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					 “INNOVATION” EXPOSED

AN ONGOING INVENTORY OF
  MAJOR PRIVATIZATION
 INITIATIVES IN CANADA’S
  HEALTH CARE SYSTEM


       2003-2005




                    March 29, 2005
                                                 Table of Contents
                                                                                                                           Page

INTRODUCTION ............................................................................................................. 1
MAJOR FORMS OF PRIVATIZATION IN CANADA ....................................................... 4
   PRIVATE FOR-PROFIT HOSPITALS ..................................................................................... 4
   PRIVATE FACILITIES AND SERVICES: TWO-TIER HEALTH CARE .............................................. 4
   CONTRACTING OUT ......................................................................................................... 4

PRIVATIZATION ACROSS CANADA [UPDATED FEBRUARY 7, 2005] ................................. 5
   THE FEDERAL ANGLE ....................................................................................................... 5
   NATIONAL DATA .............................................................................................................. 8

BRITISH COLUMBIA [UPDATED FEBRUARY 10, 2005]......................................................... 9
   2005............................................................................................................................. 9
   PRIVATE FOR PROFIT HOSPITALS ...................................................................................... 9
   CONTRACTING OUT ......................................................................................................... 9
   PRIVATE FACILITIES AND SERVICES: TWO-TIER HEALTH CARE ........................................... 10
   OTHER ......................................................................................................................... 12

   2004........................................................................................................................... 13
   PRIVATE FOR PROFIT HOSPITALS .................................................................................... 13
   CONTRACTING OUT ....................................................................................................... 13
   GOOD NEWS ................................................................................................................ 17

   2003........................................................................................................................... 17
   PRIVATE FOR-PROFIT HOSPITALS ................................................................................... 17
   CONTRACTING OUT ....................................................................................................... 18
   PRIVATE FACILITIES AND SERVICES: TWO-TIER HEALTH CARE ........................................... 19
   OTHER ......................................................................................................................... 21

ALBERTA [UPDATED MARCH 8, 2005] .............................................................................. 22
   2005........................................................................................................................... 22
   PRIVATE FOR PROFIT HOSPITALS .................................................................................... 22
   PRIVATE FACILITIES AND SERVICES: TWO TIER HEALTH CARE ............................................ 23
   OTHER ......................................................................................................................... 25

   2004........................................................................................................................... 27
   PRIVATE FOR PROFIT HOSPITALS .................................................................................... 27
   PRIVATE FACILITIES AND SERVICES: TWO TIER HEALTH CARE............................................. 27
   CONTRACTING OUT ....................................................................................................... 28
   GOOD NEWS................................................................................................................. 28



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Innovation Exposed                                                                                                         2
March 29, 2005
  2003........................................................................................................................... 29
  PRIVATE FOR-PROFIT HOSPITALS ................................................................................... 29
  CONTRACTING OUT ....................................................................................................... 30
  PRIVATE FACILITIES AND SERVICES: TWO-TIER CARE ....................................................... 30
  OTHER/TRADE .............................................................................................................. 31

SASKATCHEWAN [UPDATED MARCH 16, 2005] ............................................................... 32
  2005........................................................................................................................... 32
  HOSPITALS ................................................................................................................... 32
  OTHER ......................................................................................................................... 32

  2004........................................................................................................................... 33

MANITOBA [UPDATED MARCH 29, 2005] .......................................................................... 35
  2005........................................................................................................................... 35
  HOSPITALS ................................................................................................................... 35
  PRIVATE FACILITIES AND SERVICES: TWO-TIER HEALTH CARE ........................................... 36
  OTHER ......................................................................................................................... 38

  2004........................................................................................................................... 38

ONTARIO [UPDATED MARCH 2, 2005] ............................................................................... 40
  2005........................................................................................................................... 40
  PRIVATE FOR-PROFIT HOSPITALS ................................................................................... 40
  CONTRACTING OUT ....................................................................................................... 41
  PRIVATE FACILITIES AND SERVICES: TWO-TIER CARE ....................................................... 42
  OTHER ......................................................................................................................... 43

  2004........................................................................................................................... 44
  PRIVATE FOR-PROFIT HOSPITALS ................................................................................... 44
  CONTRACTING OUT ....................................................................................................... 45
  GOOD NEWS................................................................................................................. 45

  2003........................................................................................................................... 46
  PRIVATE FOR-PROFIT HOSPITALS ................................................................................... 46
  PRIVATE FACILITIES AND SERVICES: TWO-TIER CARE ........................................................ 48

QUÉBEC [UPDATED FEBRUARY 16, 2005].......................................................................... 51
  2005........................................................................................................................... 51
  PRIVATE FOR-PROFIT HOSPITALS ................................................................................... 51
  FOR PROFIT CLINIC AND SERVICES: TWO-TIER CARE ........................................................ 52
  OTHER ......................................................................................................................... 53

  2004........................................................................................................................... 54
  PRIVATE FOR-PROFIT HOSPITALS ................................................................................... 54

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Innovation Exposed                                                                                                       3
March 29, 2005
   CONTRACTING OUT ....................................................................................................... 55
   FOR-PROFIT CLINICS AND SERVICES: TWO-TIER CARE ....................................................... 55

NEW BRUNSWICK [UPDATED MARCH 18, 2005] .............................................................. 57
   2005........................................................................................................................... 57
   HOSPITALS ................................................................................................................... 57
   PRIVATE FACILITIES AND SERVICES TWO-TIER HEALTH CARE ............................................. 58
   OTHER ......................................................................................................................... 59

   2004........................................................................................................................... 60
   PRIVATE FOR-PROFIT HOSPITALS ................................................................................... 60
   GOOD NEWS................................................................................................................. 60

NOVA SCOTIA [UPDATED MARCH 15, 2005] ..................................................................... 61
   2005........................................................................................................................... 61
   OTHER ........................................................................................................................ 61

   2004........................................................................................................................... 62
   FOR-PROFIT FACILITIES AND SERVICES: TWO-TIER CARE ................................................... 62

NEWFOUNDLAND AND LABRADOR [UPDATED OCTOBER 27, 2004].............................. 63
   FOR-PROFIT FACILITIES AND SERVICES: TWO-TIER CARE ................................................... 63
   GOOD NEWS................................................................................................................. 63

PRINCE EDWARD ISLAND [UPDATED OCTOBER 21, 2004] .............................................. 64
   GOOD NEWS................................................................................................................. 64

NUNAVUT ..................................................................................................................... 65
   CONTRACTING OUT ....................................................................................................... 65




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Innovation Exposed                                                                                                        4
March 29, 2005
   Private, for-profit health care has proliferated,
 since the First Ministers’ Accord on Health Care
 was signed in January 2003. This inventory lists
 many of those initiatives including public private
    partnerships, evidence of two-tier access to
services, private for-profit clinics and other threats
to sustainable, equitable public health care. Know
about other instances of privatization in the health
 care sector? Please send tips and/or sources to:
                  research@cupe.ca
                         or call
                    (613) 237-1590
INTRODUCTION
Privatization within Canada’s health care system has grown relentlessly since January
of 2003, when former Prime Minister Jean Chrétien, Provincial Premiers and Territorial
Leaders signed the 2003 First Ministers’ Accord on Health Care Renewal. Our political
leaders, through this Accord, sought to assure Canadians that they were working “in
partnership” to preserve, enhance and sustain our public health care system. But
nowhere in their “commitment to Canadians” did our leaders commit to public delivery
of health care.

This inventory documents the “innovations” in Canada’s health care system that have
come to light since the signing of the Health Accord in 2003. Today there are more so-
called public private partnerships (P3), more private for-profit clinics and more private
services being offered than ever before. And there are more health care workers
losing their jobs and suffering savage pay-cuts as hospitals and other services cut
back and commercialize their operations – hundreds here, thousands there, lives
disrupted and services declining in the name of “innovation”. But how “innovative” is it
to decimate a public sector workforce comprised largely of women, or to degrade a
workforce to which many people of colour turn to find stable, decent paying jobs?

Simply put, Canada’s political leadership is tacitly aiding and abetting the privatization
of health care and is failing to honestly address the escalating commercial threats to
the public fabric of what is perhaps our most important institution. Almost weekly, new
examples of privatization come to light in communities across the country – private
hospitals, for-profit clinics, job loss and poorer service through contracting out. All the
while, politicians profess their support for keeping the system “public”, with provinces
advocating “innovation” and demanding more “flexible” funding arrangements from
their federal counterpart.

But privatization is inefficient and more expensive. Politicians looking to private
“solutions” to reduce waiting lists should take heed of recent British experience. In
May 2003, the British Medical Journal reported that surgical services contracted out to
private facilities, in the name of reducing waiting lists, cost on average a whopping
40% more. In fact, the National Health Service – funded by taxpayers – was being
charged almost double for some procedures. Recent research looking at US private
for-profit and not-for-profit hospitals showed that private facilities cost on average 19%
more, due to higher overhead charges, executive bonuses and the imperative to
provide profits for investors. The cruel joke behind insisting that everything’s okay as
long as we have a single-payer system masks the reality that public money goes
straight to private profit – in handsome fashion.




__________________________________________________________________________________________

Innovation Exposed                                                                    1
March 29, 2005
Privatization is also dangerous. The more private, for-profit involvement in our health
care system – for-profit services here, a chain of private clinics there, an investor-
owned hospital here – the greater the likelihood that the sector will be opened up
further to foreign investors and fall under demanding trade rules. Services and
investment rules in trade deals seek ever-greater commercial presence in any given
sector, in effect threatening to lock into place the “rights” of giant US health care
corporations.

Privatization, then, is rightly beginning to have an image problem, becoming
synonymous with higher costs, poorer service and job loss. Accordingly, its advocates
have begun to use new, nicer-sounding terms. Words like “innovation” dress up
mundane commercialism and defy critics to argue against good sense itself. Who
could argue with being innovative, or responsive, forward-looking or accountable? But
behind the smooth talk and pretty words lies the grim reality – while the politicians
fiddle, the public system burns.

British Columbia has faced a virtual explosion of privatization under Liberal Premier
Gordon Campbell. Contracting out has led to the very precipice of a general strike in a
province where public hospitals are opting to sell surgical services to remain open,
increasing their reliance on private insurance plans – a boon to giant insurance
corporations. The line between public and for-profit is being deliberately blurred.

Alberta is the testing ground of health care commercialization – and nose-thumbing at
the Canada Health Act – and its role as a national “Trojan Horse” in pushing
privatization has yielded impressive results elsewhere in the country, now rushing to
catch up.

Staid old Ontario is increasingly a commercial laboratory for dodgy P3 hospitals and
de-listing of services. Where Conservative Premiers Mike Harris and Ernie Eves left
off, Liberal Premier Dalton McGuinty carries on, as public-private partnerships and de-
listing continue apace.

Noteworthy exceptions exist. Saskatchewan and Manitoba have a clearer and
stronger commitment to maintaining public delivery in a public system, but signs of
strain are showing even there.

The corporate push is relentless. Faced with this assault, Canadians have to rely on
efforts like this inventory to give them a clearer sense of how widespread privatization
in our health care system actually is. Governments are keeping Canadians in the dark
about privatization’s pervasive growth, and documentation is hard to come by – there
is no single source or listing of for-profit initiatives publicly available. This “ongoing
inventory” seeks to document, from public media sources, major privatization initiatives
that our political leaders are fostering, each and every day.




__________________________________________________________________________________________

Innovation Exposed                                                                    2
March 29, 2005
Politicians sure aren’t rushing to fill in the information gap. The annual reports that the
federal Health Minister submits to Parliament are full of holes. The Health Minister
submits these reports ostensibly to report to Parliament – and to Canadians – that he
or she is fully enforcing the Canada Health Act. But huge swaths of data are missing
when it comes to the scope – and the costs – of privately delivered health care in
Canada. The provinces are not supplying the information, and the feds are not
pushing them to do so. Column after column in these reports, the relevant information
is listed as “not available”. Miraculously, the federal government still claims that it is
indeed protecting public health care in this country.

“Innovation” Exposed documents over 90 new major privatization initiatives announced
since the Health Accord was signed, when Canada’s political leaders trotted out bold
and stirring words to proclaim their concerted commitment to fix and preserve the
public system. But another commitment by our political leaders is really far more
impressive: their clear commitment to ignore the giant elephant in the middle of the
waiting room – privatization.

That elephant is even bigger today, as this inventory shows.

A note on the text:

This is a living document, with new entries added as we learn more about the
complexities of privatization. It is not a comprehensive accounting but does provide a
clear picture of the startling scope of major health care privatization initiatives at the
provincial and local levels. The pace is so fast that often our terminology – and how
we classify and describe forms of privatization – can fall slightly behind. The inventory,
in this version, distinguishes three major forms of privatization:

      private, for-profit hospitals (often P3s);
      private facilities and services (clinics, for example); and
      contracting out.

De-listing of services is, for now, mentioned in connection with “private facilities and
services”. This will likely change in the coming weeks and months, as CUPE and other
defenders of public health care collect and catalogue the raft of services that are being
de-listed from provincial health insurance plans. De-listing is itself a major form of
privatization and is a key strategy on the part of provinces that seek to diminish the
public system’s scope and relevance, while professing its vigorous defence.

The chief sources for this inventory are media reports from mainstream media and
health-related trade journals. Each entry under the provincial heading is a summary of
the initiative with corresponding sources below it, and the entries are arranged by type
of privatization.



__________________________________________________________________________________________

Innovation Exposed                                                                    3
March 29, 2005
MAJOR FORMS OF PRIVATIZATION IN CANADA
PRIVATE FOR-PROFIT HOSPITALS

Private, for-profit hospitals are proliferating in the form of public private partnerships
projects, also known as PPPs or P3s. P3s involve complex contracts between the
public sector and a group of private for-profit companies who come together as a
single consortium with the explicit purpose of bidding on private hospital contracts.

The winning bidder is typically responsible for financing, managing and operating the
hospital as well as delivering key hospital support services, usually through one of the
companies in the consortium. In some instances, the private consortium owns the
building and the public sector pays rent for its use, while in others, the public makes
lease payments, and the private companies acts as a bank. A number of these private
hospitals are at different states of completion across the country (see provincial
sections for details). P3s are still a relatively new approach to financing new
infrastructure, but governments are taking an increasing interest in the model in health
and other sectors, as they present a convenient way to take costs off of government
books and putting them off to the longer term.

British Columbia has two P3 hospital projects confirmed, Alberta has also announced
two and has more in the works. The province of Quebec is planning to merge its major
Montreal hospitals and create two superhospitals using the P3 model for financing and
service delivery. Three P3 hospitals have been confirmed in Ontario and many more
are in the works. New Brunswick and Newfoundland/Labrador are also looking at P3s
to finance new health care infrastructure.

PRIVATE FACILITIES AND SERVICES: TWO-TIER HEALTH CARE

Another increasingly common form of privatization is private for-profit clinics providing
medically necessary services from dialysis to cancer care and surgery. They allow
patients with private insurance or who wish to pay out of pocket to “jump the cue” by
paying for services out of pocket. As more and more services that were once provided
by the public sector are de-listed, ability to pay increasingly determines access to
health services.

CONTRACTING OUT

Contracting out hospital support services is typically a part of P3 deals, but the public
sector also contracts out work to the private sector directly, relying on for profit
companies to hire staff and manage cleaning, laundry, food and dietary services,
security and more. This is an increasingly common strategy used in an attempt to
save on labour costs.



__________________________________________________________________________________________

Innovation Exposed                                                                     4
March 29, 2005
But the costs to the system are great. They include reduced quality, high staff
turnover, a shortage of skills and training, higher workloads, unfair compensation as
wages are cut in half, and reduced confidence in the public system. Women are
impacted most directly by layoffs and reduced wages as women represent the majority
of workers in these classifications. It is notable that new immigrant and visible minority
women are highly concentrated in these types of jobs.

We are beginning to see the contracting out of other health services including direct
patient care. In BC everything from the management of the province’s insurance plan
to day surgery is up for sale, being contracted out to private providers.


PRIVATIZATION ACROSS CANADA [updated February 7, 2005]
THE FEDERAL ANGLE

Federal Health Minister Dosanjh Warns British Columbia About Another Canada
Health Act Violation Fine, While Quebec, Alberta and Nova Scotia Get Warning

Dosanjh says Ottawa expects to fine B.C. again this spring over private medical
facilities. The federal government fined the BC government $126,775 for allowing
patients to pay for surgeries at private clinics in 2004. Federal Health Minister Dosanjh
also sent letters to B.C., Quebec, Alberta and Nova Scotia informing them of concerns
about private MRI clinics. Minister Dosanjh is concerned that there is “queue-jumping”
within the health care system since those patients who can afford to pay the fees get
access to private MRI machines faster, which violates the Canada Health Act (CHA).

