Alberta Fertility Privatization is the Wrong Direction
You may have seen the January 11, 2016 Edmonton Journal article about the private fertility clinic opening in Edmonton.
Following that we were able to discuss the issue with 630 CHED.
Albertans voted explicitly for public health care in 2015, in funding, and in delivery. Clearly stated in the Alberta NDP platform, they would "end the PCs' costly experiments in privatization, and redirect the funds to publicly delivered services."
When asked to justify the (correct) decision to halt the Edmonton and area lab services contracting to private provider Sonic, Health Minister Sarah Hoffman had said: “I want evidence to be able to guide those decisions and I don’t have that evidence today.”
Yet what’s missing from the talk of the Pacific Centre for Reproductive Medicine opening their private fertility clinic in Edmonton is any evidence that this will save on costs or improve services. Wait times at the public clinic at Edmonton's Royal Alexandria Hospital have been dramatically reduced with recent lows of 3 to 9 months. To our knowledge no case has been explored as to how we could better meet patient needs instead through improvements to the public clinic.
A 2013 blog post by researcher Alana Cattapan raises many questions about the costs of private for profit in-vitro-fertilization (IVF). Known salaries of $1.7 million, and private fertility clinic profits of $14 million raise doubts about any possible “efficiency” in using private delivery of these services. Without disclosure of service costs and a lack of clarity on service fees, Cattapan points to information that suggest families in need of IVF services are being overbilled to help generate the plump profits these clinics enjoy. The public clinic in Edmonton operates on a cost recovery basis, so we are expecting fee increases once profit margins become the reality.
While cost concerns can not be ignored, we also have issues of jurisdiction over the operation and even ethics of these clinics. As pointed out in the Calgary Herald in 2014, when issues arose at Calgary’s private fertility clinic over the clinics insistence on using only donors of the same ethnicity, as well as confusing issues around access to egg donors, the Herald found that “Neither the government nor the College of Physicians and Surgeons of Alberta has jurisdiction over private clinic policies.”
It is believed that with the opening of the private clinic, we will see the public clinic at the Royal Alexandria Hospital eventually close. The clinic not only provides valuable services, but is the last of 2 remaining academic IVF centres in all of Canada, through the University of Alberta. The clinic provides valuable access to gynaecologic reproductive endocrinology (GREI) teaching to the University, giving students the chance to spend time in the clinic, and provide academic GREI’s lecturing in second, third and fourth years. The clinic is also known to have trained more IVF specialists at the U of A in the last 10 years than any other university in Canada.
With today's low price of oil, what’s a cash strapped government to do?
We believe the government should work to stop the opening of the private clinic. The Edmonton Journal mentions a 2014 University of Alberta study that suggests public funding of IVF treatment could save the system as much as $100 million a year. This should be the first step in improving access to IVF treatment, and saving the system money by better regulating the treatment itself under public coverage.
Should the government continue on with the private clinic we believe that guarantees to staff should be made in the new clinic that existing collective agreements will remain in place, as well as continuation of bargaining rights and representation. Staff inequities should not be allowed to exist to further the bottom lines of private providers.
While IVF treatments are not yet covered in Alberta, consultations and testing are covered. We deserve to see the contract or funding arrangements and details for services provided, and details of how these costs compare with our public clinic. Albertans need transparency in privatization experiments, so that we can see for ourselves just how much we are subsidizing private profit instead of spending money on needed services. We believe that with full disclosure of the costs of the profit margin to our system in this and other examples, we will see even greater political will to end corporate welfare in private care.