Defend Public Healthcare

The Ontario government says the unilateral federal decision to limit the growth of the Canada Health Transfer will cost Ontario $8.2 billion -- $550 for every individual in Ontario. The Ontario Fall Economic Outlook indicates that 59% of the Ontario  health care funding increase this year comes from the annual increase in funding from the federal government via the Canada Health Transfer (CHT).  The federal transfer increase accounts for $752 million out of a total provincial health care increase of $1.272 billion.   (Another $181 million comes from the increase in the Employer Health Tax revenue, with not much coming from other Ontario based revenue sources, like income or corporate tax.)  The share of new funding paid for by new federal CHT funding is up from 56% in 2012-13 and 25% in 2011-12.  Federal CHT funding now provides 24.7% of Ontario provincial government health care funding. Unfortunately, the federal government has unilaterally announced plans to reduce

As feared yesterday -- the premiers rolled. Their  media release on health care  that came out as their meeting in Niagara-on-the-Lake ended  didn't even dare to beg for better federal health care funding.  It  didn't even utter the word "federal".  Despite the hole the new federal funding policy will leave in provincial coffers, despite the protestors who told the premiers yesterday that federal funding was THE issue, restoring federal health care funding was a complete non-issue for the premiers. In another release on fiscal arrangements they did recall  that last year the  Premiers' Fiscal Arrangements Working Group   had reported  " federal health care funding would be reduced by almost $36 billion over the 10-year period from 2014/15 to 2023/24 compared to the arrangements currently in place".   But instead of demanding the cut be reversed, they  asked  only that the federal government "avoid further unilateral changes to programs&

Community pressures to preserve small hospitals:  Local opposition to hospital cuts has driven Prince Edward County residents to demand that their local hospital be allowed to break away from the multi-site Quinte Health corporation. This is becoming a more common community demand as small hospitals trapped inside much larger multi-site hospital corporations are particularly vulnerable to cuts. At worst, their ongoing viability is threatened. As expected, there is no appetite for such proposals at the mother house. Health Minister Deb Matthews has written back declaring that "de-amalgamation" is not under consideration (while, at least, also offering assurances that the government is committed to all sites in the Quinte Healthcare Corporation.) Government pressures to merge : Indeed, the direction of the government is very much in the opposite direction. The Central East LHIN has just announced that two large hospitals, Rouge Valley and Scarborough, will proc

The Ontario government just lopped another $2.1 billion off their 2012-13 deficit estimate, cutting it from $11.9 billion (as of January) to $9.8 billion . This means that since 2010 when they started their public sector austerity drive, they have now cut their deficit estimates by $18.1 billion. Deficit (in billions of dollars) 2009–10 2010–11 2011–12 2012–13 Total 2010 Budget 21.3 19.7 17.3 15.9 74.2 2013 April 19.3 14 13 9.8 56.1 Reduction in Deficit (billions) 2 5.7 4.3 6.1 18.1 Since the 2012 Budget, the government has repeatedly cuts its deficit forecast for 2012-13.  It started this year estimating a $15.2 billion deficit (just slightly lower than it estimated in 2010, as noted above). It now puts the deficit at a whopping $5.4 billion less. That is one mighty big error over the course of just one year. To put it in perspective, the government only hoped to save $8

Recent Canadian Institute for Health Information (CIHI) data indicates that Ontario has a relatively high number of "nursing-sensitive adverse events" compared to other provinces.  An "adverse event" (or "medical error") occurs when something happens in the hospital that hurts rather than helps a patient. Over the last three reported years (ending 2011-12), nursing sensitive adverse events for surgical and medical patients averaged 5.1% higher in Ontario compared to the Canada-wide average.  (If Ontario could be removed from the Canada-wide average, the discrepancy would be higher still.) Ontario funds hospitals at just about the lowest level of any Canadian province. So the same CIHI data also indicates that nursing hours per patient (or, more specifically, "per weighted case") are 12.5% more across Canada than in Ontario.  That means an extra 5.32 hours of nursing care per patient Canada-wide compared to Ontario.   It sounds pret

Aside from the predictable (but fun)  response from Deb Matthews to yesterday's Ontario Health Coalition report outlining cuts in Ontario hospitals ("It is OK" to close hospital beds, she opined), we did get a snippet or two of information from the government.  The Star reports the Health Minister's office also made these claims: 70 per cent of hospitals have seen increases  -- 63 hospitals.  This is inaccurate in some way. There are about 159 hospital corporations in Ontario (there's many more hospital facilities ).  So if 63 is accurate, that would be 39% of hospital corporations got an increase.  If it is 70%, that would be about 111 hospital corporations. So somebody got the math wrong. The largest decrease that a hospital has received is 1.2 per cent and the largest increase is 2.8 per cent. About 81 per cent of hospitals have seen no more than a 1 per cent swing, up or down. So, if this is true, the large majority of hospitals got either a very

A senior director of the North East LHIN has told the   North Bay Nipissing  that the government cut cataract surgeries by 10% across the province this year.  This has forced the North Bay Regional Health Centre to stop such surgeries until April 1 (the beginning of the fiscal year).   Another recent report indicates that the Hotel Dieu in Kingston is now performing 10 cataract surgeries per week until the end of March -- down from 60 per week. While, in the past, global funding allowed local hospitals to determine local needs, the government's new "fee for service funding" (aka "patient based funding") gives all that power to the province.  For some reason, Toronto decided to cut 10% across the province, it seems.   Local decision making anyone?  Moreover, where was the public discussion (or even notification) of this decision?  We are almost at the end of the fiscal year, and this is the first that I, at least, have ever heard of a decisio

