Trojan horse for privatization: unions want Ford’s private clinic payments redirected to hospitals as study shows the wealthiest are the ones benefiting

The alarming results of a recent study have renewed calls to reverse Doug Ford’s transfer of public funding for hospitals to private, for-profit clinics. 

The study published in the Canadian Medical Association Journal in August revealed that rates for cataract surgeries within private for-profit centres went up by 22 percent for people in the highest socioeconomic range in Ontario. The rate of surgeries declined by 8.5 percent for the lowest income-earners. The study determined that after the Province increased public funding for private, for-profit surgical centres, “patient socioeconomic status was associated with access to cataract surgery in these centres, but not in public hospitals.”

“Within public hospitals, the rate of surgery decreased similarly among patients of all quintiles of socioeconomic status,” it found. “During the funding change period, 92,809 fewer cataract operations were performed than expected. This trend was associated with socioeconomic status, particularly within private for-profit surgical centres, where patients with the highest socioeconomic status were the only group to have an increase in cataract operations.” 

To symbolize the threat of Ford's plan to permanently privatize several hospital services, the Ontario Council of Hospital Unions and the Ontario Health Coalition toted a 15-foot replica of the Trojan Horse to Credit Valley Hospital in Mississauga two weeks ago. 

They want the PC government to cancel plans to privatize surgeries and instead put the investments back into Ontario’s struggling hospitals. 

The visit to Mississauga’s hospital was part of a larger initiative. Over the next six weeks, the Canadian Union of Public Employees’ (CUPE) OCHU and OHC will be protesting at over 60 hospitals across Ontario, stressing to communities the dangers the PC legislation poses to the healthcare ecosystem; the PCs have been expanding private delivery of services through for-profit clinics historically offered in hospitals. 

(Paige Peacock/The Pointer) 
 

Referencing Greek mythology, Sharon Richer, secretary-treasurer of CUPE-OCHU, said in a press release on October 7 that the metaphor of “the Trojan Horse represents a gift, which, if accepted, threatens the recipient.” Richer went on to explain that “The false promise here is that privatizing surgeries is a solution to long waits.”

OCHU, OHC and other health sector unions have been warning that the PC legislation will lead to up-selling unnecessary medical services not covered by OHIP and will slowly take away from traditional services offered by the public healthcare system. Simultaneously, unions fear privatization will lure more healthcare workers away into the private sector, only exacerbating the current staffing crisis as low pay and burnout continues to strain the delivery of critical medical services.

“Doug Ford was talking about privatization like it's a gift for all of us and it’s certainly no gift,” Ken Cole, chair of the Mississauga chapter of the OHC, told The Pointer. “Nobody should be able to pay to get to the front of the line. Most of the hospitals, the operating rooms, are either closed at night or on the weekends, and some of them are permanently closed. We just can't have that. We just can’t.” 

Cole said the Coalition believes the PC legislation will be beneficial for individuals that can afford to skip the line, but that it will create gaps for people in the middle to lower income brackets. 

“For every penny of profit you take out of health care, that's a penny that's not going towards health care,” he said. “What Doug Ford has given us isn't a gift. We're trying to get the public to know that. He's just lying to us, and I don't use that term lightly, but he's lying to us about his privatization.”

For the next six weeks, health sector unions will be protesting at over 60 hospitals across Ontario to end the PC government’s hospital privatization plan.

(OCHU/CUPE)

Since Ford’s privatization plan was introduced in January last year, critics have argued that rather than reducing wait times, which continue to see all-time highs in Peel, privatization instead redirects funding and staff from hospitals, ultimately increasing wait-times in the public system.

“Meanwhile, these private clinics charge out-of-pocket costs, which are unaffordable for most people,” Richer said. “Ultimately, they will reduce access based on need, lengthen wait times and weaken our public hospital system.”

Earlier this year the PCs expanded the private delivery of certain services by announcing funding to clinics to perform more cataract surgeries, MRI and CT scans, colonoscopies, hip and knee replacements and other procedures. Furthering the PCs' agenda, in June, Ford issued a call for applications for new licenses for clinics looking to offer publicly funded MRI and CT scans in an effort to ramp up the PC plan to reduce wait times for surgery and diagnostics. It was the latest step in Ford’s strategy to add more private health-care providers to Ontario’s publicly funded system.

The Your Health initiative was announced at the beginning of 2023 and, for the last year and a half, the PCs has made several announcements about oversight of new private clinics. The strategy has been heavily criticized for allowing higher income earners to sidestep the traditional system.

The study published in August showed that while “expanding the role of private for-profit surgical centres has been proposed as a solution” it found that “moving surgical cases out of public hospitals and into private for-profit centres could have a negative effect on access to surgery for patients who are unable to pay.”

The study outlines what organizations like OHCU and OHC have been warning of for the past year and a half.

Despite Ford and Health Minister Sylvia Jones continuously claiming “the status quo is not acceptable”, the PC government has been drastically underspending in the midst of an ongoing healthcare crisis.

In recent years Ontario has been experiencing unprecedented capacity challenges — critics have attributed the timeline specifically to the election of Ford in 2018 — with closures of hospital emergency departments, permanent closures of hospital facilities, emergency departments and inpatient services, unprecedented levels of inpatients being treated in hallways, long waits to get needed surgeries and high bed occupancy levels, according to a recent report from CUPE-OHCU, which outlined just how severe the state of Ontario’s healthcare has become in recent years. 

OHCU and OHC have instead demanded the Province make investments in hospitals to improve staffing and capacity, which they say already have the infrastructure to offer more services but are lacking funding as the PCs promote a two-tier health care system that will leave vulnerable patients who cannot afford to pay out of pocket in a state of precarity. 

Ford’s current commitment to hospitals has been criticized for falling exceedingly short of what is actually required to meet growing need.

A report released last March from the Financial Accountability Office of Ontario (FAO) ahead of the 2023 provincial budget outlined a number of alarming projections about the PCs’ healthcare spending. The Province’s current spending plan shows a $21.3 billion health sector shortfall by 2027/28. It also highlighted that existing problems in the healthcare system are anticipated to worsen as a result of underfunding and a shortage of frontline workers. Without adequate funding being poured into the sector, the FAO’s analysis concluded it is “unlikely” the Province would be able to keep up with the growing demand. 

A scathing report released by OHC earlier this year accused the PC government of intentionally underfunding public health systems to redirect funds into the private sector.

It revealed that while public hospitals were seeing “real dollar cuts,” for-profit clinics had received shocking funding increases under Ford, noting that funding had “more than tripled in one year.” It also reported that the PCs were funding “private hospitals at double the rate per surgery than it funds public hospitals” and “private for-profit ophthalmology clinics across Ontario at 21 [percent] or more for each cataract surgery.” The report found that despite the ban in 1971 on the expansion of private, for-profit hospitals in Ontario, the last remaining facilities have continued to receive funding increases from the Province using tax dollars. Meanwhile cuts to funding for public hospitals are “pushing them into service closures and deficits”.

“Hundreds of millions in public money is being used to dismantle and privatize the core services of our public hospitals, robbing the public to build the private,” it stated. “The current provincial government has chronically underspent its health care budget, even as our public hospitals have been thrown into deficits and crisis.” The report outlines that at the same time as this chronic underfunding in the public healthcare budget, “unprecedented funding has been directed over to for-profit clinics and hospitals.”

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Twitter: @mcpaigepeacock

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