NO PENALTIES FOR PRIVATE CLINICS
The NDP administration won’t level tough new penalties against doctors and private clinics that were to come into force Monday threatening hundreds of surgery cancellations.
Victoria stridently accused the clinics of being scofflaws in B.C. Supreme Court last week and adamantly urged Justice Janet Winteringham to reject their injunction application because it would allow them to continue ignoring the Medicare Protection Act.
The government changed its mind, though, and told the clinics late Friday that the Medical Services Commission won’t use the legislation’s enforcement mechanisms and stiff penalties until Winteringham decides whether they should be held in abeyance until a ruling on the law’s validity, expected late next year or early 2020.
Lawyer Jacqueline Hughes said Victoria didn’t want the judge to feel under any pressure and to take whatever time she needed to rule on the clinics’ application to delay enforcement of provisions constraining access to private care until their validity is determined at a now-two-year-old constitutional trial.
“As you predicted, we have reached an agreement,” Peter Gall, lawyer for the clinics, told Winteringham. “I should never have doubted your optimism.”
The government claims it adopted the new punishments in April because the old provisions were ineffective and recently led Ottawa to withhold $16 million in federal health transfer payments because of “extra billing.” More could be withheld if the situation continues, it said.
The clinics dispute that rationale and say the draconian fines and penalties for treating nonexempt individuals could force them out of business.
Winteringham, however, said she would need at least a month to consider the voluminous material filed during the hearing, and told the two sides to find their own solution in the meantime.
Gall said surgeons doing multiple operations a day could face liability of $100,000 or more.
The animosity between the two sides had become so bitter that there was little prospect of a deal, in his view, and doctors wouldn’t take a chance and risk fines in the triple digits. Nearly 60 private clinics, the first established in 1995 under the former NDP government, have opened across B.C. as waiting lists in the public system lengthened over the last quarter-century.
Dr. Brian Day of the Cambie Surgery Centre, who is leading the challenge to the law, excoriated the government for its attempt to stop the private facilities from providing necessary health care. The clinics provide a safety valve and have been an essential part of the health-care infrastructure for decades, he insisted.
Government documents filed in the constitutional case show publicly funded surgeries performed at private clinics increased 109 per cent from 2013-14 to 2016-17, primarily in the Fraser, Vancouver Coastal and Northern regional health authorities.
In 2013-14 there were 5,503 publicly funded private surgeries, and by 2016-17 that number had grown to 11,485.
Hips, knees and cataracts have seen substantial increases in waiting times in many health authorities in the past five years, even though the numbers of procedures have increased during this time, the data indicate. The number of cases waiting for surgery at the end of each year also increased 15 per cent from 74,759 in 2012-13 to 85,757 in 2016-17.
Day acknowledged the clinics have been flouting the law for years, but said the constraints on private care are discriminatory — clients of WorkSafeBC injured on the job, RCMP officers and others are exempt and can legally use the clinics.
Unless blocked by an injunction, waiting lists will worsen dramatically, he predicted, and the $300 million the public system saves because the clinics reduce its workload will be lost. And if $16 million was held back, Day said, that was money the government didn’t spend because the patients paid for their own care.
“A March 2018 Ipsos poll revealed 81 per cent of B.C. residents support us,” he added. “Government’s failure to consider public opinion is undemocratic.”