Category Archives: Hospitals

Plans have been announced for a community forum on Nov. 2 to give the public a voice in the mounting chaos affecting South Bruce Grey Health Centre.

Warren (Smokey) Thomas, president of the Ontario Public Service Employees Union, will join local health care and labour activists at the community forum, scheduled for 7 p.m. Nov. 2, at the Victoria Jubilee Hall in Walkerton.

“The problems affecting the South Bruce Grey Health Centre appear to be getting more serious day-by-day,” said Thomas. “I look forward to joining other activists from the area and listening to the concerns of residents about the future of their local health care facilities.

The four-site hospital has witnessed a raft of problems that has led to speculation over the future of the SBGHC. It has been shedding clinical services, including outpatient rehabilitation, obstetrics and the day hospital in Walkerton. The community no longer is eligible to vote on board appointees and it is undergoing costly renovations to remove the present cafeterias and replacing them with reheated meals prepared off-site and transported at great distance to the four facilities.

Community Forum on the Chaos at the SBGHC

7 p.m. / Tuesday Nov. 2
Victoria Jubilee Hall
111 Jackson St. S., Walkerton

Guest Speakers
Shane Jolley, LocalMotive Project
Grant Robertson, Former NFU Ontario Coordinator
Warren (Smokey) Thomas, President OPSEU
Dave Trumble, President Grey Bruce Labour Council

The CEO of the South Bruce Grey Health Centre admits he would lose weight if restricted to eating his hospital’s proposed new diet of rethermalized food.

In a letter responding to a challenge by the Ontario Public Service Employees Union, CEO Paul Davies said he does not always follow the best diet available, and would expect to lose weight if he conducted himself “in a more healthy manner.”

“This makes the conditions of your challenge impossible for me to agree to,” he wrote.

OPSEU had challenged the CEO and the VP of Labour Relations to spend a week eating the rethermalized food they are planning to implement for patients. If the two were able to maintain their body weight, OPSEU would donate $1,000 to the hospital foundation.

Davies suggested he may be able to find other board and staff willing to take up the challenge at $1,000 per person, but said he could not agree to revisit the hospital’s decision to replace fresh food service with rethermalized meals.

“It would be pointless to alter the challenge under the circumstances,” says OPSEU President Warren (Smokey) Thomas. “The CEO is essentially saying that unless you have a perfect body mass index, you are likely to lose weight eating their food.”

Davies made no mention of VP Brenda Rantz, for whom the challenge was also issued.

To prove the challenge was serious, OPSEU has decided to donate $1,000 to the hospital foundation to be used towards the purchase of new equipment.

The union is arguing that the new rethermalized food system to be introduced by the hospital will be costly, less nutritious, displace local jobs, and deter recovering patients from eating. Serving frozen food also sends the wrong message around healthy eating, OPSEU says.

The union is sponsoring a town hall forum about the hospital at 7 pm on Tuesday, November 2nd at the Victoria Jubilee Hall in Walkerton. Rollie Anstett, Brockton’s deputy mayor, will moderate the meeting. Speakers include OPSEU President Warren (Smokey) Thomas, Shane Jolley of the LocalMotive Project, Grant Robertson, former National Farmer’s Union Provincial Coordinator, and Dave Trumble, President of the Grey Bruce Labour Council.

Peterborough is caught in a catch 22. The new hospital is supposed to receive $13 million in post-construction operating funding, but the funding is conditional on expanded volumes. These volumes will be difficult to achieve as the hospital cuts jobs towards balancing its budget.

Ken Tremblay, CEO of the Peterborough Regional Health Centre, came to the Central East LHIN October 27 to deliver the first quarterly update since having his controversial fiscal restraint plan accepted by the LHIN board this summer.

The hospital is undertaking $27 million worth of projects intended to restructure the hospital to end the flow of red ink. His presentation was heavy on the financials and light on quality indicators, something he promised to remedy come his next appearance in January.

Unlike Muskoka Algonquin, which has refused to make further cuts, Peterborough is cutting 283 positions, many of them clinical front-line jobs.

