On Thursday, May 5, Ontario Health Minister Eric Hoskins announced plans to implement 12 recommendations to bolster accountability, regulation, quality and safety in the increasing number of non-hospital medical clinics in Ontario. As Mr. Hoskins stated:
“As the [health] system evolves and patients increasingly receive care outside of hospitals in more accessible community settings, it is important that its oversight and regulation evolve to ensure that patients are protected. Patients deserve a high and consistent level of oversight, transparency and quality, regardless of where they receive care.”
The recommendations being implemented are coming from the recently released report, Building an Integrated System for Quality Oversight in Ontario’s Non-Hospital Medical Clinics, prepared by Health Quality Ontario, which advises the Province of Ontario on the quality of health care.
The report recommendations include that Ontario:
- Develop a single system of oversight for all clinics, including 273 “out-of-hospital premises” such as pain, colonoscopy and plastic surgery clinics and 935 “independent health facilities” such as diagnostic testing facilities.
- Introduce quality oversight, legislation, which, should be aligned to patient risk and clinic performance rather than at set calendar-based trigger points.
- Establish an Executive Officer.
- Establish a permanent expert committee to make recommendations. Membership should include patients.
- Owners of non-hospital medical clinics should be required to apply for registration and registration should be made contingent on passing inspection.
- Standardized plain-language summaries of inspection reports should be posted in clinic waiting rooms and online.
Gaps in medical facility regulatory structure
The genesis of the report and recommendations announced last Thursday are in response to a number of instances that came to light in 2014 of patients suffering serious harm from infections in a pain clinic and in several endoscopy clinics in 2011 and 2012. One of the pain clinics guilty of treating patients in an unsterile setting was the Rothbart Centre of Pain Care in Toronto. By last report, 13 patients were infected with Staphylococcus aureus bacteria from receiving treatment at the clinic. Paul Harte, former President of the Ontario Trial Lawyers Association, represents many of the injured patients. In a recent Toronto Star article, Mr. Harte said he is not surprised by the shortcomings identified in the report but is hopeful they will be addressed. “This report confirms what we already know: the existing regulatory structure puts patients at risk. The report has identified significant gaps and makes reasonable recommendations. It remains to be seen how quickly Minister Hoskins will move forward, but this is a good start.”
This is welcome news for the protection of patients. As more healthcare services are downloaded out of hospitals and into private clinics we may sadly see more of these stories in the future. If the province is going to continue to reduce funding to our hospitals and not give doctors and healthcare professionals the resources needed to safely and adequately treat patients, more people will be put at risk.
The Rothbart Pain clinic and the three endoscopy clinics were privately run. The clinics now face multiple lawsuits for the harm caused to the patients. If the coming regulatory oversight does not result in better safety at these clinics it may be that the lawsuits can cause private clinics to adopt safer practices.