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Showing posts from September, 2010

Georgian Bay General Hospital losing services and restructuring

Georgian Bay General Hospital (with facilities in the small towns of Midland and Penetang) is losing services.

Recently, Hospital CEO Paul Heinrich told local media what people can expect as the hospital moves forward with its 20-year master plan announced two weeks ago.

"We knew we had to make changes because of the costs involved and the impact on our budget," said Heinrich.

"We will be continuing to change the service mix at GBGH in response to more regionally-based health system design and changes to technology and patient needs."

"For example, in the future, we will likely cease to provide inpatient paediatrics because we do not have the critical mass, expertise and volume that other centres do."

"The divestment of the diabetes education program to the Family Health Team was a very successful project," he added.

"The outpatient lab service is still to be operated by the hospital...We investigated the possibility of divesting it, bu…

Congresswoman requests investigation into contracted-out food services after Sodexho settles with New York state

Sodexho  reached  a $20 million settlement with the Attorney General of the state of New York in July for overcharging 21 school districts and the state university for food services.  "This company cut sweetheart deals with suppliers and then denied taxpayer-supported schools the benefits," Attorney General Cuomo said in a statement.


Now, Congresswoman Rosa DeLaura has asked the United States Department of Agriculture (USDA) to begin an investigation by the Officer of the Inspector General and to alert state education and agriculture agencies to the $20 million settlement.  Congresswoman DeLaura states:


Attorney General Cuomo's investigation revealed that it is common practice within the food service industry for providers like Sodexo to leverage their size and market dominance to obtain rebates from vendors that supply food products, equipment and supplies without passing those savings onto local school districts - despite federal and state laws and local contract languag…

Improving hospital ER Services in rural and northern areas?

Under the title of "Improving ER Services In Rural And Northern Ontario," the provincial government has asked "a group of leading health care experts to examine and develop recommendations for improving emergency services in small and rural communities."

The new "Emergency Room Task Force" will develop recommendations for emergency rooms in rural and northern areas to adapt to staffing challenges. The government notes:  "minor staffing challenges -- a doctor's unforeseen family emergency or a nurse's unexpected illness, for example -- can impact a hospital's emergency services."

The Task Force is certainly high powered: six of the fourteen panel members are either Ministry or LHIN leaders, including two Assistant Deputy Ministers.  The Task Force is supposed to submit a final report to the government in the spring.

The government claims that "there have been no unplanned ER closures in Ontario since 2003." What it doesn'…

Nursing home residents win major award after for-profit chain fails to meet staffing standard

A U.S. jury slammed the owners of a  major U.S. nursing home with a $677 million verdict this past summer, sending shock waves through the industry.

A class action lawsuit on behalf of 32,000 nursing home residents blamed staff shortages for the misery encountered by the residents — echoing a common complaint across the country that for-profit nursing homes are too concerned with profits rather than residents.

Critics charge that many companies drastically cut payroll expenses to prop up stock prices after Wall Street investment firms went on a nursing home buying spree.

"The major problem for most nursing homes in California and in the nation is staffing," said Pat McGinnis, executive director and founder of the California Advocates for Nursing Home Reform.

On July 6, the Humboldt County jury found that Skilled Healthcare on numerous occasions violated state regulations requiring it to keep a minimum number of nurses on duty at its 22 homes in the state.

The lawsuit accused…

Contracting-out hospital transcription services. Shared service corporations expand scope

Hospital 'shared service corporations' are popping up all across Ontario to take over support services for Ontario hospitals.  Most of these are not-for-profit corporations owned by the area hospitals.  Sometimes the shared service corporation delivers the hospital support service, other times it contracts the service out for the hospital to a 3rd party. 

The main focus to date for the hospital shared service corporations  has been on the supply chain and back office services. The process has gotten a lot of cash support from the Ontario Ministry of Finance and the government has bragged about it as one of the main ways it is (allegedly) making  the public sector more efficient.  It's part of the centralization of hospital services.

