The appointment of Tony Clement as health minister by Canada's newly elected prime minister, Stephen Harper, has alarmed some supporters of the country's publicly funded national healthcare system. They regard Mr Clement, who was previously Ontario's health minister, as preferring a two tier (public-private) system.
“It's quite shocking,” said Mike McBane, executive director of the Canadian Health Coalition, a public health advocacy group. “It sends a very clear signal that the prime minister would appoint someone who is ideologically committed to privatising the delivery of the public healthcare system, someone who was aggressively involved in dismantling the Ontario healthcare system, in firing nurses and shutting down hospitals.”
Mr McBane's comments appeared in a news article by a freelance journalist from Ottawa, Wayne Kondro, that will appear in the journal of the Canadian Medical Association on 28 February but which was made available online on 7 February (www.cmaj.ca/news/07_02_06.shtml).
Mr Harper had said during the election campaign that “there will be no private, parallel system.” His party, the Conservatives, had also promised to work with the provinces to “allow for a mix of public and private healthcare delivery, as long as health care remains publicly funded and universally accessible.”
Speaking to the BMJ , Mr McBane referred to these promises. He said, “All the private corporations want the taxpayers to pay the bill. So public funding is not the issue. The issue is [whether we want] investor-owned, private, for-profit delivery.
“Stephen Harper is on record as saying he doesn't care about the delivery as long as you don't have to pay for it. Our point is … there are a whole series of inferior performance indicators [among private hospitals], so that anyone who is evidence based would care a lot about the mode of delivery.”
Mr McBane added that Mr Clement aggressively promoted privatisation of the healthcare delivery system and he saw no reason to think he would change now, “especially under Mr Harper's direction.”
The CMAJ article also quoted Natalie Mehra, director of the Ontario Health Coalition, a network of organisations advocating a one tier, public healthcare system and that has recently issued a legal opinion saying that mixed private-public clinics contravene national and provincial laws. She said that Canadians should be deeply concerned about Mr Clement's appointment, given his support for privatisation and deregulation of long term care facilities and for the creation of profit making hospitals in Brampton and Ottawa. She says he also approved a private cancer care clinic in Toronto.
Mr Clement was lauded for his role in the Ontario government's handling of the crisis over the outbreak of severe acute respiratory syndrome, during which he called the public health system “close to collapse.” But even here critics maintain that the system's deterioration was self inflicted, because it had been “gutted by Tory government measures that included laying off thousands of nurses, as well as scientists in provincial health labs, scant months after Clement assumed the portfolio,” wrote Mr Kondro.
However, the president of the Canadian Medical Association, Ruth Collins-Nakai, said that Mr Clement brings a wealth of experience to his new post.
Mr Clement will serve in the first federal Conservative government to have been elected since 1988.
