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Ideology blamed for rebuff of private surgery plan:
Knee replacement proposal rejected by government would
have saved enough to perform another 276 operations, critic says
Globe and Mail
March 22, 2007
By Lisa Priest
For the third day in a row, the Ontario government was put on the hot seat and was asked to explain why it dismissed a proposal to do knee replacement operations at a private hospital -- even though it would have saved taxpayers more than $1.6-million.
Progressive Conservative finance critic Tim Hudak told the Ontario Legislature yesterday that the savings from the proposal by Don Mills Surgical Unit would have meant another 276 knee operations could be performed at the private Toronto hospital.
Mr. Hudak was responding to stories in The Globe and Mail that revealed how the Ontario government rejected a proposal to do 1,500 knee replacement operations at the private hospital for $5,800 each, which is $1,082 lower than community hospitals are paid per operation.
"Judging by the minister's rhetoric, it seems to be driven by rigid ideology," Mr. Hudak said in a telephone interview. "Unfortunately, while the government clings to this dated ideology, patients are suffering on long waiting lists."
Despite three days of questions from the opposition this week, Mr. Hudak said no clear answer has been given for the government's rejection of the proposal. Given that Don Mills Surgical already does publicly funded knee arthroscopies and cataract surgery, he wondered why it would not be able to do knee replacements.
"I'm not clear and no real explanation has ever been given by [Premier] Dalton McGuinty on why he's refusing this proposal that would give quick access to patients suffering on waiting lists," Mr. Hudak said yesterday.
Don Mills Surgical is one of three surgical hospitals that operate under the province's Private Hospitals Act. Also known as Don Mills Surgical Centre, it was allowed to continue private operations in Ontario after the public health-care system was introduced.
Cosmetic surgery and unfunded prostate cancer therapy, in addition to provincially financed cataract and orthopedic services, are performed at the 44-year-old hospital.
During Question Period yesterday, George Smitherman, Minister of Health and Long-Term Care, reiterated his government's track record on reducing waiting times, saying it has increased access to hip and knee replacements.
"We've produced results in the context of our public health-care system, and we believe fundamentally that this is the way to go forward to continue to reward the public health-care system for the innovations that it's making and for the improved access that is being provided to the people of the province of Ontario," Mr. Smitherman said.
Waiting times are a particularly sensitive issue for the Ontario government, which has been working feverishly to reduce some of the lengthier queues. Although progress has been made -- waits for knee replacement, for example, have dropped by 30.2 per cent or 133 days since August/September of 2005 -- queues remain long.
Specifically, 90 per cent of patients requiring knee replacements had them done within 307 days, according to Ontario figures for December of 2006 to January of 2007.
Zoltan Nagy, executive vice-president of the Canadian Independent Medical Clinics Association, said there are no facts he knows of that would support rejecting such a proposal. "If you talk to orthopedic surgeons, they love to operate," Mr. Nagy said in a telephone interview from Vancouver. "And the more they do, the more skilled they become and the more efficient, effective, they become."
If Ontario did sanction such a proposal, it would be following in the steps of British Columbia, Alberta and Manitoba. Those provinces have contracted out procedures to private clinics in an attempt to reduce lengthy waiting times. In Ontario, however, private hospitals, including those that provide publicly funded care and do not allow queue-jumping, remain a hot-button issue.
Sharon Sholzberg-Gray, president and chief executive officer of the Canadian Healthcare Association, said she would be careful in looking at costs per case alone because some private clinics do only uncomplicated cases, which typically would be less costly.
"Some joint replacements are more routine than others," Ms. Sholzberg-Gray said yesterday.
James Waddell, medical lead for the bone and joint health program for Toronto central local health integration network, said many of the orthopedic surgeons he knows wouldn't have time to operate at a private hospital as they already operate three days a week in public hospitals; the other two days are devoted to consultations and patient follow-up.
However, one orthopedic surgeon interviewed, Paul Wong, said if he operated at Don Mills Surgical, he could double his operating-room time from his current 1½ days.
Reprinted from the Globe and Mail, March 22, 2007.
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