Category Archives: Hospitals

In the UK elections, some Labour Party candidates are facing the public’s wrath over expensive P3 hospitals – or as the British call them, PFIs – Private Finance Initiatives.

In Birmingham, Labour’s Gisela Stuart’s seat is threatened despite having held the seat since 1997.

The Birmingham Post reported in February that taxpayer would pay £2.58 billion for their new hospital, including interest and service charges. That’s a mark-up of 300 per cent.

Given Ontario’s rush to build P3 hospital projects, the McGuinty Liberals may want to take note.

John Scheel, a retired banker tells the Financial Post that P3s are more expensive, generate excessive returns, and are not transparent.

Scheel begain researching P3 deals after Oakville residents woke up to the fact that their taxes would have to fund the $200 million share of their new $1.5 billion P3 hospital.

The comments are not new — OPSEU has been among P3 critics since the concept came to Ontario.  However, to see such a critique in the  Financial Post is new.  When one of Canada’s wealthiest municipalities contemplates a surtax to cover the cost of these expensive projects, decision-makers finally take notice.  See link below:

http://www.financialpost.com/opinion/columnists/story.html?id=df1e677d-0168-4fe7-a328-17b56e220d40

A new report suggests a number of radical ways of bringing down health care costs, including reducing the cost of doctors and moving to central bargaining for health care contracts.

The report, Ideas and Opportunities for Bending The Cost Curve, was published by the Ontario Hospital Assocation, the Ontario Association of Community Care Access Centres and the Ontario Federation of Community Mental Health and Addictions Programs.

The report complains of the “whip-saw” effect of hospital negotiating separately with bargaining agents, suggesting those outside of central bargaining are driving up labour costs.

The OHA estimates that central bargaining saves them as much as $27 million, and that another $10 million could be saved if the OHA became the exclusive bargaining agent for all hospitals.

Similarly the OHA would like all hospitals to participate in the OHA benefits plan and to opt out of premiums under the Workplace Safety and Insurance Act, instead paying the benefit costs directly to the workers. The OHA estimates it could save a further $31 million from these changes.

 The three groups say the province could save $2.2 billion annually if Ontario’s spending on doctors was in line with those of other provinces. At present, Ontario spends $842 per capita on physician services, compared to $675 per capita in the rest of the country. They say that difference amounts to $2.2 billion.

The OHA has been pushing for an amendment to the Public Hospitals Act that will move away from the current physician privileges system to a hospital-physician contract model.

The Health Minister responded to the report by suggesting the province has no plan “right now” to do battle with doctors over how much they are paid. However, the Toronto Star reports that insiders told the newspaper that Matthews’ tough stance in the fight with pharmacies is intended “to send a out a clear message” to other players in the health system.

OPSEU’s Hospital Professional Division is expected to enter into central bargaining next year. Their contract expires at the end of March, 2011.

With regards to drugs, the report suggests Ontario can better leverage its size to achieve better pricing and purchasing arrangements. The Ontario spends $310 per capita on drugs compared to $280 in other provinces. BC is the lowest at $222 per capita.

The Central East Local Health Integration Network will be making a decision about the future of the Peterborough Regional Health Centre at its board meeting Tuesday, April 20. The CE LHIN will discuss and make decisions regarding a peer review of the hospital undertaken this winter. The recommendations are expected to identify $26 million in “efficiencies.” The item is on the agenda at 9:45 am. The meeting takes place at the Peterborough Golf and Country Club. The proceedings of the LHIN boards are open to the public, however, there is no opportunity for the public to address the board during these meetings. The Peterborough Health Coalition is encouraging those concerned about the future of their hospital to come out.

Speaking to business leaders at Toronto’s Fairmount Royal York Hotel, Health Minister Deb Matthews was met outside the hotel by hundreds of protesters angry over cuts to their local hospitals.

Organized by the Ontario Health Coalition, the rally included both community and labour speakers. Sara Labelle, Chair of OPSEU’s Hospital Professionals Division, spoke about workload issues facing lab professionals amid increased cuts to hospital services.

Buses brought in protesters from various communities across Ontario, including the Niagara Region and Northumberland County.

