Private donors and private clinics re-shaping the health-care landscape in Victoria

Outside forces are combining to reshape what health care looks like in BC. Private donors and private clinics are relieving pressure on the federal government by contributing more to vital medical infrastructure and the overall continuum of health care across the province. But their contributions also raise concerns about questions of undue influence over what gets funded and about equitable access to public health care.

Philanthropy has always played an important role in Canada’s health-care landscape. In 2023, Peter Gilgan made a historic $105-million donation to Trillium Health Partners in Mississauga, Ont.—the largest donation ever made to a hospital in Canadian history.  A BC philanthropist donated $33.8 million to VGH and UBC Hospital Foundation to establish the BC Multiple Sclerosis Research Network which will advance research into a next generation of cell-based therapies, including stem cell transplantation.

Victoria examples of hospital philanthropy

“Philanthropy is a catalyst in elevating basic care. Every year, donors fund 40% of the equipment at Royal Jubilee and Victoria General hospitals, illustrating the vital role philanthropy plays in our health-care system locally. Without donations, hospital care would look a lot different,” said Victoria Hospitals Foundation CEO Avery Brohman.

It also means that philanthropic or social funding directs and advances medical research and resourcing in particular medical areas at the behest of private donors. Despite the directive, the benefits to a broader community are more than welcome.

This week, the Victoria Hospitals Foundation (VHF) announced a private $1 million donation helped push its Imaging is Power campaign across the $11-million goal line. The donation was made by an individual who had “been a strong user of imaging tools” in their own treatment. Occasional or tribute donors often give to honour the care they received or someone they have lost to a particular disease.

Led by Dr. Alan Andrew, Island Health’s medical director of imaging, the campaign will supply a new CT scanner, SPECT/CT scanner, and C-Arm imaging device for the Heart Catheterization team at Victoria General Hospital (VGH), and will finance the refurbishing of three MRI machines using innovative technology. The machines will be stripped down and entirely rebuilt.

“Cutting-edge equipment will improve the quality of care provided to our patients, and will also allow us to acquire images more efficiently, which will help reduce wait times,” said Dr. Andrew. The province asserts that it has stepped up improving imaging wait times and services.

Each day, 500 people undergo scheduled scans at VGH and the Royal Jubilee Hospital (RJH).

The province’s 2023/2024 Medical Imaging progress report, released in June, shows a 43% increase in the number of CT exams from 2016/2017 and an 83% increase in the total number of MRI exams performed in BC compared with 2016/17. The report claims that the province now has the second-shortest wait time in Canada for diagnostic imaging, with an average wait of 159 days or less for an MRI exam.

One of the more significant outcomes to growing diagnostic capacity in the CRD is the power of diagnostic screening to identify and address health problems early on, before they become more serious. Prevention and timely diagnosis are key factors in reducing financial costs of illness to the public health system and to individuals and families.

Private clinics mean more services

Private clinic operators have argued that their services do the same—reduce backlog, costs and support prevention. They also raise serious questions around fair and equitable access to care and the siphoning of much needed staffing resources away from a public health system already working at a deficit.

The rise of private clinics and telehealth options are not new to residents of the CRD. In 2022, the telecom giant Telus, spent more than $2.5 billion expanding into health care, as a way to differentiate itself from its telecommunications competitors and grow its revenues. Sprout Family Health and the newly announced Care2Talk clinic in Victoria join a growing field of pay-per service options offering a range of hybrid online and in-person services.

In an economy where Victorians are struggling to pay rent and buy groceries—and who may have no family doctor—paying for care out of pocket is beyond reach. The BC College of Physicians and Surgeons recognizes that virtual care options also create additional inequities for people who lack access to technology, have limited digital literacy and who face other challenges participating in virtual communication.

Care2Talk’s private virtual health management clinic located in the Hillside Shopping Centre will begin in-person appointments this fall. On its roster of virtual care professionals are nurse practitioners and doctors, including three who work at Trillium Health Partners in Mississauga.

But do they take workers away from the public system?

When asked if he feels his business is siphoning nurses off an already taxed public system Care2Talk CEO Jordan Schley said: “There's actually an abundance of nurse practitioners in BC that are looking for a hybrid working environment, working two, three hours a day, supporting a handful of patients. We have 62 applicants ready to join our team.”

The staffing pinch is real and the shift of nurses to private clinics like Jared Schley’s or other virtual services won’t help it. Stats Can nursing employment numbers in 2022 showed 5,325 nurse vacancies in BC, and that, by 2031, roughly 27,000 nurses will be needed to keep up with the health-care needs of its expanding population.

The Canadian Federation of Nurses Unions’ (CFNU) Sustaining Nursing in Canada report says the nursing workforce struggles with “several complex intersecting issues, including chronic shortages, inadequate staffing, excessive workloads, mandatory overtime, toxic workplaces, and endemic violence.”

The CFNU says the province must invest in retention, recruitment and retiree returns if it is to effectively counter staff shortages and high burnout rates in the profession. As Schley sees it, there would be enough nurses to go around if only the province would address the current nursing working environment challenges.

“We run the same competition to attract talent. We're just offering a completely different work environment,” he said. But, from a client perspective, the offering only works for those who can afford it.

While private clinics argue they are alleviating the burden on the overall health-care system, donor funding for research and equipment is the far more equitable and far reaching contribution in what is becoming an increasingly complex health-care landscape in Victoria.

Deloitte’s The Future of Health in Canada 2024 report anticipates more of the social giving and virtual care trends in “the delivery of health care moving from bricks and mortar acute settings to virtual and home settings as well as increasing speciality centres of excellence.”

“There's this kind of Uber model of health care coming,” says Schley “where you opt in to work a couple days a week and have no overhead and no clinic.”

The future of health care in the CRD may soon look far different than it currently does in less time than we imagine.