Two community meetings around cuts to the Perth and Smiths Falls District Hospital drew significant crowds this week.
Cuts at the two-site rural hospital corporation are particularly severe. The Perth and Smiths Falls District Hospital is seeking to find 6 per cent in savings primarily through reductions to health resources used by the community, including a cut of 12 beds, six at each site.
This is only the beginning given every hospital is struggling with zero-based budgeting from the province that is expected to impact the bottom line to 2016-17. The situation is made worse at hospitals like Perth and Smiths Falls due to the simultaneous implementation of a new funding formula that doesn’t appear to appreciate the unique demographic demands of the region.
The Health Minister and local opposition MPP Randy Hillier say services are not being cut, but are being reallocated. But is this really true?
The cuts include physiotherapy where the equivalent of more than three full-time positions will be lost at the hospital.
Numerous provincial reports have acknowledged that seniors are having trouble connecting with publicly funded physiotherapy.
Last week it was the turn of Dr. Samir Sinha, the provincial lead on Ontario’s Seniors Strategy. Sinha called for more publicly funded physiotherapy in the community, but the last OHIP-licensed private physiotherapy clinic to open in Ontario was in 1964. Health Minister Deb Matthews has been silent on this issue despite cuts to physiotherapy in about half of Ontario’s hospitals during the past year. This is one more.
Hillier says evidence of this new general reallocation includes a new medical facility in Napanee, which is more than 130 km away and not likely to pick up the slack for local residents in Perth and Smiths Falls.
Hillier dismissed the bed cuts, blithely saying the hospital is full of patients who could be helped elsewhere. Like where? Tell us Randy.
The reality is Ontario has among the lowest per capita number of hospital beds not only in Canada, but in much of the developed world (only three countries in the OECD have fewer – Mexico, Turkey and Chile). Ontario has cut 18,500 beds since 1990, making us the lowest of the low. Clearly it has no plans to stop cutting. While it sees local community services as an alternative, it has never built a system capable of absorbing the beds that have already been lost, let alone services that could accommodate additional new bed cuts.
When the Health Restructuring Commission of Canada set similar targets for cuts to beds in psychiatric hospitals, it was under the proviso that such alternatives been put in place first. Successive governments failed to listen, the beds were cut, and now we have a mental health system that even the government acknowledges is falling considerably short of community need and costing Ontarians billions of dollars in lost productivity. We reached the Commission’s target for mental health bed cuts in 2008, although cuts continue even in the Health Minister’s own backyard of London, Ontario. The services to replace them are about half of what they should be according to the Commission’s plan.
Health Minister Deb Matthews has been reluctant to expand the stock of long-term care beds despite thousands of Ontarians waiting for access. Home care also has its own wait lists and is likely to see little change when funding increases are restricted to increments of 4 per cent per year. For those in need of more intensive home care, the province is introducing new rules that make it impossible for Community Care Access Centres to use their discretion and waive the cap on maximum hours of care a home-bound patient can receive. That includes palliative patients and those waiting at home for placement into a long-term care bed. In our book that’s fewer options, not more.
Hillier does not believe that one of the two local hospitals could eventually close, that workers at the hospital are merely fear mongering.
No doubt many citizens in Shelburne Ontario felt the same way. Shelburne was similarly linked with the Orangeville Hospital as part of Headwaters Health Care. Shelburne was eventually closed by increments, services slowly leaving the hospital one at a time. Now local citizens face an uphill battle trying to get it back.
They are also beginning to figure out that there is no reallocation in Thunder Bay, where that city’s Chronicle Journal said it was time for the hospital CEO to read the riot act to the Local Health Integration Network. The newspaper noted that last Wednesday 27 patients in the emergency department were to have been admitted to the hospital but couldn’t because there were 17 patients in hallways on stretchers who had prior claim on any bed to come free. The hospital has 86 so-called “alternate level of care patients,” but they have nowhere else to go and the 375-bed hospital is respecting its duty to care for these individuals. The province says new long-term care beds are coming, but the newspaper notes they will only be replacing three long-term care homes slated to close.
When bed shortages reach this level, hospitals usually declare a bed crisis. That means their patients get first priority on any long-term care beds that come open – before those who may be just as acute and have been waiting months at home.
While many volunteered at these meetings to work on a plan to save services at their hospital, it’s a pity they won’t have the assistance of their local MPP, who has decided to accept the rhetoric of the Minister of Health.
Also: Watch Operation Maple’s economic tour of Smiths Falls with OPSEU’s Dave Lundy. As these latest hospital cuts would indicate, it is time to rethink the direction we have travelled in the last 25 or 30 years.