Something is definitely off this holiday season. Instead of being invited to the usual round of parties, we’re getting invitations to demonstrations and press conferences. Instead of decking the halls we’re decorating placards.
How oblivious Health Minister Deb Matthews is to this growing unrest is hard to tell, although the recent revelation that she never read the ORNGE audit suggests a shocking disengagement that likely extends well beyond that scandal.
Today in Arnprior staff at the local hospital will be marching to protest ongoing shrinking services. A few more physiotherapy hours to be lost in January, some x-ray… this is the hospital that decided to totally do away with personal care workers (PSWs) as it sheds staff to balance its frozen budget. This slow striptease of staff has a way to go if the government thinks it can continue on this road to at least 2018.
Today is also the day that VON PSWs in Grey-Bruce Counties go back to the bargaining table in a last attempt to avoid job action. One of the workers pointed out that a staffing agency is advertising on Kijiji for temporary PSWs. Is the VON or Red Cross Care Partners – also in a strike countdown – contemplating hiring strike breakers, or are the more affluent residents of this community seeking some interim help should all hell break loose? The classified ad says the employment agency is willing to negotiate wages, something that so far their real employers don’t seem willing to do.
We went through a similar countdown last week with Frontenac Community Mental Health and Addictions Services in Kingston. They are supposed to represent this brave new world of improved community-based services that Matthews has been selling, but their agency’s base budget has been cut. In the end the workers got enough for their bargaining team to recommend a deal – it has yet to be ratified. This is one of the agencies that’s supposed to pick up the slack from 60 full-time equivalent jobs departing the local psychiatric hospital. That’s clearly not happening.
Next week we are travelling to London not for eggnog, but to talk to more mental health workers who have seen their clients similarly betrayed by this phoney health transformation.
Back in 2006 when George Smitherman introduced his legislation to create the Local Health Integration Networks, he also amended the Public Sector Labour Relations Transition Act to ensure workers were not the victims of transformation. At the time the Liberal government recognized the importance of recruiting and retaining enough health professionals. If their work were to transition to community-based agencies, then their union, contract and rights would transition with them.
Yet so many of these cuts only come with vague promises of where these jobs will land. That makes it next to impossible to implement a seamless transition of professional and support staff. Most of the time these promises are just window dressing for the dismantling of local health care. That’s the real disappointment. We’re not against true transformation – who could argue the present system is serving us well? Yet the ham-fisted approach by this government is only damaging the promise of a more responsive patient-based system.
Over the summer we recognized there were significant issues with how the Ontario Association of Community Care Access Centres was planning on delivering home care services into the future. We wrote to the Minister of Health seeking an audience to present our analysis. She never even graced us with a reply let alone a meeting. Evidently ORNGE highlights just how Matthews would rather not hear what she doesn’t want to hear.
The Wynne government likes to think that they have spared health care from their austerity budgets. This spring health care got a little over two per cent in overall new funding. Just prior the election the Auditor General of Ontario had warned a target of three per cent was “aggressive.” To our colleagues in other public sector occupations that two per cent may seems lavish compare to their own hardship. The reality of those other public sector cuts is likely now showing up in the social determinants of health.
Two per cent is not a lot, especially when hospital CEOs estimate their real costs are rising somewhere between three and five per cent. It’s not a lot when drug prices are rising five percent. It’s not a lot when workers are finding it increasingly difficult to support their families on suppressed wages and are seeking new deals. It’s not a lot when the system is facing huge transition costs.
Those transition costs include hospital mergers that have been prompted by new funding rules that favour the big over the small, the urban over the rural. This fall we have been watching closely the dance between the Scarborough and Rouge Valley hospitals.
They spent months consulting the public curiously without ever putting the full cost of transition on the table. When the hospital boards of the two hospitals finally had to make a decision, there those costs suddenly were. It was going to cost $30 million for one-time bare bones transition costs. It was going to cost another $5 million annually for wage harmonization. The hospitals felt a merger would not be possible without a feasibility study on the creation of two new construction projects. That feasibility study is estimated to cost between $10-$15 million more. All this is on top of the $1.3 million already spent on community consultation. That’s potentially more than $50 million to be spent without presenting one minute of direct care to a patient. The hospital claims the merger and new buildings will save money in the long term.
That’s $50 million at just one hospital in one community. That’s $50 million the province will likely be willing to spend while telling PSWs living in poverty that they can’t have a raise after having been frozen for six years. That’s $50 million that will not be put against the growing mental health problem that has been exasperated by rising social and economic inequality brought about by other deep public sector cuts.
The Harris Tories figured out after two years of chopping public hospitals that their transformation strategy was not only failing, but that health transformation costs a bundle. They eventually put billions of dollars into that transformation only to increase wait times, jam ERs, and create an acute shortage of doctors.
The Wynne government continues to try and sell us on the idea that they are not cutting health care, but between the costs of inflation, aging, population growth AND health transformation, the system is drowning.
We’d rather be drinking eggnog in mid-December, but understand that the fight has only just begun.