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Showing posts from December, 2011

2/3 of paramedics report verbal, physical, or sexual abuse on the job

New research from St, Michael's Hospita l in Toronto suggests that more than two-thirds of paramedics have experienced verbal, physical or sexual abuse on the job. "EMS providers can experience violence in the workplace as they perform their jobs in unpredictable environments and near people in crisis," said Blair Bigham, the lead investigator. "Anecdotal reports and workplace safety records have highlighted cases of verbal, physical and sexual abuse, yet until now, there has been little scientific research. More research is needed to understand the impact of this workplace violence." The study found: Verbal abuse was reported by 67.4 per cent of EMS workers surveyed.  Intimidation was reported by 41.5 per cent.  Physical abuse was reported by 26.1 per cent.  Sexual harassment was reported by 13.6 per cent.  Sexual assault was reported by 2.7 per cent. Patients, or patient family and friends were the most common perpetrator. The study was based

Economic recession driving mental health problems

British charities have warned that people's fears over losing their jobs and homes have fuelled a massive 20 per cent jump in the number of people suffering from mental health problems in 2011. And the  British National Health Service has reported that nearly 10 million more prescriptions were issued for anti-depressants in England than at the start of the crisis in 2007, a 28 per cent rise.  Mental health charities said the stress of recent years means more people are experiencing mental health problems. At the same time, British public health care is being squeezed.   Is the same true on this side of the pond? I haven't seen the figures -- but  I wouldn't be surprised. 

Ornge air ambulance only the tip of the iceberg?

The Toronto Star concludes an editorial on the Ornge affair (where the Star revealed that the top boss of the air ambulance was raking in an incredible $1.4 million annually) that Ornge should be more accountable to the public. ...Ontarians deserve more transparency and accountability from an entity that runs largely on $150 million of taxpayer funds and provides a vital service. At a time when the health system is under financial pressure, we need to know that public money is being properly spent. Quite right.   But the excuse used for not revealing the enormous pay out was that Ornge (a not-for-profit entity expected to report its top salaries to the public) had set up for-profit entities.  The Star does not mention that many, many totally for-profit outfits get bags of money to provide public services and are under no obligation to report publicly.   What about them?  Don't we also "need to know that public money is being properly spent"?

P3 hospitals forced to spend "EXTORTIONATE SUMS" on contractors -- Health Minister

Last night Andrew Lansley, the British health minister, condemned the high fees charged by private corporations to do basic repair work in public private partnership (P3) hospitals.   P3s allow private corporations to become involved in the financing and maintenance of hospitals.   Ontario has followed Britain into using P3s for hospital projects. Lansley told the Telegraph : "[Hospitals are] being forced to spend extortionate sums on private contractors rather than spending that money on helping sick patients get better." The Telegraph (a conservative newspaper) reports that a series of Freedom of Information requests has disclosed how hospitals that are locked into long term P3 deals are forced to pay “hyper-inflated” charges for basic services.  Figures uncovered by the Telegraph show the following examples of charges from private corporations that won P3 hospital contracts: North Staffordshire hospital paid £242 to put on  a padlock North Cumbria University Hospi

Hospital closures on the Drummond agenda?

The Toronto Star reports that the Drummond Commission is looking at the Saskatchewan hospital closures of the 1990s as a model of reform, with the support of the Minister of Finance, funding hawk Dwight Duncan. Next month, the treasurer will get some political cover from a commission engineering a massive overhaul of Ontario government services, headed by influential economist Don Drummond. Health care is at the top of the hit list. After working on two recent studies of health-care inefficiencies, Drummond's reform agenda is no secret: reintegrating the system; and reallocating more money to health promotion, community care, home care and long-term care.... They are also looking at a far more painful and protracted restraint exercise, one that gets relatively little attention: In the early 1990s, Saskatchewan's new NDP government faced a financial reckoning when credit rating agencies started downgrading the province's debt. Then-premier Roy Romanow resolved to close

