The province may let contracted private clinics keep patients overnight for as long as three days so they can take on more complex surgeries than the day procedures they've so far been permitted to perform.
That possibility is mentioned in a health ministry discussion paper of potential surgical reforms that's gone out for stakeholder comment.
"Improved access to surgical services may include performing select surgical procedures which have length of stay up to three days, in private surgery centres using public funds," the paper says, adding the change would require amending the Hospital Act.
B.C. Health Minister Terry Lake announced an extra $10 million Monday to perform more day surgeries this summer – some through private clinics using public funds – in order to cut wait times.
But NDP health critic Judy Darcy said letting private surgery clinics go beyond day surgery to multi-day stays would be tantamount to turning them into full-fledged "private hospitals."
Private surgery clinics so far perform barely one per cent of government-funded procedures in B.C. when public operating rooms aren't available.
Longer patient stays would open the door to many more surgeries flowing to private facilities, Darcy said, adding critical staff may follow, further reducing capacity in public hospitals.
"Health professionals are in short supply – anaethesiologists, specialty nurses – and if we drain them out of the public system into the private system we effectively become captive to private for-profit clinics," Darcy said.
She called the proposal a "game changer" that has been quietly advanced under the guise of a short-term "band-aid" to cut waits.
"They ought to be doing the innovation and the strategic investment to use our public system to the maximum."
Fraser Health does not initially foresee hiring private clinics to supply the extra 500 surgeries it plans over the summer – it will open more of its own closed operating rooms.
But the Vancouver Island and and Vancouver Coastal health authorities have indicated they expect to make some extra use of private surgeons.
Health Minister Terry Lake was unavailable for an interview.
The ministry instead issued a statement defending extended private clinic stays as a successful method of handling more hernia surgeries in Toronto.
"This is just one option that is on the table for consideration," it said. "Not all of these will be implemented."
The policy paper indicates the main reason that about one in six hospital operating rooms are closed at any time is lack of funding, while staff shortages and lack of demand are also responsible in some cases.
The ministry says it's working to increase training for specialist nurses and support recruitment and retention of key specialists, including anaethesiologists.
Doctors of B.C. president Dr. Bill Cavers said health watchdogs are right to be wary of the potential to drain staff from the public system, but said the association believes some increased use of private surgery clinics "can be a good idea" as long as it's publicly administered and funded, and quality and safety standards are upheld.
Demand on hospitals can vary due to flu season or a backlog of patients waiting for a particular procedure, he said.
"We feel that utilizing different avenues of access to care can improve the overall efficiency of the system," Cavers said. "We have surgeons right now who can't get enough operating room time."
He said he doesn't foresee large numbers of clinics opening to the extent that they might cause problems for the public system.