Premier Doug Ford recently announced that 50 per cent of surgeries would be shifted to for-profit clinics under a new attempt to permanently resolve the backlogs that hospitals are currently facing. This is a consequential step towards privatizing Ontario’s healthcare system, but not without its problems.
Professor Mathieu Poirier, a member of the School of Global Health at York University, provides his opinions on the matter, particularly regarding the inequities birthed by a private system: “There’s much more we should be doing to clear surgical backlogs and fix staff shortages, but proposals to offload surgeries to for-profit clinics divert attention away from reforms needed to address this issue.
“For-profit healthcare delivery has been repeatedly demonstrated to be less equitable and less efficient than public and non-profit delivery,” Poirier adds. “This is because of the inescapable fact that for-profit care requires a portion of public funding be diverted away from care and towards private profit.”
Poirier also highlights that these inequities may affect not only patients but also employees. “If care providers become incentivized to work in these private clinics, we risk exacerbating existing inequities and seeing reduced service capacity in the public and non-profit hospital systems,” he explains. Healthcare workers must be paid living salaries and given raises, the latter is not helped by Bill 124, which caps salary increases at 1%.
Essete Tesfaye, a fourth-year student in the Global Health programme at York University, speaks on healthcare staff being adversely affected due to a possible for-profit system: “This is a two-fold issue because, on the one hand, public healthcare can’t afford to pay people as high as they are paying in the private sectors, but it’s also an issue in that only the people who are able to be accepted into the privatized hospitals will benefit from having that higher salary.”
Essete adds that it is unfair to expect healthcare workers to accept lower salaries strictly for principle while they are in the public healthcare system.
Speaking on communities who face health inequities and how privatization affects them, Essete adds, “We talk a lot about healthcare equity and making sure that people get the resources they need, but we are taking away resources from the people who already have a higher need for them.”
Professor Pat Armstrong, a professor of Sociology at York University explains that while Ontario’s hospitals may be privately owned, they operate under a not-for-profit basis.
“What Ford is proposing includes more for-profit services and we have lots of evidence that for-profits tend to cost more, have a pattern of lower quality care, shift hard cases to the hospital, often charge extra fees for ‘extra’ services and may upsell, not to mention taking staff from other areas when the real shortage is staff, not surgery space.”
Armstrong explains that such a move is not necessary to stabilize the healthcare system since several not-for-profit clinics, particularly those affiliated with hospitals, help lift the burdens of wait times from hospitals.
In his final comments, Poirier says, “A more distributed model of surgical and outpatient care is not a bad idea, but it should be integrated with our hospital system and safeguards to protect the system-wide equity and sustainability must be central to its design and implementation.” Armstrong echoes Poirier’s comment, “Remember for-profit firms have to make a profit and, in corporations, are primarily responsible to their shareholders, not the public”.
