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Showing posts from May, 2011

One step forward in Niagara

The Ontario Health Coalition reported today that the Minister of Health and Long Term Care has finally relented and agreed to a review of the (so-called) "Hospital Improvement Plan" in Niagara.  As reported earlier, the Niagara municipal leaders had asked the Minister for a review in April. The review will only focus on the parts of the HIP that have been implemented -- not those still pending.   The review will involve the Local Health Integration Network, the Niagara Health System hospital, and regional municipal leaders. They will establish terms of reference for the review.  Local municipalities have shown good leadership on the HIP, so many in Niagara will be looking to them to stand strong.  No doubt, community members will work hard to ensure that this is a serious attempt to review the HIP and not a whitewash. The people in local communities (with the OHC) have fought the closures and cutbacks that came with the HIP tooth and nail.  So this step forward is their

Hudak PCPO promises to privatize, cut services, and restrict workers' rights.

Here is a list of the main items regarding labour in the Progressive Conservatives policy manual ("Changebook") released on Sunday: Labour laws: "We will make Ontario’s labour laws fairer for union members and taxpayers. We will change Ontario’s labour laws to give union members more flexibility and a greater voice. We will give all individuals the right to a secret ballot in certification votes. We will introduce paycheque protection so union members are not forced to pay fees towards political causes they don’t support. Unions will be required to be transparent and open with their financial information, just as businesses and charities are." Goodness gracious, I hope they did not pay a lot of money to whoever wrote this. Except for the part about making it more difficult for construction workers (who have "card certification") to form a union, it's a model of vagueness.   Nevertheless, details be damned, it's clear enough that they in

First Canadian acquired case of NDM-1 superbug -- in an Ontario hospital

In 2010, a   study   published in the famous academic journal   The Lancet Infectious Diseases   flagged the emergence of NDM-1, an enzyme that  confers high levels of resistance of gut bacteria to almost all antibiotics, leading to potentially life-threatening pneumonia and urinary tract infections   The study concluded,  "The potential of NDM-1 to be a worldwide public health problem is great, and co-ordinated international surveillance is needed." At that time, NDM-1 was widespread in India.   But Canada now has it's first domestically acquired case of NDM-1 -- in an Ontario hospital, according to a new  study  in the Canadian Medical Association Journal .   A man admitted to a Toronto hospital with a stroke later tested positive for NDM-1. He hadn't travelled outside of southwestern Ontario for the past 10 years; none of his family members or friends had travelled to India.  Fortunately, t he man remained asymptomatic and did not spread the organism to othe

Public health care: Canada lags other countries, Ontario even further back

Among the claims made by the critics of socialized health care in Canada, one often repeated suggestion is that Canada is an out-lier (a socialist throwback , even) and that many highly developed European countries have a more privatized health care system. Well of course, the range of services covered by the public system varies from country to country, with one providing this range of services, another providing that.  But the most comprehensive single comparison is the percentage of health care costs covered by the public system. And those figures make clear that Canada has some catching up to do if it is going to match the public coverage provided by other developed countries. The 2010 study National Healthcare Expenditure Trends from the Canadian Institute for Health Information (CIHI)  reports (p. 65) that the share of health care costs in Canada covered by the public system is behind almost all European countries.  Only the Switzerland and  the Slovak Republic lag behi

Ontario has lowest increase in health care expenditures

The Canadian Institute for Health Information reports that the increase in health care expenditures by the Ontario government is lower in 2010 than any other province, at only 2.4%.  The Canadian average was 3.9% . Ontario health care expenditures saw the second lowest expenditure increase in 2009 and the third lowest increase in 2008. Ontario had the lowest increase of any province for the three years 2008, 2009, and 2010.  The average Ontario increase over the last three years was 4.3%, while the Canadian average was 5.2%. -- Doug

Tories waving goodbye to Canada Health Act?

