VICTORIA — Two high profile and closely linked private Vancouver medical clinics have been illegally charging patients for treatment, says an audit released Wednesday that is certain to reinvigorate the debate over private health care in B.C.

The province’s Medical Services Commission said it found more than 200 cases of so-called extra billing at Cambie Surgeries Corp. and at the Specialist Referral Clinic, both private clinics founded by controversial Vancouver doctor Brian Day.

“The audit found evidence patients are being billed for publicly insured medical services, which is a contravention of sections 17 and 18 of the [B.C.] Medicare Protection Act,” said Tom Vincent, chairman of the Medical Services Commission.

“If the practice of extra billing does not stop within 30 days the commission will seek a court-ordered injunction.”

The findings bring to a head lingering questions over Day’s clinics, which for years have been openly charging patients for private care.

On Wednesday, Day said he will continue to operate — and bill — as normal, and that he will ardently fight any attempted injunction. However he said he will respect any court-ordered injunction.

“We will be before the court showing the reason why such an injunction would be inadvisable because it would make patients suffer,” he said.

Day is already part of a B.C. Supreme Court case challenging the Medicare Protection Act, and seeking the provisions preventing patients from paying for surgery to be declared unconstitutional.

He said that in the days to come he expects some patients to join that suit.

A similar case in Quebec led to such a finding by the Supreme Court of Canada in 2005, which Day pointed to as precedent.

“There is nothing immoral, illegal and unethical about a citizen in a free and democratic society spending their own funds to extricate themselves from pain and suffering,” said Day.

“Should a B.C. resident suffering, and sometimes, dying on a waiting list have the same constitutional rights to extricate themselves from the waiting list that the Supreme Court of Canada granted to residents of Quebec?”

Day added that if there was an injunction, his clinics would be barred from treating B.C. patients, but would still be able to treat people from outside the province not covered by MSP.

“We’d be faced with a ludicrous situation that an Albertan coming to B.C. has more privileges and rights than a B.C. resident does,” he said.

An official with the Ministry of Health said in the event of an injunction, the clinic would also still be able to treat B.C. residents involved in a workplace injury whose care is being funded by WorkSafeBC.

WorkSafeBC uses private clinics such as Day’s in an attempt to speed up returns to work.

“The longer an injured worker is off work, the less likely they are to return,” said WorkSafeBC spokeswoman Donna Freeman.

“So access to medical care and healing is extremely important.”

Health Minister Mike de Jong was careful with his comments, making clear the audit was not a reflection on all private clinics.