There's a private pediatric clinic run by nurse practitioners in London. Should Ontario fund it?

A private pediatric clinic run by nurse practitioners in London, Ont., is calling on the province to fund their services, which they say is reducing wait times and unnecessary emergency department visits for patients without family doctors. 

Healthy Kids Urgent Clinic operates a fee-for-service model charging between $65 to $85 for a visit. The clinic's founder says he'd rather be allowed to bill the Ontario Health Insurance Plan (OHIP) than charge families.

"There's a need for access to primary care and people are struggling to access those in a timely fashion, so clinics like ours are trying to provide solutions to people," said Kevin Zizzo, who runs the clinic at 350 Oxford Street West.

In Ontario, nurse practitioners are authorized to prescribe medications, complete a patient's comprehensive health history, order lab tests and some diagnostic imaging tests. But unlike physicians, they cannot bill OHIP directly. 

Some nurse practitioners work in salaried positions at a limited number of publicly-funded family health teams, and nurse practitioner-led clinics. 

Zizzo, who started his clinic in 2023 and treats children from birth to 17, believes health care is a basic human right, but with limited opportunities in publicly-funded teams, he says he's forced to charge fees.

"Paying for health care is a controversial topic and I don't think any Canadian wants to or should have to pay for health care with a publicly funded system. I think people are frustrated with the current health-care system and the lack of resources that are available to them," Zizzo said. 

The Ontario Medical Association said in May that 2.3 million Ontarians don't have a family doctor.

The federal government is preparing to issue a new interpretation letter of the Canada Health Act (CHA) in the coming weeks. A spokesperson could not provide specifics, but told CBC News the revision would continue to strengthen universal healthcare so patients don't have to pay out of pocket. 

The CHA doesn't clarify what services are or aren't allowed to be delivered by non-physicians, including nurse practitioners. Even if it did, Ottawa couldn't force the provinces to fund them. 

In April, Ontario's Health Minister Sylvia Jones wrote a letter to her federal counterpart, Mark Holland, asking him to prohibit non-physicians from charging for publicly funded services.

"Our government has been clear, we will continue to expand access to primary care until every Ontarian who wants access to a provider, has it and our budget introduced just a few months ago, investing an additional $546 million to expand interprofessional primary care teams shows we are taking action," spokesperson Hannah Jensen said in an email.  

Critics who oppose any privately funded health care model say they understand Zizzo's clinic is providing a needed service, and hopes the provincial government could fund nurse practitioners, if given the chance.

"Throwing up any kind of financial barrier is not going to relieve wait times for people. It was never meant to be fee-for-service to get access," said Peter Bergmanis of the Ontario Health Coalition's London chapter. "If this is a grey area, then each province is endowed with the power to be inclusive and [Ontario] can include this."