As Ontario’s Minister of Health announced that the role of private clinics would be expanded to help reduce growing hospital backlogs, a local child care provider explained why private operators in this field were not taking the provincial money and did not create new places.
There is a cross-lesson for Health Minister Sylvia Jones in the experience of the provincial $10-a-day child care program.
That’s not to say Jones and Premier Doug Ford are wrong to steer health care toward using private clinics to provide more surgeries and other medical procedures to address staffing and bed shortages. increasingly chronic in Ontario hospitals, including the Peterborough Regional Health Centre.
The minister said all the right things about how increased public funding for private clinics would work. Care would be available with an OHIP card and there would be no additional cost to patients. The clinics already exist and that would be an expansion of their use, not the introduction of new private outlets at taxpayer expense.
Or are these all good things?
Jones’ comments address the concerns of public health care advocates who oppose any shift to a public-private partnership. But these critics are too caught up in the status quo and a mythological belief that Canada’s public medicare system is the best possible method of health care delivery and needs to be strengthened by cutting private clinics, not using more their services.
It is quite clear that other developed countries provide better, faster and in some cases cheaper health care with a combination of public and private coverage. How this might happen here would require study, but information on a variety of options is available.
The Ford government is responding to a crisis and not rolling out a detailed plan based on a thorough review. He did not specify what types of surgery will be more available, where, or exactly how a system where the full cost is covered by OHIP would work.
The advantage of a fairly rapid deployment despite this lack of detail is that the clinics already exist and raise public funds. Fine-tuning this system will be easier than starting from scratch.
On the other hand, the private child care sector has been slow to sign up to a provincial/federal subsidized initiative aimed at reducing child care costs for parents — the goal is an average of $10 a day.
The Ontario government announced earlier this week that the deadline for signing private operators has been extended by two months to November 1. In Toronto, less than a third of private operators have signed up so far, a rate likely similar in other centers.
The CEO of a successful not-for-profit licensed child care center in Peterborough told The Examiner that was not surprising.
Sheila Olan-MacLean of Compass Early Learning and Care noted that private child care
don’t want to provide audited annual statements, public information that would let anyone interested know how they are spending their money.
Many also object to government-imposed limits on their profits.
These requirements should also apply to the expansion of public/private health care, but the focus on profit should not be the focus. There can be room for profit in a well-run system.
We go back to the experience of other countries where monitoring is accepted and the end result is better, faster and sometimes cheaper care.
Private partnership can be part of an improved health care system, but the Ford government will need to adopt established best practices and transparent regulations to make it happen.