News
Is toilet paper bad for the environment?
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A U.S.-based non-profit advocacy group is pushing toilet paper manufacturers to stop using Canada’s boreal forest as a resource.
The Natural Resources Defense Council recently released a report on manufacturers that it says are using what it calls virgin forests — previously untouched forests (sometimes called old-growth forests) — as a resource for toilet paper.
CTVNews.ca reached out to the toilet paper manufacturers mentioned in the report to understand sustainability goals and how the industry is adapting to the changing climate. But experts say these big companies need to do more by shifting toilet paper away from forests to more sustainable options.
In the 2022 report titled the “Issue with Tissue”, the NRDC ranked popular toilet paper brands based on sustainability and eco-friendly ingredients.
The group claims the majority of popular brands in Canada and the U.S. are using wood fibre and pulp from the Canadian boreal forest, alleging that this practice leads to the destruction of ecosystems and decreases the carbon-capturing power of trees. Wood pulp and fibre is a co-product of the logging industry which harvests trees from Canada’s boreal forest.
The boreal forest covers 270 million hectares of which Spruce, Fir, Pine and Tamarack trees are most common. Canada’s boreal forest is 28 per cent of the world’s boreal zone and it is integral to the health of the planet by purifying the air and regulating the climate.
The NRDC alleges Canada uses one method to harvest trees called clear-cutting, which is the practice of removing a large area of forest at one time.
“Canada has the third highest intact forest loss of any country on the planet,” Shelly Vinyard, boreal corporate campaign manager with NRDC, told CTVNews.ca in an interview. “Every single year more than 400,000 hectares of boreal forests are clear-cut, and that’s roughly the size of a small city block every minute.”
According to the National Forestry Database, Canada harvested 143.1 million cubic metres of trees in 2020. CTVNews.ca reached out to the Ministry of Natural Resources and Forestry to understand how it balances the need for wood and manages forests sustainably.
“There are many different harvesting systems in Canada – clear cut is only one of those systems,” a spokesperson from the ministry told CTVNews.ca in an email. “All forest harvesting systems in Canada have been designed to emulate natural disturbances (e.g. wind, fire, etc). When we refer to harvesting trees, this does not always mean the clear-cut system, which is part of even-aged management.”
The ministry said that clearcutting is used in certain forest types in specific conditions.
The NRDC says by understanding how toilet paper could be hurting Canadian forests, consumers can make better decisions. It also hopes the report will encourage mass manufacturers to shift away from virgin forests and towards sustainable alternatives. Virgin forests are untouched trees also known as old-growth forests.
Forests store carbon at their roots and the older the tree is the more CO2 it captures and stores. Virgin forests are older trees because they have not been touched and are left to grow. By shifting practices away from virgin forests, NRDC says the impacts on the environment would decrease lowering carbon emissions released into the atmosphere.
“It’s really (manufacturers’) responsibility … they shouldn’t be making us complicit in the destruction of the boreal forest and other forests on the planet,” Vinyard said. “They have an opportunity here to really take full accountability of the impact of their source decisions right now. And to offer much more sustainable alternatives by using recycled content and minimizing their impact on intact forests.”
According to the Ministry of Natural Resources and Forestry, Canadian trees are subjected to sustainable forest management practices, liming natural disturbances.
“Retaining old-growth trees to provide critical habitat for plants, wildlife and other organisms is a key principle of sustainable forest management. In many jurisdictions, harvesting guidelines call for a certain proportion of old-growth or veteran trees to be retained,” the email read.
HOW SUSTAINABLE ARE CURRENT BRANDS?
The NRDC report looked at toilet paper brands on the market in July 2022. It took data from websites, product packaging and company communications to evaluate the ecological footprint of the products.
Using variables from A to F, the scorecard gave the highest points to brands made from 100 per cent recycled content. According to the NRDC, recycled fibre has “enormous benefits” for forests and the global climate.
“Recycled content has one-third the carbon emissions of tissue fibre made from virgin wood,” according to the Environmental Paper Network’s Paper Calculator 4.0.
Toilet paper is made using wood pulp and fibre, which is what Vinyard says is a “co-product” of the larger logging industry.
