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Showing posts from August, 2010

Conservatives attack LHINs for contracting out. Seriously.

The LHINs have contracted out $33 million of work to consultants. 

Fitting with their recent turn towards criticising everything LHIN, even the provincial Conservatives are complaining.

Money gobbled up by consultants would be better spent helping patients who are facing service cuts from cash-strapped hospitals, Conservative critic Norm Miller told the CBC.  "We see the LHINs as diverting money that should be going to front line health services: to procedures, to doctors, to nurses."

It is a major problem that so much gets privatized or contracted out by the current government (and their minions). A lot of money is wasted.  

But it's kind of hard to believe that Tim Hudak's Conservatives are going to do much better. This is the party that introduced compulsory contracting out in home care (now in its sixth year of suspension following repeated outbreaks of public anger) and privatized P3 hospitals, which practically breed consultants. 

Indeed, the Ontario Auditor…

Another advantage of publicly funded health care in Canada. Medicare works.

An interesting blog piece by Jim Stanford concludes that "the higher... the out of pocket fees associated with medical care, the more individuals will cut back care when they are worried about their employment and economic security."

Stanford is drawing on a new study entitled “The Economic Crisis and Medical Care Usage” which looked at the impact of the recession in five developed countries: the U.S., the UK, Germany, France, and Canada.  "Canada and the U.K. have the lowest user fees among the five countries surveyed; and in those countries, there was virtually no change under the recession in patterns of care utilization."

The U.S., without a universal health care system (and much higher out of pocket fees), fared much worse.  When compared with Canadians, almost five times as many Americans reported reducing their use of routine medical services during the recent recession.

Sudbury hospital funding announcement less than it appears. Northumberland hospital facing new threats.

Local Liberal MPP Rick Bartolucci announced an extra $4.9 million for Sudbury Regional Hospital last week.  (The Liberal MPPs often seem to be able to free up their schedules for these cash announcements.) 

In fact, most of the money ($4 million) is just the 1.5% base hospital funding increase that was announced five months ago in the provincial budget.  (Although there are now reports that some hospitals won't even get that.)   I have yet to hear anyone suggest that 1.5% will cover hospital inflation costs. So this isn't much of an announcement. 

And the rest of the cash? Well there's some to make up for costs associated with last year's H1N1 epidemic ($60,000 -- whoppee) and $500,000 to cover extra operating costs associated with moving into a new facility.  More encouragingly, there was $400,000 for new neurosurgical procedures.

We are now five months into the  province's fiscal year, and we are only now beginning to hear a little bit of information on this ye…

Campaign to save Ontario hospitals steps up in Niagara and Ottawa

A couple of pics from the recent OCHU / CUPE Local 2875 rally to stop bed cuts at the Queensway Carleton Hospital in Ottawa. It was a great day. (And thanks for the pics to Louis and Local 1974 at Kingston General!)  Also -- the People's Healthcare Coalition, has collected more than 5,000 signatures calling for an investigation into what led to the decision to close the emergency rooms at Port Colborne and Fort Erie hospitals in Niagara. "We've had tremendous support so far," Coalition representative Pat Scholfield said, noting she collected several hundred signatures at the Market Square Friday morning. "Our goal is Queen's Park".

The continuing story of bungalow bill - LHIN style. PCs pound Liberals on health care

The Liberals continue to pay a heavy price for their health care sins.  And for the Progressive Conservatives (now leading in the latest poll), the LHINs are the gift that just keeps on giving. 

The Erie St. Clair LHIN boss has now issued an apology for making his, er, 'frank' remarks regarding Progressive Conservative leader Tim Hudak:  “Let’s be very clear — this guy is making this crap up and it’s false. I don’t think the public is stupid enough to believe him.” Notably, the 'apology' does not extend to Hudak, just to the local population.  (But for all the groveling, see the What's New section of the Erie St. Clair LHIN web site.)

Adding to the joy of Progressive Conservatives everywhere, the chair of that very same LHIN claimed  "I don't think it's a lot of money" when asked about the $54,075 in per diem payments that she received last year (a 29% increase over the year before).

