Defend Public Healthcare

Amidst the storm of criticism of Local Health Integration Networks (LHINs), the Minister of Health and LTC, Deb Matthews, has now said that bringing doctors and health units under the LHIN umbrella will likely be discussed when a much-anticipated legislative review of the LHIN system eventually takes place.  (This review, previously scheduled for this year, has now been put off until after the next election.) The LHINs have, slowly but surely, taken over responsibility for hospitals, nursing homes, home care, community health clinics, and other community health services.  But doctors, public health units, and ambulance services remain outside of their dominion. The doctors probably won't tolerate having to put up with the LHINs -- they will want to deal directly with the province (the people with actual political power, not just the flak catchers). The public health units (currently under municipal control) are more of a question, to my mind. They already get 75% of their app

The McGuinty government flak catchers at the Hamilton Niagara Haldimand Brant LHIN just keep at it. Not satisfied with all the (negative) attention they received for effectively shutting down the hospitals in Fort Erie and Port Colbourne, they are now in the midst of shutting down 181 complex continuing care beds across the LHIN. The Hamilton Spectator reports today that between "December and May, area hospitals closed 123 of 809 beds used to treat the dying, patients with multiple complex conditions, seniors with dementia and those needing restorative care to get home. " The plan is to close a further 58 beds by April 2012. "We've been able to reduce the number of beds without reducing access to service because the CCAC (Community Care Access Centre) is now taking care of these individuals in the community said Alan Iskiw, LHIN interim CEO. This does not sit well with widespread reports that the CCACs (which oversee home care) are cutting services to deal

The LHINs have contracted out $33 million of work to consultants.  Fitting with their recent turn towards criticising everything LHIN, even the provincial Conservatives are complaining. Money gobbled up by consultants would be better spent helping patients who are facing service cuts from cash-strapped hospitals, Conservative critic Norm Miller told the CBC .  "We see the LHINs as diverting money that should be going to front line health services: to procedures, to doctors, to nurses." It is a major problem that so much gets privatized or contracted out by the current government (and their minions). A lot of money is wasted.   But it's kind of hard to believe that Tim Hudak's Conservatives are going to do much better. This is the party that introduced compulsory contracting out in home care (now in its sixth year of suspension following repeated outbreaks of public anger) and privatized P3 hospitals, which practically breed consultants.  Indeed, the Ontario

The Liberals continue to pay a heavy price for their health care sins.  And for the Progressive Conservatives (now leading in the latest poll), the LHINs are the gift that just keeps on giving.  The Erie St. Clair LHIN boss has now issued an apology for  making his, er, 'frank' remarks regarding Progressive Conservative leader Tim Hudak:  “Let’s be very clear — this guy is making this crap up and it’s false. I don’t think the public is stupid enough to believe him.” Notably, the 'apology' does not extend to Hudak, just to the local population.  (But for all the groveling, see the  What's New  section of the Erie St. Clair LHIN web site.) Adding to the joy of Progressive Conservatives everywhere, the chair of that very same LHIN claimed  "I don't think it's a lot of money" when asked about the $54,075 in per diem payments that she received last year (a 29% increase over the year before). The Chair, Mina Grossman-Ianni has donated $2,422 to t

As reported here  a week and a half ago, the Erie St. Clair Local Health Integration Network (LHIN --  the guys charged with funding and restructuring Ontario health care) was planning to bring in Disney speakers for an hour or two at an upcoming LHIN conference.  Well (following a lot of public criticism), it now appears that even the LHIN finds this idea too goofy (or, perhaps, just a little mickey mouse).  So they've pulled the Disney speakers.  But the Erie St. Clair LHIN CEO, Gary Switzer, is not backing down graciously.  Here's his response to Tory leader,Tim Hudak, who had criticised the plan:  “Let’s be very clear — this guy is making this crap up and it’s false. I don’t think the public is stupid enough to believe him.” The Windsor Star notes that Switzer countered  Hudak, claiming the LHIN was not going to spend $10,900 for Disney speakers to lead the 90 minute chat, but rather only $9,500. (At this point I might note that I'd be more than willing to talk

The provincial government Estimates (a document where the government lays out in some detail how it intends to spend the money in the provincial Budget) indicates that health care 'provincial programs' are going up $943,146,400 this year compared to last year.  (Line item 1412 .)  Just shy of a billion dollars. Now that's a whopper of an increase: a 37.5% increase in fact ! While the provincial government is giving its own 'provincial programs' a massive increase, the LHINs (the main funder of hospitals, home care, and long term care) will be getting a miserly 1.5% increase. In fact the total increase for the LHINs, $322 million, is about a third of the $943 million increase for the (much smaller) 'provincial programs' budget. A cynic might suspect the government is giving itself a free hand to make funding announcements, while the LHINs are stuck with the job of telling hospitals, homes, and home care providers that 'There's no money, ther

