Short takes: “Scrouge Hospital,” Ontario Shores WSIB surcharge and more

The proposed merger between The Scarborough Hospital (TSH) and the Rouge Valley Health System has been unprecedented in its overall transparency. If anything, we have been inundated with information. But so far there has been no discussion of what the merged super hospital would be called. Given the merger appears to be driven by cost – the two hospitals are trying to deal with a potential combined deficit of $28 million by next year as a result of funding decisions made at Queen’s Park – there is no question that all the happy talk will soon give way to discussion of “hard decisions.” It will doubtlessly be “hard” for the deciders, even harder for those likely to lose their jobs or for patients losing access to care. Given this dynamic, we thought the new name was rather straightforward. Combining the two names together, one emerges with the “Scrouge Hospital.”

During yesterday’s TSH board meeting it was clear that important initiatives at the hospital were getting parked as a result of merger discussions. Board Chair Steve Smith indicated that committees formed around governance and planning as well as human resources were being placed “in abeyance” while merger talks proceeded. One board member questioned whether a proposed capital IT expense would be wasted if the merger took place (the answer was ‘no’). Rhonda Seidman-Carlson, Vice President of Interprofessional Practice told the board that elements of the clinical practice plan had to be “slowed down” slightly. CEO Robert Biron told the board that he felt more like the VP of Integration. His entire verbal report dealt with the merger. Denis Lanoue, representing the community council, told the board that his members were concerned that the merger would become a distraction to the hospital’s efforts at system transformation. No kidding! (More on this tomorrow).

For several years now we have been writing about the struggles of the OPSEU local at Ontario Shores to improve the health and safety environment at the psychiatric hospital. Despite a significant number of Ministry of Labour orders earlier this year, the mental health facility is still reporting an unacceptable level of workplace incidents leaving staff with both mental and physical injuries. It occurred to us that this must be having an impact on the WSIB premiums the hospital is paying. The Workplace Safety and Insurance Board either gives hospitals rebates or surcharges depending on their safety track record. Evidently the impact of the ongoing problems at Ontario Shores’ is costing them dearly. The last surcharge/rebate list from WSIB shows that Ontario Shores paid an additional $259,668.25 in surcharges to the insurance board. While there have been bigger surcharges levied on hospitals, relative to the size of Ontario Shores’ $119 million budget this is a whopper.

Finally, a new article in the Canadian Medical Association Journal highlights some key changes in Ontario hospitals between 1994 and 2009. Written by Carl van Walraven, MD, MSc, the article notes that hospital use dramatically decreased (from 8.8 per cent of the general population to 6.3 per cent). Patients became significantly older – the median age rising from 51 to 58 – as well as more acutely ill on admission. That might be reflected by the proportion of patients brought to hospital by ambulance — dramatically increasing from 16.1 per cent to 24.8 per cent. “Risk of death at one year for people admitted to hospital remained significantly lower in 2009 than in 1994,” writes the author.

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