Kingston Health Council Report Released

Jeff Green | Feb 14, 2024

Report on Cataract Surgery in Kingston offers a long view of the pitfalls of healthcare privatisation.

The Kingston Health Council (KHC), and its affiliate the Ontario Health Council, have been persistent critics of the Ford government's efforts to support private delivery of publicly funded healthcare as part of the solution for the increasingly stretched Ontario Healthcare system.

This week, the KHC is releasing a new report, entitled “A Clear Eyed Analysis of Cataract Surgery Privatization – The Kingston Health Sciences Centre’s contract with a private-for profit company”.

The report is based upon documents obtained from the Kingston Health Sciences Centre (KHSC) using freedom of information requests, and searches for information regarding Independent Health Facilities, new Integrated Health Facilities Centres, and the Ontario Business Registry The intention of the study was to get a picture of the flow of money, contractual relationships and how service delivery has played out in a relationship that was entered into in 2021, and formalised when a contract was signed a year

It was shared with the Frontenac News, in advance of its release on Thursday, February 15.

The contract was signed February of 2023 between the KHSC, which oversees both Kingston General Hospital and Hotel Dieu Hospital, and Focus Medical Ancillary, to perform some of the hospital’s cataract surgeries.

The KHC report quotes an article from the Whig Standard, wherein the CEO of KHSC, Dr. Pichora, said that the hospital did not have enough nursing staff to keep up with the demand for cataract surgery, and that was why it was entering into the contract. The surgeries would remain under hospital oversight and would be done by hospital surgeons at the Focus Medical Ancillary owned site. There would be no extra charges to patients.

The 2023 contract formalised a memorandum of understanding which had been in place for two years, since February of 2021. If Focus Medical Ancillary does not sound familiar, it operates in Kingston as Focus Eye Centre, and is owned by the same person, Kevin Chadwick.

According to the KHC report, between February of 2021, and September of 2023, the cost to the Ontario taxpayer for the KHSC ordered surgeries, that have been performed at the Focus Eye Centre, has been 56% higher than if they had been done at KHSC. The costs are outlined in the report.

“The total cost was $2.1million, including top up funds from provincial grants. If the same 2,590 procedures had been done in KHSC it would have cost $1.3 million” according to the report

The KHC report goes on to outline a complicated contractual relationship between the KHSC and FMA, concluding that the contract may have lapsed in September of 2023. but that the arrangement has been maintained.

It also said that the original rationale for off-loading the surgeries, all the way back in the fall of 2021, was for it to be a temporary solution to problems brought on by the COVID pandemic.

“Ostensibly, extra temporary space was needed so the hospital could ‘focus on urgent work,’ such as cancer cases, more complex ophthalmology cases and orthopedic cases. KHSC ophthalmology operating rooms (OR) were to be used for more urgent non-ophthalmologic cases, and the proposal, to make up for the loss in operating space, was that easier eye surgeries would go to FMA. This was the public story explaining why KHSC was using the FMA facility” – KHC report page 7.

However, in a briefing note released in April of 2023 by KHSC, the temporary arrangement seems to have changed into a pilot project that is being proposed as a model for not only cataract surgery, but other health care services as well: “The continued collaboration with Focus Eye Centre (FEC) …. demonstrates a return on investment with a public and private partnership which has moved activity to the community that does not require academic hospital care.”

The report pointed to what it calls convenient wording in the above-quoted passage: “In this sentence, ‘community’ needs to be read as a ‘for-profit clinic’ and ‘public and private partnership’ as a contract to privatise. If a real ‘community-based’ clinic was needed, a better option would have been to establish a facility completely operated by the hospital,” it says.