Defend Public Healthcare

The Ontario government has finally taken some steps to respond to the long-standing problem of bed shortages in Windsor, promising 60 new beds.  Quite a turn-around, given the full-on attack on hospital services that characterizes much of government health policy. There has been a whole stream of hospital back-up problems in Windsor -- the elimination of 120 hospital beds between  1996 and 2010,  a major increase in ambulance off-load delay s, an attempt to impose  an illegal $600 a day charge  on hospital patients,  an officially recognized bed crisis, the failure of a public-private partnership long term care project, and, most recently, the failed attempt to create 18 hospital beds in a for-profit retirement home. It's not clear what finally got the government to make such a promise. They have promised 30 inpatient beds and 10 rehabilitation beds for Windsor.   They have also promised twenty "short stay" beds -- but it is not clear (to me...

The head of the Erie St. Clair Community Care Access Centre (CCAC) is seeking $4.68 million in new funding to help her agency deal with an $8 to $10 million deficit, the Sarnia Observer reports. CUPE  Local 4370 president Brian Biggers told the Observer that worker hours have been reduced. " It's having a sort of revolving door effect on staff, " he said. " Because staff have to move on to other things. They have to survive. " The CCAC has asked the Chatham Kent hospit al to limit its referrals to the CCAC because of the CCAC's budget deficit. The Ministry of Health and LTC claims that improvements in home care will offset the budget squeeze on hospital services. However, the Observer reports a doubling of in-patients at the local Sarnia hospital waiting for less intensive forms of  health care. Meanwhile the Chatham-Kent hospital is planning to cut over 20 beds. The government agency responsible for funding the CCAC was unavailable for comme...

A Windsor hospital has been officially blocked from setting up hospital beds in a for-profit retirement home.  As noted in June , the Hotel Dieu Hospital was trying to create 18 "assess and restore" hospital beds in a for-profit retirement home in Amhertsburg.   The hitch for the Ministry of Health and LTC wasn't the for-profit nature of the home, it was that the home  didn't meet the building and fire code for hospital services.  This despite $300,000 in renovations by the retirement home and nine months of planning.    For the hospital project, the retirement home installed wheelchair-accessible bathrooms, the flooring was changed from carpet to vinyl, and a nursing station, common room and dining room were built. Apparently , the relatively new retirement home was built to a different building code than that required for hospitals and so cannot house hospital patients. The Ontario government has practically made moving work out ...

The private owners of the bridge from Windsor to Detroit have been waging a long fight to stop the development of a second bridge across the border, annoying the Conservative government of Stephen Harper and enraging Canadian business.   Perrin Beatty, head of the Canadian Chamber of Commerce (which represents tens of thousands of Canadian businesses) has called   the new crossing “the single most important thing we can do to improve the functioning of the border” and complained " what you have is massive amounts of money being poured into a campaign to spread misinformation.”   The for-profit bridge owners are now collecting signatures  for a referendum to get a constitutional change to prevent Michigan from supporting a second bridge without another referendum. Privatization of what is properly a public amenity has led to the creation of a powerful vested interest opposing the expansion of the service.  Other businesses are completely vexed, and even the...

In May, Hotel Dieu Hospital in Windsor was seeking to establish 18 hospital beds in a private nursing home in Amherstburg.  The beds are so-called "assess and restore" hospital beds, designed to help patients transition from hospital back to home (or, failing that, a nursing home).   Assess and restore hospital beds are supposed to relieve pressure on more expensive to operate acute care beds, while also providing the special services needed to help patients make the return to home.  The hospital itself already operates 15 such transitional beds. In early May, the Ministry of Health and Long Term Care told the Windsor Star , that they were reviewing the proposal, as such a change needs approval under the Public Hospitals Act .   The private nursing home is operated by Seasons Retirement Communities, headquartered in Oakville.  Seasons Retirement   Communities  is a privately held partnership  created  in 2009 which owns and operates ove...

