Skip to main content

Winnowing down hospital services

The Ontario Health Coalition has raised concerns about a Niagara Health System plan to close  beds at the Welland Hospital.  The beds are housed in a wing of the Welland hospital that includes an “extended care unit” and a “long-term care unit”.  The hospital plans to sell off the license to operate these beds, possibly to a for-profit company.



Niagara health care activist Sue Salzer calls this a surprise move.  “It even goes beyond the devastating cuts in the  NHS ‘Hospital Improvement Plan’.”


The NHS  suggests  that it is one of the few acute-care hospitals that still operate long-term-care beds.  


For the record, most hospitals provide both acute and non-acute services, and some provide long term care services.   NHS provides a whole range of health care services to the community far beyond acute care.   Only half of its in-patients fall into  the ‘acute’ care category.  And many more patients never even see a hospital bed, much less an acute care bed.   Here is NHS' own account of its beds:


Acute (Medical, Surgical, ICU/Cardiac Care, Obstetrics, Paediatrics, Oncology, Palliative, Nephrology, Geriatric Assessment)                                                                                               444


Mental Health (Psychiatric care)                                                                                                 58

Complex Continuing Care                                                                                                        195

Sub-Total Beds (Hospital Services)                                                                                    697

Addiction Services (Detox and Recovery)                                                                                 78

Long Term Care (Residential care for the elderly)                                                                   115

Total Beds (including Addiction & LTC Programs)                                            890       

The hospital also has another 252,512 annual visits to its ambulatory clinics & community programs. 


Selling off long term care sounds like health care fragmentation.  Whatever happened to health care integration?


What's next for the chopping block?  Complex Continuing Care, Addiction Services, Mental Health, Community Programs, Ambulatory Clinics?    


There's no doubt that more services will get the heave-ho if the hospital budget squeeze continues.  


One sign -- Look for the new mantra that hospitals are all and only about acute care. 

Comments

Popular posts from this blog

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

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. 

Paramedic Services in Canada: Structure, Privatization, Unionization and other issues

Governance and Funding :  While police and fire services are usually municipal services, Emergency Medical Services (EMS) are typically controlled by provincial governments.  In Ontario, regional municipal governments have responsibility for delivering and funding EMS.  But even in Ontario the province plays a key role, strictly regulating EMS, providing funding for 50% of the approved land ambulance costs, and paying 100% of the approved costs for air ambulance, dispatch, base hospitals, First Nation EMS, and for territories without municipal government. Delivery :  Like police and fire services, EMS is predominantly a publicly provided service in Canada.   But businesses have now made some significant in-roads into EMS, primarily  Medavie,  a private corporation based in the Maritimes that describes itself as not-for-profit.  Medavie goes back over 70 years, with its roots in health insurance.  It still operates Medavie Blue Cross with 1,900 employees.  It now a