Defend Public Healthcare

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 &

As often noted in this space, the Ontario Liberal government claims  they are expanding community care to make up for all the cuts to hospital care. Well now it looks like even the Toronto Star can't quite swallow that one. Today, Star luminary Bob Hepburn follows up his recent column on cuts to home care with another one ( Chilling tales of home-care crisis call for action ) and its worth a read.  Here's an excerpt: D’Andrea is one of tens of thousands of Ontario residents affected in the past year by the quiet move by government agencies that connect patients with community health services to slash funding for all except what they deem to be the worst cases. Such critical services include those provided by speech-language pathologists, physiotherapists, occupational therapists, dieticians, nurses and others.  The result is that patients are now getting just a fraction of the help they really require or are forced to go on lengthy wait lists. At the same time, highly sk

The Toronto Star today makes a major big deal about changes in Ontario's home care system that are being developed by the Central West Community Care Access Centre (CCAC). Apparently, the CCAC is trying to improve coordination by making sure that "everybody in the circle of care is in the communications loop and knows what they are doing so that you look at the person as a whole being," according to Margaret Mottershead, CEO of the Ontario Association of Community Care Access Centres. In the past such care has been uncoordinated because it has involved multiple community health-care agencies and multiple health professionals, says Dr Brian Golden who is working with the Central West CCAC on this reform. One agency sends a nurse to a patient’s home, another dispatches a personal support worker and another an occupational therapist. ...To this end, a single agency will be responsible for all aspects of a patient's care - not only healing the wound, but addres

As it turns out, the new (and much ballyhooed) emergency room wait time funding will not go to any ER with less than 30,000 ER visits per year.    This is just the latest in a series of Liberal government hospital policies that discriminate against smaller towns and cities (remember, for example, the ER closures in Niagara?). Lake of the Woods Hospital, a reasonably large hospital in Kenora, falls 4,000 short of the 30,000 visit minimum. But its June wait time figures are 9.1 hours for high acuity and 5.2 hours compared to provincial expectations of eight and four hours, respectively. Local hospital president Mark Balcaen showed some guts, took this on, and defended his community: "The public sees ER wait times the same whether they are in a small, rural, isolated community or are in a large metropolitan area....A long ER wait is still a long ER wait no matter the size of the community or hospital. The people of Kenora complain just as much as the people of any other lar

Complaints are already emerging about government control of the new Emergency Room wait times funding.  Here's the conclusion of today's Cornwall Standard Freeholder editorial: The ministry, at least in Cornwall's case, is putting the cart before the horse with the $800,000 incentive. The money should be used to open up more long-term care beds. This would move more people out of acute care beds and go a long way in reducing unacceptable wait times. (The full editorial is here .) This isn't just in Cornwall's case.  Queen's Park in Toronto has all the control and so local hospitals (and local communities) cannot fashion local solutions that actually meet local needs. dallan@cupe.ca

With a C. Difficile outbreak dragging on since March at the Nanaimo Regional General Hospital in BC, some concern is now beinng expressed about hospital overcrowding: Infection control experts say they may need to cancel some non-emergency surgical procedures in order to get control of the ongoing outbreak of Clostridium difficile at Nanaimo Regional General Hospital, though that option would be a last resort.....Overcrowding at the hospital continues to hamper housekeepers efforts to keep up with cleaning and it has put an additional strain on nursing staff, who have to follow meticulous protocol visiting patients.... NRGH continues to operate over capacity "almost all the time," Wale  (the hospital's Executive Medical Director of Quality) explained. ....Overcapacity creates too many opportunities for the spread of infection. "We'll need to review whether we'll need to start turning down the routine operations to keep this under control," Wale sai

