Defend Public Healthcare

Funding increase hits new low: The Ontario government plans health sector spending growth of 1.2% this year compared with the interim spending estimate for 2014/15.   This deepens the trend to cut health care funding increases. ($000s) 2005-6 2006-7 2007-8 2008-9 2009-10 2010-11 2011-12 2012–13 Actual 2013–14 Interim 2014–15 Plan 2015–16 Health and Long-Term Care 32,947 35,655 38,118 40,734 43,054 44,414 46,491 47,571 48,933 50,173 50,771 % Increase 4.0% 8.2% 6.9% 6.9% 5.7% 3.2% 4.7% 2.3% 2.9% 2.5% 1.2% The average increase over the last four years is 2.2%.  Over the previous six years, funding increases averaged 5.9%, well more than double the more recent average.  This year's plan of 1.2% is a new low.  In 2011, the then Auditor General noted that various factor

CUPE and OCHU are campaigning for a legislated minimum average of four worked hours of nursing and personal care per resident per day in long-term care (LTC) facilities. Key points:  [1] The relevant population is increasing rapidly; [2] New beds are not being created at the same pace; [3] Resident acuity and impairment are increasing; [4] Increasing acuity requires more care; [5] The province of Ontario provides less funding and less care than other provinces; [6] Expert research supports our proposal; [7] The experience of CUPE members in the homes provides some of the most compelling evidence of the need for more care.  History:  In the past, Ontario did have a standard of care, but it was taken away by the Mike Harris Progressive Conservative government.  At the time of its abolition the standard was insufficient – it was set at only 2.25 hours per resident per day.  Since that time the homes have changed dramatically: residents are much more impaired. The Ontario He

New data  published by the Canadian Institute for Health Information (and based on a mandatory survey undertaken by Statistics Canada) indicates that staffing at Ontario long-term care facilities (LTC) falls short of other provinces.  The Long-Term Care Facilities Survey indicates that Ontario has 0.598 health care full time equivalent staff (FTE) per LTC bed. Canada (excluding Quebec, which is not included in the survey) has 0.641 staff per bed.   In other words, Canada as a whole has 7.2% more health care staff per resident compared to Ontario. This despite the relatively low number of higher paid nursing staff in Ontario. RNs and especially RPNs are underrepresented among all health care staff in Ontario LTC facilities, with RNs comprising just 11.5% of health care FTEs and RPNs comprising just 19.3% of health care FTEs. Across Canada the corresponding figures are 13% and 25.6%. Fewer RPNs to RNs: Ontario has a relatively low number of RPNs compared to RNs in LTC faci

Government data suggests for-profit long-term care bed s are less desired by the public than not-for-profit beds.    There are long wait lists for a beds in long-term care (LTC) facilities.  (This is driven by the government's decision to add only a few new LTC beds despite the rapid growth in the number of people 85 and older, the main users of these beds.) But some LTC facilities attract longer line-ups than others. In early 2014, there were 41,842 beds at private, for-profit LTC facilities in Ontario (54% of the total of 78,138 beds).  But only 6,781 people in the community put themselves on a wait list for one of these beds.  In other words, each for-profit bed has 0.16 people on the wait list for it.    In contrast, there were 19,599 not-for-profit LTC beds (25% of the total), but 9,113 people put themselves on the wait list for them.   In other words, there were 0.46 people waiting for a not-for-profit bed.   That is 2.9 times higher demand than fo

Ontario hospitals report a significant decline in the number of patients in hospital beds who are waiting for a long term care bed.  This has been the main category of the so-called "hospital bed blocker" -- the Alternative Level of Care (ALC) hospital patient -- so it is a significant change.  From November 2009 to March 2013, the number of patients waiting for LTC was reduced by 1,282 patients, an astonishing decline of 41%. This sounds like a victory for better management, but the real story appears to be more complex. This has not happened because a decline in the relevant population. As noted earlier , the 85 and older population is growing  very quickly. Instead, this coincides with a decline in the number of people (at home and in the hospitals) on long-term care waiting lists of 5,000.  As of 2012, we are down to only 32,000 people in total waiting for a long-term care bed, according to the Auditor General . Both of these reductions in wait lists coincide

The death of a resident at a Toronto long-term care facility, allegedly at the hands of another resident, has raised concerns about inadequate staffing levels in Ontario. Recent Statistics Canada data indicates that Ontario "homes for the aged" fall well short of staffing for homes for the aged in other provinces.  The total hours of staffing per resident  in Ontario homes for the aged are significantly less than the Canada-wide average.   For Ontario the average is at 4.0 paid hours per resident per day while the Canada-wide average (including Ontario) is 4.9 hours .    That is almost one hour more paid staffing time per resident per day -- or 22.5 % more.  If Ontario were excluded from the Canada-wide data, the gap would be even larger.   Three caveats.   The data refers to paid hours, not worked hours.  This overestimates the actual amount of care as paid hours includes vacations, holidays, sick leave, etc.   Second, the Stats Canada data reports all   s

The government's new senior's "action plan" discussed in the last post follows on from Dr. Samir K. Sinha’s report   for the government “Living Longer Living Well”.  Sinha's report is labelled only as “Highlights and Key Recommendations”.   A “ full report will present considerably more detailed findings and recommendations that will enable the government to expand upon and provide some specific means of implementing the themes and recommendations set out in this Highlights and Key Recommendations document.” So there may be more to come.   The "Highlights" report makes numerous recommendations in 13 areas.  Indeed the recommendations are stated in a distinctly vague way.  Moreover, they generally follow the well tread path in existing government policy.    Despite some recognition that the elderly population is growing very rapidly,  there is no recommendation for expanded LTC or hospital services and no call for new funding.     Significan