Canada Health Transfer -- Our day may come

The Conservative federal government has taken advantage of their majority status and announced that they will reduce funding increases to the provinces for health care in the years ahead. A smart move on their part -- the Conservatives don't like public health care much, so it is no surprise they don't want to fund it.  They have done little or nothing to enforce the Canada Health Act and only announced that they would maintain Canada Health Transfer funding increases in the face of an electoral 'gun' (when they hurriedly made up health care funding policy during the  election, after the opposition made health care funding an election issue).   And they no doubt are hoping that perceptions about the economy and the fact that they are years from the next election will allow them to slip this through. But the economy may well improve and an election will come before the Conservatives cut the funding.  So our day may come... CUPE has  called for  a collaborative app

Old ideas are new again. Drummond & the OHA

Star columnist  Martin Cohn reports that the Drummond Commission into Ontario public sector reform has taken a major interest in the thoughts  of the Ontario Hospital Association. The OHA reportedly claimed to Drummond that " Ontario's current situation is much more challenging than in the 1990s...   With regard to hospitals specifically, the current situation is much more difficult than in the past. " Cohn concludes:  The government could save billions with coordinated strategies to  avoid  institutionalized care for the frail elderly, for example with homemaker services. That's why the OHA suggested to Drummond that  funding  for community care, mental health and addiction services should increase by 5.5 per cent - far more than now budgeted. Where would the money come from? This is where the big hospitals are showing leadership by sticking up for the little guys - likely at their own expense: " Given that this sector has the smallest overall budget

Workers' increases less than 1/2 of economic growth

Amidst all the hysteria over public sector wages (Tim Hudak has again demanded a wage freeze for public sector workers) it is useful to ask if public sector workers are taking more than their fair share of the economic growth in Ontario --or if they are falling behind. OCHU's comments to the Don Drummond Commission on public sector reform in Ontario, reviews just that question and finds that since 1995 hospital wages have risen less than half as quickly as the nominal growth in the economy. Wages are paid in "nominal dollars": they are not, unfortunately, protected against inflation.  So you might have a higher dollar wage than you did ten years ago, but if inflation has increased more rapidly than your wage, you are actually less well off.  As a result, the comparison between "nominal wages" and "nominal growth" (economic growth including inflation) is appropriate.  Are the nominal dollars we are paid keeping up with the nominal growth in the On

Most CCACs in DEFICIT (& the money fight begins)

Nine of the province's 14 Community Care Access Centres (CCACs) are in deficit, the Chatham Daily News reports.  The local Erie St. Clair CCAC has asked for $5.2 million to tide it over this year.  The Local Health Integration Network (LHIN) is only handing over $1.5 million for now and refused its request to let its deficit run over to next year.   Gary Switzer, the LHIN CEO, said the CCAC may end up needing that money, "we just don't have enough data to determine what the real need is." But Betty Kuchta, the CEO of the Erie St. Clair CCAC,  replied that the CCAC may have to put hospital patients looking for home care on waiting lists.  Kuchta said waiting lists mean more frail, elderly people will stay in hospital when they could be cared for at home.   The costs of the province's 'Home First' program, designed to get patients out of hospital, are driving up CCAC costs across the province, it seems.   The 14 LHIN CEOs are meeting in January to

"High level of satisfaction with public reporting" Oh really?

The Ontario Auditor General did a follow up to his 2009 report on health care acquired infections (HAIs) in long term care homes.  The good news is that all three of the homes he examined are now doing the twice daily cleanings of rooms for residents with C. Difficile infections. The bad news is that there is little movement on public reporting of HAIs in LTC. (OCHU helped win this in the hospital sector several years ago.)  Here is the AG's comment: The Ministry indicated that it had examined whether long-term-care homes should be required to publicly report patient-safety indicators such as HAI rates, as hospitals do. The Ministry noted that it had consulted with the long-term-care homes and other stakeholders and that there was a high level of satisfaction with the current extent of voluntary public reporting through Health Quality Ontario. Although Health Quality Ontario  does not provide public information on cases of C. difficile or hand-hygiene compliance among reside

Strengthen the Power of the LHINs! (They are kidding, right?)

