Some 6,800 Canadians are opening their mailboxes to find letters warning them they may have been infected with hepatitis or HIV while undergoing exploratory procedures at an Ottawa clinic – one that failed an inspection.

Canadians have faced similar scares before. Inaccurate hormone-receptor tests were given to breast-cancer patients in Newfoundland and Labrador between 1997 and 2005. In the tainted blood scandal, about 32,000 people were infected with HIV and hepatitis C between 1980 and 1990.

In this latest case, the patients had colonoscopy or gastroscopy procedures from April, 2002 to June, 2011, and though the risk of being infected by hepatitis B, C or HIV is considered “very low,” it is an unnecessary risk just the same. Patients sent for these procedures – which examine the colon and the stomach – are entitled to expect that the infection prevention and cleaning protocols at the clinic are similar to those of hospitals.

But they would be wrong to do so. Patients are only now finding out – almost a decade later, in some cases – because, until this year, the College of Physicians and Surgeons of Ontario had no authority to inspect the 276 clinics in the province that do medical procedures with certain forms of anesthesia. There are similar powers in British Columbia and Alberta.

According to Hugh MacLeod, the chief executive officer of the Canadian Patient Safety Institute, this latest scare shows there must be “due diligence” to “ensure harm does not take place.”

That includes clinic owners taking responsibility for the proper sterilization of equipment.

Patients could inquire about equipment’s cleanliness, but the clinic owners may not know, or follow, proper sanitation practices.

When health care is not properly integrated and regulated, with controls and systems in place, patients pay the price – in this case in the form of anxiety about blood tests to determine whether they have infectious diseases.

As more publicly funded medical procedures are farmed out to private clinics, provinces must move swiftly to ensure these institutions are subject to uniform standards that are subject to inspection. To do anything less is to put patients at risk.

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