New fees charged by two hospitals for outpatient services represent a wedge that will undermine Medicare and breach the Canada Health Act, says the Ontario Public Service Employees Union.

The union sought a legal opinion last month after two rural Ontario hospitals in Kincardine and Deep River announced that patients would have to pay for outpatient physiotherapy delivered at the hospitals.

 “The government is clearly testing the waters with this,” says Warren (Smokey) Thomas, president of the 130,000 member public service union. “If these fees are accepted by the public, what’s to stop them from charging for drugs and other non-OHIP covered treatments presently delivered by hospitals without charge to patients?”

The opinion, prepared by Cavalluzzo Hayes Shilton McIntyre and Cornish, states “the imposition of such fees and the progressive erosion of access to insured outpatient physiotherapy services at hospitals in Ontario violates the spirit and intent of the Act by impeding access to medically necessary services.”

In Kincardine the hospital recently closed its physiotherapy department, instead leasing the space to a numbered company. The hospital is in turn paying for inpatient physiotherapy provided by the company, but telling outpatients who used to come to the hospital that they would now have to pay for their treatment.

While OHIP will pay for physiotherapy of patients upon discharge from a hospital – such as in the case of hip replacements – it must do so at a designated provider under the OHIP plan. The company that is providing service at the hospital is not a designated provider, leaving patients to travel 70 km to the nearest designated facility.

In Deep River the hospital announced its staff would begin charging for physiotherapy services, reducing staffing slightly to reflect the fact that some will no longer be able to afford medically necessary treatment.

“This is taking place in the midst of a federal election campaign,” says Thomas. “Where is the enforcement of the Canada Health Act? Where is the McGuinty government’s commitment to public health care?”

For a complete copy of the legal decision, please click here.