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
Labels:

Comments

Post a Comment

Popular posts from this blog

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 in Ontario in 2022/3, up from 47,543 in 2021/2. 
Post a Comment
Read more

More spending on new hospitals and new beds? Nope

Hospital funding:  There is something off about the provincial government's Budget claims on hospital capital funding (funding to build and renovate hospital beds and facilities).    For what it is worth (which is not that much, given the long time frame the government cites), the province claims it will increase hospital capital spending over the next 10 years from $11 billion to $20 billion – or on average to about $2 billion per year.   But, this is just a notional increase from the previous announcement of future hospital capital spending.  Moreover, even if we did take this as a serious promise and not just a wisp of smoke, the government's own reports shows they have actually funded hospital infrastructure about $3 billion a year over the 2011/12-2015/16 period. So this “increase” is really a decrease from past actual spending. Even last year's (2016-17) hospital capital funding increase was reported in this Budget at $2.3 billion - i.e. about 15% more th
Post a Comment
Read more

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 33,778 full t
Post a Comment
Read more