Opinion: Expand private role in Quebec health care? Not so fast

During the last provincial election campaign, Premier François Legault discussed the option of more private health-care facilities being built as a means of easing the pressure on a system that was already in crisis pre-pandemic. “If we want to change the health network, we have to change the recipe, innovate and review the place of the private sector,” Legault argued while on the campaign trail. More specifically, he was advocating the construction of privately owned and operated “mini-hospitals” where patients could be treated at public expense.

Health-care issues appeared to be eclipsed by other issues during the campaign — including the contentious Bill 96 — and Legault and the Coalition Avenir Québec sailed to a predictable victory with a comfortable majority in the National Assembly, in part due to a divided and deflated opposition.

But plans for an expansion of private health care should not go without further scrutiny, in particular challenging the idea that this is the only or best way to improve the dire mess everyone knows we’re in: staff shortages, emergency ward shutdowns and overworked, exhausted doctors, nurses and all health-care providers.

Right-leaning politicians often wrap up privatized health-care provision as somehow novel or innovative — as both Legault and Ontario Premier Doug Ford have done — but there’s nothing new about it. Privatization, to one extent or another, has long been the goal of right-wing politicians, who argue the private sector can do things at less expense than the public sector.

Quebecers should be especially wary of these claims, seeing as Quebec has often been at the forefront of allowing more private health-care facilities to open. Again, the reasoning was that this would remove the burden from the stressed public facilities and make things run more smoothly. But, coincidentally or not, the opposite has in fact happened: hospitals are more strained, there are staffing shortages and more anxiety among the public about their ability to access even basic health care.

If our own example isn’t good enough, the British example is a particularly telling (and dire) one. For the past decade, a series of Conservative prime ministers preached the gospel of private health care somehow improving the system for Britons. Ten years after a huge outsourcing of British public health services to private-sector providers, the system is on the brink of disaster.

In June, a lengthy analysis of British health care by the University of Oxford and provided a frank, damning indictment of this privatization. “Private-sector outsourcing corresponded with significantly increased rates of treatable mortality,” read the report, “potentially as a result in the decline of health-care services.” That’s an academic way of linking the shift toward privately provided health care and people dying unnecessarily.

The authors’ conclusion: “Our findings suggest that further privatization of the NHS (National Health Service, the British government agency that oversees health care) might lead to worse population health outcomes.”

While Legault won a significant majority — his government clearly can act unilaterally, without the need for opposition support — he should not be allowed to pursue a similar path without providing a more detailed explanation of precisely how this is going to work. Lives are at stake.

In the early days of the COVID-19 pandemic, some of the worst death traps in elder care — so bad they received international attention in places like the New York Times — were privately run facilities. These are well-known parts of the public record and hardly ancient history. Given how shaky, untrustworthy and inefficient our multi-tiered, partly private system is, it’s frankly astonishing that Legault can even float the idea of increased privatization without widespread outrage.

There need to be more questions about this plan. And there need to be far, far better answers.

Matthew Hays teaches courses in media studies at Marianopolis College and Concordia University.

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