Defend Public Healthcare

The Ontario government has gotten into another donnybrook with private clinics for a second time in less than a year.   Over the summer, they got into a messy dispute with private physiotherapy clinics. The government stopped 94 physiotherapy clinics from directly billing OHIP. Ontario Health Minister Deb Matthews said that, over the years, licences to provide these services have been bought up by large corporations.   Moreover, she charged, the " existing 94 clinics have had an unlimited ability to bill the government   and have become very creative in they way they bill." The government claimed that an audit of 15,000 records from the clinics found that 58% of them failed to support OHIP billings.  Five-minute exercise classes were sometimes billed as physiotherapy,  care plans did not measure up, record keeping was incomplete, and  physician referrals were sometimes lacking. “There is extraordinary growth in expenditures and the audit was one of those factors

While the Harper Conservative government has pushed ahead with its Comprehensive Economic Trade Agreement (CETA) with the European Union, the Ontario Liberal government has failed to protect public health care. Under the North American Free Trade Agreement (NAFTA) protection for public health care was initially supposed to be provided through the Annex II Social Services Reservations.   Annex II protects social services “maintained for a public purpose”. Unfortunately, the meaning of “public purpose” is disputed and the provision may not provide protection where there is private sector involvement in health care.  To clarify that health services delivered as public services are excluded from NAFTA, the parties negotiated a general reservation in 1996.   This addition to NAFTA's Annex I meant that services provided by provinces since 1994 would be excluded from NAFTA liberalization. With CETA, however, general reservations like those seen in Annex I under NAFTA

As two Liberals on the (presumed) left of the party declare their intention to run for the leadership, it bears recalling that almost all of the major problems the Liberals have faced in the last few years have come from attempts to re-position the party to the right. First, Premier McGuinty (and  departing Finance Minister Dwight Duncan) supported moves to privatize public services. This led to a series of failures and scandals that angered the public: Mississauga gas plant Overpaid private contractors at eHealth;  Scandalous, hidden extra costs at the Brampton "public private partnership" (P3) hospital;  Bloated salaries, highly dubious corporate payments, and limited public oversight enabled at ORNGE by privatization ;  and A massive corporate payout after the Liberals opened up energy production to for-profit corporations Indeed, the Globe reports that the corporation that won the  now infamous Mississauga gas plant project (cancelled at great expense durin

Tim Hudak's  concerns  about the proposed Liberal public sector bargaining legislation are numerous.   The legislation  fails to impose an immediate pay freeze on workers. ( "It's not a wage freeze, it just kicks the problem down the road until 2015 and then maybe gets around to freezing wages at a higher level.")  It  exempts municipal workers, police, firefighters and public transit workers.  The changes to interest arbitration fall short. It doesn't stop performance bonuses. Hudak says the Tories would open existing contracts to impose a freeze on all public sector workers. Waiting for contracts to expire, as the Liberals propose, would take to long.   For good measure, Hudak also wants public sector layoffs and a 12.5% spending cut in all ministries except health and education.  "You need to not only freeze pay for government workers, you need fewer of them," Hudak said. As far as the proposed Liberal legislation is concerned, Hudak

Progressive Conservative leader Tim Hudak has kept his powder dry and has reframed from personally criticizing the Liberals' proposed public sector labour legislation. Or even commenting on it.   Instead, he sent out Monte McNaughton , who faulted the proposed legislation with a variety of vague criticisms:   the legislation "is clearly lacking teeth" and exempts too many workers,  McGuinty "is taking a weak approach," and "doesn't have the courage to make tough decisions". But McNaughton did not say the PCs would actually vote against the bill.   Hudak's absence and McNaughton's refusal to say the PCs will oppose the legislation, make it look like the PCs are open to some sort of a deal with the Liberals. They had better watch out -- the Liberal labour strategy has led the Liberals to a sudden, sharp drop in the election polls. So it may not be a winning strategy for the PCs to twin up with the Liberals on it.  The Liberals wil

It's now apparent that the Pogressive Conservatives will allow the Liberals to batter teachers and school support staff with legislation imposing takeaways. Even if this legislation does  pass, the question is what will the twin parties do to the rest of the public sector? There is, after all, a lot more bargaining coming up. Is more legislation coming from the twins? While I'm no lawyer, sweeping legislation covering all workers in the public sector sounds like it may have more constitutional problems than legislation covering this or that bargaining unit after there has been a genuine attempt by the employer to bargain a collective agreement. But if the Liberal/PCs have to bring in legislation imposing a compensation freeze and concessions unit by unit, that is going to bring an awful lot of political problems for them.

