Skip to main content

English reforms lose their appeal in Ontario?




England has had a disproportionate impact on health care reform in Ontario over the last decade or so --under both Liberal and Progressive Conservative governments.  

After the election of a Conservative-Liberal Democrat government in Britain in 2010, English health policy took a decided turn towards bonzo-privatization.  (As elsewhere, this was done on a "need to know" basis: the electorate were only informed about the policy after the election.)

So it was with a worried eye that I looked at the latest report on these reforms and what they might mean for Ontario from Ontario's (very establishment-oriented) health care think tank, "The Change Foundation".

The good news is that The Change Foundation shows rather tepid interest in the latest English reforms.  Here, for example, are their two take away lessons from the English reforms:


Quality improvement in primary care must be integrated with a performance measurement framework which is connected and aligned with performance measurement for the broader healthcare system. We need an overarching quality outcomes framework with an integrated, cascading set of measures. Ontario can learn from England’s experience with the NHS Mandate, its closely linked Outcomes Framework, and the integration of performance measurement with payment.
We can also learn from the NHS England’s experience with patient and public engagement. They have a history of involving patients, informal caregivers and the public in the development of healthcare guidance and quality standards, and the Health and Social Care Act provides additional opportunities for patients and families to express their views about their healthcare system.

Not much more than quibbles from where I sit.

Perhaps the Foundation's rather limp interest is connected to the problems the legislation had getting passed, the replacement of Health Secretary Andrew Lansley (who had led the reforms), the flack the Tories are getting over the reforms, and widespread doubts the reforms will actually solve anything. 



Photos: Run Prime Minister Run (with apologies to Cary Grant) and Oops! by  Byzantine_K

Comments

Popular posts from this blog

Ford government fails to respond to 72% increase in COVID inpatient days, deepening the capacity crisis

COVID infections continue to drive up hospital costs and inpatient hospitalizations in Ontario. For the most recent fiscal year (April 1, 2022- March 31, 2023) hospital stays related to COVID cost $1.221 billion, according to new CIHI data.   This is about 4% of total hospital spending, creating a very significant new cost pressure beyond the usual pressures of population growth, aging, inflation, and rising utilization.   Costs for COVID related hospitalizations increased 22.2% in Ontario in 2022/23 from the previous fiscal year, rising from $999 million to $1.221 billion.  That rise is particularly notable as the OMICRON spike of late 2021 and early 2022 had passed by the the 2022/23 fiscal year.   The $222 million increase in COVID hospitalization costs came in the same year as the Ford government cut special COVID funding and, in fact, cut total hospital funding by $156 million.     In total, there were 60,653 COVID hospitalizations...

The hospital crisis: No capacity, no plan, no end

While Canada has achieved universal public healthcare coverage, that does not mean conservative forces have given up trying to erode that coverage and expand corporate care where it does not currently exist. The battle has become particularly intense in Ontario under the Ford Progressive Conservative government, which is implementing serious cuts to the level of care and moving to bring in for-profit mini-hospitals. Inadequate Staffing.   Less and less of hospital spending is on staff.   Employee compensation as a share of hospital expenditures has consistently shrunk in Ontario. This is not some immutable law of hospital development.  It is in stark contrast with the rest of Canada, where compensation has become a larger share and now accounts for 67.1%. Hospitals in provinces other than Ontario now have 18 percent more staff per capita than hospitals in Ontario. Overall, if Ontario had the same staffing capacity as the other provinces and territories, there would be another...

Paramedic Services in Canada: Structure, Privatization, Unionization and other issues

Governance and Funding :  While police and fire services are usually municipal services, Emergency Medical Services (EMS) are typically controlled by provincial governments.  In Ontario, regional municipal governments have responsibility for delivering and funding EMS.  But even in Ontario the province plays a key role, strictly regulating EMS, providing funding for 50% of the approved land ambulance costs, and paying 100% of the approved costs for air ambulance, dispatch, base hospitals, First Nation EMS, and for territories without municipal government. Delivery :  Like police and fire services, EMS is predominantly a publicly provided service in Canada.   But businesses have now made some significant in-roads into EMS, primarily  Medavie,  a private corporation based in the Maritimes that describes itself as not-for-profit.  Medavie goes back over 70 years, with its roots in health insurance.  It still operates Medav...