“The forest is clear cut and then the wood is used for multiple different products like solid wood and toilet paper… the pulp used to make toilet paper is a co-product for the logging industry helping to make it more economically viable to clear cut these essential forests,” she said.
According to the government, Canada is committed to finding “sustainable” forest practices and decides each year which trees are harvested.
“Provinces and territories manage their public forest resources over long-term planning horizons (some 100-200 years), determining the annual volume of commercial tree species that is allowed to be cut each year,” a ministry spokesperson said in the email. “Overall, the country harvests only about 0.2 per cent of the total amount of forested land every year in Canada.”
Toilet paper can also be made up of post-consumer fibres, which are scraps of paper people would throw in a recycling bin.
The NRDC says post-consumer, also known as recycled paper, aids the recycling industry by creating a “circular economy,” which supports jobs and alternatives from sending paper waste to landfills.
Some credit was given to companies using virgin forest fibre that sources wood sustainably with a Forest Stewardship Council certification, which the NRDC says is the only certification system that minimizes logging impacts and has safeguards for protecting Indigenous Peoples’ rights. Some companies have mixed certifications.
CTVNews.ca went through the list and noted which brands on the scorecard are available in Canada.
The majority of toilet paper brands in Canada, according to the NRDC’s report, are using wood from old-growth trees.
Kruger Inc., a Montreal-based manufacturer told CTVNews.ca in an email that in 2011, it was the first Canadian tissue company to earn an FCS certification.
“One-hundred per cent of our fibre (recycled and virgin) is third-party certified by either FSC or Sustainable Forest Initiative (SFI), assuring that the virgin fibre in our products come from sustainably managed forests,” Francois Paroyan, general counsel and corporate secretary of Kruger, said in the email.
After trees are harvested the pulp fibre is used to make toilet paper and other products. The pulp is gray in colour and not white like the final product.
To be white, toilet paper manufacturers sometimes use elemental chlorine-free (ECF) bleach. Several Canadian brands lost points for use of the bleach the report states, due to the impacts the chlorine gas has on water communities.
The highest-scoring Canadian toilet paper brand for sustainability is Scott Essential Standard Roll, manufactured by Kimberly-Clark. The brand received a B+ for being 100 per cent recycled toilet paper, using 20 per cent post-consumer fibres and using no chlorine bleach in its product. But the brand lost points for not having a forestry certificate which ensures the pulp and fibre is from sustainable sources.
The Natural Resources Defense Council recently released a report on manufacturers that it says are using what it calls virgin forests — previously untouched forests (sometimes called old-growth forests) — as a resource for toilet paper. (Natasha O’Neill/ CTVNews.ca via The Issue with Tissue report)
The highest ranking bamboo toilet paper scored a B. True Earth Paper Corp., which makes Silk’n Soft Oh Natural Unbleached toilet paper, uses bamboo and is not bleached. According to the report, the company does not have a Forest Stewardship Council certification.
“The sourcing of bamboo is maintained by our factories in Asia, the bamboo comes from natural mountain-grown bamboo in areas such as Jiangxi and Zhejiang and is not a threat to pandas. In some cases bamboo is harvested from plantations,” Brad Kornelson, spokesperson for Truth Earth Paper Corporation, told CTVNews.ca in an email. “Our factories undergo a third party audit and they must pass the audit and must be FSC certified before we elect to enter into a manufacturing agreement.”
The NRDC also analyzed the company’s Silk’n Soft White toilet paper, which is also made with 100 per cent bamboo but is bleached using ECF, and lowered its grade to a C.
“Our current focus is to change our packaging,” Kornelson said. “We are working with our factory to not only replace our plastic wrapper with cardboard (but) we are working to have the wrapper made from bamboo fibre as well as the cardboard tube and the shipping case as well.”
Other bamboo toilet paper from TUSHY scored a C from the report due to using chlorine bleach to whiten.
“The bamboo grows naturally, with no fertilizer (and has a) FSC certificate,” a spokesperson for TUSHY told CTVNews.ca in an email. “TUSHY is first and foremost a bidet company that strives to cut down toilet paper use by over 80 per cent and save trees and thus the planet one flush at a time.”