Now that  bothersome provincial election is over with, the powers that be are talking more frankly about health care restructuring. There was, of course, the musings from Don Drummond (the Bay Street advisor to the provincial government on public sector reform) about health care "structural redesign".  But we have also gotten this call to strengthen the power of regional health authorities (either LHINs or a some new form of regional health authority) to make changes and consolidate.  Strengthen and empower regional healthcare - whatever the structure. Government should strengthen Local Health Integration Networks (LHINs), or their next iteration, by giving them the autonomy and discretionary funds - in short, the power - to do the work they are mandated to do. That means letting them shift funding to meet the particular needs of the population they serve. That means consolidating agencies, but with respect and assurance for local input. This was the first recommend

Taxpayers face increasing P3 costs

The conservative British newspaper, the Telegraph reports that British taxpayers now face paying five per cent more per year for hospitals built through public private partnerships (P3s) because the debts are linked to inflation.  P3s bring private corporations into hospital financing and support services. When the BBC program Panorama contacted 85 hospital trusts with PFI deals, it found 80 of them said they were having to make increased payments to the corporations due to inflation. The hospitals did not protect themselves against inflation, while the private P3 corporations did, it seems. Margaret Hodge, the Labour MP who now chairs the Public Accounts Committee, admitted to the BBC program: "We should have been much more transparent about the costs. I think we got the balance wrong." Richard Bacon, a Conservative member of the committee, said he thought taxpayers were being "ripped off". Ontario is going ahead with its own privatized P3 hospital spree, despi

Hudak Progressive Conservatives attack public sector wages

The Ontario Progressive Conservatives (PCs) tried to amend the provincial government's Throne Speech yesterday with a legislated wage freeze for public sector workers. The NDP joined the Liberals to vote down the amendment 69 to 37. PC Leader Tim Hudak said  "I mean, we're simply asking public servants not to get a wage increase next year because families in the private sector are cutting back." In fact private sector wage settlements have been significantly higher than public sector wage settlements this year and last.   Naturally, the salaried class (including many PC-supporting bosses) are doing better -- this confirmed by recent Conference Board  and   AON  reports.   The Conference Board reports private sector salaried staff are doing especially well.   With inflation running at 2.7% in Ontario, a wage freeze would mean a significant reduction in real wages.  Hudak is broadening his attack on public sector workers.  During the election Hudak's fo

The Nerve! Saskatchewan private clinic director resigns

The Medical Director  of Saskatchewan's new for-profit surgical clinic has resigned.  It turns out he is ALSO the head of the Surgery Department at Regina General Hospital -- and has been for the last 11 years.  The brains behind the Health Region sees no conflict of interest. DUH! But having the Director wear two hats in this situation is an obvious conflict of interest, Suzanne Posyniak, a spokesperson for the Canadian Union of Public Employees, told the CBC .  . "How can you be responsible for ensuring that the hospital is doing the maximum number of surgeries in house, fully using all of its own infrastructure, and at the same time managing a for-profit clinic that needs business from the region to turn a profit?" Posyniak said. "You could tell this story to anyone and they would roll their eyes and think 'Duh … of course this is a problem,'" Posyniak said. With the Health Authority  denying a conflict of interest in such an obvious cas

Four ambulance salaries unreported? What about the real problem?

The Toronto Star ran a top of the front page news report yesterday on how the publicly-operated Ornge air ambulance service stopped reporting the salaries of four of its top bosses a few years back.  The excuse the organization is peddling, apparently, is that it has set up some for-profit companies legally separate from Ornge and so does not have to report the salaries under the law. Today, the Star editorialists got in quite a lather about this concluding, "it's up to (Health Minister Deb) Matthews to bring greater transparency to a company that provides a vital public health service and spends quite a lot of taxpayer dollars doing it." This over four unreported salaries?  Wow, call the Mounties. I suppose this does qualify as news, however.  Public providers should report publicly -- and not skirt the rules. But, step back, and the real scandal isn't that the salaries of four public sector bosses aren't reported. Rather it's that the multitude