More hospital savings . Joanna Frketich reports Hamilton Health Sciences needs to find $20 million to $25 million in savings, while Hamilton St. Joseph's is cutting $10 million to $12 million, and Burlington's Joseph Brant must cut $4 million.   In total, $34 to $41 million in cuts for Hamilton area hospitals.    That is in the range of 1.7% to 2.7% of the hospitals' budgets.  This is on top of earlier cuts.  Over the past year the three hospitals found $30 million in savings.  The government would no doubt focus on the increase in home care funding of $8.7 million -- but even that funding also had to cover Niagara, Haldimand and Brant. It also barely covers the cost pressures of inflation, aging, and population growth, never mind hospital cuts and the squeeze on new long term care beds. Beatrice Fantoni reports Windsor Regional is laying off 34 Registered Nurses after the province put off over six years its promise to open 58 complex continuing care and reh

Premier designate Kathleen Wynne has strongly suggested that hospital cutbacks will continue  Of the cuts just announced at the Ottawa Hospital, Wynne says the government is "transforming the health-care system, so services that need to be delivered in a hospital setting are delivered in a hospital setting, but services that don't are delivered elsewhere....It means there will be alterations in the health institutions in our cities and our towns." One would hardly know she is referring to the cut of 290 jobs (and about $31 million) at the Ottawa Hospital.  The Ottawa cuts are just the latest in a spate of cutback announcements in the last few weeks.  Bluewater Health in the Sarnia area is looking to cut $5 million by cutting staff, reducing the number of nurses in its cardiac care unit, changing the bedside staffing model, and merging its critical care units.  The Niagara Health System has recently unveiled a partial plan to deal with its $13 million d

Jane Meadus of the Advocacy Centre for the Elderly says that some seniors are being pushed out of hospital too soon under the province's Home First policy, the Ottawa Citizen reports. "Patient safety is at high risk...While many patients will do well at home with extra home-care services, there are many who are too sick to be cared for at home." Some elderly patients are being "forced" to go home to recuperate without being given the option to apply for long-term care and waiting for a bed while in hospital. And that might violate their legal rights.  In other cases, people are being pressured to enter private retirement homes, which can cost $5,000 a month and might not be able to provide the care needed, Meadus told the  Citizen . "There have already been cases where people have died due to being forced into them while really requiring long-term care." ACE has received about 250 complaints from across Ontario in the past year. "Disc

Quinte Health Care is simply stopping elective surgeries for a week to deal with funding shortfalls from the provincial government.   The hospital's CEO Mary Clare Egberts told The Intelligencer that the cuts weren't in keeping with QHC's new " patient-first " strategy but a lack of provincial funding leaves few options.   The Intelligencer adds that QHC will also reduce physiotherapy for outpatients at all four of its hospital sites effective November 1 and is looking for other ways to cut costs (e.g. reducing sick pay, overtime, and supplies). The nearby Perth & Smith Falls District Hospital is planning to cut 12  beds, along with a wide range of other services (e.g. housekeeping) to deal with its funding shortfall. Departments have been told to cut 6%. In Sudbury, there was no relief for Health Sciences North from its recent " peer review ".   With the loss of 30 beds earlier this year for non-acute ("ALC") patients, the

Sudbury hospital officials expect the shortage of hospital beds in the city will force 4 surgeries a day to be cancelled.  Thirty have been cancelled this month. Dr. David Boyle, the hospital's medical director of surgical services told the CBC he's frustrated because his department has toiled away at reducing surgical wait lists. “We've worked hard over the last two years to improve all of our wait lists. We still have quite a lot of stressors on our wait list compared to the other parts of the province."   Boyle said the problem lies in the absence of a home care strategy for seniors. Earlier this year, the hospital (Health Sciences North) was forced to cut 30 beds. The government is expected to require the hospital to cut another 30 beds next March.   Meanwhile, Betty Kutcha, CEO, of the Erie-St. Clair Community Care Access Centre told the Chatham Daily News , that personal support home care is becoming more limited as the agency is required to direct its

VRE Some Ontario hospitals are giving up on trying to control the superbug VRE. No doubt the hospitals are responding to the government funding squeeze on hospitals. Below, i nfection control experts offer a tart warning of the consequences of this policy . We've been downs a similar road before: past cuts to hospital cleaning (and hospital beds) helped lead to the explosion in superbug infections in recent years. In the period ahead we will see more and more examples of how hospital cuts will affect patient care.  Local hospitals isolate, others relax about super bug  Hamilton Spectator  Fri Sep 7 2012  Page: A16  Section: Editorial  Byline: Allison McGeer, MD, Kevin Katz, MD, Mary Vearncombe, MD, Toronto  'Big and   dumb' VRE not the worry it was: Local hospitals isolate, others relax about   super   bug (Aug. 30) As directors of  infection prevention  programs at Toronto hospitals, we are always   happy   to see thoughtful discussion of the issu