Manitoba inking 3 more deals with private providers for out-of-province surgeries

Hundreds of Manitobans could be sent out of province for surgery as part of the government’s continuing effort to reduce the surgical backlog.

The province has quietly reached deals with two private providers — Cambie Surgical Centre in Vancouver and Clearpoint Don Mills in Toronto — and is working on finalizing a third agreement that expands the type of procedures Manitobans can receive at the Cleveland Clinic in Ohio.

These three centres will now offer foot, ankle and shoulder surgeries to Manitobans.

The province says Cambie and Clearpoint both have the means to complete 200 procedures in each of the next two years, while soon up to 150 surgeries could be done in Cleveland, a clinic which the province also contracted with last year to provide hip and knee replacement surgery.

Sometime within the last month, the province listed the agreements online, according to a website that tracks archived web pages. The province has not publicized the signing of the contracts. No patients have been sent so far.

The contracts are one part of Manitoba’s efforts to quickly provide surgical and diagnostic care, a government spokesperson said.

Fraction of surgeries

“Our government and the diagnostic and surgical recovery task force are concurrently investing in increasing procedures within the public health system, building long-term procedure capacity within the public health system, and procuring procedures both in and out of province to produce the best results and getting Manitobans the care they need faster.”

The number of out-of-province procedures that have been done — 367 so far — is a small fraction of the 26,500 procedures the task force has procured by signing contracts with provincial providers, the spokesperson said.

The province reached deals last year with hospitals in northwestern Ontario, North Dakota and Ohio for hip, knee and spinal surgeries.

It inked arrangements earlier this year with the University of California San Francisco for shoulder-related surgeries and the Mayo Clinic for heart-related tests.

Sending patients out of province for care remains a source of contention.

Critics, ranging from political parties to medical professionals, have expressed dismay that the province’s health-care system has reached the point where out-of-province options are being sought.

Two sleep specialists resigned from their task force roles after saying their proposal to cut a wait list was ignored. Dr. Dan Roberts said the task force tried to sell him on sending multiple sclerosis patients to the U.S., which he rejected in favour of a local proposal.

The Progressive Conservative government has maintained out-of-province care is a temporary solution while the health-care system builds up its ability to perform additional surgeries and diagnostic tests here.

NDP Leader Wab Kinew wouldn’t commit his party to abandoning out-of-province contracts if elected in the fall because he says he doesn’t know the full extent of the damage done to health care by the PCs, but his party would prioritize local solutions.

“The concern that we have is that there have been solutions right here in Manitoba being offered from local surgeons that have been ignored,” Kinew said.

The province’s deal with Cambie Surgical Centre in Vancouver was finalized in the last few weeks, after around six months of discussions, said Dr. Brian Day, who owns the centre. 

“The Manitoba government essentially reached out to us to see if we had capacity. They knew of our existence and the kind of surgeries that we were performing,” the orthopedic surgeon said.

He acknowledged his private clinic is well-known because of his long-standing crusade to provide patients with access to private care when the public system cannot offer timely care.

A man looks off into a distance, while seated in front of a window.
Dr. Brian Day has championed private health care. (Darryl Dyck/The Canadian Press)

Last month, the Supreme Court of Canada announced it wouldn’t hear Day’s appeal challenging B.C.’s limits on private insurance and extra billing. He had argued that when waits in the public system are so long, those restrictions violate the principles of universal and reasonable access to health care enshrined in the federal Canada Health Act.

The Manitoba Health Coalition objects to all out-of-province contracts, but the non-profit group has particular reservations about the province teaming up with a prominent opponent of universal public health care, provincial director Thomas Linner said.

“I think the government of Manitoba understands that the optics of this are not very good,” said Linner, suggesting politicians would have stood beside Day at a public announcement if they were proud of this deal.

“I think they know the Cambie Surgeries, politically, is antithetical to the views of Manitobans, and I think it’s really unfortunate that they’ve decided to go forward with this.”

A man in a suit speaks passionately.
Thomas Linner, the provincial director of the Manitoba Health Coalition, has reservations around the government teaming up with an avid proponent of private health care. (Justin Fraser/CBC)

Day said his efforts aren’t undermining the public health-care system. He said he’s only threatening “the public union monopoly,” which he said the Manitoba Health Coalition, which has ties to unions and the provincial NDP, is defending.

They don’t want any competition, he said.

“There is no monopoly of any type that serves the person who wants or needs the service efficiently or well, because they don’t have to provide good service because they’re the only show in town,” Day said.

Building capacity

The government didn’t respond to questions about its contract with Cambie Surgical Centre.

The number of procedures done outside the province since the task force’s formation in late 2021 remains well shy of initial estimates.

Health Minister Audrey Gordon was not made available for an interview, but she suggested last month the public health-care system is stepping up.

“When we talked out-of-province surgeries, we said it was temporary. It was temporary to allow us to be able to build capacity here at home and we are doing that, and Manitobans are responding by staying home to get that care,” she said in an interview with CBC News.

“As our capacity increases, the need for out-of-province surgeries will naturally decrease, and that is what I think we’re starting to see.”

Some Manitobans aren’t comfortable leaving the province, while others still aren’t aware of the option, she said.