A bidet is a water pressure attachment to the toilet which sprays a person clean after use. According to TUSHY, bidets cut down on toilet paper usage by using one-eighth of a gallon per use unlike the 37 gallons needed to create a single roll of traditional paper.
The lowest-scoring Canadian toilet paper brand was Great Value Ultra, sold by Walmart, which received an F.
A spokesperson from Walmart Canada told CTVNews.ca in an email “the products mentioned in the report are not products that are available in Canada.”
Great Value Ultra toilet paper sold in Canada is made domestically.
Walmart Canada’s spokesperson pointed to a portion of its website where it says “By 2025, Walmart’s goal is that private brand products made of pulp, paper, and timber will be sourced deforestation and conversion-free.”
According to an article published in The Daily Memphian, an independent local paper in Memphis, Tenn., toilet paper brands Great Value and HDX are manufactured at a Kruger plant in the city.
Initially, CTVNews.ca received a response saying none of Kruger’s brands were represented in the report. When asked specifically about The Daily Memphian article Kruger responded by saying it doesn’t comment on specific brands it produces.
The “Issue with Tissue” report says Great Value toilet paper uses non-recycled paper from Canada’s boreal forest and is bleached using chlorine, and its manufacturers do not have a forest certificate.
When asked about the low score and the allegations in the report, Kruger’s counsel Paroyan told CTV News in an email only that “large retail customers often use multiple suppliers in the tissue category to supply their consumer demands, and we do not comment on our private label customers.”
According to Paroyan, the “majority” of fibre used by Kruger in Canada is sourced from Canada. He added about 25 per cent of the total Canadian fibre used is recycled content.
“We are always interested in advancements in the tissue industry, and regularly explore the use of alternative fibres,” Paroyan said. “Our decisions are guided by our stringent fibre procurement policy. Alternatives to traditional wood fibres are on our radar and we are weighing their positives and negatives including efficacy challenges, environmental impact (emissions associated with lifecycle of the product) and detractions, and consumer expectations.”
Other Canadian toilet paper brands found in stores scored low on the NRDC’s ranking due to using the majority of pulp from virgin forests, bleach to whiten the paper and not having a forestry certificate.
Scott 1000, Cottonelle Ultra and Scott Comfort Plus, manufactured by Kimberly-Clark, were given Fs by the NRDC.
The Cottonelle Professional brand, by 35 per cent recycled fibres, 20 per cent of which is from post-consumer materials.
The rest of the paper is from virgin forests and is bleached using a mix of ECF, the NRDC said, giving this brand a C.
Manufacturer Procter & Gamble had one Canadian toilet paper brand on the list, Charmin, which was given an F for being made of 95 per cent virgin forest fibres. The other five per cent was recycled materials, according to the NRDC.
The company has a mixed forest certificate and uses ECF bleach, the report details.
“Recycled toilet paper…has one-third the carbon footprint of products like Charmin, which are made from 95 per cent virgin fibre,” Vinyard said.
The Kirkland brand, by Costco, received an F as well. It is made 100 per cent out of virgin forests and is bleached using ECF, the report reads.
CTVNews.ca reached out to Procter & Gamble, Kimberly-Clark and Costco for a comment but did not hear back before publication.
VIRGIN FOREST IMPORTANCE IN CANADA
Canada’s forests stretch 347 million hectares and are under increasing pressure from insects, natural disasters and humans, according to a report by the Council of Canadian Academies (CCA).
Hundreds of tonnes of carbon are captured through photosynthesis and stored in the roots of trees. When a tree is no longer living or uprooted, that carbon seeps back into the atmosphere.
The CCA report says, 65 per cent of forests in Canada are being used for harvesting. They are storing 208 tonnes of carbon per hectare.
The Ministry of Natural Resources and Forestry records forest carbon release when a tree is harvested.
“Over the long term, a strategy that aims to maximize the carbon absorption and storage in the forest, while also storing carbon in long-lived wood products (and ensuring maximum value and use for anything harvested) will generate the best benefits,” a ministry spokesperson said. “That means balancing sustainable harvesting with conservation.”
In March 2022, 90 scientists from around the world wrote a letter urging the federal government to ensure old-growth forests are protected in the country’s climate action plan.
