Monthly Archives: May 2013

Federal health funding scheduled to drop when it most needed — McBane

Michael McBane of the Canadian Health Coalition speaks to the Canadian Health Professionals Secretariat meeting Thursday. Seated next to him is NUPGE's Len Bush.

Michael McBane of the Canadian Health Coalition speaks to the Canadian Health Professionals Secretariat meeting Thursday. Seated next to him is NUPGE’s Len Bush.

OTTAWA – In the late 1970s it was Monique Begin, then Federal Minister of Health and Welfare, who suggested that citizens needed to mobilize into coalitions to make noise in society to get anything to work.

As Michael McBane, the present National Coordinator of the Canadian Health Coalition said Thursday, “governments are not likely to see the light first.”

In 1979 the Canadian Health Coalition began, with many of the provinces quickly following suit with their own coalitions, including the Ontario Health Coalition.

The first project the national coalition embarked on was a campaign to abolish extra billing by doctors. Charging user fees over and beyond those provided by Medicare, the campaign eventually led to a ban on extra billing as part of the new Canada Health Act passed in 1984.

Speaking before the Canadian Health Professionals Secretariat in Ottawa yesterday, McBane says that while some things have changed, we are still fighting similar “zombie” ideas that keep on coming back.

Today the coalition is again fighting extra billing by private clinics, this time without a federal government willing to enforce the principles of the Canada Health Act.

“We no longer have three parties that believe in Medicare,” says McBane.

Transfer payments from the Federal government to the provinces was originally intended to allow Canadians to access consistent national standards of health care regardless of where they lived.

The Harper government is clearly on another path.

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Transferring hospital services to private clinics — a line in the sand

Code Blue in Ottawa: Marlene Rivier chairs a panel including (R-L) Maude Barlow (Council of Canadians), Mike McBane (Canadian Health Coalition) and Natalie Mehra (Ontario Health Coalition).

Code Blue in Ottawa: Marlene Rivier chairs a panel including (R-L) Maude Barlow (Council of Canadians), Mike McBane (Canadian Health Coalition) and Natalie Mehra (Ontario Health Coalition).

OTTAWA – Natalie Mehra says The Ontario Health Coalition is drawing a line in the sand when it comes to service transfers to private endoscopy clinics from The Ottawa Hospital.

Speaking at a “Code Blue” forum in Ottawa last night, the director of the coalition said the privatization of these hospital services were “unprecedented,” part of a series of changes that had become “divorced” from planning around patient need in the Ottawa region.

Mehra raised questions about the capacity of these private clinics to absorb 4,000 endoscopies, particularly when they were likely to lengthen wait lists.

Given endoscopies are going to be individually funded by the Local Health Integration Networks this year, funding normally allocated to the hospital for these procedures cannot flow from the LHIN to the private clinics given such clinics are outside the scope of the LHIN.

The transfer of endoscopies to private for-profit clinics also is in direct contradiction of the Ontario Health Minister’s commitment to transfer services to not-for-profit providers in the community.

Mehra also debunked the myth that the cuts to hospital services were merely part of a new reorganization of health care, noting the lack of funding support from Queen’s Park to home care over the last decade. Even with the recent funding increases, per patient funding is lower today than it was before the McGuinty Liberals took power in 2003.

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Academics present evidence that austerity really does kill

Ontario is presently entering year two of its austerity program, convinced that it is the only way out of an economic problem that wasn’t even created here.

We have previously highlighted economic arguments that suggest austerity creates a self-defeating “fiscal drag” that compounds debt and deficit problems. Now a new book by a pair of academics on either side of the Atlantic argues that not only is austerity self-defeating, but it is also bad for your health.

In The Body Economic: Why Austerity Kills, David Stuckler and Sanjay Basu present a convincing analysis that austerity policies have made citizens involuntary subjects of a grand experiment in public health. If you recently lived in the UK, Greece, Spain or Italy, you’ve likely recently witnessed very different population health outcomes than if you lived in Sweden, Iceland or Denmark.

The authors argue that this is not the first time this austerity versus stimulus experiment has taken place. In the U.S. States that adopted the depression-era “New Deal” stimulus programs had much better health outcomes than those that refused to do so.

“Economic choices are not only matters of growth rates and deficits, but matters of life and death,” the authors write.

In their peer-reviewed study, the pair of PhDs state that investment in the right programs can not only alleviate human suffering, but can itself spur economic growth. For every $1 invested in public health programs, the net benefit to the economy is $3. By anyone’s standards, that’s a sweetheart deal. Yet ideology prevents us from seeing the evidence before us.

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Lou Rinaldi must be stewing over Biron’s appointment as TSH CEO

Nobody can say Robert Biron didn’t know what he was getting into.

The former CEO of Cobourg’s Northumberland Hills Hospital has come to the big city, the next in line to take on the seemingly impossible task of fixing The Scarborough Hospital.

The good news is, unlike many of his counterparts at other hospitals, Biron will release the full details of $18 million in financial measures the hospital plans to implement to balance the budget.

The bad news is The Scarborough Hospital is still facing $18 million in cuts and fee hikes.

Biron is suggesting that there might yet be some flexibility in how the hospital tackles its deficit, telling The Toronto Star that “my first priority as we move forward is to reach out to these key stakeholders and hear about their concerns and suggestions about how we might move forward together to redefine health care delivery in Scarborough.”

