If cutting surgical wait lists is the only goal, Doug Ford's plan could work

Now that Ontario Premier Doug Ford has unveiled his government's plan to reduce surgical wait lists by giving a greater role to privately run for-profit clinics, the big question is whether the plan will succeed.

A key factor in how that plays out is the definition of success.

Ford and Health Minister Sylvia Jones are not claiming their proposal, which was announced Monday, will fix all the problems in the health system — merely that it will speed up the pace at which patients get certain surgeries and procedures. 

"We're taking action to reduce wait times for surgeries," Ford told the news conference. "No matter where you live, we want to connect you to more convenient care closer to home."

Hospital administrators know that if they devote more resources to one specific part of the health-care system, it can show results. 

That means if all the Ford government wants to accomplish is reduce wait times for cataract surgeries and hip and knee replacements, the plan has a shot at achieving that goal, provided it's done right. 

Anthony Dale, chief executive of the Ontario Hospital Association, acknowledges that the plan will face challenges.

"We have a huge amount of change management and risk management ahead of us if we're to successfully implement this," Dale said in an interview. 

There's widespread agreement that some surgeries could be performed more efficiently — without sacrificing the quality of care — in specialized clinics outside of hospitals.

The issue that stirs impassioned debate is whether those specialized clinics should be run on a non-profit basis under hospital management or on a for-profit basis under the private sector. 

The Ford government's plan allows both the non-profit and for-profit models. That's what makes the plan both politically defensible and politically charged.

Defenders of private sector involvement will point out that numerous facilities in Ontario providing publicly funded health-care operate on a for-profit basis. Most of those are performing diagnostic testing, such as X-rays, ultrasound and pulmonary function tests, but there are also dialysis and sleep clinics. 

Expanding this to some of the most commonly performed surgeries opens the door to a new revenue stream.

The plan begins with a major expansion of cataract surgeries outside hospital this year, and aims to see hip and knee replacements done in community surgical centres starting next year.