Advocacy groups argue any harvesting of old-growth forests is not sustainable, saying the benefits old trees have cannot be replaced with new saplings. The scientists said old-growth forests contain 30 to 50 per cent more carbon than replanted trees, and newer trees cannot absorb carbon at the same rapid rate as older trees.
“We are deeply concerned by the evidence of continued deforestation and degradation of primary forests globally and in Canada because of the resulting impact on greenhouse gas emissions and the biodiversity crisis,” they wrote in the open letter to Prime Minister Justin Trudeau.
According to the ministry, some products can “lock away” carbon after being processed. If Canada harvests sustainably by creating products that can be used multiple times while also using all parts of the tree – “in other words doing more with less”– the logging industry can provide valuable resources while also protecting forests.
But advocates like NDRC believe single-use wood products, like toilet paper continue to harm Canadian forests.
“Most consumers don’t even understand the impact or the cost of their toilet paper and tissue choices,” Vinyard said.
News
Just bought a used car? There’s a chance it’s stolen, as thieves exploit weakness in vehicle registrations
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The fight against Canada’s worst-ever auto theft epidemic has largely focused on ramping up inspections at shipping ports, where organized crime groups have exported the overwhelming majority of stolen vehicles.
But criminals are adapting, police say, by increasingly selling hot vehicles in Canada to unsuspecting buyers with little protection, exploiting a weakness in provincial registration systems that veteran investigators argue needs to be fixed.
“The market is so lucrative it’s easy cash,” said Det. Sgt. Greg O’Connor of Peel Regional Police, west of Toronto.
While it is impossible to know what criminals do with all stolen cars and difficult to track shifting trends, police now estimate nearly one-third of stolen vehicles are being resold in Canada, marking a significant increase from just six months ago when the vast majority of vehicles were believed to have been exported.
And often, buyers have no idea.
Derek Crocker bought a used Ford F-150 pickup truck from a dealership in Toronto in 2022. Just a few months later, his own investigation revealed the truck’s vehicle identification number — or VIN — had been replaced, mirroring the VIN of a similar truck registered in Utah.
“The whole reason you buy it from a dealership is so you don’t have to worry about dealing with that sort of thing,” he said.
In retrospect, there were small tells.
After Crocker entered what should have been the truck’s unique VIN in Ford’s app, the function to remotely start the vehicle never worked. The app also listed the vehicle as being located in the United States and indicated a different amount of fuel than his own vehicle tank was holding.
But it wasn’t until his F-150 was in an accident and required body work that the problem with the VIN was revealed. The repair shop ordered parts based on the VIN it saw on the dash. But the parts did not match.
“So I Googled the VIN number that was on my truck, and I found a truck for sale in Utah,” said Crocker.
It turns out that was the true VIN, which thieves had cloned, placing fake VIN stickers with the Utah truck’s VIN on top of the true number for the truck Crocker bought.
VINs are most prominently displayed on a vehicle’s dashboard, as well as on the ownership title. When a vehicle is stolen, the VIN is flagged across North America to prevent it being sold.
But criminals are replacing the VIN plate, often with one from a comparable vehicle that has been totalled, legally exported or one registered in another province or U.S. state. They may go through junkyards, export records or simply walk through a mall parking lot to find a VIN to clone.
In doing so, they re-VIN or “wash” the vehicle of its stolen status.
Crocker called police, who seized the vehicle and returned it to the insurance company of the original owner.
Crocker’s own insurance would not cover his loss because he’d — albeit unknowingly — purchased a stolen vehicle. After a long discussion with the dealership that sold him the stolen truck, his money was returned.
“They did nothing extra,” Crocker said. “They didn’t help me at all.”
How could 2 cars with the same VIN be registered?
Provincial centres that administer vehicle registration, such as ServiceOntario, do not have a system that checks if VINs already exist in other jurisdictions.
“You can have a vehicle registered in one province and the same VIN on a different vehicle registered in another and we need to stop that,” David Adams, president and CEO of Global Automakers of Canada, told a recent auto theft summit in the Greater Toronto Area.
Neither Canada nor the United States has a national vehicle registry. Multiple police agencies are urging federal and provincial governments to create one.