February 5, 2005
“Dosanjh: B.C. won’t turn over extra-billing data”, Vancouver Sun
January 14, 2005
“Canada ‘trails other nations’”, Vancouver Sun
December, 2004
“Enforcing the CHA”, cupe.ca

Competition in Health Care? An Argument by the
Vice-Chairperson of the federal Standing Committee on Health

Federal conservative MP Rob Merrifield, vice-chairperson of the federal Standing
Committee on Health, and representative of Yellowhead, Alberta, says that
“competition” should be built into the “single-payer [public] health care system” in order
to “keep it sustainable”. He defines “competition” to include private clinics that provide
services such as MRI’s and cataract surgery that are publicly funded but charge user
fees.

January 31, 2005
“Health care system collapsing”
The Daily Townsman (Cranbrook, B.C.)

__________________________________________________________________________________________

Innovation Exposed                                                                    5
March 29, 2005
The “Third Way”, Alberta Premier Ralph Klein and Québec Premier Jean Charest

Alberta Premier Ralph Klein claims that Québec Premier Jean Charest is “on-side” for
his “third-way” health care system. What Klein calls “third way” health care delivery
incorporates a public/private mix, neither American nor Canadian in his view.

After hearing about Klein’s “third way”, Carolyn Bennett, filling in for Federal Health
Minister Ujjal Dosanjh, issued a warning that the federal health minister has the power
to withhold transfer payments from a province that violates the Canada Health Act by
allowing for-profit health care.

Klein wants to use the provinces’ umbrella ‘Council of the Federation’ to establish a full
administrative and lobbying staff in Ottawa. Klein assumes that special
accommodation made for Québec on health care and other issues can also be made
for every province in Canada.


Alberta will hold a symposium on health care privatization in May

January 15, 2005
“Klein finds “third way” ally in Charest”
Canwest News Service
“Que. Backs Klein’s ‘third way’: Charest supports Alberta’s pursuit of new health-care solutions”
Edmonton Journal
January 13, 2005
“Alberta Premier Ralph Klein is being put on notice by Ottawa over his proposed health reforms.”
Broadcast News



Private Medical Imaging Clinics

A Canadian Institute for Health Information (CIHI) report on MRI and other medical
imaging reveals a substantial number of private clinics operating in Canada. Normand
Laberge, chief executive officer of the Canadian Association of Radiologists, says in an
interview in the Vancouver Sun about the study, that Canada already has a “two-tier
system. That’s the issue for government, if they (the government) don’t make the
decision about two-tier, it will happen anyway”.

Approximately 16% of all MRI machines in Canada are private, according to the 2004
CIHI study (24 private and 127 public). In Québec, more than a third of all MRI
machines are private. There are 14 private and 26 public MRI machines in Quebec, or
35% private machines. In Alberta, almost one quarter of all Nuclear Medicine
Cameras are private – 13 private and 42 public, or 24% private machines. About 5%
of all medical imaging machines in Canada are private (64 private and 1332 public).
January 14, 2005
“Canada ‘trails other nations’”, Vancouver Sun
“Medical Imaging in Canada, 2004”, Canadian Institute for Health Information (CIHI)
http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=media_13jan2005_e
__________________________________________________________________________________________

Innovation Exposed                                                                                  6
March 29, 2005
Canada Health Infoway Privatization

Canada Health Infoway has invested $1.4 million mainly in the private sector.
January 11, 2005
“Canada Health Infoway invests $1.4 million”
Canada Newswire



Private Health Care Spending Increasing Faster than
Public Health Care Spending: CIHI

According to the Canadian Institute for Health Information (CIHI) in 2004, the amount
Canadians paid either from their own pockets or through private insurance firms,
increased more than public sector spending on health. The annual increase in 2004
for private health expenditures was 6.1%, while public sector spending only increased
by 5.8%. The figures come from CIHI’s annual report issued in December 2004 called
“National Health Expenditure Trends”.

National Health Expenditure Trends, 1975-2004, Canadian Institute for Health Information (CIHI),
December 2004 http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=media_08dec2004_e#report

Federal Health Minister, Ujjal Dosanjh, does not intend to oppose private health care
services in place, nor does he intend to take a stand against new private health care
enterprises coming on line. He is quoted as saying that the federal government’s role
is “…not to monitor, not to dictate, but to ensure that we nudge each other as different
jurisdictions to come together” to provide a level of universal care.

        Ottawa Citizen, Aug 7/04 “Better public health care would ‘stem the tide’ of privatization:
        Dosanjh, Jenny Lee

On September 29, Justice Mosley of the Federal Court released a decision rejecting
an application by a coalition of public health care defenders. The coalition was
seeking declarations from the Court that the Minister of Health has failed to monitor
compliance with the Canada Health Act and does not properly report to Parliament on
the administration and operation of the Act. The Judge referred the matter back to
Parliament.
        www.cupe.ca Sept 30/04, “Monitoring, Reporting and Enforcement of Canada Health Act Up to
        Parliament – Judge”

In a major court case that could determine the future of Medicare, a Quebec doctor
named Jacques Chaoulli and his patient George Zeliotis claim that their constitutional
rights have been violated by a Quebec law that prevents queue jumping.

Hearings by the Supreme Court of Canada in the Chaoulli case began on June 8th.



__________________________________________________________________________________________

Innovation Exposed                                                                                    7
March 29, 2005
A group of 10 senators, led by Senator Michael Kirby and a group of for-profit health
corporations have joined the case to ask the Supreme Court to open the door to a full-
fledged private health insurance system in Canada.

Two Quebec courts have already dismissed the challenge, ruling that the provincial
law is intended to prevent discrimination based on ability to pay and is in keeping with
the charter of rights.

       Canadian Press, June 9, 2004, “Private health hurts, court told: Top judges hear a defense of
       Medicare. Where would staff come from lawyer asks,” Dennis Bueckert.

       CTV News, June 8, 2004, “Medicare going on trial in Supreme Court case”, CTV new Staff.
       www.CTV.ca (09/06/04).

Canada’s health minister says he is open to provinces exploring private, for-profit
health care delivery.

       Toronto Star, April 28, 2004, “Health minister open to “options”. Wants for-profit services
       explored. Remarks draw fire from critics,” Mary Gordon.

       Ottawa Citizen, April 28, 2004, “Ottawa opens up Medicare. Provinces given OK to ‘experiment’
       with private firms,” Mark Kennedy.

In November 2003, the government of Canada established an office inside Industry
Canada to promote Public-Private Partnerships for public infrastructure. The office’s
mandate is to create awareness about P3s and offer promising new business
opportunities for “Canadian service firms to provide cost-effective, innovative solutions
to infrastructure and service needs”.
       http://strategis.ic.gc.ca/PPP (April, 2004), Headlines Archive December 2003.

The Martin government is open to revising the Canada Health Act. Government is
open to making the Act more flexible. Health care is expected to be key issue in the
upcoming federal election.

       CP Wire, “Ottawa Open to Revising Canada Health Act, source say,”
       Thursday March 25, 2004, Dennis Bueckert.
       Broadcast News, “The Martin government is open to the idea of revising the Canada Health
       Act,” Friday March 26, 2004.

NATIONAL DATA

The Canadian Association of Radiologists claims that over half of the MRI’s performed
in Canada in 2003 were done in private clinics.

       Broadcast News, Saskatchewan Update, July 7/04




__________________________________________________________________________________________

Innovation Exposed                                                                                   8
March 29, 2005
BRITISH COLUMBIA [updated February 10, 2005]
2005

PRIVATE FOR PROFIT HOSPITALS

70% Jump in the Cost of the P3 Abbotsford Hospital to $355 million

The Public-Private-Partnership (P3) Abbotsford Hospital and Cancer Centre will now
cost around 70 per cent more than what the BC Liberals announced. In December
2001, a feasibility study indicated the 300-bed hospital would cost $211 million dollars.
The price jumped to $286 million when the government sought proposals in September
2003. The builder, called Access Health Abbotsford, revealed in July 2004 that the
cost increased again to $325 million. Construction now has an estimated $355 million
price tag. The cost has increased 68.2 per cent – or $144 million – more than the
original estimate. A HEU-commissioned financial analysis by forensic auditor Ron
Parks projected that the public will pay $1.4 billion in lease payments to the private
consortium over the next 33 years. The government agency responsible for the
project, Partnerships BC, says the new price reflects its new designation as a regional
referral centre with a larger emergency ward. [However, there is no promise that the
public will be protected from budget overruns should costs go even higher.]
Partnerships BC say a value-for-money report and the detailed agreement will be
released in 2005. Abbotsford is in the Fraser Valley about 80 km east of Vancouver.

December 2004
“Controversial P3 hospital project under way despite union’s concerns over 70% price hike:
Partnerships BC says costs justified by added features”
Daily Commercial News and Construction Record
December 13, 2004
“Hospital workers slam rising cost of new centre”
The Daily News (Prince Rupert)
December 10, 2004
“Costs up 70% for Abbotsford P3 hospital”, cupe.ca

CONTRACTING OUT

Contracted Out Hospital Cleaning Found to be Unsafe

The Hospital Employees Union (HEU) – the BC health services division of CUPE – and
the BC Nurses’ Union are urging the BC Auditor General to carry out a thorough audit
of housekeeping services in four health authorities where cleaning work has been
privatized. A joint union report “Falling Standards, Risking Risks: Issues of hospital
cleanliness with contracting out” released in November 2004, documents numerous
concerns over poor cleaning and inadequate infection control at St. Paul’s Hospital in
Vancouver. Surveys and meetings at Burnaby and Eagle Ridge Hospital have
uncovered similar cleaning concerns. Since health authorities began contracting out


__________________________________________________________________________________________

Innovation Exposed                                                                           9
March 29, 2005
laundry, food and support services, dietary and hygiene standards have declined at
Lower Mainland and Fraser Valley hospitals.

December 13, 2004
“Auditor General urged to audit hospital cleaning in four authorities”, heu.org
December 3, 2004
“Another BC hospital study reveals scary conditions under privatized cleaning”, cupe.ca
November 26, 2004
“New cleaning concerns: investigation reveals widespread problems with housekeeping at
St. Paul’s Hospital”, heu.org
“Privatization and Cutbacks Hurt Health Care”, cupe.bc.ca



Interior Health Regional Authority Hires FHG International to Review
Status of Hospital Food Services

Interior Health has hired an independent consulting firm to review the food services in
their hospitals. FHG is an international company that has done market research and
feasibility studies in Canada, the U.S. and the former Soviet Union. Food services
were recently amalgamated in the region. The review is expected to begin in January
and should take about 12 weeks. [Contracting out can result from amalgamation and
consultant reviews.]

December 2004
“IHA reviewing status of food services”, Free Press, evsos.com



PRIVATE FACILITIES AND SERVICES: TWO-TIER HEALTH CARE

Victoria’s First Private MRI Clinic

CML HealthCare Imaging Inc., based in Ontario, will soon open the first private MRI
clinic in Victoria. The cost of an MRI at the new private clinic will start at $900.
Vancouver Island Health Authority spokesperson Suzanne Germain said that if MRIs
were contracted to the CML clinic, they would be publicly funded. If the private MRIs
are funded by a third-party insurance, such as the public health care system, the
Canada Health Act is not violated. Many private clinics have blurred the definition of
“third-party insurance”. The definition seems to now include employers, benefactors,
friends and sometimes even relatives.

February 4, 2005
“MRI scans go private”
Vancouver Island News Group




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Innovation Exposed                                                                        10
March 29, 2005
Vancouver Island Health Authority contracts private firm South Island Surgery

The Vancouver Island Health Authority contracted the private company South Island
Surgery to perform 98 surgical procedures in August 2004.

February 4, 2005
“MRI scans go private”
Vancouver Island News Group



BC Fined by Ottawa for Private Clinics – Ottawa to Fine BC Again in Spring 2005

The federal government fined the BC government $126,775 for allowing patients to
pay for surgeries at private clinics in 2004 – a violation of the Canada Health Act. [If
patients have to pay out-of-pocket for “medically necessary” procedures, health care is
not universally accessible – a pillar of the Canada Health Act.] The Vancouver Sun
reports that the fines relate to violations occurring in the fiscal period of 2001/2002.
Federal Health Minister Ujjal Dosanjh has said that BC will be fined again this spring
over patients’ use of private medical facilities during the 2002-2003 fiscal year.
Dosanjh says in the Vancouver Sun that he is “judgmental about the province that
continues to allow (this) kind of situation to remain…(they) aren’t providing adequate
services to its citizens, when we are giving them gobs of money”. He pointed to the
recent federal transfer of $41 billion over 10 years to provinces and territories.
February 5, 2005
“Dosanjh: BC won’t turn over extra-billing data”
Vancouver Sun
February 4, 2005
“Feds to fine BC for clinics”
Vancouver Sun



BC Won’t Turn Over Extra-billing Data to Ottawa

Federal Health Minister Dosanjh has commented that, although obligated, BC is not
reporting regularly on Canada Health Act (CHA) violations. In response, BC Health
Services Minister Shirley Bond argued in the Sun that the term “medically necessarily”
– those procedures covered by the CHA – should be clarified. Vice-president of the
Elk Valley and South Country Health Care Coalition (EVSCHCC), Barbara Kosiec says
a more flexible definition of “medically necessary” “serves as a tactic to cover the
explosion of private clinics in BC that are offering affluent patients more immediate
care, which meets the philosophy and goals of the Liberal government towards
privatizing the public sector”.
February 5, 2005
“Dosanjh: BC won’t turn over extra-billing data”
Vancouver Sun
December 22, 2004
“EVSC Health Care Coalition”
The Free Press (Fernie)
__________________________________________________________________________________________

Innovation Exposed                                                                    11
March 29, 2005
BC Wasting Tax-Payers Money on Private Health Care Clinic Profits

BC is letting hospital operating rooms lie idle while contracting out surgeries to private
companies. The Vancouver Island Health Authority (VIHA) has announced that it will
spend $2.1 million on more than 2,000 surgeries and 500 procedures at private clinics
by April 2005. Since the BC government will pay for all health care procedures at the
private clinics, VIHA spokesperson Dr. Glen Lowther says that the contracting out is
consistent with the Canada Health Act. Cataract surgeries, bladder procedures, joint
operations and hernia repairs are among those open to the bidding process. Former
BC Health Services Minister Colin Hansen has said that four of five health authorities
in BC have announced similar plans to contract out surgical procedures to private
clinics.

December 10, 2004
“Vancouver Island asks for private surgery bids”
Edmonton Journal



OTHER

De-listing

Coalition condemns serious flaws with BC Pharmacare

In the report titled “Access to Medications in British Columbia: Does Pharmacare pass
the drug test?” The Better Pharmacare Coalition (BPC) outlines that 91% of the 60
drugs waiting to be approved for funding are already funded by other provinces.
Gail Attara, Executive Director of the Canadian Society of Intestinal Research (part of
the coalition) argues: “Pharmacare use(s) a form of medicine rationing that reduces
physician treatment choices and harms patients”. Under the BC Liberals, pharmacare
coverage has been cut. Seniors now pay a greater share of their drug costs, as some
drugs have been delisted altogether. The BC hearing aid program has been
eliminated. Coverage for preventative health care – chiropractic, massage therapy,
physiotherapy, naturopathy and non-surgical podiatry – has been de-listed. Routine
eye exam coverage for adults between the ages of 19 and 64 has been cancelled.

February 8, 2005
“Coalition says prescription plan ignores patients”
The Daily News (Kamloops)
February 7, 2005
“Healthcare coalition condemns serious BC Pharmacare flaws”
News Release, Better Pharmacare Coalition, betterpharmacare.com
“Privatization and Cutbacks Hurt Health Care”, cupe.bc.ca




__________________________________________________________________________________________

Innovation Exposed                                                                    12
March 29, 2005
2004

PRIVATE FOR PROFIT HOSPITALS

The P3 agreement with a private consortium called Access Health Abbotsford to build
the new Abbotsford Hospital and Cancer Centre is scheduled to be signed in October.
Details of the contract will not be released to the public until after it is finalized. Access
Health Abbotsford is composed of PCL Construction Group, Brookfield LePage
Johnson Controls and the Canadian branch of ABN Amro Bank. The Consortium will
finance, design, build and operate the new hospital, with the government proposing to
pay for using the building through a lease arrangement.

       Maple Ridge News, Aug 7/04, p. 0012, “Streifel resurfaces, raps P3 hospital.”
       Chilliwack Progress, Aug 17/04, p. 0014, “Alberta abandons P3 hospital.”
       Abbotsford News, Sep 2/04, p. 0004, “P3 project worthwhile – even NDP agrees.”
       Abbotsford News, Oct 5/04, p. 0001, “$5.2 million payment looms for hospital.”

The sod was turned on September 30th for construction of the Academic Ambulatory
Care Centre at the Vancouver General Hospital, the province’s first P3 project.
The 11-storey building is scheduled to be completed in 2006. The facility will be built
and operated for 30 years by Access Health Vancouver (AHV). The AHV consortium
is made up of ABN AMRO Bank N.V., PCL Constructors Westcoast, a joint venture of
IBI Group and Henriquez Architects, and Brookfield LePage Johnson Controls.
The Vancouver Coastal Health Authority (VCH) will lease space as the main tenant
and will assume ownership of the building at the end of 30 years. VCH will rent
216,000 of the 365,000 square feet in the new facility. AHV will lease out the
remainder of the space to private tenants.