Privatized P3 hospitals driving costs up

Negotiations have begun to increase funding in Britain for hospitals laid low by the burden of expensive public private partnership (P3 or, as the British say, PFI) deals.   P3s bring private corporations into hospital support services and hospital financing. A Maidstone and Tunbridge Wells hospital spokesman told Kent media : “MTW is part of a national review of NHS trusts that require financial assistance to support their private finance initiative (PFI).  The trust is working closely with its PCT commissioners, strategic health authority and the Department of Health as part of this ongoing assessment." Maidstone and Tunbridge Wells hospital is one of 22 trusts identified as needing cash support to meet its P3 payments. Its privatized P3 hospital is brand new.   British Treasury Select Committee P3 advisor Mark Hellowell recognizes that P3 hospitals have higher fixed costs and so  argues that they must be paid more per procedure than other hospitals. "Since some

P3 plan a threat to pension plans?

The British government,  as  noted ,  is trying to lure pension plans in to the government's deeply troubled public private partnership (P3) infrastructure development. The business oriented newsmagazine, The Economist  reviews this proposal and concludes with some words that should provide some caution for anyone who might need a pension one day. "The infrastructure plan may also point to a longer-term possibility. Two academics, Carmen Reinhart and Belen Sbrancia, have suggested financial repression as one way out of the debt crisis—forcing domestic investors to accept negative real returns. Pension funds are being invited to invest in these plans on a voluntary basis. But their assets are a very tempting pool for politicians to tap. Some day in the future, pension funds may find they are obliged to invest in such projects, regardless of the potential returns—for the good of the country, of course." That would be a very negative outcome for pension plans --

Public sector employment flat

Public sector employment in Ontario was almost exactly the same in the third quarter of 2011 compared with the second quarter, Statistics Canada reports . Ontario 3rd quarter 2010  2nd quarter 2011  3rd quarter 2011 % change  from 2nd quarter 2011  % change  from 3rd quarter 2010 Public sector                                            1,332,209 1,334,248 1,334,883 0.0 0.2 Federal general government 179,183 186,566 181,935 -2.5 1.5 Provincial and territorial general government 92,708 92,705 95,006 2.5 2.5 Over the last year there has been a very small increase in public sector employment in Ontario: 2,674 jobs or 0.2%.   Canada-wide public sector employment increased by 0.5% (18,500 jobs) over the last year, but decreased by 0.3% over the last quarter (a loss of 12,550 jobs).  

P3s? Construction Association concerned about impact on Canadian firms

The Canadian Construction Association is lobbying the federal government to consider other methods of infrastructure development than the current public private partnership (P3) model. A Vancouver construction industry report indicates that P3s " have worked only for a handful of very large Canadian construction firms. Ninety per cent of the Canadian construction industry, however, is made up of small and medium-sized firms." "The problem is in the financing component of the P3s.  Traditionally, Canadian general contractors have depended on bonds purchased from the bonding industy for financial backing for projects. P3s don’t use bonds in the same way. They require letters of credit – cash from recognized financial institutions.   Often P3s require 10% of the cost of a project covered by money in the bank. On a very large project, that can amount to hundreds of millions of dollars.   Most construction companies in Canada are not financially l

Selling bonds -- a cheaper alternative to P3s

As noted earlier , the British government is reviewing its use of public private partnerships (P3s, or, as the British call them, PFIs) for the development of public infrastructure like new hospital buildings.  The government now says  it's the   ‘end of PFI as we know it’.      Unfortunately,  they seem to be more interested in simply pulling pension plans and foreign money into the PFI vortex. The PFI advisor to the British House of Commons Treasury Select Committee,  Mark Hellowell waded in to this mess earlier this week . Instead of wrapping pension plans into PFIs, he points to a cheaper way to involve pension plans in infrastructure. "The Treasury is currently pulling its hair out trying to find ways of bringing pension funds into infrastructure investment. But the cheapest way to do this is, of course, to sell bonds to them.  They will currently buy them at a real interest rate of something like minus 3% – not bad for projects that will put people into work in th