Defend Public Healthcare

Will the Progressive Conservatives (PCs) push for a large scale review of health care?  Ottawa Citizen reporter Pauline Tam says PC health critic Elizabeth Witmer is hinting this will be the price for the PC support for the Liberal minority government.  The review would focus on     improving elder care, chronic-disease management and disease prevention. The former health minister, who presided over hospital restructuring under Premier Mike Harris, criticized Liberal health spending as “ad hoc” and directionless. “They’ve never told us where they’re going, or why they’re going there, and I think the last time any government did that was our government under Mr. Harris.” With hospital closures, centralization of services, and service cuts, the 1990s PC review of the healthcare system was expensive, chaotic, and much hated. Key PC policies were later reversed (as discussed here many times). And there is little reason to think another major restructuring will be better this ti

Don Drummond’s ' lecture ' for the C.D. Howe Institute does not propose too much new, but does raise some possibilities of what his Commission on Ontario public services might recommend for health care.  The main point Drummond makes is that health care restructuring must happen more quickly.  Although Drummond has tried to distance himself from the health care reforms of the Mike Harris government, the two are united in many ways.  Both are driven to system redesign by a goal of implementing austerity.  Drummond doesn’t quite have the nerve to say that public health care is unsustainable, but the threat of unsustainability sustains his argument.  Here are key parts of Drummond’s proposals in his C.D. Howe Lecture: Like the Harris reforms, a key part of the argument is to cut hospitals and increase home care.   This is a very old proposal that has been worked on for, literally, decades. It’s often presented as a new idea, especially when austerity is in the air.   Whi

For-profit long term care (LTC) beds for the elderly increased by over 2,100 in Ontario between 2003/4 and 2009/10 according to new Statistics Canada data.   The number of for-profit facilities increased by 70, taking a large majority in the growth in facilities, gaining 70 out of the total of 94 new LTC facilities. However, with slightly stronger growth in the number of beds operated by not-for-profit operators, not-for-profit operators actually increased their share of the total number of LTC beds by a couple of percent.  Nevertheless, 60% of  all LTC beds are still operated by for-profit corporations.   As well, 65% of the facilities are operated by for-profit corporations. The biggest increase in beds over the six years was in not-for-profit facilities operated by lay organizations.  These lay facilities saw their number of beds increase from 9,600 beds to 13,200 beds.  Municipal homes also increased their share of total beds.  The Stats Canada reports are linked below.

Patients and family members have settled their lawsuit over a superbug infection at a Quebec hospital. At a coroner's inquiry into the outbreak, the hospital's unionized workers said the outbreak should be blamed on staffing problems that worsened after the institution cut four cleaning jobs. As a result of staffing shortages, patients' rooms were only disinfected during the week and bathrooms in the ER were cleaned just once a day. Dr. Anne Vibien,on staff at the hospital in St-Hyacinthe in 2006 told the inquest that a strict plan drawn up by administrators to increase disinfection procedures was never enacted because of staff shortages.  Rooms were not disinfected often enough, she added. Toilets in the emergency room were cleaned just once a day. Sixteen patients died.  The hospital has admitted there were problems with the cleaning procedure but claimed there were no direct links to the outbreak.   The families of patients who died after contracting C. difficile

The number of full time equivalent staff in Ontario long term care (LTC) facilities increased from 51,898 to 62,739 between  2003/4  and to  2009/10 .  That's an increase of 10,841 staff, or 20.9%. That is significantly more rapid than the growth in the number of approved beds (which increased by 8.8% over the same period, as discussed earlier this week).  This may reflect the growing age and infirmity of residents in LTC homes. Still staffing falls far short of need. Will the staffing increase continue? It's hard to see other alternatives in the longer term.  But right now there is a decided lack of enthusiasm for long term care from the Minister of Health and LTC and problems in the industry are bubbling down south, thanks to government austerity. Kaiser   reports that the stocks of US nursing-home operators — and the landlords that rent to them — have tanked since late July, when the federal US government announced an 11.1 percent cut in Medicare reimbursements (thanks

After repeated  British reports revealing failure   of public private partnerships (P3s) for public infrastructure projects, the British Chancellor has announced a fundamental review of the government's use of P3s (or, as the Brits call them, PFIs) .   A recent House of Commons Committee report put the cost of capital for a typical PFI project at 8%, which is double the government rate of around 4%.  And for capital intensive projects like new hospital buildings, that adds up to a whole lot of extra cost for the public to swallow.   Chancellor George Osborne said    “We have consistently voiced concerns about the misuse of PFI in the past and we have already taken steps to reduce costs and improve transparency... We want a new delivery model which draws on private sector innovation but at a lower cost to the taxpayer and with better value for public services.” The Financial Times suggests that the government wants more "direct" private sector investment in p