Exclusive: Telus Handed BC Contract to Provide Eating Disorders Care

British Columbia’s Island Health has awarded a contract to Telus, a corporation the province took to court last year over health clinic extra-billing, to provide services to people with eating disorders.

Celeste Macevicius, who has been involved for several years supporting friends with eating disorders, said she finds the decision appalling.

“Telus is not a leader in health care,” said Macevicius, who is also connected to Vancouver Island Voices for Eating Disorders but stressed that she was talking for herself and not the group. “They are a phone company.”

After years of neglect in eating disorder care, the contract might be seen as better than nothing, she said, “but it’s allowing privatization to quietly creep into health care and especially mental health care, which needs better public funding, not more just off-sourcing to private care.”

Eating disorders such as anorexia nervosa, bulimia or binge eating are complex mental illnesses “involving relentless unhealthy thoughts and behaviours towards food, weight and body shape,” according to Island Health.

They are widely misunderstood, poorly treated and deadly, said Macevicius, who was visiting a friend in hospice the day she spoke to The Tyee. “There are many more friends I have who have been imminently facing death, and to hear that the solutions are codes to enter into the Telus app just feels so neglectful and so negligent and cruel.”

Nobody from Island Health, which delivers health-care services on and around Vancouver Island, was available for an interview by deadline.

Nor did representatives of Telus, a publicly traded corporation worth $35.8 billion, respond to a request for an interview Tuesday.

Sonia Furstenau, BC Green leader and MLA for Cowichan Valley, said Island Health awarding Telus a contract to provide eating disorder services is outrageous.

“Suffering, human suffering, should not be a commodity,” said Furstenau. “But it’s more of the same and I think people need to start paying attention to what outcomes we’re getting from this government, which is that companies with a profit motive are able to enter into areas that should be seen as government services.”

Telus has been expanding into health care for several years, seeing it as a way to differentiate itself from its telecommunications competitors and grow revenues.

By 2020, the company had spent more than $2.5 billion on forays that included buying health clinics and becoming a major provider of electronic medical record services.

A year ago B.C.’s Medical Services Commission filed for an injunction in the BC Supreme Court alleging the Telus LifePlus program’s billing practices contravened the Medicare Protection Act. The parties settled the dispute in April with an agreement the corporation will no longer offer access to family doctors for patients who pay thousands of dollars in fees.

At the same time that Telus was fighting with the government over extra-billing, it was negotiating with Island Health to provide counselling and support services for people with eating disorders.

The health authority issued the Request for Proposals on Dec. 20 last year, just four business days before the holiday break, and closed the competition on Jan. 25.

Macevicius said that when she and others from Vancouver Island Voices for Eating Disorders learned about the RFP, they contacted non-profits who work in the area and encouraged them to apply. But by then none were able to prepare a proposal in the short time available.

Members of the group also asked Island Health to be involved in evaluating proposals or implementing the contract, she said, but were turned down.

“As I understand it, nobody with lived experience of an eating disorder was consulted in designing the RFP or putting it out,” Macevicius said, adding that both the government and the health authority know that when developing programs and services it is a best practice to involve people with lived experience.

Recently, many months after the competition closed, people in the community learned that Island Health had awarded the contract to Telus.

The result is concerning, Macevicius said, adding that eating disorder services on the island have been cut in recent years and have long been insufficient.

“When somebody is going to their walk-in clinic or to an eating disorder clinic, they should be expecting to have publicly funded health care that’s going to be connected to other publicly funded resources in their community, and instead they’re being given a code to go to a company.”

After being referred to Telus, eating disorder patients say they receive a code that allows access to health services the company provides digitally. One person who had tried the service said it did not appear in any way tailored to people with eating disorders and seemed no better than going online and searching randomly for a counsellor.

“Giving people a code, and often discharging them from the other outpatient service in their area, asking them to be independently signing up to virtual appointments for a time-limited amount of time, is not a continuum of care, it’s not team-based,” Macevicius said. “I question how specialized it is, and I’m not confident that Telus is able to meet the requirements that Island Health put in the RFP of this care being trauma informed and culturally safe and accessible.”

The Request for Proposals did not specify a contract value and an Island Health spokesperson did not provide answers to questions Tuesday.

The RFP document said Island Health was seeking proposals from organizations “with expertise in eating disorders” to provide virtual and in-person counselling and support services, including access to psychiatrists, psychologists, dietitians and primary care providers.

In particular the care was to be for adults or young adults who have had a persistent struggle with an eating disorder who have not benefited from traditional recovery-focused treatment.

“These clients tend to have low engagement with recovery focused treatment and moderate to high life interference and they require counselling and support services to enhance quality of life and support harm reduction from the eating disorder,” it said. “Individuals with acute psychosis, severe substance use and significant behavioural presentations are not eligible for these intended services.”

The services were to be open to clients from the Island who self-referred and the successful proponent was to have experience working with vulnerable populations and providing trauma-based care. Initial contracts were to be for no longer than two years and could be extended for up to eight more years.

On southern Vancouver Island, eating disorder services for adults have been provided by the Ministry of Children and Family Development, through which patients who are considered “recovery oriented” can get access to services at St. Paul’s Hospital in Vancouver or other treatment.

Macevicius said there are better ways to provide care for people with eating disorders than dividing them into two streams and the government appears to be ignoring what people say they need and what has worked elsewhere.

“We’re in a situation where everybody is either too sick or not sick enough and including Telus as a new option seems like just another way to classify people into excluding them from services,” Macevicius said, adding that “reluctance or facing barriers to feeling recovery oriented is a core part of the illness.”

At the same time, she said, the Island Health contract further embeds Telus and privatization in the health-care system.

“It’s so far from what’s needed to address people’s needs who have eating disorders,” she said. “I find it concerning both from the perspective of eating disorder care and from the broader perspective of B.C.’s health-care system right now.”