Unsafe practices, extra-billings at private outpatient surgery clinics should be cautionary lessons for Ontario health minister

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 business. 

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 for-profit (or are they private-not-for-profit) 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)

Michael Hurley
President, Ontario Council of Hospital Unions (OCHU)
416.884.0770

Stella Yeadon
CUPE Communications
416.559.9300