VANCOUVER - Doctors who bill patients for health-care services outside the public system could face criminal charges and fines in British Columbia as the NDP government enforces a law introduced by the Liberals over a decade ago.
Health Minister Adrian Dix said that starting in October, patients will have the right to file a complaint against a doctor who has charged them for services covered by medicare, including surgery or diagnostic procedures such as MRIs.
"It's the government's responsibility to strengthen the system and focus on improvements that prevent the need for parallel systems where people feel they need to buy their way to the front of the line," Dix said Wednesday.
Physicians who refuse to refund patients could be fined $10,000 for a first offence and $20,000 for a second infraction, he said, adding a criminal conviction could mean they'd be banned from billing the Medical Services Plan.
Patients who do not get their money back would be refunded by the Medical Services Commission, which will handle complaints and try to recover the cash directly from physicians so people don't have to launch legal action, the Health Ministry said.
Charging patients for publicly paid health services is prohibited under the Canada Health Act and British Columbia's Medicare Protection Act.
"It's our expectation that those providing health care in British Columbia follow the law and that our laws protect people, protect patients," Dix said. "In British Columbia, we've had an approach, really, over a long period of time, of 'Don't ask, don't tell' with respect to these issues. And that approach, I think, has to end."
The changes will affect 56 private surgical clinics and 17 private MRI facilities in the province, and Dix said they will now be required to follow the law that prevents extra billing.
"Previous health ministers, previous premiers, those I'll name, Premier (Christy) Clark and Premier (Gordon) Campbell, had said they would act on this question, and they did not. Today, we are taking steps to protect patients and our public health-care system by bringing into force sections of the Medicare Protection Act that was passed unanimously by the legislative assembly in 2003."
Based on audits, Health Canada estimated extra billing in British Columbia came to $15.9 million in 2015-16. The federal government reduced funding to the province by the same amount this year.
Dix said the province will be asking Ottawa to return the money, which could pay for 53,000 MRIs as well as thousands of surgeries.
He said British Columbia's laws against extra billing will now be brought to the same standard of those in Alberta and Ontario, where patients are repaid if they are charged for services.
Dr. Michael Klein, a board member of Canadian Doctors for Medicare, said he's pleased with the enforcement aspect of the announcement as well as increased funding already announced to allow for more hip and knee replacements through a centrally managed surgical wait list.
"If you're not providing sufficient money to keep operating rooms open and running diagnostic facilities, that becomes an incentive for entrepreneurs to do what they've done," he said of private clinics.
Orthopedic surgeon Dr. Brian Day, who launched a B.C. Supreme Court lawsuit to argue for patients' constitutional right to pay for speedier surgery, said court proceedings that have been on hold for several months involving his Cambie Surgery Centre are set to resume on Monday.
"If the clinics all close, which they could, those people would be added to the public wait lists," he said.
"We're talking about children waiting for spinal surgery and people waiting for cataract surgery."
Day opened his clinic in 1996 when the NDP was in power. The clinic was among four that were recently audited by the federal government.
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Note to readers: This is a corrected story. A previous version incorrectly reported trial resumes on Tuesday, in para 15.