The Ontario Health Coalition is drawing attention to a new study out of the United Kingdom that showed privatization of surgeries in England led to growing inequality, longer wait times, and disruption of the public health care system.
The study, authored by Professor Allyson M Pollock and Graham Kirkwood, compared outcomes in Scotland, which invested in the public healthcare system over the same period, and found stark differences in costs and equality.
Pollock said in a Zoom call on Wednesday that the data examined was collected from 1997 to present, noting that in 2003, the health ministry for England had been using public funds to contract for-profit companies to provide elective hip, knee, and cataract surgeries with the stated policy objective of reducing waiting times.
The result, she said, was the opposite, with England's policies shrinking public surgeries and creating a two-tier system with longer wait times for all patients.
"The private sector takes away precious resources from the public system," Pollock said. "In addition to the significant amount of money diverted to private owners, public hospitals lose doctors and other staff who are required to manage and monitor more complicated eye care."
The report noted that staff moving from public to private also destabilizes training, because private clinics don't do training. Private clinics also don't have the facilities to perform complex cataract procedures, so the surgeries that do require more complex care all need to be handled by the public.
"The private sector cherry-picks healthier patients, discharges them early, and then washes its hands of patients, so that the management of readmissions, including complications following surgery, goes back to the public system," Pollock said. "Meanwhile, the poorer and sicker patients suffer longer wait times in England. In Scotland, where privatization is minimal, access to care is based on need instead of affluence."
Pollock said, meanwhile, Scotland has more than doubled admissions for hip and knee surgeries and cataracts between 1998 and 2019 without the use of private contracts.
Executive director of the Ontario Health Coalition, Natalie Mehra, drew comparisons to the current path the provincial government is headed down.
"We are about 10 to 15 years behind where they are currently at in privatization in England," she said. "That does not mean that it will take 15 years for us to catch up. The Ford government announced an unprecedented expansion of private clinics this summer, with plans to redirect $155 million away from public hospitals to private clinics."
To Mehra's point of how quickly privatization can become the norm, the report found that nearly 60 per cent of cataract surgeries were being delivered privately in England last year, up from 15 per cent in 2019. Along with that, the annual expenditure for the procedures nearly doubled.
While discussing the dangers of privatization, Mehra alleged that private clinics in the region have been operating unethically, charging for procedures that are covered by public healthcare.
She said the Health Coalition had reached out to area clinics to see what they were quoting for a cataract surgery, and the results were troubling.
"We called all of the private clinics in London and Kitchener, we asked how much it would cost to get a cataract surgery. The answer should be zero, as it's covered by OHIP," she said. "However, London's private clinics gave us answers ranging from $1,750 to $4,900 per eye... In Kitchener, half of the clinics gave us prices ranging from $1,200 to $8,000."
She alleged some of the clinics were misleading, making it sound like medically unnecessary services, such as coloured lenses, were part of the necessary surgery.
Mehra noted that it's unlawful to charge more than OHIP for a procedure under the Commitment to the Future of Medicare Act.
