TORONTO, Oct. 7, 2013 /CNW/ - Recent disciplinary proceedings reviewing
the unsafe, dangerous and, in one case illegal, practices of several
doctors doing medical procedures at private, out-of-hospital medical
clinics, along with reports of questionable billing practices at
privately-run endoscopy clinics, should be a cautionary lesson for
Ontario's health minister, who is moving swiftly to expand private
surgery clinics in Ontario, says Michael Hurley the president of the
Ontario Council of Hospital Unions (OCHU).
Shifting sophisticated procedures, including surgery, from public
hospitals to private clinics, is a key element of the Ontario Liberal
government push to downsize that many believe threatens the viability
of community hospitals.
Private outpatient clinics in Ontario function outside of the
legislation that sets stringent operational mandates for public
hospitals. Oversight of private doctor-led procedure and surgery
clinics falls under the Independent Health Facilities Act and the
College of Physicians and Surgeons of Ontario (CPSO). Currently
private, ambulatory clinics are not mandated to report publicly about
infection outbreaks, adverse patient outcomes during procedures,
patient deaths, how many patients are transported to public hospital
when surgeries go awry and how often emergency services are called.
In a scathing rebuke of a former anesthesiologist who contributed to the
death in 2007 of Krista Stryland, a liposuction patient who bled
excessively following surgery, CPSO's disciplinary committee said last
week that the doctor "failed to recognize the limitations of what could
be done in your outpatient setting when adverse events occurred."
Further, the committee said there was a failure to ensure that Stryland
was stable on entry to the recovery room and that the clinic failed to
call for help in a timely manner because there was delay in calling
911. When paramedics arrived at the clinic they found Stryland - who
was lying in a pool of blood - with no vital signs.
"Small ambulatory surgical clinics are not equipped to handle the
surgeries that go wrong. This is why the US Congress suspended Medicare
funding to private clinics after numerous preventable deaths. There are
risks with this government policy that Ontarians need to be made aware
of," says Hurley. He urged the health minister to put the safety and
health interests of patients first and put the brakes on moving more
surgeries and procedures out of hospitals into stand-alone clinics.
In a separate recent disciplinary proceeding, a Trenton area doctor who
lost his license to practice following many patient complaints has been
also accused of using his clinic to run an illegal mail-order drug
In addition to increased scrutiny on patient outcomes and care quality
at private, out-of-hospital clinics, the billing practices of some of
these independent facilities are also raising concerns as the province
is poised to cut more hospital surgeries and procedures and expand
Ontario's reliance on independent, private facilities. Recent reports
that a private clinic that took over endoscopy work when the Ottawa
hospital's clinic was closed earlier this year, is asking patients to
pay a controversial extra-fee of $80 for procedures covered under OHIP,
should be another red flag for the provincial government that "moving
surgeries from public hospitals will bring financial exploitation of
the public," says Hurley.
Regulatory changes to facilitate the expansion of private surgery
clinics began in earnest in the dead of summer without any significant
public consultation. The changes do not require approval from the
Ontario Legislature, so will not be publicly debated by MPPs. OCHU has
urged the Liberal government to hold province-wide hearings on the
regulatory changes and on the implications of this major policy shift.
SOURCE: Ontario Council of Hospital Unions (CUPE)
For further information:
President, Ontario Council of Hospital Unions (OCHU)