Health care slashers and right-wingers are beginning to understand the pickle they are in over the falling faith in the the LHINs, the Liberal government's instrument of choice to cut health care services.  Here's the conclusion of today's Ottawa Citizen editorial : With an aging population and rising health-care budgets,it is difficult to imagine a year in which every health network in the province doesn't face some very tough decisions involving a region's crucial health-care services. Without public trust, those decisions will be much harder, if not impossible. Which is why Marin's (the Ombudsman) findings are crucial. Indeed, LHIN imposed cuts will be harder now that the LHINs have been discredited.  (What a pity!)  But this won't stop those cuts. And here's another troubling thought.  If the LHINs are becoming blunt instruments,  another instrument may be introduced to make the cuts down the road.  In other provinces the trend has been for

A darn good letter on the McGuinty government's  introduction of the LHINs from local CUPE hospital activist, Paul MacDonald. It was published yesterday in the Toronto Star .  Paul -- yes -- public sector union and community activists did do a pretty fair job campaigning on the problems associated with the LHIN model, and did so pretty much right from the get go.  And YES, it is nice to see that at least some of those problems are becoming more apparent to a broader section of the population now. So a thanks to all the local union and community activists who got the ball rolling! -- Doug LHIN system should be scrapped; Secret health unit meetings 'illegal,' Aug. 11 Toronto Star, Sat Aug 14 2010 Page: IN7 Section: Letter Re. Secret health unit meetings 'illegal,' Aug. 11 Not only should these secret LHIN board meetings be deemed illegal, the entire system of LHINs should also be deemed illegal. When an unelected, unaccountable board of overpaid bur

The Windsor Star (not usually my favourite editorialists) has an interesting editorial today on the LHINs (and the Ombudsman report): Obviously there are many issues the government needs to deal with. And how is it that Matthews is only now getting around to establishing standards for community engagement between LHINs and the public? Conservative Leader Tim Hudak calls these networks "unaccountable, unelected, secretive and entitled health-care bureaucracies." NDP Leader Andrea Horwath called the report a "damning indictment of a system that is unaccountable and completely unresponsive to the community whose interests it should represent." Both are right. Horwath makes sense when she calls for a full review. Marin calls the LHINs in general "defensive and recalcitrant," with an attitude that says "We did nothing wrong and we won't change." For that reason alone, the health minister must step in now. If you need more evidence of the '

Deb Matthews is staunchly defending the decision to close the emergency rooms in Fort Erie and Port Colborne despite the sharp critique of the LHINs (illegal) consultation process by Andre Marin, the Ontario Ombudsman.  Matthews told Niagara area papers "We're not revisiting that decision. The decision remains the right decision...we're absolutely not going to be reopening that decision."  Obligingly, the LHIN chairwoman Juanita Gledhill said her board doesn't plan to revisit its earlier decisions either.  Big surprise. This does not bode well for other smaller hospitals.  Even in the face of months of community outrage, calls from the opposition parties, and an Ombudsman's report suggesting a phony consultation process, Matthews will not even consider a review of the decision to close the small hospital ERs. Now there's a government official determined to do some damage. So it is interesting to hear that  Port Colborne Mayor Vance Badawey says &

Boy, I almost feel sorry for the Local Health Integration Networks (LHINs).  They are taking a terrible pasting following the Ombudsman's report that exposes their community 'consultations' as a complete scam.  Apparently, one LHIN leader thought conferring with pals at his private golf course (open to anyone who can afford $8000 in green fees) was an acceptable form of consultation. While anyone who has been involved in health care knows the the LHINs do not really consult their communities, I feel pretty confident that the Tories and the right-wingers (who are kicking the LHINs now that they are down) actually prefer "a process that makes no pretence of consultation than a dishonest sham.  Better the honest dictatorship than the faux democracy."  (As, in fact, Christie Blatchford suggested yesterday in the Mop and Pail .) Despite the Ombudsman report, Deb Matthews and the Liberal government refuse to review the closures of hospital emergency rooms and servic