Andre Picard’s piece in the Globe today suggests that the Tories will keep the 6% Canada Health Transfer funding escalator intact only until 2016  -- that's the most minimal version of the promise they made during the election campaign.   Picard, however, suggests the Tories will avoid a ten province deal and instead create different deals with different provinces, with increases only keeping up with inflation after 2016.  The deals would tie the money to specific items in different provinces (e.g. wait times for certain surgeries in Ontario, catastrophic drug coverage in New Brunswick.)   There is also even the suggestion that ultimately the Tories may get rid of all federal- provincial  transfers and instead give the provinces revenue from the GST.    The CHT cash transfer currently supplies about $27 billion to the provinces for health care.  For Ontario that covers about 23% of provincial health care spending ($10.746 billion).  Such changes would radically reduce the federal

PCs LHIN line: unbelievable

Well what about the Ontario Progressive Conservative promise to close the LHINs and turn the money over to health care?  PC leader Tim Hudak talks  like that is going to pay for health care services in some significant way. This almost makes me laugh -- it will save less than two-tenths of one percent of the health care budget, And that's if they can find another way to fund and coordinate health care providers without having to pay for it. The PC line on the LHINs is not serious .

University dumps corporate food -- and gets fresh, instead

The food was so bad, the president of the University of Winnipeg, Lloyd Axworthy, says that  “we were at the very bottom. We were being hung in effigy by students...Even the poutine was bad.” So, t wo years ago, he decided to buy out the contract of its large, multinational catering firm.   In its place, the school established its own arm’s-length culinary company, Diversity Foods, in partnership with the local non-profit SEED Winnipeg .   The Globe and Mail reports that it  was mandated to serve organic, locally grown food of an ethnically diverse variety, and to employ inner-city residents as their primary labour force. The University now has a service that provides much better food. At the same time it has increased revenue for the University.  In fact  the food is so popular that the university’s executive chef is Winnipeg’s most in-demand caterer.   What's more the school’s buying power has persuaded suppliers to finally provide sustainable, organic products to th

PCs LTC policy: the song remains the same

The Canadian Press reports that of the 40,000 new or renovated Long Term Care (LTC) beds the Progressive Conservatives (PCs) are promising, only 5,000 are going to be new beds - the other 35,000 are simply renovations of existing beds (over ten years). I'm underwhelmed.  We have a province which has a couple of thousand patients in acute or medical care beds waiting for a LTC bed and which has experienced a  tripling of wait times for an LTC bed since 2005. And with an aging population, things are not going to get magically easier any time soon. The PCs policy sounds pretty much like a continuation of the existing policy to slow the growth of LTC beds.

Hospitals on PC chopping block, again? It seems like old times...

On Tuesday, as part of their health care funding announcement, the Ontario Progressive Conservatives promised  40,000 new and renovated long-term care beds Increasing investments in home care, and giving families more control over services There are exactly zero  promises regarding hospitals.  Given that the PC funding promise is more like a promise to cut services (see yesterday's note),  the emphasis on long term care and home care will likely mean an especially hard time for hospitals.   That is completely consistent with the initial approach of the Mike Harris PC government in the 1990s.  The Harris PCs actually cut hospital funding (not just by letting inflation erode the value of their funding, but by actually reducing the number of dollars provided).   And they did this under a fog of rhetoric about better long term care and better home care.  Eventually, rising public anger forced them to reverse direction and increase hospital funding (quite significantl

Workers' wages fall

The beleaguered Liberal Party of Ontario is in a conundrum.  There is increasing pressure from the right for them to attack unionized public sector workers, with both the Globe and Mail and the Toronto Star  running editorials this week urging the Libs to turn their guns on public sector workers (the Sun papers, needless to say, were already there). Not coincidentally perhaps, news stories this week appeared highlighting the Liberal government's plan to cut 4,900 public service jobs. The Libs are going to have to figure out which side they are on, it seems. For the record, public sector settlements in Ontario are coming in at exactly the same as private sector settlements in 2011 -- 2.2% annual average increases.  This means that, with  inflation running at 3.6%,  public and private sector workers are losing about 1.4% of their income this year. Last year, average annual private sector settlements ran a little higher than public sector settlements: 2.1% versus 1.9%.  (