       The Vancouver Sun, Oct 4/04, p. B7, “Sod turned on first P3,” Maurice Bridge

CONTRACTING OUT

The Hospital Employees Union and cleaning staff in Fraser Valley Health Authority
hospitals are sounding the alarm about a lack of cleanliness and resulting health
concerns in FHA’s facilities. The cleaning function for the Authority has been
contracted out to Sodexho Canada since last winter. Statements by the HEU followed
an order by Health Minister Colin Hansen for a review of the departments at the Surrey
Memorial Hospital where two women complained they contracted severe and flesh-
eating infections, and after a series of incidents occurred at other FHA hospitals.

HEU spokeswoman, Margi Blamey said that “we think Surrey Memorial is an example
of what’s going on in other facilities. Patients and staff have brought up concerns in
other hospitals.” Among the concerns/incidents raised:

  o     in March, MSA Hospital cleaning staff reported that blood and birthing material
        remained in delivery rooms that were supposed to be clean, and needles and
        trash were left behind in emergency room beds
__________________________________________________________________________________________

Innovation Exposed                                                                      13
March 29, 2005
  o     in April, Royal Columbian Hospital’s special care nursery was closed due to a
        superbug outbreak
  o     in August, complaints by patients about the lack of cleanliness in the Royal
        Columbian’s ER let the FHA to promise that the private contractor would
        provide more staff
  o     in September, a patient at the Royal Columbian complained that she was put in
        a bed with wet and soiled sheets
  o     in September, the Workers’ Compensation Board was brought into the
        Abbotsford hospital to review health and safety procedures. The WCB found
        that Sodexho’s health and safety procedures were appropriate for cleaning
        hotels, not hospitals

       The Abbotsford Mission Times, Nov 19/04, p1, “Probe should include local hospitals, says HEU:
       Infections a major concern after Surrey patients contract flesh-eating disease.” Christina Toth

The British Columbia government has finalized the contracting out of the administration
of the Medical Services Plan and Medicare to a private American company. The 10-
year contract, handed out to Maximus Inc, is worth $324 million. Maximus will register
clients, process medical and pharmaceutical claims, and oversee the medical
program’s responses to patients.

Opponents of this move are particularly concerned that the contract will put personal,
private information of British Columbians in the hands of U.S. authorities. At the end of
October, B.C. Privacy Commissioner, David Loukidelis, released a report that found
that the U.S. Patriot Act allows American authorities to access personal information of
Canadians if it ends up in the U.S. or is held by U.S. firms in Canada. Although the
B.C. government passed a law in October aimed at preventing U.S. authorities from
examining information about British Columbians held by private U.S. companies, it has
not followed many of the Privacy Commissioners recommendations designed to
ensure the security of such information.

       The Province, Nov 5/04, p A4, “B.C. OK’s plan to contract out medical claims to U.S. outfit,” Ian
       Bailey
       The Daily Courier, Nov 5/04, pA2, “Health claims contracted out to U.S.-based firm: B.C. Health
       Ministry announces privatization of MSP claims with a 10-year contract worth $324 million.”

A shortage of operating room nurses has led St. Paul’s Hospital in Vancouver to
contract out 1,000 surgeries ranging from orthopedic knee operations to hernia repairs.
The work will be done by three private clinics: Cambie, False Creek and Ambulatory
Surgical Centres.




__________________________________________________________________________________________

Innovation Exposed                                                                               14
March 29, 2005
The B.C. Nurses’ Union is calling for an investigation into working conditions at St.
Paul’s. According to union president Debra McPherson: “There’s an over-reliance on
nurses working overtime and on-call, and staff are simply burning out.”

In September Health Minister Colin Hansen stated that the government was looking at
giving private clinics more work. He also said at that time that private clinics may be
able to get some procedures done faster and cheaper.

       The Vancouver Sun, Nov 3/04, p A1, “Nurse shortage forces St. Paul’s to use private clinics,”
       Joel Baglole

       The Daily Courier, Nov 4/04, p A2, “Nurses demand probe after hospital surgeries diverted to
       private clinics.”

The Fraser Valley Health Authority closed bids on September 24 for the contracting to
private clinics of 2,500 MRI procedures. The contracted scans are to be performed by
March 31, 2005.

       National Post, Sep 15/04, p. A1, “Privatized care keeps expanding,” Scott Stinson and James
       Cowan

The use of private clinics to perform publicly funded surgeries has been growing
steadily in B.C. since first allowed in 2002. Four B.C. health authorities, Vancouver
Coastal, Vancouver Island, Fraser and Interior, are increasingly engaging in this
practice. In Vancouver, between September 10 and the end of October, 1400 day
surgeries, paid for out of the public purse, will have been performed in private clinics.
Since March, the Fraser Health Region has spent $875,000 contracting out surgical
care to private clinics. The Interior Health Authority has recently disclosed that it will
pay a private, for-profit clinic in Kelowna $615,000 to perform 480 day surgeries over
the next 6 months, or $1280 per surgical procedure. Only the Northern Health Region
does not contract out surgical care. To date, the surgery has consisted of simple day
procedures such as cataract removal, although the Provincial Health Minister has
indicated that he is considering contracting out more complicated procedures that
involve overnight stays.
       The Vancouver Sun, Sep 10/04, p. B1, “Backlog of surgeries cleared,” Jim Beatty
       National Post, Sep 16/04, p. A21, “A second quiet revolution?” Editorial
       B.C. NDP NEWSWIRE, Oct 6/04, “Campbell wasting precious public health resources on for-
       profit clinics,” newswire@news.bc.ndp.ca




__________________________________________________________________________________________

Innovation Exposed                                                                              15
March 29, 2005
More than 8,000 workers -- 90% of them women -- have lost decent jobs paying an
average of $18/hour as a direct result of Bill 29. Their work -- most of it in hospital
cleaning, dietary services, laundry and security -- has been contracted out to foreign
corporations which pay $9-$11/hour and provide few benefits. The wages of those
who clean operating rooms, sterilize their linens and prepare and serve patient food
throughout B.C.'s largest and most expensive metropolitan areas are now the lowest in
the country. Care aides and nurses -- especially those providing care to seniors -- have
also been hit hard by job losses, and Bill 29 has left many other health care workers
vulnerable.

       National Post, Jul 15/04, Op Ed, “B.C. wants to turn back the clock,”
       Chris Allnut [former Secretary-Business Manager, HEU]

The provincial government has announced that Bill 92, designed to prevent doctors
from charging a fee for procedures covered by the public system through the
imposition of heavy fines, will not be passed. The Provincial Health Minister,
Colin Hansen, has indicated that the government will not let its Bill 92 get in the way of
its own expansion of private clinic use.

       Alberni Valley Times, Sep 10/04, p. A5, “Expanded use of private medical clinics considered.”

The total number of job losses resulting from BC’s Bill 29, the Health and Social
Services Delivery Improvement Act is now up to about 7,000, with thousands more
expected by the end of the year. Bill 29 has made it legal for employers to ignore
negotiated contracts that are legally binding. And employers are taking full advantage
of the opportunity to get around job security provisions in contracting out public health
care work.

       Bill 29, Health and Social Services Delivery Improvement Act, Legislative Session:
                                                   rd
       2nd Session, 37th Parliament Passed on 3 reading, 27th day of January, 2002,
       http://www.leg.bc.ca/37th2nd/3rd_read/gov29-3.htm

       HEU, 2004.

Pink slips were issue to more than 1,000 unionized health support workers from
Nanaimo to Victoria on February 23rd. The Vancouver Island Health Authority has
decided to contract out its housekeeping and food services to Morrison Health Care
Food Services and Crothall Services Canada, both divisions of Compass Groups
Canada.

Layoffs of 1,029 full-time, part-time and casual workers will roll out over the next six
months. Of those losing their jobs, 90% are women. The average wage of most
workers was 19.50 before the layoff. The contractors are expected to pay 9.50 an
hour.

       Times Colonist (Victoria), “Contracts axe union jobs: More than 1,000 health
                                                              th
       workers face layoffs, outside firms hired,” February 24 , 2004, AI, Bill Cleverley.
__________________________________________________________________________________________

Innovation Exposed                                                                                     16
March 29, 2005
       Daily News (Nanaimo), “’Sad Day for health workers” Health Authority giving jobs to
       private contractors; 141 workers to be laid off,” Ai/Front, Valerie Wilson.

GOOD NEWS

B.C.’s Interior Health Authority is breaking the privatization mold and keeping its
new, centralized laundry service in house. The move to centralize will still cost the
equivalent of 50 full-time jobs, but the Salmon Arm facility will still improve on the
hugely negative repercussions to workers and service delivery that have been
wrought in other parts of the province.

       www.cupe.ca May 20/04, “B.C. health authority to keep centralized laundry in house.”

2003

PRIVATE FOR-PROFIT HOSPITALS

Passed in November 2003 by the Gordon Campbell Liberals, Bill 94, the Health Sector
Partnerships Agreement Act, makes private hospitals legal. It sets out the legal terms
for entering into public private partnership hospitals and for contracting out, making
privatization of BC’s health system more attractive to for-profit corporations and easier
to do.
       Bill 94, Health Sector Partnerships Agreement Act, 2003 Legislative Session: 4th
       Session, 37th Parliament; Third Reading on the 27th day of November 2003.
       http://www.leg.bc.ca/37th4th/3rd_read/gov94-3.htm

Interior Health Authority plans what sounds like a public private partnership project for
a new long-term care facility for seniors and people with disabilities. Six different
groups of for-profit companies have submitted expressions of interest to build, design,
operate and staff the facility privately. Construction planned to begin in spring of 2004.

       Nelson Daily Times, 07/16/2003, Page 1/Front, Kathy Keil.

Kimberly B.C. purchases hospital from Interior Health Authority with idea to turn the
hospital into a “health mall” providing for-profit “fringe services” in a 3-way partnership
with the town, the Health Authority and a private management company.

       Medical Post, O1/14/03, Vol. 39, no. 2, David Kosub.

A feasibility study is underway to look at public private partnership for new hospital
near Parksville, proposed by US firm.

       Times Colonist (Victoria), 05/15/03, B3.




__________________________________________________________________________________________

Innovation Exposed                                                                            17
March 29, 2005
A hospital and cancer centre in Abbotsford, BC, will be a public private partnership.
Several firms have submitted bids. A newly established crown agency, “Partnerships
BC” will look at proposals.

       Free Press (Fernie), 01/28/03, Matthew Claxton.
       The Province, 05/05/03, A6, Kent Spencer.
       Canadian Press Newswire, 05/04/03.
       Broadcast News, 01/28/03.

CONTRACTING OUT

The BC liberals’ brutal dismantling of the public health system has led to the
elimination of nearly 3,000 health care workers’ jobs over the last 18 months. Another
6,000 health care workers will likely lose their jobs by mid-2004 as a result of facility
closures, service reduction and privatization of support services.

       HEU, 07/30/03, News Release, www.heu.org.

Vancouver Coastal Health Authority (VCHA) announced a 5-year cleaning contract
with Aramark Canada Ltd., and hands 850 layoff notices to unionized workers in
Vancouver Hospitals. Workers earning half as much and without adequate skills or
training will now be responsible for cleaning and infection control in operating rooms,
intensive care units and other highly specialized settings.

       Vancouver Sun, 31/07/03, Pamela Fayerman and Greg Mercer.

Vancouver Island Health Authority (VIHA) is also on a privatization spree when it
comes to support services. Privatization of housekeeping services at Cowichan
District and Cairnsmore Place puts 33 full-time jobs at risk. A request for proposals
(RFP) has been issued to privatize housekeeping in several other major hospitals in
the area as well. An RFP was issued to privatize patient food production and
distribution at a number of facilities a month earlier.

       Cowichan Valley Citizen, 13/07/03, Andrew Costa.

The Vancouver Coastal Health Authority’s privatization spree will result in the layoffs of
hundreds of front line health care workers in a number of facilities – mostly women.
Hospital support services including food services and hospital cleaning in sensitive
areas such as intensive care units, special care nurseries and operating rooms will be
contracted out to private companies that will hire inexperienced workers at 50% of the
wages of public sector workers.

       News Releases, 05/30/2003 and May 27, 2003, Hospital Employees’ Union, (www.heu.org).




__________________________________________________________________________________________

Innovation Exposed                                                                       18
March 29, 2005
More layoffs in yet another round of privatization, this time the Vancouver Coastal
Health Authority signs a 10-year contract for the transfer of laundry responsibility for
Lions’ Gate and Vancouver Hospitals to American owned K-Bro Linen Systems.
Another 47 workers will be laid off.

       News Releases, 06/03/2003, Hospital Employees’ Union, (www.heu.org).

Unprecedented, Bill 29 overrides collective agreements by permitting ongoing
contracting out and privatization of health service delivery. Thousands of jobs lost
already. More to come.

       Bill 29: Health and Social Services Delivery Improvement Act, Honorable Graham
       Bruce, Minister of Skills Development and Labour. Passed at Third Reading, 2001.
                              nd           th
       Legislative Session: 2 Session, 37 Parliament, January 27, 2002.
       The Province, 04/15/03, A6, BC Briefing.
       Vancouver Sun, 04/15/03, B1 Front, David Hogban.
       Vancouver Sun, 06/07/03, G4, Business in BC.
       Daily News (Nanaimo), 06/06/03, A9, In Brief.

Vancouver Island Health Authority seeking tenders from the private sector for food
services and considering privatizing housekeeping at several facilities.

       Times Colonist (Victoria), 06/11/03, A3, Jeff Bell.

Interior Health Authority to privatize food services through centralized kitchen in
Vernon.

       Trail Daily Times, 02/21/03, 1/Front, Lana Rodlie.

Fraser Health Authority privatizes and centralizes laundry services. Laundry is now
being trucked to Alberta.

Food services and Housekeeping at BC Children’s Hospital and Women’s Health
Centre privatized.

       The Daily News (Kamloops), 05/29/03, A1/Front, Cam Fortems.
       Vancouver Sun, 05/28/03, B2.

PRIVATE FACILITIES AND SERVICES: TWO-TIER HEALTH CARE

Health Canada charges BC government for allowing a well-known private clinic, (False
Creek Surgical Centre) to charge user fees for medically necessary services. This
fundamental breech of the Canada Health Act cost the province a minimal $4,610 of its
share of the Canada Health and Social Transfer.


__________________________________________________________________________________________

Innovation Exposed                                                                        19
March 29, 2005
       The Province, 06/27/03, A27, Don Harrison.

       The Globe and Mail, 06/27/2003.

Patients who can afford to will be able to pay for MRI or CT scans at private clinics and
in Abbotsford as of mid-December, 2003. Canadian Health Scan, a for-profit
company, will allow patients to obtain results before the rest of the population and thus
to jump the queue for treatment in the public system. Neither the director of Medical
Imaging Services for the Fraser Health Authority, nor the Canadian Association of
Radiologists supports the proliferation of private CT scan clinics in Canada.

       Abbotsford News, 11/20/2003, “Two-tier health system is here’: Lutton”.

A group of 14 radiologists is setting up The Fraser Valley MRI Clinic. The radiologists
will rotate between this new private clinic and the public hospitals where they currently
work. Instead of improving access to MRIs for the whole community, the general
public will continue to wait while those who can afford to pay will be able to obtain
services right away.

       Abbostford News, 11/22/2003, “Add Private MRI to Medical Mix”.

Saint Mary’s Hospital plans to sell surgical and other services, but retain its status as a
public, not-for-profit hospital. Huge budget cuts by the provincial government have
forced administrators to look at new ways to generate funding and keep the hospital
open. Now 50 or 60% of revenue will come from private insurers – up from about
10%. Using the public facilities to provide non-medically necessary procedures, as well
as providing health services for high-class executive, is being considered. The
hospital is also looking at providing expedited surgery for those covered under the
Workers’ Compensation Board and others not covered under the Canada Health Act.

Private providers would be able to lease the facilities to make a profit. This means that
the hours that the hospital can provide its regular non-profit functions will be curtailed,
and long wait lists for publicly insured services would become even longer.

       Vancouver Sun, 09/24/2003, “St. Mary’s Hospital to sell surgical services,” Pamela Fayerman.

B.C. government in negotiations with US-based multinational Baxter International Ltd.
will provide treatment for kidney disease and kidney dialysis in the Fraser Valley
Health Region.

       HEU News Release, 03/24/03, “Nurses Demand Halt to Talks with US Health Giant
       Linked to Patient Deaths”, www.UnofficialOpposition.com, (4/25/2003).

Cambia Surgery Centre (a for-profit clinic) in Vancouver continues to operate by
invoicing third party payers (relatives or companies).

       Calgary Herald, 03/14/03, A6, David Heynan.