Kudos to Maria Babbage at the Canadian Press for today's  story on hospital deficits. Nobody else is digging up the facts on hospital funding like she is.  Nevertheless, the bottom line is hardly surprising: For the second year in a row, more than a third of Ontario hospitals are bleeding red ink, amounting to a $107-million shortfall. Sixty-one of the province's 159 public hospitals, or 38 per cent, reported a deficit in the last fiscal year that ended March 31... The financial picture of Ontario hospitals is largely unchanged from the previous year, when 61 hospitals reported shortfalls amounting to $154-million... There is concern that while the number of cash-strapped hospitals remained steady, it may be a different story in 2011 due to shrinking provincial funds. But buried at the end of the story is a surprising fact: The Niagara Health System, which (in)famously played ball with the Ontario government by cutting services and Emergency Rooms, got a WHOPPING $49 mill

It looks like we are making some progress in the Cornwall area – according to a local media report , the LHIN has tentatively agreed to contribute half the costs for 20 interim LTC beds at Cornwall Community Hospital. Previously, the LHIN CEO had called the proposal for 20 beds at the Cornwall hospital a "knee jerk reaction." A Cornwall hospital official now says "The Champlain LHIN is showing its commitment to the Cornwall Community Hospital."  The hospital hopes to have the interim long term care beds up and running at least on a temporary basis in the fall.  St. Joseph's Continuing Care (which provides Complex Continuing Care and LTC) in Cornwall is also getting 8 LHIN funded beds. (Despite media reports that the LHIN will add six beds at Glengarry Memorial Hospital, a local source indicates that complex continuing care beds are being changed to stroke beds, with a very modest staffing increase.)  All of this is to deal with the overcrowding at the Cor

The Champlain LHIN is "Rethinking Healthcare".  And it's pretty scary. For populations of 50,000 to 100,000, the LHIN suggests that ‘polyclinics’ (like the new ‘Orleans Family Health Hub’) could be a substitute for local hospitals.   In fact the document specifically promotes polyclinics for urban and suburban settings. And whether it is a hospital or a polyclinic, facilities for these communities should not do surgeries requiring overnight stays, but rather be limited only to day surgeries. The thinkers at the Champlain LHIN also opine that  "So much of what a hospital does could be done anywhere".  So strip malls would provide dialysis and primary care facilities (doctor’s offices and the like) would provide Urgent Care. Hey Dude , where's my ER? Some distance away, it seems.  Only "District Hospitals" serving 100,000 to 200,000 people would get to keep their emergency rooms. And they could be an hour away.  (I think you can pretty much

The Champlain LHIN boss, Dr. Robert Cushman, has practically ridiculed the Cornwall Community Hospital for proposing to place 30 convalescent beds in the hospital to help deal with the growth of alternate level of care (ALC) patients. According to Cushman, the proposal is a 'knee jerk reaction'. How on earth does this fit with the Health Minister's new plan to create more short term 'restorative' beds? This response is also disappointing as the North East LHIN recently added 136 convalescent beds to the Memorial site of Sudbury Regional Hospital (for at least a year) to deal with their growth of ALC patients. It also seems the Central East LHIN will postpone the proposed cut of convalescent beds at Northumberland Hills Hospital for a year. Dr. Peter Zallan, of the Sudbury ALC Committee, notes that the creation of new convalescent beds at the Memorial site of Sudbury Regional was important: "Without the Memorial site, this place wouldn't be functioning

The Liberals have doled out about $70 million in recent weeks to tide over  a dozen or so hospitals facing deficits or other problems as the fiscal year ends.   Of course, many other communities have just been left to suck up service cuts.  (About 70 hospitals are in deficit and about 30 are forced to get cash advances from the government just to meet payroll.) The claim is that this  differential treatment is based on a scientific estimate of the merits of the claims by the various hospitals. And, heavens, it certainly has nothing to do with politics. So it is interesting to note that about half of the money went to communities that pushed back the hardest: Niagara and Brampton.   Cornwall also got about $5 M.  The local LHIN boss claims that a LHIN " team spent considerable time and energy reviewing the hospital 's clinical services, administration, and governance before concluding   that $6.6 million of additional annual operating funding was necessary." 

The Progressive Conservatives are now attacking the Local Health Integration Networks ( LHINs ). MPP and former Tory cabinet minister Jim Wilson says: "Invoices reveal that many of the same consultants who were getting rich off of eHealth were getting even richer by billing LHINs at the same time. In fact, one consultant who happens to be McGuinty's former health advisor, billed $80,000 to the Toronto Central LHIN at the exact same time she was getting paid $327 an hour by eHealth to, among other things, write a letter to a Liberal pollster not even involved with eHealth . This diversion of much-needed health dollars is significant. As an MPP , I receive phone calls all the time from constituents who can't find doctors, timely medical procedures, long-term care beds or homecare for loved ones. At the same time, I hear from hospitals that are facing deficits, nursing homes that want to expand to meet demand, and other health agencies that are struggling. A lot of