Defend Public Healthcare

COVID infections continue to drive up hospital costs and inpatient hospitalizations in Ontario. For the most recent fiscal year (April 1, 2022- March 31, 2023) hospital stays related to COVID cost $1.221 billion, according to new CIHI data.   This is about 4% of total hospital spending, creating a very significant new cost pressure beyond the usual pressures of population growth, aging, inflation, and rising utilization.   Costs for COVID related hospitalizations increased 22.2% in Ontario in 2022/23 from the previous fiscal year, rising from $999 million to $1.221 billion.  That rise is particularly notable as the OMICRON spike of late 2021 and early 2022 had passed by the the 2022/23 fiscal year.   The $222 million increase in COVID hospitalization costs came in the same year as the Ford government cut special COVID funding and, in fact, cut total hospital funding by $156 million.     In total, there were 60,653 COVID hospitalizations...

By 2027 the PC health care funding plan falls $21.3 billion short, their hospital bed plan falls 500 beds short, their plan to free up hospital capacity by moving hospital patents to long-term care is unlikely to work, and their nurse and PSW staffing plan will fall 33,000 short according to the Financial Accountability Office ( FAO ).  Important and appalling news. But the human problems are actually much worse. The FAO focuses on measuring the gap between the government's stated plans and the government’s stated aspirations.  The bigger -- and much more important -- problem is that the government aspirations fall so very far short of actual human needs. So, on staffing, the FAO makes no claim that government aspirations are adequate to human need. Indeed, their staffing projections do “not reflect an assessment about the quality of services that should be provided by these programs.” As a result, the FAO estimates the government aims to add 1,000 hospital beds between no...

The Financial Accountability Office has released the Ford PC government's funding plans for the various health care sub-sectors .   The news is not good.   The funding plans for 2022/3 in several key line items are down compared to actual funding in 2021/2 :  Funding plans for long-term care services are down $26 million – or down 0.4% compared to last year's actual funding.  Overall funding to the Ministry of Long-Term Care (LTC service funding plus LTC Capital and Development funding) is down $315 million, with the LTC Capital line item down a full $376 million. The LTC Development line item was also completely unspent over the last five quarters. These are mysterious changes when there is a 38,000 person LTC wait list, a desperate shortage of LTC facilities that meet modern design standards, new legislation that forces hospital patients to move into LTC facilities they did not choose, and frequent claims by the government that it is quickly building new...

Contrary to popular perception, there are more assaults  in hospitals than in any other industry. Long-term care facilities are also major sites for assaults.  Health care as a whole has  by far  the most assaults that result in lost time injuries – far, far more than any other sector.  Assaults in hospitals and LTC are overwhelmingly on women, and they are increasing over time.   Health care support jobs have seen almost half of all the assaults on health care staff.   Health care support jobs are now the occupation with the most assaults resulting in lost time injuries - - far more than police and firefighters combined. Workplace Safety and Insurance Board (WSIB) data  on approved lost time claims for violent assaults shows that hospital employees have more approved lost time injury claims for assaults than any other industry.  With 2,459 over 2011-2019 that is 10% of the total lost time injuries for assaults and 44% more than...

With as much fanfare as it could muster, the Ford PC government re-announced its Budget plan of $300 million for hospitals to deal with the backlog of surgeries and procedures caused by the COVID-19 shut down of hospital services.  Despite the (attempted) fanfare, the Financial Accountability Office (FAO) has reported that the government’s budgeted plan for dealing with the backlog will fall hundreds of millions of dollars short of what is required to clear the COVID-19 backlog over three and a half years . The government says it is not working with the FAO estimates (indeed) and declined to make an estimate of how long it would take to deal with the backlog. The government did, however, state that it will “closely monitor” surgical outputs and wait times and will “implement additional measures if needed”. The government claims the funding will enable hospitals to operate at 110-115% capacity. Operating room hours will be extended into the evening and weekends.  That's ...

The Financial Accountability Office (FAO) Budget and Economic review has identified planned government spending savings that come via [1] announced program changes (program cuts like the government’s cut to OHIP+), [2] announced efficiency targets (identified areas where the government hopes it will find savings without service cuts), and [3] cuts that have not yet been announced by the government. While the government has identified some spending cuts of type 1 or 2 above, the government’s spending plan needs billions of dollars in extra, unidentified and unannounced cuts to meet its savings targets according to the FAO (type 3 cuts, as above). For health care, this amounts to $5.2 billion in unidentified and unannounced cost savings needed for the government’s health spending plan to work in 2023-24.  Even though the cuts identified to date have been major and painful, $5.2 billion is many times more than the cuts announced and implemented to date. [1] The unident...

The Progressive Conservative government has justified its health restructuring plans with the claim that administrative expenses are much higher in Ontario than in Canada.  When introducing the reforms, health minister Christine Elliott  claimed , “Over the last five years, Ontario has spent 30% more than the Canadian average in administrative expenses on its health care system.”   Elliott did not indicate her source of information. Presumably, however, the Progressive Conservatives are referring to the CIHI simplified and user friendly “ Your Health System ” graphs. Those graphs show “administrative expenses” in Ontario at 5.8% in Ontario while it is 4.5% in Canada.   This CIHI measure is actually fairly narrowly defined. It is the percentage of “the legal entity’s” total expenses associated with the administrative, finance, human resources and communications functional centres. However “the legal entity” used for this estimate is [1] only...

Bowing to public pressure and the over-capacity crisis in our hospitals, the Ontario minister of health and long-term care, Eric Hoskins, announced Friday hospital funding of $187 million to deal with next year’s flu season. While this is significant it is inadequate for several reasons: The funding is for the  next fiscal year. In other words, the minister is merely leaking information that would normally be released with the Budget. Most of this is not new money. Following pressure from labour and the community, the minister announced  $100 million for hospitals last fall to fund 1,200 beds.  But the government also made clear that money may not continue in the next fiscal year starting April 2018 -- the continuation of the funding would depend on the "budgetary process".  So this announcement merely confirms that this money will continue at least one more year and, positively, that they will increase the annual funding...