Are there more managers and fewer front line staff? At some hospitals, absolutely

Earlier this year we issued a freedom of information request to 20 sample hospitals where OPSEU represents health care workers to understand whether managers are in fact replacing front line health care workers.

Nine of 20 hospitals reported an increase in managers proportionate to front line staff over the past five years.

It’s a frequent complaint we hear.

While the requests were sent out in February, the information took much of the year to trickle in.

Resources are getting ever tighter in the hospital world – Ontario hospitals are experiencing no increase in their base budgets this year. How hospitals allocate their funding does matter.

Some hospitals actually reduced managers – at Kingston General Hospital, for example, managers dropped from 146 in 2008 to 125 in 2012. Staff has remained almost exactly the same over the past five years at 2,453. Other hospitals that dropped managers include the Chatham Kent Health Alliance, South Grey Bruce Health Care and the Windsor Regional Hospital.

Others show that our members were right.

Thunder Bay Regional Health Sciences Centre is the most dramatic example. In 2007 there were 71 managers to 1,680 full-time equivalent (FTE) staff. This year they reported staff is down to 1680.62 full-time equivalents after peaking in 2009 at 1,747 FTEs. However, the managers kept on growing, presently reported to be 90. The ratio was once one manager for every 23.66 FTEs. Now it’s one for every 18.67 FTEs.

All mental health centres we surveyed showed increases in management.

At Ontario Shores Centre for Mental Health Sciences we heard stories about clinical spaces being renovated to make space for new managers. The numbers support these observations. While staff has grown from 860.41 FTEs in 2007/08 to 933.87 earlier this year, managers have outpaced them, growing from 46.67 FTEs to 60.48 FTEs over five years. That’s an increase in ratio from one manager for every 18.44 workers to one manager for every 15.44 workers.

At the Royal Ottawa Group managers increased over five years from 76.29 to 90.09 FTEs while staff were reduced from 1,082.31 to 981.33 FTEs over the same period.

At the Waypoint Centre for Mental Health, where the numbers were expressed in hours, managers increased more modestly from being 4.34 per cent to 4.42 per cent, although hours were substantially down for both staff and management.

Other hospitals that saw considerable growth in managers relative to staff include York Central (now Mackenzie Healthcare), London’s St. Joseph’s Health Care, Quinte Health Care, and the Rouge Valley Health System.

Several hospitals gave us a broader ratio of what they consider “unit producing personnel” (UPP) to management and support operations (MOS). While the number of management and support staff went up at the Niagara Health System and Hawkesbury and District General Hospital, there were more UPP staff proportionately at Peterborough Regional Health Centre and The Ottawa Hospital over the last five years.

Peterborough has also experienced significant losses in unit producing staff, peaking in 2009/10 at 1,499.52 to 1,347.89 FTEs earlier this year. MOS dropped from a peak of 235.71 also in 2009/10 to 195.29 this spring.

Among the 11 hospitals that reported fewer managers to staff than five years ago, some have increased managers more recently. Sarnia’s Bluewater health cut front line staff between 2008-09 and 2009-10 by nearly 33 FTEs but added three more managers during the same period. They have added another manager since while continuing to reduce front line staff.

Similarly managers at Chatham Kent have more workers to supervise than five years ago, but slightly fewer than last year after adding slightly more than 1.5 management FTEs while reducing about two and a half front line staff.

What it cost us to find out.

3 responses to “Are there more managers and fewer front line staff? At some hospitals, absolutely

  1. hmmmm… Ontario Shores again….
    Wouldn’t you think with all those managers running around they could get “something” right?
    Maybe violence so bad because there is a shortage of front line care givers.
    Refer back to Circle of Trust video and intimidation of workers…
    What are managers so afraid of?
    Sounds like this Admin has passed their expiry date.

  2. I have been complaining about the misuse of money for non-clinical purposes even to the Minister of Health at AMO conference for the past two years. When the driving force for your organization is how much does it cost instead of what is the medical need of this patient i.e. run it like a business you will need more bean counters than clinical staff. The premise is wrong so everything else is wrong!

  3. It’s all a big farce. Less front line workers, cutting treatment programs, next to no Dr./Pt. contact or therapeutic relationship, no structure, no accountability for violent behaviour, and leaving nursing staff with no option but to quit and find other employment. Retention of staff is almost non existent. Staff who are experienced are few, leading to increased risk of violence as skills are needed to intervene before violence occurs. Every new computer tool that needs to be filled out takes away from client care and therapeutic interactions on a daily basis. Patients are bored and frustrated! Ontario Shores talk the talk but don’t walk the walk! It’s amazing that one man ran the hospital before divestment and knew the patients by name, welcomed them in his office, attended their ORB hearings, knew what was going on all the time. Now… who is it? Does anyone really know? Its a real shame. Do the board of governors not question anything? No one dare say anything…. or they will be next!

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