A pdf of the letter sent to the Minister of Health is available here.
Kristyn Wong-Tam
MPP TORONTO CENTRE
July 19, 2024
Sent by email
Hon Sylvia Jones
Ministry of Health
RE: Conflicts of Interest And Health Care Privatization
Dear Minister Jones,
I am writing to raise concerns about the lack of safeguards in your government’s creeping privatization of Ontario’s public health care system. As you know, the application deadline for establishing private health care facilities is approaching in August 2024. Public interest must be at the center of good government.
When your government passed Bill 60, enabling the privatization of health care to commence, you promised to establish safeguards to ensure that privatization did not remove doctors from our public health care system. The safeguards you promised have failed to materialize.
Minister, I urge you to address this harmful risk proactively. Please provide a detailed account of the measures implemented to prevent talent drain from public hospitals and clinics. Ontarians must understand and have a chance to evaluate the strategies to retain skilled health care professionals within our public institutions.
Furthermore, as the Official Opposition, we have stated that conflicts of interest will arise when establishing private US-style health care. The administrators positioned to run proposed private clinics already work in public hospitals and clinics. This is a clear conflict of interest and one that should not be permitted to protect public health care in Ontario.
Do you agree that it would be a conflict of interest for individuals on the board of public hospitals or clinics to apply to operate private clinics offering identical services?
After reviewing the application process, I am concerned that your government’s safeguards are wholly inadequate. I note that in your government’s “Call for Applications to License Community Surgical and Diagnostic Centres for MRI and CT Services in Ontario” that applicants are told that “If licensed under the ICHSCA, the Ministry would be relying on the licensee to manage and mitigate any conflicts of interest and uphold its fiduciary duty pursuant to the hospital organization's rules and policies on this issue” (Page 16, Question 50). This means for example, in plain English, that (1) if someone is applying to operate a private clinic that would compete with a hospital's revenue, and (2) they happen to work at that same public hospital, that they are to be trusted with avoiding conflicts of interest. However, there is no specified oversight body, no accountability processes, and no clear place to file a complaint when applicants are not managing their conflicting interests appropriately — this “safeguard” is deeply deficient.
There is a simple solution to this problem: applicants who have a fiduciary duty to a public hospital should be excluded from being a licensee. A basic requirement should be for licensees to notify the hospital board of their application. The Director of the Integrated Community Health Services Centres could ultimately decide on suitability of the application rather than leaving it to the applicant to manage. Finally — from a public interest standpoint — all successful licensees should be publicly published by name so that members of the public are aware of who the owners are from a public transparency standpoint.
None of these rudimentary safeguards exist.
I note that your Ministry has set an application deadline of August 12, 2024. Ontarians are counting on your government to live up to your promises or our health care system will suffer. Please elaborate on the steps your office and ministry have taken to address Ontarians' concerns about likely conflicts of interest and respond answering if you will implement the safeguards I am proposing.
I look forward to your response as soon as possible. Please do not hesitate to contact my office at [email protected] or 416-209-6322 if you have further questions.
Yours very truly,
Kristyn Wong-Tam
Member of Provincial Parliament for Toronto Centre
Suite 401, 120 Carlton St.
Toronto, Ontario
M5A 4k2
cc: MPP France Gelinas