Prescription needed for medical woes

PUBLISHED : Monday, 27 August, 2007, 12:00am
UPDATED : Monday, 27 August, 2007, 12:00am


Having to wait for hospital care is a given at any major urban Canadian centre.

Patients and families swap horror stories about who had to wait the longest for care in hospitals. Patients are sometimes left for days in a bed in the hallway because there are no rooms available. Brian Day, the local orthopaedic surgeon who took over last week as president of the Canadian Medical Association during an annual meeting in Vancouver, believes some simple changes could elimination waiting times. But those simple changes will mean major shifts in the way Canadians view their health system and the national health insurance for all citizens, known as Medicare.

'Wait times are not a necessary evil,' says Dr Day. 'Wait lists won't have to be studied and queue-jumping won't be an issue since there will be no queues.'

Before Dr Day became president of the Canadian Medical Association, he was already one of the best-known and controversial doctors in the country. His claim to fame is embodied in the nickname his critics have granted: Dr Profit.

In 1995, he opened the Cambie Surgery Centre in Vancouver - Canada's first for-profit hospital.

Last year, when it became known that Dr Day was going to take over as president, supporters of public health care were worried - and Dr Day has given them good reason. He wants to make it easier for people who can afford it to get health services in the private sector.

As he points out, inserting private care does not spell the end of universality. In fact, government bodies themselves have been forced to pay for care. Recently, a woman from Calgary about to give birth to quadruplets was sent by Alberta health officials south of the border to Montana to have her babies there. It was an odd decision. Calgary, one of the most economically vibrant cities in Canada, had a shortage of neonatal intensive care beds. But the province could afford to pay the C$215,000 (HK$1.6 million) costs of the cross-border medical care.

What are the implications of a medical system where some can pay while most cannot? The rise of Dr Day and private clinics across the country has seen a parallel rise in groups pushing for the maintenance of the public health care system. Danielle Martin from Canadian Doctors for Medicare said polls showed there was no appetite for more private involvement in the health care system or for the introduction of co-payment systems in which patients paid some costs.

'There is no groundswell of demand from citizens for a national party that would implement such a policy,' said Dr Martin. 'I don't believe Dr Day's personal views could possibly drive the activities of an entire association.'

Even members of the Canadian Medical Association, the national association representing doctors who have elected Dr Day, appear reluctant to push the issue. Among doctors themselves, there is clear evidence of deep divisions in the back-and-forth between those wanting more private services and those wanting to strengthen the public side of health care.

At their convention this week, doctors voted down a resolution to explore user-pay models, indicating their reluctance to pursue further privatisation. But at the same convention, they voted in as Dr Day's successor another controversial physician who was the first doctor in Quebec to open a private magnetic resonance imaging (MRI) facility.

It seems that doctors, like most Canadians, want changes to the health care system, but have yet to come up with a simple prescription.