“The reality is this is a national issue. And that’s why a national registry that moves itself beyond any sort of provincial jurisdiction is important in all capacities,” Nick Milinovich, deputy chief of Peel Regional Police, said in an interview.
CBC News asked Ontario’s Ministry of the Solicitor General why the province’s database can’t detect whether the same VIN is actively being used in another province or state.
“If changes to the provincial registration process are required, we won’t hesitate to make them,” it responded in a statement.
How to spot a potentially stolen car for sale
While it is impossible to know precisely how many fraudulently registered stolen vehicles are back on the road, recoveries have surged.
“The number of re-VINS is just blowing through the roof right now,” said O’Connor. “It’s costing drivers, banks, insurance companies big money. It’s a massive problem.”
It is impossible to know the full extent of the illegal economy and the proportion of vehicle exported versus those kept in the country. But police forces across southern Ontario have reported a surge in recoveries of vehicles that have had their VINs altered.
Car buyers are being advised to look at the VIN on the dashboard and the pillar between the front and back driver’s side doors to see if the numbering is bubbling, a sign there may be a sticker on top of the real VIN.
Running the VIN through a paid service like Carfax could also yield key warning signs. For example: a vehicle that records show has been declared salvage after a crash later reappearing undamaged. Or a VIN with a sales and registration history almost exclusively in one province or state suddenly being for sale in another.
If an insurance company discovers a vehicle has a fraudulent VIN, the policy is voided. When police seized Crocker’s truck, insurance would not pay to replace it. He was only able to recover his money when the dealership that sold the stolen truck paid him out.
But police and insurance investigators have begun to warn of a proliferation of re-VINed vehicles being sold exclusively through social media platforms like Instagram.
“If you’re paying cash for that vehicle [in a private sale] or you do a bank transfer,” said O’Connor, “there’s no recourse.”
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CBC’s David Common informs Len Green that his stolen car has been found in Ghana, 8,500 kilometres from Toronto, where it first went missing a year ago.
Registry employees alleged to be in on the crime
Police also allege organized crime has recruited employees at ServiceOntario, the registration centres operated on behalf of the province that offer an array of services, including issuing licences and managing the database of registered vehicles.
At the end of 2023, Toronto police charged seven ServiceOntario employees with a collective 73 charges, including fraud over $5,000, tampering with a vehicle identification number, breach of trust by a public officer and trafficking in identity information.
They allegedly provided an auto theft ring with registered addresses for specific vehicle models. Once stolen, the same employees assisted the ring in “re-VINing” the vehicles.
Fraudulent VINs may never be detected, although Peel police alone have seized more than 50 such vehicles in 2024 alone.
At other times, employees at ServiceOntario have flagged suspicious activity, such as when the same person shows up dozens of times to register different vehicles. That was allegedly the case with Milton Hylton, who was charged with 168 counts of various Criminal Code offences in March.
He was released on bail, pending trial. No charges are yet proven.
WATCH | An alleged repeat re-VINer is arrested:
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According to the warrant used to search his home and requested by Peel Regional Police Const. Gurinder Athwal, the 24-year-old travelled to “multiple ServiceOntario locations throughout the province and fraudulently registered vehicles.” Police say more than 100 vehicles were involved, and describe stolen Dodge Rams, Dodge Durangos and BMWs among them.
CBC News was present at the moment of Hylton’s arrest in Mississauga as multiple undercover police vehicles conducting surveillance moved in.
As investigators searched and then towed his silver Mazda, they say they found documents to register even more vehicles inside.
Hylton had just a few weeks earlier been banned from entering ServiceOntario locations without an appointment, because of suspicions. He was in the company of a woman he identified as his girlfriend. His sister was also arrested days later and now faces 36 charges of uttering forged documents and trafficking of stolen goods.
3rd-party registration being exploited
In a news release, Peel police describe Hylton as using “loopholes in the ServiceOntario procedures that allow ‘authorized’ individuals to conduct third-party transactions.”
While third-party registration is intended for car dealers, provisions for it mean nearly any individual can transfer registration of a vehicle or register a vehicle in another person’s name.
This process is typical in other Canadian provinces, too.
“It’s a huge problem,” said O’Connor. “And that’s how a lot of these vehicles are getting through.”
