For all the shortfalls in Ontario’s health system, the reality is that despite having among the lowest per capita levels of funding, the province is matching if not excelling the Canadian average in many categories measured by the Canadian Institute for Health Information (CIHI).
Whether this reflects well on Ontario or badly on the rest of the Canada is an open debate.
CIHI is widely respected as being an unbiased source of information for health planners although they remain at the mercy of local health providers who provide the inputs.
Mortality rates, for example, have been known to fluctuate widely once a hospital has learned to game the system. Only unexpected deaths count, so most deaths become expected.
CIHI has established a site where you can compare provinces on 37 indicators. Just enter your province and determine whether you want the summary or the detailed report. (Click here to access the site)
Dexter Whitfield, Director of the European Services Strategy Unit and Adjunct Associate Professor, Australian Workplace Innovation and Social Research Centre, University of Adelaide. Whitfield spoke at an Ottawa conference this week noting the acceleration of privatization during periods of austerity.
Canada has the dubious distinction of being a global leader when it comes to outsourcing and privatization of public services and infrastructure.
The rush to outsource comes with very little debate in our legislatures and rarely rises above the noise during general elections. Yet it represents a fundamental shift in how we access government services.
We’re in Ottawa this week for a national conference organized by the National Union and the Public Services Foundation of Canada on new forms of privatization. The message is clear – no public sector worker is safe from a tsunami that threatens to cut jobs, reduce wages, degrades public services, costs more, reduces accountable and ultimately attacks democracy.
Privatization and outsourcing take various forms, including public-private partnerships, social impact bonds, direct service contracting and even the transfer of funds to individual users who are forced to become their own employer.
Dexter Whitfield, a professor at Australia’s University of Adelaide, notes that private-public comparisons are often misleading, pitting new proposals against the status quo rather than a comparable public option. Not only are in-house proposals discouraged, but are actively blocked.
Kat Lanteigne and Dmitr Chepovetsk in a scene from Tainted.
Tainted has been on the road for three days now, encountering enthusiastic, emotional and well-informed audiences in Hamilton, London and Windsor. Next week there will be six more performances in Toronto, Kingston, Ottawa and Thunder Bay. Two special performances will take place in a committee room at Queen’s Park and in the Center block of the Canadian Parliament.
Tainted tells the story of the fictional Steele family, which playwright Kat Lanteigne imagines to be living in a modest working-class house near Hamilton. The three sons in the story are hemophiliacs; the play opening with 12-year old Leo at summer camp getting instructed how to self-infuse his Factor 8 from his older brother while rehearsing a speech that will profess his love for the camp’s 22-year old lifeguard.
For Leo, he didn’t see his love coming, and neither did the family see the tsunami that was about the overtake them as that life-sustaining Factor 8 turns out to be contaminated with Hepatitis C and HIV.
The roller coaster of a play charms us in the early going as we get to know the Steeles – then ramps up as the inevitable tragedy unfolds.
The Champlain CCAC continues to lurch from crisis to crisis. Is it time for the province to intervene — again?
“It’s a question of how we can do work more efficiently and maybe less people.” – Patrice Connolly, vice-president of people and stakeholder engagement, Champlain CCAC.
The Ottawa Sun is reporting the Champlain CCAC has cut services to a patient who has multiple sclerosis and cannot bathe, dress, or cook. Without his visits he cannot also do the exercises needed to keep him from stiffening up.
Over the summer Champlain realized that it was headed for a $6.8 million operating deficit and reset the threshold for personal support services to an assessment score (RAI) of 15.5 – this on a scale that goes to 28.
Further, staff have been told to instruct patients in need of care how to access other services, “many of which have a co-pay fee.”
States the Champlain CCAC in their June minutes: “staff recognize this is a hardship for clients and families, however the Champlain CCAC must also work within the budget it is provided.”
Sean Meagher (ED of Canadian Doctors for Medicare) and lawyer Steven Shrybman discuss the potential threat to Canadian Medicare by the Charter challenge in the BC Supreme Court.
They had to dodge a marathon to get there, but it was worth it.
Participants at this weekend’s Ontario Health Coalition Action Assembly were in a buoyant mood despite the many challenges facing the health system.
Rather than finding defeat, activists took heart that Canadians still feel strongly about public Medicare despite a much more well-funded opposition from business elites.
The delegates crammed into a modest community centre gym where getting to a speaker’s microphone was at times a logistical challenge. It wasn’t lost on anyone that this low-budget grassroots organization was having a significant impact in defending our public health system as Director Natalie Mehra listed off successes the coalition has achieved over the past year.
“If the public was not with us Medicare would have been gone a long time ago,” said Doris Grinspun, CEO of the Registered Nurses Association of Ontario, who participated in a panel looking at how we push back.
Grinspun warned that “medical tourism” threatened to bring an end to the single tier system. If Ontario hospitals were selling a ticket to the front of the line to international patients with money, it was only a matter of time before rich Ontarians demanded the same right. That principle is what is keeping the RNAO fighting so hard on this issue.
The Peterborough County-City Health Unit claimed it couldn’t afford to make overdue pay adjustments in September for its smallest bargaining unit. The question is, does it have the resources it needs to respond to the next big virus?
In September Peterborough residents narrowly avoided the first strike in their health unit’s history. Despite acknowledging significant inequities in how they compensate staff, the Peterborough County-City Health Unit argued they couldn’t afford to play catch-up with the smallest of the unit’s three staff bargaining units. Professional staff at PCCHU were earning as much as $3,000 a year less than internal counterparts with identical job descriptions.
That should be worrying for more reasons than just internal equity.
They key to health reform is to ensure there are sufficient resources upstream so that expensive problems don’t fester downstream.
The PCCHU admits that for some programs there have been no increases in funding for about a decade.
Public Health Units played an important role in limiting the spread of SARS in 2003-04. According its website, Public Health Ontario has been recently working with the Ontario Ministry of Health and Long-Term Care, the Public Health Agency of Canada and other partners to monitor and provide timely guidance regarding the respiratory illness EV-D68. Should Ebola be confirmed in Canada, public health units will also be called upon to track and stem the spread of the deadly virus.
Marching on Queen’s Park in 2008. OPSEU remains proud to be one of the founding organizations behind the Ontario Health Coalition. This weekend we give thanks to our allies who have kept the public interest at the center of the health care reform debate.
Recently the UK Guardian reported on Sweden’s rejection of tax cuts and privatization by returning the Social Democrats to power. Eight years’ experience with privatization of public services didn’t leave Swedes feeling confident about the broadening control of public services by private interests.
“For years, people had been accusing schools run by private equity of pocketing the state’s money and putting it into their offshore bank accounts,” said one education stakeholder, “but now it looked like these companies weren’t even capable of running a business properly.”
Facing a similar choice in Ontario’s last general election, voters also rejected Tim Hudak’s promise of more tax cuts and more job cuts and privatization in the public sector.
There is no question that there is an ideological conflict going on over the future of health care delivery in Canada.
Public and private spending on health care across the country is about $200 billion. That’s a very attractive target for those who recognize that even shifting a small share of that pie from the public to private sphere can result in very handsome profits.