Defend Public Healthcare

The Ontario government has finally taken some steps to respond to the long-standing problem of bed shortages in Windsor, promising 60 new beds.  Quite a turn-around, given the full-on attack on hospital services that characterizes much of government health policy. There has been a whole stream of hospital back-up problems in Windsor -- the elimination of 120 hospital beds between  1996 and 2010,  a major increase in ambulance off-load delay s, an attempt to impose  an illegal $600 a day charge  on hospital patients,  an officially recognized bed crisis, the failure of a public-private partnership long term care project, and, most recently, the failed attempt to create 18 hospital beds in a for-profit retirement home. It's not clear what finally got the government to make such a promise. They have promised 30 inpatient beds and 10 rehabilitation beds for Windsor.   They have also promised twenty "short stay" beds -- but it is not clear (to me) if these are suppo

England has had a disproportionate impact on health care reform in Ontario over the last decade or so --under both Liberal and Progressive Conservative governments.   After the election of a Conservative-Liberal Democrat government in Britain in 2010, English health policy took a decided turn   towards bonzo-privatization.  (As elsewhere, this was done on a "need to know" basis: the electorate were only informed about the policy  after the election.) So it was with a worried eye that I looked at the latest report   on these reforms and what they might mean for Ontario from Ontario's (very establishment-oriented) health care think tank, "The Change Foundation". The good news is that The Change Foundation shows rather tepid interest in the latest English reforms.   Here, for example, are their two take away lessons from the English reforms: Quality improvement in primary care must be integrated with a performance measurement framework which is

Recent Canadian Institute for Health Information (CIHI) data indicates that Ontario has a relatively high number of "nursing-sensitive adverse events" compared to other provinces.  An "adverse event" (or "medical error") occurs when something happens in the hospital that hurts rather than helps a patient. Over the last three reported years (ending 2011-12), nursing sensitive adverse events for surgical and medical patients averaged 5.1% higher in Ontario compared to the Canada-wide average.  (If Ontario could be removed from the Canada-wide average, the discrepancy would be higher still.) Ontario funds hospitals at just about the lowest level of any Canadian province. So the same CIHI data also indicates that nursing hours per patient (or, more specifically, "per weighted case") are 12.5% more across Canada than in Ontario.  That means an extra 5.32 hours of nursing care per patient Canada-wide compared to Ontario.   It sounds pret

Earlier I noted that while the provincial government was imposing concessions (and, yes, of course, wage freezes) on unionized public sector workers, the Conference Board of Canada was predicting 2.7% increases for non-union employees in Ontario in 2013 (up from 2.6% actual increases in 2012). Now, Statistics Canada data suggests this may be part of a long term trend.  Data in a new report indicates that in Canada between 1998 and 2011 the hourly wages of full time management occupations went up 34.7% in real terms (i.e. after accounting for inflation).   The rest did much worse.  "Health occupations" saw a 3.8% real increase.  That is about a quarter of one percent per year -- management occupations did about  nine times better.  "Social Sciences, education, and government service" did worse still with a 2.5% increase over the 13 years.  Worst of all? " Occupations unique to processing, manufacturing, and utilities" at 1.5%.  Outside

The death of a resident at a Toronto long-term care facility, allegedly at the hands of another resident, has raised concerns about inadequate staffing levels in Ontario. Recent Statistics Canada data indicates that Ontario "homes for the aged" fall well short of staffing for homes for the aged in other provinces.  The total hours of staffing per resident  in Ontario homes for the aged are significantly less than the Canada-wide average.   For Ontario the average is at 4.0 paid hours per resident per day while the Canada-wide average (including Ontario) is 4.9 hours .    That is almost one hour more paid staffing time per resident per day -- or 22.5 % more.  If Ontario were excluded from the Canada-wide data, the gap would be even larger.   Three caveats.   The data refers to paid hours, not worked hours.  This overestimates the actual amount of care as paid hours includes vacations, holidays, sick leave, etc.   Second, the Stats Canada data reports all   s

Yesterday,  I wrote about the significant lack of nursing care in Ontario hospitals compared to the other provinces.  Even on a Canada-wide basis, there was 5.32 hours more nursing care per patient than in Ontario in 2010-11 (year end March 31).   That sounds kind of shocking. But it looks like it is getting worse.  Other data from CIHI indicates that over the course of 2011, Ontario hospitals lost thousands of nurses. Specifically, there was a sharp reduction in the number of Registered Nurses (RNs) working in Ontario hospitals in 2011, with a cut of 2,750 RNs to 58,699 according to new  CIHI data .  That is a loss of 4.5% of RNs.   Compounding the problem,  there was a decline in the number of Registered Practical Nurses (RPNs) working in hospitals in Ontario as well, with the numbers declining from 13,373 in 2010 to 13,126 in 2011.  That's a decline of 247 RPNs  -- or a loss of 1.8% of RPNs in one-year.  This is a significant change from the previous years: there

The “cost per weighted case” in Ontario hospitals in 2010-11 was $5,143, according to a new report from CIHI.   (This indicator measures the relative cost-efficiency of a hospital’s ability to provide acute inpatient care.)  The Ontario cost per weighted case compares with a Canada-wide average of $5,230.96. In other words, the Canada-wide average is 1.7% higher than Ontario.   Ontario has improved its position relative to the other provinces since 2009/10, when the  Canada-wide average was only 0.08% higher.   Ontario’s lower costs are especially significant as (presumably) Ontario hospital wages (like other wages) are higher than most other provinces.  Of all the other provinces, only Quebec has a lower cost per weighted case. As well, despite the lower costs per weighted case, clinical lab hours per weighted case, diagnostic services hours per weighted case, and pharmacy hours per weighted case were all higher in Ontario than the Canada-wide average.   Of the reporte