Ontario NDP calls for a special audit into clinics charging for primary health care

The South Keys Health Centre on Bank Street began charging patients $400 last year to access nurse practitioners. Other clinics charge more.

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Published Apr 08, 2024 • Last updated 15 hours ago • 3 minute read

A file photo of Ontario NDP Leader Marit Stiles. Photo by Tony Caldwell /POSTMEDIA

Ontario’s New Democratic Party is calling on the province’s auditor general to investigate the growing number of clinics that are charging fees for primary health care.

In recent months, there has been a proliferation of private clinics offering primary care by nurse practitioners for a fee. That is leaving some of the 2.3 million Ontario residents who don’t have family doctors facing financial barriers to primary healthcare, said party leader Marit Stiles.

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“We are calling for a special audit. Anyone charging patients for healthcare should be held accountable, full stop,” said Stiles.

The province’s auditor general, Shelley Spence, would be required to do such an audit this year if requested by the public accounts committee. The NDP health critic, France Gélinas, put such a motion before the committee on Monday but the motion was voted down.

Such special audits have been done in the past. Last August, the auditor general released a special report on changes to the Greenbelt, which had been requested by all three opposition party leaders.

Stiles said the issues are both important and timely.

“I think Ontarians deserve to know exactly how widespread this issue is,” Stiles told a press conference. “Our system is built on the principle that you should not have to pay for health care.”

A number of fee-based nurse practitioner clinics have opened in Ottawa and eastern Ontario in recent months as growing numbers of area residents have lost their family physicians.

The South Keys Health Centre on Bank Street began charging patients $400 last year to access nurse practitioners. Other clinics with similar, and higher, access fees have also opened in the region. And, earlier this year, a patient at an Appletree clinic in Ottawa, who needed a routine cancer screening test after receiving a notice from the provincial government, was directed to make an appointment with a nurse practitioner. When she arrived, she was told the appointment would cost $110.

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Nurse practitioners, who are registered nurses with graduate degrees and a broad scope of practice, work in many areas of the Ontario health system. That includes hospitals, long-term care homes and clinics that are all funded by the Ontario government. In those cases, they are paid a salary. But independent nurse practitioners are unable to bill patients under the Ontario Health Insurance Plan (OHIP), as physicians can. That means they are legally able to charge fees for their service according to experts as well as the Ministry of Health.

But Stiles and Gelinas said the growing number of clinics and what they are charging for is poorly understood and shouldn’t be happening.

“The Canada Health Act is very clear: health care providers cannot engage in extra billing or charge for medically necessary services, but we are seeing evidence every day that patients need to pay to gain access to primary care services,” said Gélinas.

Ontario Health Minister Sylvia Jones has characterized the situation as a “loophole” and encouraged the federal government to close it, after her government vowed to crack down on “bad actors” charging fees for primary care.

Recently, the Ministry of Health wrote to an Ottawa woman who paid $110 for a pap test to say that she was on her own for that fee because services delivered by independent nurse practitioners are not insured under OHIP.

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