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Showing posts from April, 2012

LHINs get stuck with even less funding

The Local Health Integration Networks (LHINs) are getting stuck again.   According to the newly released Budget Estimates, the government is cutting their funding.  The cut is, at least, small ($3.25 million out of a total LHIN funding of $23 billion). LHINs are the primary funders of hospitals, long term care homes, and home care.  Last year, at least they got a little bit of an increase -- 0.9% (based on the scope of services the LHINs are currently supposed to cover).  That gives the LHINs a whopping $64 million extra to play with compared with two years ago.  That might sound like something until you consider they provide $23 billion in services.   In effect, the government is making the LHINs the bad news bearers.  With no new money, they are going to have to squeeze the providers.  Health care consultants who dreamed that LHINs would become powerful agents for change will be disappointed.  At most, the LHINs will have to suffice with encouraging change through a  la

Health care funding 1/3 of cost pressures

Health Care Funding Crisis.   The government has announced that global hospital funding will be frozen this year.  This is down from even the very modest 1.5% increases in the last two years.  Other forms of hospital funding are also down sharply – with the government promising to increase total hospital operating funding only 2% this year (2012-13).  This is well less than half the total budgeted expense increase in each of the previous two years.    The Budget states that the government will hold “ growth in hospitals' overall base operating funding to zero per cent in 2012 - 13”.  Presumably, this means “global funding” (payments for existing services and jobs) will be frozen.  However, “total hospital operating funding will grow by 2.0 per cent in 2012 - 13”.  This, the government says is for “ongoing support for key services such as wait-times initiatives and priority treatments, including for chronic kidney disease and transplants.” Exactly what this means remains vag

Concession demands grow -- as Ontario economy grows

The Ontario government opened with the idea of a compensation freeze for public sector workers -- but now they appear to be calling for concessions. The Globe reports today that they simply demanded teachers accept a  pay freeze for two years, no movement within the existing salary grid, and an end to retirement payouts for unused sick days.   This while the Ontario economy continues to grow -- as it has since the latter part of 2009.   Real growth of the Ontario economy over the first two years of the CUPE central hospital collective agreement (from the fall of 2009 to the fall of 2011) was 5.5% according to Ontario government figures.  Growth in terms of nominal dollars (i.e. growth including inflation) was 9.8%, with the economy growing from $582.2 billion to $639.4 billion. Workers wages, are, of course, paid in nominal dollars -- and have not increased at that rate in the hospital sector or elsewhere. Over the calendar years 2009, 2010, and 2011 inflation increased 6%, e

Aging at Home or Waiting at Home? Hospital bed cuts

The Ontario government withdrew funding for 30 ALC beds at the Memorial site of the Health Sciences North hospital in Sudbury.   The Sudbury Star reports that since the beds closed, the hospital has re-opened 6 or 7 beds at the Memorial site, paid for out of the hospital's own funds.  In addition, the number of ALC patients at another site of the hospital has increased from 44 to 77 -- an increase of 33. On Friday,  18 people admitted to emergency were lying in cots awaiting a bed. The result?  The hospital is now designated in 'crisis' and to get it out of crisis, hospital patients will be given priority over people waiting at home for long term care beds.  The hospital beds for ALC seniors, the Star reports, cost $600-$700 per day -- more than twice the cost of ALC beds at Memorial.   The hospital is stuck paying this it seems while trying to eliminate a $9 million deficit by September 2012. It doesn’t sound like the government’s plan to cut costs

Business School & Accountants Association: P3s unproven

The British Association of Chartered Certified Accountants  and Manchester Business School have concluded that "The value-for-money case for PPP (public private partnerships or P3s) in the public sector has yet to be proven. The benefits gained from the availability of 'extra' finance, the transfer of risk from public to private sector, and improvements in decision-making processes are too nebulous to provide any certainty that they outweigh all the known problems." Author Professor Graham Winch of the Manchester Business School told the Telegraph ,  "PFI (another name for P3s) has undoubtedly allowed the UK to acquire more social infrastructure earlier, and this has stimulated short-term economic growth, but it has led to an overhang of debt in the shape of commitments to unitary charges stretching some 30 years into the future and constraints on the flexibility of public bodies in using their infrastructure".

Ontario union wage settlements and inflation

Ontario union wage settlements averaged 1.6% in the first two months of 2012 in both the public and private sectors.  This is close to the average of 1.7% in 2011, and 2.0% in 2010, with public sector settlements trailing private sector settlements in both of those years. Inflation has been somewhat higher than the average annual wage settlements.  Inflation was  2.4% in 2010 in Ontario, 3.1% in 2011, and is running at 2.6% this year to date, according to the Ontario Ministry of Labour.   If this trend continues for the rest of the year, annual average settlements will be 2.93% less than inflation over the three years.    Regardless, the government is angling for a compensation freeze (and more).   Collective agreements covering 592,084 employees come open in 2012 – making this one of the bigger bargaining years.  Most of the employees affected are public sector (74%).   By far the largest share comes from the school board sector (255,400) in August.  In total, CUPE has 39

Over 90% of hospital privacy curtains contaminated

A new study published in the American Journal of Infection Control reports that over 90% of hospital curtains examined six times over a three week period at a US hospital were contaminated at least once with Staphylococcus aureus, MRSA, VRE, or aerobic gram-negative rods. "Forty-one of 43 curtains (95%) demonstrated contamination on at least 1 occasion, including 21% with MRSA and 42% with VRE. Eight curtains yielded VRE at multiple time points: 3 with persistence of a single isolate type and 5 with different types, suggesting frequent recontamination." Hospital curtains are frequently touched by hospital patients, staff, and visitors. The study concludes that "privacy curtains are rapidly contaminated with potentially pathogenic bacteria. Further studies should investigate the role of privacy curtains in pathogen transmission and provide interventions to reduce curtain contamination."

Hospital boss -- Ontario Budget means double the cuts

The CEO of the Windsor Regional Hospital says the hospital will have to cut $4 million in hospital expenses as a result of the recent Ontario provincial Budget. (The Budget froze global hospital budgets.)  He had been planning to cut $2 million, apparently with the expectation that the Budget would provide some growth in global budgets this year.  "How can we find those savings without reducing existing services or reducing staff?" he asked. The hospital boss, David Musyj, called on the government to help move surgeries out of hospitals and into clinics, and introduce legislation preventing arbitrators from awarding wage increases hospitals 'can't afford,' CBC reports . While hospital global budgets were frozen by the Budget, the government promised to increase hospital funding 2%.   As is typical, the Liberal government has left the details of the new funding vague for now.  Still, total hospital funding increases are well less than half of last year's