Defend Public Healthcare

The move to cut public services has gained more speed.  Prime Minister Harper has now praised the (savage) cuts the new British government is proposing and has called it a model for the G20 (which subsequently agreed to pursue deficit reduction).  Harper, in effect, is joining  a growing movement in European counties to move away from the policy of public sector spending to stimulate the economy and towards a policy of public sector cuts to reduce government deficits. Notably, other ruling circles believe that the world economy is still in danger of falling into a second  recession and that the private sector still needs a public sector stimulus.  Obama falls into this camp, but he is less and less able to deliver the goods, with more and more resistance in Congress.  More successfully, China is spending $123 billion to expand public health care insurance and its economy (like much of the rest of the developing world) is growing strongly. How this will pay out is unclear, at least

The Champlain LHIN is "Rethinking Healthcare".  And it's pretty scary. For populations of 50,000 to 100,000, the LHIN suggests that ‘polyclinics’ (like the new ‘Orleans Family Health Hub’) could be a substitute for local hospitals.   In fact the document specifically promotes polyclinics for urban and suburban settings. And whether it is a hospital or a polyclinic, facilities for these communities should not do surgeries requiring overnight stays, but rather be limited only to day surgeries. The thinkers at the Champlain LHIN also opine that  "So much of what a hospital does could be done anywhere".  So strip malls would provide dialysis and primary care facilities (doctor’s offices and the like) would provide Urgent Care. Hey Dude , where's my ER? Some distance away, it seems.  Only "District Hospitals" serving 100,000 to 200,000 people would get to keep their emergency rooms. And they could be an hour away.  (I think you can pretty much

The tripling of waits for Ontario LTC beds has driven up the number of alternate level of care (ALC) patients in hospitals.  The Ontario Health Quality Council notes that every 3.3 day increase in the average hospital patient wait for an LTC bed is associated with a 1% increase in the number of hospital beds that are ALC. Now we are at 16% of acute beds that are filled with ALC patients. This despite a dramatic reduction in in the number of hospital admissions for ambulatory care sensitive conditions.  In 2007-8 there were (according to the Quality Council) 296 hospital admissions  per 100,000 population for all ambulatory care sensitive conditions. This is down from about 400 in 2002-3. That's about a 25% reduction in just five years.   So, for example, there has been a huge reduction in hospitalizations for angina  (the admission rate has decreased more than half over the last six years) and there has been a major decline in hospitalizations for asthma in the last four years

Some interesting observations from the Ontario Health Quality Council in its recent report: • Despite a major increase in LTC beds several years ago, wait times for an LTC bed have tripled since the spring of 2005 and are now at 105 days (over three months). For those waiting in the community, the wait is 173 days; for those waiting in hospital, it is 53 days. The latter contributes to the growth of ALC beds in hospitals. Only 40% of those needing LTC care got their first choice of home when placed for the first time. • One in four people placed in LTC could potentially be cared for in alternative settings. • There has been no major improvement in injury rates for health care employees in the past six years.  Although hospitals have lower injury rates than other sectors, such as LTC, overall healthcare has higher injury rates than other industries, such as construction and mining. The increase in LTC wait times should be no big surprise: as reported earlier, the government has s

The Champlain LHIN boss, Dr. Robert Cushman, has practically ridiculed the Cornwall Community Hospital for proposing to place 30 convalescent beds in the hospital to help deal with the growth of alternate level of care (ALC) patients. According to Cushman, the proposal is a 'knee jerk reaction'. How on earth does this fit with the Health Minister's new plan to create more short term 'restorative' beds? This response is also disappointing as the North East LHIN recently added 136 convalescent beds to the Memorial site of Sudbury Regional Hospital (for at least a year) to deal with their growth of ALC patients. It also seems the Central East LHIN will postpone the proposed cut of convalescent beds at Northumberland Hills Hospital for a year. Dr. Peter Zallan, of the Sudbury ALC Committee, notes that the creation of new convalescent beds at the Memorial site of Sudbury Regional was important: "Without the Memorial site, this place wouldn't be functioning

Christina Bisanz, CEO of the Ontario Long Term Care Association (the association of the for-profit LTC homes) wants to see nursing homes become a "hub" for all types of care.   With the right kind of planning, she says, Ontario's existing homes could feature day programs for the frail elderly who have dementia or chronic diseases, "to help them to live in the community as long as possible." Bisanz said nursing homes can become "more than just a residence where 24-7 care is given." Reportedly, in some Ontario long-term care homes, that's already happening. While it is hardly surprising that the for-profits would want to increase their business (and their profits), wouldn't it be better if our public hospitals (or other public providers) became health care hubs?  Instead the hospital managers are turning over more and more of their business to the for-profits. In my view, this isn't just a problem for public hospitals.  We need to see a

Cornwall Community Hospital is canceling surgeries due to a bed shortage.  As usual, the spin is there are too many alternate level of care (ALC) patients convalescing in the hospital.  Nobody, however, flags the rather more relevant fact that there has been a huge reduction in hospital beds in Cornwall.  In 1995/96, there were 207 acute beds in Cornwall; by 1997-98 that had been cut back to 148.  The Health Services Restructuring Commission ('HSRC'--the grim reaper of hospital servicies during the Harris government) planned to cut that further to 129 by 2003. But now, there are only 94 acute care beds in Cornwall. It's the same story if you look at the total number of hospital beds in Cornwall (i.e. including rehabilitation beds, mental health beds, and other non-acute services). The numbers shrank from 366 in 1995/96 to 255 in 1997/8. Although the HSRC plan was to bring back fifteen of the lost beds, what actually happened was that by 2009 the level had fallen to on