The Chair, Mina Grossman-Ianni has donated $2,422 to the Liber…

Wage freeze: Is Dwight Duncan gaming the Ontario deficit?

As reported a few days ago, the Ontario government (quietly and) retroactively, revised the 2009-10 budget deficit downwards another $2 billion when it released the Public Accounts. 

And as reported way back on July 12 (before any public mention of the current consultations with unions on a compensation freeze), Finance Minister Dwight Duncan had predicted that the 2009-10 deficit would decrease.

But he also predicted that the 2010-11 deficit estimate would be revised downwards too.

“If you're starting off with a smaller deficit for the year ended, presumably if you follow the plan we've laid out, then the numbers will improve down the line — assuming no cataclysmic or unanticipated event”.
While the revision for the 2009-10 deficit has now happened, the revision for the 2010-11 deficit has not.  Or at least not yet. 

The deficit is now forecast to be higher this year (when the economy is growing) than it was last year (when the economy was shrinking). 

I'm not an econom…

Rural hospital should be a hub for health care. Barry's Bay clinic shines a light

While the McGuinty government is trying just about everything (short of bricking up the front doors) to stop health care from happening in hospitals, St. Francis Memorial Hospital in Barry's Bay is trying out a very interesting experiment that is expanding the range of local services available through the hospital.

Instead of the usual attempts to close down hospital clinics, the hospital has opened a Community Care Access Centre (CCAC) nursing clinic.  The CCAC used to sponsor a health clinic, but although it was located right next door to the hospital, red tape and bureaucratic obstacles ate up hours of time for patients, doctors and nurses if any referrals were necessary.  The clinic closed in February, unable to sustain itself on low patient volumes.

The pilot project in the hospital was launched on June 28 and is scheduled to wrap up on Sep. 12. Reportedly there will then be talks between the CCAC, the hospital, and the Champlain Local Health Integration Network (LHIN) to det…

A goofy idea goes down. The Liberals (and the LHIN) retreat.

As reported here a week and a half ago, the Erie St. Clair Local Health Integration Network (LHIN --  the guys charged with funding and restructuring Ontario health care) was planning to bring in Disney speakers for an hour or two at an upcoming LHIN conference. 

Well (following a lot of public criticism), it now appears that even the LHIN finds this idea too goofy (or, perhaps, just a little mickey mouse).  So they've pulled the Disney speakers. 

But the Erie St. Clair LHIN CEO, Gary Switzer, is not backing down graciously.  Here's his response to Tory leader,Tim Hudak, who had criticised the plan:  “Let’s be very clear — this guy is making this crap up and it’s false. I don’t think the public is stupid enough to believe him.”

The Windsor Star notes that Switzer countered Hudak, claiming the LHIN was not going to spend $10,900 for Disney speakers to lead the 90 minute chat, but rather only $9,500.

(At this point I might note that I'd be more than willing to talk all day

"Bob Chiarelli get off your butt and help us fight these hospital cuts!"

Yesterday about 200 people joined a rally called by OCHU and CUPE Local 2875 at Queensway Carleton Hospital in Ottawa to protest bed cuts. Queensway Carleton employees were joined by hospital workers from Cornwall, Brockville, and other points in eastern Ontario. Local 1974 at Kingston General chartered a bus. A few workers even came from OCHU Area 4. And it was a very pleasant protest.

Local 2875 President Ian Rayment called on local Liberal MPP Bob Chiarelli to come through and help the Local union stop the cuts.

The chant of the day? I nominate: "Bob Chiarelli get off your butt and help us fight these hospital cuts".  Local 2875 met with him a few months ago, to little avail. But Chiarelli has just been elevated to cabinet -- so he should have more ability to deliver now. We will see.

In the past, most hospital protests were in smaller cities, so this is something new. On September 2, a protest at Providence Healthcare (in Scarborough) brings the protests to Toronto.


Port Colborne considers legal challenge of Ontario hospital emergency room closure.

