Monthly Archives: January 2010

Cornwall Community Hospital is the latest hospital to get additional funding to offset its deficit. The hospital has received $5 million in new funding to its annual operating budget, reducing its deficit from $8 million to $3 million. According to the Cornwall Standard-Freeholder, there is a plan to save $2.1 million by cutting eight beds and reducing the number of surgeries by 10 per cent. … The Ottawa Citizen reported on Wednesday that the Ottawa Hospital and the Queensway-Carleton Hospital have contracted with a private retirement home to provide 74 temporary beds for elderly alternate level of care (ALC) patients. The Ottawa Hospital will close 28 vacated beds as part of the process.  Retirement homes are not health care facilities. Unregulated, they are only covered under the Landlord-Tenant Act.  Last summer the Office of the Chief Coroner sent a letter to the Ontario Hospital Association cautioning hospitals of such transfers. Investigating the death of an ALC patient that had been placed in an unregulated retirement home, the Chief Coroner wrote “health care professionals should be reminded that frail elderly patients who are totally functionally dependent and have significant care needs are not appropriate for placement in the private care homes.” The Coroner said such patients should remain in a setting that is as resource intense as a licensed long term care home. …  The Ottawa Citizen also reported this week of a new study of occupational strain at four Ottawa hospitals. The study concluded that employees are overworked and suffering “unsustainable” levels of stress in a system that’s already as lean as can be. Written by Carleton University professor Linda Duxbury, the report says stress levels are making it difficult for nurses, doctors and other staff to look after patients properly. Michael Donaldson, president of OPSEU Local 464, told the Citizen You’re trying to meet these timelines identified by the ministry, and they’re on the white board in the ER: Are we up? Are we down? We’re barraged by information about how we’re doing.” The result is a steady rise in staff burnout, higher rates of sick leave, workplace injuries and medical errors. Marlene Rivier, president of Local 479 criticized a controversial absenteeism program that required sick employees to report to the hospital’s health insurer. Those who don’t, risk having their pay docked. “People feel harassed, they feel devalued, they feel they’ve become the object of suspicion,” she said.

Just prior to last November’s Ontario Hospital Association Conference, OHA CEO Tom Closson called for hospitals to be placed under Freedom of Information legislation.

Ontario is the only province that excludes its publicly-funded hospitals from such scrutiny.

Addressing the OHA, newly minted health minister Deborah Matthews saluted Closson for taking the initative.

“The people of Ontario expect both a strong health care system, and fiscal responsibility. And it’s our job to provide both,” she said. “One part of restoring that trust is being transparent and how we’re spending and what we’re doing. It’s about showing Ontarians that we’re achieving and being honest about our shortcomings.”

Matthews said that with Closson’s leadership at the OHA, Ontario will be able to restore trust and regain public confidence in the health system.

Enter the Friends of the Ajax/Pickering Hospital. The Friends are a diverse community-based group that advocates on behalf of its local hospital in West Durham.

In 2008 the Rouge Valley Health System board decided to move all inpatient mental health beds from the Ajax-Pickering Hospital to the Scarborough Centenary Hospital. The plan had been kept under wraps until the Rouge board approved it, and within three days, the Central East LHIN had rubber stamped the move without any community consultation or input.

While the Rouge Valley Board has continually argued that consolidation of mental health beds at Scarborough Centenary was part of their deficit reduction plan, the Friends have always doubted whether there were any costs savings to be had.

Not only did Rouge have to renovate Centenary to accommodate the transfer, but a brand new state-of-the-art psychiatric intensive care unit at Ajax-Pickering would be abandoned as part of the process.

Last year the Friends decided to ask for the information on costs related to the transfer from Rouge Valley. They received a letter back from former Tory cabinet minister Janet Ecker, Chair of Rouge’s Board. In it she said the Board’s finance committee met and considered the Friends request.

“The committee has advised me that RVHS follows financial disclosure practices that are generally consistent with the industry and in compliance with statutory reporting requirements,” Ecker wrote. “Based on the above, the committee has concluded and advised me that disclosure of the highly detailed information requested in your letter would be inconsistent with the hospital’s disclosure practices and those of the hospital industry.”

The Friends have since sent in a Freedom of Information request, and been told the information they seek is unavailable. They are appealing.

If the OHA and the Ministry of Health were serious about this, they would give the Friends the information they seek and make disclosure a priority.

It’s time for the OHA and the Ministry to open up the hospitals to disclosure, not just talk about openness and transparency.

At first it looked like a re-run of 2007’s fight to save mental health services at Lakeridge Health in East Durham. Without dedicated funding, Lakeridge’s mental health services stood between the hospital and its legal obligation to balance its budget.

January 19 the Central East LHIN confirmed their decision to deny Lakeridge the ability to cut these services, stating new funding had been found.

Shortly after the decision, a memo was sent to staff at Lakeridge stating the LHIN had contributed another $4.1 million to the hospital’s base funding. The hospital said it was also expecting additional growth funding to bridge its remaining funding gap. For the first time since amalgamation, Lakeridge is likely to balance its budget.

The additional funding marks an important victory for the community. OPSEU had been part of effort to save Lakeridge’s mental health services.

In 2007 the Ministry had given a clear directive for hospitals to divest themselves of mental health programs that weren’t already receiving dedicated funding from the Ministry.

To its credit, the Central East LHIN stepped in at the time and refused to let Lakeridge divest these services, putting the LHIN at odds with the Ministry.

