Soaring regulatory fees threat to abortion clinics
B. C. College of Physicians and Surgeons says it needs to charge the true cost of accreditation
I’m looking for $ 9,000 next year and there’s not a lot of areas to cut. Now we’re looking at what we could cut, and it could be service hours. JILL DOCTOROFF EXECUTIVE DIRECTOR, ELIZABETH BAGSHAW WOMEN’S CLINIC
VICTORIA — Women’s health clinics, health authorities and the Opposition NDP are lining up to criticize new fees that could lead to service cuts at community abortion clinics.
Two Metro Vancouver women’s centres and one Vancouver Island clinic are facing 400 per cent increases to regulatory fees charged by the College of Physicians and Surgeons this year, which will mean bills of $ 9,000 this year.
For a non- profit organization like the Elizabeth Bagshaw Women’s Clinic in Vancouver, it will likely mean a reduction in operating hours, said executive director Jill Doctoroff.
“It’s huge,” she said. “Already we are bare bones. … I’m looking for $ 9,000 next year and there’s not a lot of areas to cut. Now we’re looking at what we could cut, and it could be service hours.”
The clinic is open Tuesday to Friday and one Saturday a month. It offers surgical abortions up to the end of 16 weeks of pregnancy — which are covered by government health insurance — as well as ultrasounds, counselling, birth control, sexually transmitted infection screening and HIV testing.
The College of Physicians and Surgeons licenses, regulates and disciplines doctors and also accredits certain medical facilities to make sure they meet requirements.
In a statement, the college said it has provided “therapeutic abortion clinics” partial exemptions from fee increases since a decision was made in 2008 to charge private surgical and medical facilities higher accreditation fees. Those exemptions end in the fiscal year starting April 1.
“The new fee reflects the true cost of the service,” the college said. “According to a college board policy in place for several years, the subsidy cannot continue.
“While the appropriate level of accreditation for TA clinics and how to pay for it are worked out, this issue is not one that should pose any barriers to access to abortion services for the women of the province.”
The college is now treating the non- profit women’s health clinics the same way it treats for- profit surgical centres, and that’s not fair, said NDP critic Maurine Karagianis.
“I suspect it’s the for- profit guys like the Cambie clinic that have somehow complained and the college has taken a bit of a philosophical shift,” she said.
Karagianis raised the issue in the legislature this week.
Health Minister Terry Lake said in a statement he is “concerned” about the college fee decision and urged all sides to work together to reduce the impact on women’s health.
“I’ve asked my deputy minister to call the college to try to understand the reason for the increase, and why it is happening over such a short period of time,” he said. “I will have a report back from him once this conversation has happened.”
Losing the women’s clinics would have a huge effect on the health care system, said Karagianis, because they offer a safe place for women to have sensitive health care procedures like Pap tests. Many women do not have a family doctor and are uncomfortable doing such procedures with random doctors at walk- in clinics, she said.
“Right now, you can get emergency care in an emergency situation in a hospital, but it really denies women the legal right they have to choose,” said Karagianis.
The fees are also not supported by the Vancouver Coastal Health Authority and the Vancouver Island Health Authority, which provide operating funding to the women’s centres. In a joint letter to the college, both authorities said the fee hike “seems inappropriate” and the clinics have fixed budgets, funded mainly by government, that don’t allow them to make up the extra money elsewhere.
The clinics are different from private surgical facilities, argued the health authorities. They save the health care system money by treating women in the community instead of in a hospital, and provide an environment without fear and stigma.
The college said while it is “actively engaged” to help find a solution, the fee increases are going ahead.