Well, we found out a little bit more about where the government's hospital funding is going with the announcement of $100 million for 'payment for results' funding yesterday.  And it pretty much summed up what's wrong with this approach. First: unlike global funding (set at a mighty 1.5% or less ) this funding is centrally controlled.  Local hospitals have to spend it as directed by the central government, whatever local needs actually are.   Second: the government (and local Liberal MPPs) primarily see these announcements as a media opportunity, parading it to the media as their latest accomplishment.  If you keep everybody guessing where the money is going and when it is coming, you can always manufacture a media story.  Think of a manipulative and stingy Santa Claus.  Moreover, this model favours whatever item is politically expedient at the moment.  How can the government get headlines?  So much for a rational process focused on human needs. Third: The mo

CUPE Local 1943 president Karen Ward has broken the news that Peterborough Regional Health Centre is planning to lay off 42 CUPE members.  CUPE's employment security language may help divert some of this into early retirements and voluntary exits. The hospital has already eliminated another 31 CUPE positions, through attrition and a hiring freeze. The hospital is meeting with its four union locals to deal with the layoffs. Earlier, the Ontario Nurses Association announced that 85 RNs will be given layoff notices with another 44 RN positions already eliminated. The two OPSEU locals at the hospital have already seen the loss of positions -- indeed, over 50 hospital paramedical and office positions remain vacant. A total of 182.3 full time equivalent positions (283 actual jobs ) are supposed to be eliminated across the hospital, making this the biggest hospital cuts since the Rouge Valley Health Centre. The community has held rallies and planted lawn signs demanding local Liberal

Research by Robert Kavcic of BMO Nesbitt Burns suggests that Ontario deficit numbers will be favorably revised (again), in the near term, due to better than expected economic growth (and job growth). "Ontario saw annualized real GDP growth of 6.8% and 6.2% in the two quarters through 2010Q1, the strongest pace since 1999. Our Provincial Economic Momentum Index (PEMI), made up of 36 monthly indicators, also suggests that activity in the province is growing at a full standard deviation above the trend rate, and points to further upside in real GDP growth in the months ahead.Employment has been a key support to the province’s momentum, sprinting 3.1% in the past year, the fastest rate in Canada and nearly recouping all of the job losses seen during the recession…. Regardless of how growth plays out in the quarters ahead, the recent performance of Ontario’s economy has been substantially better than the Province expected in its FY2010/11 budget.” While the bank report (predictabl

Niagara Police were just awarded close to 10% over 3 through an interest arbitration award. (Interest arbitrations are a way to settle contract disputes for 'essential' workers without using strikes or lockouts. In Ontario, they are typically used for police and  fire fighters as well as  hospital and long term care employees).  The Niagara contract expires December 2011 and the  award comes from the well known arbitrator George Adams, who was the chair of the OCHU-Ontario Hospital  interest arbitration that covered the years 1995-2001. Despite all the compensation complaints (histrionics?)  from the provincial government, the Niagara Council Chair is much more sanguine: "It is what it is. This is the decision of the arbitrator. We'll accept that and will now move forward for the next three years." For more on this, see here  . dallan@cupe.ca

Well, when the full Canadian Press story on hospital funding came out this morning, Health Minister Deb Matthews was cited as claiming hospital funding went up last year by 5.6%. That's an awful lot more than previously reported.  The Accountability Agreements the Ministry of Health and Long Term Care signed with the Local Health Integration Networks set out an increase of $429 million (from $13.896 billion to $14.325 billion). That's an increase of only 3.08%. (For the  2008/9 and 2009/10 Accountability Agreements see here and here , pages 43 and 48.) If correct, that's an additional funding increase of 2.52% -- or  $350 million . So, was the Minister misquoted, did she get her figures wrong, or did some extra money role in? And if the latter, should we expect a similar bump up in funding this year as well? dallan@cupe.ca

