Book review: My Fight for Canadian Healthcare: A Thirty-Year Battle to Put Patients First

My Fight for Canadian Healthcare: A thirty-year battle to put patients first By Brian Day, Sutherland House Books, 2025. ISBN: 9781990823442. Hardcover, 458 pages.

Dr Brian Day, a Vancouver orthopaedic surgeon, is arguably Canada’s most prominent and controversial critic of our single-payer, publicly funded health care system. To his supporters, his tireless advocacy for a private care option for patients languishing on wait lists, along with his willingness to call out hypocrisy among those citizens—notably politicians—who publicly decry private care while privately embracing it, he is a champion of patient rights. 
 
To his detractors, Day (“Dr Profit”) advances a dangerous vision that, if realized, will see doctors drawn from the public system into a private one offering better pay to those choosing to provide care to the wealthy. Wait times for those unable to pay for essential care will increase, and the egalitarian ideals embodied in the Canada Health Act will be eroded.  
 
My Fight for Canadian Healthcare recounts how frustration with budget-driven operating room cutbacks at UBC Hospital in the 1980s created lengthy wait lists and motivated Day to search for a solution. Assembling a team of like-minded surgeons, he conceived of and, in 1996, opened Cambie Surgery Centre, a private surgical clinic in Vancouver with six operating rooms. 
  
Driven by continued frustration over laws that prohibited patients languishing on wait lists from accessing private surgical care, Day says he “decided to try my hand at medical politics.” Following a term as Canadian Medical Association President (2007–2008), and inspired by the 2005 Supreme Court of Canada decision in Chaoulli v. Quebec—which gave Quebecers the right to seek private care when the public system could not meet their needs—Day decided to challenge the restrictions on private care contained in BC’s Medicare Protection Act.  
 
Cambie Surgeries Corporation v. British Columbia was launched in 2009. Eleven years later the BC Supreme Court released its decision upholding the impugned sections of the Act. This decision was upheld at the BC Court of Appeal, with the litigation ultimately proving unsuccessful in April 2023 when the Supreme Court of Canada denied leave to appeal.  
 
The book’s final chapters examine the future of health care in Canada and include an examination of the hybrid public-private systems in countries that consistently outperform Canada in delivering universal health care. 
 
While Day is critical of the judiciary for failing to overturn laws that prevent citizens from accessing private care, he takes an even dimmer view of politicians: 

“The approach of governments to [health care] reform is a randomized mixed bag of arrogance, authoritarianism, hypocrisy, ignorance, and most of all, inertia. The present crisis threatens to drive provinces into insolvency. It does so as it inflicts misery, pain and death on patients. ”
 
Despite its serious tone, the book offers moments of levity—such as a photograph of Day fixing the broken leg of a pregnant mountain sheep that later startled staff and patients when it escaped from the lab onto a ward at Vancouver General Hospital.  
 
In one of the book’s most compelling chapters, Day recounts how his character was shaped by his childhood in England: “I was born and raised in the roughest, toughest area of post-war Liverpool.” He describes witnessing a horrific crime at the home of a babysitter when he was just 3 years old, a trauma he kept secret until adulthood: “Perhaps that experience built up an attitude of resilience whenever I faced conflict and confrontation…. My interest in the sport of boxing added to my stubbornness...”. 
 
My Fight for Canadian Healthcare is a vivid account of a determined surgeon’s 3-decade effort to establish a legitimate role for private care within Canada’s health care framework. While his legal bid to overturn restrictions on private care for patients facing unreasonable waits failed, Day’s firsthand experience with politicians and the courts makes for a valuable read that will prove instructive for the next generation of health care leaders charged with ensuring that timely access to essential medical care becomes a reality for all Canadians. 
 
—David J. Esler, MD 
Vancouver 

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Dr Esler previously served on the BCMJ Editorial Board with Dr Day. 

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.