Hospital closures on the Drummond agenda?

The Toronto Star reports that the Drummond Commission is looking at the Saskatchewan hospital closures of the 1990s as a model of reform, with the support of the Minister of Finance, funding hawk Dwight Duncan.

Next month, the treasurer will get some political cover from a commission engineering a massive overhaul of Ontario government services, headed by influential economist Don Drummond. Health care is at the top of the hit list.
After working on two recent studies of health-care inefficiencies, Drummond's reform agenda is no secret: reintegrating the system; and reallocating more money to health promotion, community care, home care and long-term care....
They are also looking at a far more painful and protracted restraint exercise, one that gets relatively little attention: In the early 1990s, Saskatchewan's new NDP government faced a financial reckoning when credit rating agencies started downgrading the province's debt. Then-premier Roy Romanow resolved to close 52 hospitals and reopen them as well-being centres offering community-based care. He ignited a firestorm.
Drummond has looked closely at the Saskatchewan experiment because it comes closest to a sustained transformation of government finances.
It's a lesson Duncan has also heeded. The treasurer has taken to telling his fellow Liberals in caucus and cabinet that the prairie New Democrats pioneered an ambitious reform model - and provide an example of how good government can be rewarded by voters in the next election.

Why they might think the two models are comparable is unclear. The 52 small hospitals closed in Saskatchewan in the 1990s are nothing like the hospitals in Ontario. In total, Ontario has 155 hospital corporations operating 211 hospital sites for a population of 13 million. As many cities have multiple hospital sites, we probably have hospitals in about 190 towns and cities.

If Saskatchewan had the same number of hospitals per capita, it would only have 12 or 13 hospital corporations with about 16 hospital sites in 15 towns.

But the story in Saskatchewan is completely different. Even now (may years after the 52 closures) there are hospitals in 40 towns spread around the province.

If Ontario had the same number per capita, we would have hospitals in 520 towns. We would need to open up hospitals in another 330 towns to get to Saskatchewan's level of service.

Moreover, Drummond and Duncan have the tricky business of explaining why they want to follow a hospital model that costs about 20% more per capita than Ontario's system does.

Comments

Ford government fails to respond to 72% increase in COVID inpatient days, deepening the capacity crisis

COVID infections continue to drive up hospital costs and inpatient hospitalizations in Ontario. For the most recent fiscal year (April 1, 2022- March 31, 2023) hospital stays related to COVID cost $1.221 billion, according to new CIHI data. This is about 4% of total hospital spending, creating a very significant new cost pressure beyond the usual pressures of population growth, aging, inflation, and rising utilization. Costs for COVID related hospitalizations increased 22.2% in Ontario in 2022/23 from the previous fiscal year, rising from $999 million to $1.221 billion. That rise is particularly notable as the OMICRON spike of late 2021 and early 2022 had passed by the the 2022/23 fiscal year. The $222 million increase in COVID hospitalization costs came in the same year as the Ford government cut special COVID funding and, in fact, cut total hospital funding by $156 million. In total, there were 60,653 COVID hospitalizations...

The hospital crisis: No capacity, no plan, no end

While Canada has achieved universal public healthcare coverage, that does not mean conservative forces have given up trying to erode that coverage and expand corporate care where it does not currently exist. The battle has become particularly intense in Ontario under the Ford Progressive Conservative government, which is implementing serious cuts to the level of care and moving to bring in for-profit mini-hospitals. Inadequate Staﬃng. Less and less of hospital spending is on staff. Employee compensation as a share of hospital expenditures has consistently shrunk in Ontario. This is not some immutable law of hospital development. It is in stark contrast with the rest of Canada, where compensation has become a larger share and now accounts for 67.1%. Hospitals in provinces other than Ontario now have 18 percent more staﬀ per capita than hospitals in Ontario. Overall, if Ontario had the same staﬃng capacity as the other provinces and territories, there would be another...

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...

Defend Public Healthcare

Search This Blog