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OTTAWA - A Conservative candidate's suggestion that a private clinic be used as a model for health delivery across Canada prompted opposition charges that Prime Minister Stephen Harper wants to expand for-profit health care outside the public system.

Peter Kent made the comment during a recent campaign debate in Toronto's Thornhill riding.

He subsequently insisted in an interview with The Canadian Press he was not backing the contentious notion of a separate system of private health care.

His Liberal opponent in Thornhill and Green Party leader Elizabeth May countered that an expansion of private hospitals modeled after the Shouldice Hospital -- which profits in part by providing hernia surgery paid through the public system for Ontario residents -- would erode medicare and lead to a two-tier system.

"Thornhillers don't need to be reminded that the best example of efficient private delivery of public health care is right here in our own community," Kent said in the debate last week with Liberal incumbent Susan Kadis and other Thornhill candidates.

"We need more Shouldice institutes right across the country," he added. "That's one way we'll be able to meet the challenges of health care".

The Liberals circulated Kent's statement by email and he confirmed them in a weekend interview.

But Kent said he was "not at all" proposing a parallel private system.

Kent, a former broadcaster who ran unsuccessfully for the Conservatives in the 2006 federal election, argued Shouldice provides hernia surgeries more efficiently than public hospitals at less cost.

"I think Shouldice is a perfect example of private health services delivered within the public health-care system," he reiterated. "I think we have to repeat the success of Shouldice across the country".

Shouldice Hospital has long been a lightning rod for controversy in federal and provincial elections. Although it is privately owned, the Shouldice is publicly financed and patients are treated without extra charge.

That controversy resurfaced again in this campaign when Prime Minister Stephen Harper took a thinly veiled jab at NDP Leader Jack Layton for undergoing a hernia operation there.

"I use the public health-care system, my family uses the public health-care system," Harper said during the English-language debate. "And it turns out I was the only national leader that had exclusively used the health-care system."

A spokesman for Harper rejected the claims that Harper and the Conservatives want to establish a parallel private system in Canada.

"Our government's goal is to work with the provinces to ensure health care is paid for through the public system," said communications director Kory Tenecyke.

The 89-bed Shouldice was established in 1945 and, because of its long history and specialized care, was exempted from a ban on private health services when Ontario introduced its public health act in 1973. It is now the only private hospital allowed under the act.

The Ontario Health Insurance Plan pays surgery and ward costs at Shouldice for Ontario residents, who pay for the hospital's semi-private rooms themselves, according to the hospital's website.

Other provincial plans pay only ward costs and part of the surgery costs for out-of-province Canadian patients, while U.S. patients pay the total bill either themselves, through private health insurance or through government medicaid for low-income patients.

A research essay on the hospital published in 2000 by the Canadian Union of Public Employees accused Shouldice of engaging in "cream skimming" by only accepting patients who require straightforward hernia operations, and referring more-costly complicated surgery to the public system.

The essay says Shouldice makes a profit by focusing on basic surgery through OHIP, as well as treating U.S. and out-of-province patients.

The union said at the time that Shouldice was an "anomaly" that did not represent a threat to the public system -- but May and Kadis disagree.

They argue the establishment of similar hospitals and clinics would inevitably draw resources and talent from the public system and lead to private U.S. health-insurance involvement in the Canadian health system.

"The Conservatives are trying to implement a private health-care system by stealth," said Kadis, a breast-cancer survivor and former board member of the Canadian Breast Cancer Foundation who is running for re-election.

May said the expansion of private hospitals in Canada would quickly spark a challenge to the public system by U.S. insurance companies under the North American Free Trade Agreement. She predicted U.S. firms would demand equal access to insurance coverage for patients using the hospitals.

"Whenever you have for-profit health delivery, you've opened yourself up to a NAFTA challenge," she said, pinning blame on Harper.

"He's the only leader who worked for an organization whose goal was to destroy our health-care system," May said - a reference to Harper's term as president of the National Citizens Coalition in the late 1990s. Insurance agent Colin Brown founded the right-wing organization in the 1960s to oppose the introduction of medicare.