Skip to main content

Hospital centralization wears thin in Quinte. The perils of putting all your eggs in one basket

A pretty good editorial from the Belleville Intelligencer on one peril of hospital centralization.

QHC needs to rethink putting eggs in one basket

It's emergency surgery only at QHC hospitals this week and it's all because of a breakdown in sterilization equipment -- at one hospital site.That should prompt some questions about how the corporation centralizes its services. Scheduled surgeries and procedures at hospitals in Belleville, Trenton and Picton have been cancelled until Sept. 20 due to broken sterilization equipment....

Years ago, when QHC was established, it was the work of corporate planners that things like dietary needs, equipment distribution, supplies and even sterilization were centralized in the interest of cost-effectiveness.But, when something goes wrong in the central site where a certain crucial service is based, as we see with sterilization and surgery cuts this week, it illustrates the flaw in the scheme.  With the current onset across Canada of increased rates of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin- resistant Enterococcus (VRE) in busy hospitals, it is worrisome that closure of one sterilization unit can affect so many sites, locally.

While this will blight hospital surgeries in Quinte for a while, it is actually part of a broader problem.   It's not just in Quinte that hospital support services are being centralized -- it's right across the province.  And it's not just support services that are being centralized -- it clinical services too.  Just ask Hamilton...
 
Moreover, the issue flagged by the Intelligencer is just one sort of problem with hospital centralization -- there's a lot more reasons to be concerned: access to health care services in local communities, the vibrancy and viability of smaller communities, the loss of local jobs, and, yes, even costs.
 
The centralization (and closure) of hospital services directed by the Health Services Restructuring Commission (HSRC) in the 1990s did not lead to reduced spending on hospitals and health care – indeed, there was a significant increase in spending. And many HSRC directed hospital-restructuring projects left a shambles for health care workers to clean up.

A second instance of the centralization of services in the 1990s was the centralization of jail services. Two large, centralized jails were built along with a new centralized facility to cook and chill jail meals. The result did not impress the provincial auditor general. Existing institutions actually produced food more cheaply. And the new cook-chill facility was only able to supply six institutions instead of the promised ten. Despite a decline in the average inmate count, operating costs for institutional services increased by 19% over four years.

As cost savings are often the real reason for the centralization of hospitals services, Ontario's recent experiences with public sector centralization should not be dismissed out of hand. 
 
dallan@cupe.ca

Comments

Popular posts from this blog

Public sector employment in Ontario is far below the rest of Canada

The suggestion that Ontario has a deficit because its public sector is too large does not bear scrutiny. Consider the following. 

Public sector employment has fallen in the last three quarters in Ontario.  Since 2011, public sector employment has been pretty flat, with employment up less than 4 tenths of one percent in the first half of 2015 compared with the first half of 2011.


This contrasts with public sector employment outside of Ontario which has gone up pretty consistently and is now 4.7% higher than it was in the first half of 2011.



Private sector employment has also gone up consistently over that period. In Ontario, it has increased 4.3% since the first half of 2011, while in Canada as a whole it has increased 4.9%.







As a result, public sector employment in Ontario is now shrinking as a percentage of the private sector workforce.  In contrast, in the rest of Canada, it is increasing. Moreover, public sector employment is muchhigher in the rest of Canada than in Ontario.  Indeed as…

The long series of failures of private clinics in Ontario

For many years, OCHU/CUPE has been concerned the Ontario government would transfer public hospital surgeries, procedures and diagnostic tests to private clinics. CUPE began campaigning in earnest against this possibility in the spring of 2007 with a tour of the province by former British Health Secretary, Frank Dobson, who talked about the disastrous British experience with private surgical clinics.

The door opened years ago with the introduction of fee-for-service hospital funding (sometimes called Quality Based Funding). Then in the fall of 2013 the government announced regulatory changes to facilitate this privatization. The government announced Request for Proposals for the summer of 2014 to expand the role of "Independent Health Facilities" (IHFs). 

With mass campaigns to stop the private clinic expansion by the Ontario Health Coalition the process slowed.  

But it seems the provincial Liberal government continues to push the idea.  Following a recent second OCHU tour wi…

Hospital worker sick leave: too much or too little?

Ontario hospital workers are muchless absent due to illness or disability than hospital workers Canada-wide.  In 2014, Ontario hospital workers were absent 10.2 days due to illness or disability, 2.9 days less than the Canada wide average – i.e. 22% less.  In fact, Ontario hospital workers have had consistently fewer sick days for years.

This is also true if absences due to family or personal responsibilities are included.
Statistics Canada data for the last fifteen years for Canada and Ontario are reported in the chart below, showing Ontario hospital workers are consistently off work less.
Assuming, Ontario accounts for about 38% of the Canada-wide hospital workforce, these figures suggest that the days lost due to illness of injury in Canada excluding Ontario are about 13.6 days per year ([13.6 x 0.68] + [10.2 x 0.38] = 13.1).

In other words, hospital workers in the rest of Canada are absent from work due to illness or disability 1/3 more than Ontario hospital workers. 

In fact, Canad…