The shared services corporations are now slowly increasing their reach into other areas of hospital work.

The latest development is that COPHA (a fairly new shared services corporation for hospitals in central Ontario) has overseen the contrac…

On shutting hospital ERs: increased waits, increased congestion

As part of ongoing provincial cutbacks, the Niagara Health System hospital closed the Emergency Departments (EDs) in two of its smaller sites last year, converting them into Urgent Care Centres (UCCs). 

The hospital now recognizes that it "has been experiencing serious issues with off load delays" at its three remaining EDs despite a policy for ambulances to bring at least some patients to the converted UCCs (and the maintenance of similar patient volumes at the UCCs).  Nevertheless, sicker patients are now being brought to the EDs. The hospital notes:

At the same time while our volumes in the Emergency Departments in Welland and Niagara Falls have remained relatively stable the acuity level of the patients presenting are higher. As the acuity increases the resources required to manage these patients expands, resulting in more diagnostic testing and physician assessments. This causes an increase in the “time in the ED” hence increases congestion, crowding and potential of OL…

Are more convalescent hospital beds on the way? Windsor's proposal.

Hotel-Dieu Grace Hospital in Windsor is proposing a special unit to handle the Alternate Level of Care (ALC) patients. (These are patients no longer receiving acute or complex continuing care.)

The hospital is applying to the Erie St. Clair Local Health Integration Network for an ALC unit as a short-term fix to its overcrowding problem. The unit would provide dedicated beds for ALC patients.

Pat Somers, senior vice-president of patient services and chief nursing executive says the backlog of ALC patients creates "significant pressure for our system." and the "gridlock" hasn't cleared with flu season on the horizon.  "Our concern is that we will not be able to respond in the nimble manner that we would like."

As elsewhere, this is leading to backlogs in the hospital, starting with long waits in the Emergency Room.

Like most Ontario hospitals, bed occupancy is dangerously high at the Grace -- 98%.  The hospital's plans call for 90 per cent of its…

BC for-profit clinics charging extra. 'Patient based funding' runs amok?

The BC Health Coalition has released a report showing that for-profit clinics are charging patients extra to jump the queue for services covered by public health care:  "Research conducted over three months (June – August, 2010) by BCHC staff has revealed that for-profit clinics across the province continue to openly charge patients additional fees to jump the queue for services that are publicly insured." The BC Health Coalition’s report can be found here.

Also this week, the BC government announced extra funding for 'patient focused funding' (aka price based funding), a funding model that has some similarities to 'fee for service' funding used in the US.BC is  reported to be increasing this form of funding to 20% of hospital funding by 2012-13. 

The NDP has called on the government to audit private clinics as they could be getting a share of 'patient-focused funding' for surgeries and MRIs.

BC Health Services Minister Kevin Falcon has acknowledged th…

For-profit retirement homes not a solution to hospital overcrowding

As noted in a blog earlier this week (on a recommendation to start funding retirement homes), some hospitals started to transfer their hospital patients to retirement homes a couple of years ago as a response to hospital overcrowding.

The Queensway Carleton Hospital in Ottawa was an early adopter of this trick, shipping patients out of the hospital and into a for-profit retirement home. Here’s what happened, with dire consequences for one senior.

Between May 2008 and December 2009, when the trial run ended, Queensway Carleton patients were discharged to a retirement home in the city's southwest. Over 19 months, some $2 million in public funding went to the retirement home to pay for 30 beds and the associated staff to provide care. The money came from the Queensway Carleton and the Champlain Local Health Integration Network (LHIN), Eastern Ontario's health authority.

A 92-year-old Ottawa woman was transferred from the Queensway Carleton Hospital to the privately run retirement…

Ontario Health Coalition - Health Action Assembly and Conference -- November 6, 7

The Ontario Health Coalition is hosting a Health Action Assembly and Conference on the sustainability of health care. The Assembly and conference take place Saturday November 6th and Sunday November 7th, 2010 at the Bond Place Hotel, 55 Dundas St. E., Toronto.

