A clinic that provides dental care for "medically complex" patients has introduced a policy that requires some patients to pay up front to secure space in an operating room, raising concerns that people may forgo treatment because they or their families can't afford to pay.
Patients who seek treatment at the clinic include people with disabilities, who may be eligible for basic dental care through the provincial government. But coverage provided by that program falls short of suggested fees from the B.C. Dental Association, meaning patients could face a bill for hundreds or even thousands of dollars for medically recommended dental treatment.
The new payment policy is among several changes introduced in July at the Vancouver General Hospital dental clinic. The clinic is operated by Vancouver Coastal Health and is one of several facilities linked to an RCMP investigation into alleged financial irregularities at the University of British Columbia's Faculty of Dentistry.
That investigation, disclosed by UBC in April, concerns alleged financial irregularities related to the faculty's General Practice Residency Training Program, in which postgraduate dentists are trained at hospital and community clinics, including the VGH dental clinic.
The RCMP have said the investigation, which is ongoing, could involve amounts up to $5-million.
The changes at the VGH dental clinic, set out in a letter to patients, include a requirement that all patients require a referral to be seen in the clinic.
The revised policies are not an attempt to recoup funds that may have been misspent or misappropriated, a Vancouver Coastal Health spokeswoman said.
"The VGH dental clinic's mandate is for dentistry that requires hospital support for clients who cannot receive dental care in a usual dentist office environment," Vancouver Coastal Health spokeswoman Anna Marie D'Angelo said in an e-mail.
"We are definitely not trying to recoup any funds."
Recent changes in the medical leadership of the clinic prompted a review that "uncovered some practices that are incompatible with the clinic's mandate and ongoing operation," Ms. D'Angelo added in the e-mail.
For example, "the clinic was seeing a broad range of patients, including many of whom are healthy individuals who do not require the services the clinic was originally meant to provide," she said.
The VGH dental clinic was formerly run by Christopher Zed.
Mr. Zed was medical director of the VGH clinic as well as the former associate dean of strategic and external affairs at UBC's faculty of dentistry. Dr. Zed left those positions last December as investigations into alleged financial irregularities were under way.
Attempts to reach Dr. Zed have not been successful.
Changes at the clinic are "not directly related to the allegations of financial wrongdoing that are being investigated," Ms. D'Angelo said.
"We are taking steps to bring the clinic in line with its original mandate, which is to provide specialized services to patients with the highest needs, including those who are medically complex patients and inpatients, and those who have mental or developmental disabilities," she said.
Joan Rush, a retired Vancouver lawyer who has written a report on access to dental care for people with disabilities, learned of the changes when she was asked to pay more than $4,000 to secure operating room space for pending dental treatment for her son, who is severely autistic.
Ms. Rush has filed a complaint with the patient care office of Vancouver Coastal Health in relation to the new policy.
In a report on disability assistance released in May, the B.C. Auditor-General found the province's Ministry of Social Development has not defined the extent to which basic needs should be met by the program.