Why is the OHA not standing up for hospitals?

You have to wonder about the Ontario Hospital Association and its publicly stated views of the Drummond Commission report.

Upon the release of the report, the OHA publicly welcomed it despite what the Dean of Queen’s University’s Faculty of Medicine refers to as the report’s “anti-hospital sentiment.”

“Overall, the OHA and its member hospitals welcome the perspective that Mr. Drummond brings to the broader public sector and intend to review the report and its recommendations carefully,” the OHA stated in a February 15 release.

That was the last OHA release, on Drummond or anything else.

Cleary interim CEO Mark Rochon is not as quick to make public statements as Tom Closson, his predecessor. However, the silence is beginning to be noticed, making one wonder how much of the austerity kool-aid the OHA is really willing to drink.

Rochon did say he favoured more consolidation among hospitals – no surprise given his role with the Health Services Restructuring Commission that closed hospitals and amalgamated many others in the early 2000s.

That doesn’t mean the OHA’s members have been equally silent, although most are putting in considerable effort to keep up their happy talk. The CEOs prefer to go to safe territory, such as supporting the motherhood issue of better health service integration. Few want to talk about rationalizing services – an inevitable outcome if Drummond’s recommendations around restraint are accepted.

Threats of dramatically reduced funding levels happen to come at a time when the hospitals are experiencing a surge in patient activity.

Last Friday it was reported The Ottawa Hospital was overcapacity by 115 per cent – this at a time when it was experiencing a norovirus outbreak that has already spread to 43 staff according to CTV News.

Quinte Health Care is under similar pressure this winter.

Mary Clare Egberts, President and CEO of Quinte Health Care, suggested the funding levels wouldn’t be sustainable, requiring QHC to “find even more ways to be efficient.”

“Patients are going to have to understand that their care might be delivered differently,” she told her board, suggesting that not all services will be able to delivered through the hospital.

The question is, who will get funding to pick up these services, and will it be as “patient-centered” as the hospitals would like to believe?

SE LHIN says to expect zero increase for hospitals

The South East Local Health Integration Network, according to the Belleville Intelligencer, has already told hospitals to expect zero increase in funding this year.

With general inflation running at 2.5 per cent, plus the impact of aging and population growth, this will likely mean a real cut to hospitals of close to 5 per cent. Will the other LHINs follow with similar restraint?

Austerity was clearly on the mind of The Scarborough Hospital’s Dr. John Wright. Wright had attempted to engage the Toronto East General Hospital in merger talks, arguing declining funding levels were at the root of his efforts. Talk of rationing services between the two hospitals clearly got the community spooked, and TEGH backed off quickly, noting opposition from the Central East LHIN.

Others have been more cautious, suggesting the devil will be in the details. Many of the 105 Drummond health care recommendations are incredibly vague and nothing is costed, leading to questions around how any of this will be possible?

Dr. Kevin Smith, CEO of Hamiton’s St. Joseph’s Health Care and supervisor of the struggling Niagara Health System, suggested that he might be okay with the direction of Drummond as long as there was money up front to implement change.

“What I wonder is if we have the cash flow for some of the up-front expenses that would lead to long-term efficiency,” Smith told the St. Catharines Standard. “If we have the cash flow, that is great. But if not, we need to know from the government what we can enact.”

David Musyj, CEO of the Windsor Regional Hospital, said he liked the overall recommendations, but says Drummond misunderstood the constraint hospitals faced when dealing with alternate level of care patients. He told the Windsor Star that staff was already working hard to optimize capacity and apply best practices, making him question whether Drummond had actually visited a hospital while working on his report. “His comment in that regard is very naïve and offensive,” he told the newspaper.

While the OHA and most of its CEOs were reluctant to criticize Drummond, Dr. Richard Reznick, Dean of Queen’s University Faculty of Health Sciences, was less reluctant to share his views. On his BLOG, Reznick echoes Kevin Smith, noting there is a lack of “financial empowerment” that promotes and enables health care integration.

While he agrees that we should focus more on chronic care, it should not be at the expense of the hospitals.

“The fact that we need to focus more on chronic care should not mean that we systematically decimate the great hospital-based care that we have worked so hard on for so many years,” he writes. “To be sure we need to do both, but that should not mean diverting money away from hospitals.”

Reznick takes issue with Drummond promoting what he perceives to be an “anti-hospital sentiment,” noting that some of “our best, most creative, and fiscally responsible institutions are our acute care hospitals.”

Reznick’s strongest language is on the issue of private delivery of public health care. In this BLOG, he states “Drummond argues for maintaining the principles of a single payer system, but argues for introducing an expansion of private – for profit – delivery. This is a very slippery slope, and I have grave concern, that encouraging this model will ultimately result in an American style system and erode one of Canada’s most cherished possessions.”

To read Reznick’s point-by-point analysis of Drummond’s health care recommendations, click here.