For instance, the warrant in the Hylton case alleges he transferred vehicle ownerships to both a speciality tool shop in Etobicoke and an automotive exporter in St. Catharines. Neither business authorized the transfers, and both insist Hylton is neither an employee nor known to them.
Were the vehicles in question stolen, the new registration would have detached them from their previous owners. Anyone buying the vehicles would be none the wiser and would have no insurance or other protection if the vehicle’s stolen status was ever uncovered.
Peel police say Hylton sold dozens of vehicles over a year through social media under the Instagram handle “Royalty in the Building.”
That name is associated with Facebook and Instagram accounts where apparent car buyers offer testimonials.
“I called up Milton. I told him I got my money up, I need plates, I need a car. And he got it just like that,” a person said in a testimonial while standing in front of a Honda Civic.
“Got my new SUV, fully loaded. Tints, light, rims, inside’s clean. Everything’s legit,” another person said in a testimonial.
“You give him your cash. You’re on the road. You ain’t got to go to ServiceOntario. You don’t got to do no running around,” said another.
WATCH | Inside a weeks-long auto theft investigation:
CBC’s David Common gets exclusive access inside an auto theft surveillance operation, targeting a suspect who allegedly re-vinned more than 100 stolen vehicles to be resold, sometimes to unsuspecting buyers in Canada.
CBC News spoke with several police and insurance officials from across the Greater Toronto Area about third-party registrations.
Each insisted the loophole needed to be closed to prevent illegal transfers. But none wanted to speak on the record, citing the provincial Ministry of Transportation as a good partner they did not want to publicly besmirch.
Meanwhile, the auto theft problem continues to grow.
In 2022, an unprecedented $1.2 billion worth of vehicles were stolen across the entire country. By 2023, more than $1 billion was lost in just Ontario alone, according to the Équité Association, the national organization charged with reducing insurance fraud.
“It’s one of the top three revenue generators for organized crime,” said Milinovich. “It’s high reward, low risk, and an easy crime.”
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OTTAWA –
A new poll suggests the Liberals have not won over voters with their latest budget, though there is broad support for their plan to build millions of homes.
Just shy of half the respondents to Leger’s latest survey said they had a negative opinion of the federal budget, which was presented last Tuesday.
Only 21 per cent said they had a positive opinion, and one-third of respondents said they didn’t know or preferred not to answer.
Still, 65 per cent of those surveyed said the plan to spend $8.5 billion on housing, aimed at building 3.9 million homes by 2031, is good for the country.
Leger’s poll of 1,522 Canadians last weekend can’t be assigned a margin of error because online surveys are not considered truly random samples.
People in Alberta were most likely to say they had a very negative impression of the budget, with 42 per cent selecting that option compared to 25 per cent across the entire country.
More than half of the people who took the poll said they are in favour of the government’s plans to spend more on energy efficiency, national defence and student-loan forgiveness for health care and education workers.
And 56 per cent said they think the increase to the capital gains tax inclusion rate — a move that’s estimated to raise another $19.4 billion in revenue over the next four years — is a good thing.
The Liberals are billing the change as critical to their plan to improve generational fairness by taxing the ultra-rich.
It has drawn criticism, including from the Canadian Medical Association, which warned on Tuesday that it could affect the country’s ability to recruit and keep physicians.
The budget proposes to make two-thirds of capital gains — the profit made on the sale of assets — taxable, rather than half. For individuals, this would apply to profits above $250,000, but there is no lower threshold for corporations.
The medical association said many doctors will face higher taxes because they have incorporated their practices and used those companies to save for retirement.
While the Liberals are aiming changes to the capital gains tax at younger Canadians including millennials and gen-Zers, Leger’s poll found it had the support of 60 per cent of respondents over the age of 55 — the highest among any age group.
People between 18 and 35 were least likely to support the Liberal plan to spend another $73 billion on defence in the next two decades. Just 45 per cent of respondents in that age group said ramping up defence spending is good for the country, compared with 70 per cent of people over the age of 55.
Leger also asked questions about the country’s fiscal future.
Almost half the respondents, 47 per cent, said they want to see the government cut back on spending and programs to get the budget balanced as quickly as possible.