The City of Port Colborne passed a motion Monday night to seek legal advice on legal actions it might take  regarding the shutdown of the local hospital's emergency room, the Tribunereports.

"We have made the move to seek that legal advice and take the appropriate steps," said Mayor Vance Badawey.  Barbara Butters, a councillor for Ward 4 in Port Colbourne was even franker:  "Do whatever it takes to make sure these charges get laid because there's no way those SOBs should be getting away with this," Butters said as citizens cheered from the public gallery.

 Municipalities are playing are bigger role defending local hospital services. Good on them!

Wage freeze rationale fizzles as Ontario deficit shrinks (retroactively)

Of the provincial deficit and Dwight Duncan, the provincial Finance Minister, the Toronto Starsuggests that the “spectre of looming shortfalls … helps bolster Duncan’s case for a planned wage freeze for more than 1 million public servants, including nurses, teachers and bureaucrats.”

Well, that argument is weakening.

The Public Accounts for the province have now come out for 2009-10 and the deficit is a lot smaller than Finance Minister Dwight Duncan and the Liberal government forecast. In fact, another $2 billion was lopped off the provincial deficit.

The Liberal government also reduced its deficit estimated by $3.4 billion the day before the March provincial budget. That makes the 2009-10 deficit $5.4 billion less than the Liberals had estimated it to be half way through the year.

(When I see discrepancies this size, it does make me wonder if I've put too much faith in Finance Ministry forecasts.)

In any case, the government will not get one-tenth of $5.4 billion through its …

Pressure works: Health Minister finds the cash for beds in Kitchener

Following the political storm over the fumbled restructuring of mental health hospital beds in Kitchener, London and Cambridge (reported here earlier), the Minister of Health and LTC, Deb Matthews, has found some cash for hospital beds in Kitchener. 

But befitting our model of transparency, the Health Minister can't say how much money is promised, according to the London Free Press

Murkier and murkier.  Hospital funding is getting less transparent  -- and more political. 

It's the squeaky wheel that gets the grease. So my advice to local communities is -- squeak on.

Ontario cutbacks and wage freeze -- But even the WSJ has its doubts as Greece goes down for the count

Greece is likely the leading test case for public sector austerity, a policy which is beginning to sweep into other countries, and even our own Ontario, with its bed cuts and public sector wage freeze.

So it's interesting to see that even the not so labour-friendly folk at the Wall Street Journal are beginning to express some misgivings.  Here's the lead from their recent story on Greece's growing economic woes:

Greece's deepening recession is driving joblessness steadily higher, feeding discontent with the government's austerity program and dragging on the broader economy.   Greece's gross domestic product contracted by 3.5% in the second quarter from a year earlier, hitting retailers hard and sending unemployment rates to above 12% of the work force, according to data released last week.  Forecasts vary on how bad unemployment could get. The International Monetary Fund predicts the jobless rate will reach 14.8% by 2012. But some labor experts fear that before…

Ontario municipalities press government on bed shortages as Liberal MPP takes the heat

The Cornwall Standard Freeholderreports that the Association of Municipalities of Ontario (AMO) has established at its annual conference a committee with representatives of municipalities from all over Ontario to deal with the shortage of beds for long-term health care patients and lobby the provincial government for help.  (This sounds connected to some work by municipalities at the AMO conference reported earlier.)

Cornwall mayor Bob Kilger said the AMO is putting a document together to incorporate feedback from municipalities all across the province with similar problems. Then the committee will meet with stakeholders, such as hospital officials and government representatives. Councillor Sid Gardiner added the committee should make  progress as it puts pressure on the provincial government with the weight of 90% of Ontario municipalities.

Meanwhile the cuts continue.  After the closure of the adult diabetes clinic at the Northumberland Hills Hospital (NHH) earlier this year, now w…

Wage freeze consultations dawdle as Liberals fall to second place

The first two weeks of the Liberal government's consultations with unions on a 'compensation freeze' are up. 