__________________________________________________________________________________________

Innovation Exposed                                                                            20
March 29, 2005
The Vancouver Coastal Health Authority plans to contract out thousands of surgeries
to private clinics. Other health authorities may follow suit.

        Vancouver Sun, 06/11/03, A1/Front, Judith Lavoie.
        The Province, 06/11/03, A3.

        The Province, 06/12/03, A8, John Birmingham .


Patient pays $6,000 for sinus surgery at private clinic to jump surgery line at False
Creek Surgical Centre.

        Vancouver Sun, 03/26/03, A1/Front, Pamela Fayerman.

In Vancouver a patient can buy a Positive Emission Tomography (PET) scan, which
can monitor and detect heart problems. More than 1,100 patients have paid $2,500 to
be scanned.

        Edmonton Journal, 03/16/03, D8.
        Vancouver Sun, 03/22/03, B6, Joanne Laucius.
        Vancouver Sun, 06/12/03, B1/Front, Pamela Fayerman.


OTHER

Increase in for-profit Retirement Homes and Assisted Living arrangements. BC’s
Interior Health Authority plans to move the Penticton and District Retirement Centre
into a facility privately run by the Good Samaritan Society in the next year.

        Penticton Herald, 02/05/2003, A3, Joyce Langerak.

Private payment for drugs is increasing as BC government increases deductibles and
de-lists drugs from provincial drug plan (anabolic steroids, anti-fungal creams, drugs
for incontinence).

        Coquitlam Now, 03/12/03, p.13, Elaine Gordon.

        Sylvia Fuller, Canadian Centre for Policy Alternatives, “Fair Pharmacare?
        A Backgrounder on the government’s changes to BC’s pharmacare program,” April
        2003.




__________________________________________________________________________________________

Innovation Exposed                                                                      21
March 29, 2005
ALBERTA [updated March 8, 2005]
2005

PRIVATE FOR PROFIT HOSPITALS

P3 for the New Southeast Hospital?

In the Calgary Herald, the chair of the Calgary Health Region (CHR), David Tuer, said,
“we have not decided how we are going to build that [the Calgary southeast] hospital”.
Tuer said the region will still look at a P3 arrangement. However, in August 2004, the
CEO of the Calgary Health Region Jack Davis promised that `there will be no P3’. The
Alberta Friends of Medicare (FOM) chair Dr. Avalon Roberts says ‘the contradictory P3
statements by Chairman Tuer and CEO Davis beg the question - what is going on?”

Dr. Roberts comments that “with the current surplus the province is running, the
government can easily afford to meet Calgary’s demand for the much needed
replacement hospital…the southeast hospital should be built the tried, true and tested
way as a publicly funded, owned and operated hospital.” CEO Jack Davis agrees.
He said that ‘a hospital is much more complex than an office building and that no one
has more expertise than the CHR’.

Finance Minister Shirley McClellan says rising oil and gas prices have put the province
in a position to record a $4.3-billion surplus in 2004-05. This amount is more than ten
times what the government forecast last spring. Health spending in Alberta in 2003-
2004 is about the same as it was 10 years ago – just over 5 per cent of GDP (gross
domestic product).
March 1, 2005 “Alberta’s surplus eclipses forecasts”, Globe and Mail.
February 28, 2005 “Calgary hospital P3 flip-flop?”, cupe.ca.
January 28, 2005 “Calgary Health Region must clear up southeast hospital P3 confusion”,
keepmedicarepublic.ca.
January 27, 2005 “Hospital boss eyes P3 option: Health region chairman denies funding flip-flop”,
The Calgary Herald.
November 2004 “Public Remedies, Not Private Payments”, Parkland Institute.

Private Hospital may be considered on Tsuu T’ina nation aboriginal reserve
outside Calgary

Big business has approached the Tsuu T’ina nation to build a private hospital near
Calgary. Chief Sandford Big Plume says that he has an agreement in principle from
Premier Klein for construction of a road that would lead to the private hospital.
However, Chief Big Plume says the private hospital would have to be beneficial to the
Tsuu T’ina nation, as well as its partners, to be considered.
November 24, 2004 “Band looks to build private hospital”,
Daily Commercial News and Construction Record.
November 20, 2004 “Health Act could permit Alberta aboriginal band to build private hospital”,
Calgary Herald.
__________________________________________________________________________________________

Innovation Exposed                                                                               22
March 29, 2005
PRIVATE FACILITIES AND SERVICES: TWO TIER HEALTH CARE



‘Third Way’ health care system pushes privatization

A ‘third way’ health care system, that incorporates privatization, was included in
Alberta’s throne speech March 2 (2005) by newly appointed Lt.-Gov. Norman Kwong.
A `third way’ is Premier Ralph Klein’s latest code for more private for-profit care,
borrowed from British Prime Minister Tony Blair. Klein spoke about it on a winter trip to
the Empire Club in Toronto, and Montreal.

However, the premier himself recently acknowledged that surgeries contracted-out to
private clinics cost 10 per cent more.

Lt.-Gov. Kwong says the government will “make whatever legislative changes are
needed to allow innovation to occur throughout the health system”. Opposition critics
fear that major privatization initiatives may come after the government session
concludes in May 2005.

Klein says that he wants to give the regional health authorities more leeway to “try
new ideas, encourage competition and choice and see what works and what doesn’t”.
This way he then distances himself from the contentious privatization issue.

Klein is basically advocating the Mazankowski report and another previously secret
second report that argues for:

      user fees;
      a reduction in the number of “essential” services under Medicare;
      privatization all other health services (that are not under Medicare);
      use of `innovation’ to complete the first three points.

Klein doesn’t believe Prime Minister Martin will stop him and he is prepared to use the
dispute resolution system if he runs into the barrier of the Canada Health Act. Federal
Public Health Minister Carolyn Bennett said that Klein will face problems with Ottawa if
his plan means putting money into private clinics instead of the public system.
The Canada Health Act outlines that the federal health minister has power to withhold
transfer payments from a province that violates the act. Klein may think Alberta can
absorb any denial of its federal health care funding share. Klein has threatened to pull
Alberta out of the Canada Health Act in the past.

However, Alberta Health Minister Iris Evans says in a Canadian Press interview “it’s
certainly not in my view, or on my agenda, to drive a two-tier system or something that
looks like an advantage for the rich over the poor”.




__________________________________________________________________________________________

Innovation Exposed                                                                    23
March 29, 2005
Meanwhile, Klein believes that because of Martin’s treatment of Québec through
asymmetrical federalism, Alberta can also gain special status. Klein wants to use the
new coalition of premiers, the Council of the Federation, to push his agenda. He also
says Québec Premier Jean Charest supports his ‘third way’.

Klein will open Alberta’s first office in Washington, D.C. shortly where he will do his
own lobbying.

Alberta will hold an international health care symposium in May 2005 where
international health care systems will be discussed. Klein thinks France, Switzerland
and New Zealand have systems worth evaluating. So far, his only Alberta example of
the ‘third way’ is a publicly funded, privately owned, hip and knee replacement hospital
in Calgary (the for-profit Health Resource Centre) in the former Grace Hospital site.
The for-profit centre is getting paid 10 per cent more than what it costs in the public
system to do the same services.

Klein thinks Albertans should be able to buy elective surgeries or health care.
Presently, Albertans can buy a private MRI test rather than wait for a public test.
Using their private test results, they can then jump the public queue for treatment.
Also, Albertans can buy medicare-insured cataract surgery when it is ‘bundled’ with
uninsured laser surgery. Patients get the medicare procedure as part of the deal.

Klein has also spoke about charging patients a deductible of $400 to $1,700 for health
care and de-listing some health services now covered by medicare. A key
recommendation of the Graydon report is a deductible geared to income which is a
user fee by any other name.

Roger Palmer, former Deputy Minister of Health and Wellness, outlined other parts of
what the ‘Third Way’ could include: medical savings accounts and long term care
‘insurance’. “Supply side changes would include P3s, privatization, primary care,
electronic health records, scope of practice and case rates”, Palmer said.

Klein’s government returned to power after a November 22 (2004) election where they
were re-elected with a reduced majority.

March 3, 2005 “Alberta throne speech keys in on medicare reform, education as top goals”,
Canadian Press.
March 1, 2005 “The Third Way and the Government of Alberta’s Throne Speech”,
keepmedicarepublic.ca.
February 12, 2005 “Private health care explodes”, Times Colonist.
February 7, 2005 “Full of holes”, cupe.ca.
January 18, 2005 “Klein misread intent of health care”, Torstar News Service.
January 17, 2005 “Finding common cause”, Montreal Gazette.
January 15, 2005 “Klein passes the health-care buck”, St. Albert Gazette.
January 14, 2005 “Klein’s “third way” will boost privatized health care”, cupealberta.ab.ca.
January 14, 2005 “Klein says he’s found an ally in Charest for changing medicare”, Canadian Press
Newswire.
January 13, 2005 “Ottawa warns Klein over health system”, Canadian Press.

__________________________________________________________________________________________

Innovation Exposed                                                                             24
March 29, 2005
January 13, 2005 “Public money won’t fix health care, Klein says”, The Toronto Star.
January 12, 2005 “Klein Why we need more private health”, The Toronto Star.
January 9, 2005 “Liberals critical of Alberta premier’s plan”, Edmonton Sun.
December 27, 2004 “Klein makes pitch for buying health care”, The Toronto Star.
November 19, 2004 “No Need to Tax the Sick in Debt-Free Alberta”, Tammy Horne, The Parkland
Institute.
November 2004 “Public Remedies, Not Private Payments: Quality Health Care in Alberta”
Tammy Horne and Susan Abells, The Parkland Institute.
November 13, 2004 “Medicine for profit”, The Toronto Star.

Privacy Commissioners Criticize Private Clinics

Alberta’s privacy commissioner, Frank Work, has found three private clinics in violation
of the Health Information Act. They include LifeMark Health Institute and the Hys
Centre Physical Therapy clinic. Meanwhile, the federal privacy commissioner,
Jennifer Stoddart, criticized Dynacare Laboratories and Viewpoint Medical Assessment
Services for privacy violations.

The private clinics were faxing confidential medical reports to the wrong recipients.
Formal charges could not be made since private clinics don’t fall under the Health
Information Act because they don’t receive direct government funding.
December 21, 2004 “Alberta medical clinics criticized for careless faxing of health information”,
Edmonton Journal.



OTHER

Home Care

Capital Health Authority Contracts TELUS Home Sitter

TELUS Home Sitter, an Internet-based remote home monitoring system is being used
by Telus in a partnership with Capital Health Authority (CHA) in Edmonton.
The system means people at work can watch a sick family member at home or health
care workers can monitor patients at home. The CHA says it is working with Telus to
provide “the level of quality our medical professionals will require for specific
applications, such as supporting an aide or family member who is doing wound care,
monitoring adults at risk of wandering and possibly monitoring children receiving care
in a home setting”.

January 15, 2005 “Klein passes the health-care buck”, St. Albert Gazette.




__________________________________________________________________________________________

Innovation Exposed                                                                                  25
March 29, 2005
Long Term Care

Food and Laundry Staff at Calgary’s Bethany Care Centre laid off due to contracting
out

Starting March 21 2005, Aramark Corporation will be accountable for food and laundry
services for the long term care centre, Bethany Care Centre in Calgary. The present
public workers who are paid $12 to $15/hour will be replaced with Aramark workers
who will earn half the amount.

February 3, 2005 “Bethany laying off 60 staff”, Calgary Herald.

Calgary Health Region (CHR) will contract out 600 new continuing-care beds to
private, long-term care (LTC) companies

The CHR has announced that Intercare and AgeCare will build three new LTC
facilities. Intercare already runs three for-profit LTC centres while AgeCare runs two.
The Coalition of Seniors Advocates is against the deals. They say fifty-seven per cent
of seniors live under $20,000/year and there is no plan for the low income senior.
The contract will be a type of P3 (public-private-partnership).

January 20, 2005 “Seniors and nurses criticize private long-term care contracts”, Fast Forward Weekly.
January 15, 2005 “Private care beds boosted”, Calgary Herald.

New Private LTC beds for rural Alberta

A new $50-million capital program that will partly go to the private sector will be used to
build new supportive living facilities for seniors in rural Alberta. The Alberta
government will partner with regional health authorities and the private and/or
voluntary sectors using a model that was used in the Healthy Aging Partnership
Initiative (HAPI) and the Seniors Supportive Housing Incentive Program (SSHIP).

October 21, 2004 “Supportive living facilities for seniors to be built in rural Alberta”, gov.ab.ca.


De-listing

Capital and Calgary Health Regions Cut Public Physiotherapy Service

Capital Health Region (Edmonton) will now cover only two 15-minute physiotherapy
sessions under Medicare after an initial assessment. For the last ten years, patients
have been eligible for six publicly funded sessions after an assessment. The Calgary
Health Region has also limited physiotherapy services to people with low incomes and
fracture and joint replacement conditions.

January 31, 2005 “Physiotherapy services cut by Capital Health
(The Alberta Physiotherapy Association)”, Canada News-wire.

__________________________________________________________________________________________

Innovation Exposed                                                                                     26
March 29, 2005
2004

PRIVATE FOR PROFIT HOSPITALS

The Calgary Health Region’s first public private partnership health care facility opened
on June 21, 2004. Bentall Real Estate Services built the $23 million facility and will
lease about 1/3 of the space to the region to house the South Calgary Health Centre.
Bentall will manage and maintain the building. The centre will be what is described as
“an urgent care facility.” Patients requiring hospitalization will be transferred.

       The Calgary Herald, June 8, 2004, “First P3 health facility set to go,” Mario Toneguzzi, B3.

Premier Ralph Klein announced that they had not confirmed where the remaining $475
was coming from to match the province’s $42 million already committed, before putting
the shovel in the ground on Calgary’s new south hospital. At the groundbreaking
ceremony, he announced that the Calgary Health Region will be looking at a number of
options to fund the new hospital including public private partnerships (P3).

Two weeks earlier, the Calgary Health Region was seeking approval from the province
to enter into a P3 deal for a health care facility in another downtown Calgary location.
The deal between the Health Region and Bentall Real Estates, who will design, build,
operate and maintain the $60 million Sheldon M. Chumir Health Centre facility was all
but finalized.

       Calgary Herald, July 14, 2004, “CHR Studies Cash Options,” B2.
       Calgary Herald, June 30, 2004, “Health Region Proposes second Bentall Centre,”
       Mario Toneguzzi, B8.



PRIVATE FACILITIES AND SERVICES: TWO TIER HEALTH CARE

Premier Ralph Klein wants flexibility in the Canada Health Act so that he can charge
patients for upgraded medically necessary services at new private clinics in Calgary
and Edmonton. A proposed bone and joint centre and a proposed cardiac centre
would be great ways to use our expertise to raise money, says the premier of
Canada’s richest province. He also said he would support the Capital Health Region
of they want to build a hotel near the hospital for patients who want to pay extra for
luxury accommodations while waiting for or recovering from surgery.

       Edmonton Journal, “Private Health – ‘So What?” Friday March 26, 2004,
       A1/Front, Kelly Cryderman.



Premier Ralph Klein threatens two-tier health care, considering such things are user
fees, de-listing medical procedures or charging a deductible for doctor visits. Says he
wants to scale down Medicare to a more basic critical services program and have the

__________________________________________________________________________________________

Innovation Exposed                                                                                27
March 29, 2005
private sector deliver less important treatment procedures. He says he will come up
with a five-point plan for “tough” reform.

       Grand Prairie Daily Herald-Tribune, “Another Bill 11 Battle on the Horizon?” Tuesday
       March 16, 2004, p. 6, Darcy Henton, Canadian Press.

       Broadcast News, “Premier Ralph Klein has announced a five-point plan to decide on
       a set of tough measures to reform Alberta’s health care system,”
       Wednesday March 17, 2004.

       Winnipeg Free Press, Monday Feb 23, 2004, A3.

       Vancouver Sun,Tuesday Feb 24, 2004, A1 Front, Jeff Lee.

Devonshire Care Centre, 120 LTC Facility – A private company called Summit Care
Corporation is responsible for financing, planning, building and managing the facility
under a 30 year contract with the Capital Health Authority.

       Summit Care/ Devonshire Village website
       http://www.devonshirevillage.com/service.html

       Capital Health Authority Website.
       Qc. Treasury Board Doc.

CONTRACTING OUT

The Calgary Health Region is contracting out at least 500 knee and hip surgeries
at a cost of $6 million annually to the Health Resource Centre, a private clinic.
The services will cost 10 per cent more than if they were provided in a local hospital.
The region announced that it would pay for the use of the HRC’s operating rooms,
beds, and staff, who will provide care to each patient for four to seven days.
The agreement with HRC is for two year and will be re-evaluated at that time.

       Calgary Herald, Oct 22/04 p. B1, “Clinic to east wait lists,” Mario Toneguzzi

GOOD NEWS

The Calgary Health Region will build and operate the city’s planned southeast hospital.
The Region had long been considering a public-private partnership to build the new
hospital. At least three companies, including two linked to multinationals, had
indicated interest in building and operating the hospital and leasing it back to the
Region. The province is expected to cover about half of the hospital’s $500-million
price tag, and is considering financing the remaining costs by issuing savings bonds.