The Ontario Liberal government has largely  justified  its rush to prevent free collective bargaining in the education sector by claiming that without such legislation junior teachers will get their normal increment steps on the wage grid as they accrue more experience as teachers.  To wit, they argue : " Current teacher and support staff agreements expire on Aug. 31, 2012. If these are not replaced by September 1, the terms of existing contracts will automatically roll over. If this were to happen, the cost for teachers moving up the grid and for continuing the existing retirement gratuity and sick leave provisions would be $473 million." This is curious as the government actually agreed to allow the increment increases in its memorandum of understanding with the catholic teachers association - albeit on the 97th day of the school year. The trade-off loss of three days professional development pay does not occur until well into 2013 and 2014: October 11, 2013, December

The Progressive Conservatives claimed yesterday that the province has little or nothing to show for the money spent on eHealth. This was news to me, as I have watched my own family physician change from written notes to electronic records in the last couple of years. The PCs refer to a  news article showing delays with the diabetes registry, no doubt meaning the  Toronto Sun  eHealth cover story (discussed here  last week).  But even the Liberal loathing  Toronto Sun   indicated that progress had been made on several fronts: e.g. an encrypted health email system, widespread use of electronic health records by doctors, and electronic movement of lab records. Didn't the PCs read the whole article?  Health Minister Deb Matthews was quite right to reply that the PCs were making accusations they know to be false. To boot, the big problem cited by the Sun  -- the diabetes registry -- is because the corporation contracted to do the work hasn't delivered on time.  Like the PCs

The Drummond report on public services is coming out tomorrow (Wednesday) between 2:25 pm and 3 pm, reportedly. Drummond has said that many of his proposals will not be supported by the government.  So some of the proposals are non-starters right from the get go.  But they may provide cover for the Liberal government when they come in with their own package of cuts. Drummond is being used to set the government up as the voice of "moderation" I reckon. Incredibly, Mop and Pail columnist Andre Picard suggests that the objections to these proposals from some (like the Ontario Health Coalition) are based on "mock outrage".  Does Picard actually believe the outrage is mock?  No doubt his comment pleased Picard's editors' at the Globe , but it is far from the truth. It is not 'mock outrage' that is driving the Ontario Health Coalition (OHC) and others to work so hard to respond to Drummond.  It is real fear about the future of public healthcare.  T

The Police Association of Ontario has released several documents on Tim Hudak and the the Progressive Conservatives. And they appear decidedly not pleased: "The PAO remains very concerned about comments made by the Progressive Conservative Party Leader Tim Hudak in relation to the Arbitration System. We simply cannot sit on the sidelines – there’s too much at stake." This is unusual territory for the Police Association, but they feel compelled to speak out: "It is very unusual for the PAO to side with one Party over another, or take a position during an election, as we recognize that we need to work with whichever political party is elected. The PAO desires to remain nonartisan. However, our concern is so great that the PAO’s Board of Directors feels compelled to inform our membership of what is very likely to occur if Tim Hudak’s PC Party is elected." Some other election materials prepared by the PAO on arbitration ( Just the Facts Maam and Election 9

As part of his campaign to justify his 'last resort' plan to freeze public sector wages, Progressive Conservative leader Tim Hudak told reporters that he 'would try to negotiate with the province’s unions to ensure wages don’t rise faster than economic growth in the future.' Well public sector wage settlements this year are about half of the inflation rate. This means wages are falling in terms of what you can actually buy, never mind getting any part of the economic growth of the province. Public sector settlements are also lower than private sector settlements. And they were lower than inflation and lower than private sector settlements last year too. Faster than economic growth? It's hard to solve economic problems if you prefer to make up myths and blame the innocent.

Standing outside the Fort Erie Hospital, New Democrat leader Andrea Horwath    condemned catastrophic cuts to health care including the closure of emergency rooms at the hospital and nearby Port Colborne. The Fort Erie hospital's emergency room was closed in September 2009, just months after the emergency room in nearby Port Colborne was also closed. Horwath was accompanied by the family of Reilly Anzovino, a teenager who died after a car crash in 2009 when her ambulance had to travel 20 kilometres to a hospital because Fort Erie's ER was closed. Her family believes her life may have been saved if the Fort Erie ER had remained opened.  Horwath has promised to re-open the two Emergency Rooms. The Liberals side-stepped the issue on Saturday, according to the Toronto Sun.   Right now, we can only guess and fear. But given the funding plans, cuts to more emergency rooms sounds likely  after the election. 

The Ontario government is launching a massive drive to bring many more public private partnership (P3) hospitals to Ontario. While this is getting little play in the election, this form of privatization will have major consequences for Ontario. England  started the P3 (or "PFI") craze, launching a similar, massive P3 drive over a decade ago.  They are now beginning to regret it dearly, with 60 hospitals falling into financial crisis due to their P3 deals.   Here are some of the results in England   according to  the normally conservative newspaper,  The Telegraph  : The taxpayer owes a total of £121.4 billion on P3s  projects -- although they are worth only £52.9 billion. Next year’s P3 bill alone will be £8.6 billion (a little under  $14 billion ) The National Audit Office reported in April that that each household will have to pay nearly £400 ($632) next year. Young people starting work this year will pay taxes for the P3s until they are nearly 70