University faculty unions were one of the groups involved in the first two weeks of consultations. So here's the resolution on those consultations from the university faculty unions, passed on to the government Wednesday evening:

The Ontario faculty associations and other groups representing academic staff have received reports from their delegation about the issues discussed the week of August 9, 2010 with COU (Council of Ontario Universities) and government officials. We are confident that these issues can better be addressed at the local level by free collective bargaining. This would acknowledge the diversity of Ontario’s universities and their respective financial situations. We also do not accept the government’s premise that compensation is the cause of the current financial situation, nor its determination, made even before commencing its consultation p…

Wage freeze anyone? Ontario cost of living rises 2.9% -- Thanks Dalton McGuinty!

Buried in today's Statistics Canada report on inflation in July is the fact that inflation in Ontario has increased from 1.6% to 2.9%.   The new "Harmonized Sales Tax" (HST) came into effect on July 1 in Ontario.  As the HST transfers costs to consumers,  the increase in the cost of living in Ontario is now the highest in the land. 

This means you have to earn 2.9% more dollars to maintain your standard of living as of a year ago.  And if your wages were frozen (as the government would like), your standard of living would go down by an equivalent amount.

 For those of you lucky enough to live in Toronto or Ottawa, the increase is 3.1% and 3.0% respectively. (The Statistics Canada report is here and a quick Canada-wide summary from the Globe and Mail is here ).

It's worth remembering that the same McGuinty government that brought you the HST also wants to freeze your wages.

OPSEU members strike during wage freeze consultations. They deserve our support

In the midst of the first two weeks of consultations over the Ontario government's proposed compensation freeze, members of the Ontario Public Service Employees Union have begun a strike for a first contract at Northern Ontario School of Medicine (NOSM). 

After voting 97% in favour of strike action, picket lines went up at the school’s two main campuses in  at Laurentian University in Sudbury and at Lakehead University in Thunder Bay.  About 150 clerical, administrative and technical staff are involved.  Outstanding issues include hours of work, overtime, sick leave, family leave, and wages.

The Ontario Confederation of University Faculty Associations (OCUFA), which has not reported any progress at its discussions with government on the compensation freeze, wrote to the School in solidarity with the strikers.  OCUFA  noted:

Employee compensation is not the cause of the current challenges, and we do not accept that restraint on the part of your support staff will solve them. We wil…

For some things, there's lots of bucks. Ontario MOHLTC 'provincial programs' gets 37% increase

The provincial government Estimates (a document where the government lays out in some detail how it intends to spend the money in the provincial Budget) indicates that health care 'provincial programs' are going up $943,146,400 this year compared to last year.  (Line item 1412.)  Just shy of a billion dollars.

Now that's a whopper of an increase: a 37.5% increase in fact!

While the provincial government is giving its own 'provincial programs' a massive increase, the LHINs (the main funder of hospitals, home care, and long term care) will be getting a miserly 1.5% increase.

In fact the total increase for the LHINs, $322 million, is about a third of the $943 million increase for the (much smaller) 'provincial programs' budget.

A cynic might suspect the government is giving itself a free hand to make funding announcements, while the LHINs are stuck with the job of telling hospitals, homes, and home care providers that 'There's no money, there's no…

Municipal leaders take concerns about local hospital cutbacks to Deb Matthews

The Association of Municipalities of Ontario is meeting and at least two municipalities are taking this opportunity to raise concerns about hospital cutbacks with the Minister of Health and Long Term Care, Deb Matthews.

Lambton County Warden Jim Burns has indicated that a delegation was to meet with Minister of Health Deb Matthews Monday to discuss recent cuts to the Petrolia emergency room, now closed from 8 p.m. to 8 a.m. "It's also a really good opportunity to meet with provincial ministries.  This issue is vitally important to all of Lambton country," Burns said. "It touches almost every municipality. I know the minister is aware of what's going on, but I think it's very, very important to have that face-to-face chat with her."

