Orillia doctor, officials weigh in on plan for private clinics

“We really need to do something different to catch up and get these patients into these surgeries,” says doctor Orillia, president of the Ontario Medical Association

The provincial government recently announced plans to invest in private health clinics – a move that local health care providers have mixed feelings about.

With more than 200,000 backlogged surgeries across the province, the government plans to implement its plan to invest in community-based private health clinics in three phases.

The clinics will first come to Windsor, Kitchener-Waterloo and Ottawa to address a backlog of cataract surgeries, among other things, followed by additional investment to allow private clinics to perform more complex surgeries like hip and knee replacements by 2024.

As part of its plan, the provincial government is investing US$300 million in 2022-23 and stressed that care in for-profit clinics would be covered by the OHIP, according to a Jan. 16 press release.

On the one hand, local healthcare providers said they are keen to reduce wait times for surgeries.

“People are waiting far too long for the elective surgeries and procedures like (for) cataracts, hip and knee replacements and some of the diagnostic imaging and CT scans and MRIs, and the pandemic has really made those wait times worse,” said Rose Zacharias, an Orillia-based physician who is currently President of the Ontario Medical Association.

“We really need to do something different to catch up and get these patients to these surgeries, so this announcement is encouraging.”

Done right, investing in private health clinics will free up valuable hospital space, Zacharias said, as numerous elective surgeries can take place outside of hospitals.

“Many of these cases are at risk of being canceled or rescheduled if, for example, they were booked in a hospital operating room and then something more flashy comes along,” she said.

“Imagine someone who’s waiting a year and a half for hip surgery, and on that particular day, there’s a car accident happening on Highway 12 … and we’re dealing with a multi-car collision, and there’s a lot of broken bones … that.” This person’s time slot in the operating room is being postponed, it’s being canceled because it can wait.

Although the province has not yet announced any investments specifically in Orillia, both Zacharias and Carmine Stumpo, President and CEO of Orillia Soldiers’ Memorial Hospital, expressed concern about potential staffing issues in communities like Orillia, where the greatest challenge is closing the hospital get fully occupied.

“Our biggest challenge right now is having … skilled, trained staff who can work in the operating room,” Stumpo said. “We have reached our usual staffing level again and want to continuously increase it in order to be able to offer more cases and more surgeries. Creating new centers will not solve the staffing problem.”

“For us, our focus right now is optimizing our available space because we have the capacity to do more,” he said.

Still, Stumpo said the hospital is “all committed to finding different avenues of care” to reduce the backlog of surgeries caused by the pandemic.”

Zacharias said it is imperative for private clinics and hospitals to work hand in hand to ensure there are enough resources in the community and suggested the possibility for health workers to split time between clinics and hospitals.

If managed properly, such an arrangement could even help with hospital staff who are burned out.

“The staff can work maybe a week in a clinic and the rest of the time in the hospital, and we actually believe that it can even help to keep the staff to deal with the burnout problems that we face, when we have some time in the lower acuity environment. ” She said.

When asked about the ability for wealthy people to enroll in private clinics, Zacharias stressed the importance of screening for surgeries in both public and private settings as needed.

“We absolutely believe that nobody should pay out of their own pocket to jump in line,” she said.

For Elizabeth Van Houtte, a local social worker and longtime Simcoe North NDP candidate, the provincial government’s move to fund private clinics signals a step toward privatizing healthcare in Ontario.

Van Houte highlighted the chronic underfunding of Ontario’s health care system, the wage caps introduced by Bill 124, and her own personal experiences while working in private and public social work settings in Canada and the United States.

She pointed to a recent Toronto Star column that said Ontario would need to spend an additional $7.2 billion this year to average what other provinces spend per capita on health care.

“If you can’t fund a public system, what makes you think you will fund a private system?” she said. “Ontario contributes the least to healthcare. They have the money…they get their down payment from the federal government, and they haven’t used most of the money on COVID — they’ve been sitting on it.”

Van Houtte also argued that the current shortage of health workers was due to both burnout and wage caps introduced by Bill 124.

“If you treat your healthcare professionals (see above) at a 1 percent increase … they just left the profession,” she said. “Where do you get these new people for private clinics from?”

Citing private nursing homes, Van Houtte also stressed that Ontario has tried — and failed — private healthcare options.

“Remember the long-term care facilities? They had the highest death rates during COVID,” she said. “We’ve already tried it. It has failed miserably and long-term care advocacy groups have laughed to the bank and there is evidence… they made inordinate amounts of money during COVID.”

With funding for private clinics planned, Van Houtte worries Ontario could have a split healthcare system and worries residents may need private health insurance to cover a variety of health conditions.

“You’re going to have a split healthcare system, and people are going to have to get insurance,” she said. “Who will pay for this insurance?”

“They have to pay the premiums, or we can download that onto the employers, who (many of whom) aren’t paying benefits now anyway.”

Recalling her complicated pregnancy while working in the United States, which required a long hospital stay, Van Houte said the bill for her stay was over $1 million.

If she hadn’t had coverage footing the bill, she probably wouldn’t have gotten her daughters, she said.

“We didn’t have to pay a dime for it, but that’s the reality. What if I didn’t have insurance? I probably would have gone home. I probably never would have had the kids,” she said.