The overload on hospital beds is catching up with Windsor/Essex Emergency Medical Services (ambulance services). The Windsor Star reports that the time spent by EMS paramedics waiting in hospital emergency rooms has increased 350% since 2009, increasing from 2,653 hours in '09 to 9,557 hours in 2011. EMS paramedics can't leave a patient at a hospital until the hospital takes over care, but sometimes hospitals are so backed up they have no room for new patients. The dramatic increase in "off-load delays" has driven up EMS costs, the Star reports. But, aside from driving a cost explosion, the off-load problems are also delaying EMS response time. "We have a limited amount of ambulances in the county," EMS Chief Randy Mellow told the Star . "There are times when we delay non-emergency calls sometimes up to an hour if we don't have an ambulance." The off-load delays stem from a bed shortage in Windsor that spiked after a "public private pa...

The failure of their advocate in the provincial election, Tim Hudak, has not stopped critics of interest arbitrators. Today the Windsor Star (a long time critic of public sector unions) attacked not just interest arbitrators, but also Dalton McGuinty (who opposed 'finagling' with the arbitration process during the election). The Star said arbitrators "might as well be senators" and suggested an arbitrator "thumbed his nose" at the government. A hospital boss also got in on it.  Annoyed about an interest arbitration award, David Musyj, the boss of the Windsor Regional Hospital said, "Something has to be done to fix the system. The arbitration system is broke and continues to be broke." The Star adds "Of course it is. That goes without saying. It's been broken for years." In fact, this was a significant point of dispute during the election. Hudak's Progressive Conservatives advocated policies on public sector bargain...

An ongoing shortage of acute-care beds in Windsor forced 22 patients to wait in the  emergency room  at Windsor Regional Hospital on Thursday and threatened to cancel elective surgeries, the Windsor Star reports.  The hospital is running at 103 per cent bed capacity, according to  hospital CEO David Musyj . "For hospitals to run at their best they should be at 90 per cent capacity. Anything over that and the staff burn out" Musyj noted. The Local Health Integration Network claims it has added extra beds to deal with the long standing bed shortages in Windsor, citing 26 new complex-care beds at Windsor Regional, 60 interim long-term care beds at Leamington Court Retirement Home, and 16 new short-stay beds at Hotel-Dieu hospital. MPP Taras Natyshak (NDP-Essex), said the Liberal government should have moved faster to redevelop the former Grace Hospital site into a longterm care facility.   A long term care public private partnership (P3) on the old G...

The  Windsor Star  has called for the resignation of the Health Minister over  the Windsor long term care public-private partnership (P3) that recently fell apart.  The Star has also called for  a review of the project by the Auditor General. The Grace Hospital saga continued this week as a Ministry of Health spokeswoman admitted the province was "not aware" developer Lou Vozza was facing a mountain of civil judgments in 2009, just as the Liberals were expanding the scope of his contract to build a longterm care facility. As the number of claims against Vozza became public - almost 30 parties were registered in Superior Court on June 24, the day the contract was finally cancelled - the sense of disbelief continued to grow. How was it possible that Health Minister Deb Matthews, who just three weeks ago expressed faith in Vozza's ability to get the job done, would be oblivious to his financial woes from the get-go? How could she be "very pleased" with his p...

More trouble at Windsor's public private partnership (P3) long term care (LTC) project on the old Grace Hospital site.  This is the long delayed LTC project that is driving up the bed backup at local hospitals.   After much delay, the Ontario Minster of Health and Long Term Care had announced the private developer had come through -- on the (supposedly) final day of the deadline But, the  Windsor Star reports  that eleven days later, the guy hired to demolish parts of the building left and took his cranes with him.   He said he hadn't been paid. The Minister then told the Star that "this issue has nothing to do with the developer's ability to continue to move forward with the project.  This is an issue between the contractor and subcontractor." But the Star reports the owner of the cranes, was pretty clear that wasn't the problem.  "I haven't been paid, and the job's not started. So I'm moving my equipment out."  The equipme...

