In Brief: Hospital cuts as transfers, Pupatello’s ego gets the better of her

Pop quiz: who wrote this: “Our government expects – as do health care providers – that this change will exacerbate the health conditions of patients with chronic conditions and those who are at risk of developing such conditions. In addition, given preventative care is less costly that emergency or acute care treatment, your policy represents a significant download to provinces and especially Ontario, where the vast majority of refugee claimants reside.” If you guessed Ontario Health Minister Deb Matthews, you’d be correct. Matthews’ wrote Federal Citizenship and Immigration Minister Jason Kenney in December over the impact of cuts to the Interim Federal Health Program for refugees. Tomorrow (Wednesday) opponents of the federal cuts will be meeting outside of Deb Matthews’ downtown Toronto office to ask Ontario to have a heart and provide stop-gap coverage for these disenfranchised refugees left without coverage. Demo starts at 11:30 am near Bay and Wellesley Streets in Toronto.

Windsor Regional Hospital is closing its long-standing Acute Injuries Rehabilitation and Evaluation Centre after the facility lost $300,000 last year. Once a revenue-generator for the hospital, the centre provides assessment and treatment services to people injured in automobile accidents or on the job. Revenues came from WSIB and other private insurance providers. The hospital claims two other private centres have meant that this insurance work done by the hospital has “dried up.” Curiously Windsor lawyer Suzanne Dajczak told the CBC that the closure would mean costs would shift to the patients. “When you’re injured, you’re under stress, finances generally are cut – in the cases that I see, substantially. They usually come when they’re denied and, yes, they’re going to struggle, and it’s going to be more difficult for injured workers” (Emphasis added). Is Ms. Dajczak suggesting that these private clinics may be less supportive of injured worker claims than the public hospital?

After the Minister of Health suggested health services were not being cut, but instead being transferred, we decided to start tracking media stories about these “transfers” from hospitals and their impact on communities. The latest comes from Trenton, where Quinte Health Care is trying to deal with a $10 million shortfall. The Trentonian says that shortfall could increase by another $5 million in coming years. CEO Mary Clare Egberts told municipal council that the “current funding formula is not sustainable.” Proposals include closing five inpatient beds in Trenton, eliminating the remaining outpatient physiotherapy services, “transitioning” point of care testing to Belleville General and diverting “appropriate urgent” emergency room patients also to Belleville. We’re not sure how “point of care” testing can be transferred elsewhere given the whole point of “point of care” is that it happens at point of care. For all the talk of patient-centered care, we’re not sure how transferring care further from patients fits the bill either. One Councillor told the community newspaper “all this is money driven. It’s not patient driven.” No kidding.

Did the leading candidate to replace Dalton McGuinty really suggest her rivals were a bunch of lightweights? The Toronto Star’s Robert Benzie reported on an editorial meeting with Sandra Pupatello in which she said “when I stand back and look at the cast of candidates, even I would pick me. I have to be plain about that,” she said. If there was any doubt about what she meant, she added “if we took this year out of the Liberal government, who do you think would be the cast? It would be Bentley, it would be Duncan, it would be Matthews. It would not be this cast. I get that.” Perhaps she got that, but any politician worth her salt would understand that you don’t trash your rivals on the eve of a leadership convention, especially if you eventually expect them to throw their support behind you. Former leadership candidate Glen Murray called her comments “pretty hurtful.” The public has been loath to warm up to PC Leader Tim Hudak, but Pupatello’s ego could end up helping her future political rival more than she thinks.

Ontario has been rebuilding dozens of its public hospitals racking up billions in future debt obligations. You’d think after splashing out on all this brick and mortar, Health Minister Deb Matthews wouldn’t turn around and insist the private not-for-profit sector build separate infrastructure to offload services from these hospitals. Matthews is sold on the model promoted by the non-profit Kensington Eye Clinic, convinced that other not-for-profit clinics can achieve similar results by taking a number of services out of hospitals and delivering them in a similiar stand-alone assembly line environment. Matthews said last week she wants to see a similar model for hip and knee surgeries, MRIs, colonoscopies and dialysis. Yet just a few weeks ago the medical director of the Kensington Screening Clinic suggested in healthydebate.ca that his operation was at a disadvantage because doctors who performed colonoscopies in public hospitals were able to retain their full OHIP fee, whereas in his clinic they had to surrender 40 per cent of their OHIP fee to pay for his clinic’s overhead costs. Forty per cent for overhead? The implication is that his clinic is being disadvantaged by public hospitals. He doesn’t actually say what the remedy is, but instead rants about the image of private clinics. Could it be he expects government to increase their compensation for these clinics, paying more for certain procedures? And what about the idea of integration? Isn’t taking services out of hospitals and placing them in stand-alone facilities the opposite of integrated health services? Matthews may want to take another look at this one.

There is much nervousness in Niagara. Despite anticipation of the March opening of their new and costly P3 mega hospital in the outer reaches of St. Catharines, some believe a much promoted second mega hospital for the southern part of the Niagara peninsula may never come to pass. At stake is the future of a series of smaller hospitals that dot communities from Niagara-on-the-Lake to Fort Erie, Welland, Port Colborne and Niagara Falls. Kevin Smith, the provincially appointed supervisor for the Niagara Health System, recommended a second hospital in the southern part of the region to replace these smaller and aging facilities. At the end of the restructuring process, the Niagara Health System would only have two sites. Some are ready to strike up the band and get behind the new hospital, others are worried that a long delay or failure to build the second hospital will overburden the new hospital to open this spring. The question is: will delays in committing to a second hospital mean the series of existing community hospitals will be left in limbo, the NHS reluctant to support new services, expansion or renovation of these hospitals? How likely will it be for the present cash-strapped government to commit to a second $700 million plus facility in the southern part of the peninsula? Will there come a point where community hospitals will close before a new hospital can be built? Its high stakes, especially with a government that believes in closures as service transfers, even if those services presently don’t transfer to anywhere but a promise. The region is also a political caldron, all three parties holding significant seats in the region, including PC Leader Tim Hudak, long-time Liberal cabinet Minister Jim Bradley and NDP Municipal Affairs and Housing critic Cindy Forster. Andrea Horwath recently jumped into the fray, suggesting moving everything to a second mega hospital would strip local communities of nearby health resources and create unequal geographic access to care.