Defenders of public health care in Saskatchewan are breathing a qualified sigh of relief today. That’s because fears the Saskatchewan government’s much anticipated health care announcement would call to emulate Alberta’s controversial Bill 11—which permits doctors and for-profit health care facilities in Alberta to charge patients for basic health services in a way that is new and unprecedented in Canada—appear so far unfounded.
Indeed, yesterday’s release of the Saskatchewan government’s Patient First health care plan made no mention of adopting Alberta’s controversial “dual practice” model. However, the plan’s myopic insistence on expanding Saskatchewan’s existing and very expensive for-profit surgical services demonstrates that this government still has a tenuous commitment to the principles of universal public health care.
The Patient First plan does contain some promising policies, particularly in regard to renewed efforts to recruit and retain health care professionals for our chronically under-staffed public health system. Additionally, expanding the scope of practice for certain health care professionals could be beneficial to the efficiency of the health care system—to the extent that it does not download responsibilities or increase already unsustainable workloads on existing workers.
Expanding our current public health care workforce is an urgent necessity. For example, spending on private for-profit nursing staffing agencies, to plug growing gaps in our workforce, has grown from $1.4 million in 2020 to over $50 million last year. These agencies were originally designed as a short-term way to complement the public system by providing options for staffing in hard-to-staff rural and remote regions, not as a perpetual and very expensive band-aid for the public sector workforce as a whole.
As the Canadian Federation of Nurses Unions demonstrates, the use of these agencies also undermines morale, quality and continuity of care, and it diverts much-need public money to the private sector. Hopefully the new recruitment and retention tools, as well as the new standards for staffing outlined by the government, will allow us to reduce our reliance on these private agencies in the future.
Yet, despite the potential positive impact these policies could have, they are overshadowed by the government’s insistence on expanding the use of private, for-profit surgical centres. The Patient First health plan states that the government will “expand the scope of publicly funded surgeries that can be performed through provincial partnerships with private surgical providers.” This may mean that the number of for-profit surgeries increase and the types of surgeries allowed in private clinics will as well—and this is a concerning acceleration of an existing, and problematic, approach.
Since 2014, the Saskatchewan government has relied almost exclusively on private clinics to address surgical wait times. That’s when it ended its successful Saskatchewan Surgical Initiative (SSI), which delivered a “significant short-term injection of funding to expand public surgery capacity,” in the province. As we showed in our No Time to Wait report, despite the Saskatchewan government’s preference for private-sector solutions to the wait-time problem, the only significant reduction in wait-times came through concerted public investment in the capacity of the public system via the Saskatchewan Surgical Initiative. Once that investment ended and the province relied solely on private providers, wait times increased once again.
While we do not know how much private surgical providers are charging the Saskatchewan government today for these procedures, we do know what Clearpoint—the owner of Surgical Centres Inc.—charges in other jurisdictions. A funding agreement between a Clearpoint-owned clinic and Ontario Health documented charges two to three times higher than those of public hospitals for identical surgical procedures. If the province’s budget is as tight as the government suggests, we can ill afford to funnel those limited dollars into the profits of what is a subsidiary of a private equity company.
The good news is that the government has listened, at least partially, to the advice of health policy experts and health professionals in its approach to expanding the recruitment and retention of health care workers, as expressed in the Patient First health plan. Some of these initiatives approximate what other health care unions and professional associations have been asking for to help expand the public sector workforce.
The less good news is, that the government’s openness to good policy advice on health care does not extend to its spending decisions, which have committed precious public dollars to expensive for-profit care in the private sector, which has been shown time and again to deliver poorer results than investments in the public sector.
Payments to for-profit private health care providers
Saskatchewan Health Authority Payee Disclosure List 2024/25
RN/RPN/NP contract staffing agencies
5010675 ONTARIO Ltd (Gratitude Health) $3,783,439
Elite Intellicare Staffing $3,507,497
Goodwill Staffing & Recruitment $1,920,416
New Horizons Staffing Incorporated $18,659,046
Solutions Staffing Incorporated $1,923,923
Truecare Alliance Staffing $3,556,632
Select Medical Connections Ltd $6,081,879
Nurse Relief Incorporated $7,238,951
McCare Global Healthcare Services Incorporated $722,429
Ezcare Nursing Agency $175,121
Finney Taylor Consulting Group Ltd $297,734
Lifeline Healthcare Staffing Agency Incorporated $6,252,050
Payments For-Profit Surgeries
Canadian Surgery Solutions $1,774,350
Surgical Centres Incorporated (Clearpoint Health Network)) $14,249,188
Payments to For-Profit Diagnostics
Prairie Skies Medical Imaging Incorporated $14,850,577
National Medical Imaging $250,100
Open Skies MRI $861,166