       Calgary Herald, Aug 9/04 p. B1, “Region will build new hospital alone…,” Kerry Williamson and
       Sarah Chapman
       www.cupe.ca Oct 5/04, “P3 Hospitals Canned in N.B. and Alberta”



__________________________________________________________________________________________

Innovation Exposed                                                                             28
March 29, 2005
2003

In the past year, Alberta’s Health Minister Gary Mar has revealed plans to join forces
with the private sector in all aspects of health care over the long term. RFPs have
been issued by the Calgary Health Region for privatization of all aspects of the city’s
health system.
       The Daily Courier (Kelowna), 01/10/03, A5.
       The Times-Herald (Moose Jaw), 01/03/03, 6, CP.
       Calgary Sun, 01/04/03, 18, CP.

PRIVATE FOR-PROFIT HOSPITALS

Calgary Health Region announces to the press that they are prepared to enter
into a deal with the private sector to build a new hospital. Calgary Health Region
seeks private sector bids to build a $25 million parkade at Foothills Hospital and
is looking into P3s to build a new $200-300 million hospital in the city. The land
has been purchased and requests for proposals have been issued.

       Calgary Herald, 05/10/03, B3, David Heyman.
       Edmonton Journal, 01/13/03, A6, David Heyman.
       Calgary Herald, 01/13/03, A1/Front, David Heyman.

New private, for-profit hospitals are proposed for Edmonton. They will likely do work
now done in public hospitals. Primary health care teams and other reforms have
potential to improve the health care delivery, but the hospitals also risk being “taken
over by US-style, corporate health management organizations.”

       The Edmonton Journal, 11/10/2003, “One-stop shopping
       for health care lauded,” Rick Pedersen, A6.

Three new P3s in Edmonton: Edmonton Health Authority announced plans to develop
3 new PPP hospital projects. The deadline for business proposals is January 20th,
2003.

       Canadian Press Newswire, 01/04/03, Edmonton.

Peace Country Health has been given the green light to pursue proposals for private
funding to be used to upgrade and renovate community health care facilities.
Locations include the Queen Elizabeth II hospital and replacement of the acute care
wing of the High Prairie Hospital in Grande Prairie.

       Fort McMurray Today, 11/10/2003, “P3s in the works for Peace Health region,” Debi
       Ruhl (Grande Prairie Herald-tribune), 5.



__________________________________________________________________________________________

Innovation Exposed                                                                         29
March 29, 2005
CONTRACTING OUT

Edmonton’s Capital Health has awarded a multi-million dollar ambulance contract to a
private company. More than 40 paramedics could lose their jobs as their current deal
through Emergency Medical Services expired in January 2004.

       The Edmonton Sun, 08/27/03, Keith Bradford.
       The Edmonton Sun, 09/05/2003, “Private contract puts jobs of paramedics
       on the line,” Keith Bradford.

The Calgary Health Region (CHR) adds a common cancer detecting diagnostic
procedure to the list of medical services to be contracted out to the private sector. A
request for expressions of interest in setting up private clinics to perform endoscopies
has been issued. Negotiations are underway with a for-profit company, Health
Resource Centre, who already provide a number of private procedures. The CHR is
also planning to build a private hospital in the form of a public private partnership in
Calgary’s deep south.

       The Calgary Herald, 13/07/03, David Heyman.

David Tuer, chair of the Calgary Health Region, suggests private surgical clinics for
out-of-towners (non-Canadian tourists) and instituting health premiums based on how
often people use the system, among other measures to raise money to address the
health region’s financial deficit. Health Minister Gary Mar sees merit in the proposals.
       The Sault Star, (source: Calgary Herald, Calgary Sun), 07/07/03, B9.

       The Edmonton Journal, 07/07/03, B1 Front.

PRIVATE FACILITIES AND SERVICES: TWO-TIER CARE

The Alberta government increased the accommodation fee for seniors in long term
care facilities to $40/day from $28. What is essentially a 42.9% rent increase has been
brought in by the Tories to increase the profit of Extendicare. The private, for-profit
company has a monopoly over long-term care facilities in the province. The new
money will not go to cover health care costs but will go to profits. Extendicare
benefited in the same way from Ontario’s increased funding for long-term care
services, without improving access to care.

       Fast Forward Weekly, 11/13/2003, “Nursing home user fees linked to private profits,”
       Tom Babin, 4.




__________________________________________________________________________________________

Innovation Exposed                                                                            30
March 29, 2005
Ontario Man buys CT scan at private Calgary clinic.

       Edmonton Journal, 03/16/03, D8.
       Vancouver Sun, 03/22/03, B6, Joanne Laucius.

Private Clinic to do major surgery. Health Resource Center (HRC), a for-profit surgical
clinic in Calgary, continues to operate providing health services to third party payers.

       Globe and Mail, 09/14/02, Brian Laghi and Dawn Walton.
       Calgary Herald, 03/14/13, A6, David Heynan.

Alberta’s “expert panel on de-listing” established by the Mazankowski Report. Council
considers de-listing and cost-sharing for chiropractic care, reduces eye exams for
children to one every two years.

       Edmonton Journal, 03/16/03, A6, Tom Olsen.
       Calgary Herald, 03/16/03, A10, Tom Olsen.
       The Leader-Post (Regina), 03/08/03, B7, Graham Thomson.
       Edmonton Journal, 03/06/03, A1/Front, Graham Thomson.
       Medical Post, 01/21/03, Barbara Kermode-Scott, Vol 39, No. 3.
       Edmonton Journal, 01/07/03, A1/Front, Tom Olsen.

Two-tier access in Edmonton. Nurse jumps queue by paying for MRI.

       Edmonton Journal, 12/09/02, Susan Ruttan.

On January 8, 2003, patient jumps 8-month queue by paying for MRI.

       Edmonton Journal, 09/01/03, B3, Don Thomas.

Negotiations underway for private funding of Youville long-term care projects in
Edmonton. The 100-bed long-term care facility will be built by Citadel – a private
company that operates several other seniors’ facilities in Edmonton.

       St. Albert Gazette, 02/19/03, 1/Front, Glenna Hanley.

OTHER/TRADE

Calgary Health Region is looking to export its expertise to the UK health system by
joining a multi-national bidding consortium called Anglo-Canadian Clinics. The
consortium was chosen as the preferred bidder to provide management and health
services in three outpatient surgical centres in London. So far the consortium is
comprised of UK investors and Calgary-based Surgical Centres Inc.

       Calgary Herald, “CHR Ponders Role in U.K. bid,” September 13, 2003, B3, Tarina White.
__________________________________________________________________________________________

Innovation Exposed                                                                             31
March 29, 2005
SASKATCHEWAN                [updated March 16, 2005]

2005

HOSPITALS

Service Cuts and Layoffs: privatization by stealth

        ● Yorkton Hospital kitchen downsizing

Yorkton Regional Health Centre in the Sunrise Health Region has announced food
service worker layoffs in order to bring in “rethermalized food”. The health region says
it is “wasteful and inefficient” to maintain a fully operational kitchen. CUPE 4980
President Pearl Blommaert disagrees. “There’s no substitute for good nutrition”, she
says. (Only private “rethermalized food” companies will benefit.)

March 6, 2005 “Yorkton health workers campaign to maintain hospital kitchen”, cupe.sk.ca.

        ● Sun Country Health Region wants to layoff laundry workers

Sun Country Health Region wants to lay off 28 laundry workers in nine communities.
More than 2,000 people have signed a petition urging the board to scrap the proposal.

October 19, 2004 “Citizens petition health board to stop laundry closures”, cupe.sk.ca.



OTHER

Long Term Care (LTC)

Service Cuts and Layoffs: privatization by stealth

        ● Province announces 325 public LTC layoffs and the closure
          of 90 public LTC beds

Health Minister John Nilson has announced that 90 LTC public beds will close and 325
public LTC staff will be laid off throughout Saskatchewan. The announcement comes
at the same time the province’s Health Services Utilization and Research Commission
estimates that the proportion of seniors will increase to 15 percent of the total
population by 2015. (By closing public beds, private LTC providers will benefit.)

The number of publicly funded LTC beds has dropped by 8.4 percent since 1996 in
Saskatchewan, while the number of private-for-profit LTC beds has increased by 63
percent.

May 18, 2004 “Health care cuts amount to privatization by stealth, says CUPE”, cupe.sk.ca.
“2004-2005 Saskatchewan Alternative Budget of Choice”, ccpa.ca.
__________________________________________________________________________________________

Innovation Exposed                                                                           32
March 29, 2005
Pharmacare

Some good news: Saskatchewan Prescription Drug Plan adds 37 new products

Drugs for the treatment of migraine headaches and for the management of HIV are
included in the new 37 products covered under the province’s prescription drug plan.

However, Saskatchewan citizens pay high drug deductibles compared to other
provinces. According to the Saskatchewan Association of Health Organizations
(SAHO), total government per capital spending on drugs in 1997 was the lowest in the
country except for Newfoundland.

November 5, 2004 “New Drugs Added”, gov.sk.ca.
“2004-2005 Saskatchewan Alternative Budget of Choice”, ccpa.ca.



2004

Premier Lorne Calvert has indicated that he is willing to work with the Muskeg Lake
Cree Nation regarding their plans to own and operate an MRI unit on their Saskatoon
Reserve. The premier said that Health Minister John Nilson will meet with Nation
representatives to explore the concept further.

       The Star Phoenix (Saskatoon), July 8/04 p. A3, “Government open to MRI on reserve,”
       Lana Haight and James Wood

The Muskeg Lake First Nation is proceeding with plans for its own Magnetic
Resonance Imaging (MRI) clinic in Saskatoon, despite government objections. The
band's business advisor, Lester Lafond, says the province rejected the plan, but he
says it is going ahead anyway, with or without government support. Lafond says the
new service would fill a need in Saskatchewan. But the Ministry of Health is funding a
new MRI facility for Regina, which will increase the province's capacity by about 50%.
He says the issue is not only with acquiring the actual MRI machine, but also with
finding qualified technicians.

       SASK.CBC.CA, News “First Nation considers private MRI clinic”
       Last Updated: Apr 5 2004 03:53 PM CDT.

Former NDP Finance Minister Janice McKinnon recommends looking at health care
user fees to address rising costs. Premier Lorne Calvert has rejected the argument
that health spending is out of control.

       The Star Phoenix (Saskatoon), 11/15/2003, “Keep open mind to health-care user
       fees” McKinnon, Lana Haight, B10.

       Health Edition, 11/28/2003, Volume 7 Issue 46, www.healthedition.com



__________________________________________________________________________________________

Innovation Exposed                                                                           33
March 29, 2005
Creeping privatization through changes to personal care home legislation allowing
unlimited number of beds in homes, in conjunction with a decline in the number of
publicly-funded beds, results in the expansion of for-profit personal care homes for
level 1 & 2 care.

       Presentation to CUPE Health Care Conference, 02/06/03, Ottawa, (“Personal Care
       Homes: The Privatization of Health Care in Saskatchewan”).
       Broadcast News, 12/05/02, “Yorktown, Saskatchewan – A private personal care
       home raising questions at a public sector union”.

Privatization of food services in Regina Qu’Appelle region. Services to be centralized
and rethermalized food to be served.

       The Leader-Post (Regina), 06/14/03, D10, Neil Scott.




__________________________________________________________________________________________

Innovation Exposed                                                                      34
March 29, 2005
MANITOBA [updated March 29, 2005]
2005

HOSPITALS

Service Cuts and Layoffs: privatization by stealth

        ● Petition and rally to stop closure of maternity ward at Victoria
          General Hospital

More than 350 people have signed a petition to stop the closure of the maternity ward
at Victoria General Hospital in Winnipeg’s south end. There was also a rally at the
provincial legislature on March 27, 2005. The birthing centre is scheduled to close
before the summer of 2005.

March 27, 2005 “Birthing ward rally”, Winnipeg Free Press.
March 16, 2005 “Birthing centre to close”, Winnipeg Free Press.



Some Good News: Province commits to public dental surgeries for kids –
but little action yet

In early December 2004, the province committed to fund an additional 600 children’s
dental surgeries at the public Misericordia Health Centre in order to reduce waiting
lists. The provincial NDP government had rejected the idea of using private clinics to
reduce the list. “Costs at Misericordia are cheaper”, said Health Minister Tim Sale.

However, the Winnipeg Sun reported that according to the Winnipeg Regional Health
Authority only two surgeries had been performed as of March 18, 2005. Minister Sale
said the delay was caused by the additional time needed to find anesthetists, train
nurses and purchase the necessary equipment.

In March 2004, the Manitoba Federation of Labour (MFL) urged the government to
begin the process of establishing a universal dental program for all children in
Manitoba.

March 18, 2005 “Major Dental Delay”, The Winnipeg Sun.
December 2, 2004 “NDP Rejects Private Clinics for Children’s Dental Surgery”, The Daily Graphic.
March 4, 2004 “Manitoba Federation of Labour Annual Brief to Cabinet”, mfl.mb.ca.




__________________________________________________________________________________________

Innovation Exposed                                                                             35
March 29, 2005
PRIVATE FACILITIES AND SERVICES: TWO-TIER HEALTH CARE

New P3 research centre planned for Winnipeg

In partnership with the University of Manitoba, the International Centre for Infectious
Diseases (ICID) will soon open in Winnipeg. The non-profit organization will form a P3
with private business. New vaccines, biomedical devices and “systems of prevention
and bio-safety” will be developed. Named “BioMed City”, the new P3 will expand
Winnipeg’s private biomedical sector. The federal government issued $3 million in
start-up funding for the ICID.

February 15, 2005 “Private-public partnerships planned for BioMed City”, Canadian Medical Association
Journal 172 (4).

Private clinic for eating-disorders expanding

The Westwind Centre in Brandon - Canada’s only private eating-disorder clinic - is
expanding. The Centre recently bought a second house to accommodate more
patients. The clinic charges $250 per day and more than half of the clients are
American.

February 10, 2005 “Health”, Broadcast News.

Manitoba government asks judge to reverse decision province must pay for private
health care

The provincial government is asking the Court of Appeal to reverse the Court of
Queen’s Bench ruling that the province must pay for abortions at private clinics. The
province fears it will set a precedent making Medicare coverage mandatory at all
private clinics.

Two women brought the case forward in 2001 when they went to the (then) private
Morgentaler Clinic since they felt the wait was too long for a hospital abortion.
Associate Chief Justice Jeffrey Oliphant ruled December 22, 2004 that there was a
violation of women’s rights when the province did not cover the costs of the abortions.
The province was ordered to refund the two women.

However, the decision opened up the door for refunding potentially thousands of
women and other private clinic patients. The province argues that the “decision goes
far beyond the funding of abortions and suggests that everyone is constitutionally
entitled to a health care service based upon the time of their choosing without regard
to medical necessity.”

Now the former Morgentaler abortion clinic is the non-profit Jane’s Clinic. Morgantaler
sold it in April 2004. The province began funding abortions at Jane’s clinic in the


__________________________________________________________________________________________

Innovation Exposed                                                                             36
March 29, 2005
summer of 2004. The Winnipeg Free Press quotes Health Minister Tim Sale who said,
“funding for Jane’s Clinic will not be jeopardized by this appeal”.
January 28, 2005 “Manitoba minister fears ‘death of medicare’”, Winnipeg Free Press.
January 27, 2005 “Manitoba defends right to set health care priorities: Sale”, gov.mb.ca.
July 8, 2004 “Manitoba to pay for abortions at clinic”, cbc.ca.



Good News: Now public clinic expanding

Winnipeg’s now public Pan Am Clinic will be expanding to relieve the pressure on
hospital emergency rooms. A new Minor Injuries Clinic, within the Pan Am Clinic, will
be opening for patients with non-life-threatening injuries. As well, the Pan Am Clinic
will be open extended hours, seven days a week. The province has contributed an
additional $2.1 million annually for this expansion.

The Pan Am Clinic was purchased from private owners in 2001 by the province of
Manitoba. Since then the clinic has doubled in size. The now public clinic performs a
wide range of orthopedic and plastic surgeries, although it originally specialized in
sports medicine.

January 11, 2005 “Pan Am Clinic to take 50,000 patients from ERs”, Winnipeg Free Press.
June 3, 2004 “NDP would stop public funding of private clinics”, cbc.ca.



Business in Manitoba pushes privatization and P3s

A Winnipeg Chamber of Commerce poll by Probe Research says that two-thirds of
Winnipeg’s business owners believe the private sector should be given a bigger role in
Canada’s health care system. The respondents called for more P3s in health care.

Health Minister Tim Sale pointed to the high cost of employee health benefits in the
U.S. due to private health care. He wondered why business leaders in Winnipeg
would want to spend more on employee health benefits. General Motors, for example,
spends more on health benefits than it does on steel.

