Ontario’s healthcare system was under pressure before the global pandemic publicly exposed and exacerbated its weaknesses. Post-pandemic, many have argued the system is in crisis. Hospitals are overwhelmed, there is a significant shortage of labour, and in many cases, patients aren’t receiving timely care. The Ford government has publicly recognized that the status quo is no longer an option, and that private healthcare has a role to play in the solution
The Announcement
In January 2023, Premier Ford and Health Minister Jones announced plans to reduce patient wait times and backlogs for various surgical and diagnostic procedures by leveraging existing community clinics across Ontario. While the majority of existing clinics in Ontario are considered “private”, the Minister assured Ontarians that they will be able to receive care with their OHIP card, never their credit card. The government has already faced considerable backlash from critics and pundits for ‘privatizing healthcare’, however, this announcement was one of the most significant healthcare announcements in recent years and in our view, is a very positive development for Ontario. If implemented correctly, Ontario could see backlogs and wait times reduced beyond pre-pandemic levels.
Bill 60, Your Health Act
While we don’t have all the details, the government did table Bill 60, Your Health Act, in February that renamed Independent Health Facilities as Integrated Community Health Service Centres (“ICHSC”) and enabled credential recognition for healthcare workers in other Canadian Provinces. Bill 60 also grants significant powers to the Minister of Health to influence a call for applications and who is granted a license.
Next Steps
It is clear that the Ontario government wants to move quickly. They have publicly announced that they want diagnostic imaging to begin in clinics in 2023 and surgical procedures to begin in 2024. As a result, the call for applications will require applicants to outline the details of the physical nature of the proposed centre, including its address and distance to other integrated community health services. This means applicants will need to have a facility essentially ready to go before they are even issued a license. Applicants with deeper pockets will likely have a leg up on this part of the application as they can conceivably make those investments without a guarantee of a license.
Two other key priorities include health system integration and protecting health human resources (“HHR”) from being poached from hospitals. It is clear that diagnostic and surgical centres will have to be integrated with local health partners, including hospitals. What is still unclear is what the nature of that integration will look like. Further, the government has indicated there will be safeguards to prevent poaching from hospitals. Applicants will need to submit a staffing model, complete with evidence of its sustainability. Schedule 2 of Bill 60 amends several pieces of Legislation to allow healthcare workers registered or licensed in other provinces to immediately start practicing in Ontario without having to wait or complete their registration with the Ontario regulatory college. While other provinces are not happy about this, many applicants will probably use out-of-province HHR as part of their staffing models.
The application will also require a description of any uninsured services being provided at the centre. Applicants will need to outline how they will comply with the provisions of the Legislation and ensure there is no queue jumping or extra billing. Clinics will be able to offer upgrades (ex. for cataracts or implants) but they cannot require anyone to buy upgrades. This section is specifically designed to protect patients against a requirement to pay above and beyond what OHIP covers. Above all else, the government is prioritizing quality of patient care. There are numerous frameworks and safeguards in place to ensure that the patient experience is a top priority for all clinics that are granted new licenses. For example, the Ministry will have the authority to prescribe an inspection body with inspection powers for all clinics and will enable the ICHSC Director to order a licensee to cease delivery of licenced services until in compliance with quality and safety standards.
Our View
In making these historic changes to Ontario’s healthcare system, it is clear that Premier Ford and Minister Jones are prioritizing patients over critics. Many have argued that this is a move to ‘privatize healthcare’. While the government is leaning on the private sector for support, there will be no two-tiered systems. Ontarians will continue to use their healthcare just as they have in the past, but if all goes to plan, they will be able to access even more critical health services in their local communities