Bill 160 Schedule 9 Amended in the Public Interest
The government passed the health care omnibus bill — Bill 160 — prior to Christmas and it has been promulgated into law.
The three political parties proposed a total of more than 100 amendments to the Bill. Those amendments went to the Standing Committee to to voted on in early December. (Membership in the Standing Committees follows the make-up of the Legislature so the governing party currently has a majority on all Committees.) The Liberals voted down all amendments proposed by the Opposition Parties. The amended Bill then went to the Legislature and was passed.
Our concerns about paramedic services, long-term care, private clinics and retirement homes were not addressed.
We were, however, able to get Schedule 9 — the section on Private Hospitals — amended to meet every one of our concerns.
This is what happened:
Schedule 9 repealed the Private Hospitals Act. This may sound like a good thing, but in fact, it was quite the opposite. The Private Hospitals Act (1971) was passed to limit private hospitals. It was a short Act, and a good one. Essentially, it banned all future private hospitals (after 1971) and stopped them from expanding, gave the Minister powers to require private hospitals to be licensed annually, to refuse the transfer (sale) of a license in the public interest, and enabled the Minister unfettered powers to revoke a private hospital’s license in the public interest. When the Shouldice Hospital tried to sell out to Centric Health, one of the largest transnational private health companies in the world, we cited the powers in this Act to ask the Minister to stop the sale. We were successful. Thus the Private Hospitals Act has, by and large, protected Ontario’s public non-profit hospital system from incursions by private for-profit hospitals and transnational chain companies for almost two generations. So when the government introduced Bill 160, we were extremely concerned. We warned that the government was, in Schedule 9, lifting the ban on private hospitals and the powers of the Minister to stop their expansion and control them, without replacing those powers in the new legislation. We wrote an open letter to all MPPs we organized press conferences, asked the NDP to raise questions in Question Period, and we sought high-level meetings with the Premier’s, Government House Leader’s and Health Minister’s offices.
The Premier & the Health Minister agreed and stepped in to direct the bureaucrats to draft amendments.
The Premier’s staff agreed with our analysis and facilitated meetings with the Health Minister’s staff and high-level bureaucrats. We brought our lawyers and ultimately key officials from the Premier’s and Health Minister’s offices agreed with our analysis and worked with us to fix it. The government delayed the legislation and agreed to make amendments to Schedule 9. We reviewed the amendments and the Premier’s and Health Minister’s offices agreed to change the language until we were satisfied. All this to say that the amendments, in the end, met all of the requirements we asked of the government regarding the issue of private hospitals.
This is what we achieved:
- The ban on private hospitals was restored. Only the 5 still-existent private hospitals that were grandfathered in under the 1971 Private Hospitals Act are allowed to continue.
- No private hospital can expand its services or its bed capacity. No private hospital may move its location.
- The Minister’s powers to license these facilities is reinstated along with the powers for the Minister to refuse the transfer, suspend, or revoke a private hospital’s license in the public interest.
- Only the grandfathered-in private hospitals may accept a patient for inpatient services and provide treatment. No other entity can do that, and no other entity can hold itself out as providing hospital services.
- We also won an improved definition of private hospital (as a facility that provides overnight accommodation and medical and nursing care). This will help to limit private clinics from turning into private hospitals.
- We also won expanded powers for the Ministry to control transfers of licenses among private clinics, and to revoke or suspend those licenses in the public interest.
In the end, we are satisfied that the government heard us and the amendments to Schedule 9 continue and expand the limits on private hospitals.
But private for-profit clinics (not hospitals) can still expand and take over public hospital services unless we stop them.
However, Bill 160 rolled the private clinics providing outpatient diagnostics and procedures (not hospitals) legislation (called the Independent Health Facilities Act) into the new legislation and renamed it, even more euphemistically, the Community Health Facilities Act. The Act remains the same as it was. It allows the expansion of private clinics by the stroke of a pen of a bureaucrat in the Health Ministry. It was always a bad Act and remains so. We have successfully fought back every attempt to expand private clinics in recent years. We will have to continue to do so until we win legislation that rolls the clinics back into public ownership and stops the expansion of private clinics.
Bottom line? The premier and the Health Minister agreed with the protections we were seeking in the public interest. They worked with us to change their own legislation to stop the expansion of private hospitals and expand public control over them. This is a great achievement in the public interest. Now we need to roll the private clinics’ services back into public non-profit hospitals….
Misinformation from MPPs:
Some of you have received letters from your local Liberal MPPs containing false information about Bill 160 Schedule 9. These letters mislead, mix up the issues between private hospitals and private clinics, and in some cases contort the truth in order to avoid admitting that the government made mistakes in the original draft version of Bill 160. The way that the Bill was written before the government agreed to work with us to amend it, private hospitals would be able to expand in Ontario. The powers of the Minister to exert the public interest over these hospitals were removed. There was no clear definition of private hospitals. In addition, private clinics would be able to expand with the stroke of a bureaucrat’s pen. Even with the amendments that we have won, private clinics can still expand with the stroke of a bureaucrat’s pen, but they cannot turn into full private hospitals with overnight beds and services.
Further, the government has been stating that the Private Hospitals Act was written in the 1930s. This has sown some confusion. It may well be that there was a private hospitals act passed in the 1930s. But the version that was changed by the Omnibus Bill and Schedule 9 was the version that is listed as the 1971 Private Hospitals Act in the government’s own e-laws. This 1971 version would have been significantly amended from the 1930s version of the Act since there was no public hospital system in the 1930s therefore there would be no ban on private hospitals etc.
While we thank the Premier and Health Minister for their help and for recognizing this issue as a serious one that needed to be addressed, the letters that we have seen from a few local Liberal MPPs are egregiously misleading, and sometimes, outright dishonest about what happened with Bill 160 and the issue of private hospitals. You can see the course of the events in November/December on our website here: http://www.ontariohealthcoalition.ca/index.php/urgent-action-alert-new-bill-allows-private-for-profit-hospitals-more-private-for-profit-clinics/ .
Thank you to the NDP for helping!
The NDP kept up the pressure in the Legislature while we were negotiating with the Health Minister and Premier’s office. NDP Leader Andrea Horwath asked key questions in Question Period for several days in a row to make sure that the government was held accountable to come through with the changes we were seeking to protect against the expansion of private hospitals. You can see the videos of those questions in the Legislature and the answers from the Health Minister here:
Question 1 November 28 https://youtu.be/lTvLBxZXVzU
Question 2 November 29 https://youtu.be/eXag3w9_ 2Sw
Thank you — what an amazing team effort!
Thank you to all of you who contacted your MPPs, came out to the Legislature to help put on the pressure. Thank you to OCHU/CUPE and Unifor for helping to facilitate meetings with the Premier’s and Minister’s staff. Thank you to lawyers Steven Barrett and Ethan Poskanzer for working day and night to help. To all the organizations, from nurses to seniors’ groups, the Council of Canadians, health care unions for writing and presenting submissions to the Standing Committee pushing for amendments. To OPSEU for bringing out your members to help fill the Galleries at Queen’s Park. It was a team effort and everyone made a real difference.