Hudak PCs announce plan to (not) support health care

Well it's confirmed.  The Ontario Progressive Conservatives are going to try to run as defenders of health care. The only problem is that what they are promising falls far short of the reality of actually defending health care. Yesterday, the PCs announced  that the party's 'top' funding priority will be health care: they will increase health care spending $6.1 billion per year more.  Sounds good right? However, they only promise to get to the extra $6.1 billion by the end of their first term -- four years from the election.  Moreover, as health care is an expensive proposition, $6.1 billion is less than it appears.   Total spending for the Ministry of Health and Long Term Care this year is $47.139 billion.  So a $6.1 billion increase is a 12.9% increase.   With four years to get to that increase,  the average annual increase would be only 3.1%.    That's less than the current rate of inflation in Ontario: currently the consumer price index is increasi

Hudak Conservatives spell out attack on public sector workers

Shades of Mike Harris, former Harris cabinet minister and current Progressive Conservative leader Tim Hudak has stepped up his attack on public sector workers.   In particular Hudak has sharpened his aim at those, like hospital workers, who do not have the right to strike and are required by law to settle collective agreements through interest arbitration.   Here's an account of Hudak's latest refinement of his position on public sector interest arbitration from the Osprey papers : A Tim Hudak government would open up arbitration laws and make the ability of governments to pay for public sector wage settlements " one of the dominant factors " arbitrators must consider.  " We need to get a better balance, so it's a  fair  deal for the people who are paid by taxes and for those who pay taxes, " the PC leader said. " Public sector pay and benefits need to reflect private sector realities. "...." I would open up the act to make sure th

PSW Registry Announced

The Ontario government has announced that it is creating a 'registry' of personal support workers (PSWs). The Ministry of Health and Long Term Care says "PSWs will have the opportunity to sign up with the registry and provide key information such as: contact information, current employment, educational background and years of experience.  Employers and the public could use the registry to verify this important information, and employers would be better informed to meet patient needs."   The registry, they claim, will be up and running no later than the summer of 2012.   The full role and governance of the registry remains unclear, however.   The Ministry promises that "c onsultations with PSWs, their representatives and other stakeholders will begin in the summer." The government initially considered putting PSWs under the control of a regulatory college, but decided not to follow this path, at least as a first step.  The government's  Health Profession

South East LHIN restructuring plans not likely until after election

Tremendous controversy has been stirred up by the South East LHINs development of a clinical services plan for  area hospitals. The idea is to develop a more efficient regional health system with greater co-operation between its seven hospital corporations. "Everything we're going to do, moving forward, is going to be hinging on this Clinical Services Road Map," LHIN chair Georgina Thompson told the Belleville Intelligencer .    Brockville in particular has been concerned that its hospital would be downgraded.   Now the LHIN has ruled out removing all surgeries from Brockville, but it remains far from clear how clinical services will be structured.  Hospital restructuring in other areas has led to the removal of services from smaller communities, or to region-wide specialization, where hospitals become not so much general hospitals for their local area, as specialized facilities serving a broader region.  This, in turn, creates serious problems for local  access to

So the private sector assumes the P3 risk, eh?

Advocates of public private partnerships (P3s) often claim the private sector partner will assume the risk. In fact, it's the major way they justify the additional costs of P3s.   Well, take a look at what is in effect a P3 long term care project in Windsor.   A project to redevelop the Grace hospital site as a LTC facility is now well behind schedule.  According to the Windsor Star , the developer owes millions of dollars to creditors, there are liens on the property and he is in arrears on his taxes to the tune of more than $1 million. The developer won the rights to develop the project in 2007 and was supposed to have it completed by March 2010, a little over a year ago.  Now the Star reports the landmark building grows more dilapidated with each passing day. Overgrown weeds, broken windows, busted concrete, mountains of gravel and a punctured building laced with graffiti are what remain of the former Salvation Army hospital.  "I don't have to go to Detroit -I

Hospital urgent care reduced (as privatization reduces public health care)

The London Free Press reports that a 'shortage' of doctors could close the London St. Joe's Urgent Care Centre on summer weekends. Fewer than half of the weekends in June, July and August are fully staffed so far, and a doctor shortage could extend into the fall, said Dr. Gary Joubert, head of emergency medicine in London. "I'm very disappointed . . . I want it to be fixed. The people of London expect the urgent care centre to be open," said Health Minister Deb Matthews,who is also a London MPP.   Matthews allowed that many hospitals face challenges staffing ERs, but added "I'm not aware of any that have cut their hours in such a drastic way," she said. St. Joe's disputed Matthews' suggestion that the closures are simply a St. Joe's issue: "It's important to remember that this isn't a single hospital issue, it's a city-wide issue," the St. Joe's CEO said.   London hospitals   started  using a private