To see the full video, go to:

The Ontario government is seeking to establish rules around pay-for-performance bonuses paid to hospital executives, but the Ontario Hospital Association is cautioning that a uniform formula for arriving at such bonuses is unworkable.

Executive salaries in Ontario’s hospitals “tend to be higher than in other provinces, where governments have taken ‘a more active role’ in setting compensation levels,” the Hay Group’s Moshe Greengarten told the Globe and Mail. The compensation consultant also said Ontario’s compensation levels are well below those of hospitals in the United States.

The government wants to ensure pay-for-performance is based on factors such as reducing infection rates and reducing wait times for ER patients and others high priority procedures, such as hip and knee replacements.

Tom Closson, president of the OHA, told the newspaper that he fears the province could impose uniform performance standards that would not be equally appropriate to the settings. As an example, he said rural hospitals don’t have issues with emergency wait times, while larger hospitals have responsibilities to foster research and train doctors.

Premier Dalton McGuinty said on Friday “we don’t call it public service for nothing. They (health care executives) need to feel a sense of mission, a sense of cause.” McGuinty said the government could go beyond freezing executive salaries, suggesting there could be rollbacks of some of the top earners.

Top earner among active hospital CEOs is the University Health Network’s Robert Bell, who earned $830,000 last year, including bonus and taxable benefits. Closson said there were individual doctors who earned more than Bell, however, doctor salaries are not published. Specialized surgeons can earn as much as $1 million per year.

BARRY’S BAY, ON, April 1 /CNW/ – St. Francis Memorial Hospital in Barry’s Bay is cutting front-line care positions and closing beds in order to eliminate an operating deficit.

The hospital is eliminating seven full-time registered practical nursing positions, reducing the hours of housekeeping, maintenance, food services and recreational programming.

It is also closing seven beds, reducing overall capacity for the community. St. Francis also intends to increase revenues by introducing a fee for parking at the hospital. These cuts follow an earlier closure of a CCAC clinic adjacent to the hospital.

The Ontario Public Service Employees Union has been told by hospital officials that no changes will be made to the plan despite a funding increase of 1.5 per cent in the March 25th provincial budget.

 The original plan was based on a funding freeze. “The province had set a target for all hospitals to have 70 per cent full-time nursing staff,” said Warren (Smokey) Thomas, President of the 130,000-member Ontario Public Service Employees Union. “Now St. Francis has precisely zero full-time RPNs on staff. Instead they will be replaced by less qualified personal support workers. It seems like every government priority from the past six years is going out the window in the name of budget cutting.”

 The union is concerned that most of its membership at the hospital is now working on a part-time basis. OPSEU says that this may be just the start – the government has indicated in its throne speech that it intends to further restructure health care, bringing in changes that will disadvantage small and rural hospitals like St. Francis.

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Where small and rural hospitals fit within a new funding formula and introduction of competitions is not yet clear. When these issues were raised in the Throne Speech, there was widespread concern about small and rural hospitals having to compete with larger urban hospitals for the right to perform certain procedures.  This concern was echoed by the Ontario Hospital Association. However, the Ministry has since indicated to us that rural hospitals will not have to compete. While this is some relief, we will be watching and engaging the government with regards to the details of any new funding formula and its impact on the hospital sector.

The Northumberland Hills Citizen’s Health Coalition is organizing a second rally to pressure Queen’s Park to save key health services scheduled to be cut by the Cobourg-based hospital.

Where: Victoria Hall, Cobourg
When: 10 am, Saturday, April 10

The Northumberland Hills Hospital is cutting its diabetes clinic, outpatient rehab and closing 26 beds to balance its budget.

It was clear from the Local Health Integration Network board that there are no immediate plans to replace the services, although they do plan to meet with the Ministry to discuss the gap left behind by the closure of the diabetes clinic.

The LHIN made it clear that it did not have the funds to provide replacement beds in the community for the 16 alternate level of care beds that are among those scheduled to close at the hospital.

Observing that 11 other communities have had their hospitals receive additional base funding in the past year, the Coalition plans to pressure Queen’s Park to do the same to save these services.

The rally will include a brief march through the town followed by speeches at the hall.