Nfld. & Labrador

About-face: Health department reverses stand on private eye surgeries

After months of cautioning patients away from using private clinics, the Department of Health is pulling back.

Decision comes months after accusing some private clinics of breaking the law

The Department of Health wasn't too keen on private clinics for eye surgeries, but it reversed that position today. (The Associated Press)

After months of warning patients away from using private clinics for eye surgeries, the Department of Health is pulling back, the minister announced Wednesday, giving eye doctors increased options for where they can perform surgeries.

The change will allow patients to schedule publicly funded eye surgeries either at a private clinic, which must be approved by government, or hospital. There is no timeline for when this would take effect.

"All ophthalmologists will now have the option to use our own hospital operating rooms, as well as approved clinics, should they choose," Health Minister John Haggie said.

The move will "improve access and reduce wait times," according to a press release from the department, which also reassured patients that they won't be on the hook for any provincially covered fees if they use a clinic.

Haggie said he'll be keeping a close eye on surgeons who use their own offices.

"We take our role ... in ensuring patient safety very seriously," he said.

Criminal fees?

The department said it plans to consult the Newfoundland and Labrador Medical Association about how it will pay doctors performing the surgeries — a point of contention last winter, when Haggie sounded the alarm over ophthalmologists who allegedly billed patients directly for insured eye surgeries rather than requesting payment through the Medical Care Plan.

Health Minister John Haggie said Wednesday patient safety is still top of mind. (Ted Dillon/CBC)

That left patients paying out-of-pocket for MCP-covered procedures and prompted Haggie to accuse some surgeons of hoodwinking their patients.

"Individuals who've paid up to $4,000 per eye for what is an insured service … that's a clear contravention of both the Canada Health Act and our own provincial legislation," he said last February.

"There are potential criminal activities here."

Ongoing discussion

Haggie then pushed to ban all private clinics from performing eye surgeries, even setting up a hotline for any patients who suspected they'd mistakenly paid for surgeries that should have been covered by the public purse.

But axing the clinic option meant long waits for basic surgeries, leading one St. John's doctor to protest the decision to allow patients to go under the knife only in hospitals.

In some cases, he said, patients faced a two-year wait.

"Government has bottlenecked the health-care system by only paying for eye surgery to be done in a hospital setting, which has dramatically increased wait lists and wait times," Dr. Christopher Jackman said last June.

He proposed that private clinics — like the one he operates — should be allowed to perform the surgeries and bill the cost to MCP.

Eye surgeon Christopher Jackman called on officials to allow publicly funded cataract surgery in private clinics. (Mark Quinn/CBC)

Other surgeons, such as Dr. Justin French, an ophthalmologist in Corner Brook, and Dr. Ken Roberts, who led an an ophthalmologist's association, chimed in with similar advice.

The department seemed to take those suggestions to heart months after Jackman filed a lawsuit against it, claiming Haggie's warning against clinics had cost him $10,000 per week in lost revenue from procedures he could no longer perform.

"Discussions around where cataract surgery can be performed have been ongoing for some time," Haggie said Wednesday.

He thanked health workers, and French in particular, for their input.

French's proposal for a private clinic, which sparked a public rally when it was rejected, "started a conversation that has led down this road to today's announcement," Haggie said.

'Step in the right direction'

In an emailed statement, sent on behalf of Jackman, the decision is praised as a "very important advancement." 

"The fact that government has listened to the need and made a decision in favour of better patient outcomes is positive news and brings us in line with other Canadian provinces," reads the statement. 

Tracey Bridger, president of the NLMA, applauded the decision, saying broadening access to surgery will have a "huge impact" on reducing wait times.

"This is definitely a step in the right direction," she said.

"We know there's a wait list for cataract surgery already, and the wait list is only going to go up as our population ages. So this is really going to help."

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