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Resisting the Privatization of Canadian Health Care Systems

Quebec and other provinces must listen to the health care professionals

On August 18,  Ontario Health Minister Sylvia Jones and Ontario Minister of Long-Term Care Paul Calandra announced the second phase of the government’s post-pandemic “Plan to Stay Open.” This plan is meant to “address the immediate pressure facing the health system, and to stabilize the health and long-term care sectors for the future.” When asked about potential privatization within the proposed plan, Minister Jones stated that “all options are on the table.” The Doug Ford government has come under fire recently for suggesting that the privatization of health care was being considered as a way to relieve the burden from hospitals. These announcements have renewed debates over the state of health care systems throughout Canada, including in Quebec. 

Throughout 2020, Quebec endured the worst COVID-19 outbreak in Canada, suffering more than half of all infections and deaths in the country despite representing only 22 per cent of its population. Problems of understaffing, insufficient beds, and long wait times existed even before the pandemic. Western Quebec waited an average of 18.9 hours for a hospital bed from January 30 to February 26 this year, nearly seven hours above the government’s 12-hour goal. While unveiling its new health reform action plan in March, Quebec Health Minister Christian Dubé stated that “the status quo is no longer supportable” for the health care system. 

The Coalition Avenir Quebec (CAQ) government has acknowledged the system’s failings, including a lack of personnel, insufficient resources for an aging population, a lack of access to rapid care, an outdated medical data system, and a lack of access to general practitioners. This problem does not exist solely in Quebec: Canada as a whole is facing a family doctor shortage due to retiring physicians and fewer medical school graduates choosing the specialty.

In March, the CAQ announced a health reform plan titled “Human and Efficient Plan.” It uses a three-year timeline to work on four aspects of the system: personnel, access to data, information technology, and infrastructure. Big-ticket items on the agenda include accelerating access to front-line health services through a one-stop phone service, reducing emergency room wait times, and improving working conditions for nurses. 

Notably, part of the plan includes more work performed by private clinics. During the pandemic, about 14 per cent of surgeries in Quebec were performed in private clinics but were paid for by the province. The government wants to increase that number to roughly 20 per cent to take the load off the public system. Unions representing Quebec health care workers have expressed concerns about the government’s intention to give greater priority to the private sector. They are calling for a temporary hold on new health care privatization projects, saying that these plans could make it even harder to recruit personnel to the public sector. One reason for this is that doctors in Canada are prohibited from working simultaneously in the public-pay and private-pay health sectors. 

While for-profit surgical clinics, among other medical practices, have existed to varying degrees across Canada for decades, these agencies have been quietly filling staffing shortages during the pandemic – at a growing cost to taxpayers. While some argue that privatization could take the pressure off the public system, it could also increase inequities among patient care for people residing in Canada, and pull more doctors and nurses away from the public system. With a limited pool of health care professionals, patients who cannot access private insurance might wait longer for care in comparison to patients who can pay out of pocket. 

While privatization can provide an immediate solution to insufficient hospital beds and staff, its long term effects can be damaging. Instead, the Quebec government should listen to the suggestions of health care professionals who are striving for reform. For years, health experts have been pushing for more access to family doctors. Currently, an estimated 1.5 million Quebecers do not have access to a family doctor, with the average wait time to find one listed at 600 days. With nearly 20 per cent of Quebecers waiting to find a family doctor, hospitals have been placed in an impossible position: to treat not only those who need serious medical attention but also those who would otherwise be treated by a family doctor. With American hospital workers sounding alarms of burnout following repeated staff resignations, one can make the case that privatization does not do much to alleviate the problem either. 

Rather, there are many ways to improve Quebec’s health care system, some of which have been proposed in Legault’s reform plan. Increasing virtual access to doctors and health care professionals is one example to provide more immediate and equitable care. Furthermore, administrative and mental health support for health care professionals can further work to retain their employment in the public sector. It is vital for the Quebec government to collaborate with health care professionals and unions in pursuit of a more effective health care system.

Get involved with the Canadian Nurses Association’s ongoing advocacy campaigns to raise awareness about issues affecting nurses and the public. Support health care unions in Quebec, like the Fédération de la Santé et des Services Sociaux and the Fédération de la Santé du Québec, which advocate and represent health care workers throughout Quebec. Legault’s government must be held accountable to collaborate and communicate with health care unions.