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Showing posts from February, 2013

It's OK to close hospital beds

Aside from the predictable (but fun) response from Deb Matthews to yesterday's Ontario Health Coalition report outlining cuts in Ontario hospitals ("It is OK" to close hospital beds, she opined), we did get a snippet or two of information from the government. 

The Star reports the Health Minister's office also made these claims:

70 per cent of hospitals have seen increases  -- 63 hospitals.  This is inaccurate in some way. There are about 159 hospital corporations in Ontario (there's many more hospital facilities).  So if 63 is accurate, that would be 39% of hospital corporations got an increase.  If it is 70%, that would be about 111 hospital corporations. So somebody got the math wrong.The largest decrease that a hospital has received is 1.2 per cent and the largest increase is 2.8 per cent.About 81 per cent of hospitals have seen no more than a 1 per cent swing, up or down. So, if this is true, the large majority of hospitals got either a very small absolute inc…

Contracting out costs soar 26% per year

Contracting out of medical transcription work is becoming more common in Ontario hospitals.

So it is noteworthy that our sister union in BC, the Hospital Employees Union, reports today that "the cost of outsourcing medical transcription services in the Lower Mainland has increased by an average of 26 per cent a year over the last five years, according to financial documents produced by health authorities."

Regardless, the health authorities "plan to completely contract out in-house medical transcription later this year and fire about 130 medical transcriptionists (MTs), who currently work directly for health authorities."

Currently, about 50 per cent of medical transcription volume is contracted out in B.C.

HEU has also raised questions about the accuracy and privacy of patients’ medical reports when transcribed by a network of home-based workers across the country.  The Union has asked B.C.’s privacy commissioner to investigate.

Photo: Wistechcolleges

Ontario cuts cataract surgeries by 10%

A senior director of the North East LHIN has told theNorth Bay Nipissing that the government cut cataract surgeries by 10% across the province this year.  This has forced the North Bay Regional Health Centre to stop such surgeries until April 1 (the beginning of the fiscal year).Another recent report indicates that the Hotel Dieu in Kingston is now performing 10 cataract surgeries per week until the end of March -- down from 60 per week.
While, in the past, global funding allowed local hospitals to determine local needs, the government's new "fee for service funding" (aka "patient based funding") gives all that power to the province.  For some reason, Toronto decided to cut 10% across the province, it seems.  
Local decision making anyone? 
Moreover, where was the public discussion (or even notification) of this decision?  We are almost at the end of the fiscal year, and this is the first that I, at least, have ever heard of a decision to cut cataract surgeries by…

Private clinic deal ends badly while Ontario inks up more

Health Edition reports that the Quebec Health Minister has decided not to renew the contract with  RocklandMD, the private hospital that has done about 9,000 publicly funded surgeries since 2008 in Quebec. The contract expires September 2014. 

While the private clinics have tried to edge into the business via simpler surgeries, RocklandMDclaimsto be able to perform  a broad range of day surgeries, “from the simplest to the most complex, in various specialities and within very short times.”

The public health insurer found  that RocklandMD was charging people illegal facility fees (a charge often leveled against private clinics).  RocklandMD disputes this and is resisting attempts to recover the money.  Health Edition reports that the matter is headed for(where else?) the courts.  

Quebec plans to bring all the surgeries back into the public system. 

Meanwhile, Ontario is looking to turn surgeries over to private mini-hospitals.


Ch-Ch-Ch-Changes from the Liberals on bargaining and health

The Throne Speech from the new Liberal government of Kathleen Wynne sticks fairly close to previous Liberal policy.

But it does make a few noteworthy new turns.

With the past Liberal government, the claim was they would expand home care. The problem was their expansion was more imaginary than real -- and the claimed expansion was served up as justification for real cuts in hospital and long term care. There is barely any change here:
"Along with all parties in the legislature, it (the government) understands the pressing need to expand access to home care in Ontario. And so your government will continue to expand the support available to people in their homes, and to address the needs of men and women across Ontario currently waiting for the home care services they require." So, if we take them at their word, they will "continue" their existing policy. Whoopee.  The good news? At least there is some recognition here that they need to address the needs of peop…

Home care funding falls short - of even aging cost pressures?

The Ontario government likes to suggest that the planned annual 4% nominal increase in "home and community care" funding will offset their cuts to hospital services and squeeze on long term care beds.

But it's not totally clear that this funding will offset cost pressures on home and community care arising from the rapid growth in the elder population -- never mind growth in the entire population,  never mind inflation, never mind unmet home care needs, never mind hospital cuts, never mind the squeeze on long term care beds.

The Ontario Ministry of Finance estimates that those aged 85 and over will increase 18.8% in the four years from 2012 to 2016. That equals a 4.4% annual average increase. The 90 and over portion of that group will increase much more: 35.1%. That's almost 8% per year.

This is relevant to the cost pressures on home care as this age group requires an awful lot of home care. A December 2012 Statistics Canada report indicates that 54% of the pop…

Hospital cuts in 1.7% to 2.7% range

More hospital savings.

Joanna Frketich reports Hamilton Health Sciences needs to find $20 million to $25 million in savings, while Hamilton St. Joseph's is cutting $10 million to $12 million, and Burlington's Joseph Brant must cut $4 million.  

In total, $34 to $41 million in cuts for Hamilton area hospitals.   

That is in the range of 1.7% to 2.7% of the hospitals' budgets. 

This is on top of earlier cuts.  Over the past year the three hospitals found $30 million in savings.  The government would no doubt focus on the increase in home care funding of $8.7 million -- but even that funding also had to cover Niagara, Haldimand and Brant. It also barely covers the cost pressures of inflation, aging, and population growth, never mind hospital cuts and the squeeze on new long term care beds.

Beatrice Fantoni reports Windsor Regional is laying off 34 Registered Nurses after the province put off over six years its promise to open 58 complex continuing care and rehabilitation beds.  Th…

Attack on free collective bargaining political, not fiscal

In December, it was predicted that outgoing finance minister Dwight Duncan would   reduce his deficit forecast just before his departure (for Bay Street).  Duncan had somehow estimated in his fall economic statement that the 2012-3 deficit would be  $14.4 billion, i.e. higher than the 2011-12 deficit  -- and even higher than the 2010-11 deficit!

Sure enough, Duncan lopped another $2.5 billion off the deficit in January.

In 2010, the McGuinty / Duncan government started its campaign for a wage freeze in the provincial public sector, citing the state of the public books.  At that time they had estimated deficits totaling $74.2 billion from 2009/10-2012/3.

Deficit (in billions of dollars) 2009–10 2010–11 2011–12 2012–13 Total 2010 Budget

It's raining cuts

Premier designate Kathleen Wynne has strongly suggested that hospital cutbacks will continue

 Of the cuts just announced at the Ottawa Hospital, Wynne says the government is "transforming the health-care system, so services that need to be delivered in a hospital setting are delivered in a hospital setting, but services that don't are delivered elsewhere....It means there will be alterations in the health institutions in our cities and our towns."

One would hardly know she is referring to the cut of 290 jobs (and about $31 million) at the Ottawa Hospital.

 The Ottawa cuts are just the latest in a spate of cutback announcements in the last few weeks.

 Bluewater Health in the Sarnia area is looking to cut $5 million by cutting staff, reducing the number of nurses in its cardiac care unit, changing the bedside staffing model, and merging its critical care units.

 The Niagara Health System has recently unveiled a partial plan to deal with its $13 million deficit. The…