Tremblay said “it was a time of change and uncertainty,” anticipating a working capital deficit of $107 million by next year. Even with the cuts, PRHC is looking at an operating deficit of $8.9 million for 2010/11.

Tremblay said it was important for the community to see new investments that are part of the LHIN’s clinical services plan. However, the watchwords at Queen’s Park appear to be “wait until next year.”

He said the morale of staff was important, comparing the hospital to an airline: “you wouldn’t want to get on an airplane where everyone looks angry,” he said. Tremblay admitted that medical staff have been guarded about their consent for the action plan.

Tremblay says they have got some of the lost hours back by reducing the absenteeism rate by 17 per cent using a wellness approach.

The LHIN is working with the hospital to free up the post operating funding as soon as possible.

The CEO said Peterborough was walking a tightrope and that “we’re in the middle now: a tough spot to be.”

While Peterborough didn’t take out the number of beds the Peer Review had recommended, he said the hospital was still struggling with its rate of patients who have completed their acute care but have nowhere else to go.

With a lengthy wait list for nursing home beds and the Community Care Access Centre struggling with its own finances, the Central East LHIN has the highest number of “alternate level of care” patients in the province. “ALC is the elephant in the room,” he said.

Tremblay indicated it was up to Peterborough to “perform its way out of this challenge,” comparing his situation to the auto makers – “unlike GM we are refinancing without public support.”

Tremblay said much of the transition included changing the staffing mix. Part of that change includes replacing RNs with RPNs in the dialysis unit. Tremblay says other hospitals had already gone down that road. He added that the trend is towards home dialysis, which involves no RNs or RPNS – “its your spouse.”

Ontario Nurses Association Vice-President Vicki McKenna told the Peterborough Examiner earlier this year that “The RNs there are dealing with very ill people and their health condition can change literally in a heartbeat.” She said that fragmenting care by having RPNs seek advice of RNs on the unit led to worse health outcomes.

The College of Nurses is expected to visit the hospital soon.

The Peterborough Health Coalition is monitoring the changes carefully, urging those who are affected by cuts at the hospital to come forward and share their stories.

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As a postscript to this story, Roy Brady of the Peterborough Health Coalition makes the point that restructuring is always very costly — in this case $8.9 million including early retirement and severance packages. The cost of this restructuring is very much part of the deficit situation.

The frustration is, when the province finally gets around to providing funding for needed services identified in the LHIN clinical services plan, the hospital will also have costs associated with recruiting to replace many of these positions.

Kudos to the board of Muskoka Algonquin Healthcare for recognizing further cuts to services are not going to fulfill its mandate of “proudly serving communities with quality health care.”

It’s just a pity they hadn’t arrived at this destination a year ago when the Burk’s Falls & District Health Centre faced closure.

A week before the Ontario Hospital Association’s annual conference, other hospitals would certainly would be watching this situation very closely.

Technically the LHIN could withhold all public funding to the MAHC until it signs its accountability agreement, but that would result in a game of chicken nobody would likely want to play.

While the government is promising a funding formula, for now the funding they receive is totally on an ad hoc basis. It has been clear for some time that MAHC, like many other Ontario hospitals, has not had the money it needs to serve the local population.

The hospital has approached the LHIN to make up its shortfall, but as MAHC CEO Barry Monaghan would know first-hand, the LHIN does not have that kind of discretionary spending available to it. Monaghan used to serve as CEO of the Toronto Central LHIN.

In the all too familiar two-step, the LHIN must approach the Ministry of Health to make up the funding shortfall. When the media start asking questions, however, the Ministry refers them back to the LHIN.

Clearly the Ministry is ducking and weaving and using its LHIN as a scapegoat. However, the community is getting more familiar with the game and knows who makes the real decision.

In this year’s provincial budget there is a substantial gap between what hospitals are supposed to get and what they are receiving for core funding. One can’t help but think the unreleased details of the health budget contain funding to address hospitals that have nowhere left to cut. With less than a year before a provincial election, it will have to be substantial.

As part of funding needed to address MAHC, the province should consider putting back the Burk’s Falls facility. If they don’t, as the pattern has previously shown, the Tories will.