A Windsor developer met the requirements set by the Ministry of Health and LTC to proceed with turning the former Grace Hospital site into a long-term care facility, the Windsor Star reports. That was the last day this public private partnership (P3) had to meet the Ministry's deadline, so the developer just made it.   As reported earlie r, the 256 LTC bed P3 project has been stalled for years while the city has been desperately short of long term care beds, causing the local hospital to fall into a bed crisis.  The new LTC facility was supposed to be completed in March of 2010.     Health Minister  Deb Matthews  said Friday, "We will be watching these developments very closely, given the challenges this project has experienced. As I understand it, workers were on site today to begin preparations for demolition. We know it's in everyone's best interest, especially patients and future residents, to get this project done as quickly as possible. I ...

Advocates of public private partnerships (P3s) often claim the private sector partner will assume the risk. In fact, it's the major way they justify the additional costs of P3s.   Well, take a look at what is in effect a P3 long term care project in Windsor.   A project to redevelop the Grace hospital site as a LTC facility is now well behind schedule.  According to the Windsor Star , the developer owes millions of dollars to creditors, there are liens on the property and he is in arrears on his taxes to the tune of more than $1 million. The developer won the rights to develop the project in 2007 and was supposed to have it completed by March 2010, a little over a year ago.  Now the Star reports the landmark building grows more dilapidated with each passing day. Overgrown weeds, broken windows, busted concrete, mountains of gravel and a punctured building laced with graffiti are what remain of the former Salvation Army hospital.  "I don't have...

The  Essex St. Clair Local Health Integration Network has agreed to move up funding for twenty new complex continuing care beds at Windsor Regional Hospital to help deal with the city's hospital bed crisis.   This $2 million solution sounds better than forcing all the 'excess' Windsor patients down the highway to a  Leamington for-profit retirement home, as threatened earlier .   The LHIN reports that hospital occupancy in Windsor has fallen  to 100% since the bed crisis designation three  weeks ago.  " We ... have fewer patients waiting in emergency and fewer cancelled surgeries. " And, in not entirely unrelated news, Mississauga's two hospitals (Credit Valley and Trillium) have received more than $25 million in additional operating  funding  from Queen's Park to help them provide services in their recently-completed redevelopment spaces.  So, the (pre-election) hospital funding announcements continue...  ...

Following furors  in Windsor and Toronto , Health Minister, Deb Matthews has told hospitals not to charge patients waiting for a long term care bed more than $53.23 a day.  That's a lot less than the $1,800 a day that some wanted to charge, to help reduce hospital bed occupancy.  “It is completely inappropriate and unacceptable for any individual in this province in a hospital waiting for long-term care to be charged more than $53.23 per day,” Matthews  told the legislature Tuesday. These special charges have been around (and complained about) for some time, as jammed-up hospitals have felt increasing pressure to boot out patients.  So it's good to see the Ministers has finally felt compelled to do some thing about it.  Bed occupancy does need to be reduced -- but not by undermining medicare.   This is a good day for public health care.  dallan@cupe.ca

Long-term care act can't be overridden Windsor Star Tue Feb 22 2011  Page: A7  Byline: Jane E. Meadus  Column: Letters to the editor  Re: Crisis designation 'too little, too late,' by Sonja Puzic, Feb. 17. Gary Switzer, CEO of the Erie-St. Clair  Local Health Integration  Network, announced recently that the LHIN has designated area hospitals as being in " crisis " mode, allowing hospital patients increased access to long-term care home beds. While the LHIN does have such authority, the statement that this measure means that " patients who don't accept the first available long-term care bed in the community will face a $600 per day fee to remain at the hospital " is not in accordance with the law. Under the regulations to the Long-Term Care Homes Act, when hospital patients are designated as " crisis, " they move to the top of the list for their home choices. There is no requirement for them to accept beds in homes they have no...