A City of Cornwall delegation led by Mayor Bob Kilger will be pushing for a solution to the Cornwall Community Hospital's bed shortage when they meet with health minister Deb Matthews, the Cornwall Standard Freeholderrep…

LHIN failures make cutbacks more difficult -- but beware the future, Ontario

Health care slashers and right-wingers are beginning to understand the pickle they are in over the falling faith in the the LHINs, the Liberal government's instrument of choice to cut health care services.  Here's the conclusion of today's Ottawa Citizeneditorial:

With an aging population and rising health-care budgets,it is difficult to imagine a year in which every health network in the province doesn't face some very tough decisions involving a region's crucial health-care services. Without public trust, those decisions will be much harder, if not impossible. Which is why Marin's (the Ombudsman) findings are crucial.

Indeed, LHIN imposed cuts will be harder now that the LHINs have been discredited.  (What a pity!)  But this won't stop those cuts.

And here's another troubling thought.  If the LHINs are becoming blunt instruments,  another instrument may be introduced to make the cuts down the road. 

In other provinces the trend has been for governments …

"We told ya so!"

A darn good letter on the McGuinty government's  introduction of the LHINs from local CUPE hospital activist, Paul MacDonald. It was published yesterday in the Toronto Star

Paul -- yes -- public sector union and community activists did do a pretty fair job campaigning on the problems associated with the LHIN model, and did so pretty much right from the get go.  And YES, it is nice to see that at least some of those problems are becoming more apparent to a broader section of the population now.

So a thanks to all the local union and community activists who got the ball rolling! -- Doug

LHIN system should be scrapped; Secret health unit meetings 'illegal,' Aug. 11

Toronto Star, Sat Aug 14 2010 Page: IN7 Section: Letter

Re. Secret health unit meetings

'illegal,' Aug. 11

Not only should these secret LHIN board meetings be deemed illegal, the entire system of LHINs should also be deemed illegal.

When an unelected, unaccountable board of overpaid bureaucrats, acco…

The LHINs in Disneyland. I just wish that what is happening to Ontario hospitals was only in fantasy land.

The Windsor Star (not usually my favourite editorialists) has an interesting editorial today on the LHINs (and the Ombudsman report):

Obviously there are many issues the government needs to deal with. And how is it that Matthews is only now getting around to establishing standards for community engagement between LHINs and the public? Conservative Leader Tim Hudak calls these networks "unaccountable, unelected, secretive and entitled health-care bureaucracies." NDP Leader Andrea Horwath called the report a "damning indictment of a system that is unaccountable and completely unresponsive to the community whose interests it should represent." Both are right. Horwath makes sense when she calls for a full review. Marin calls the LHINs in general "defensive and recalcitrant," with an attitude that says "We did nothing wrong and we won't change." For that reason alone, the health minister must step in now.
If you need more evidence of the 'We …

Wage Freeze (not). OPSEU announces more action

OPSEU (the Ontario Public Service Employees Union) is planning an August 19th protest near Ottawa: Tell Premier Dalton McGuinty: Wage cuts, corporate tax cuts and under-funding public services hurts Ontario!     The protest will take place at a Liberal fundraiser at (where else) a golf club . The protest starts at 6 am.  Donations will be accepted for the Champions for Children Foundation of the Children’s Aid Society of Ottawa.

OPSEU has also announced that their very recent Youth Employment Services settlement includes a signing bonus of $250 for every employee, a 2% raise in the second year of the agreement and improvements in health and welfare, including $300 for eye care. Sounds like some good work.

For more on the OPSEU protest see here.

Deb Matthews determined (to do some damage to small Ontario hospitals)

Deb Matthews is staunchly defending the decision to close the emergency rooms in Fort Erie and Port Colborne despite the sharp critique of the LHINs (illegal) consultation process by Andre Marin, the Ontario Ombudsman. 

Matthews told Niagara area papers "We're not revisiting that decision. The decision remains the right decision...we're absolutely not going to be reopening that decision."  Obligingly, the LHIN chairwoman Juanita Gledhill said her board doesn't plan to revisit its earlier decisions either.  Big surprise.

This does not bode well for other smaller hospitals.  Even in the face of months of community outrage, calls from the opposition parties, and an Ombudsman's report suggesting a phony consultation process, Matthews will not even consider a review of the decision to close the small hospital ERs.