OECD calls for improved pay and status for long term care workers

The influential Organization for Economic Cooperation and Development (OECD) has released a new report ( Help Wanted? Providing and paying for long-term care  ) that concludes that      aging populations in developed countries will cause spending on long term care to double or triple by 2050.  Spending  on long-term care currently accounts for 1.5% of the economy in developed countries. The growth in demand for long term care leads the OECD to  conclude  that pay and working conditions in long term care (including home care) must improve: "Major reforms to attract more care workers and retain them in the sector should be put in place quickly. Most long-term care careers are dead-end jobs with a high turnover and low pay and benefits....Upgrading the status of the long-term care workforce by improving pay and working conditions is key." These conclusions are particularly striking as the OECD is tightly tied to ruling elites, and is generally known for being boss-friendly

The miracle of health care privatization (@ only $19,393 per family)

The privatized US health care system has set another record with the highest ever dollar increase in health care costs for a family of four.  Millman, one of the world's largest independent actuarial and consulting firms,  reported   last week that total costs for a US family of four for health care is $19,393 per year.  That is an increase of $1,319 over the previous year.    The only good news is that the annual  increase was only 7.3%  -- which, apparently, is very good for the privatized US system. "In 2002, American families had healthcare costs of $9,235, and those costs have now doubled in fewer than nine years," said Lorraine Mayne, Milliman principal and consulting actuary. "As costs continue to grow ... the total cost of care for American families constitutes a larger and larger portion of the household budget." Canadians cannot afford health care privatization (and neither can Americans).  

ALC hospital beds: Is Ontario making any progress?

In November 2007, there were 4,528 "ALC "or alternative level of care patients (i.e. patients waiting for a different sort of care while they are in a hospital bed, usually long term care, hospital rehabilitation care, hospital complex continuing care, or, in some cases, home care).  By April 2011 there were 4,256, a decline of 6%, or 272 patients (although there was also a decline in the number of hospital beds reported ). The decline is significant but quite modest.  Especially when you consider that the numbers did not always decline over that period.  The numbers dipped each spring since 2007 and rose at other times. Only a few months previous to April 2011, the ALC count was much higher:: 4,748 in January 2011. That's 220 more than November 2007, a 4.9% increase .   And from November 2007 to November 2010, the number of ALC patients increased 111, or 2.5% So there are legitimate questions about the government's main ALC strategy -- Aging at Home, which was an

ONA hospital interest arbitration award coming this month

The Ontario Nurses' Association and the Ontario Hospital Association have concluded their hospital interest arbitration hearings for a new central hospital collective agreement for Registered Nurses.  The hearings lasted one day, April 30.   The arbitration board will issue the award this month and it will be shared with all ONA hospital bargaining unit presidents at a hospital sector meeting on June 3, 2011. OPSEU's central paramedical hospital group is scheduled to have interest arbitration hearings later in June.   Wage settlements in the Ontario public sector have rebounded to 2.2% in 2011, after dipping to 1.9% in 2010.  

Reporter's award shows how important public access to hospital information is

Derek Spalding of the Nanaimo Daily News  has won the local reporting award at the National Newspaper Awards for his  investigation  into the spread of Clostridium difficile at Nanaimo Regional General Hospital.  Repeated  freedom -of-information requests finally revealed that the Vancouver Island  Health Authority  intentionally withheld information in order to downplay the  bad  news about  C. difficile  to the public.   The Nanaimo Daily News reported that according to documents  it obtained a  deadly 11-month outbreak of Clostridium difficile at the hospital in 2008 was largely blamed on inadequate housekeeping.  Subsequently, the Island Authority tried to end its contract with the private corporation that cleans the hospital ( without success -- click here for more).  The story shows how important public access to hospital information is.  OCHU/CUPE has been fighting for access to hospital superbug information for years, with some, limited success: most notably helping t