The survey was done by phone between September 23 and October 7, 2004.

November 19, 2004 “Manitoba business groups push health P3s”, cupe.ca.
November 17, 2004 “Business leaders want bigger health care role”, Winnipeg Free Press.




__________________________________________________________________________________________

Innovation Exposed                                                                          37
March 29, 2005
OTHER

Long Term Care (LTC)

Good News: New long-term care (LTC) regulations

The Manitoba government has passed new regulations for both private and non-profit
long-term care homes. The legislation includes standards of care, personal attention
and privacy rights. Homes need to meet these new standards or risk having their
licenses revoked. The new regulations came into effect March 1, 2005. The
government has increased LTC funding in order to help operators meet the new
standards.

The Manitoba Society of Seniors approved of the new rules, but called for new whistle-
blower protection for staff. LTC workers need protection so that they may safely report
if standards are being maintained.

In March 2004, the Manitoba Federation of Labour called for new LTC standards to
reflect the increased level of care in LTC homes.

March 11, 2005 “Nursing home residents get bill of rights”, Winnipeg Free Press.
March 4, 2004 “Manitoba Federation of Labour Annual Brief to Cabinet”, mfl.mb.ca.



2004

The Workers Compensation Board (WCB) sent about one-third of its 1000 day-surgery
patients to the private Maples Surgical Centre in 2003. The terms under which
medical care is provided to WCB clients, members of the RCMP and the Canadian
military, and refugee applicants do not fall under the Canada Health Act.

        Winnipeg Free Press, Aug 5/04, p A1, “Private clinic OK for workers,”
        David Kuxhaus and Mia Rabson
        National Post, Sept 10/04, p A1, “Loophole lets injured workers seek private care:
        Federal employees, too,” Tom Blackwell

As the head of Winnipeg Regional Health Authority looks to the private sector for help
with financing, Premier Gary Doer says private sector funding for the health care
system is fine with him, as long as there are enough workers available to make it run.

        CBC News Winnipeg, 11/14/2003, “Private sector should support public health:
        WRHA”.

Maples Surgical Centre is a functioning private surgical clinic in Winnipeg. They
provide both cosmetic and other potentially non-elective surgeries, from orthopedic to
cataract surgery. The clinic has been unable to secure a contract with government to
provide insured services.

__________________________________________________________________________________________

Innovation Exposed                                                                           38
March 29, 2005
       Winnipeg Free Press, 05/06/03, A5.
       Maples Surgical Centre, Winnipeg, MB. www.nationalsurgery.com ( 05/24/03).




__________________________________________________________________________________________

Innovation Exposed                                                                    39
March 29, 2005
ONTARIO [updated March 2, 2005]
2005

PRIVATE FOR-PROFIT HOSPITALS

Royal Ottawa P3 Hospital Deal Goes Ahead

The Royal Ottawa Health Care Group (ROHCG) has closed the P3 deal with the
Ontario Liberal provincial government’s blessings. The deal closed despite clear
promises during the provincial election campaign that the government would stop
privatization. Natalie Mehra, Ontario Health Coalition coordinator said “(t)his is the
most serious privatization our province has seen to date since it attacks cornerstone
Medicare services for an entire generation”.

The Healthcare Infrastructure Company of Canada, a joint venture of Carillion Canada,
Borealis Infrastructure Management (wholly owned by OMERS) and EllisDon
Corporation, will finance, design, build, property manage, maintain and provide non-
clinical services at the P3 facility. CIT Capital Finance, a unit of CIT Group Inc.,
arranged the senior debt facility. The hospital will be transferred to the ROHCG after
22 years.

The hospital will be three-stories with a seven-storey tower where the University of
Ottawa’s Ottawa Institute of Mental Health Research will be housed. In late 2006/2007
the building should be completed. The 400,000 square foot building will house
services specializing in mental health care with 188 patient beds. The hospital will
include outpatient and outreach services and a large teaching and education area.

George Langill, CEO of the ROHCG, says that P3s will be the norm for many projects
in Ontario “since the health infrastructure needs in Ontario grossly exceed the
government’s commitment to capital”.

January 25, 2005 “CIT Arranges Senior Debt Facility for Royal Ottawa Health Care Group Hospital
Facility Transaction Marks Second Health Care Public-Private Partnership in Ontario, Canada”, Canada
Newswire.
December 17, 2004 “P3 Hospital Deal Signed in Ottawa with Support of Liberal Government Despite
Promises to Protect Healthcare from Privatization”, Ontario Health Coalition.
November 25, 2004 “P3 hospital project on verge of construction”, Daily Commercial News and
Construction Record.

P3 Will Cost More than Public: William Osler P3 Health Centre Hospital Facility in
Brampton, Ontario

A new study by economist Hugh Mackenzie argues that Brampton’s new hospital will
cost Ontario $175 million less if it were built with public financing. A main reason is
that the government can borrow money at rates substantially lower than the Brampton

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March 29, 2005
hospital’s private sector partners. Over the 27-year course of the deal, the higher
interest rate will make the project $344 million more expensive than public financing.

The Brampton Health Coalition attended the beginning of construction. The group
members burned “McGuinty money” for the media, to protest the money wasted on the
P3 deal.

The study was based on partial disclosure of the hospital deal. The “Direct Lenders
Agreement” which contains the actual financial transactions and service privatization
remains secret. CUPE, The Ontario Health Coalition, OPSEU and SEIU are still
fighting in court for full disclosure.

CIT Capital Finance, a unit of CIT Group Inc., arranged the senior debt facility.
The Brampton P3 is a year behind schedule and smaller than originally planned.

January 25, 2005 “CIT Arranges Senior Debt Facility for Royal Ottawa Health Care Group Hospital
Facility Transaction Marks Second Health Care Public-Private Partnership in Ontario, Canada”,
Canada Newswire.
December 2004 “Ontario Health Coalition: The Pulse Newsletter”, web.net/ohc.
October 20, 2004 “Ontario Health Coalition: Analysis of Brampton Private P3 Hospital Deal”,
ontariohealthcoalition.ca.



CONTRACTING OUT

Ontario creates the Hospital Business Services (HBS) Corporation to Increase
Privatization

The Ontario government is providing $42 million in start up capital over the next two
years to have Hospital Business Services (HBS) privatize and merge hospital services.
HBS has the mandate in 16 Toronto area hospitals to amalgamate human resources,
information technology, purchasing, and materials management. Starting in March
2005, 677 full time equivalent positions will transfer from the 16 hospitals to the new
HBS while many hospital workers will be laid off. Michael Hurley, President of the
Ontario Council of Hospital Unions/CUPE calls this funding “blood money rewarding
hospitals for laying off staff and cutting services and programs to patients”. The HBS
will have the power to contract services out to private for-profit providers delivering
housekeeping, dietary and laundry services.

Rallies to support public, non-profit delivery of services have been held in London,
Kitchener and in other Ontario centres.

February 10, 2005 “Privatization only thing on Ontario government’s hospital agenda”, cupe.on.ca.
December 2004 “Update: Hospital Cuts and Privatization” Ontario Health Coalition newsletter,
web.net/ohc.




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March 29, 2005
“Megaplant” Laundry Facility Planned

Plans to create a “one-stop shop” laundry facility for hospitals across Ontario are
currently being developed at Booth Centennial Healthcare Linen Services. Booth’s
board has agreed to sign a 30-year lease on a warehouse near Pearson airport. The
plant is slated to open in July 2005. It will be a $20 million expansion to deliver laundry
services in a 300,000 square feet building. Booth is currently a not-for-profit
organization jointly owned by 26 Ontario hospitals.

January 22, 2005 “The big clean”, Globe and Mail.



PRIVATE FACILITIES AND SERVICES: TWO-TIER CARE

Changes to CT and MRI Clinics Questioned

The Ontario government has paid $75,000 to have four CT and MRI clinics converted
from for-profit to non-profit status. CML Healthcare Ltd. (a for-profit company),
however, is still operating five other CT and MRI clinics sixteen months after Ontario’s
Liberal government announced that it would cancel all nine contracts with for-profit
clinics.

NDP Leader Howard Hampton questions the $75,000 spent on the for-profit to not-for-
profit conversion in a Canwest News Service article: “The parent companies in these
deals are the same parent companies that the Conservatives did the deals with, but
when you strip away the veneer – the shell of the not-for-profit corporation –
underneath you find that this is just the same profit-driven enterprise that the
Conservatives signed on with. It’s just that the Conservatives were open about it.”

The president of the Ontario Association of Radiologists, Ray Foley, says “(t)here has
been a significant lack of disclosure. No information has been provided. The people
who have been brought into the fold have been put under a gag order. And our
freedom of information request (for background on the deal) has essentially been
denied”.

Superior Imaging in Thunder Bay, KMH Cardiology and Diagnostic Centres in
Richmond Hill and Kitchener, and Kingston MRI Inc. in Kingston have converted to not-
for-profit status. CML has 5 for-profit clinics in Huntsville, Ajax and Mississauga.

February 12, 2005 “Ont. Liberal stance on diagnostic clinics dismissed as smoke and mirrors”,
Canwest News Service.




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March 29, 2005
Good News: Ontario Liberals announce plans to spend $120 million on new,
replacement MRI and CT machines, increase operating hours, and replace old cardiac
and radiation therapy equipment in public hospitals

February 4, 2005 “MRI-CT In-Hospital Investment Applauded by Ontario Health Coalition”, web.net/ohc.
February 3, 2005 “McGuinty Government Reduces Wait Times By Delivering 119,865 Additional MRI,
CT, Cancer and Cardiac Procedures”, newswire.ca (Ministry of Health and Long Term Care).
February 4, 2005 “Province to spend at least $120-million to cut MRI, CT waits” Globe and Mail.

Private Companies to be Included in New Thunder Bay Research Centre

Siemens has signed a contract with the new cancer research centre called ICR-
Discoveries (Institute of Cancer Research). The new research centre will partner with
Thunder Bay Regional Health Sciences Centre (TBRHSC) and the Northern Ontario
School of Medicine (NOSM). It is reported that as the research centre grows, private
for-profit companies will be included.

December 1, 2004 “Research centre proposed” Northern Ontario Business.



OTHER

Home Care

Ontario Government Review of Home Care Does Not Include Competitive Bidding
Evaluation says Ontario Health Coalition

“The Minister of Health promised a review of (home care) competitive bidding but has
instead set up a smoke-and-mirrors process to entrench privatization for the long
term,” said Ross Sutherland, a nurse and Ontario Health Coalition spokesperson.
“The government will not even consider evidence from any other Canadian provinces
with non-profit delivery of homecare.” At a press conference, the Coalition released a
policy paper outlining public home care recommendations for the government review.

December 6, 2004 “Homecare Review just “Smoke and Mirrors”: OHC”, web.net/ohc.

Long Term Care

Good News: Long Term Care Privatization Prevented in northwestern Ontario

Members of CUPE Local 65, patients and families in Fort Frances, Ontario have won a
campaign to prevent Rainycrest Home for the Aged from being taken over by
Extendicare, a large for-profit health care corporation.

January 21, 2005 “CUPE members prevent privatization in northwestern Ontario” cupe.on.ca.



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March 29, 2005
2004

PRIVATE FOR-PROFIT HOSPITALS

The capitol cost for the Brampton P3 hospital has increased from $350 million to
$536 million in 2 years, a 53% increase. The total cost, including capital costs and the
privatization of staff and services, is at least $2.6 billion, with no equipment and other
costs included. If the deal is signed under the terms that have been disclosed to date,
the government will pay a 1% higher borrowing rate than the government borrowing
rate. This higher borrowing rate means the public will pay at least $124 million more
for this privatized hospital than it would if the government financed the hospital directly
and kept it public. The hospital has admitted that it will have to reduce the size of the
hospital and its beds and services due to financial constraints.

       Ontario Health Coalition Press Release, Aug 6/04,
       “Over $100 Million Wasted in Secretive P3 Hospital Deal.”

On July 23rd, the Royal Ottawa Health Care Group signed a deal with The Healthcare
Infrastructure Company of Canada, a private consortium, to build the new Royal
Ottawa Hospital. The deal is projected to cost $256 million over the next 20 years and
eight months. Construction is expected to be completed by the end of 2006. The
design and construction costs of the hospital are already $26 million more than the
$100 million figure cited in the former Conservative government’s leasing plan.
The new ROH, which is comprised of the Royal Ottawa Hospital and the Brockville
Psychiatric Hospital, will have 50% fewer beds than the combined beds in the existing
institutions. As well, the public can expect 14% fewer nurses and 38% less support
staff.

       Canada News-wire, Aug 25/04, “Health care Trojan Horse to visit CKCU Folk Festival in
       Ottawa.”
       Ottawa Sun, July 24/04 p 3, “P3 hospital a done deal; health officials,
       private consortium ink agreement,” Sean McKibbon
       www.rohcg.on.ca “ROH signs deal for new public hospital.”

On April 8, Ontario’s Liberal government released the report of an independent study
led by Michael Decter. The report recommends streamlining the way hospitals are
bankrolled, embracing privately funded hospitals. The ministry of health is reviewing
the recommendations to forge ahead with public private partnerships as the model for
funding all new hospitals.

       The Toronto Star, “More P3 schemes possible: Liberals,” April 9, 2004, Richard
       Brennan and Robert Benzie (web version).
       Capital Health Planning Review, January 16, 2004, http://www.pir.gov.on.ca/
       Ontario Government News Release, April 8, 2004, Ministry of Public Infrastructure
       Renewal, http://www.pir.gov.on.ca/



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March 29, 2005
CONTRACTING OUT

The Ontario government is considering a private consultant’s report (Hay Group
Report) that says hospitals could save $200 million if they were operated more
efficiently. The report identifies the 25% “most efficient” hospitals in the province in
areas such as laboratories, communications, finance, food services, health records,
human resources, materials management, pharmacy and systems report. It
concludes that if the remaining 75% of hospitals followed similar operating practices
in these areas, then the $200 million savings would be realized. In most cases these
“efficiencies” were obtained by contracting out the work. In order for contracting out to
occur, the government would have to bring in legislation abrogating collective
agreements and abolishing successor rights. When asked whether the Ontario
government was considering such legislative changes, the Health Minister did not
answer the question. A spokesperson for the Ontario Hospital Association said that
there would have to be “wide consultation” if the government were to scrap successor
rights.

       Toronto Star, Sep 24/04, “Hospital jobs on the block, union charges,” Ron Ferguson
       Toronto Star, Sep 22/04, p A1 “Hospitals wary of cuts,” Ian Urquhart

The University Health Network is considering whether to hire an outside company,
Carillion Canada, to provide facilities management services, excluding housekeeping.
The UHN is composed of the Toronto General, Toronto Western and Princess
Margaret Hospitals.

       Toronto Star, Sep 24/04, “Hospital jobs on the block, union charges,” Ron Ferguson

GOOD NEWS

The provincial government has begun to “buy back” private MRI clinics. The clinics
were set up under the previous Conservative government. To date, MRI clinics in
Kingston, Kitchener and Richmond Hill have been converted to non-profit entities.
The government paid each of the clinics $25,000 to compensate for costs associated
with conversion. While it would have been preferable for these clinics to be fully
integrated into the public health care system, their hours of operation have expanded
significantly since converting to non-profit status. A fourth operator, DC Diagnosticare
Inc, is a publicly traded corporation. Reportedly, the government has made an offer of
$14 million to buy its assets, including clinics in Ajax, Huntsville and Mississauga.




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March 29, 2005
2003

PRIVATE FOR-PROFIT HOSPITALS

The Royal Ottawa Hospital will be the first public private partnership in Ontario after all.
Despite an election promise to scrap the P3 deal and build the hospital publicly, the
Liberal government announced on November 21st that the deal would go ahead. The
previous government’s plans for both the Royal Ottawa Hospital and the William Osler
Hospital in Brampton will go ahead virtually unchanged.

In the only minor change to the deal, the public will now pay a mortgage for the facility
with the private consortium acting as the bank, instead of the lease-back arrangement
that was originally planned. The hospital will be built with private funds and the
companies’ profits will come off the top of the hospital’s operating budget. The public
sector will own the hospital once the contract is over left with an aged building that will
be in need of finances for repair and renewal. The finer print details remain hidden
from public scrutiny.

       The Ottawa Citizen, 11/22/2003, “Spin on new ROH deal an insult,” Randall Denley, F1.
       The Toronto Star, 11/22/2003, “P3 hospitals, Morain house to go ahead”,
       Valerie Lawton and Mike Funston, A1.

The Eves government has announced that Ontario’s first private hospital deal has
been signed. The Royal Ottawa Hospital will be built, owned and operated under a
controversial P3 arrangement. The province will lease the hospital back from the
private company, making it more expensive for the public purse over the long run.
Cabinet has approved the Health Care Infrastructure Company of Canada’s $100
million proposal. The same company’s $350 million proposal was selected to build,
manage and operate the William Osler Hospital in Brampton. A series of agreements
dealing with everything from how services are run to building permits and ground
leases still have to be negotiated. The Ontario Tories are intent on getting the deal
signed and sealed before the October 2nd, provincial election.

