Will by-elections become referendum on hospital cuts in Scarborough, Ottawa?

Five provincial by-elections could be a referendum on changes to the health care system that are starving local hospitals. Two of these contests are in ridings where hospital cuts have been especially prominent on the public agenda.

Called for August 1st, the very short by-election campaigns are being held mid-summer, a time when voter turnout is expected to be low – generally an advantage to the government.

The most interesting contest to watch will be Scarborough-Guildwood, where the two urban hospitals are starting to talk about merging to deal with a collective $28.4 million impending shortfall next year.

The hospitals contend that their costs are rising by 5 per cent per year while their funding has remained stagnant.

Cuts have already begun – this year The Scarborough Hospital is eliminating close to 200 positions, has closed two surgeries and 20 surgical beds, and last week shuttered an outpatient clinic for those suffering from rheumatoid arthritis.

Most of these are not services likely to find their way to community-based provider agencies despite Health Minister Deb Matthews’ assertion that the funding freeze is an intentional part of her restructuring plan. Users of the arthritis clinic have already told the media they don’t know where they will go this month.

Two other local Liberal MPPs have been pointing the finger at the senior management and the board of The Scarborough Hospital. Bas Balkisoon and Soo Wong had called upon the Health Minister to appoint a supervisor to take over The Scarborough Hospital this spring amid community opposition to a plan to consolidate services between the Birchmount and General campuses. The restructuring plan was scuttled after an expert panel decided that the changes represented a “clinical risk.”

Appointing a provincial supervisor didn’t seem to help last time. Toronto East General CEO Rob Devitt had been appointed to take over the hospital in 2007 amid similar turmoil.

Now The Scarborough and Rouge Valley hospitals are in merger talks, and likely other drastic measures will soon be on the horizon. The Central East Local Health Integration Network (LHIN) put the two hospitals together to work out their problems after rejecting the controversial parts of The Scarborough Hospital’s first consolidation plan. Public engagement is expected beginning in August (after the by-election) and will run to October, when a plan is expected to be approved by the two hospitals and submitted to the LHIN in November.

If the MPPs think the turmoil at The Scarborough Hospital will subside with the arrival of new CEO Robert Biron, they are likely mistaken. Biron implemented several controversial cuts after arriving at the Northumberland Hills hospital in Cobourg in 2010. The cuts likely cost Liberal Lou Rinaldi his seat in the last general election. Despite the rhetoric, there has never been adequate replacement of these lost hospital services in the Cobourg-Port Hope community.

Rookie Liberal candidate Mitzie Hunter may be tempted, like her adjacent Liberal MPPs, to bash the hospital’s leadership, but clearly the problems mostly have their roots in decisions made at Queen’s Park. She should tell us what her plan is to overcome the $28.4 million funding shortfall that the Health Ministry has created.

CEO of city-building organization CivicAction, Hunter will be placed in a difficult situation choosing between her party and her community. A misstep here could likely render a lost seat, both opposition parties traditionally doing well in the riding since its creation in 2003.

The Ontario Health Coalition already plans to draw attention to the hospital cuts in Scarborough-Guildwood during the short campaign.

The threat in Dalton McGuinty’s former Ottawa South constituency likely comes more from the right, not the left. Cuts to The Ottawa Hospital are likely fresh in the minds of local voters. The hospital announced it was eliminating close to 300 full-time equivalent positions this winter, reducing cataract surgeries (despite longer than average waits) and privatizing about 6,000 endoscopies per year. About 4,000 of those endoscopies are colonoscopies relied upon by individuals suffering from inflammatory bowel syndrome.

A regional representative of the Crohn’s and Colitis Foundation told the media that the decision to close the Riverside endoscopy clinic will lengthen wait lists for diagnosis at a time when the disease is impacting a greater number of Canadians.

Despite significant changes to services provided by the hospital, the Champlain LHIN refused to undergo the same public process that The Scarborough Hospital is following. Claiming the hospital was simply following its accountability agreement; the Champlain LHIN washed their hands of the problem and in doing so equally damaged their own reputation. The LHINs have been a cornerstone of the McGuinty/Wynne government’s health policy.

Unlike a general election, the by-elections pose no risk to voters who may wish to express their displeasure with the government’s handling of the health file. Even if the Liberals lost all five by-elections – which is unlikely – they would still have the most seats and retain the right to govern in the minority provincial parliament.

A couple of unexpected losses, however, could prompt changes to the Wynne government’s health care funding policies.

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