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Performance Problems: 37 Health Care Issues from the Auditor General

The litany of health care problems identified by the Auditor General  in her 2015 report is frightening. Here's thirty-seven of them dealing with LHINs, LTC, EMS, Rehab Hospitals, Health Infrastructure, Home Care, and Health Human Resources. Local Health Integration Networks (LHINs): A Lot of Problems LHINs have not met performance expectations. "Most LHINs performed below expected levels in the year ending March 31, 2015. In that year, LHINs on average achieved their respective local targets for six of the 15 performance areas".  Also: "Based on the provincial results that include all 14 LHINs, only four of the 11 provincial targets that measure long-term goals for LHINs were met." Performance has not improved. "While province-wide performance in six of the 15 areas measured has improved between the time the LHINs were created and 2015, in the remaining nine areas, performance has either stayed relatively consistent or deteriorated since 2010 or

Ontario overestimates deficit -- for the seventh year in a row

Shocker.  The Ontario government is forecasting that it will beat its deficit forecast -- for the seventh year in a row . The deficit for this year is forecast in t he province's Fall  Economic Outlook and Fiscal Review  to be $1 billion less than forecast in the spring 2015 Budget .  The forecast for next year is already $300 million less than in the 2015 Budget.  That would make eight years in a row. For this year, the decline in the deficit was driven by higher than expected revenue ($1.245 billion more revenue,  primarily due to an underestimation of revenue from the Hydro sell-off and $600 million higher than forecast revenue from personal income and land transfer taxes).  Lower than expected interest expense on debt ($140 million) has also helped.  Program spending however is $397 million higher than expected.   The major in-year increases in spending compared with the 2015 Budget are in two areas, the Hydro privatization and the new Green Investment Fund:

Canadian hospital funding now 25% more than Ontario funding

Provincial government per capita expenditures on hospitals continue to decline.  This is the third year of absolute decline according to Canadian Institute for Health Information (CIHI) data. Of course hospital services are also affected by inflation, like other services.  One way to measure this is the total health care price index.   CIHI  reports the health care implicit price index over this three year period has increased by approximately 8.3% (160.9/148.6). That is equal to about 2.7% per year. This inflation means the 2012/13 per capita hospital funding  would have to increase to $1,534.95 in 2015/16 just to keep up with increasing health care prices.  Instead the government expended just $1395.73. In other words, in three short years, the government has reduced real spending on hospital services by 9.1% per person ($1395.73/ $1534.95). If we considered the impact of an aging population on hospital costs (usually put at about 1% per year in extra costs), the

The long series of failures of private clinics in Ontario

For many years, OCHU/CUPE has been concerned the Ontario government would transfer public hospital surgeries, procedures and diagnostic tests to private clinics. CUPE began campaigning in earnest against this possibility in the spring of 2007 with a tour of the province by former British Health Secretary, Frank Dobson, who talked about the disastrous British experience with private surgical clinics. The door opened years ago with the introduction of fee-for-service hospital funding (sometimes called Quality Based Funding). Then in the fall of 2013 the government announced regulatory changes to facilitate this privatization. The government announced Request for Proposals for the summer of 2014 to expand the role of "Independent Health Facilities" (IHFs).  With mass campaigns to stop the private clinic expansion by the Ontario Health Coalition the process slowed.   But it seems the provincial Liberal government continues to push the idea.  Following a recent second OCH