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Private clinics looking to expand into Saskatchewan, saying they can reduce waits

Progress is being made in wait times, says CUPE.

Private clinics looking to expand into Saskatchewan, saying they can reduce waitsA company contracted with the Alberta government to perform knee and hip surgeries in Calgary says it would be interested in coming to Saskatchewan, if the provincial government plans to increase the private-sector delivery of health care. In their recent throne speech, the Saskatchewan Party government promised that surgical wait times would be reduced to no longer than three months within four years.

"We know from Canadian experience that private clinics exacerbate wait times, poach scarce health professionals from the public sector and increase the cost of health services," said Kathy Storrie, president of the Saskatchewan Health Care Coalition and a Regina-based researcher for the Canadian Union of Public Employees.

Bernie Simpson, chief operating officer of the private, for-profit Networc Inc., said Saskatchewan's drive to cut wait times is similar to what brought his company into the Alberta system. Networc has not actively considered expanding to other provinces, nor has there been discussions with the government, said Simpson.

"We didn't realize that Saskatchewan was evolving or potentially evolving their system to be hospitable to private providers."

Orthopedics is one of the major obstacles in clearing what the government describes as a "backlog" or "bulge" of patients needing surgeries.

At the end of June, there were 27,589 patients waiting for surgeries, a number essentially unchanged since the Saskatchewan Party took office in 2007.

Of that number, 7,140 were patients waiting for orthopedic surgery. In the first six months of the year, 40 per cent of the patients who had surgery had waited longer than three months.

  "Many of the private surgical centres in Canada only survive on the basis of doing workers' compensation cases."

But while the government has made clear its openness to private health care – the concept of more "independent partners" was also touted in the recently released patient-first review – its potential role remains fuzzy at this point.

The government has said the backlog can be dealt with through a "surge" – a temporary boost in the number of procedures done – using "one-time money".

"I'm not sure who would come in to set up a private surgical clinic on a temporary basis," said Tom McIntosh, a University of Regina political scientist who specializes in health-care issues, in a recent interview.

McIntosh said there may be an argument that increased private provision would be the best way to deal with the wait-time issue.

But that may only be the case if the private operators are incorporated permanently into the provincial health-care system.

McIntosh also noted many of the private surgical centres in Canada only survive on the basis of doing workers' compensation cases. In the case of the Health Resource Centre, about 40 per cent of surgeries are done outside medicare for federal employees and prisoners and for workers' compensation boards, including Saskatchewan's.

On Thursday, Sask. Party Health Minister Don McMorris appointed a working group to develop a wait-time reduction plan that will be in place by April 2010.

McMorris said all options are on the table, but there is an initial emphasis on finding efficiencies within the public system.

But when asked about a model similar to that of the Health Resource Centre being used in Saskatchewan, McMorris noted that with an aging baby boom population the demand on the system for surgeries is likely to rise even if the backlog is cleared.

"As we move forward past that four-year... level, we may need to look at expanding our capacity absolutely on an ongoing basis," he said.

"Will we need quite the capacity when that backlog is reduced? Probably not. But we'll still have to increase from where we're at today. So, as I'm saying, all options are on the table."

Storrie said the provincial government, in making its promise, failed to acknowledge that progress has already been made toward reducing wait times. She cited a federal-provincial wait time strategy implemented in 2004.

"As a result of this coordinated strategy, wait times for medically necessary surgeries have dropped significantly in Saskatchewan and across the country," Storrie said.

"Clearly, the provincial-national strategy is a success story, one that uses public sector solutions to reduce wait times." CUPE researcher Cheryl Stadnichuk cited data from the surgical care network demonstrating progress in specific surgeries. For instance, about 70 per cent of patients requiring knee replacement surgery in March 2004 were waiting longer than 26 weeks, compared to 39 per cent in June 2009, she said. "It looks to us that progress is being made on surgical wait times," Stadnichuk said.

Links and sources
  Canadian Health Coalition

Posted: November 06, 2009

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