Defend Public Healthcare

Hospital 'shared service corporations' are popping up all across Ontario to take over support services for Ontario hospitals.  Most of these are not-for-profit corporations owned by the area hospitals.  Sometimes the shared service corporation delivers the hospital support service, other times it contracts the service out for the hospital to a 3rd party.  The main focus to date for the hospital shared service corporations  has been on the supply chain and back office services. The process has gotten a lot of cash support from the Ontario Ministry of Finance and the government has bragged about it as one of the main ways it is (allegedly) making  the public sector more efficient.  It's part of the centralization of hospital services. The shared services corporations are now slowly increasing their reach into other areas of hospital work. The latest development is that COPHA (a fairly new shared services corporation for hospitals in central Ontario) has overseen the con

Cornwall Community Hospital has come out with a new, draft five year plan .  The plan calls for a focus on "core services".  It states: CCH has identified the need to move to a more coordinated and strategic approach to determining the breadth and scope of clinical services based on community need, available resources, capacity and talent.  CCH can not provide all services to all people and recognizes the need to employ evidence based best practices in its core service areas. This certainly fits with the McGuinty government's focus on shrinking the role of public hospitals.  The plan also, however, raises the idea of the hospital focusing on health and health care "versus being just a hospital".  This is perhaps the main tension for smaller hospitals: see their services paired back to a smaller and smaller list of 'core services' or become a hub for a range of health care services in their local community. The former tendency is certainly gainin

A pretty good editorial from the Belleville Intelligencer on one peril of hospital centralization. QHC needs to rethink putting eggs in one basket It's emergency surgery only at QHC hospitals this week and it's all because of a breakdown in sterilization equipment -- at one hospital site.T hat should prompt some questions about how the corporation centralizes its services. Scheduled surgeries and procedures at hospitals in Belleville, Trenton and Picton have been cancelled until Sept. 20 due to broken sterilization equipment.... Years ago, when QHC was established, it was the work of corporate planners that things like dietary needs, equipment distribution, supplies and even sterilization were centralized in the interest of cost-effectiveness.But, when something goes wrong in the central site where a certain crucial service is based, as we see with sterilization and surgery cuts this week, it illustrates the flaw in the scheme.  With the current onset across Canada of in

It's hard to count the number of times Deb Mathews highlights the claim that the Ministry of Health and LTC is providing surgeries closer to home in her short letter on bariatric surgeries that is appearing in newspapers across Ontario today. If you count just the exact phrase "closer to home" it's only twice, but if you add in references to "here at home", "in Ontario", or "in the province" you get  nine hits. (I think. You can count for yourself  here .) While it is admirable that the government is trying to build capacity for bariatric surgery in Ontario (rather than ship patients off to the U.S. of A.), isn't it just a bit rich to hear so much emphasis on moving surgeries closer to home from a government bent on centralizing surgeries, emergency rooms, and other acute care services? The lady doth protest too much, methinks.  More evidence that centralizing services is a weak spot -- and the government knows it. dallan

Following the political storm over the fumbled restructuring of mental health hospital beds in Kitchener, London and Cambridge (reported here earlier), the Minister of Health and LTC, Deb Matthews, has found some cash for hospital beds in Kitchener.  But befitting our model of transparency, the Health Minister can't say how much money is promised, according to the London Free Press .  Murkier and murkier.  Hospital funding is getting less transparent  -- and more political.  It's the squeaky wheel that gets the grease. So my advice to local communities is -- squeak on. dallan@cupe.ca

Health care slashers and right-wingers are beginning to understand the pickle they are in over the falling faith in the the LHINs, the Liberal government's instrument of choice to cut health care services.  Here's the conclusion of today's Ottawa Citizen editorial : With an aging population and rising health-care budgets,it is difficult to imagine a year in which every health network in the province doesn't face some very tough decisions involving a region's crucial health-care services. Without public trust, those decisions will be much harder, if not impossible. Which is why Marin's (the Ombudsman) findings are crucial. Indeed, LHIN imposed cuts will be harder now that the LHINs have been discredited.  (What a pity!)  But this won't stop those cuts. And here's another troubling thought.  If the LHINs are becoming blunt instruments,  another instrument may be introduced to make the cuts down the road.  In other provinces the trend has been for

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 '

Boy, I almost feel sorry for the Local Health Integration Networks (LHINs).  They are taking a terrible pasting following the Ombudsman's report that exposes their community 'consultations' as a complete scam.  Apparently, one LHIN leader thought conferring with pals at his private golf course (open to anyone who can afford $8000 in green fees) was an acceptable form of consultation. While anyone who has been involved in health care knows the the LHINs do not really consult their communities, I feel pretty confident that the Tories and the right-wingers (who are kicking the LHINs now that they are down) actually prefer "a process that makes no pretence of consultation than a dishonest sham.  Better the honest dictatorship than the faux democracy."  (As, in fact, Christie Blatchford suggested yesterday in the Mop and Pail .) Despite the Ombudsman report, Deb Matthews and the Liberal government refuse to review the closures of hospital emergency rooms and servic

In recent years, the Ontario government has encouraged the creation of regionally based, shared service corporations to provide some support services for hospitals.  Similar shared service organizations are now being created in other provinces. In Saskatchewan a report by the consulting firm Deloitte recommended the establishment of a provincial shared services organization.  As is typical, they advocated an immediate start with supply chain management and procurement.  But they also advocated a later move into human resources and finance and then into other support services such as laundry and housekeeping.  In Ontario, the shared service organizations have focused on the supply chain and a few other fairly small aspects of hospital support services.  If they too move into housekeeping, dietary, maintenance, or other support services, it will have a significant impact on industrial relations and, potentially, on local jobs and services.  The march towards the centralization of s