       Ottawa Citizen, 09/09/03, Mohammed Adam, B1/Front.

The Board of Toronto’s Centre for Addiction and Mental Health is considering a P3 to
finance a plan to amalgamate four treatment sites with encouragement from the
provincial health ministry.

       Toronto Star, 07/10/2003, Theresa Boyle.




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March 29, 2005
It is rumored that the Sudbury Hospital is a candidate for a public private partnership
(P3). The Uxbridge site of Markham Stouffville hospital will be a P3 and potentially
15 other hospital sites across Ontario.

       The Sudbury Star, 05/23/2003, Jason Simac.
       The Pulse, July 2003, Ontario Health Coalition Newsletter.
       The Toronto Star, 04/12/2003, E1, Theresa Boyle.


(Date) Ontario announces P3 Hospital for Lakeridge Health Corporation
(Markham/Stouffville/Uxbridge). Eight for-profit clinics are also underway.

       National Post, 02/18/2003, A4, Tom Arnold.
       Uxbridge Times, 04/25/03, p.1.
       Uxbridge Times, 05/21/03, p.1, Carly Foster.

The William Osler Health Centre selected a preferred bidder. The Health Infrastructure
Company of Canada is the consortium that has been selected to build, own and
operate the new hospital in Brampton under a P3 arrangement. Construction is
scheduled to begin in the next couple of months.

The corporate consortium consists of 3 companies:

   Borealis Infrastructure Management Inc.,
   Carillion Canada Inc.,
   The Ellis Don Construction firm.

       William Osler Health Centre, News Release, 05/12/03, www.williamoslerhc.on.ca/
       Press Release, “Brampton hospital announces potential corporate owners,”
       Canadian Union of Public Employees, www.cupe.ca/www/57/OslerP3/, (05/20/03).

Timmins and District Hospital seeks private partners for a new Medical, Educational
and Dialysis centre.

       The Daily Press (Timmins), 01/24/03, Joyce Hunter.

December 2002, RFP for public private partnership at Royal Ottawa Hospital released.

       Royal Ottawa Health Care Group, Press Release, 12/13/02.




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Innovation Exposed                                                                      47
March 29, 2005
November 2002, RFP for public private partnership hospital at William Osler Health
Centre in Brampton.

       Government of Ontario Press Releases, 11/30/02,
       http://www.newswire.ca/government/Ontario (05/22/03).

       William Osler Health Centre, Press Release, Canada Newswire, 10/17/02.

PRIVATE FACILITIES AND SERVICES: TWO-TIER CARE

A number of services will be de-listed as a result of the Ontario Provincial
government’s May 18th 2004 Budget announcement. Chiropractic services, eye
exams, and physiotherapy will no longer be covered by OHIP. Critics say this is
shortsighted, especially in view of the government’s talk of preventative health and
wellness, and community-based care. It will harm those who are already less fortunate
and increase the burden on the acute health care system in the future.

       Metroland Papers, May 26, 2004, “Optometrists fear delisting will add to eye problems Page 1.

       Cambridge Times, May 20, 2004, “Budget one step closer to two-tier health care: people who
       can’t afford to pay must do without says MPP,” Carol-Ann Nugent, 1/Front.

       Toronto Star, May 21, 2001, Eye tests gone in a blink; Chiropractors, physio also delisted Long-
       term costs will be greater Critics; Richard Brennan, A1.

A private CT scanner clinic is to open in Thunder Bay. The same radiologists, who will
own and staff the private clinic, currently work at Thunder Bay Regional Hospital.

       Kenora Daily and Miner News, 11/04/2003, “Private Scanner Still a Go”, A2.

Private clinics don’t shorten waiting lists; they make them longer by poaching staff from
the public sector. KMH Cardiology and Diagnostic centre located in Kitchener, is
Ontario’s first of seven privately run MRI clinics to open this summer. KMH hired its
first technologist by taking her away from a public hospital in Windsor. Kingston’s
private MRI clinic, Kingston MRI, has also lured a full-time technologist away from the
public sector. She was previously working at Kingston General Hospital.

       The Kingston Whig-Standard, 01/08/03, A1/front, Sarah Hammond.
       The Toronto Star, 30/07/03, A20, Editorial.

Patients pay $2,500 for membership in North York medical practice where
“personalized health planning” includes timely access to care and shorter waits for
MRI scans.

       The Globe and Mail, Margaret Wente, June 17, 2003.




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March 29, 2005
In January 2003, 107 bids by 43 corporations were submitted to the Ontario Ministry of
Health offices to run 20 for-profit MRI clinics and 5 CT scan clinics. By the end of the
summer, selected companies will be providing private for-profit MRI scans in Kingston,
Kitchener and Thunder Bay.

Typically, the clinics will be open for OHIP billable services 35-40 hours/week and the
machines will be used to service customers with private insurance and Worker’s
Compensation Board claims in the off hours. The limited hours of services for the
public system means claims that these clinics will shorten waiting lists are unlikely to
be realized. Concerns about poaching staff from hospitals and from public not-for-
profit providers are well founded. Especially considering a $10,000 bonus offered by
the Kitchener private MRI providers to attract radiologists.

       Toronto Star, 01/08/03, AO6, Carolyn Mallan.
       Daily Miner and News, 03/27/2003, A2.
       Metroland Paper, 03/21/2003, 8, Lynn Rees Lambert.
       Kingston-Whig Standard, 06/25/2003, 7.
       The Observer (Sarnia), 03/26/2003, 1/Front.

       Toronto Star, 04/12/2003, E1, Theresa Boyle.

Belleville-based Quinte MRI vows to open private MRI clinic in next two years.

       Ottawa Citizen, 01/05/03, A8, Trish Audette.

Bids close for companies to operate CT scanner in Brantford. Race is over for
companies to set up private clinic. A private CT scanner is expected to be up and
running in Brantford by March. The CT scan clinic will be privately owned and
operated in Brantford, despite a clear need for a CT scanning machine in nearby
Simcoe.

       The Expositor (Brantford), 01/09/03, A8.

Four corporations win right to open publicly funded, private for-profit MRI and CAT
scan clinics. The four corporations are: DC Diagnosticare, Kingston MRI Inc.,
Superior Imaging, and KMH Cardiology and Diagnostic centre.

       Canadian Press Newswire, 02/21/03, Andrea Baillie.

Kingston is one site announced to receive a new privately run MRI clinic this spring.
Other services have been licensed in Vaughan, Kitchener, Ajax and Mississauga.

       Brockville Recorder and Times, 02/25/03, A1, Mark Calder.




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March 29, 2005
Ontario continues to privatize home care services through the competitive bidding
model, driving not-for-profit providers out of business in several areas (Kingston,
Guelph, etc.).

       The Guelph Tribune, 03/21/03, p.8, Virginia McDonald.

New long-term care beds continue to be privatized.

       Ottawa Citizen, 04/16/03, C7.
       The Dunville Chronicle, 03/05/03, 1/Front, Karen Best.

City of Hamilton calls for management proposals to run the Wentworth Lodge, a
municipal long-term care facility. The proposals include privatization of the Lodge.

       Ancaster News, 04/30/03, p. 36, Craig Campbell.

Ontario government closes private for-profit cancer clinic at Sunnybrook hospital. It
failed to prove that health care could be provided more efficiently and effectively and at
a lower cost in a private, for-profit facility, as Premier Mike Harris claimed it would.

       London Free Press, 02/26/03.
       Toronto Star, 12/04/03, A23, Karen Palmer and Vanessa Lu.
       The Record (Toronto Star News Service), 03/03/03, A7, Ian Urquhart.

Private Positron Emission Tomography (PET) clinic opens in Mississauga.

       Toronto Star, 03/13/03/, B4, Melissa Leong.
       National Post, 03/12/03, A17.
       Medical Post, 04/08/03, David Hodges, Vol. 39, No. 14.
       Medical Post, 03/25/03, Andrew Skelly, Vol. 39, No. 12.
       Canada Newswire, 03/11/03.

Health Canada orders private clinic providing cancer diagnoses for $2,500 each to
suspend services. The PET company (Care Imaging) was approved to offer fee for
service tests using equipment specifically for patients with heart problems – not cancer
patients.

       Sault Star, 03/25/03, B3, Source: Canadian Press.




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March 29, 2005
QUÉBEC [updated February 16, 2005]
2005

PRIVATE FOR-PROFIT HOSPITALS

Big Business Lobbying for French P3 Hospital Site, While Province Holds
“Consultations”

Four out of five studies, costing $38 million, recommend a downtown St-Luc site for the
new french P3 teaching hospital, CHUM (Centre Hospitalier de l’Université de
Montréal). Big business, however, is lobbying for an Outremont site. Meanwhile, the
province has announced that it will hold some form of consultations on the P3 hospital
and release all project studies and documents.

Social activists and patients-rights groups want the hospital built downtown at the
current site of the St-Luc hospital since it is more accessible for the francophone
population. Recent surveys published in the Globe and Mail reveal that a majority of
Montrealers approve of the St-Luc site.

The province is being lobbied by big business led by Power Corporation’s founder
Paul Desmarais to build on the Outremont site. Canada’s first private emergency
clinic, MD Plus Medical Clinic on Beaumont Ave., is right across the street from the
Outremont site and there are expansion plans. Corporations are hoping to profit from
new private clinics, laboratories and further land development in Outremont.

In 2004, ex-prime minister Brian Mulroney and former Québec premier Daniel Johnson
issued a report recommending that the hospital be built on the site of St. Luc hospital
at 1000 St. Denis St.

February 15, 2005, “Charest Government in a Slump”, Globe and Mail.
February 15, 2005, “Emergency clinic plans to add MD”, Montreal Gazette.
February 10, 2005, “Public to have say on CHUM site”, Montreal Gazette.
February 7, 2005, “Battle erupts over Montreal hospital site”, Globe and Mail.

English P3 McGill University Health Centre

The McGill P3 teaching hospital will combine a new building with a renovated existing
building.

February 7, 2005, “Québec has been studying PPPs overseas”, Montreal Gazette.

Health Ministry’s Director of Investments Expresses Reservations about P3 Hospitals

John Gauvreau, the Ministry of Health’s director of investments has expressed
reservations about building the new hospitals as P3s. He is quoted in the Montreal
Gazette as saying “(f)or the department, the (health) institutions and the private sector,
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March 29, 2005
such PPP-mode projects are a daunting challenge”. He continued by referring to “the
necessary resources, their complexity, the completion time, the sharing of risks and
responsibilities between the partners and, finally, the definition of needs, which must
evolve in time in accordance with changes inherent to the delivery of care”.

February 6, 2005, “PPPs are perhaps not the best idea for hospitals: Health department not
enthusiastic. British PPP hospital has lots of shops but an undersized emergency room”, Montreal
Gazette.

Agency to Advise Government on P3s Created as Bill 61 is Passed

Québec Treasury Board president Monique Jérôme-Forget has ensured Québec’s two
new hospitals will be P3 even though it will delay their construction by three to four
years. Bill 61 created an agency to advise government on P3s. Bill 61 was passed
before Christmas (2004).

February 6, 2005, “PPPs are perhaps not the best idea for hospitals: Health department not
enthusiastic. British PPP hospital has lots of shops but an undersized emergency room”,
Montreal Gazette.

Doctors Against P3 Hospitals

Specialist doctors and medical residents told a National Assembly committee that P3
hospitals will introduce the profit motive into health care. “There’s no place for profit”
said Yves Dugré, president of the Fédération des médecins spécialistes du Québec.
Quebec’s medical residents said they worry that doctors, faced with performance
criteria, will not have time to teach medical graduates who are qualifying to practice
medicine.

November 11, 2004 “There’s no place for profit in health care“, Montreal Gazette.



FOR PROFIT CLINIC AND SERVICES: TWO-TIER CARE



Canada’s First Private Emergency Clinic Expands

The MD Plus Medical Clinic, across the street from the Outremont railway yard, is
expanding by hiring more staff. Another doctor will be hired who will also opt out of
medicare.

February 15, 2005, “Emergency clinic plans to add MD: Nearly 500 patients pay out of pocket”,
Montreal Gazette.




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March 29, 2005
Study Finds 60 per cent Increase in the Number of Québec Doctors Operating Outside
Medicare in For-Profit Clinics – Double Billing Also Found

There is a 60 per cent increase in the number of Québec doctors charging patients for
medically necessary services in the past five years, says a Montreal Gazette study.
For instance, at two private clinics in Westmount, doctors charge enormous fees to the
patient as well as billing medicare – double billing. Patients can pay huge ‘set-up’
fees: for example $2,000 for knee and shoulder surgery and $600 for gastrointestinal
procedures.

Compared to the rest of Canada, where there is only one doctor in BC who charges
user fees, this is a startling discovery. In Ontario, doctors can opt out of medicare, but
their patients can seek reimbursement.

Health Minister Philippe Couillard vows to strengthen the public system by changing
the law. The provincial law could be changed to give more power to the provincial
medicare board to fine clinics that charge illegal user fees. However, five years ago,
patients were reimbursed by a private surgery clinic in Montréal that billed patients a
“facility fee” of $400 per hour following an investigation by the Québec government.

February 15, 2005, “Québec’s 90 opt-outs: Number of province’s doctors operating outside public
system is soaring”, Montreal Gazette.
February 15, 2005, “Clinics’ spread vexes ministers: Couillard aide says he’s ready to fight”,
Montreal Gazette.
February 14, 2005, “Private clinics charge ‘set-up’ fees”, Montreal Gazette.
February 14, 2005, “Fees were reimbursed in case of double-billing”, Montreal Gazette.

New For-Profit PET and CT Clinic, Public Facility Underused

There is a new PET (positron emission tomography) and CT clinic in Montréal called
the Ville-Marie. Meanwhile, due to lack of government funding, public Hotel Dieu’s
PET machine is running at about 70 per cent capacity.

January 4, 2005, “Québec promoter asks: Why wait for a scan?”, The Windsor Star.



OTHER

Long Term Care

The Proposed P3 Foyer Saint-Charles Long Term Care Home in Québec City will Cost
$14 Million More than A Public Facility

A government-commissioned study has revealed that the proposed P3 long term care
home called Foyer Saint-Charles in Québec City will cost $14 million more than a
public facility. CUPE Québec released the study by the consulting firm Malette
Services-conseils using an access to information request. Provincial minister Monique
__________________________________________________________________________________________

Innovation Exposed                                                                            53
March 29, 2005
Jérôme-Forget has plans to build between 3,000 and 5,000 P3 long term care beds.
Québec Federation of Labour President Henri Massé says “that means a half billion
dollars we’ll give to the private sector for nothing”.

January 24, 2005. “A P3 that costs taxpayers more”, CUPE in Brief, scfp.qc.ca.
January 20, 2005, “Government-commissioned study says Québec P3 long-term care home to be more
expensive”, cupe.ca.

Home Care

Charest Government Privatizing Personal Home Care Services

The government intends to sub-contract personal home care services. “In 2001, (the
Solidarity Health Coalition) condemned the perverse effects of contracting-out
housekeeping services, and now it is personal services that are going to be privatized
(in home care)”, says Isabelle Matte, spokesperson for the Solidarity Health Coalition.
Also, user fees for home care may be coming. These policy shifts were announced
when the government released the document “Details to promote the home-care
support policy”.

December 2, 2004 “The new home-care policy is a violation of the right to health”, Solidarity Health
Coalition.



2004

PRIVATE FOR-PROFIT HOSPITALS

The Québec Government has announced that two new Montréal superhospitals will be
built as public-private partnerships. To this end, Québec Treasury Board president,
Monique Jérôme-Forget, wants to get legislation (Bill 61) passed by December that will
create the Agence des partenariats public-privé du Québec, to act as the government’s
P3 manager.

Each superhospital has a budget of $1B. The provincial government will contribute
$800 million towards the construction of each hospital and the remaining $200 million
will have to be raised by the hospitals. Financial syndicates will likely construct and
own the superhospitals and rent them back to the hospital boards for 30 years, at
which point they will revert to public ownership.

The development of the public-private partnerships will mean a 3-year delay in the
completion of the facilities.

        Montreal Gazette Oct 9/04, p. A1, “MUHC angry as Quebec hedges,” Aaron Derfel
        Montreal Gazette Oct 8/04, p. A11, “Superhospitals to be public-private projects,”
        Kevin Dougherty


__________________________________________________________________________________________

Innovation Exposed                                                                                 54
March 29, 2005
More information about the Quebec government’s perspective on “Public Private
Business Partnerships” (PPBP) can be obtained at:
       http://www.tresor.gouv.qc.ca/marche/partenariats/engl_bpartnerships.htm

CONTRACTING OUT

On December 18, 2003 “An Act to amend the Labour Code” was passed in the
Quebec National Assembly. The Act makes changes to the Quebec Labour Code that
encourage contracting out. It removes previous job protection provisions for work that
is contracted out, and renders public sector workers’ collective agreements null and
void if they are hired to “follow the work”.

       http://www.publicationsduquebec.gouv.qc.ca

FOR-PROFIT CLINICS AND SERVICES: TWO-TIER CARE

Three Montreal doctors have opened a private medical clinic providing 24-hour patient
care, including health check ups, minor surgery, MRI tests and lab work. The clinic is
located near the wealthy Montreal neighbourhoods of Outremont and the Town of
Mount Royal.

