Skip to main content

Posts

Showing posts from August, 2012

P3 deals are "millstones" says Health Minister

The growing crisis of public private partnership (P3) hospitals in Britain has now forced the health minister to announce that he will be sending in “hit squads” to make savings at twelve hospitals where the P3 contracts have gone “horribly wrong” the conservative   Daily Telegraph  reports. This is a follow up from the government's February  announcement  that seven health care trusts with P3 (or, as the British call them, "PFI") hospitals would get  £1.5 billion in emergency funding to help them avoid cutting patient services as a result of their P3 deals. The Health Minister Simon Burns told the   Press Association , "there are these seven which are at the top of the scale, which are having a significant drag on their day-to-day running because of the PFI costs. The trusts have got significant problems as a result of these irresponsible PFI schemes that the last Labour government allowed, and we have said, with those, that if they have a regime in place th

When a wage freeze is not a wage freeze

In its dispute with teachers, the Ontario Liberal government sometimes tries to claim that one union's offer of a wage freeze is not in fact a wage freeze. The rationale here is that even though no teacher would get a general wage increase for two years, some junior teachers would progress up the wage grid as they accumulate service. This is an unusual take on wages.  And as noted in an earlier post , it is particularly peculiar point for the Liberals to harp on as they actually have agreed to service based pay increases in their deal with the catholic teachers association. But the Liberal argument is also a rather one-sided interpretation of a wage freeze. Pay based on service doesn't just go up -- it also goes down.  Pay based on service gradually increases as junior workers gain experience, but it also falls sharply when senior workers retire or quit and are replaced by a new worker.  The "gradual increase" and the "sharp fall" in pay is especiall

Long-term care: expansion or contraction?

A 2011  Conference Board of Canada  report done for the for-profit long-term care (LTC) facilities in Ontario estimates (based on population projections and utilization by age) that 238,000 Ontarians will be in need of long-term care by 2035.  This compares with about 98,000 today. So we are looking at a need to increase long-term care 143%.   With a 1.5% annual increase in the number of LTC beds, the Conference Board estimates Ontario would be 127,000 beds short of need, with the gap gradually increasing year by year until 2035.  That's an increase of 103,000 from the current wait list of 24,000. The report notes that government policies could affect utilization. Certainly, this is what the government appears to be hoping to achieve. But even moderating the  huge growth in need would require some big leaps in policy handiwork. A more likely scenario may just be to provide less care to those in need. Compounding the problem,  the Liberal government may not choose to in

Long-term care industry plans reinvention during austerity

Not all beds in "long-term care" facilities provide long-term care. "Convalescent care" beds are a form of "short-stay" beds in long-term care (LTC) facilities.  Convalescent beds receive an extra $70.94 more per day than standard long-term care beds.  That's 45.7% more funding than the $155.18 for a standard bed.   Started in 2005, the LTC "convalescent care" program is now   a “Home First Program” that is designed, in part, to reduce hospital Alternate Level of Care (ALC) days.  “As not all patients are ready to return home immediately from the hospital, convalescent care is proving to be a solution suitable for patients that no longer need hospitalization but are still too frail to go home.”    The LTC convalescent care focus is supposed to be on rehabilitation, daily living activities, restorative care, physiotherapy for strengthening, and “specific client goals that will support their transition back home”.   Patients can stay fo

More legislative attacks from the Liberal/PC twins coming?

It's now apparent that the Pogressive Conservatives will allow the Liberals to batter teachers and school support staff with legislation imposing takeaways. Even if this legislation does  pass, the question is what will the twin parties do to the rest of the public sector? There is, after all, a lot more bargaining coming up. Is more legislation coming from the twins? While I'm no lawyer, sweeping legislation covering all workers in the public sector sounds like it may have more constitutional problems than legislation covering this or that bargaining unit after there has been a genuine attempt by the employer to bargain a collective agreement. But if the Liberal/PCs have to bring in legislation imposing a compensation freeze and concessions unit by unit, that is going to bring an awful lot of political problems for them.

Liberal attack on free collective bargaining unprecedented

In the past, government might legislate workers back to work after a lengthy strike or lock-out. Usually, the parties were directed to settle their dispute through an independent arbitrator. Such intrusions by government into free collective bargaining however have gotten  rapidly worse  in the last year or so. Just over a year ago, the Ontario Liberals brought in legislation permanently banning walk-outs at the TTC.   Then in June, after several weeks on strike, postal workers were legislated back to work by the federal government.  They were told they had to settle their dispute with Canada Post through an employer-biased arbitration process (which they have subsequently fought in the courts, with some success).  The Feds also announced in June that they would legislate Air Canada ticket agents back to work less than a day after they walked off the job.  In October, the government told flight attendants even before they could strike that they would legislate them back to work too

LHIN boss: We are going to take money out of hospitals

"We are going to have to take money out of the hospitals. It's not a small amount. We're talking about millions," Debbie Hammond, CEO of the government's Central East Local Health Integration Network told the Scarborough Mirror . One result is hospitals will specialize, focusing on what they do best, Rouge Hospital CEO John Wright said. "Not all hospitals will do all things. That is coming and that is exactly what the government wants."  Some services will move out of hospitals into the community, and hospitals will work with each other, "sorting out who does what," Wright added.  "There's no way to say, 'I want a full-service hospital in my backyard.' The hospital will go bankrupt and close." Centralizing hospital services across regions will make those services harder to access as families are forced to travel further to access services and visit loved ones.   Those without cars will be especially hard hit. Servi

272 billion reasons to fear privatization

Below is a list of the 11 US health corporations on the Fortune 500 list.  They had a combined revenue of approximately $272 billion in 2011.   They make about $15 billion in profits. These aren't your friendly mom and pop businesses.  This is BIG business. Trying to reform America's largely for-profit health care system is bound to come up against these interests.  With such large revenue streams they have incredible power and resources to divert health care reform to match their own interests.  They have (literally) billions of reasons to do so. Corporate health care has not led to good results.  The privatized American system is far and away the most expensive health care system in  the world.  Despite this, tens of millions of Americans have no health care insurance and tens of millions more have inadequate health care insurance. Already, we are beginning to see a similar trend (on a smaller scale)  in the long term care, health care infrastructure, and home care s