Skip to main content

Drummond Commission: Structural Redesign of health care. Oh great...

Don Drummond says his Commission on public services in Ontario is spending 40% of its time on  health care “structural redesign”, Martin Cohn at the Toronto Star reports.    Drummond adds,  “We do not even have an integrated health care system”.   

"Structural redesign" and more "integration" could mean a lot of things, but it sure sounds like he is contemplating more restructuring of health care employers.  Proposals to move money out of hospitals are also  possible (and perhaps even privatization  -- although Drummond was told not go there). 

Drummond claims his reforms will be more 'strategic' than past system redesigns that failed.  But the Mike Harris government also tried 'structural redesign' of the health care system.  Ultimately the costs of the Harris redesign went through the roof, many of the the plans to shutdown or merge hospitals were abandoned, and the Harris government began providing funding increases to hospitals again.
Cohn says Drummond is worried the reforms won’t get traction with the public. After convincing McGuinty to reduce the government's funding plans last week from 1.8% increases to 1% increases, Drummond told Cohn, “You’ve got to understand there’s consequences to a number like that, and the consequences aren’t easy. That kind of worries me — if you’re out of sync with the general expectations . . . you just meet resistance all the time.”

One might also ask why a Bay Street banker thinks he has the knowledge to propose “structural redesign” of health care. The failed Harris reforms actually involved significant consultation and research. 

Cohn also notes that Drummond hopes to benefit from a realignment of political forces.   That is credible: the Liberals and PCs are both focused on the same deficit cutting track, and both parties would probably prefer to package cuts as 'structural redesign.'     

There's not even a hint that Drummond will take a hard look at what his former colleagues are doing to us through P3 private finance of hospitals.  There's a lot of money there and the financial crisis looks set to make this an even worse deal for the public.  Moreover, we are bound to pile up a lot of debt there and, last I heard, that P3 debt was still hidden from the province's books, despite longstanding talk that it would be brought onto the books. 

Finally, despite reducing funding plans from 1.8% to 1% per year, Cohn reports the Liberals are still contemplating 3% increases for health care, a relatively modest cut from previous Liberal promises.   Except for 1% increases in education, the plan is to stick funding cuts on the other sectors, it seems.


Popular posts from this blog

Health care funding falls, again

Real provincial government health care funding per-person has fallen again this year in Ontario, the third year in a row.  Since 2009 real funding per-person has fallen 2.6% -- $63 per person. 

Across Canada real per person funding is in its fourth consecutive year of increase. Since 2009, real provincial funding across Canada is up $89 -- 3.6%.
In fact the funding gap between Ontario and Canada as a whole has gown consistently for years (as set out below in current dollars).

Ontario funds health care less than any other province -- indeed, the province that funds health care the second least (B.C.) provides $185 more per person per year, 4.7% more.  
Provincial health care spending in the rest of Canada (excluding Ontario) is now  $574 higher per person annually than in Ontario. 

 Ontario has not always provided lower than average health care funding increases-- but that has been the general pattern since 2005.
Private expenditures on health care have exceeded Ontario government increases …

Ontario long-term care staffing falls far short of other provinces

CUPE and others are campaigning for a legislated minimum average of four worked hours of nursing and personal care per resident per day in long-term care (LTC) facilities.  New research indicates that not only is LTC underfunded in Ontario, it is also understaffed compared to the other provinces. 
LTC staffing falls short:  The latest data published by the Canadian Institute for Health Information (and based on a mandatory survey undertaken by Statistics Canada) indicates that staffing at long-term care (LTC) facilities falls far short of other provinces. 
Part of this is driven by a low level of provincial funding for LTC.

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]

Occupancy r…

Six more problems with Public Private Partnerships (P3s)

The Auditor General (AG) has again identified issues in her annual reportwhich reflect problems with Ontario health care capacity and privatization.   First, here are six key problems with the maintenance of the 16 privatized P3 ("public private partnership") hospitals in Ontario:
There are long-term ongoing disputes with privatized P3 contractors over the P3 agreements, including about what is covered by the P3  (or “AFP” as the government likes to call them) contract.The hospitals are required to pay higher than reasonable rates tothe P3 contractor for  maintenance work the contractor has deemed to be outside of the P3 contract. Hospitals are almost forced to use P3 contractors to do maintenance work the contractors deem outside of the P3 contract or face the prospect of transferring the risk associated with maintaining the related hospital assets from the private-sector company back to the hospitalP3 companies with poor perf…