St. John's surgeon warns hospital-only cataract surgery will mean longer wait times for patients

The provincial government wants to ban private clinics from providing cataract surgery and that will drive up wait times that already exceed two years, says one eye doctor.

Dr. Christopher Jackman says patients facing two-year wait, leaving province for procedure

Eye surgeon Christopher Jackman is calling on Newfoundland and Labrador's provincial government to allow private clinics to perform publicly-funded cataract surgery in private clinics. (Mark Quinn/CBC)

A St. John's eye doctor is warning that wait times will increase dramatically if the Newfoundland and Labrador government bans private clinics from providing cataract surgery.

"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," said Dr. Christopher Jackman, speaking publicly for the first time since the province's health minister raised concerns about cataract surgery months ago.

"The government proposes to take away people's rights. The right to health care, the right to choose and the right to the latest technologies."

Jackman agrees cataract surgery should be a covered by the provincial Medical Care Plan but he says private clinics — like the one he operates — should be allowed to perform the surgeries and bill MCP the cost.

People are resorting to flying out of the province in order to have cataract surgery.- Christopher Jackman

Several weeks ago, the province's justice department sent CBC News a statement reiterating what one of its lawyer said in court in May

"The province will draft regulations which will clarify that the removal and replacement of a cataractous lens by any procedure is an insured service and must be performed in a hospital. The province intends to take the aforementioned step on or before 15 June 2018," it said.

Regulation change will harm patients

Jackman said changing the rules to ensure cataracts can only be removed in a hospital would be a mistake that is most certainly not in the best interest of patients.

"We know that in some cases people are waiting more than two years for cataract surgery," Jackman told reporters at a media briefing on Tuesday.

"Unfortunately, things have gotten so bad that we recently learned that people are resorting to flying out of the province in order to have cataract surgery."

Health department committed to change

In an email to CBC News following Jackman's statements on Tuesday, the Department of Health and Community Services said it is in talks with the Newfoundland and Labrador Medical Association about which medical procedures currently provided in hospitals might be provided in physicians' private medical offices. 

The department said that "to date, no decision has been made about ophthalmologists providing cataract surgery in their private medical offices."

Cataract surgery is covered by Newfoundland and Labrador's Medical Care Plan. (CBC)

It also said the province "has committed to regulatory amendment on or before June 15, 2018, to clarify that the removal and replacement of a cataractous lens by any procedure is an MCP (insured) service and must be performed in a hospital."

Health minister sparked controversy

In February, provincial Health Minister John Haggie said he had been receiving reports that at least one eye doctor is asking patients to pay out-of-pocket for cataract surgery, a procedure that is covered by MCP. He also said cataract surgery is not permitted to be done outside of a hospital.

There are potential criminal activities here.- John Haggie

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

"There are potential criminal activities here."

Issue heads to court

Jackman responded by filing a court application asking a judge to rule that  he has not broken the law by removing cataracts in his private clinic.

"The applicant seeks a declaration by this honourable court that there is no legislative prohibition of removing a lens or a cataractous lens from a patient's eye in a private medical clinic," says a court document filed by Jackman's lawyer.

Jackman said he's removed cataractous lens in his clinic as part of an elective, not publicly insured, service to improve a patient's vision — not as part of publicly insured cataract surgery service.
Newfoundland and Labrador Health Minister John Haggie speaking with CBC News on Tuesday. (Mark Quinn/CBC)

He slammed Haggie's comments questioning if eye surgeons in the province are breaching the Canada Health Act, arguing they damaged Jackman's own reputation and those of other ophthalmologists in Newfoundland and Labrador.

In court documents, Jackman said that in February he stopped performing a number of medical services, "due to a threatening letter he received from Health Minister John Haggie and his subsequent comments about criminal activity."

Jackman said this decision is costing Jackman Professional Medical Corporation a loss of revenue of approximately $10,000 per week, according to documents filed at the Supreme Court of Newfoundland and Labrador.

Jackman's application is scheduled to return to court in late June.