In November of 2009 Lakeridge presented before the LHIN their deficit reduction strategy. However, they said they could not cut further without putting programs at risk, including mental health, outpatient physiotherapy, the day hospital and a respiratory rehabilitation program. The hospital expressed its desire to maintain these services.

Lakeridge will now amalgamate its respiratory rehabilitation, day hospital, and outpatient physiotherapy at a new Lakeridge Centre of Excellence for Rehabilitation Services to be located in the Whitby hospital site this fall.

Hamilton Health Sciences is the latest hospital to begin cuts to services in anticipation of underfunding from the province. In a memo distributed on Wednesday, CEO Murray Martin said notifications would go out next week to affected staff along with offers of early retirement. Matthews indicated to staff that costs were rising by 4 per cent while the best case scenario was for a 2 per cent funding increase from the province. That means a shortfall of $17-$35 million on the hospital’s $1 billion budget. “Because we are already a very lean organization, operating in the most efficient way possible, any further savings we implement will, at this point, affect services,” Martin wrote. Across the city, St. Joseph’s is expected to cut $7-$13 million from its budget to make ends meet. Ontario hospitals have been told to plan three scenarios – a funding freeze, a one per cent increase and a two per cent increase. When contacted by the Hamilton Spectator, Health Minister Deborah Matthews said she couldn’t say whether or not hospitals have a chance of getting a base increase of more than two per cent. “We’re very much in the planning stages right now,” she told the newspaper. 

Have your say!

 OPSEU has set up a web site where you can quickly assemble an original e-mail to your MPP about the proposed funding freeze. Choose from a series of points and add in your own original thoughts. The site allows you to copy the letter to the premier, health minister and two opposition health critics. Go to www.avoidingzero.ca

Hospitals continue to decline as a share of Canada’s health care spending according to recent data from the Canadian Institute for Health Information (CIHI). In 1975 hospitals accounted for 44.7 per cent of Canada’s health care spending. In 2008 CIHI estimates hospitals will represent 28 per cent of health spending – a drop of 2.7 per cent from 1998. The biggest increase in health spending has been on drugs, which now take up a greater share (17.4%) than physicians (13.4%). In 2008, spending on drugs was expected to grow by 8.3 per cent, compared to 5.8 per cent for hospitals and 6.2 per cent for physicians.

By Warren (Smokey) Thomas
OPSEU President

The peer review of Peterborough’s new hospital is the latest review by the Local Health Integration Network (LHIN) that will likely ignore the central problem – there isn’t enough funding for the hospital and supporting community services.

 This territory has been covered before – and recently.

Last year the Central East LHIN sent in an expert team to look at how the Peterborough Regional Health Centre (PRHC) could reduce the number of patients occupying so-called “alternate level of care beds.” By definition, these patients have completed their acute care treatment but are unable to leave their beds for a variety of reasons, including wait lists for home care and a significant shortage of nursing home beds.

The review found Peterborough was serving a much older population than the rest of the province and by extension, enduring additional cost. In Ontario 12.9 per cent of the population is over the age of 65 years. In Peterborough City and County, that percentage jumps to 18.5 per cent. In Haliburton Highlands, almost one quarter of residents are seniors.

In addition, Peterborough serves a regional function, providing specialty services that cannot be offered at a ring of smaller hospitals, including Haliburton Highlands, Ross Memorial, Northumberland Hills, and Campbellford Memorial.

During the 1990’s, the Health Restructuring Commission recommended a target of 100 long term care beds for every 1000 people over the age of 75. That would translate to 1,750 long term care home beds in the Peterborough region. Today there are currently only 1,111 beds – just 62 percent of the recommended number. These beds are operating at 99 per cent capacity.

These factors all suggest that Peterborough Regional Health Centre is being asked to take on much more relative to its size, yet its funding is considerably lower than comparable hospitals of the same size.

For example, the new Brampton Civic hospital was built at the same time as the PRHC. It opened with fewer beds than Peterborough, yet receives almost $30 million more in annual operating funds.

This situation has been compounded by province-wide funding levels that have remained below the costs hospitals are facing through inflation, population growth, aging, competitive wage settlements and spirally drug and equipment costs.

Last year most hospitals needed between 3.5 and 4 per cent to simply stand still. They received 2.1 per cent from the province. This year the province is threatening to freeze funding. If real costs go up by an estimated 3 per cent, that means Peterborough will be additionally short-changed by about $6 million.

Last year’s review found Peterborough Regional Health Centre was already doing a lot of things right.  Many of that committee’s final recommendations will require more investment in staffing, administration, and training. The report also recommended the creation of a 12-bed specialized geriatric behavioural support unit, an 18 bed interim long term care unit, and an out-patient follow-up clinic.

Is it any wonder PRHC can’t balance its budget?

Peterborough MPP Jeff Leal needs to stop making excuses and find the money Peterborough needs to fund its new hospital, build more long term care beds, and improve home care services.

Meanwhile the Peer Review committee would be well-advised to listen to the community. Given Peer Reviews constitute a committee of health care executives from outside the community; the LHIN should attach community representatives to the project.

Peterborough is too important to the LHIN to start cutting jobs and services at the hospital. Identified by the LHIN as one of two future cardiac care centres, Peterborough should be planning for future growth, not looking at ways of getting even smaller.

 This article was also submitted to the Peterborough Examiner.

Want to send MPP Jeff Leal an e-mail about the situation? Go to www.avoidingzero.ca