The closure of eight downtown Toronto hospice beds is hardly creating buzz in the health care community. But it should.
Perram House hospice is not big enough to warrant major headlines, but it is symbolic of why the government’s policies around service transfers to community-based providers are so flawed.
Perram House gave its workers two days’ notice that the hospice will close on Wednesday. Up until this point, there was no indication that the operators were even considering closure. If you visit the Perram House website, as of this afternoon it still is promoting its services. There’s still a button to become a “friend” of Perram House. There’s still an endorsement from actor Eugene Levy, even if the internet link to the video doesn’t work anymore.
We don’t know when the Toronto Central LHIN found out about it, but they reported to us that three of the patients have been transferred to the Grace Hospital and two more are now at home in the hands of the Community Care Access Centre. They figure their job is done.
Eight hospice beds are now gone from the mix. This is not how health system planning is supposed to take place. There was no public consultation. There is no assessment of need. It is closing because the Perram House board has decided to do so.
Perram House’s board has offered no explanation for the sudden closure.
We do know the course of events: After eight years of wage freezes, the workers decided to join a union — our union. At bargaining Perram House offered them a further cut in salary. They might as well have told the workers “screw you and your union.” When a strike vote was taken, the board of Perram House decided to close its doors.
Is it any wonder then that hospital workers are not flocking to work in these so-called community-based agencies? Is it any wonder that there is incredible resistance by workers to taking services out of hospitals and delivering them in the community?
If Health Minister Deb Matthews has not figured this out yet, this is an object lesson. This is evidence.
And where did these patients go? For most, they got sent back to the hospital. Is that where they and their families want to be?
How did the government protect the workers in this instance? They didn’t. It’s clear from the response of the Toronto Central LHIN all they cared about was moving the patients.
The LHIN says that Perram House was indirectly funded by them through the CCAC. They also received funding through the Ministry of Health. They did not have an accountability agreement with Perram, although the CCAC would have an accountability agreement with the LHIN. The LHIN could have worked with the CCAC and Perram House to find another operator. It didn’t.
We are not dinosaurs who are simply protecting our turf. We represent workers in hospitals and community-based settings. We were one of the first unions in Ontario to organize a family health team.
If we expect workers to be willing to work in this sector, they have to be treated better than this. Patients need to be treated better than this.
Otherwise the government’s ill-conceived reforms will only meet stiffer and stiffer resistance.
The LHINs have to be far more consistent about protecting services. Central East was certainly willing to do so for Liberty Housing and Support, a transitional mental health facility in Parkdale.
When the Salvation Army planned to close Liberty in 2011, the Central East LHIN stepped in to ensure it remained open until such time as services could be transferred elsewhere.
Toronto Central appears to be rolling over on the workers, patients and families involved with Perram House.
If the LHINs are expected to be planning bodies, public health care services need to be in hands of reliable and stable operators.
If Deb Matthews wants more health services to be delivered in the community, she is going to have to give some serious reconsideration to how this sector works and who its operators are.
Perhaps she can start by coming out to see these workers as they take to the streets tomorrow.