OTTAWA — The thorny question of who should pay for abortions when the wait for publicly funded procedures is too long landed back in Manitoba after the Supreme Court of Canada refused to hear the case on Thursday.

As is customary, the high court did not offer a reason for its decision not to grant a leave to appeal filed by two Manitoba women who had to pay for abortions at a private clinic.

The women started a class action lawsuit against the provincial NDP government in 2001, arguing they had no choice but to pay for privately funded abortions because the wait for a hospital procedure was as much as eight weeks.

A Court of Queen's Bench justice ruled in December 2004 that the government should fund abortions at private clinics.

However, the Manitoba Court of Appeal overturned that decision last September, prompting the women to go to the Supreme Court in a bid to have the original ruling reinstated.

But the high court's refusal to hear the case means the issue can only be decided by a trial.

Manitoba began funding abortions at a not-for-profit clinic in Winnipeg in 2004.

However, the government is ready to defend its earlier position in court because it says the case could reach beyond the abortion debate into the province's power to decide how health-care dollars are spent.

It could, for example, affect the way governments handle long waiting lists for other procedures, such as hip and knee replacements, said Conservation Minister Stan Struthers, speaking on behalf of vacationing Health Minister Tim Sale.

"We need to have that kind of control so we don't break our system," said Struthers.

"We want to make sure these decisions are made in terms of medical necessity rather than the unpredictability of someone having a procedure done - whatever that procedure may be - and then just sending us the bill."

Lawyer Robert Tapper said he will need time to talk with his clients about whether they want to proceed with their lawsuit.

While he expressed disappointment with the high court's decision, he said there are still legal merits to taking the province to court even though it has taken steps to address long wait times.

"It would compensate a number of people who were put in an untenable position by the totally hypocritical position of the government of Manitoba," said Tapper.

He also dismissed the government's claim the case could have more sweeping financial implications for the province.

"These were abortions, these were not hip replacements," said Tapper. "Whether one is a medically necessary procedure or not is a question of medical science and a question of fact and I am not going to tie the two together."

In overturning the Court of Queen's Bench 2004 ruling, the Manitoba Court of Appeal didn't get into the merits of the health-care debate.

It simply said the matter is too complex to be decided without a trial and more evidence needs to be heard.