The OHC, as community-labour coalition, plays a vital role defending public health care (and public hospitals).  The Assembly and conference will be a great way for local union activists to learn more about the challenges to public hospital services and the community campaigns that are so necessary to defend them. 

Please click here to learn more and to register for the assembly and conference.

dallan@cupe.ca

Hospital progress in Ottawa and Sault Ste. Marie. But not so much in Niagara

Sault Ste. Marie has won its battle to maintain funding for seven mental health beds the Sault Area Hospital was scheduled to lose when it moved to its new facility this spring. 

The move is expected to save three or four jobs at the Sault Area Hospital and keep service at current levels.

Other modest victories were achieved in Ottawa. The Ministry of Health and LTC has agreed to fund four beds for babies who need extra care at birth at both the Montfort Hospital and Queensway Carleton Hospital. The annual cost of the initiative totals $2.6 million.

(Perhaps I'm just a cynic, but we are getting closer to an election, aren't we?)

Less helpful was an editorial in the St. Catharine's Standard.  The piece notes that the Regional Municipality of Niagara will likely consider the Ontario Health Coalition's proposal that the province investigate the Niagara Health System (the NHS -- which has made a hash of things by cutting Emergency Rooms among other things). 

The editoria…

Hospitals as a health care hub VERSUS Paring down to core services

Cornwall Community Hospital has come out with a new, draft five year plan.  The plan calls for a focus on "core services".  It states:

CCH has identified the need to move to a more coordinated and strategic approach to determining the breadth and scope of clinical services based on community need, available resources, capacity and talent.  CCH can not provide all services to all people and recognizes the need to employ evidence based best practices in its core service areas.
This certainly fits with the McGuinty government's focus on shrinking the role of public hospitals. 

The plan also, however, raises the idea of the hospital focusing on health and health care "versus being just a hospital". 

This is perhaps the main tension for smaller hospitals: see their services paired back to a smaller and smaller list of 'core services' or become a hub for a range of health care services in their local community.

The former tendency is certainly gaining more s…

Fund retirement homes and drive up health care privatization

The push to privatize hospital services (and increase the privatization of long term care) took another step in the Ottawa area this week. This time through a proposal for the government to fund retirement homes, facilities which are overwhelming private and  for-profit. 

To date, retirement homes have not been funded by government (although recently hospitals have taken to sending patients to them, sometimes with disastrous results).

This proposal comes as the provincial government cuts hospital beds, cuts home care services, and slows to a trickle the creation of new long term care beds.

dallan@cupe.ca

Solving ambulance delays

With hospital cuts, there has been some problems with ambulance offload delay, as paramedics wait longer to offload their patients to overloaded hospital staff.  As noted earlier, Niagara region reports a 68% increase in offload delays

This in turn puts pressure on EMS response times as paramedics are forced to wait in ERs.

Some municipal leaders have mused about sending more fire trucks to EMS calls, as a way to respond to this problem.   

But fire trucks are among the most expensive items for municipalities. The 2007 Performance Benchmarking Report (from the Ontario municipal Chief Administrative Officers and City Managers) reports that  each fire vehicle cost $281 per in-service hour in Hamilton, $284 in Toronto, $239 in London, $270 in Thunder Bay, and $207 in Ottawa. The median cost for urban municipalities was $239 per hour, the same as the Toronto rate.

In contrast, one hour of in-service ambulance time cost $147 in 2007. With a $92 differential that means a savings of $184,0…

On diverting patients from hospitals. Is that deja vu I'm feeling?

With the elimination of hospital emergency rooms (ERs) and the reduction in hospital beds, ambulance "offload delays" (where overflowing hospitals and ERs make it impossible for paramedics to transfer their patients to hospital staff) are once again growing.

This is reminiscent of the ER problems about a decade ago after the cuts to hospital services occasioned by the Harris government.  At that time,  ambulances were turned away from backlogged hospitals, infamously resulting in the death of a young asthma sufferer, Joshua Fluelling.

