson told a news conference at the Ontario legislature.

"I don't think anybody in Canada has been asked to vote for that, but I think there's a real danger that it would happen."

Using private clinics to help lower wait times actually hurt the public health system in the U.K., said Dobson, who noted that the British system is left to deal with the most seriously ill patients.

"The private, for-profit clinics are carrying out the simple, less risky, less costly operations on the healthier part of the population," he said.

"That leaves the (British) National Health Service hospitals carrying out similar operations on the less healthy... in addition to providing intensive care, emergency admissions, training doctors and nurses - all of which are expensive."

Britain's National Health Service saw administrative costs jump from four per cent to 15 per cent when it switched from global hospital budgets to a system of paying set amounts for each procedure in an effort to reduce wait times, he added.

Dobson, who was health minister under Prime Minister Tony Blair from 1997 to '99, said he's not the only current Labour MP opposed to the focus on a competitive health-care market for some surgeries.

"We've had the rather peculiar situation where eight members of the government have been parading outside their local hospitals, in the campaign to prevent closures and cutbacks," said Dobson.

"That includes two or three cabinet ministers protesting against the local impact of the national polices that they subscribed to."

Ottawa is funding pilot projects to explore different ways of providing recourse to patients who can't get care within the guaranteed time limits. In the meantime, each province will decide on its own method of recourse.

Quebec, which has announced guarantees for knee and hip replacements and cataract treatments, allows patients who can't get the care within the time limits to seek attention in private clinics.

A spokesman for federal Health Minister Tony Clement said Monday that Canada does look at the experience of other countries, including the U.K., to see how they've dealt with wait-times strategies.

"Our government has always been clear that guaranteed wait times will be achieved within the publicly funded health-care system, and within the bounds of the Canada Health Act," said press secretary Erik Waddell in an e-mail to The Canadian Press.

"Every step taken to move toward guarantees will provide us with valuable information and experience on how the system can work."

The Ontario Health Coalition, which sponsored Dobson's visit to Canada, said Monday that unlike previous attempts to restructure hospitals, the increasing use of private clinics to cut wait times is reforming the system in ways most people are not even aware of.

"The (Mike) Harris (provincial) government did it through a travelling restructuring commission that made public its plans for each community and with a lot of debate," said spokeswoman Natalie Mehra.

"This particular restructuring is taking place much more under the radar through accountability agreements between the government and hospitals that are not public."

The coalition and the Canadian Union of Public Employees have organized a public speaking tour of Ontario for Dobson, with stops scheduled in the next two weeks in Sudbury, North Bay, Peterborough, Kingston, Windsor, London, Kitchener and St. Catharines.

Source: Canadian Press

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