Just 16 per cent said spending more and running large deficits is the best plan for the next five years, and 14 per cent want to see the government increase taxes to bring the deficit down.
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Alberta’s health ministry says an audit has determined that more than 40 medical clinics in the province are advertising membership fees for services, nearly a year after one such plan landed a Calgary clinic in hot water.
The audit was launched last December. In July, CBC News reported that a medical clinic in Calgary’s Marda Loop district was moving to a membership system and planned to charge $4,800 a year for a two-parent family membership, covering two adults and their dependent children.
The next day, Health Canada said the arrangement at the Marda Loop Medical Clinic equated to patients purchasing “preferential access” and warned Alberta that it could face cuts to federal health transfers if the situation wasn’t handled.
Alberta Premier Danielle Smith and Alberta Health Minister Adriana LaGrange directed Alberta Health to investigate, and the clinic halted its plan for membership fees shortly after.
In December, LaGrange told CBC News that “appropriate action” would be taken if audits determined that violations were found, adding the province would do whatever it took to ensure clinics were in compliance.
The province promised the audits early in the new year. Now, the health ministry says it has conducted interviews to gather information on operations and business models of the clinics, adding this work is ongoing.
“Over 40 clinics in the province [advertise] a membership meant to pay for a defined set of uninsured services, while also providing insured services covered under the Alberta Health Care Insurance Plan at no cost to Albertans,” wrote spokesperson Andrea Smith in a statement.
“Once this review is completed, its findings will be used to inform next steps. Alberta’s government will also determine if additional audits of more membership clinics is required.”
In July, Health Canada said executive and primary health clinics charging patients enrolment and annual membership fees exist in a number of provinces. Generally, investigations have indicated that clinics provide members with an variety of uninsured services, such as life coaching and nutritional services.
“However, in some cases … these fees are also a prerequisite to accessing insured services at the clinic (i.e., medically necessary physician services). Mandatory fees to access or receive preferential access to insured services are contrary to the Canada Health Act,” the government department wrote in a statement.
A spokesperson for LaGrange told CBC News in July the ministry wasn’t aware of any other clinics offering services for membership fees that didn’t align with legislation.
What comes next for those 40 clinics is a murky grey area, said Fiona Clement, a professor at the University of Calgary in the department of community health sciences. Much of it has to do with the exact language being used when services are outlined as parts of packages.
“We’re on the razor’s edge of exact wording there that runs them afoul. Really, I think it will come down to what the government is willing to fight with these clinics about,” she said.
CBC News asked the provincial government for a list of the clinics identified, but did not receive it by publication time. A spokesperson with the province said if any clinics are found to be non-compliant with legislation, appropriate action would be taken.
Report had identified 14 clinics
Clement said the big issue that got the Marda Loop Medical Clinic in hot water was the concept of guaranteed access.
“That’s the problem that Marda Loop got into, because there you are charging access to medical care, which is the part that contravenes the Canada Health Act,” Clement said.
At the time the Marda Loop clinic fell under scrutiny, it was clear there were other such clinics providing membership programs, in Calgary and Canada.
In 2022, researchers from Dalhousie University and Simon Fraser University released a paper tracking the number of clinics taking private payment across the country. Between November 2019 and June 2020, the period of the analysis, there were 14 private clinics in Alberta with a range of membership fees and private payment.
“So, 40 is a larger number than I was expecting. And I think it speaks to growth in this area, the number of clinics that are charging fees for different parts of care,” Clement said.
“I think it underscores the lack of stability, and the need to really think about how we’re funding primary care, because more and more clinics are turning to this private charge as a revenue source to keep the doors open.”
Provinces that allow private health-care providers to charge patients for medically necessary services have dollars clawed back by the federal government under the Canada Health Act.
According to Health Canada, Alberta was subject to a $20,450,175 deduction to its Canada Health Transfer payment in March 2024 under the diagnostic services policy. That’s up from $13,781,152 last year.
But the province received $20,538,796 in partial reimbursements tied to its March 2023 and 2024 deductions, which represents actions that Alberta Health has taken to limit patient pay for publicly funded goods or services, according to Clement.
“I guess we’re making some progress. But it’s still a big number, which says there’s still a lot of patient billing going on,” she said.
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