The day before Vancouver’s first emergency and primary care center opened in 2018, the provincial government held a press conference to celebrate the facility as a step toward improving the quality of healthcare in the city.
“We want people to get the care they need in their communities,” Health Minister Adrian Dix said on Sunday.
Less than five years later, that relationship has soured.
The clinic is deeply embroiled in a legal battle that has ultimately forced doctors to stop providing patients with ultrasounds, x-rays and other critical diagnostic tests, despite having the equipment in-house to do so.
“Unfortunately, when our patients come to us in their most distressed state, we have to tell them that they can’t have the test done right now, even though we have the facilities down the hall,” said Dr Eric Cadesky, a GP and Seymour Health’s chief medical officer.
“We have to send them elsewhere. It’s heartbreaking for us.”
At the heart of a BC Supreme Court case is a bitter battle over billing for those diagnostic services, which court documents say has left the clinic’s owners vulnerable to a takeover with more than $10 million in debt.
BC approached Seymour Health for help
The saga began when the government approached Seymour Health, a private company, about launching an emergency and primary care (UPCC) clinic in Vancouver earlier in 2018. The company said the province wanted to emulate the success of its existing team-based clinic in the region . South Granville area.
The sites were promised as one-stop shops with primary care physicians, nurse practitioners and diagnostic services such as lab work, ultrasound and x-rays in one place.
Seymour Health claimed it told the county it was essential to run those tests in-house if the clinics were to be a viable alternative to emergency care – otherwise patients would end up in the hospital anyway.
To make the clinics financially viable, Seymour Health planned to charge the county’s diagnostic work to the medical services plan (MSP).
The company claimed that the government initially agreed to the MSP billing plan, but never granted licenses and permissions necessary to send the bills.
“If Seymour Health had been told there was little or no chance of getting the licenses… it would have refused to build the City Center Clinic,” court documents said.
Cadesky said the clinic conducts $2.1 million worth of tests each year, but only gets $180,000 in funding from Vancouver Coastal Health (VCH).
Breaking: has contacted the Department of Health for comment, but they have not responded in time.
Company, owners use own money to cover tests
Seymour Health’s applications for the necessary billing licenses were denied in 2019, 2020 and again last month. The company said it initially paid out of pocket to keep the diagnostics running.
The owners, Sabi Bining and Sandeep Parmar, said they personally invested $3.4 million, obtained millions more in loans and took out a second mortgage to cover costs.
“At that time, Seymour Health was in a state of financial crisis,” the court said.
“The clinics were running well and to the satisfaction of both doctors and patients, but the continued failure of the government … has pushed Seymour Health to the brink of insolvency.”
Vancouver Coastal Health is going to court
On June 7, VCH filed to appoint a trustee to clear the company’s debts and eventually take over the emergency and primary care centers.
“The overriding consideration in this case is the need to protect the 70,000 patients who will almost certainly be significantly harmed if Seymour does not continue to operate under new ownership or some form of restructuring,” the filing said.
“Status quo is not a viable option.”
The health authority said Seymour Health’s financial problems extend beyond the MSP billing problem, starting with problems paying rent in 2019. According to the court, the health authority has charged Seymour Health with more than $6.7 million in loans and unpaid rent given, which has not been reimbursed.
“I think it’s really important for the public to know that Vancouver Coastal Health has been working with Seymour for over a year on their financial issues, and we’ve taken the steps we’ve taken to make sure we reach the urgent center for primary care and the primary care clinic opens for those patients and they can be served continuously,” said Bob Chapman, Vancouver Community vice president for VCH, who oversees VCH’s primary care clinics in Vancouver.
Court documents also revealed that last fall, VCH commissioned an external Ernst & Young audit of the company’s finances, which, according to Chapman, found that “they would not be able to continue to meet their financial obligations.”
Cadesky said the health authority’s injunction effectively forced his clinic to stop performing diagnostics because they can’t run into more debt while the moratorium plays out.
In the meantime, Chapman said, patients said downtown hospitals should provide diagnostics — keeping patients back in hospitals that should help avoid the UPCCs.
If VCH is successful in its acquisition, Chapman said the authority would continue to offer the diagnostic tests.
The company sued the county and VCH for breach of contract. The claim said the company’s operating losses now exceed $12.5 million, while the owners have personally lost $8 million.
“(The owners) are seeking increased damages based on the fear, humiliation, embarrassment and mental distress they have experienced as a result of the enormous financial strain they have suffered caused by the government’s conduct,” court documents said.