Open this photo in gallery Dr. Brian Day, Medical Director of the Cambie Surgery Centre, sits for a photograph at his office in Vancouver in this file photo from Aug. 31, 2016. DARRYL DYCK/The Canadian Press

British Columbia’s public health-care system fails thousands of patients every day by making them wait for necessary medical care, causing them to suffer and increasing their risk of permanent harm, says a lawyer for private medicine advocates.

Robert Grant, who represents a group of plaintiffs led by Brian Day, chief executive officer of the for-profit Cambie Surgeries Corporation, on Thursday began his response to final arguments in the decade-long case.

“They have a right to an alternative,” he told B.C. Supreme Court Justice John Steeves. “They have a right to ameliorate their harm, to end their harm, to address their harm by seeking private surgical services.”

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The plaintiffs are challenging the constitutionality of key provisions of B.C.’s Medicare Protection Act, arguing that patients have a right to pay out of pocket for swifter access to necessary medical care when waiting times in the public system are too long.

They seek to overturn key provisions that prohibit physicians from accepting pay from both public and private purses, limit extra billing and ban health insurance for services that are already covered under the public plan.

Critics say allowing a two-tier system would upend the very foundation of Canada’s public health-care system and argue that hospital and physician care should go first to those who need it most, not those who can pay the most.

Mr. Grant rejected the argument that such a system would allow those who can afford it to jump the public queue.

“What happens is you leave the queue,” he said. “You go and you pay for the surgery yourself, the doctor, you pay for the surgeon, you pay for the facility. And, importantly, you leave the public wait list, creating a space for someone else.”

Mr. Grant dismissed the idea that the case was driven by greed, adding that many doctors who have been working in both systems because provisions of the law are not enforced remain deeply committed to the public system.

“It’s simply outrageous to characterize them as individuals primarily motivated by money,” he said.

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Earlier Thursday, lawyer Joseph Arvay, representing an intervener group comprising two patients, two physicians and two health organizations, argued that it is impossible to determine whether the provisions in question deprived the plaintiffs of their right to life, liberty and security of the person without knowing what the threshold is for triggering that section of the Charter.

“Is it any wait? Or is it only for very long waits? And if so, what is a long enough wait?” Mr. Arvay said. “In other words: How much of the wait causes the deprivation? Who decides what the threshold is? This is where the plaintiffs’ case gets very, very murky.”

He argued while most people have at times wished that their medical conditions could be addressed more quickly than the health-care system allows, having to wait one’s turn is not unconstitutional.

It would be a “perverse application of the Charter” to allow queue jumping by the wealthy at the expense of the relatively poorer, he said.

“If these provisions are struck down then, according to the plaintiffs, anyone and everyone with financial means who claims to be suffering, if only one day, they would have the right to go to a private clinic … and be treated ahead of the patients in line in the public system,” Mr. Arvay said.

“What the plaintiffs seek to achieve with this litigation is private health care on demand.”