Bill 138 threatens privatization of Healthcare Clinics

Bill 138 (An Act to implement Budget measures and to enact, amend and repeal various statutes) is a sweeping omnibus Bill. Two sections are of particular note for health care and the broader public

sector: [1] Schedule 37 which would enact the Supply Chain Management Act and [2] Schedule 19, which amends the Independent Health Facilities Act. Both raise serious threats of restructuring and privatization.

[2] Amendments to Independent Health Facilities Act

So-called “Independent Health Facilities” are one of the main sorts of private clinics in Ontario. Despite their name, the Auditor General reported in 2012 that they are overwhelmingly for-profit (97%). These amendments are peculiar as the last go-round with legislation on Independent Health Facilities was supposed to repeal this very Act. Under the previous government, Bill 160 was passed, including Schedule 9 which set out the new Oversight of Health Facilities and Devices Act (OHFDA). Through the efforts of community groups and labour, the OHFDA was strengthened by putting some limits on private clinics.

However, even though the Act was passed by the legislature, the government has not proclaimed the OHFDA. As a result, the Independent Health Facilities Act has not been repealed and so the protections against private clinics achieved through the OHFDA are not in place.

Now, with Bill 138 the government intends to keep the Independent Health Facilities Act. Indeed, far from repealing this Act, the government now proposes amendments to it via schedule 19 of Bill 138.

Instead of restricting the expansion of for-profit health care through the proclamation of the Oversight of Health Facilities and Devices Act, these amendments may facilitate it by easing the process for licensing.

Applications

Until this new legislation is in place, a Request for Proposal (RFP) had to be issued. It is unclear why the Bill proposes a switch from RFPs to application process and why the government thinks this is needed. But the less formal process proposed in these amendments for the creation of IHFs (via application), is arguably less transparent and easier to implement, easing the privatization of hospital services.

So not only might we be stuck with an easier process of application for private clinics, the protections against privatization won through the amendments to the Oversight of Health Facilities and Devices Act have been abandoned.

Many years of problems with private clinics:

The protections against private clinics won in the OHFDA were the result of many years of problems with private clinics. The problems were first identified by CUPE and it’s hospital council, the Ontario Council of Hospital Unions (OCHU), in 2007 when Frank Dobson, the former British Health Secretary was brought over to talk about the problems of private clinics in Britain. Tragedy struck in Ontario shortly afterwards. On September 20, 2007, Krista Stryland died after undergoing liposuction at a private clinic. Stryland bled excessively following the surgery. There followed a series of failed attempts to adequately regulate private clinics, repeated exposes by the Ontario Health Coalition of extra billing of patients by private clinics, open defiance of government by private plasma clinics, infection control problems, and more. In 2013 the government stopped 94 physiotherapy clinics from directly billing OHIP. Ontario Health Minister Deb Matthews said that, over the years, licences to provide these services have been bought up by large corporations. Moreover, she charged, the “existing 94 clinics have had an unlimited ability to bill the government and have become very creative in the way they bill”. The government claimed that an audit of 15,000 records from the clinics found that 58% of them failed to support OHIP billings.

Despite these problems, the government continues to promote private clinics, doubling down as if the last twelve years had never taken place.

How can CUPE help you during restructuring or privatization?

• Job Security
• Long notice of advanced layoffs
• Ability to bump into other positions in a layoff situation
• Superior contracting out language
• Recall rights from a layoff to an available opening
• Retraining for other positions within the Hospital
• Fair reassignment language
• Termination only for ‘just cause’ not just because the employer feels like it
• Workers can’t be forced out after giving many years of dedicated service