The Star and the Globe reported today on a meeting called by the Ontario Ministry of Finance for tomorrow with public sector labour leaders on the government's proposed compensation freeze for unionized workers. • The Star hints at an issue with this process: it is being started in the dog days of summer, when the union membership is on vacation. A coincidence? Maybe not.    Moreover, the Liberals are up for election in the fall of 2011, and the closer we get to that date, the more hesitant the Liberals will be about getting into trouble with labour. And the more leverage the unions will have.  • The Star reports that “Municipalities, which handle their own wage settlements, will not be represented.” at Tuesday’s meeting between public sector labour leaders and the Ontario Ministry of Finance. • The Star also reports that the Ontario government will save $750 million by next year through its proposed wage freeze. Whoopee. The government took $3.4 billion off last year’

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

More good news, this time with bed cuts proposed for West Lincoln Memorial Hospital in Grimsby. As usual, this is funding driven, after the hospital sucked up and paid down two years of deficits with its cash reserves  (racking up a $1 million deficit in 2008-9 and $1.5 million in 2009-10).  That money was supposed to go for better facilities.    But No. Also as usual, 'ALC' patients get the blame. And also ALSO as usual, it’s not clear where these patients will go. It remains unclear, to this writer at least, how many beds will go.  Fourteen staff positions will be ‘affected’.  The hospital says it will develop its plans in the coming weeks. That's something to look forward to. For more see this . – D. dallan@cupe.ca

Medscape reports today that 'Acinetobacter baumannii' is becoming increasingly prevalent in healthcare facilities.  This is yet another hard to treat hospital acquired infection, joining C. Difficile, MRSA, VRE,  SARS, etc. etc. etc. The A.baumannii infection is drug-resistant and particularly problematic for hospitals. Not only can the bacteria survive for months on wet and dry surfaces, but the mortality from the infection is high — ranging from 8% to as high as 42% for patients in intensive care units (ICUs). Dr. Louis B. Rice, a U.S.  infectious-disease specialist told the New York Times that "In many respects it's far worse than MRSA...There are strains out there, and they are becoming more and more common, that are resistant to virtually every antibiotic we have." The Times adds: "The bacteria, classified as Gram-negative because of their reaction to the so-called Gram stain test, can cause severe pneumonia and infections of the urinary tract, bl

A letter in todays Cornwall Standard Freeholder concerning proposed hospital bed cuts in Cornwall. I think these observations hold true across the province. -- Doug dallan@cupe.ca Dear Editor, The proposed cuts of hospital beds and services looks like a rerun of the 1990s, when many thousands of beds were cut across the province. By the end of the 1990s, the public in communities across the province rose up against the cuts and forced the Mike Harris government to improve funding for community hospitals like our own. It was only because of the determined campaigns by local communities that we were able to maintain our community hospitals to the extent that we have. Unfortunately, it now looks like we will have to do the same with the Dalton McGuinty Liberal government. We are going to have to light a fire under local members of the provincial parliament and get them to stand up and defend our local community. I know CUPE Local 7811 will do its part. And we know that many in

The provincial government has just coughed up an extra $14 million for the Niagara Health System (a multi-site hospital) for the 2009-10 fiscal year, i.e. a year which will end in just over a month (March 31). Apparently, the money will be rolled into the hospital's base funding. This following solid community campaigns against cutbacks and closures of emergency rooms (reaching a terrible culmination when a young victim died while being driven to a more distant emergency room). This also follows the recent successful campaign to get the government to keep the Grace hospital in Toronto going. -- Doug dallan@cupe.ca

Saad Rafi was recently appointed the new Ontario Deputy Minister of Health and Long Term Care. A long time senior civil servant, Saad Rafi was also the National Leader for Infrastructure at the giant consulting firm Deloitte Canada. As such, Rafi was a key proponent of Public Private Partnerships in Canada, one of the main ways corporations are trying to get their mitts on public sector dollars. While close ties between the corporate and government worlds is nothing new, critics might find this appointment a little odd: the previous Deputy bounced out of the Ministry after a scandal at E-Health that revolved largely around contracting out and privatization. -- Doug dallan@cupe.ca