CT outsourcing stirs debate in Canada
January 17, 2011
by
Brendon Nafziger, DOTmed News Associate Editor
The outsourcing of CT scans to a private clinic has provoked an outcry from labor groups and liberal politicians in Canada, who worry it represents the privatizing of health care.
Last year, a health region in Saskatchewan inked a deal with Radiology Associates of Regina to provide CT scans over a 32-month period in an effort to cut wait times. As of October, 737 people were waiting for a scan, according to the region.
The Regina Qu'Appelle Health Region said three CT scans at two public hospitals in the area were used 16 hours a day, seven days a week, "maximum capacity" for staff and equipment.
Officials estimate shifting some of the scan burden to the private group will allow them to do an additional 42,500 over the length of the contract, while saving up to $2.6 million, according to a report in the Toronto Sun.
Currently, half of all patients seeking an elective CT scan get the procedure done within about 34 days, and 90 percent get it within 300 days, according to The Regina Leader-Post.
The region hopes by adding a fourth scanner at the private clinic, all patients will get an elective CT scan within 90 days. (Patients with an emergency get the scan within 24 hours.)
But critics contend CT scanners at the two public hospitals in the region are underused, with The Canadian Union of Public Employees claiming that one scanner is left idle over the weekend at Regina General Hospital.
"I don't actually believe that this is necessary. I do think that it's something more philosophical and a direction this government seems bent on going," Judy Junor, a critic of the policy, told The Regina Leader-Post.
The region countered that many elements, including availability of a radiologist, determine operating hours for a scanner.
Health officials also say the costs for the private contract are $9.9 million, cheaper than the $12.5 million estimated for the public system to handle the added scans.
But critics dispute the claimed savings, with the CPUE arguing that labor costs for the CT technologists at the private clinic are nearly the same as with the public system. And the Leader-Post noted that a September arbitration between the union and health officials found that the region did not demonstrate that the private contracts were cheaper than keeping the work in-house.
However, the arbitration concluded that third-party contracts were the best way in the near term to help the region meet its health targets of shorter wait times for scans and surgery, the paper said.
One concern of the critics is why Radiology Associates would buy its new General Electric Co.-built, 64-slice CT scanner if the contract is only meant to be short term, according to reports.
Some politicians argued that the public system could deliver health care more efficiently, the Sun said.
"It's hard to imagine how this will be good, consistent, universal service when it's a for-profit company," said Megan Leslie, a member of parliament with the left-wing New Democratic Party, according to the paper.
But Jim Slater, the region's executive director of diagnostic imaging, denied that outsourcing CT scans was in any way creeping toward privatization, the Leader-Post said.
"With this third-party contract, we are in compliance with the Canada Health Act --so this is not a private provider," he said.
Radiology Associates, whose contract calls for it to begin offering scans in May, also denied there were any privatization worries, according to CJME radio.
Saskatchewan is thought to be the birthplace of Canada's government-funded universal health insurance, called Medicare, with the program's roots ultimately traced to the 1947 Saskatchewan Hospitalization Act.