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Inspections key to operation of private health clinics

Toronto health lawyer Elyse Sunshine says that while recent media reports about private medical clinics not meeting provincial guidelines highlight a need for those operators to take the inspection process more seriously, it's important for the public not to jump to conclusions about the seriousness of the infractions without knowing the specifics.


“It’s important for health professionals to be familiar with the inspection process, conduct preventative audits and go through their checklists to make sure they have their documentation ready because missing paperwork or not being able to verify something can result in an unfavourable inspection,” she tells AdvocateDaily.com.

“It’s very important for facility operators to comply with the out-of-hospital premises requirements and to make sure they are ready for any inspections or they risk having an unsuccessful inspection over things that are easily preventable.”

Toronto Star analysis has found that 13 per cent of health clinics in Ontario that do procedures such as cosmetic surgery, colonoscopies and pain injections have not met provincial inspection standards since they began in 2011.

Of the 330 clinics the College of Physicians and Surgeons of Ontario has inspected since then, 44 failed to meet the standards, says the newspaper. Of those, 12 failed inspections and 33 were given conditional passes — some of them, two or even three times, says The Star.

Critics say the numbers are too high and raise serious questions about the quality of care at these clinics, says the newspaper.

Sunshine, partner at Rosen Sunshine LLP, says critics are “somewhat overreacting” to the information and that it’s important to understand that there are many reasons why a clinic would fail an inspection or receive a conditional pass.

“Particularly when we are talking about clinics who have received a conditional pass, this is not necessarily something that the public needs to panic about,” she says. “In some cases, a conditional pass can be the result of the clinic not providing 'proof' that they actually meet certain requirements. It doesn’t mean that they don’t meet the requirements.”

Sunshine pointed to one instance where a clinic failed to provide documentation to support that its nurses had basic and advanced life-saving qualifications.

“It doesn’t necessarily mean the nurses don’t have these qualifications; it means that the clinic didn’t provide documentation to support that,” she says. “As such, this could be one of the reasons why the clinic didn’t do well on the inspection, but it doesn’t mean that the clinic isn’t safe.”

Sunshine points out that the College of Physicians and Surgeons of Ontario has stated said that unless the clinic actually fails the inspection,there is no public safety risk.

In light of these failed inspections, some critics have said the College provides limited information on its website about the clinics it inspects and this makes it difficult for the public to assess the severity of reported problems, reports The Star. While Inspection-Assessment Summaries prepared for each clinic are not made public, reasons are sometimes provided if clinics fail inspections, but are usually not provided if clinics pass with conditions, says the newspaper.

Sunshine says in cases where clinics are handed a conditional pass or are required to meet certain criteria, it’s fair for the public to want to know more information about the specific issues and to be able to access that information.

Sunshine says it’s not unlike Ontario’s restaurant inspection and grading system.

“If a restaurant fails, you’re not going to want to go to that restaurant and in this case if a clinic fails an inspection, you actually cannot go to that clinic since the clinic will be shut down,” she says. “So the regulator is doing its job to make sure that the clinics that remain open are not safety risks. However, because of the trend towards increased transparency, more information about these inspections is likely going to be posted publicly.  As such, to avoid any negative impressions, clinics need to make sure they handle these inspections properly from start to finish."

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