Newly leaked letters show why Kip Woodward should not be the head of Vancouver Coastal Health, the New Democratic Party's health critic said today.

In one of the letters, Woodward urges that a publicly funded health organization that he chaired be allowed to buy services from private clinics. Woodward, through a family company, has investments in one such clinic.

The letters were written before Health Minister Kevin Falcon announced on April 12 Woodward's appointment as chair of Vancouver Coastal Health's board.

The letters, which include suggestions for how public health agencies can generate more revenue, shed light on an "agenda" shared by Falcon and Woodward, charged NDP health critic Adrian Dix.

"If you're a chair and an important official, one of the senior leaders of public health care in British Columbia, advocating positions that would change that system contrary to the current law, it's probably not a good thing," said Dix, who declined to say where he got the letters.

"And if you're an investor in a major private health care facility in the province, then you have to, I think, give up those private investments if you want to lead the public health care system," he said.

Woodward did not respond to a request for an interview by publishing time.

Ideas on investment firm's letterhead

Before the appointment, Woodward was chair of Providence Health Care, an organization that delivers publicly funded health care, including at Mount Saint Joseph Hospital, Saint Paul's Hospital and six continuing care facilities.

While at Providence, Woodward wrote two letters to Falcon on Woodcorp Investments Ltd. letterhead, released by the NDP today. The letters mainly advocate for more opportunities for health care providers to generate revenue, but also suggest increasing the role of private health care providers.

"Allow Providence Health Care to bid for services from private clinics," Woodward wrote. "The introduction of competition for health care service delivery is the single best tool for cost management, and yet we are prohibited from doing this currently."

As it happens, Woodward's family investment company owns shares in a private clinic, as Public Eye reported on April 15, and he formerly sat on the board of Cambie Surgeries Corp., which runs private clinics.

"Mr. Woodward is advocating a position in this case that would directly benefit Cambie Surgical Centres and other private clinics," said the NDP's Dix. "He's doing so as chair of the board of a major public health care unit, Providence Health Care, and it seems to me . . . [that] raises some questions around conflict of interest."

The Cambie clinic is also among those suing the provincial Health Ministry in a case related to extra billing.

'He's bringing forward ideas': Falcon

Falcon said he's aware of Woodward's financial interest in the clinic but doesn't think it's a problem. "He's disclosed completely that he has an interest through a family company that he's not involved in the day to day operations of," he said. "As long as you disclose the interest it doesn't mean you must never have anything to do with even commenting on whether private clinics can be used or not."

Woodward was an outstanding chair at Providence and will continue to do an excellent job for the health authority, Falcon said. He has received no remuneration for filling either position, he said.

"He's bringing forward ideas as I've asked all health chairs to do and in fact I've asked doctors and nurses and the members of the public to bring forward ideas on how we can have a sustainable health care system," he said.

Revenue growth needed: Woodward

"I cannot emphasize strongly enough my conviction that without opportunities for business development and revenue growth, the public health care system is not sustainable," Woodward wrote in October 2009. "For Providence, in particular, the issues are a lack of control over how and how much we are funded."

He continued, "The assumption that we can maintain a world class system of health care by focussing exclusively on cost containment is self-defeating. Sooner or later, we have to start talking about cost recovery."

He sketched 17 ideas to bring money in to Providence. They included charging non-Canadians more for health services, much as international students pay higher fees than Canadians do for university courses. "Why not let Providence Health Care set rates for non-residents based on actual costs and what the market will bear?" he asked.

"We have spent millions training and obtaining some of the world's finest physicians," he wrote. "Let's use them."

He cited cardiology, HIV/AIDS, mental health and eating disorders as areas where people from elsewhere might pay to be treated at Providence. Aging "clients" or those with a chronic disease could be sold "high end boutique services," he said. Providers should be allowed to extra bill for services that the province's Medical Services Plan doesn't pay for, he said.

The suggestion followed on a September letter where Woodward told Falcon, "I agree with you that too much time and study goes into every effort." He assured him, "We are sensitive to public perceptions and politics."

A briefing note VCHA staff prepared for Falcon ahead of a Nov. 30, 2009, meeting with Woodward said, "Evaluating the merit of each concept requires analysis which has not yet been undertaken. A number may align with the analysis underway on medical tourism." It suggested striking a team with members from the ministry, Providence and the health authority to evaluate Woodward's list. "It is not possible to determine which ideas have merit without further work," it said.

'Recipe for Americanization': Dix

The NDP's Dix said it makes little sense to sell access to things like treatment for eating disorders when there are already long wait lists for British Columbians needing help.

Woodward is advocating using the public system that "all of us paid for" and using it to serve a private clientele, Dix said. Those kinds of changes will cost more money, make the system less efficient, and force people to wait longer for treatment.

"This is a recipe, these proposals, and outright advocacy, for the Americanization of health care," he said. "I have no problem with Mr. Woodward advocating for American health care. I have no problem with Mr. Woodward investing in whatever for-profit health care clinic he wants to invest in. What I do have a problem with is secret discussions, a secret agenda, between the minister and Mr. Woodward."

Falcon and Woodward are both on the fringes of the debate over public health care, said Dix. "Hopefully this will disclose a little of what their agenda is."

As chair of a health authority, Dix said, Woodward should be dedicated to protecting public health care, not advocating changing it in ways that would contravene federal and provincial laws.

That Falcon appointed Woodward to the position says a lot, Dix said. "Clearly he was aware Mr. Woodward held these views and was promoting those views when he made him the head of Vancouver Coastal Health."

Vancouver Coastal Health, as Falcon's April 12 announcement of Woodward's appointment says, "is responsible for the delivery of $2.9 billion in community, hospital and residential care to more than one million people in communities, including Richmond, Vancouver, the North Shore, Sunshine Coast, Sea to Sky corridor, Powell River, Bella Bella and Bella Coola."