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"Disrupt" hospitals. What, again?

A new report from the Mowatt Centre makes various recommendations to reform health care.  A key proposal is set out in yesterday's Toronto Star by author Will Falk:
Modernize the organization of hospitals by disrupting existing models. Services in today’s general hospital could be provided more efficiently elsewhere: academic centres focused on excellent diagnostic work-ups; specialty clinics providing routine procedures efficiently and accessibly, and networks of care that monitor patient well-being for chronic conditions — an organized system with public funding and in partnership with traditional hospitals.
Demands to remove work from hospitals are old hat. Obviously such moves would have a major impact on hospitals and their employees. Unlike similar proposals from other reports, this study does not advocate privatization. But the Falk does argue that "regulatory barriers need systematic review and removal".

The full report is here: Fiscal Sustainability and the Transformation of Canada's Healthcare System

Tom Walkom in today's Toronto Star  adds:
"the report  hints at introducing market mechanisms such as auctions into the system. Britain did something similar when it required doctors and hospitals in its public National Health Service to form trusts that competed with one another and with private health firms. Critics in that country say these changes are paving the way for full-scale privatization of British medicare.  But in Canada, there has been little discussion so far of what happens when faux markets are created in health care. As things heat up, expect more."

No surprise, the report was supported financially by 1% adviser, KPMG,"because of its commitment to help its clients understand the challenges faced by governments and to contribute to the discussion of strategies that can be used to address these challenges.


Fifteen years ago, the Mike Harris government promised hospital cuts and restructuring would solve our problems and reduce costs.  The restructuring itself ended up costing much more than promised and the Harris government eventually reversed the funding cuts and increased hospital funding sharply.

We may well be gearing up for something similar once again.


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Ontario has 0.575 health care full-time equivalent employees (FTEs) per bed staffed and in operation.[1]  The rest of Canada reports 0.665 health care FTEs.[2] The rest of Canada has 15.7% more health care staff per bed staffed and in operation than Ontario.[3] 

No other province reports fewer LTC health care staff per resident (or per bed) than Ontario.[4]

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