It was a fight, but, during the federal election, the people forced the federal Conservative Party to commit to increasing health care transfers to the provinces by 6% for two years after the expiry of the current ten year health care transfer deal in 2014.   But we only squeezed two years out of the Tories.  The last deal  guaranteed  secure transfers for ten years.  Much more of a push is needed to get a commitment beyond two years. Now Tim Hudak is the latest Tory to drag his feet.  When asked by the Globe and Mail " if he would push the Prime Minister for a second 10-year accord, Mr. Hudak would say only that he wants funding to continue." This appears to be  as feared : Hudak has  clammed  up in Conservative solidarity.  People outside of the federal and provincial Tory parties have been calling for a ten year deal with the same escalator for some time .    Unfortunately, Hudak's position goes directly against Ontario's interests. New federal health

There is not an awful lot new for health care in the recently released Ontario Liberal Party election program, Forward Together .   As far as hospitals are concerned, they emphasize the development of new hospitals. They play down that this will largely be done through expensive and troubled "public private partnerships" (which have been discussed many times on this site).  Nor do they mention that these are not really new hospitals -- just redeveloped hospital facilities.  Nor that as they have redeveloped hospitals, they have actually closed hundreds of hospital beds, closed emergency rooms, and cut some other services too.  The Liberals emphasize removing patients from hospitals and treating them elsewhere, a long term policy of the Liberals.  This policy has been used to justify the bed cuts and the dangerously high bed occupancy levels.  Somewhat more positively the Libs claim: "We will ensure that Ontario keeps the shortest surgical wait times in the country an

Tim Hudak and the Progressive Conservatives may be taking Christina Blizzard's suggestion  that they trim their message and focus on attacking public sector "entitlements".    His response to the  Toronto Star's dismissal of the PC municipal program was to attack public sector union settlements and interest arbitration: " Dalton McGuinty’s broken arbitration system has cost municipalities hundreds of million of dollars for excessive wage settlements that hamstring local leaders and burden families who pay the bills. For nearly eight years, Dalton McGuinty has handed out unsustainable collective agreements, which set the benchmark for arbitrations with municipal public sector workers. .... On Oct. 6, Ontario families will face a  clear   choice  between more of Dalton McGuinty downloading the cost of his  broken  arbitration system onto municipalities, or an Ontario PC government that will provide families with relief." Hudak and the PCs may be unaffected

The Association of Municipalities of Ontario had a workshop on interest arbitration  at its annual  conference yesterday:  “ Arbitration and the Ability to Pay” .   Municipalities use interest arbitration to settle collective bargaining disputes with police, firefighters, and, sometimes, paramedics.   The municipalities, it seems, are not happy with interest arbitration. As one delegate said:  "It's a cookie-cutter process and the cookies suck." But then again, are employers ever happy?  Workers also have to live in a cookie dough world -- but spend less time whining for caviar.   In its report on the arbitration workshop, the London Free Press  quotes Dalton McGuinty as stating that it would be "unwise" to "finagle with the arbitration system."   That's a positive step forward. Globe & Mail columnist Adam Radwanski had speculated in May that the Liberals and Progressive Conservatives would bend the arbitration process to favour employ

Dalton McGuiny told the Association of Municipalities of Ontario that a Progressive Conservative government would mean  that Ontario municipalities  will find themselves back in the Mike Harris days of cost cutting and downloading, the Toronto Star reports . Cost cutting for sure.   But I am not sure how McGuinty's funding plan is any better. According to the Auditor General, the funding plan of the Liberal government would see  a sharp reduction in overall spending increases ( from 7.2% over the last eight years to 1.8% for the next two)  That's quite a tumble, to a level of increase that is less than the government's inflation forecast (and 60% of the inflation rate right now). Programs outside of health care, education, post secondary / training, and social services will see decreased funding: reducing spending 1.8% annually for Justice and 5.6% annually for all other programs. That is one heck of a hit for Ontario municipalities, who depend on cash from the

Contrary to the angry  suggestion of the Ontario Progressive Conservative party about “fat raises,” public sector union settlements are far behind the current rate of inflation in Ontario -- in fact, exactly half of the rate of inflation.   The Ontario Consumer Price Index ( according to Statistics Canada) increased 3.0% for the 12 month period ending July 2011.  This is down from 3.6% for the year ended June 2011.   Meanwhile public sector settlements in the first half of the year averaged only 1.5% per year according to the Ministry of Labour.   As has been the case for some time, union settlements are falling behind the rising cost of living.   Private sector union settlements have averaged 2.0% for the first half of the year. Private sector settlements were also a little higher than public sector settlements in 2010. "Fat raises"? Hmm....Mr. Hudak really did inhale.

The beleaguered Liberal Party of Ontario is in a conundrum.  There is increasing pressure from the right for them to attack unionized public sector workers, with both the Globe and Mail and the Toronto Star  running editorials this week urging the Libs to turn their guns on public sector workers (the Sun papers, needless to say, were already there). Not coincidentally perhaps, news stories this week appeared highlighting the Liberal government's plan to cut 4,900 public service jobs. The Libs are going to have to figure out which side they are on, it seems. For the record, public sector settlements in Ontario are coming in at exactly the same as private sector settlements in 2011 -- 2.2% annual average increases.  This means that, with  inflation running at 3.6%,  public and private sector workers are losing about 1.4% of their income this year. Last year, average annual private sector settlements ran a little higher than public sector settlements: 2.1% versus 1.9%.  (