Now there's a government official determined to do some damage.

So it is interesting to hear that  Port Colborne Mayor Vance Badawey says "I w…

Ontario home care "wait list" turns into the home care "forget list".

As often noted in this space, the Ontario Liberal government claims they are expanding community care to make up for all the cuts to hospital care.

Well now it looks like even the Toronto Star can't quite swallow that one. Today, Star luminary Bob Hepburn follows up his recent column on cuts to home care with another one (Chilling tales of home-care crisis call for action) and its worth a read.  Here's an excerpt:

D’Andrea is one of tens of thousands of Ontario residents affected in the past year by the quiet move by government agencies that connect patients with community health services to slash funding for all except what they deem to be the worst cases. Such critical services include those provided by speech-language pathologists, physiotherapists, occupational therapists, dieticians, nurses and others.  The result is that patients are now getting just a fraction of the help they really require or are forced to go on lengthy wait lists. At the same time, highly skilled hea…

LHIN catches the flak -- but the Ontario government pulls the strings. I am almost feeling sorry the the LHINs.

Boy, I almost feel sorry for the Local Health Integration Networks (LHINs).  They are taking a terrible pasting following the Ombudsman's report that exposes their community 'consultations' as a complete scam.  Apparently, one LHIN leader thought conferring with pals at his private golf course (open to anyone who can afford $8000 in green fees) was an acceptable form of consultation.

While anyone who has been involved in health care knows the the LHINs do not really consult their communities, I feel pretty confident that the Tories and the right-wingers (who are kicking the LHINs now that they are down) actually prefer "a process that makes no pretence of consultation than a dishonest sham.  Better the honest dictatorship than the faux democracy."  (As, in fact, Christie Blatchford suggested yesterday in the Mop and Pail.)

Despite the Ombudsman report, Deb Matthews and the Liberal government refuse to review the closures of hospital emergency rooms and services o…

New antibiotic resistant superbug coming to Canada. The good news? Normal hospital infection control can help stop the spread.

A study published today in the famous academic journal The Lancet Infectious Diseases flags the emergence of a new antibiotic resistant superbug and concludes:  "The potential of NDM-1 to be a worldwide public health problem is great, and co-ordinated international surveillance is needed."

The bottom line: a new gene confers high levels of resistance of gut bacteria to almost all antibiotics, leading to potentially life-threatening pneumonia and urinary tract infections. 

While NDM-1 is believed to have started in India, it is now present in Britain and similar infections have been found in Canada.  The BBC comments:

NDM-1 can exist inside different bacteria, like E.coli, and it makes them resistant to one of the most powerful groups of antibiotics - carbapenems.  These are generally reserved for use in emergencies and to combat hard-to-treat infections caused by other multi-resistant bacteria.  And experts fear NDM-1 could now jump to other strains of bacteria that are alre…

CCACs discover that coordination is the better way. But Ontario Liberal government policy of compulsory contracting out undermines coordination

The Toronto Star today makes a major big deal about changes in Ontario's home care system that are being developed by the Central West Community Care Access Centre (CCAC).

Apparently, the CCAC is trying to improve coordination by making sure that "everybody in the circle of care is in the communications loop and knows what they are doing so that you look at the person as a whole being," according to Margaret Mottershead, CEO of the Ontario Association of Community Care Access Centres.

In the past such care has been uncoordinated because it has involved multiple community health-care agencies and multiple health professionals, says Dr Brian Golden who is working with the Central West CCAC on this reform.

One agency sends a nurse to a patient’s home, another dispatches a personal support worker and another an occupational therapist. ...To this end, a single agency will be responsible for all aspects of a patient's care - not only healing the wound, but addressing the c…

Small hospital problems just keep rolling in -- now Kenora complains about Ontario MOHLTC wait times funding

As it turns out, the new (and much ballyhooed) emergency room wait time fundingwill not go to any ER with less than 30,000 ER visits per year.   This is just the latest in a series of Liberal government hospital policies that discriminate against smaller towns and cities (remember, for example, the ER closures in Niagara?).

