Opinion: The orthopedic surgery proposal is a step in the wrong direction

0

Content of the article

The Alberta government recently passed legislation that supports its goal of having 30 percent of the province’s surgeries performed at private facilities. It also allows companies to contract with the government for health services and to enter into agreements with doctors to provide these services.

Advertising

Content of the article

Details recently emerged showing that health ministry officials have engaged in closed-door discussions with surgeons, lobbyists and investors. These discussions surrounded a proposal to build a 270,000 square foot private surgical facility. This $ 200 million site would perform all elective orthopedic procedures in the Edmonton area.

Private delivery raises several concerns. Studies show that for-profit facilities tend to provide lower quality care than non-profit facilities. It is unclear how the government will oversee quality or whether it will leave it to the College of Physicians and Surgeons, which is responsible for accreditation of these institutions. Services provided in for-profit establishments tend to be more expensive than those provided in non-profit establishments, given the need for a profit margin. Conflicts of interest can also arise from the fact that surgeon-investors have both obligations to patients and financial stakes in the profitability of these establishments.

Advertising

Content of the article

Although developers tout the profitability of private facilities, the public system subsidizes private profits. For example, the government recently launched a call for proposals for a Health Contracts Secretariat, which will use public funds to strengthen the private system by identifying private delivery opportunities, assessing barriers to entry and attracting private providers through market information.

The Edmonton facility is also likely to benefit from government subsidies. For example, public hospitals will treat surgical complications resulting in hospital readmissions. Acquiring this land with money or tax credits and building this facility will either require public investment or costs will be reflected in the contract with the facility.

Advertising

Content of the article

Private facilities can generate profits by providing “enhanced” services to patients, which are paid for out of pocket. Although the law prohibits granting preferential access to those who purchase improved services, it is unclear how the government will monitor and prevent this. There are various reports of patients feeling pressured into purchasing these services.

Costs will be minimized in the proposed facility by employing non-unionized nurses. Given the government’s plans to eliminate hundreds of nursing positions, those whose positions are laid off may have no choice but to take non-union jobs at private establishments. The long-term care sector provides ample evidence of how the use of non-unionized staff, among other factors, can contribute to poor working conditions and problems with the quality of care.

Advertising

Content of the article

The proposed facility insists on contractual conditions that will make contracts expensive to cancel. This strategy poses financial risks to government and taxpayers. It also appears to be a policy measure designed to ensure that privatization can withstand a change of government. The public system previously accepted financial risks for a private orthopedic facility in Calgary, costing taxpayers millions.

The project presents significant problems of transparency. Lobbyists had access to senior Ministry of Health officials before the legislation was passed, raising concerns that lobbying rather than the public interest would influence who receives private contracts, the terms of those contracts and the how these establishments will be regulated. Alberta Health Services, which is responsible for delivering health services, has been dealing at arm’s length and will be pressured to accept this initiative. The NDP has called on the Auditor General to investigate, alleging that these meetings constitute political interference in the procurement process.

Advertising

Content of the article

New details suggest that the government intends to proceed aggressively with the privatization of health service delivery. Similar privatization initiatives may be underway elsewhere in the province. Unfortunately, it appears that most of the government’s efforts have been aimed at ensuring profitability for investors rather than protecting the public and taxpayers. The government appears to be pursuing this agenda without considering evidence, experience or principles of good governance. If the government insists on expanding private provision, it must do so in an open and transparent manner and support and strengthen the public system. This installation is a step in the wrong direction.

Lorian Hardcastle is Associate Professor in the Faculty of Law and the Cumming School of Medicine at the University of Calgary. Ubaka Ogbogu is Associate Professor in the Faculties of Law and Pharmacy and Pharmaceutical Sciences at the University of Alberta and a Pierre Elliott Trudeau Foundation Fellow. The opinions expressed are those of the authors and do not represent those of the Pierre Elliott Trudeau Foundation.

    Advertising

    comments

    Postmedia is committed to maintaining a lively but civil discussion forum and encourages all readers to share their views on our articles. Comments may take up to an hour of moderation before appearing on the site. We ask that you keep your comments relevant and respectful. We have enabled email notifications. You will now receive an email if you receive a reply to your comment, if there is an update to a comment thread that you follow, or if a user that you follow comments. Check out our community guidelines for more information and details on how to adjust your email settings.


    Source link

    Share.

    About Author

    Leave A Reply