Defend Public Healthcare

Another change proposed in the Broader Public Sector Accountability Act (Bil 122) is to make hospitals subject to the Freedom of Information and Protection of Privacy Act (FIPPA) as of January 1, 2012. The change is some time off:  the government, with some reason, claims that it will take the hospitals time to prepare for freedom of information (FOI) requests.  But once in place, records from the previous five years will be subject to FOI requests, the government assures us.   LHINs have been subject to FOI requests since 2005 (the year they were established). Personal health information is excluded from FOI requests. The Act also sets some requirements for the public posting of expense claim information by designated broader public sector organizations. The proposed legislation requires Local Health Integration Networks and hospitals to post information about expense claims onto their public web sites -- other broader public sector organizations may be required by regulation

The provincial government is bringing in legislation that will set standards for broader public sector organizations that contract out for good or services. This is part of the proposed Broader Public Sector Accountability Act , introduced on the 20th.  The proposed legislation would establish procurement rules, a supply chain 'code of ethics' and a procurement policies and procedures standard. Since April 1, hospitals, schools, colleges and universities have been required to follow a provincial " Supply Chain Guideline."  The "Guideline" incorporates two principles: a Supply Chain Code of Ethics and a Procurement Policies and Procedures standard.  Until the new procurement and expense claim directives are issued under the new legislation, BPS organizations have been told to follow these Guidelines.   As expected, the government is also limiting the ability of hospitals and other broader public sector organizations to use public funding to hire lobbyist

Some of the commentary on the Auditor General's report on hospitals use of consultants is over the top.  Here's the Sun's   Christina Blizzard : For those of you who wonder why we're taxed to death, yet our health system is still an unholy mess, wonder no more.  Your money is being thrown into a black abyss to pay for well-connected insiders -- with little or no accountability. Hmm... not really. The cash thrown overboard by contracting out work to consultants is not big money, relative to what we have to spend on health care.  (If only health care reform were such a simple issue.) A more promising start would be to look at the areas actually driving health care costs. Drugs, medical equipment and doctors.  Or at least look at the major areas where hospitals are contracting-out services.  And that is not for consultants.  dallan@cupe.ca

The Auditor General makes two general observations about the contracting out of services to consultants: [1] Ontario’s health-care sector makes extensive use of consultants, and [2] all too often, they do this without following sound business practices. The Auditor found some problems with the practices of the Ministry of Health (e.g. the Ministry seemed to favour certain consultants in some cases) and more in the practices of the LHINs. But it's the hospitals that really get the brunt of the Auditor's criticisms. "We noted far too many instances at the hospitals we visited where sound public-sector business practices were not followed in the selection and oversight of consulting ser­vices." So hospitals did not require: • assignments to be well defined and properly justified before consultants were engaged; • adequate contractual arrangements with fixed price ceilings; • payments to be tied to specified deliverables; and • consultant performance to be p

The  National Post reports that private health care and home care "business is booming and expected to grow even more in the next decade."  And the Americans are coming:   "The Canadian market is growing and will grow by another 25% at least over the next 10 years," says Peter Thompson, a franchise consultant with Plutus Consulting Group. There are already between 18,000 and 19,000 franchised private health firms in the United States -- a mature, saturated market, according to Mr. Thompson-- but the Canadian market is still in its infancy. That has companies south of the border looking to take advantage of the growing demand in and lack of well-established competition in the market. "The Americans are looking at the Canadian market and licking their chops," Mr. Thompson says. "It is a growing potential marketplace here." David Millman, who bought the rights to a Toronto franchise of a U.S.-based home care provider adds, "There is a lot

The Sudbury Regional Hospital has been operating 100 transitional beds for patients who no longer need acute care services at one of its old sites -- the Memorial Hospital.  (The Memorial had been one of the main sites for the hospital until a new facility opened earlier this year.)  Opening beds for such patients at underutilized hospital sites has been a modest trend in the past year, as high hospital bed occupancy chokes up the hospitals.  Northern Life reports the hospital is opening thirty more such beds at the Memorial site -- but without provincial funding.  Hospital vice-president Dave McNeil suggests this is going to cause significant budget problems for the hospital. Worse, all the Memorial beds are slated to close April 1, 2011, as funding commitments run out. In June, the Sudbury Regional Hospital board recommended that the site be kept open until 2013.  And yet currently, the hospital sometimes moves in to triple over-capacity (which means housing patients in i

The Toronto Sun reports that tomorrow the Ontario Auditor General Jim McCarter will release a follow-up to his  report on contracting-out by eHealth Ontario, a report that set out some pretty rotten contracting-out practices. The Auditor General told the Sun his office was asked to conduct spot audits on the use of consultants at the Ontario Ministry of Health, Local Health Integration Networks (LHINs) and hospitals. “We look at the procurement and oversight of consultants at the ministry,” McCarter said of his 30-page report. “We picked a few LHINs to have a look at and we went out to a number of hospitals to have a look at consultants’ procurement and use and ... (the report says) here’s what we found”. When the Auditor General's report on eHealth came out in October 2009, Toronto Star columnist Jim Coyle noted that the Auditor General had highlighted the near total reliance on outside consultants at e-Health. By 2008, the eHealth Program Branch had almost 300 consul