Ontario Health wants public-private integration as hospitals struggle with staffing

The head of Ontario’s health-care bureaucracy wants more integration between the public and private sectors to prevent hospitals from being “cannibalized” as the Ford government considers introducing more privately delivered care to reduce pressure on the public system.

In a sit-down interview with Global News, the CEO of Ontario Health said the private sector has historically operated independently in Ontario and suggested the continuation of that system could lead to additional poaching.

“We’ve got to be careful about this, and we can’t be taking from the public system over into the private system. It’s a zero-sum game,” Matthew Anderson told Global News.

While the Ford government has yet to reveal in specific detail which procedures and services could be shifted into an OHIP-funded private delivery model, Health Minister Sylvia Jones has said Ontarians shouldn’t be “afraid of innovation.”

Without clarity on exactly what innovation means, health-care advocates have begun sounding the alarm on the privatization of services, arguing it will erode the public system and jeopardize patient care.

“It is reckless, it is dangerous and yes, indeed, it does actually threaten the public health-care system,” said Natalie Mehra with the Ontario Health Coalition.

Anderson pushed back on the assertions of privatization and said that’s not what Ontario Health is advocating for.

“If my family hears ‘privatization’ their mind will likely go to funding. They will be concerned that they now have to pay out of pocket to get access to something. And the premier has made that clear, we’re not talking about additional private-funded services,” Anderson said.

Instead, Anderson said the agency is pushing for more control of the private sector, including which services it could perform, the funding it would receive and collaboration with the public sector.

“What we are saying is can we create one funding envelope so that you can’t create this scenario over here where an independent facility can just start doing more procedures,” Anderson said. “We can control at a funding level how many they’re doing. ”

Anderson gave a hypothetical example of a cataract clinic that pledges to increase procedures by 25 per cent, which would require an increase in staffing. Typically, Anderson said, private clinics hire staff from local hospitals, further depleting their resources.

“In an integrated system we would look at that and say how are you going to achieve this 25 per cent increase without taking staff from the public system.”

Anderson said under this model hospitals would be responsible for involving private clinics, allowing them to dictate which procedures should be prioritized rather than “just doing more stuff.”

Premier Doug Ford said last week that “everything is on the table” when it comes to private delivery but promised the publicly funded system would cover “100 per cent” of the cost of care in a private facility.