Former premier defends private health care
Gordon Campbell joins fight against B.C. government’s crackdown on clinics
Former premier Gordon Campbell has provided an affidavit to support an injunction to prevent the B.C. NDP from punishing private clinics and diagnostic facilities until a constitutional challenge is decided.
The one-time B.C. Liberal leader said his administration did not clamp down on access to private health care as it eased lengthy queues for surgery formed because the public system was unable to meet needs.
Campbell’s six-page sworn statement is part of an application seeking a B.C. Supreme Court order suspending enforcement of changes to the Medicare Protection Act that take effect Oct. 1.
The handful of patients and two clinics engaged in marathon litigation attacking the validity of restrictions on private care filed several similar affidavits to buttress their lengthy argument urging the court to intervene until their trial concludes.
The B.C. NDP government said it adopted the provisions in April because it feared the federal government would reduce transfer payments.
The clinics, however, insist enforcement of the act could bankrupt them and private diagnostic facilities while causing untold suffering and perhaps death to British Columbians as the 70,000 they treat annually join historically lengthy waiting lists.
During his time governing from 2001-11, Campbell said he and his cabinet wrestled interminably with the provision of private care.
Although the Medicare Protection Act effectively prohibited enrolled specialists from providing services in private clinics, he said the previous NDP government had permitted such contravention of the law for the same reasons his cabinet confronted.
“I was informed through many government briefings, reports and communications, that the wait times for scheduled medically necessary surgeries continued to increase and that delays in receiving medically necessary surgeries caused suffering and could cause permanent harm to many British Columbians,” Campbell said.
“Because of the information we had about long wait times for surgeries in the public healthcare system and the increasing costs of the health-care system, the government decided to carry on the practice of allowing enrolled surgeons to provide some private surgical services to non-exempt British Columbians in private medical clinics in the province to allow them to deal with their personal healthcare needs outside of the public system.”
The delays in the public system could not be alleviated, the former premier insisted, even when increased efficiencies could be found.
In a 2005 Quebec case called Chaoulli, the Supreme Court of Canada ruled that it violated fundamental rights to restrict patients from seeking private treatment when the public system failed to provide timely care.
“After the Chaoulli decision, I stated publicly that the government did not want a two-tier health-care system in Canada — one in Quebec after Chaoulli and a second, lower tier in the rest of Canada, including B.C.,” Campbell said.
“British Columbians should have the same right as the residents of Quebec to access private health care to avoid lengthy waits in the public system, and patients, not the government, should be free to make that choice for themselves.”
His government considered eliminating the restrictions on access to private health care, but did not for fear of losing transfer payments from Ottawa.
Those same concerns, he said, had caused his government in 2003 to pass the amendments the NDP proclaimed in April, which provided substantial fines and charges to enforce the restrictions on private care.
The changes also for the first time ban private diagnostic imaging.
Campbell said his government did not proclaim those amendments and took no steps to enforce the restrictions because they would be “harmful to the health of British Columbians.”
“Delays in receiving what had been considered medically necessary surgeries — and the inability for the province to meet the established wait time guidelines — caused suffering and the risk of permanent harm to many British Columbians,” the ex-Liberal leader maintained.
“Many patients were already waiting too long for needed diagnostic services and surgeries.”
Campbell said his government was unable to fund health-care needs and was forced to ration care.
It wanted to minimize the negative effects on patients, he added, by allowing them to make their own choices about how and where to obtain needed care.
“To learn from other globally recognized public-health systems, I led a fact-finding visit to Sweden, Norway, France and the United Kingdom in 2006,” Campbell explained.
“I learned from this visit that all of these countries had hybrid health-care systems that incorporated elements of private care and funding, and delivered better public health care at a lower cost than British Columbia and the rest of Canada ... a hybrid healthcare system would cause no harm to the public health-care system in B.C., while providing benefits to many British Columbians.”
The 34th premier and mayor of Vancouver, who now lives in Ottawa, Campbell said the tour “made it clear that public-health systems could thrive when complemented by supplementary private service. Indeed, the complementary system appeared to contribute to a better overall universal public health-care system.”
The province has not yet filed a response to the injunction application, which is set to be heard Aug. 13.
The constitutional challenge is expected to continue well into next year.
Many patients were already waiting too long for needed diagnostic services and surgeries.