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Vancouver: Medicare Dies Here?

Showdown over private 'urgent care' clinic.

Tom Sandborn 1 Dec 2006TheTyee.ca

Tom Sandborn is a regular contributor to The Tyee with a focus on labour and health issues.

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To shouts of "shut it down" at a noon hour rally, 150 angry protesters outside Vancouver City Hall condemned the NPA majority on city council for refusing to block the opening Dec. 1 of a for-profit emergency clinic by the False Creek Surgical Centre.

The rally, sponsored by the B.C. Federation of Labour, heard Fed president Jim Sinclair say that Mayor Sam Sullivan should act immediately to say "Vancouver isn't going to be the place where the death of medicare happens."

The proposed "urgent care" clinic will only accept patients who do not require intense medical intervention, and will charge an initial examination fee of $199, with additional fees for each diagnostic procedure.

By the end of the day on the Nov. 30, B.C. Health Minister George Abbott, fresh from an "extraordinary meeting" of cabinet at which provisions of new legislation were enacted that will allow the Medical Services Commission to investigate the False Creek Surgical Centre's billing arrangements, warned that the clinic operators would be taking "a considerable legal risk" opening on Dec. 1, according to reports from Canadian Press. Abbott said any provincial action could leave the clinic open for days or weeks.

'Full-blown American style'

Sinclair and other speakers at the rally denounced the NPA majority on city council for refusing to hear 28 speakers who had asked to address them about the clinic that morning, and for defeating a resolution brought by Vision councillor Raymond Louie, calling for the mayor to intervene to prevent the scheduled opening.

"This is not just the thin edge of the wedge," Hospital Employees Union Secretary and Business Manager Judy Darcy told The Tyee at the rally. "This city council is allowing medicare to die on its watch. What we're seeing at this new clinic is full-blown American-style health care. It is unprecedented for city council to refuse to listen to its citizens."

"That's a ridiculous statement," NPA councillor Peter Ladner told The Tyee in a phone interview later the same day. "It would have been a waste of three hours or more for us to hear speakers who had all indicated in their e-mails that they were focused on the issue of the clinic and the Canada Health Act. That is not our jurisdiction. The suggestion that the city shut down this clinic in advance of determining whether they are in compliance with our bylaws is improper. Our staff is looking into the matter and if the clinic is not in compliance, they will take steps. There was no need for a council motion. It was out of order and meaningless."

Vancouver Mayor Sam Sullivan issued a Nov. 28 press release saying "city staff are reviewing the activities and plans of the False Creek Surgical Centre to ensure it complies with all of our bylaws."

The Mayor added: "My staff have been in contact with the office of Provincial Health Minister George Abbott to advise them that should any application for a private emergency room be brought before council, we will be seeking confirmation from both federal and provincial governments concerning compliance with the Canada Health Act."

'We should have listened'

COPE councillor David Cadman is impatient with the suggestion that the matter can be resolved after the clinic opens by bylaw enforcement officers making a post hoc inspection. Speaking outside the city hall doors at the B.C. Fed rally, Cadman told The Tyee: "If we wait for that, the clinic can appeal any bylaw ruling and stay open indefinitely. We should have listened to the citizens who wanted to speak today, and done something useful today. This is the first time I can ever remember that council has refused to listen to citizens this way."

Even if the private urgent care clinic is stopped, other business models pose similar threats to medicare, say critics. As reported in The Tyee, "the Copeman Healthcare Centre in Vancouver has already started charging patients thousands of dollars before they can see a family doctor working in its office. It's a controversial move, but one that could set a precedent. If the provincial and federal governments allow the clinic to continue charging what can be compared to an exclusive club's membership fee, it won't be long before the practice spreads."  [Tyee]

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