For-profit cancer clinic costs more, doesn’t cut wait times

Polls show that Canadians overwhelmingly support public — not private, for-profit — health care. (In a 2011 Nanos Research study, for instance, 94% said yes to public health care.) So it’s not surprising that when Sunnybrook Hospital in Toronto opened the province’s first ever private cancer treatment clinic, many Ontarians had questions. The centre opened in 2001, receiving over $4 million as a start-up grant, even though the company was operating for its own profits.

For-profit clinic lacks transparency

The provincial government wouldn’t answer many of the questions that Ontarians raised about its contract with the clinic operators. Although the for-profit facility was financed with public money, the contract was considered to be a “commercial secret” that prevented the public from accessing key details about the deal. To date, the full contract has never been made public.

It was only after months of pressure from opposition parties that the terms of the deal were ultimately subject to scrutiny in the provincial legislature. When NDP Health Critic Frances Lankin was finally able to view the contract, she was barred from making a photocopy and had to take notes by hand. Public concern about the contract continued to build, eventually forcing a special audit by the provincial auditor general.

Private costs more

The audit revealed that the public was paying far more for services at the private clinic than they would have at public facilities. The for-profit clinic had been charging $500 more per procedure. The auditor general also criticized the lack of tendering process for the contract and questioned why a public option had not been considered from the start.

No reduction in wait times

The auditor general said that despite promises, the for-profit cancer clinic at Sunnybrook had not reduced patient wait lists after more than a year of operation. In fact, the additional cost for each treatment would have bought more treatments per dollar — reducing wait times for patients — if the investment had gone to a public cancer treatment centre.

For-profit clinic drains expertise away from public hospitals

At the time the clinic opened, there was a serious shortage of specialists and nurses across the province. Because it received more funding than public cancer treatment centres did, it was able to lure a large portion of staff away from local public hospitals with higher wages. So rather than reducing wait times at other facilities, the new clinic effectively increased them by exacerbating staff shortages. In fact, the lead oncologist at the treatment centre had previously worked in the public system before he left to form his own private company to take on the Sunnybrook contract. Princess Margaret Hospital also lost a significant number of experienced nurses to the for-profit centre.

Private clinic closes amid public pressure

The findings of the auditor general’s special report, coupled with public opposition to the deal, ultimately led to the closing of the clinic in 2003, just two years after it opened. The clinic was replaced by increasing capacity at a lower cost in the public cancer treatment system.