Private Surgery Centres

"Albertans want improved options for health care while maintaining essential services in the public health system. To make this happen, patients may be given the option of purchasing services they're waiting for now - like hip, knee or cataract surgery. The private health care system will be closely monitored by government. Albertans will continue receiving essential health care services in the public health system, regardless of their ability to pay."
Highlights from Alberta's New Health Policy

Alberta's "health policy framework website" is easy to confuse with its "getting on with better health" website. The "getting on" initiative was launched July 12, 2005, followed by framework in late February 2006. The structured consultation documents in the 2005 initiative didn't say anything about purchasing hip, knee or cataract surgery through a private health care system but the framework document took that controversial step. It appears that the Klein government doesn't consider timely access to hip, knee and cataract surgery to be essential; tell that to someone who is in pain or who is going blind.

In British Columbia a system of private health care developed with no public consultation, and as far as I can determine by interviewing past cabinet ministers, with no explicit government policy decision. The website for the Cambie Surgery Centre states that when it opened in 1996 it "was the first medical facility of its kind in Canada". It goes on to say that the Workers Compensation Board (WCB) was one of the Centre's first supporters. It may be that Dr. Brian Day, one of the Clinic's founders, and a few bureaucrats at the WCB are the only one's who fully understand the history behind this chapter in the development of private health care in BC. In the ten years since the opening of the Cambie Surgery Centre, private surgery centres have proliferated. In the legislature, Health Minister George Abbott appears to delight in reading a list of the dozens of clinics that opened when the NDP was in power. Notwithstanding the Medicare Protection Act, it is widely known that in BC some surgery procedures can be paid for in the same manner as the controversial proposal in Alberta. When pressed about the practice those who offer the services will say that it is just uninsured services that are being purchased, or that there is some misunderstanding, but dozens of patients on the North Shore had no misunderstanding when they had their cataracts removed within days by paying $1,750 per eye.

BC should have the same kind of public discussion that is occurring in Alberta. Should the parallel private surgery centres be allowed to accept privately paying patients, as some have done "under the table"? Should the private clinics be bought out and made public as happened to at least one clinic in Manitoba? Should you be able to go to any of the private clinics, present your CareCard and have Medicare pay the bill just as you do when you go to your doctor's office? Ignoring these questions, or hiding from the fact that the private clinics gained a foothold in the late-1990s, isn't in the interest of advancing public policy, satisfying the public or making health care more accessible.

Premier Campbell has completed his quick tour of some European health facilities. He should now begin the "real dialogue" on the question that he posed in the Throne Speech: "What are the fundamental changes we must make to improve our health and to protect our precious public health care system for the long-term?" He could start by laying all his cards on the table. Having toured parts of Europe with his private-care promoting brother-in-law, he should declare his preconceptions as a way of opening the debate. It isn't good enough to pretend to have consultation followed by the government implementing what it claims it heard, and it isn't good enough to continue to slide into major change with no public discussion as happened with the WCB's support of private clinics.