Category Archives: Uncategorized

Ebola threat should spark overdue investment in public health

Photograph of the Peterborough County-City Health Unit front entrance.

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.

Continue reading

Problems at clinics should prompt rethink on competitions for hospital services

Photograph of table with thousands of cards on it while an unidentified person speaks at a nearby podium. July 8 the Ontario Health Coalition brought more than 80,000 signed cards to the Ontario legislature opposing the transfer of clinical services from hospitals to private clinics.

July 8 the Ontario Health Coalition brought more than 80,000 signed cards to the Ontario legislature opposing the transfer of clinical services from hospitals to private clinics. (Photo courtesy the Ontario Health Coalition)

The media is applauding Health Minister Dr. Eric Hoskins this week for promising greater transparency around private clinic inspections that had previously been kept secret by Toronto Public Health and The College of Physicians and Surgeons of Ontario (TCPSO).

Tom Closson, the former President and CEO of the Ontario Hospital Association, suggested in the Toronto Star last week that “bringing out-of-hospital clinics up to the same standard as hospitals regarding transparency would increase public confidence in the care they are seeking.”

Ontario’s Action Plan for health care includes systematically taking clinical services out of public hospitals and transferring them to a sector that has a history of two-tier medicine, questionable user fees, unnecessary up-selling, significant quality control issues and too little transparency. The latest revelations, particularly around infection control at several private clinics in Toronto, may have persuaded the government not to carry out spring and summer competitions for selected hospital clinical services – at least for now.

They may have learned from the Ottawa Hospital’s ill-timed decision early in 2013 to divest 5,000 endoscopies to the private sector at the same time the TCPSO was making public the list of clinics that failed inspection public – including one Ottawa endoscopy clinic that may have exposed patients to HIV, hepatitis B and hepatitis C from equipment that may not have been properly sterilized.

This spring the Ontario Health Coalition collected more than 80,000 postcards expressing opposition to the transfer of services from public hospitals to private clinics. Without any clear indication from government whether the competitions are on hold, the coalition is now working towards a November 21st mass rally in Toronto to push further on the issue.

Continue reading

Straight Talk: Beds so old it’s sometimes hard to find parts

If there is job security for someone like John Hopkins it’s because hospitals are increasingly having to make do with what they have.

A maintenance mechanic with South Grey Bruce Health Services, Hopkins is continually called upon to make basic equipment repairs. That includes finding parts for aging beds at the four-site rural hospital.

“I liked tinkering with things as a kid,” says Hopkins, including destroying several of his parent’s audio tape decks by taking them apart.

The fact that somebody like Hopkins is kept frequently “tinkering” says a lot about the state of Ontario’s hospitals. Years of funding freezes are taking their toll on both staff and equipment.

Watch John’s story by clicking on the window above.

Blood services staff fuming over blame for low inventory

Photograph: A fire destroyed this  blood service mobile unit over the summer. Amid the lowest inventory levels in six years, CBS executives have decided not to replace it or the 7500 units of blood it collects annually.

A fire destroyed this blood service mobile unit over the summer. Amid the lowest inventory levels in six years, CBS executives have decided not to replace it or the 7500 units of blood it collects annually.

Canadian Blood Services is telling staff that national blood inventory levels are at their lowest since 2008.

In a memo sent out September 30, Chief Supply Chain Officer Ian Mumford calls it “a serious performance gap,” leaving an already demoralized staff to wonder if they are being blamed for poor decisions made by the organization’s executives.

CBS has been dismantling much of its infrastructure around volunteer collections in recent years, including the closures of entire facilities in Thunder Bay, Ontario and Saint John, New Brunswick in 2012.

When an Ottawa-based bloodmobile caught fire this summer, CBS thought the volumes generated by it were insignificant and chose not to use the insurance to replace it. That blood mobile collected 7500 units a year.

Another mobile truck that could generate similar volumes has been sitting idle in an Ottawa yard for most of the year.

