The Quebec government has decided
to forge a partnership with Montreal-area private clinic
Rockland MD - just two months after an inquiry by the
province's medical insurance agency ordered the clinic
to stop its private-healthcare practices.
In the deal, Montreal's Sacré-Coeur
Hospital would rent space, equipment and nursing staff
from Rockland MD on an as-needed basis starting in September,
in order to increase the hospital's day-surgery capacity.
The surgeons would stay within the public system as
employees of Sacré-Coeur; their patients wouldn't
be billed.
Hospital unions are opposing the
Montreal deal vehemently because it essentially bypasses
Sacré-Coeur's severe shortage of nurses. The
hospital is short 115 nurses.
ABRUPT
ABOUT-FACE
In June, Rockland MD was found by the government to
have charged patients illegal "accessory fees" of up
to $1,300 to get expedited treatment, while simultaneously
billing the government for insured medical procedures.
In an apparently 180, health minister
Dr Philippe Couillard - who ordered the June investigation
in response to public pressure - is now backing the
proposed contract between Rockland MD and Sacré-Coeur
Hospital. Negotiations are ongoing but the 18-month
deal is already agreed to in principle.
PRIVATE
PARTNERS
Proponents of the deal say the partnership could alleviate
the hospital's clogged waiting lists, adding room for
as many as 1,300 surgeries over the length of the contract,
but critics are questioning its legality.
"This is a clinic that was found
guilty barely two months ago, that the Minister [Couillard]
publicly denounced," said opposition health critic Eric
Caire of the conservative ADQ party in a release. "The
clinic is not an accredited affiliated private clinic.
The contract was not open for public bidding."
Under Bill 33, passed by the National
Assembly in December 2006 in response to the Supreme
Court's 2005 Chaoulli decision but not yet enacted,
Quebec hospitals will be permitted to subcontract certain
procedures to affiliated private clinics, accredited
by the government, after a bidding process.
PUBLIC
EXTENSION
Marie-Claude Prémont, PhD, a McGill health law
professor and associate dean of graduate studies, agrees
with Mr Caire. "They're circumventing the regulations
that the new laws set in place," she says. "What they
are proposing would be illegal under sections of Bill
33."
But clinic-owner Dr Fernand Taras
says that's not pertinent at the moment. "It's under
the existing law and Bill 33 does not apply at this
stage," he says. "We provide the physical setting for
the patients, but it's like an off-campus extension
of the hospital."
"[The Rockland MD deal] is an illustration
of what we have proposed since 2003, the private sector
working with the public network without expenses for
patients," Dr Couillard told Radio-Canada.
"It's a very short term view,"
says Dr Prémont, "because it just deals with
[Sacré-Coeur's] needs now and not the needs of
the entire medical community."
"It appears that the government
of Quebec is determined to break the public healthcare
system under the guise of addressing wait times," says
the Canadian Health Coalition's Michael McBane. "It's
basically a perversion of Canadian values. Instead of
investing in fixing the infrastucture, they are fragmenting
it."
Similar agreements are rare but
increasing in frequency across the country. The last
few years have seen such deals arise in Quebec, Alberta
and most recently in BC, where nearly $1 million of
publicly funded cataract surgeries were subcontracted
out to the private sector from December 2006 to April
2007.
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