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Ontario tables health reform bill to expand private clinic procedures

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Queen’s Park in Toronto, Monday, Feb. 20, 2023. The Ontario legislature is set to resume sitting after a two-month winter break that began in December. THE CANADIAN PRESS/Frank Gunn

TORONTO — Ontario tabled legislation Tuesday to allow more private clinics to offer certain publicly funded surgeries and procedures, which the health minister said comes with several patient safeguards, although the government doesn't yet know who will inspect those facilities.

Health Minister Sylvia Jones said the legislation will enable the province to designate "expert organizations" to inspect the clinics, but the province hasn't decided on those organizations yet. 

"There are a couple of options on the table," she said Tuesday at a press conference. 

"We will, through regulation, ensure that the appropriate regulator, whether that is an outside regulator or in-house, is happening."

The legislation does set out a process for complaints, bring the new clinics under the purview of the patient ombudsman, and establish a renewal process, so the clinics are not assessed on a "one and done" basis, Jones said.

Patients at the clinics – including new facilities that will perform hip and knee surgeries – will not have to pay out of pocket, rather the procedures will continue to be publicly funded, Jones said.

The minister announced last month that the legislation was coming, and since then opposition parties and some health-care advocates have been critical about the role of for-profit clinics. Many have raised concerns about clinics "upselling" patients, pressuring them to select services that cost more than what is covered by the Ontario Health Insurance Plan.

Under the legislation, clinics won't be allowed to refuse service to a patient who opts for the OHIP-only service, and they won't be allowed to charge patients an additional fee to get services faster than other people, the government said.

The legislation is aimed at reducing wait times and surgical backlogs. 

"Our bold and innovative plan will significantly reduce surgical and diagnostic wait times, enhance collaboration across the health system and ensure patient safety will continue to be paramount," Jones said.

Clinics would be required to provide details of infection prevention and control policies to the province, as well as a staffing plan "to protect the stability of doctors, nurses and other health-care workers at public hospitals." Physicians at those clinics must also have hospital privileges, under the proposed law.

Jones said there will be no cap on the number of new clinics the government will license.

NDP Leader Marit Stiles said the plan is not transparent or accountable enough, taking issue with the government introducing the legislation without knowing who will inspect and regulate the clinics.

"As far as I can tell, there is no oversight – there's the promise of some oversight, sometimes, somewhere to be determined," she said.

The legislation also includes new "as of right" rules, that would see credentials of health-care workers registered in other provinces and territories automatically recognized in Ontario, without the need to register right away with a regulatory college in this province.

The bill was the first piece of government legislation introduced as the legislature resumed Tuesday following a winter break. 

Premier Doug Ford dodged most questions about his relationships with developers during the first question period, as the opposition peppered him with queries about developers attending his daughter and son-in-law's $150-per-ticket stag-and-doe event last summer.

Ford has said he did nothing wrong when developers who are longtime family friends attended the event, which is typically held to raise money for an engaged couple.

The scrutiny of Ford's relationships with developers comes after the province announced in November that it is removing about 7,400 acres from 15 different areas in the protected Greenbelt, while adding more parcels elsewhere, in order to build 50,000 homes.

Stiles, in her first question period as head of the Opposition, asked Ford multiple questions about the stag and doe, and his dealings with developers. 

"Can the premier explain to Ontarians how they were, are supposed to believe that these developers weren't given a heads-up about his plans for the Greenbelt?" asked Stiles.

"My family is separate than the political process," Ford said in response. "They aren't involved."

Ford said he asked the integrity commissioner to look at the stag and doe and the commissioner's office "found there was no violation."

The Office of the Integrity Commissioner of Ontario has said that based on information provided, Ford had no knowledge of gifts given to his daughter and son-in-law and there was no discussion of government business at the summer event.

Media reports cite sources as saying lobbying and government relations firms were asked to buy tickets.

In another development on Tuesday, Green Party Leader Mike Schreiner said he's staying put after considering an invitation to jump ship and join the Liberal party. 

He said he heard from thousands of people in his home riding of Guelph, Ont., and beyond after a group of 40 prominent Liberals asked him to join their party and run for leader. 

"I felt I owed it to the people of Ontario to consider a different option," Schreiner told reporters after question period.

"And I chose after that consultation with my constituents in Guelph, people across the province have been very clear to me that the best way I can make a difference is as the Ontario Green leader."

This report by The Canadian Press was first published Feb. 21, 2023.

Allison Jones and Liam Casey, The Canadian Press


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