When appeals are issued, the call center staff in Sudbury are usually swamped. We’re told the phones ring off the hook and there are too few staff to answer all of these calls. That too has an impact on inventory — but that’s not all.

Continue reading

Pro-rating funding for PSW wages creates unintended consequences

Photo of PSW with client. Caption: More than nine months after expressing Ontario's intention to retain PSWs,  implementation continues to hit major bumps in the road.

More than nine months after expressing Ontario’s intention to retain PSWs, implementation continues to hit major bumps in the road.(CanStock Photo)

In 2010 a provincial coalition of experts was assembled to look an integrated hospice palliative care system in Ontario.

Hospices are a specialized residential facility for palliative care patients. As the coalition’s report states, “hospice palliative care is a philosophy of care that aims to relieve suffering and improve the quality of living and dying.”

To do that the government relies on these hospices to produce a substantial portion of own-source revenue, most of that coming through fundraising.

Among the many recommendations in the four-year-old coalition report is one to increase the percentage of public funding for Ontario’s hospices to 80 per cent of their operating expenses. Presently it is about 50 per cent.

It may be wise to keep that in mind as the hospices now grapple with unexpected costs associated with the government’s initiative to improve PSW wages and address the sector’s ongoing recruitment and retention issues.

Continue reading

Will health care derail the 2017 target for balancing the books? Not likely.

Picture of coins to illustrate folly of the Conference Board of Canada's health care projections.

The Conference Board suggests that a 4.5 per cent annual increase in health spending will derail plans for a balanced budget in 2017. The thing is, that’s more than double the rate of increase the Wynne government is presently spending on health. (Canstock Photo)

The Conference Board of Canada likes to tell the world that it is independent and unbiased, but a quick look at its board of directors will reveal that it is mostly dominated by leaders from Canada’s corporate sector.

That includes representatives from banking, energy, insurance, and telecommunications, to name but a few of the private sectors chiefs that dominate the board. There are also, for good measure, a handful of board members from the public sector, including two university presidents and one hospital CEO, Michelle DiEmanuele from Trillium Health Partners.

DiEmanuele should be very familiar with what Ontario is spending on health care given Trillium has been subject to the same freeze on base funding that other public hospitals have experienced.

Overall Ontario budgeted for a 2.2 increase in nominal funding for the health care sector in 2014-15. Factor in the present inflation rate of 2.5 per cent (August CPI – Stats Canada), that means health care experienced an overall drop in real inflation-adjusted funding of -0.3 per cent. Add to that the impact of population growth and aging, the real cost pressures are probably closer to 4.5 per cent.

Continue reading

Ontario keeps its secrets as hospital labs may face more privatization

The Ministry of Health has only promised to release a redacted version of a Deloitte report that may shape the future of lab services in Ontario. (Canstock Photo)

The Ministry of Health has only promised to release a redacted version of a Deloitte report that may shape the future of lab services in Ontario. (Canstock Photo)

The Ontario government has been less than transparent when it comes to the future of its public medical laboratories.

A recent Deloitte Review of Ontario’s public lab system has been the subject of much discussion in the lab world. We’ve been told by those who have seen it that it sets the stage for the next phase of privatization within the sector. Not content to take volumes generated by community-based health care providers, the big laboratory companies are now seeking to siphon off more of the hospital work. One laboratory company – Lifelabs – represents about 70 per cent of all community lab work in the province.

Ontario is very selective about who it will let see the Deloitte report contrary to Premier Kathleen Wynne’s heartfelt election promises to be more transparent.

As the largest representative of laboratory professionals in the province, OPSEU sought the Deloitte report through a freedom of information access request earlier this year. We were told that the government had the right to withhold the report given “advice to government” was exempt from such requests. Early on in the process we were promised that a redacted version would be available pending an opportunity by an undisclosed third party to intervene. Months later we are still waiting.

Given the policy discussion the Deloitte report is generating behind closed doors, it’s time to let the public in. This is a critical piece of the health system that is being largely discussed in secret.

Continue reading