Jane Meadus, a lawyer with the Toronto-based Advocacy Centre for the Elderly,  says  it's illegal for hospitals to charge patients $600 per day, even if they refuse to leave for a bed in a nursing home.   Meadus said that under the Health Insurance Act, the maximum a hospital can charge a patient awaiting placement is $53.23 per day.  "That doesn't change in a crisis," she said. ( The $600 fee planned by Windsor hospitals comes with a designation of a hospital bed crisis in the area.)   She said the demands for extra payment come when patients and their families are particularly stressed and vulnerable. Windsor Regional Hospital president and CEO David Musyj said he's aware of the group's position on the hiked fees, but the new policy won't change.  "I disagree with her interpretation of the regulations," said Musyj. He said the $600 fee is not meant to be a revenue generator or meant as a threat to patients to free up beds, but is designed t...

There is a pretty simple explanation of the Windsor Essex hospital bed crisis: the provincial government has forced the closure of a lot of hospital beds in the area. In 1995-96 there was 1,183 hospital beds at the three hospitals in the area. Now, Windsor Regional Hospital claims 669 (for the year ended March 2010); Hotel Dieu, 305 ; and Leamington District something less than 88 .  So now there is somewhere less than 1,062 beds in Windsor Essex. That is a 10.2% reduction in the number of beds. And this probably underestimates the cuts.  Leamington District, as far as I can find, does not report the current number of beds, but rather reports that they had 88 beds several years ago and then cut staff and beds.  Moreover, the start year noted above, 1995-96, was already six years into the massive beds cuts during the Harris and Rae governments.  Indeed, by 1996, about a quarter of the province's beds that existed in 1990 were gone. It's possible that...

The p roposed medium term remedy for the Windsor Essex hospital bed crisis is to open 62 interim long term care beds at a Leamington retirement home next month. The Leamington Court home is reportedly part of Allegro Residences, which, in turn, is part of the Maestro Group, which is based in Montreal and operates residences across the country with a staff of 2,500.   This, of course, raises the issue of shipping public hospital patients off to retirement homes -- homes which are overwhelmingly run on a for-profit basis.  Serious questions have been raised about the quality of care for hospital patients at retirement homes. And in Windsor, doubt is also being raised about the wisdom of shipping hospital patients miles away.  Any forced movement of hospital patients can have a serious health impact. But there is also concern that shipping Windsor seniors miles down the road to Leamington will leave them isolated from their loved ones and put more strain on families. "I...

After declaring a hospital bed crisis in Windsor Essex, Gary Switzer, CEO of the Erie-St. Clair Local Health Integration Network told the Canadian Press `` Currently we have, in one of the hospitals, 19 patients waiting in the  emergency room  for a bed. '' There's `` more to be done '' to help hospitals in the Windsor area Premier Dalton McGuinty said Wednesday. He should know.  Ken Deane, until very recently an Assistant Deputy Minister of Health and LTC, was appointed supervisor by the government of the  Hôtel-Dieu Grace Hospital  in Windsor on January 5.  Deane reports directly to the Minister of Health and LTC. But there still is no sign that the hospital bed cuts will stop any time soon. dallan@cupe.ca

Hotel-Dieu Grace Hospital in Windsor has received funding for an additional 14 beds to handle patients who no longer require acute care.   A separate unit will be set up where so-called alternative level of care, or ALC, patients can be treated. The initiative was approved by the Erie St. Clair Local Health Integration Network (LHIN). Pat Somers, Hotel-Dieu's vice-president of operations and chief nursing executive, said the new beds will be in place by January 2011 and remain at the hospital for at least a year. "We certainly welcome this help, but it's in no way going to solve our ALC issue," she said, noting that on Wednesday alone, 67 ALC patients were occupying acute care beds at Hotel-Dieu. Overall occupancy has been 99 per cent and at least three elective surgeries were cancelled due to a lack of beds. Leamington District Memorial Hospital, in the same LHIN, also received funding from the LHIN for 10 specially designated ALC patient beds. Earli...