Defend Public Healthcare

The conservative newspaper The Telegraph reports that an economic think-tank, The Integenerational Foundation, has found that the total cost of  British P3s (public private partnerships) has reached such great heights that it is threatening Britain’s AAA credit rating. The credit rating determines how cheaply the Government can raise money on the international markets. The lower it goes, the more it costs the government to borrow money. The think tank reports that the P3 debts are £239 billion ($380 million), 80 per cent higher than the report of £131.5 billion in P3 debts released this week by the government in its new "Whole of Government Accounts". The think tank warned the cost of P3s has been under-appreciated. “Such build-ups clearly put Britain’s AAA credit rating at risk by adding over a quarter to the country’s £1 trillion national debt,” said Angus Hanton, co-founder of Intergenerational Foundation. Reportedly, P3 debt is up to £13,000 per taxpaying househ

A lot has been made about the announcement in the Ontario Health Action Plan that the Local Health Integration Networks (LHINs) would expand their role to include the doctors. But in the fine print, the government did not actually promise to hand over funding responsibilities for the family doctors to the LHINs. Au contraire, they specifically promised  that the government would continue to have a funding role for the doctors. The government only promised to 'integrate' family health care into the LHINs, and then mumbled something about identifying some model that brings planning and accountability "for the full patient journey" under the LHINs. Well, as the LHINs have done not too much planning for any health sector, this may not amount to much.  The LHINS most powerful tool has been money.  The government has kept the major portion of the new health care cash for itself and passed on only scraps for the LHINs to dish out to the hospitals and other health sect

The new Ontario Health  Action Plan puts a lot of emphasis on primary care.  Changing the way the doctors practice in order to divert patients from hospitals seems to be a major goal.   But how is the government going to do this? It's unlikely the doctors will agree to change their practices simply to keep the government happy. In the past we have seen a lot of efforts by the Liberal government to change primary care practices. The establishment of Family Health Teams (FHTs) come to mind.  But a recent study indicates the doctors who made the switch to FHTs saw WHOPPING big increases in their incomes. And certainly government funding for the docs has gone, way, way up.   Negotiations between the doctors and the Ontario government are upcoming.  The Health Minister recently suggested to the Ottawa Citizen editorial board that the doctors will take zeroes. We will see if that is the whole story, or just for the fee schedule. 

British "taxpayers face a £200bn ticking timebomb from long-term spending commitments that have not been properly costed," the Independent reports. "The Commons Public Accounts Committee criticised the Treasury for not keeping a grip on the 'staggering numbers'  involved in 'spend now, pay later' projects which are a storing up massive bills for future generations." Most of the debt (£131.5 billion) is for privatized P3 (public private partnership) projects, primarily hospitals and schools.   The P3 debt is "four times more than the assets secured by the deals". The other £70 billion of unaccounted debt is for decommissioning nuclear power stations and outstanding claims for medical negligence. The government promises to end P3s "as we know it" (although the changes the Conservative government will implement will almost certainly be less than one might hope).  Ontario merrilly continues with its own P3 program for hospitals, ev

Dr Charles Saunders, deputy chair of the British Medical Association Scotland, recognizes that Scotland has made progress fighting hospital acquired infections, but flags the threat rising bed occupancy now poses : "There is pretty good evidence that once you get high bed occupancy rates then it is very difficult to stop a lot of HAI. Part of that is because you don't have time to get things properly cleaned and partly it is because once you get to those high rates, you tend to move people around hospitals a lot. So they get admitted to one ward and maybe go through three or four different wards in the next few days. If they have anything when they come in, they have an opportunity to spread it quite widely and they also obviously increase the opportunity they have to pick up stuff by being in different wards." Yet, Scotland has more than twice as many hospital beds per capita compared with Ontario.  -- Ontario has one of the highest hospital bed occupancies in the d

One interesting line in the Ontario government's new "Action Plan": "In addition to integrating family health care into LHINs, we will introduce further reforms to promote more seamless local integration, with fewer layers of administration, to ensure we have a system truly structured around the complex needs of an aging population." What might "fewer layers of administration" mean?  That is unknown, at least to this writer.  But some have pointed to the oddity of the Ministry of Health and LTC funding the LHINs, the LHINs then funding the CCACs, and the CCACs then funding the contracted home care providers. Especially as the CCACs have been restructured so their boundaries coincide with the LHIN boundaries. Other thoughts?

Privatized P3 (public private partnership) hospitals in Britain are proving so expensive that seven of them will get £1.5 billion ($2.4 billion)  in emergency funding from the government to help them avoid cutting patient services, the Guardian reports.  The hospitals will be able to access the £1.5 billion over the next 25 years, until their P3 contracts end. Andrew Lansley, the British health secretary, said he had been forced to use taxpayers' money because certain hospitals could no longer afford their P3 deals. The Conservative health secretary blames the previous Labour government for bungling the P3 deals, although critics of  P3s had long claimed that the deals were far too expensive.   "The problems facing some parts of the NHS left to us by Labour now have to be sorted out. Tough solutions may be needed for these problems, but we will not let the sick pay for Labour's debt crisis," the Conservative health secretary claimed.   The Guar