Critics ‘alarmed’ by private surgery plan they say will poach staff from the public health system

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Registered nurses are being offered $750 a day to work for a private group renting unused operating rooms at Riverside Hospital on Saturdays, this newspaper has learned. That amounts to up to twice as much as some RNs earn working at The Ottawa Hospital.

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Ontario government officials have given assurances that private organizations would not poach hospital staff as part of its plan to outsource some surgeries. But there are reports that hospital nurses and others have been approached about working for the Academic Orthopedic Surgical Associates of Ottawa (AOAO), which will be performing surgeries on Saturdays. The group has also been hiring other health professionals and clerks.

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The Riverside campus of The Ottawa Hospital (TOH), which is a day surgery center, operates Monday to Friday with operating rooms sitting empty on weekends. This agreement allows AOAO to rent its operating facilities on the weekend.

The Ontario Nurses Association said over the weekend it was “deeply alarmed” at the situation and called for more transparency about details of the agreement allowing AOAO to rent public operating rooms. On Saturday, local nurses rallied outside Riverside Hospital.

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“ONA is demanding answers to a number of serious concerns about patient safety, poaching of public-sector nurses and other staff from The Ottawa Hospital and which — if any — standard regulations are being followed,” the Ontario Nurses Association said over the weekend.

Surgeons working with AOAO began performing hip and knee surgeries at the Riverside last Saturday, using sterile instruments shipped in from Toronto for the day, according to sources. The privately run surgical clinic is scheduled to operate between 7 am and 5 pm Saturdays with patients remaining in recovery until up to 9 pm

It is the first initiative of its kind in the province and is being closely watched by hospitals around the province, said Dr. Virginia Roth, chief of staff at TOH. The agreement is in keeping with the government’s push to expand private surgeries and reduce surgical backlogs, which ballooned during the pandemic. It is novel, though, because, unlike agreements to outsource OHIP-funded cataract surgeries to private companies, these surgeries are being performed inside the hospital in space rented by a private company.

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Roth said the hospital would have loved to do more surgeries on the weekend, but didn’t have the human resources to do so. She said human resource challenges could limit how many surgeries AOAO is able to perform.

No details about the agreement with the hospital and the province have been made public.

The Ottawa Hospital has an orthopedic surgery wait list of 2,065 patients.

The launch of the initiative comes as opposition politicians are questioning why so many operating rooms in the province are sitting empty at a time when the government is outsourcing surgeries to private organizations.

On Monday, Ontario NDP Leader Marit Stiles introduced a motion calling on the provincial government to increase funding so that hospitals can expand surgical capacity in their own unused operating room space.

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“The infrastructure to expand surgical capacity already exists and it is sitting idle,” she said, calling on the government to fund and fully utilize public operating rooms instead of further privatizing surgeries. The Ontario government has underspent on health care to the tune of more than $4 billion, according to the Financial Accountability Office.

Andrew Longhurst, a health policy at Simon Fraser University in British Columbia who does research on surgical delivery and wait times, said the arrangement would likely leave the hospital researchers competing for the same nurses.

“Why is a public hospital with unused OR (operating room) time allowing profit making in its OR?” he asked.

When Premier Doug Ford and Health Minister Sylvia Jones announced the plan to outsource more surgeries to private companies earlier this year, Ford said the province would make it “easier, faster and more convenient for you to connect to care.

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“A lot of people want to have endless debates about who should provide care. All I care about, all Minister Jones cares about, all our government cares about, is that you get the care you need safely and quickly,” he said.

The province says private organizations applying to do surgeries must present a human resources plan, to protect hospital staff, but they provide little information about how that would be assessed or regulated. It is unclear whether AOAO provided a human resources plan.

Critics say they fear the plan will undermine the public health system by competing for scarce staff — making wait times in emergency departments and for other procedures longer.

A spokesperson for Jones recommended TOH for the orthopedic surgery initiative.

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“We are excited to see our partners, like The Ottawa Hospital, taking innovative actions to eliminate the joint replacement surgical backlog and reduce patient wait times so more Ontarians can receive the care they need, closer to home. The Ottawa Hospital is doing its part in helping clear the region’s surgical backlog by opening up operating rooms to existing staff on the weekend when they are not in use by the hospital,” said spokesperson Hannah Jensen.