Fluelling, 18, was having a severe asthma attack in January 2000 when his ambulance was redirected from the closest hospital, Scarborough Grace Hospital, and sent to Markham-Stouffville Hospital, more than twice the distance away. Scarborough Grace was on critical care bypass and not accepting new patients the night of Fluelling's attack. On route to Markham, the teenager suffered respiratory failure and brain damage. He died later in hospi…

Providence Healthcare: hospital bed cut protests come to Toronto

CUPE Local 1590 and the Scarborough Health Coalition sponsored a great public meeting Thursday on bed and service cuts at Providence Healthcare hospital. 

Local 1590 president Kevin Tyrell spoke to the crowd about the plan to shut down Providence hospital beds over the next four years, taking beds out through a program called "Transformation by Design".   The idea here is that in turn each hospital ward is closed down and renovated.  But when each ward is reopened, it has fewer beds!

The hospital has already cut $2 million and is still $2.1 million in deficit.  Kevin and others at the public meeting spoke of the great job the hospital has done in the past and fears that good quality care will become a thing of the past as beds are chopped. 

As usual, this is being done with little or no public consultation by the government or the LHIN. 

Also as usual, the claim is that better home care will replace hospital rehabilitation services. But with home care cutbacks coming,  it…

CUPE National Health Care Sector Meeting -- Victoria, B.C. -- October 20-22

CUPE's National Health Care Sector meeting October 20-22 in Victoria British Columbia still has some spots open. 

This meeting is a great chance for member activists, elected leaders, and staff from every region in the country to gather together to learn from each other, pick up new information and strategies, and build our strength as a union and as champions of public, not for-profit health care.


Keynote speakers, panels, plenary sessions, workshops and a fabulous reception are all in the works to make our time together interesting, fruitful and fun. You can register on-line here to confirm your space.

Childcare on-site is available during meeting hours and off-site child care subsidy is offered. Application forms can be found in the on-line registration kit.


Information regarding travel and accommodation (including links to book accommodation online) can also be found in the on-line registration kit

I'm planning to attend -- I think it will prove to be a very interesting …

Hospital cuts force paramedics to cool their heels in ERs

A new report from Niagara EMS suggests that hospital cutbacks, including the closure of two hospital Emergency Rooms in Fort Erie and Port Colbourne, has resulted in longer "offload delays" for paramedics, as they wait to transfer their patients to hospital staff at the remaining three ERs in the area.

In fact, the offload delays are projected to increase 68% in 2010, reaching 10,000 unit hours for paramedics.

Since the restructuring of hospital ERs last year and the resulting increase in patient arrivals by ambulance to the three remaining ERs, "off-load delays have increased significantly and have now surpassed the previous peak of 7,075 unit hours set in 2008."

Niagara Falls Liberal MPP Kim Craitor said he had heard ambulance off-load delays are increasing and he's concerned about the situation. "I don't disagree with anything they say in that report."  Without sufficient beds to move patients into, the problem will not be resolved, he added.  …

Premier Dalton McGuinty: Step over the Health Minister and fix the home care mess

Ouch! Health Minister Deb Matthews won't like this.

A leading Toronto Star columnist, Bob Hepburn, urges Premier McGuinty today to step in and order Health Minister Deb Matthews to fix the mess in home care.

...the McGuinty government is pressuring hospitals to reduce costs. To do that, hospital administrators are slashing the number of beds and pushing patients out the door faster than ever, turning them over to community health authorities. However, cash-strapped Community Care Access Centres, which arrange for support from local health-care professionals, have simultaneously cut funds for all but the most severe cases.
These cuts - more than 50 per cent in some areas - have been made suddenly and without consultation.  The dramatic reductions started to show up last fall and have continued to this day. Hardly a day goes by without more layoffs and more reduced workloads for health-care professionals. The result is that patients who need critical services provided by occupationa…

Overcrowding, cancelled surgeries and fire code violations at Sault Area Hospital

The Sault Area Hospital board of directors got a frank report on Tuesday of hospital hallways crowded with patients, fire code violations and cancelled surgeries, the Sault Starreports.  "It's a very difficult situation for our staff, but really for our patients, because they don't have the privacy they deserve in the hallways," according to Marie Paluzzi, the hospital's interim vice-president and chief operating officer.

