When faced with underfunding, should hospital CEOs make clear the consequences, or should they quietly find ways to cut services that may be less noticeable to the public?
For the first time since the Harris government, the McGuinty government has frozen base funding for hospitals. In addition it has introduced a new funding formula that is having negative repercussions for some.
We have always argued that having a funding formula makes sense, but such a formula should be grandfathered in so that hospitals on the losing end of the equation are not adversely affected. There are also questions about whether the formula itself is fair, some arguing that existing patterns of use are partly determined by where existing services are, as opposed to where services should be.
The net result of these changes in funding is hospitals are faced with particularly difficult choices this year.
Many choose to quietly go about their chopping, limiting input to board and management. Others talk publicly about consequences leaving the broader community an opening to debate what should take place.
The latest to talk about consequences is David Musyj, CEO of the Windsor Regional Hospital. Last week Musyj warned of possible layoffs and cuts to services, such as endoscopy and ultrasound – both he says are offered at private clinics in his community.
Musyj says he is looking to find $1.6 million in savings this year, and likely will be required to find more savings going into the future.
The hospital CEO says the choices are limited because a lack of community services to fill the gap, including access to primary care.
This is not the first time Musyj has sent out warnings, the more surprising given the proximity of the Windsor Regional Hospital to Finance Minister Dwight Duncan’s electoral constituency. Many hospital CEOs would be reluctant to rock the boat this close to a major cabinet minister’s home turf.
Musyj is no treat when it comes to collective bargaining – despite already established patterns that make the outcome of an arbitrated settlement a foregone conclusion, he seldom settles at the bargaining table. The reason may lie in the accountability agreements with the LHINs that make allowances for arbitrated settlements, not negotiated ones.
We have also previously noted that his history of blaming modest staff wage increases for the hospital’s funding woes is counterproductive and poor for morale.
The fact that Musyj is laying out the consequences to the community is a good thing. At least the citizens of Windsor will realize there are consequences to the decisions the government is making. It also opens up to the community the opportunity to discuss the proposed cuts before they happen.
The question is, why are not more CEOs being equally as open?
When the Peterborough Regional Health Centre went through its hospital improvement plan, CEO Ken Tremblay was nowhere near as open. Many in the community were incredulous over his suggestion that 160 full-time equivalent jobs could be eliminated from the hospital without any impact on service delivery.
Windsor residents may be further confused by the drama played out over a $1.6 million shortfall in the hospital’s operating budget while the politicians promote the idea of a new $1.2 billion mega hospital for the community.
It really is a bit much to be talking about cutting services and layoffs over a million plus while promoting a mega project of a billion plus. Surely this should elicit a big “huh?” in the Windsor community. If there is plenty of money for bricks and mortar, then there surely should be for endoscopy and ultrasound.