Nursing levels low and getting lower

Yesterday, I wrote about the significant lack of nursing care in Ontario hospitals compared to the other provinces. Even on a Canada-wide basis, there was 5.32 hours more nursing care per patient than in Ontario in 2010-11 (year end March 31).

That sounds kind of shocking.

But it looks like it is getting worse. Other data from CIHI indicates that over the course of 2011, Ontario hospitals lost thousands of nurses. Specifically, there was a sharp reduction in the number of Registered Nurses (RNs) working in Ontario hospitals in 2011, with a cut of 2,750 RNs to 58,699 according to new CIHI data. That is a loss of 4.5% of RNs.

Compounding the problem, there was a decline in the number of Registered Practical Nurses (RPNs) working in hospitals in Ontario as well, with the numbers declining from 13,373 in 2010 to 13,126 in 2011. That's a decline of 247 RPNs -- or a loss of 1.8% of RPNs in one-year. This is a significant change from the previous years: there was 19% growth in RPNs employed in hospitals between 2006 and 2010.

Overall, 2,997 nurses were lost from Ontario hospitals in 2011. In total, that is a loss of 4% of nurses - in one year.

That doesn't sound good.

Given the much tighter funding that hospitals are facing in 2012 and 2013, I'm expecting the levels of nursing care in Ontario to fall further behind.

Unless something is done about it.

Photo: Lower Columbia College

Deficit? Public spending ain't the cause. Revenue, however...

With the election over, pressure to cut public programs has become quite intense. In almost all of the corporate owned media someone is barking on about it.

Another option -- increasing revenue from corporations and the wealthy is not mentioned. However, data clearly indicates that Ontario does not have an overspending problem compared to the other provinces.

Instead, it indicates Ontario has very low revenue.
Ontario has the lowest public spending of all the provinces on a per capita basis (see the chart from the 2014 Ontario Budget below). So there is little reason to suspect that we have an over-spending problem. If anything, this suggests we have an under-spending problem.

The Ontario government has also now reported in the 2014 Budget that Ontario has the lowest revenue per capita of any province. This is particularly notable as other provinces are quite a bit poorer than Ontario and therefore have a much more limited ability to pay for public spending. (Also notable in this…

Budget underwhelms on health care. Bait and Switch is such a nasty term

Last year the government promised a 4.64% health care funding increase in 2018/19. Then, earlier this month, they announced they would deficit spend to improve hospitals, mental health, home care, and child care. Three of the four items cited by the government for improvement were part of health care.

As it turned out the government did in fact promise in today's Budget to deficit spend $6.7 billion. (Due to a $1 billion fall in expected revenue, the extra spend amounts only to an extra $5.7 billion for 2018/19 programs – but that is still a significant chunk of new found cash for program spending.)
If health care had gotten even a proportionate share of this new $5.7 billion in program spending, it would have added an additional $2.4 billion to health care -- in other words about another 4% increase.

But all health care got -- despite the government’s health care rhetoric -- was an extra $284 million. That may sound like a lot but with a total health care spend of $61 bill…

Ford government promise falls far short of solving hospital hallway medicine problem

Tens of thousands of new Long-Term Care (LTC) beds needed just to offset aging
The new Progressive Conservative government in Ontario has promised 30,000 new long-term care beds over the next ten years, often connecting this to their promise to end hospital hallway medicine. But how does this promise stack up with growing demand for these facilities?
Most people 85 and older live in collective dwellings (LTC facilities, seniors residences, multiple level of care facilities). The setting with the largest number of elders 85 and older is LTC facilities, with about 35% of the population 85 to 89 years old and almost 40% of the population 90 to 94 years. Older people are even more likely to be in a LTC facility.
The population 85 and older is the main driver of the need for long-term care beds.
An additional thirty thousand LTC beds by 2028 will only partially offset the rapid growth in the 85+ population. The ministry of finance projects 42.5% growth in the most relevant population (85 a…

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