Ontario docs are leaving – patients have trouble finding good doctors

{August 24, 2012}   Envious Docs protest Dr. Day’s Private Clinic and People’s right to choose

B.C. government asks for injunction targeting private clinic

Written by Canadian Press on August 23, 2012

VANCOUVER | The British Columbia government filed an application Wednesday for an injunction that would force a controversial private clinic operator to stop billing patients, a move that will likely see the province’s courts become the latest to weigh the constitutionality of this country’s health-care laws.

The commission will have to argue that patients should wait and sufferThe province’s Medical Services Commission released an audit last month that concluded the Cambie Surgery Centre and the Specialist Referral Clinic, which are owned by the same company, have been illegally billing patients for procedures that are supposed to be covered by the public system.

The commission ordered them to stop the practice by Aug. 17, but the clinics ignored that deadline, prompting the request for an injunction. No date has been set to hear the application.

The audit’s findings were no surprise. The clinics’ outspoken operator, Dr. Brian Day, has openly admitted flouting the health-care law for more than a decade, repeatedly challenging the province to attempt to shut him down.

With the injunction, it appears Day has received his wish.

The doctor has already filed his own court case challenging the constitutionality of the province’s health-care law, which effectively bans clinics from billing patients for services already covered by the public system.

He suggested the pending fight over the injunction will only hasten his ability to make his arguments.

“We consider this application good news for us, because as you know, court hearings take a long time, and we will be able to put our arguments before the dispassionate and objective judge,” Day said in an interview Wednesday.

“The arguments will be before the court for them to reflect on and they’ll be in the public domain, and the arguments are very powerful on our side. The commission will have to argue that patients should wait and suffer.”

The Medical Services Commission issued a statement confirming it filed the injunction application, but it declined further comment.

The commission’s audit concluded the clinics were engaged in a practice known as “extra billing,” which refers to any instance in which a patient is billed for a procedure that is supposed to be covered by the provincial health-care plan.

The Cambie Surgery Centre opened in 1996 and offers a range of procedures, from orthopedic surgery to neurosurgery. The Specialist Referral Clinic opened several years after that and provides quick access to medical specialists who, in turn, offer to refer patients to Cambie Surgery Centre.

Last week, more than a dozen doctors and health-care workers gathered for a protest outside one of Day’s facilities, calling on the B.C. government to put an end to private billing at the clinics.

Earlier this year, two people from Alberta who paid for care in the United States launched separate court challenges of that province’s health-care laws.

In 2005, the Supreme Court of Canada struck down a Quebec law that banned private insurance in that province.

“Last week, more than a dozen doctors and health-care workers gathered for a protest outside one of Day’s facilities, calling on the B.C. government to put an end to private billing at the clinics.”

 Clearly the protesting docs and nurses prefer people to be on waiting lists for weeks or months,  rather than see them seek private, better and faster treatment.



Doctors’ poor decisions blamed for long waits causing harm in gov’t response to private clinic’s lawsuit

By Pamela Fayerman, Vancouver Sun January 15, 2013

Five B.C. patients, including two students, a cancer survivor and a terminally ill cancer patient — all of whom faced unacceptably long waits for care in the public health care system — have joined private clinics owner Dr. Brian Day (shown here) in a lawsuit against the government.

Photograph by: .. , Vancouver Sun files

If patients are waiting too long for treatment and suffering harm as a result, it’s mostly because doctors aren’t making the right decisions, the government says in response to a lawsuit by private care providers.
Dr. Brian Day and five patients — including a Kelowna boy who became a paraplegic after waiting more than two years for risky spine surgery — maintain the Charter of Rights and Freedoms gives people the right to seek expedited care in the private system if they’re worried about long waits in the public system affecting their health.
But the government’s 27-page statement of defence says patients shouldn’t experience “unnecessary or unreasonable pain or suffering” if treating physicians exercise their “professional judgment appropriately.”
Doctors are supposed to assess, treat and prioritize patients according to their medical conditions, the statement says, so if any of the plaintiffs suffered, it was because of “decisions made by, and actions taken or not taken by their treating physicians.”
It is doctors who “exert the greatest degree of control over the timing of the delivery of surgery to any given patient,” says the statement, filed in B.C. Supreme Court on behalf of the Medical Services Commission, Minister of Health and Attorney General.
Patients and their family doctors also share responsibility in ensuring no harm comes from excessive waits since patients have the option of being treated by a doctor who can see them faster or they can seek approval from government to be treated outside B.C. and Canada, the statement says.
Taking aim at doctors who work at private clinics, the government’s statement of defence says private medicine is all about “maximizing the income of their owners and of the physicians who practise there.”
The single-payer, public health care system is based on the tenet that access to medical care should be based only on need, not ability to pay, it says. A dual private/public system largely benefits those who can afford to buy expedited medical care and private clinics only exacerbate waits, it adds.
“The time spent by a specialist operating in a private clinic is time that he or she is not available to treat such patients and to thereby reduce his or her wait list.”
It says the government is there to pay and facilitate the work of doctors, and the health minister’s role is to set expectations, standards and goals for health authorities, as well as to monitor performance.
“The ministry has a very limited role in direct service delivery, rather, the ministry’s role is that of steward of the health care system, which it carries out through funding decisions, development of social policy and the establishment of the legislative framework for the health care system.”
A trial on the lawsuit, which was filed last summer, is not expected before the fall.
Day, co-owner of the Cambie Surgery Centre and Specialist Referral Clinic, dismissed the statement of defence as false “rhetoric and propaganda.”
“The response from the Attorney General’s office represents an appalling and blatant admission that they lack accountability and responsibility. They take the position that Canadians can be legally forced to wait, suffer, and even die as they wait for care.
Ryan Jabs, spokesman for the B.C. government, said the agencies being sued are there to “protect the integrity and sustainability of the health care system and uphold the Medicare Protection Act.”
Sun Health Issues Reporter
© Copyright (c) The Vancouver Sun

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