Yesterday 120 Ontario Health Coalition members entered Queen’s Park to meet with 70 MPPs a day after one of the most controversial provincial budgets in recent history. There are a total of 107 MPPs in the legislature.
With health care funding falling below that recommended by the Drummond Commission on Public Service Reform, one opposition MPP told his visitors, “there is a significant bump in the road coming.”
The lobbyists arrived at the MPPs offices to talk about jammed hospitals; thousands on wait lists for nursing home beds, and severely rationed home care. They also expressed their concerns about the prospects for increased privatization.
The OHC members sought a commitment to put into place a moratorium on hospital bed cuts, reasonable funding for the full continuum of care (including home care, nursing homes and hospitals) and a commitment not to go down the privatization road.
Of the MPPs we spoke with, there was a reluctance to give us the tick marks we sought on those questions.
All realized the present health care system posed significant challenges and that the questions depended on the state of reform.
Not surprisingly, most wanted to see services moved out of hospitals, although not always for the same reasons.
At one visit we pointed out the advantage of rural community hospitals had in performing community lab services (ie. tests ordered by doctors and clinics outside the hospital), something they were now prohibited from doing. From this, the MPP tried to box us into saying that every hospital could be everything to everyone. This was not what we were saying. We could have suggested the alternate extreme, that they wanted hospitals to be nothing to anyone, but instead stuck to the script.
Some felt it would be more efficient to move services out into the community, as if hospitals somehow existed in another country.
On the one hand MPPs wanted hospitals to specialize, on the other they wanted to move services closer to the patients who needed them. These are contradictory ideas.
One government minister told us that hospitals weren’t safe and therefore anyone who could be served elsewhere should be. We also heard this from the opposition.
This is a little like saying your house is on fire, and rather than call the fire department, you should simply leave and build a new house somewhere else. And too bad about those who had to stay behind. Surely there is a responsibility by the government to ensure these facilities are safe for all users.
One opposition MPP said health care is the entitlement we have all earned. He described the government’s aging at home strategy as the “aging alone “ strategy, a phrase that got several heads bobbing in agreement.
With some MPPs advocating for hospitals to be limited to acute care services only, we pointed out that hospitals were performing a variety of needed services that fit outside that definition, including rehab and addiction services. Many of these services had grown organically in response to and with support from the community.
If these services are high quality and being performed efficiently, why fix something that’s not broken just because it doesn’t fit within a rigid ideological frame?
The government created the LHINs to take into consideration regional needs within the health care system. That’s not a one size fits all model.
Not all meetings went well. As one lobbyist described their experience with an ill-informed opposition backbencher who preferred to talk rather than listen, the Vladimir Mayakovsky poem (and Billy Bragg album) “Talking To The Taxman About Poetry” came to mind.
Most of the meetings were relatively brief – usually about 20 minutes to half an hour. At least one MPP asked to meet again to resume the conversation.
While the lobbyists – including both community members and health care workers – told their own personal stories, so did some of the MPPs.
Rather than standing outside shouting at the building, this was an opportunity to come inside and start a conversation.
The question is, how open are the MPPs to continuing that conversation?
As a postscript to this story, Niagara Health System has had more than its share of hospital-borne infections, raising safety questions from the community. Last year there were 37 C-Difficile-related deaths at the hospital. After 10-years of contracting out management of its cleaning and infection control, NHS ended its relationship with U.S.-based Aramark and has brought the function in-house. They have also hired more cleaners. To us, this is far more responsible than taking clinical services out of hospitals because of safety concerns.