Private sector involvement in health clinic called ‘alarming’
Think-tank slams province for letting medical corporation manage facility
Vancouver Coastal Health is being criticized for waving “profit-motivated” corporate partners through the door to manage an urgent and primary care health clinic in downtown Vancouver funded by taxpayers.
The Canadian Centre for Policy Alternatives says it welcomes the idea of the clinics established by the province — where doctors, nurses and other health professionals work as a team — but says they should be run on a not-forprofit basis with community oversight or governance.
“Unfortunately, there is an alarming development taking place under the watch of Vancouver Coastal Health,” the CCPA says in a report released Wednesday that refers to the City Centre Urgent Primary Care Centre at 1290 Hornby St. in downtown Vancouver and a clinic planned for south Vancouver.
Opening such clinics across the province has been a major priority for Health Minister Adrian Dix, but the government has not been open about business models and financing structures, so Postmedia and groups like CCPA have had to submit freedom-of-information requests to get details.
In a fact-checking exercise, Postmedia showed that in February’s throne speech, the government inflated the numbers of doctors and nurses being hired to work in such clinics. The government’s primary health strategy includes funding for an additional 200 family doctors, 200 nurse practitioners and 50 pharmacists. But they won’t all be working in such centres. There are eight urgent and primary care centres in B.C. with a variety of business models. Another two — in as-yet undisclosed locations — are expected to open soon.
Documents released to the Canadian Centre for Policy Alternatives, a left-leaning think-tank, show that Coastal Health invited medical corporations to run centres, says Alex Hemingway, a CCPA economist and public policy analyst. The only clinic to open in Vancouver so far was contracted by Coastal Health to an entity called Seymour Health Centre Inc., whose CEO is Sabi Bening.
The downtown Vancouver centre operates like other medical offices and walk-in clinics in the sense that services provided to patients are covered by the public health insurance plan. But many family doctors are opting for $250,000 salaries instead of paying overhead and then collecting a medicare fee for each service. The clinics have extended hours, some doctors have emergency training and the model is meant to take the pressure off hospital emergency departments.
It’s also intended that the clinics will assist the many patients who don’t have family doctors to get attached to one. Health outcomes are better when patients have a history and continuity with doctors.
Although the vast majority of doctors’ offices are privately managed by their own corporations, Hemingway said there is plenty of evidence to show that not-forprofit models deliver superior care. Hemingway said doctors’ practices are “small scale” compared with the new models of combined urgent and primary care clinics.
Hemingway said it’s worrying that Seymour Health was contracted by the health authority to run Vancouver’s first urgent care centre. According to the government, the startup costs of the clinic were $1.9 million. City Centre Urgent Primary Care has a taxpayer-funded operating budget of about $3.7 million annually, including salaries, administration and overhead cost. The centre is a partnership of the ministry, Coastal Health, Providence Health Care, the Vancouver Division of Family Practice, Doctors of B.C. and Seymour Health Care.
Hemingway said the health authority is leasing the property from a private owner, “meaning it appears to be using public dollars to enhance a privately owned real estate asset. This is an unwise use of public capital investment dollars, which could be invested in publicly owned assets instead.”
Gavin Wilson, a spokesman for Coastal Health, said the Seymour group has 80 years of experience operating primary health care clinics. The costs and the agreement between Coastal Health and Seymour “are similar to contracts we hold with not-for-profit health service providers.”
Wilson said urgent primary care centres provide same-day care for non-life-threatening problems to people who would otherwise have no other option than to go to an emergency department. They have more services than traditional walk-in clinics since they have diagnostic equipment, such as X-ray and ultrasound machines, and labs and pharmacy services.