The facility has 31 over flow beds in rooms and 10  in hallways and sunrooms.  All of them are filled with patients.

Paluzzi says the fire inspector indicates SAH is in violation of fire code regulations. "He really does not appreciate having beds in hallways."

Some elective surgeries have had to be cancelled because of a lack of in-patient beds.

Health Minister Deb Matthews has left hospital CEO Ron Gagnon with the message, "Don't look for more long-term care beds as the solution. My impression from her was that that was th…

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 ra…

Liberals poised to bring market disaster back to Ontario home care. Will this model be exported to hospitals?

Competitive bidding is coming back. Or so it seems. 

As of yesterday, the Ontario Association of CCACs had on their web site a link to a letter reporting that competitive bidding for home care services will come to four communities between October and December of 2010.

As of today, however, the link to the letter is no longer to be found.  But while the link has disappeared, the web page still works. The letter, dated August 13, indicates these plans only reflect "the current planning  among CCACs and is dependent on the issue of MOHLTC Directives for CCAC procurement." 

The Conservative Harris government introduced this model to home care in 1996: it requires Community Care Access Centres to contract out all home care services. 

As a result, for profit corporations have taken over many of the home care services provided by nurses and personal support workers in the province. 

There has been major problems with the quality of of care as longstanding not for-profit provid…

For-profit hospitals mean more Cesarean births (and that means bigger profits)

Cesarean sections are much more likely to occur in for-profit hospitals than in not for-profit hospitals according to a new study from California Watch.

Skyrocketing C-section rates in the USA are raising concerns about women's health and the medical complications that are associated with C-sections.

Data from  253 hospitals in the state show a big variation in C-section rates. At nonprofit Kaiser Permanente Redwood City Medical Center, the C-section rate was 9 percent. At for-profit Los Angeles Community Hospital, the rate 47 percent. In Riverside County, hospitals just miles apart had dramatically different rates, even though they serve essentially the same population.

Throughout the state, women are 17% more likely to have a C-section in a for-profit hospital.

In California, hospitals can increase their revenue by 82 percent on average by performing a C-section instead of a vaginal birth, according to a 2007 analysis by the Pacific Business Group on Health. The group – a coali…

Money for favorites? Another McGuinty government policy drives up doctor incomes

Leftwords reported last week that some Ontario doctors got a big raise through the McGuinty government's 'wait times' strategy (a funding system that CUPE has long opposed as it opens the door to privatization and contracting out work from hospitals).

This brings to mind that ANOTHER McGuinty government initiative that has ALSO driven up doctor incomes.

The government has been pushing "Family Health Teams" (FHTs) since 2004. While doctors run the FHTs, the FHTs employ a range of health care employees and take on a broad range of health care services, some well beyond family doctor services, including services until now done in hospitals.  

As usual, this government is trying to take more work out of our hospitals.

With last month's announcement of another 30 new Family Health Teams the total number of FHTs is now 200.  When these new FHTs become operational, 3,000,000 people will receive health services through them (an average of 15,000 patients per FHT).

So …

Ontario Health Coalition Summits on hospital "fee for service" funding

Starting September 21, the Ontario Health Coalition  (OHC) is sponsoring summits in six cities around Ontario dealing with significant changes proposed for Ontario’s hospitals.

