XPost: can.politics, tor.general   
   From: Panca@nyet.ca   
      
   Safety inspections find 13% of private clinics don’t meet provincial   
   standards   
      
      
   Thirteen per cent of health clinics in Ontario that do procedures such as   
   cosmetic surgery, colonoscopies and pain injections have not met inspection   
   standards since they began in 2011, an analysis by the Star has found.   
      
   This includes the 3.6 per cent of clinics that have failed inspections because   
   of public safety concerns.   
      
   Critics say the numbers are too high and raise serious questions about the   
   quality of care at these clinics.   
      
   		List:    Clinics that failed the College of Physicians safety inpections   
   	   
   “A rate of one in seven clinics failing or passing with conditions is just   
   deplorable. That is a failing grade no matter how you look at it,” charged   
   medical negligence lawyer Amani Oakley.   
      
   “I seriously question whether the inability to do Job 1 — that is, protect   
   the   
   public — can be rectified by something less than a complete overhaul of the   
   system we have,” she said.   
      
   Of the 330 clinics the College of Physicians and Surgeons of Ontario has   
   inspected since 2011, 44 have fallen short of meeting standards.   
      
   Twelve failed inspections and 33 were given conditional passes — some of   
   them,   
   two or even three times. (One clinic received both a fail and a conditional   
   pass. An additional 22 clinics — not counted in the 13 per cent — were   
   given   
   conditional passes because they were either new or offering new procedures, not   
   because they had not met standards.)   
      
   “The percentage of clinics that did not pass inspection without conditions   
   should be setting off alarm bells. Imagine an airline industry where one in 10   
   planes does not pass scrutiny. The frequency and intensity of inspections needs   
   to be immediately stepped up,” said medical negligence lawyer Paul Harte.   
      
   CPSO spokesperson Kathryn Clarke said the public should take comfort in the   
   fact the college is providing oversight of the clinics, something not done   
   until recently.   
      
   Prior to 2010, no organization had the authority to regulate the clinics, known   
   as out-of-hospital premises, she said, adding the college had “advanced the   
   idea” of doing the job to protect the public.   
      
   “This means a significant improvement in public safety has occurred since the   
   establishment of the program because a number of premises that were not meeting   
   the standards are no longer providing (invasive procedures requiring   
   anesthesia) to patients,” she said.   
      
   Queen’s Park gave regulatory oversight of the clinics to the college   
   following   
   a Star investigation into the regulatory black hole surrounding Ontario’s   
   cosmetic industry.   
      
   Its move came a year after the 2007 death of Krista Stryland, a young mother   
   who underwent liposuction at a Toronto cosmetic clinic.   
      
   A total of 440 inspections have been carried out on out-of-hospital clinics to   
   date, the Star’s analysis has found. Three have had the results of   
   inspections   
   pending for more than a year.   
      
   Harte said Toronto restaurants fare better in inspections than health-care   
   facilities do. A 2012 analysis by the now-defunct Grid newspaper showed 8.6 per   
   cent of inspections carried out by Toronto Public Health resulted in either   
   conditional passes or closure notices, and only 0.14 per cent resulted in a   
   closure notices outright.   
      
   Another source of comparison to out-of-hospital premises is hospitals. Since   
   2011, none of Ontario’s 150 hospitals has failed an accreditation review with   
   Accreditation Canada, an organization that measures quality standards.   
      
   Harte said the clinic inspection results are of great concern, especially   
   because the province is moving services out of hospitals and into clinics. In   
   2010, there were 209 clinics in Ontario. Today, 264 are operating and a further   
   10 are in the process of being set up. That’s a 31 per cent increase, and the   
   provincial government wants the sector to expand even more.   
      
   Clinics do not have the same degree of checks and balances as hospitals, and   
   critics say this needs to change.   
      
   Harte called on Health Minister Eric Hoskins to establish quality targets for   
   the clinics, as well as a timeline for meeting them.   
      
   Earlier this month, Hoskins announced measures to improve transparency in the   
   health system and to improve oversight of these clinics. He asked Health   
   Quality Ontario to lead an evaluation of current oversight programs in such   
   clinics and to make recommendations on improvements.   
      
   Hoskins’ announcement followed a Star investigation into infection outbreaks   
   at   
   clinics.   
      
   Since the Star reported in 2012 that nine clinics had failed inspections, three   
   more have failed theirs. They include two hair-transplant clinics in Toronto   
   and a pain clinic in Burlington.   
      
   Reasons for the recent failures include not having medical directors, not   
   properly cleaning equipment and not being set up to provide IV resuscitation   
   drugs in an emergency.   
      
   When clinics fail inspections, doctors working there are prohibited from   
   performing invasive procedures requiring anesthesia.   
      
   Progressive Conservative MPP (Leeds-Grenville) Steve Clark said he was   
   “shocked” that so many clinics did not receive full passes.   
      
   “I have a real feeling that there needs to be some systemic changes at the   
   CPSO,” said Clark, who recently tabled a private member’s bill , calling   
   for   
   more transparency from the organization.   
      
   The Star undertook the clinic analysis after the CPSO twice refused in recent   
   weeks to reveal how many clinics had failed inspections, how many had passed   
   and how many had passed with conditions.   
      
   Clarke said the CPSO did not gather information that way and directed the Star   
   to the organization’s online register , which requires users to look up each   
   clinic individually. She warned that there were chances of making errors when   
   doing manual counts.   
      
   When the Star asked a third time for a breakdown of inspection results, Clarke   
   provided the current status of clinics. There are 223 clinics registered with   
   full passes, 16 with conditional passes, 25 awaiting inspection results and 66   
   that have withdrawn from the program, meaning they are no longer offering   
   invasive procedures requiring anesthesia. Those that have withdrawn include   
   clinics that failed their inspections.   
      
   Harte agrees with critics such as Oakley who are calling for an overhaul to the   
   inspection system. He said the province should set up a separate body to   
   inspect clinics, one with more teeth and subject to freedom-of-information   
   searches to ensure transparency.   
      
   “Public confidence in the CPSO as an effective regulator of these clinics is   
   sorely lacking. The problems relating to clinic inspections ultimately stem   
      
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