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Health Law Blog

Scapegoat: Are Private Clinics Being Unfairly Painted as the Bad Guys When it comes to Health Care in Canada?

August 19, 2015

Are out-of-hospital private clinics truly the black sheep of the Canadian health care family, or is it more a case of moms always liking their publicly-funded-hospital counterparts best?  And by “moms”, we’re talking about the media, left-wing political parties, and just about anyone else who stands to gain from slamming private facilities.

Everyone Makes Mistakes

The potential for human error and adverse events, defined as “an unintended injury or complication that results in disability at the time of discharge, death, or prolonged hospital stay, and that is caused by healthcare management rather than by the patient’s underlying disease process”, is part of delivering health care in any setting, be it a public hospital or private clinic.

In 2007, for example, real-estate agent Krista Stryland died following complications that occurred during plastic surgery at Toronto Cosmetic Clinic, an out-of-hospital private clinic. Her death, which received wide-spread media coverage, was, in part, a catalyst for the College of Physicians and Surgeons of Ontario to launch the Out-of-Hospital Premises Inspection Program, which requires safety inspections for private, out-of-hospital clinics that carry out procedures under anesthetic and sedation. The results of these inspections are a matter of public record and are posted on the College’s website.

While there is some variation by province, publicly funded hospitals are likewise held to quality standards and are required to report on patient safety issues. In Ontario, for example, data on quality indicators such as incidences of surgical site infection prevention, ventilator-associated pneumonia and other adverse events, by hospital, can be found on Health Quality Ontario’s website.

Transparent-ish

On the surface then, it would appear that transparency is the watchword in health care, with both private and public facilities being more-or-less equally held accountable. Except that they aren’t. There is a greater tendency to air the dirty laundry of private clinics in the court of public opinion, while that of public hospitals gets swept under the carpet.

For example, in the fall of 2014, the Toronto Star newspaper ran a series of articles blasting private clinics that didn’t meet safety inspections. In September 2014, the Star published an article by health reporter Theresa Boyle on the failings of the Rothbart Centre for Pain Care under the headline, Public Not Told of Infection Outbreak at Private Toronto Pain Clinic. Then, in a subsequent article on November 2, 2014, Ms. Boyle wrote that since inspections of private clinics began in 2011, 13% of those facilities didn’t meet provincial standards and 3.6% have failed inspections. Another article criticized the inspection reports themselves for being “sparse” on detail.  In its November 2nd article, the Toronto Star suggested that its “investigation” into the matter of private clinics that fail to measure up may have prompted Ontario Health Minister Eric Hoskins, to announce the Province would take measures aimed at improving the oversight of private clinics, or, in Ms. Boyle’s words, “Hoskins announcement followed a Star investigation into infection outbreaks at clinics.”

The Elephant in the Room

While all of this will hopefully go a long way toward keeping consumers of health care services safe, notably absent in all of this reporting and measure-taking is mention of adverse events that are occurring on a massive scale in public health care facilities. At least that was the case until recently when National Post reporter Tom Blackwell wrote a series of articles about the deception and cover-ups in “Canada’s secret world of medical errors”. Mr. Blackwell sited research that suggests approximately 70,000 patients a year experience “preventable, serious injury as a result of treatments.” He went on to say that “a landmark study published a decade ago estimated that as many as 23,000 Canadian adults die annually because of preventable “adverse events” in acute-care hospitals alone.” Unbelievably, according to Mr. Blackwell, only a small percentage of those cases are publicly acknowledged and it is usually in the form of sterile statistics lacking any contextual narrative. Even if the media or members of the public tried to learn more, their attempts would be stymied by legislation in most provinces which bars information on adverse events being released to the public. This legislation is designed to encourage the internal reporting of medical errors.

Clearly the egregious underreporting of medical errors and adverse events in public, not private, health care facilities is the elephant in the room. Of course, the left-leaning media and the Ministry of Health won’t set their sights on that beast with anything remotely approaching the same vehemence and intensity they have with owners of private clinics, because it is not in their ideological or political interests to do so. Just another example of left-wing hypocrisy in Canada, leading to policy dysfunction.

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