Birth tourism leads to complaints of compromised care at B.C. hospital

Non-resident births in Canada increased in 2018 by nearly 15 per cent over the previous year. (Baoma Inn/Instagram)

Women making a trip to Canada to give birth to children who will eventually become Canadian residents are inciting worries about the strain they might be putting on the medicinal services framework, The Fifth Estate has found.

Canada is one of less than three dozen nations that pursue the act of citizenship dependent on origination, paying little mind to guardians’ nationality or status.

At one British Columbia clinic with a high grouping of such conveyances, grumblings have emerged that the convergence of these non-inhabitant patients — otherwise called birth sightseers — has prompted traded off consideration for nearby moms to-be and battles for nursing staff.

A portion of these patients neglect to cover clinic and specialists tabs, leaving citizens and individual consideration suppliers on the snare.

“A large portion of them, they get the Canadian identification, and afterward they leave the nation,” said Dr. Mudaffer Al-Mudaffer, a B.C. pediatrician and neonatologist who sees infants of non-inhabitants when they need basic consideration. “It influences the uprightness of the reasonableness of the wellbeing framework.”

No measurements are accessible in regards to what number of individuals are venturing out to Canada explicitly to guarantee their youngster is brought into the world here and will have a Canadian identification.

In any case, figures from the Canadian Institute for Health Information and a few Quebec clinics show there were around 5,000 non-inhabitant births the nation over in 2018, an expansion of about 15 percent over the earlier year.

Nearly one-quarter of all births at the Richmond Hospital are to non-residents. Insiders say it is having detrimental effects on the hospital and staff. (Annie Burns-Pieper)

In the fall of 2019, Cathy Shi arrived in Richmond, B.C., from Shandong, on China’s east coast, to give birth to her third child. She said through a translator that she wanted her unborn child to have more opportunities.

“My concern is about their education, such as going to university. If the kid wants to live in Canada, it would be convenient for them if they’re born here.”

Handful of hospitals

At this point, the practice of birth tourism appears to be concentrated in a handful of hospitals in Quebec, Ontario and British Columbia.

At the Richmond Hospital, south of Vancouver, non-residents make up nearly a quarter of all births, according to records obtained from Vancouver Coastal Health, the health authority which runs the hospital. In many ways, that hospital can be seen as a test case for how this issue could play out elsewhere as numbers continue to climb.

The health authority declined a request for an interview with The Fifth Estate and issued a warning directing its staff not to speak to the media.

Despite that, four current and two retired nurses shared their concerns, requesting that their identities be protected.

Since 2013/14, the number of non-resident births has tripled at the hospital. The patients — many from China — pay privately for their care, often in cash, may not speak English and are unfamiliar with the Canadian health-care system. The nurses who spoke to The Fifth Estate say the influx has led to increased workloads and has compromised care. 

Financial incentives within the medical system

Two doctors at the Richmond Hospital have delivered 1,300 of the 2,206 babies born to non-residents there since 2014, according to documents released through freedom of information.

While the health authority will not disclose their names, insiders and birth tourism company representatives say Dr. Xin-Yong Wang and Dr. Brenda Tan, two Mandarin-speaking family doctors, see the majority of these patients for prenatal care and delivery. 

Both appear on multiple websites of companies advertising services such as assistance with immigration, travel and housing to women looking to come to Canada to give birth.

Wang said the companies do not have permission to use his name. 

Tan did not respond to interview requests and a list of questions sent to her.

Wang and Tan billed the province $272,198.50 and $428,456.17 respectively in the 2018/2019 fiscal year, according to data publicly available through the province. Those billings do not include earnings from non-resident patients because they pay privately. 

There are no limits on what physicians can charge outside the public system in British Columbia, but information from birth tourism company websites suggests that these doctors earn at least $100 per prenatal visit and more than $2,500 for a delivery, several times more than could be billed through the public system for the same services.  

In an interview, Wang declined to respond to questions about how much he was earning from birth tourism but said he was not motivated financially to take on these patients.

“It’s like a dessert — occasional patients like this is fine, and it’s pretty financially rewarding … they are a small percentage of our overall income.”

Nurses who spoke to The Fifth Estate said the financial incentives within the health-care system are a problem. 

“It is all about the money. If there was no financial income for the hospital or physicians, the private pay would have been out of the door a long time ago,” said one nurse.

Unpaid bills

While these births are bringing in money, bills owed to both health authorities and individual doctors are not always paid.  

According to documents released by Vancouver Coastal Health, more than $2 million is outstanding as a result of non-resident births since 2017 at the Richmond Hospital alone. This does not include any debt that has been written off.

Bairths at the Richmond Hospital represent 11 per cent of overall non-resident births outside Quebec, according to 2018 data from the Canadian Institute for Health Information. 

No national financial data exists on how much revenue is outstanding as a result of non-resident hospital bills across the country.

But some say the health-care system and Canadian taxpayers are losing out. 

Al-Mudaffer said having an uninsured baby in neonatal intensive care can cost $10,000 a day just for the hospital bed, not including doctors’ fees.

B.C. Health Minister Adrian Dix says he is concerned when bills from non-residents go unpaid because that money could be used in the health-care system. (Mike McArthur/CBC)

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