The provincial government is moving towards a type of fee-for-service hospital funding (usually referred to by the government as "patient based funding", and by critics as "price based funding").   This is a potentially revolutionary change. The OHC notes that this funding system will encourage:

- Major hospital restructuring and cuts

- Centralization of services into fewer towns & pressure on the workforce

- A host of new administrative costs

- The end of community hospitals as we know them


This system has already been tried in the United Kingdom. There, it resulted in:

- Near-bankruptcies in large hospitals - ballooning administrative costs

- instability - privatization

- major cuts - demoralized staff

- chaotic health planning and the undermining of the national public health syste…

Wait times cash cow. Have the docs found a way past the wage freeze?

The Globe and Mail is raising concerns in its lead news story today about rapidly increasing payments to physicians.  OCHU/CUPE had raised similar concerns several months ago, uncovering a 57.6% funding increase for doctors between 2004-5 and 2009-10.

Notably, the Globe also ties the rapid increase to the development of wait time funding by the Ontario government.  OCHU / CUPE has also raised concerns about wait time funding as it is a form of price-based funding that opens the door to privatization and a market for health care.

Judging from the Globe's account, the market has resulted in handsome increases for some doctors, with 259 now billing over $1 million annually.

One group of docs that have benefited in particular is the opthamologists who do cataract surgeries through the wait times programs (sometimes at clinics like the new Kensington Eye Clinic in Toronto rather than at hospitals).  The Globe notes that health-care experts say the fee structure for doctors has not ke…

Stand by your LHIN (and show the world you love him). Well, at least for now.

The Ontario Liberals replied with a sharp attack today on the health care policies of Tim Hudak and the Ontario Conservatives. 

Naturally (and quite rightly ) they raise doubt about Hudak's support for (public) health care. 

More notably, they stand four square behind the LHINs, claiming they cut government bureaucracy. Secondly, they also suggest that Hudak and the Conservatives "oppose giving communities a local voice in health care decisions"  --  presumably due to the Conservatives' opposition to the LHINs.

We will see if they stick to this tack. The second argument in particular is a bit of a stretch. The LHINs have taken quite a beating of late and the Liberals may be tempted to change emphasis as the election approaches.


dallan@cupe.ca

Hospital surgeries closer to home? I don't think so.

It's hard to count the number of times Deb Mathews highlights the claim that the Ministry of Health and LTC is providing surgeries closer to home in her short letter on bariatric surgeries that is appearing in newspapers across Ontario today.

If you count just the exact phrase "closer to home" it's only twice, but if you add in references to "here at home", "in Ontario", or "in the province" you get nine hits. (I think. You can count for yourself here.)

While it is admirable that the government is trying to build capacity for bariatric surgery in Ontario (rather than ship patients off to the U.S. of A.), isn't it just a bit rich to hear so much emphasis on moving surgeries closer to home from a government bent on centralizing surgeries, emergency rooms, and other acute care services?

The lady doth protest too much, methinks. 

More evidence that centralizing services is a weak spot -- and the government knows it.


dallan@cupe.ca

"Aging at Home" (and how to sound like you are doing something when you really are not)

The province has announced $143.4 million more for its "Aging at Home" program.  That sounds like a pretty significant increase for a program scheduled to receive only $330 million this year.  An increase of over 50%. 

Many in the media have picked this up and, with touching innocence, given the government a lot of positive PR.  Instead of cutting health care (as the critics keep saying) theyreally are doing something!

However, this is just another way for the Local Health Integration Networks to fund hospitals, home care, nursing home services, community health services, etc., etc, etc.,  (i.e. just about any health care service you care to mention).  So the increase is  really more like a drop in the health care bucket. 

Hospitals get about $15 billion in funding, while home care and nursing homes combined add about another $4.6 billion.

So $143.4 million amounts to an increase of well less than one percent for those services.

But, at least, all the "Aging at Home&q…

Will LHINs take over responsibility for public health units?

Amidst the storm of criticism of Local Health Integration Networks (LHINs), the Minister of Health and LTC, Deb Matthews, has now said that bringing doctors and health units under the LHIN umbrella will likely be discussed when a much-anticipated legislative review of the LHIN system eventually takes place.  (This review, previously scheduled for this year, has now been put off until after the next election.)