According to its owners, the clinic is targeted at middle class patients. It charges $100
for a 20-minute visit and $75 for each extra 15 minutes. There are also special annual
packages, ranging from $895 to $1,493, that include several visits a year as well as lab
tests and access to a doctor or nurse 24 hours a day.

Federal Health Minister Ujjal Dosanjh is quoted as say that while he is “not happy”
about the opening of the clinic, there are no plans to stop it because it is not breaking
the law. He is seeking a legal opinion on the matter. Quebec Health Minister Philippe
Couillard has also indicated that the clinic isn’t illegal but that it will siphon staff from
the public system.

       The Globe and Mail, Oct 13/04, p. A5 “Private clinic opens to fanfare, concerns,” Tu Thanh Ha
       The Montreal Gazette, Oct 13/04, “’Middle-class’ patients expected at Montreal private clinic,”
       Monique Beaudin
       The Record (Sherbrooke), Oct 12/04, p. 7, “Politicians stand by as private health care clinic
       opens in Montreal,” Anne Dawson

Since 2000, 82 Quebec doctors have opted out of the medicare system. Of these 82,
thirty-six work as general practitioners and 46 are specialists, mostly ophthalmologists,
plastic surgeons, psychiatrists, orthopedic surgeons and dermatologists.

       Montreal Gazette, Sep 16/04, p. A2, Mike de Souza, Elizabeth Thompson
       Globe and Mail, Oct 13/04, p. A5, Tu Thanh Ha




__________________________________________________________________________________________

Innovation Exposed                                                                               55
March 29, 2005
Quebec has more than 50 private clinics offering diagnostic tests, cataract surgeries
and orthopedic procedures to paying patients. The province has at least 14 clinics
alone offering MRI, CT and ultrasound tests -- the most in the country.
       National Post, Sep16/04, p. A21, “A second quiet revolution?”, Editorial
       National Post, Sep 9/04, p. A1, “The Single-Tier Myth,” The Single-Tier Myth

In Montreal, an opted out physician, Dr. Réjean Ouellette has a medical practice that
consists solely of making house calls. He charges $125 in certain areas of Montreal,
$150 for other locations in Montreal and in Laval, and if he has to go further afield,
he charges more money. He only works during the day, although when building up
this practice he worked 24 hours a day.

       Montreal Gazette, Sep 14/04, p. A4, Brenda Branswell

Lasik MD, the private clinic that specializes in laser eye surgery, is expanding its
business in Montreal by offering cataract operations to those who can afford to pay.
The Quebec Health Minister, Philippe Couillard, indicated that his government is not
opposed to a private cataract centre, describing it as a “marginal phenomenon”.

       Montreal Gazette, Sep 12/04, p. A1. Aaron Derfel

LDS Diagnostic Services has several clinics in affluent neighbourhoods in Montreal,
serving patients with private insurance or who are willing to pay out of pocket to jump
the public queue. The private clinic draws from a limited pool of qualified staff,
worsening staff shortages in the public system.

       Montreal Gazette, 9/15/2003, Peter Diekmeyer.

WCB supports private health care, skirts waiting lists by queue-jumping its clients
ahead of other Quebecers. In March of 2003, then Minister of Health François Legault
admitted that the Québec Commission de la santé et de la sécurité du travail (CSST),
the provincial worker’s compensation board, refers clients to the private sector.
Access to information requests revealed dozens of contracts with private health care
providers.
       Montreal Gazette, 05/12/03, A18.

For-profit diagnostic clinics continue to operate.

       National Post, 05/09/03, FP2, Briefing.
       Montreal Gazette, 05/06/03, A6.

       Montreal Gazette, 03/27, 2003, A2, Allison Hanes.




__________________________________________________________________________________________

Innovation Exposed                                                                    56
March 29, 2005
NEW BRUNSWICK [updated March 18, 2005]
2005

HOSPITALS

Service cuts and layoffs: privatization by stealth

       ● Injunction and protests to stop Caraquet hospital closure

The province has announced that Caraquet Hospital in northeastern New Brunswick
will lose surgery, obstetrics and emergency services. Emergencies would be sent to
Tracadie-Sheila, about an hour away.

A community group, the town of Caraquet and a private citizen brought forward an
injunction application to stop the closure. They argue that the hospital cannot close
because it would violate the language rights of the predominantly francophone
population.

About 200 demonstrators blockaded a road in protest of the hospital closure at the end
of February 2005. The blockade ended after a hit and run. A minivan drove through a
wooden barrier and struck a demonstrator.

At the end of January 2005, more than two thousand people marched through the
streets of Caraquet to stop the hospital closure.

The hospital is scheduled to become a health centre on April 1, 2005.
March 18, 2005 “Government fights hospital injunction”, cbc.ca.
March 1, 2005 “N.B. health-care protest ends in hit and run”, CBC News.
January 31, 2005 “Atlantic update”, Broadcast News.



“Select Committee on Health Care” hears submissions on Bill 60,
proposed Health Charter of Rights and Responsibilities

An all-party committee of the Legislative Assembly is traveling through New Brunswick
hearing submissions as part of a public review of the proposed Bill 60, Health Charter
of Rights and Responsibilities. The proposed act includes “right to timely access of
health care services, the right to make informed decisions on health care, the right to
receive relevant health care information, and the right to investigate complaints.”
The piece of legislation would also create a health care watchdog to ensure the law
was being followed. The bill urges citizens to take care of their own health, stressing
to “use health care services in a reasonable manner, and to engage in healthy lifestyle
choices.”


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Innovation Exposed                                                                    57
March 29, 2005
Health spending is low in New Brunswick. According to the Canadian Institute for
Health Information (CIHI), the province has the second lowest per-capita health
expenses compared to all other provinces.

February 17, 2005 “Select Committee on Health Care”, gnb.ca.
January 19, 2005 “Open dialogue is healthy”, The Northern Light (Bathurst).
December 10, 2004 “Newfoundland fourth in health spending”, The Telegram (St. John’s).



PRIVATE FACILITIES AND SERVICES TWO-TIER HEALTH CARE

Ottawa threatens to put New Brunswick’s non-payment of private clinic abortions
to a dispute resolution process

Federal Health Minister Ujjal Dosanjh says that the province could face financial
penalties for refusing to pay for all abortions. Currently, abortions are covered by
provincial health insurance if two doctors approve the abortion and it is done in a
hospital. However, most hospitals have ceased performing abortions, says the editor
of the Moncton Times. The Canada Health Act states that Medicare should cover
medical procedures. New Brunswick, however, stands by the policy of not paying for
abortions in private clinics.

The federal warning comes after a Manitoba judge ruled in December 2004 that a
refusal to pay for abortions violates a patient’s right to Medicare.

January 27, 2005 “N.B. premier says province stands by policy not to pay for private abortions”,
Canadian Press Newswire.
January 26, 2005 “An editorial from the Moncton Times and Transcript”, Canadian Press Newswire.
January 26, 2005 “Health Minister Ujjal Dosanjh says he’s ready to begin a formal dispute-settlement
mechanism”, Broadcast News.
December 24, 2004 “Judge rules refusal to pay for abortions violates rights”, Winnipeg Free Press.

Premier Bernard Lord Wants Two-Tier Health Care, Says Alberta Premier Ralph Klein

CanWest News Service reported that according to Alberta Premier Ralph Klein, New
Brunswick Premier Bernard Lord supports two-tier health care. The News Service
quotes Klein who claims Lord said privately “if Alberta can do it [two-tier health care]
…other provinces can do it”.

January 17, 2005 “Klein backs down, backpedals and back flips”, The Daily News (Truro).




__________________________________________________________________________________________

Innovation Exposed                                                                              58
March 29, 2005
OTHER

Long Term Care (LTC)

Some Good News: New Brunswick Ombudsman recommends LTC medical costs to
be covered by province and LTC personal financial contribution to be based on income
only

Provincial Ombudsman Bernard Richard, in his 2003-04 annual report, has made new
recommendations for nursing homes (LTC) in New Brunswick. Among other points,
Richard recommends that the personal financial contribution formula be changed to
include income only. Presently, fees for LTC residents are based on anything they
own, as well as income. “New Brunswick’s nursing home clientele and their
families…remain subject to the most extensive asset liquidation requirements in
Canada”, says Ombudsman Richard. Presently, the Standard Family Contribution
Policy “unduly depletes residents’ financial resources, directly or indirectly penalizing
their families and dependents.”

Secondly, the provincial Ombudsman recommends, “the costs of health care services
to nursing home residents in New Brunswick be the responsibility of the provincial
government.” He says, “nursing home residents…are unjustly excluded from the
humane umbrella of public health insurance… [the] nursing home [should] provide
medically necessary palliative care that would be ensured if administered in a hospital
context.”

NDP MP for Acadie-Bathurst, Yvon Godin, agrees. Godin calls New Brunswick’s
nursing home policies “archaic” and argues that the provincial government needs to
act swiftly on the Ombudsman’s recommendations.

Representatives from Canada’s 50-Plus Association also agree. They say that “there
is still time for New Brunswick to make these changes.”

January 26, 2005 “Ombudsman’s nursing home comments hit the mark, says MP Godin”,
The Northern Light (Bathurst).
2003/2004 Annual Report, Office of the Ombudsman, Province of New Brunswick,
December 2004.
December 22, 2004 “Tommy Douglas would not be impressed with N.B. policy”,
The Northern Light (Bathurst).




__________________________________________________________________________________________

Innovation Exposed                                                                    59
March 29, 2005
2004

PRIVATE FOR-PROFIT HOSPITALS

Premier Lord favours private companies to own and operate hospitals. Considering
public private partnerships for new hospitals.

       National Post, Canadian Press, 01/03/2003, Richard Foot and Charlie Gillis.

       Canadian Press Newswire, 05/18/03.



GOOD NEWS

The New Brunswick government has decided against a public-private partnership for
the building of a 70-bed $90 million hospital in the Upper St. John River Valley.
Previously, the government had indicated that it was studying the idea of a P3
arrangement for the hospital.

       The Western Star June 25/04 p 7, “Province decides against building P3 Hospital.”




__________________________________________________________________________________________

Innovation Exposed                                                                         60
March 29, 2005
NOVA SCOTIA [updated March 15, 2005]
2005

OTHER

Long Term Care

Doctors Concerned about Long Term Care Access

Doctors in Nova Scotia are concerned that patients are having difficulty accessing
long-term care beds. Nova Scotia is one of the only provinces in Canada to charge
residents of long-term care homes for medical services [which reduces access].
The information comes from the regional findings of a national survey done in
August 2004 by the Canadian Medical Association (CMA).

February 16, 2005 “Doctor shortages, health-care worries vary between provinces”, cbc.ca.
http://www.cma.ca/multimedia/CMA/Content_Images/Inside_cma/Media_Release/pdf/2005/2-15a.pdf.
Nova Scotia Alternative Provincial Budget Fiscal Plan 2004-5, ccpa.ca.



Pharmacare

Some Good News: No Fee Increases in Seniors’ Pharmacare Program

In 2005, there will be no fee increases in the Seniors’ Pharmacare Program.
The Truro Daily News reports that Health Minister Angus MacIsaac has announced an
additional $14.2 million for the Seniors Pharmacare program for 2005. Since 1990,
when the Nova Scotia government introduced co-payments, program prescription
costs have consistently increased creating hardships especially for lower income
people. The full premium now is $390 a year, which is faced by the 39,000 senior plan
members. According to the Canadian Institute for Health Information, Nova Scotia is
the lowest or close to the lowest per capita spender on health care of all the provinces.
Nova Scotians have among the poorest health indicators in the country. For instance,
the province has the highest rates of death from cancer and the highest rate of arthritis
and rheumatism in the country.

March 4, 2005 “Holding line on drug costs for seniors is money well spent” The Daily News (Truro).
December 2003, “The Effect of Changes in Co-payment and Premium Policies on the Use of
Prescription Drugs in the Nova Scotia Seniors’ Pharmacare Program” chsrf.ca.
Nova Scotia Alternative Provincial Budget Fiscal Plan 2004-5, ccpa.ca.




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Innovation Exposed                                                                              61
March 29, 2005
2004

FOR-PROFIT FACILITIES AND SERVICES: TWO-TIER CARE

A physician in Pictou County, Dr. Felderhof, has decided to convert her family practice
into a health co-operative run by a board of directors who are co-op patients/members.
Co-op promoters have talked about fees of $10 to $25 monthly or $120 to $300
annually for uninsured services, including access to nurses. While physicians in
private practice decide what uninsured medical services they will charge patients for
(e.g. over-the-phone prescription renewals, ear wax removal, and filling out insurance
forms) and how much they will charge, community health centres do not charge for
uninsured services. Dr. Felderhof has stated that patients who cannot afford fees will
still have access to insured services at the co-op. While the co-op structure may be a
good idea, the model proposed in launched the week of October 25 in Pictou County
would will apply two levels of service to a community-based arrangement.

       The Daily News, Sept 2/04 p 4 (Opinion). “Health co-operatives: New Glasgow initiative could
       set precedent,” John Jacobs, Canadian Centre for Policy Alternatives

       New Glasgow Evening News, Oct 28/04 pA1. “N.S. docs keep eye on new co-op,” Jennifer
       Vardy.

Nova Scotia’s first private MRI clinic officially opens its doors six months after the for-
profit company, Canadian Diagnostic Services, received its first patient in the facility. It
is the third private MRI clinic in the region. A fourth is scheduled to open later this year
in Cape Breton.
       A fourth is scheduled to open later this year in Cape Breton.

A for-profit MRI clinic in Halifax, operated by Canadian Diagnostics Centre,
continues to operate outside of the Canada Health Act.

       The Halifax Daily News, 01/14/2003, p.6, Peter Mclaughlin.

Military skips MRI queue using new private clinic.

       The Western Star Corner Brook, 11/29/03, p.7.
       Halifax Daily News, 11/28/03, p.6.

A patient purchased services from MRI Canada, a for-profit MRI provider, allowing him
to jump the queue for treatment.

       The Telegram (St. John’s), 03/13/03, A1/Front, Will Hilliard.




__________________________________________________________________________________________

Innovation Exposed                                                                             62
March 29, 2005
NEWFOUNDLAND AND LABRADOR [updated October 27, 2004]
FOR-PROFIT FACILITIES AND SERVICES: TWO-TIER CARE

Premier Grimes and Newfoundland and Labrador Government considering a P3 deal
for a long-term care facility in Corner Brook. Call for expressions of interest on hold for
the moment.

       The Western Star (Corner Brook), 05/10/2003, p.3, Gary Kean.
       The Telegram (St. John’s), 03/28/2003, A3, Michael Connors.
       The Telegram (St. John’s), 04/08/03, A4, Barb Sweet.

Premier Grimes opting for a straightforward privatization rather than a P3 for the LTC
facility. May 24th deadline for requests for expressions of interest.

       CUPE meeting with Premier Grimes, May 20, 2003.

A private, for-profit mobile MRI service is under consideration for Corner Brook and
region.

       The Western Star (Corner Brook), 05/22/03, p.3.

GOOD NEWS

Premier Williams said that a long-term care facility in Corner Brook will be built as a
public facility.

       The Humber Log, Sep 29/04, p 1, “Premier keeps commitment to long-term care facility,”
       Greg Davis.




__________________________________________________________________________________________

Innovation Exposed                                                                              63
March 29, 2005
PRINCE EDWARD ISLAND [updated October 21, 2004]
GOOD NEWS

Premier Pat Binns considered building the new Prince County Hospital in
Summerside using a P3 approach. He told the media: “we looked at all the pros and
cons and we rejected it. We just felt that it wasn’t going to work as well as a publicly-
funded, publicly-administered hospital system. We visited it, we looked at it and we
said no.”

       www.cupe.ca See "Prince Edward Island”   [May 27, 2002 08:00 PM]




__________________________________________________________________________________________

Innovation Exposed                                                                    64
March 29, 2005
NUNAVUT
CONTRACTING OUT

Sodexho partners with Piruqsaijit Ltd. (the largest group of privately owned Inuit
development corporations) to provide food management, administration and
housekeeping. Sodexho readily admits the deal sets the stage for Sodexho to propose
that it provide services for Nunavut health care services.

         Nunatsiaq News, 04/18/03, Charlotte Petrie.




Know about other instances of privatization in the health
care sector? Please send tips and/or sources to:
                                 Canadian Union of Public Employees
                                          Research Branch
                                         research@cupe.ca
                                          (613) 237-1590




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Innovation Exposed                                                                    65
March 29, 2005

				
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