We Don't Need Privatization Pipe Dreams

(This op-ed was first published in the Winnipeg Free Press on June 30, 2022)

Manitoba families face unacceptably long wait times for surgical and diagnostic procedures. Pallister-era decisions to close emergency departments, cut critical-care capacity and privatize outpatient services weakened our capacity to respond to COVID-19 and caused chaos that is felt to this day in our hospitals, personal care homes and clinics.

So it is not surprising that, provided no other option, respondents to a Probe Research poll conducted on behalf of the Winnipeg Free Press would welcome whatever help they could get (“Manitobans open to private help to clear backlogs: poll”). But it is a different story when Manitobans are offered a choice.

Only a few months ago, also reported exclusively in the Winnipeg Free Press (“Tories have made health-care system sicker, majority in poll say”) the Manitoba Health Coalition worked with Probe Research to poll on a similar issue. Respondents were asked about their preference for addressing the backlog. Given the option, just over two-thirds of respondents preferred to hire and train more staff and purchase more equipment within the province’s public health system; less than a quarter preferred to pay private health care providers (including some based in the U.S.) to deliver these services (source: Probe Poll For MHC).

The Winnipeg Free Press does not provide that option in their polling question, nor do they reference this very recent poll, conducted by the same polling firm, in their reporting. The Manitoba Health Coalition believes this to be a mistaken approach that does a disservice to Free Press readers. We believe that public health care is a fundamental right for every Manitoban based on the principles (public administration, universality, comprehensiveness, accessibility and portability) and conditions (no extra billing or user fees, or queue-jumping) of the Canada Health Act. This commitment - shared by so many Manitobans - must factor into the conversation as to where we go next.

It is true that the question asked by the Winnipeg Free Press in its polling, as Tom Brodbeck is at pains to emphasize in his reporting, does assume that the private operators in question would not charge patients for their procedures. But of course this is a slippery slope. Once you begin to place more and more of the province’s surgical and diagnostic capacity in the hands of private enterprise, you run the risk that user-pay scenarios become part of the mix. They are for-profit businesses. That’s their job.  

But even ignoring the user-pay element, further out-sourcing of vital public health care services does not make sense for Manitoba families.

For one thing, any expansion of private surgical and diagnostic capacity in Manitoba would necessarily include private providers poaching staff from the public system. This runs entirely contrary to the desires of Manitoba families, and the long-term sustainability of Manitoba’s surgical and diagnostic capacity.  Vacancy rates in nursing and allied health professions are already severely affecting the operation of hospitals in Winnipeg (“Constant sense of impending doom”) and across Manitoba (“'At the breaking point”). The last thing they can afford is to lose staff to private providers. Expanding our reliance on private and out-of-province operators won’t add capacity to Manitoba’s public system, won’t tackle waitlists and won’t save money. 

Manitobans are sick of - and sick from - the chaos injected into our health care system over the past six years. But this is the tried and true practice of governments focused on private profit over public health care: they cut and defund services, allow them to slip into chaos and then sell privatization as a silver bullet. 

The Stefanson PC government clearly sees an opening to expand private health care at the expense of the public system. That is why it has brazenly appointed members to the new permanent Board of Directors of Shared Health Manitoba with links to for-profit health care (“Tories accused of private-health bias with board appointees”). This is of course very concerning to the Manitoba Health Coalition and we have written to the Auditor General to ask for an investigation into this appointment process.

Manitobans do not need privatization pipe dreams. We need structured and sustained investment in Manitoba’s public health care system to address the backlog efficiently and effectively for Manitoba families. We need the government to establish firm timelines for when the backlog will be cleared so that families know how long they and/or their loved ones will be waiting (Doctors Manitoba has made this recommendation repeatedly and the Manitoba Health Coalition supports this call).

And most importantly we need a government that is willing to learn from the mistakes of the past, instead of doubling down on the Pallister-era approach to health care.

Thomas Linner is the Provincial Director of the Manitoba Health Coalition, a non-profit, non-partisan organization dedicated to the protection and expansion of public health care in Manitoba mbhealthcoalition.ca