Defend Public Healthcare

The litany of health care problems identified by the Auditor General  in her 2015 report is frightening. Here's thirty-seven of them dealing with LHINs, LTC, EMS, Rehab Hospitals, Health Infrastructure, Home Care, and Health Human Resources. Local Health Integration Networks (LHINs): A Lot of Problems LHINs have not met performance expectations. "Most LHINs performed below expected levels in the year ending March 31, 2015. In that year, LHINs on average achieved their respective local targets for six of the 15 performance areas".  Also: "Based on the provincial results that include all 14 LHINs, only four of the 11 provincial targets that measure long-term goals for LHINs were met." Performance has not improved. "While province-wide performance in six of the 15 areas measured has improved between the time the LHINs were created and 2015, in the remaining nine areas, performance has either stayed relatively consistent or deteriorated since 2010 or...

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...

Another LHIN-based  initiative to restructure   " non-urgent patient transfers"  is underway.  Non-urgent transfers are ambulance-like transfers for patients from hospital to hospital, from hospital to long-term care, or from hospital to home. While the cost of these transfers often simply come out of the hospital budget, austerity has made this more difficult.   The latest restructuring project is in the North East  -- and is funded by the North East LHIN. Earlier this year , the government strongly endorsed a LHIN-wide plan for the South West.   As in the South West LHIN, t he North East project is supposed to develop a standardized approach to the delivery of non-urgent transportation services throughout the LHIN.   While EMS had provided much of the inter-facility transfers in the past, over the last 14 years that has changed, after the Mike Harris Progressive Conservative government introduced legislation in 2000 allowing...

Ambulances are spending a little less of their time offloading patients according to t he 2012  Ontario Municipal Benchmark Initiative (OMBI) report .   That is positive: time spent offloading patients to overcrowded hospitals could otherwise be spent responding more quickly to 911 emergency calls.  Nevertheless, we remain far behind where we were a few years ago. The OMBI study reports EMS data for 12 large Ontario urban municipalities --and also Muskoka. It indicates: The percentage of time spent in hospital Emergency Rooms (“offload delay”) has declined from 18.7% of total EMS time in 2011to 17.8% in 2012.   However, this is the same percentage as in 2010 and is up significantly from 2009 when paramedics spent 16.7% of their time waiting in ERs. Indeed, in 2007 paramedics spent 15.4% of their time in hospital ERs, and in 2006 they spent 13.3% of their time in hospital ERs.  In other words, since 2006, paramedics are s...

The provincial Ombudsman has followed up on his damning report on the privatized, non-ambulance patient transfer industry.   The Mike Harris Progressive Conservative government privatized the patient transfer industry at the turn of the century, moving the work over from Emergency Medical Services (ambulance services).    Two years ago, however, the Ombudsman and the CBC reported major problems in this newly privatized industry, including threats to patient safety and working conditions.   Ontario residents would be better off taking a taxi to a hospital than one of the privately owned vehicles used to transfer hundreds of thousands of non-critical patients each year, provincial Ombudsman Andre Marin   concluded . On July 16, 2013, the Ombudsman followed up on his earlier report,  stating  that “ Two years after promising to regulate the non-emergency medical transfer industry to protect the hundreds of thousands of pat...

The Minister of Health and LTC has strongly endorsed the restructuring of the patient transfer industry in the South West LHIN.  This may set a new model for the private corporations that often move patients between health care facilities in vehicles that look, for all the world, like ambulances -- but are not.   For the first time, a LHIN-wide patient transfer provider has been chosen, with the goal of standardizing equipment and staffing qualifications. Health Minister Deb Matthews states: "This non-emergency transportation approach is precisely the type of collaborative effort that will help transform the health care system in Ontario. Standardized equipment and qualifications will lead to enhanced quality of care and safety for all the people hospitalized in the South West LHIN." This restructuring is, no doubt, a response to the scandals uncovered in the private transfer industry over two years ago by the CBC and the provincial Ombudsman.   Ontario resi...