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Closing arguments begin in legal case over private health care in B.C.

Nov 18, 2019 | 5:01 PM

VANCOUVER — A lawyer arguing in favour of a two-tier health care system in British Columbia says the government can’t legally justify preventing patients from paying private doctors to alleviate their suffering sooner than the public health-care system can.

Peter Gall began his closing arguments today in a decade-long constitutional challenge of the Medicare Protection Act of B.C. as his client Dr. Brian Day, CEO of Cambie Surgical Corporation, looked on from the gallery.

Gall told B.C. Supreme Court Justice John Steeves that it’s entirely within the provincial government’s constitutional purview to make policy decisions about how the public health-care system is delivered.

But he says the government’s own data shows it is failing to provide diagnostic and surgical services in a timely manner, and patients have the right to take the matter into their own hands.

He says any fears that allowing private diagnostic and surgical services would result in a “radical transformation” of the public health-care system are purely hypothetical.

Waiting too long for treatment puts patients at risk of psychological anguish, prolonged pain, poorer surgical outcomes and even death, he says.

“The public system can’t provide timely diagnostic and medical services to everyone,” Gall says.

“The government can’t then prevent patients from taking their own steps, their own measures to alleviate their suffering and protect their health. That’s what this case is about.”

Government lawyers say in written closing arguments that Day’s claims of the plaintiff patients having been deprived of life, liberty and security of the person under Section 7 of the charter are problematic because those protections apply to issues of justice, not health care.

Rather than a constitutional challenge, the government alleges Day’s case amounts to “political theatre” and an attempt to force change on the health-care system for the financial benefit of doctors who earn more money from wealthy patients going to private clinics.

The province also says Day’s lawyers have failed to establish that patients suffer harm by waiting for services.

Public health care supporters, including interveners in the case, held a news conference outside the courthouse before the final arguments kicked off on Monday.

“We joined this court case because we believe in defending a public health-care system where everyone is covered, everyone is treated equally and no one goes broke paying for their care,” Edith MacHattie, a representative for a coalition of interveners, says in a statement.

Coalition members include the BC Health Coalition and Canadian Doctors for Medicare.

“Brian Day and his lawyers have argued that it’s okay to profit off people’s illnesses. We disagree. All this case has proven is that a private for-profit system would improve access for the healthiest and wealthiest while creating longer wait times for everybody else,” MacHattie says.

Day legally opened the Cambie Surgery Centre in 1996, saying he wanted to create more operating-room time for surgeons who couldn’t get it in public hospitals and that profit was never a motive. However, the facility has been operating since 2003 in violation of provisions of the Medicine Protection Act that haven’t yet been proclaimed into law.

The case landed in B.C. Supreme Court in 2016 with support from four of Day’s patients.

In 2018, Health Minister Adrian Dix announced the government would begin to fine doctors $10,000 for a first offence and $20,000 for a second violation of the act if they charged patients for publicly available services. Dix said the ‘don’t ask, don’t tell’ approach, which allowed private-clinic surgeries and diagnostic tests to continue because provisions of the law had not been enforced, would come to an end.

However, Day successfully sought an injunction that prompted a B.C. Supreme Court judge to order the government not to enforce sections of the act until their validity could be established at trial, which is expected to conclude Dec. 6.

This report by The Canadian Press was first published Nov. 18, 2019.

Amy Smart, The Canadian Press