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Health care activists set to converge on Niagara-on-the-Lake July 24-25

July 24-26 the provincial Premiers will be meeting in Niagara-on-the-Lake for the last Council of the Federation meeting before the 10-year federal-provincial health accord expires.

What comes next is largely a mystery. The federal government has committed to increased transfers but appears disinterested in what the provinces do with that money.

Federal transfers will continue at the 6 per cent threshold until 2017 but eventually align with economic growth. No matter what, the federal government has committed to a minimum growth in the Canada Health Transfer of 3 per cent.

Whereas the last accord was about reducing wait times for key diagnostics and procedures, there is no consensus about whether there will be any national objective over the next 10 years.

Health care groups are already organizing for the Niagara meeting, plans taking shape for a shadow summit and rally July 24-25.

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Ontario Shores under aggressive timelines to fix safety issues

Ontario Shores now has its orders from the Ministry of Labour.

It’s been almost a year since staff at the Whitby mental health centre went public with their concerns about violence at the Centre, expressing concern and frustration about a lack of meaningful action by their employer.

For all the activity Ontario Shores has shown to date, little has changed in the monthly statistics that show staff being assaulted on an almost daily basis.

Last September we noted a paper by Queen’s University faculty Dr. Heather Stuart suggests that aggressive behaviors differ dramatically in treatment units, “indicating that mental illness is not a sufficient cause for the occurrence of violence.”

Stuart states the “majority of incidents have important social/structural antecedents such as ward atmosphere, lack of clinical leadership, overcrowding, ward restrictions, lack of activities, or poorly structured activity transitions.”

Now Ontario Shores Centre for Mental Health Sciences has a very detailed prescription to follow from the Ministry of Labour. Limited in its scope, the Ministry of Labour is not in a position to evaluate the impact of cuts to programming at the Centre on the behavior of those in their care.

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Ottawa parody of Gangnam Style makes the case for unions

This is one of the more ambitious low-budget videos we have seen that makes the case for unions in Canada. Made by Corinne Dara, it is billed as a parody of Gangnam Style.  It certainly brought a smile to our faces. Nothing like enjoying your union-won weekend in the Ottawa snow! Check it out and pass it on using our share button.

A hornets’ nest in Trenton over plans to replace the hospital lab

It’s been a hornets’ nest for the past two months.

Quinte Health Care’s plan to shut down its lab at Trenton Memorial Hospital and replace it with “Point of Care Testing” (POCT) has raised the ire of local doctors, politicians and community members in this town of about 20,000 residents.

QHC plans to close Trenton’s lab in late September.

Doctors say the closure of the lab is the beginning of the end for Trenton’s emergency room – leaving the town with a glorified “first-aid post.” The hospital denies this, arguing the Picton and North Hastings sites maintain ERs with only POCT.

With cuts to nursing staff also part of the plan, the doctors question how emergency room nurses will have the time to safely operate POCT equipment.

POCT has remained controversial far beyond the confines of Trenton.

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Ombudsman seeking expanded role since 1975 – could this finally be the time?

“There is no effective, independent, investigative oversight of hospital administration. Period.” – Ontario Ombudsman Andre Marin, 2008

Ontario has been resisting Ombudsman oversight of its public hospitals for long enough. Marin says he is not the first to demand this oversight – Arthur Maloney called for this extension of the Ombudsman’s scope in 1975, and successive holders of the office have followed suit to successive and unresponsive governments of all stripes.

Last week NDP Leader Andrea Horwath added Ombudsman oversight of health care to her shopping list of initiatives to improve the spring budget.

Given recent experiences with ORNGE and the diluted chemotherapy drug error, one would think that the time has finally come, Ontario the last province to issue such powers.

Marin himself wrote to the Premier in March regarding changes the province was making in the wake of the privatization scandal at ORNGE. Marin pointed out that Bill 11 would create “new bureaucracy of special investigators” which would report to the Minister of Health and Long Term Care, not to Provincial Parliament.

“Far from being watchdogs, they would operate on a ministerial dog leash,” he wrote.

Similarly the position of ORNGE “patient advocate” is even more toothless, reporting not to the public or to Parliament or even the ORNGE board of directors, but to the ORNGE vice-president.

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Dedicated revenues cover most of increase for Ontario’s health care in 2013-14

This year Ontario is adding $1.3 billion to fund health care for 2013-14, but most of that increase will have come from dedicated sources amounting to almost a billion dollars.

Net contribution from general taxation will be about $360 million.

This is where the rest comes from:

• The net increase in the Canada Health Transfer (6%) will be $671 million.
• The net increase in revenue expected from the Employer Health Tax will be $134 million.
• The net increase in revenue from the much maligned Ontario Health Premium will be another $135 million.

Had the Wynne government followed Dwight Duncan’s plan from last year, the net contribution from Ontario’s general revenues would have only been a paltry $60 million to reach the $1 billion that the government had originally forecast as an increase for 2013-14.

Of the $48.8 billion to be spent on health care this year, the Feds can claim to be directly paying $12 billion through the Canada Health Transfer, or slightly less than 25 per cent.

The Employer Health Tax will contribute $5.3 billion (10.9 %) and the Ontario Health Premium will raise a total of $3.2 billion (6.5 %).

While $1.3 billion is nominally more, it is less than what is needed to cover basic inflation (1.2 %) and the impact of population growth (1 %) and aging (1 %) on the health system. Inflation in health care normally runs higher than the general inflation rate. For example, Ontario estimates drug costs will rise by 5.4 per cent this year.