What kinds of doctors are in this house?

Back in March, Health Minister George Abbott asked the British Columbia Medical Services Commission to investigate whether the controversial Copeman Medical Centre was violating any provincial laws. At the time, Minister Abbott told the legislature the commission would give an "objective" and "unbiased" answer to that question. But a Public Eye investigation has revealed one commissioner tried to open his own private healthcare clinic. Another works at a clinic that "advises" patients when they need to "step into the private system." And there's also a commissioner who wrote an editorial advocating more private healthcare in Canada.

A spokesperson for the ministry of health said Minister Abbot was on vacation was unavailable to comment. But British Columbia Medical Association president Margaret MacDiarmid - whose organization appointed two of the commissioners in question and would have been involved in nominating the third - doesn't see any need for concern.

In an interview with Public Eye, Dr. MacDiarmid explained association representatives on the commission are "are directed by BCMA policy. And they would not be creating policy on the fly" based on their personal views. Meanwhile, commission chair Tom Vincent said his colleagues are "going to consider" which commission members have "conflict problems when we're a little farther down the road."

The medical services commission, which hasn't yet ruled on the Copeman case, has nine members - including three from government and three from the medical association. The remaining "public" members are jointly nominated by the association and the province.

The commission is responsible for administering the Medicare Protection Act, whose purpose is to ensure the "universality, comprehensiveness, accessibility, portability and public administration" of the provincial healthcare system. A version of this article was originally published in today's edition of 24 hours.

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Gordon Denford, one of the commission's three "public" members, is best known as a Victoria retirement home owner. But, in 1994, the chief executive officer of Berwick Retirement Communities Ltd. made headlines in the Times Colonist when he announced plans to open a $600,000 to $700,000 private clinic at one of his homes - featuring two operating rooms.

The clinic would have charged surgical patients an hourly fee determined by the length of their operation and the supplies used. But the introduction of the Medicare Protection Act - which put a stop to extra-billing practices - forced Mr. Denford to abandon the scheme. Ironically, this is the same act Mr. Denford is now charged with administering. At the time, the developer was quoted by the newspaper as saying he thought, "A little competition to the current system as it is presently constituted would be healthy to the situation - the quality of care would ultimately improve."

But, when asked earlier this week whether he supported increased private involvement in the public healthcare system, Mr. Denford said "Not really. Because what I do support is the best service available. And I'm not particularly in favour of one thing or another." Mr. Denford declined to say how his experience as a potential private clinic operator would inform his deliberations on the Copeman case. But he did say, "There are certain plans the government has which I think will eventually lead to shortening waitlists. And I'm just one small part of it."

Mr. Denford, who was appointed to the commission by the New Democrats in 1999 and subsequently re-appointed by the Liberals, says he wouldn't be setting up a private clinic in the future.

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Douglas McTaggart, a British Columbia Medical Association representative on the commissioners, is a general practitioner at Continuum Medical Care. According to Continuum's Website, the West Vancouver clinic offers "public plus" healthcare. In other words, "when the public system can no longer meet the healthcare that you require, or do so in a timely manner" Continuum doctors "can advise you of the need to step into the private system. Through our private network of healthcare delivery you will be able to achieve a seamless transition to meet your health care goals in the most cost effective manner for you and your family."

In an interview with Public Eye, the clinic's medical director Bryce Kelpin explained Continuum regularly sends patients to "the private surgical facilities. I'm sending people over to see private specialists out of the Cambie Street facility" - the controversial private hospital whose partners include Canadian Medical Association president-elect Brian Day. Dr. Kelpin, also said Continuum is in the process of setting up a private magnetic resonance imaging and computerized tomography scan facility in North Vancouver. And the clinic is "considering" offering a medical screening program like the one at the Copeman Clinic - where patients would pay an annual fee in return for early disease detection services.

In 1993, Dr. McTaggart was also the spokesman for a group of North Shore doctors who opted out of the Medical Services Plan. Opting out means patients seeing those doctors would have to pay for their medical services upfront, forwarding government a receipt for future reimbursement. But, in an interview with The Vancouver Sun, Dr. McTaggart - who didn't opt-out himself - acknowledged some of the dropouts were charging patients more than then they'd get back from the government. Dr. McTaggart didn't respond to a request for comment.

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Mark Shonfeld is the executive director of the British Columbia Medical Association and one of its alternate representatives on the commission. In an editorial published in The Vancouver Sun back in October 1994 under the headline "Nothing to lose, everything to gain with private healthcare," Dr. Shonfeld, then president of the association, wrote he saw "no disadvantage in allowing Canadians to purchase non-essential elective procedures in Canada." And he questioned whether "health promotion and preventative care" services should be covered by the medical services plan. Dr. Shonfeld didn't respond to a request for comment.

1 Comment

For the last year and a half this citizen has been waiting on assorted lists to see medical practitioners from GP's through three count em three specialists. Guess what, now I'm on a list to get a epidral steriod injection.Quicker and cheaper for the system for the treatment of spinal stenosis. The process takes way under an hour.The list is huge because only two people do the procedure in this town.( Victoria) One has a operating room at his office and the other works in the hospital. Length of list? Only 2,000 other folks waiting for the same thing. The doctors must be fast apporoaching burn out Are the waiting folks hurting? you bet. If they had the money they would be going the private route really quickly. The guy who wants to be president of the Canadian Medical association is well known for his private clinic in Vancouver. Wonder who George Abbott is wishing to win. The other guy is a family practioner who supports the public system. So while our health minister weaves and darts and tells us about the great amounts of money being spent,which is true but maybe not all so properly directed, folks are getting tired of the delays. Expect those 5,000 beds any day now.

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