Private clinics cut down on cataract surgery waitlist, but at what cost?

A new private clinic in northwestern New Brunswick that promises to cut back on the number of elderly people waiting for cataract surgery is being eyed for criticism.

Detractors warn the Edmundston Medical and Surgical Eye Centre will cost taxpayers dearly and hurt the public health system.

The Vitalité Health Network announced on Thursday a new partnership with the for-profit ophthalmology clinic that’s expected to triple the number of cataract surgeries performed each week, starting this month.

That should help cut back on the 1,300 people waiting for the important eye surgery at the Edmundston Regional Hospital. Many patients with cloudy vision have been waiting for more than a year, even though the national benchmark wait time for cataract surgeries is closer to 100 days.

It will be the fourth such private clinic in the province that allows people to use their medicare card and get the surgery for free.

The Higgs Progressive Conservative government passed legislation in the fall of 2022 to allow for surgeries outside of hospitals. Private clinics in Bathurst, Miramichi and Fredericton now offer the quicker cataract surgery, with the provincial government paying a premium for the private service.

A fifth is planned for Moncton in a partnership between Vitalité, the Horizon Health Network and a private clinic.

The trend infuriates Chuck Chiasson, the MLA who represents the city of Grand Falls, 65 kilometres south of Edmundston.

While he’s happy people are being treated quickly for a debilitating eye condition, he said the private clinics are undermining the publicly run system.

In 2020, the Higgs government spent close to $1.5 million to set up an eye surgery suite at the Grand Falls General Hospital, he said.

“The intention behind that was to regionalize all the cataract surgeries at the Grand Falls hospital and free up operating time at the Edmundston hospital,” Chiasson told Brunswick News. “But the clinic never operated at full capacity, and probably one of the reasons was the clinicians and specialists were travelling from Edmundston to Grand Falls. And so that created problems with scheduling, snowstorms, and days where they didn’t want to come to Grand Falls.”

Chiasson said among those specialists were the two doctors who now own the Edmundston eye clinic, Nadia Lihimdi and Aissa Iggui. They’ve built two operating theatres to take on the new patients.

Cataracts are common among elderly people. Around age 40, the proteins in the lens of the eye start to break down and clump together. The clump makes a cloudy area, as if you’re looking through a frosty window. The clouded vision can make it difficult to read, drive a car or see the details in everyday objects.

The disease is progressive with age. By age 60, about two out of 10 people have cataracts. By age 75, half of people have the telltale clumps, and by age 80, it’s closer to two-thirds.

Chiasson said he spoke to people all day Friday at the Grand Falls Potato Festival who were very upset by what they view as the undermining of their hospital service.

“The Conservatives opened the door to privatization. So if you’re a clinician and you’re travelling to a publicly funded hospital every day to perform cataract surgeries, every day back and forth, and then the door is open to privatization, guess what? If you have an opportunity to have your own clinic, make more money, without having to travel, what would you do? You’d push to privatize.”

Brunswick News asked for an interview with Health Minister Bruce Fitch, but a spokesperson for his department declined the request.

Sean Hatchard said that the three private clinics in Bathurst, Miramichi and Fredericton have performed more than 8,400 cataract surgeries in less than two years.

“The program not only allows for more surgeries to be done outside of hospitals, it has also seen wait times shortened for the procedure at all three clinics,” the spokesperson said in an email. “For example, at the longest-serving clinic in Bathurst, wait times for the surgery have reduced by 74 per cent since 2022.”

But Chiasson said there was a cost to taxpayers.

“The solution is to have a fully funded public health care system. The Conservative government can’t seem to fix the problem, so what do they do? ‘Let’s farm it out to the private sector.’ So short term, we’re fixing the backlog. But long-term, each one of those surgeries cost more than doing it in a public setting.”

The clinics, he said, charged a premium of about 30 per cent because they need to make a profit.

“My question is what’s next? Will we be doing hip and knee surgeries because we have big wait times there as well. Where does it stop?”

A spokesperson for Vitalité said the manager in charge of setting up the partnership, Dr. Natalie Banville, wasn’t available for an interview.

Instead, the senior vice president delivered a statement.

“We are aware of the concerns raised and want to assure everyone that we are actively working with the medical staff to ensure that the space at the Grand Falls General Hospital will be utilized for the benefit of patients. Specifically, our goal is to develop services that will maximize the use of this space,” she said in an email.

“The opening of this clinic for cataract treatment is, and should be seen as, an improvement in access for the entire northwest zone. We anticipate a significant reduction in the cataract surgery waiting list for the region.”

Green Leader David Coon said his party’s research showed two different models cutback on surgical wait times for Canadian patients with cataracts. British Columbia organized public clinics, whereas Quebec farmed the job out to private ones.

“What’s happened in Quebec is there’s quite a lot of up-selling going on,” he warned. “People go in for cataract surgery and they’re being encouraged to purchase items they wouldn’t otherwise need or pay for a super-version of cataract surgery that isn’t covered by medicare. Meanwhile, the results in B.C. have been good in terms of getting rid of waiting lists. So it’s just a question of ownership.

“Keep it public.”

John Chilibeck, Local Journalism Initiative Reporter, The Daily Gleaner