The LHINs have, slowly but surely, taken over responsibility for hospitals, nursing homes, home care, community health clinics, and other community health services.  But doctors, public health units, and ambulance services remain outside of their dominion.

The doctors probably won't tolerate having to put up with the LHINs -- they will want to deal directly with the province (the people with actual political power, not just the flak catchers). The public health units (currently under municipal control) are more of a question, to my mind. They already get 75% of their approved…

Dalton McGunity Liberals shutting 181 hospital beds in Hamilton and Niagara

The McGuinty government flak catchers at the Hamilton Niagara Haldimand Brant LHIN just keep at it.

Not satisfied with all the (negative) attention they received for effectively shutting down the hospitals in Fort Erie and Port Colbourne, they are now in the midst of shutting down 181 complex continuing care beds across the LHIN.

The Hamilton Spectatorreports today that between "December and May, area hospitals closed 123 of 809 beds used to treat the dying, patients with multiple complex conditions, seniors with dementia and those needing restorative care to get home. " The plan is to close a further 58 beds by April 2012.

"We've been able to reduce the number of beds without reducing access to service because the CCAC (Community Care Access Centre) is now taking care of these individuals in the community said Alan Iskiw, LHIN interim CEO.

This does not sit well with widespread reports that the CCACs (which oversee home care) are cutting services to deal with the…

Privatization of hospital surgeries through price based funding and wait times

The Regina Health Region has started to privatize dental and knee arthroscopy surgeries, turning procedures over to a private clinic.  The rationale?  To reduce surgical wait times.  Oh, and the government claims the knee surgeries will cost $1,500 apiece, $179 cheaper than in the public sector. The Saskatoon Health Region is also exploring providing surgeries in a private facility.

This from a province that until recently was a model of public health care delivery.

The Ontario Conservatives raised the same idea in the last election, with a similar rationale.  But the claims were shot down (as were the Conservatives). 

But the Ontario Liberal government had opened the door to this by introducing "patient based funding"  -- something that could be better described as "price based funding" or "fee for service".   Again, part of the rationale was specialized funding to reduce wait times for surgeries and diagnostic tests. 

Look for more attempts to introd…

Non-union hospital staff forced to take two years of zeroes. An incentive for unionization?

The Toronto Starreports: "Thousands of Ontario nurses who work at ...non-unionized hospitals complain they're getting the cold shoulder from Premier Dalton McGuinty's public sector pay freeze."

While the non-union RNs are in the midst of a government imposed two year wage freeze, unionized RNs got pay increases April 1, as per their collective agreement.   “I don’t know why they’re doing this to us,” non-union RN Julia Fisher said. “The government has created a two-tier pay schedule. We’re being penalized.”

Even bosses at non-union hospitals are not pleased with the situation. They fear it will be harder to recruit and retain no-union staff.  “We are concerned the government’s freeze is creating significant inequity between union and non-unionized staff doing the same work,” said Janet Davidson, president and chief executive of Trillium in Mississauga.

Davidson's reference to "staff" is appropriate as a similar problem applies to non-unionized Register…

Should some children get better care than others? Two-tier creeps in.

The Hamilton Spectatorreports that  "[h]undreds of area families are turning to a private health service to get their children treatment for autism and other developmental disabilities because of long waits and gaps in publicly funded care.  A growing company called blueballoon has 1,400 clients in the Hamilton and Burlington area who pay as much as $125 an hour to get their kids help with a wide range of issues".(My emphasis.)

Paying privately is sometimes the only way to get access to optimal care, acknowledges Dr. Peter Szatmari, who heads McMaster University's division of child psychiatry and is considered one of the world's leading experts in autism.  And even McMaster Children's Hospital, which has among the best autism services in Canada, needs more resources.


Szatmari says improvements need to be made to ensure treatment doesn't depend on parents' ability to pay for private services. "I think these are programs that need to be universally fun…