It may be a case of the left hand not knowing what the right hand is doing. The Ontario Ministry of Agriculture, Food & Rural Affairs is providing funding to help make more local food available in the cafeterias of hospitals, schools and other public institutions.

Ontario’s Broader Public Sector Investment Fund is intended to support the agri-food sector by connecting farmers, food processors, and distributors with schools, hospitals and municipalities to increase the amount of Ontario food purchased by the broader public sector.

The initiative includes funds for local projects that encourage business between institutions and farmers and the development of an electronic marketplace that links buyers with sellers across Ontario.

Meanwhile in the heart of agricultural country, South Bruce Grey Health Centre is presently tearing out its cafeterias and replacing them with a rethermalized food system where frozen meals will replace local fresh food service.

Rethermalized food service has been controversial wherever it has been introduced. Veterans groups have been particularly vocal about the use of pre-prepared frozen meals in long term care facilities

Muskoka Algonquin Health Care says it cannot cut anymore. Short $6 million to balance its budget, the hospital board is refusing to sign an accountability agreement with its Local Health Integration Network (LHIN) that would require it to balance its budget.

The Muskoka-area hospital has gone back to the LHIN for more funding, and the LHIN is in turn is looking to the Ministry of Health for help. The hospital board admits there is no alternate plan.

Residents are fearful that any further cuts would mean one of the two remaining sites of the hospital would close. At present MAHC operates hospitals in Bracebridge and Huntsville. A third site, The Burk’s Falls & District Health Centre was closed in 2009 as part of $3.1 million in MAHC budget cuts that also included bed closures and staff cuts.

The hospital is projecting a $4.2 million deficit for this fiscal year, which is expected to grow to $6 million for 2011/12. MAHC has a working capital deficit of about $11.2 million.

MAHC Board Chair Sven Miglin told the Huntsville Forester that “this board firmly believes that Muskoka requires two acute care hospitals.”

The Chair of the North Simcoe Muskoka LHIN said MAHC was the only hospital in the province not to sign its accountability agreement.

Councillors elected to the District Council have been critical that the LHIN has not been open about the budget process for MAHC.

“The community is so frustrated,” Councillor Fran Coleman told the local newspaper, “they want answers, they want to know: are the hospitals closing?”

In the 1942 movie Casablanca, Captain Renault, in need of a quick reason to close Rick’s café to impress his German guests, indignantly says “I’m shocked, shocked to find that gambling is going on in here!” At that moment the croupier presents Renault with his winnings, which he quickly shoves into his pocket.

The government’s reaction to hospital lobbying is a little like that.

Timed to coincide with the auditor’s report on the use of health care consultants, the new Public Sector Accountability Act proposes new rules to clean up the procurement process, improve transparency and restrict the use of paid lobbyists by public entities, such as hospitals.

In the auditor’s report we learn that of 16 hospitals examined, half had paid lobbyists to press the government for more funding.

While the government fulminates about hospitals using public money for lobbying activities, the question is, given they were the target of the lobbying, how could they not have known before now?

Or was the health minister’s response a little like Captain Renault’s” “I’m shocked, shocked to find that professional lobbyists have been talking to me!”

If 50 per cent of hospitals are using lobbyists to call for more funding, it also raises an additional question. What does that say about the faith Ontario hospitals are placing in their own leadership at the Ontario Hospital Association?

Tom Closson, President and CEO of the OHA spoke October 6 to the Economic Club of Canada. He said: “It is clear that, without any significant tax increases, any plan to re-balance the provincial budget must involve a much lower rate of expenditure growth for health care.” This is despite the fact that core funding for his membership has recently lagged behind the rate of inflation. Closson went on to speak about how hospitals need to work more efficiently, claiming there were the equivalent of 16 hospitals full of patients that could be effectively served elsewhere.

Meanwhile, it’s now clear that at least half those hospitals were banging on the door at Queen’s Park looking for more money. The second week of November the OHA gathers for its annual HealthAchieve conference. This year it may be far more interesting to listen in to chatter in the corridors than what takes place on the podium.