Lake of the Woods Hospital, a reasonably large hospital in Kenora, falls 4,000 short of the 30,000 visit minimum.

But its June wait time figures are 9.1 hours for high acuity and 5.2 hours compared to provincial expectations of eight and four hours, respectively.

Local hospital president Mark Balcaen showed some guts, took this on, and defended his community:

"The public sees ER wait times the same whether they are in a small, rural, isolated community or are in a large metropolitan area....A long ER wait is still a long ER wait no matter the size of the community or hospital. The people of Kenora complain just as much as the people of any other large city when…

On cutbacks: Is it fair to compare Dalton McGuinty with Mike Harris?

Remember Peterborough Regional Health Centre?  They were effectively ordered by the provincial government to cut costs.  The result -- 283 hospital jobs (182.3 full time equivalent positions) are being cut, right this minute.

Health Minister Deb Matthews has claimed that hospital cuts aren't so bad because there is so much more community care.

But the Community Care Access Centre (CCAC) that oversees home care services in Peterborough is in a similar predicament as the hospital.  The CCAC is now reported to have fallen $14 million into deficit over the last two years -- and so it too is cutting costs, right this minute.

(Of course, they say they are cutting costs without cutting home care programs and services.  Just like the McGuinty government says it is doing in hospitals.  With probably the same degree of accuracy.)

The Mike Harris government professed that hospital cuts would be made up by more care in the community.  I don't think it is any more true now than it was then…

Home care cutbacks AND hospital cutbacks in Ontario. The rationale for hospital cuts just keeps getting slimmer

The official theory from Deb Matthews, the Ontario Minister of Health and LTC, is that hospital services can be cut because so much more community care is being offered (for more on this see here and here.)  So it was interesting to see a Toronto Starcolumn today reporting that home care services have been cut:

So Community Care Access Centres (CCACs), the government agencies charged with coordinating health services in the province, have been forced to refer only the most needy cases for help. That means other outpatients who need services such as occupational therapy or speech-language therapy must go without or pay by themselves for private service. Evidence of the cuts is clear:
• Home visits by occupational therapists dropped 24 per cent in the 2008-09 fiscal year over the same period a year earlier.
• Visits by physiotherapists were down 9 per cent.
• Visits by dieticians were off 2 per cent.
• Visits by speech-language pathologists plunged a whopping 40 per cent, from 461,484 in t…

Price based funding erodes community control of Ontario hospital services. The penny drops in Cornwall.

Complaints are already emerging about government control of the new Emergency Room wait times funding.  Here's the conclusion of today's Cornwall Standard Freeholder editorial:

The ministry, at least in Cornwall's case, is putting the cart before the horse with the $800,000 incentive. The money should be used to open up more long-term care beds. This would move more people out of acute care beds and go a long way in reducing unacceptable wait times. (The full editorial ishere.)
This isn't just in Cornwall's case.  Queen's Park in Toronto has all the control and so local hospitals (and local communities) cannot fashion local solutions that actually meet local needs.

Superbug outbreak lingers: Hospital official concerned about overcrowding. So why doesn't Ontario MOHLTC care?

With a C. Difficile outbreak dragging on since March at the Nanaimo Regional General Hospital in BC, some concern is now beinng expressed about hospital overcrowding:

Infection control experts say they may need to cancel some non-emergency surgical procedures in order to get control of the ongoing outbreak of Clostridium difficile at Nanaimo Regional General Hospital, though that option would be a last resort.....Overcrowding at the hospital continues to hamper housekeepers efforts to keep up with cleaning and it has put an additional strain on nursing staff, who have to follow meticulous protocol visiting patients....
NRGH continues to operate over capacity "almost all the time," Wale  (the hospital's Executive Medical Director of Quality) explained. ....Overcapacity creates too many opportunities for the spread of infection. "We'll need to review whether we'll need to start turning down the routine operations to keep this under control," Wale said. &qu…