In an effort to lure some of Canada’s medical tourists, and their dollars, a First Nations band plans to build a private, for-profit hospital for paying clients on its land, though experts say that aboriginal sovereignty may not extend to the building and running of health care facilities.
"We're looking at everything except emergency, psychiatric and obstetrics,” Westbank First Nation Chief Robert Louie told British Columbia television station CHBC on April 12. The 100-bed facility will cost $120 million and create 300 jobs, he said, adding that Westbank has already consulted with Johns Hopkins Hospital in Baltimore, Maryland, for possible collaboration.
Given that Canadians spend millions of dollars annually traveling as far away as India for medical procedures, "Why not keep the monies here?” Louis said.
The facility would operate outside Canada’s public health system, known as medicare. The medical journal Canadian Family Physician noted in a 2007 study that about 15 medical tourism companies exist in several provinces, sending people to Argentina, Brazil, China, Costa Rica, Cuba, France, Germany, India, Malaysia, Mexico, Pakistan, Poland, Russia, Singapore, South Africa, Sri Lanka, Thailand, Tunisia, Turkey, the United Arab Emirates and the U.S.
“Delays for medical interventions such as hip and knee replacements, spinal surgery, and ophthalmologic procedures are a serious problem in Canada,” researchers wrote in the October 2007 edition of the journal. “Federal and provincial governments are struggling to shorten waiting lists and provide timely care. Patients often wait months to obtain appointments with specialists, undergo diagnostic tests, and receive treatment. Lack of access to family physicians can make obtaining care particularly difficult.”
The private clinics already existing in British Columbia are for specialized medicine and were built after years of negotiation with provincial and federal authorities, CBC News noted. The Westbank clinic would be built on Okanagan Lake, just outside Kelowna, B.C. Louie said 92 percent of the First Nation’s 700 band members had approved the measure. The 15-acre site sits on Westbank’s 83 square miles of reserve territory, Louie said.
The band is seeking a partner to build the actual facility. This is where Johns Hopkins comes in.
"We've had discussions with Johns Hopkins but nothing is concluded yet,” Louie said, adding that the facility would be akin to the Mayo clinic.
Johns Hopkins confirmed that it had been contacted by Westbank about the possibility, the Vancouver Sun reported on April 17.
“We have had some very early, preliminary discussions with representatives of [the Westbank] First Nation regarding their desire to establish a hospital,” Johns Hopkins public affairs director Gary Stephenson told the newspaper.
According to the Vancouver Sun the facility would have 10 operating rooms, a professional chef and full laboratory and diagnostic capabilities, with phase two including a spa, a gym, a hyperbaric chamber, stem cell therapies, housing and senior assisted living.
"Patients could drink a nice bottle of wine the night before [their surgery], and there will be chefs preparing food," Louie told the Vancouver Sun. “The way legislation is written, you can't call it a hospital but that's what it will be, although it will also be a holistic medical wellness center that could include traditional aboriginal healing practices like sweat lodges, spiritual ceremonies and burning sage.”
Although Louie said that the band’s legal experts have studied the proposal, at least one constitutional law expert says it may very well be challenged by the federal government.
"I would assume that they would challenge this in the courts and to say that the Westbank First Nation doesn't actually enjoy the authority to plan and construct this kind of operation," Gordon Christie, the director of UBC's First Nations Legal Studies program, told CBC News. "This is pretty much untested waters. I don't think anyone really knows for certain how things will turn out.”