Category Archives: Hospitals

Some interesting notes from this week’s auditor’s report:

Ontario eliminated the equivalent of a regional hospital in beds cut last year.

According to information provided by the Ministry of Health and Long-Term Care, 400 fewer beds existed in the province’s hospitals from 2008/09 to 2009/10 (from 18,800 beds to 18,400 beds). Despite all the new construction, our bed capacity is the same as it was five years ago.

The province may be both increasing and aging, but the number of hospital discharges has also remained relatively static. In 2005/06 there were 1,095,000 discharges. In 2009/10 there were 1,092,000. The average length of stay has remained the same – six days.

While other countries are looking at managing their occupancy rates to build surge capacity, some Ontario hospitals are trying to build capacity by discharging patients earlier in the day to make more beds available during peak emergency room times. The Auditor General of Ontario commends this activity, but it is indicative of the level of micromanaging necessary to accommodate patient demand in these overloaded facilities.

About one in five patients discharged will need to be sent to another health care setting. That could be home with visiting care (10%), a long term care home (4%), a complex continuing care facility (2%), or palliative and other care settings (4%). Given these settings are also stretched to capacity, something has to give.

While home care has been the focus of the auditor’s comments, there are also long waits to access other forms of care. In theory, if patients cannot access this care, they remain in hospital longer. This issue has been the focus for government in recent years. The question is, if “alternate level of care” (ALC) patients are taking up more beds in the hospital, why has the average length of stay not increased over the last five years?

Unwilling to choose between its two remaining hospitals, the Muskoka Algonquin Healthcare board held firm in refusing to make cuts recently. Last week they were rewarded for standing by their community.

The province announced November 23 it was adding $4.5 million to MAHC’s bottom line this fiscal year, bringing the hospital to within $1.5 million of balancing their budget.

It is expected an additional $1.5 million will be included in the 2011-12 budget year.

Facing a $6 million shortfall, the Muskoka Region was fearful that one of the two hospitals – Bracebridge or Huntsville – would have to be downgraded to balance the budget.

OPSEU Local 380 President Barb Barry has played a key role in raising awareness about hospital cuts in the communities of Bracebridge, Huntsville and Burk’s Falls. Campaigning hard for the past three years, Barry has rallied the community to demand more funding rather than witness further devastating health care cuts.

CHESLEY, ON – The Board of Directors of the South Bruce Grey Health Centre met Nov. 24 in Chesley and, for the first time, ordered catered food from outside the facility. Staff members previously served home cooked meals from the hospital cafeteria at board meetings.

The union representing the food service workers says this demonstrates what its members have been saying about re-thermed food.

“No wonder the hospital CEO would not accept our challenge; the people who made this decision have no intention of eating the food themselves,” said Warren (Smokey) Thomas, president of the Ontario Public Service Employees Union.

Last month Thomas challenged hospital CEO Paul Davies to eat the food for a week. Although Davies declined the challenge, he did admit he would lose weight eating the food. In conjunction, OPSEU made a donation of $1,000 to the four hospital foundations.

Yesterday the hospital announced that they will no longer be microwaving the food, which they say was often overcooked or undercooked. The hospital says it will be moving to a convection-style oven system for Chesley and Durham which have converted to the re-thermed food structure.

“This is yet another setback for a system that was badly flawed from the start,” said Thomas. “The members have been doing their best in trying circumstances, but they just couldn’t make this work.”

OPSEU says the hospital should scrap its plan completely and make use of Ministry of Agriculture grants to bring in fresh locally-grown food instead.

The union has not been officially informed of the change.

Windsor Regional Hospital CEO David Musyj has continually suggested that his workers should effectively pay with their wages for his struggles to balance the budget. While the province tells us they are giving hospitals a funding increase of 4.9 per cent this year, Musyj suggest it is 1.49 per cent. His audited statement says otherwise.

Musyj claims he is stuck between a rock and a hard place. His costs are going up. In real terms, he says his funding is in decline and the LHIN is insisting on balanced budgets.

He says those costs include increases in non-wage expenses that are running between five and seven per cent. He clearly has no zero-based expectations there.

With the downturn in the economy, the hospital is also bringing in less revenue for semi-private and private accommodations – affecting their budget by another $700,000.

Windsor Regional Hospital posts its audited financial and operational highlights on-line. They tell a very different story.

For 2010 the hospital received an increase in provincial revenues of $10.836 million over 2009. That’s an increase in total provincial revenues of 4.62 per cent – not far off the 4.9 per cent figure quoted in the provincial budget. In addition, the hospital shows other revenues increasing by close to $1 million. Eighty per cent of hospital funding comes from the province, albeit more of it is being specifically directed into funding envelopes. It is therefore not a surprise that WRH managed to post a small surplus this year.

Next year the province is planning on reducing the increase in funding for all health care programs by $700 million. This year that increase was $2.6 billion. Next year it will be $1.9 billion according to finance minister Dwight Duncan’s spring budget.

That means there will be about 26 per cent less in new funding – not a decrease in existing funding. If everything else remains the same – Windsor Regional would likely see a funding increase of between $7 million and $8 million, not the $2.7 million Musyj claims. Musyj paints his doomsday scenario by conveniently looking only at the allocation for his global budget, leaving out all the other provincial sources of revenue.

Musyj’s says his staff costs are increasing by $6.2 million, but that includes the cost of adding new staff for rehab and complex care in the Malden building. It also includes $1 million in increases related to workers going up the grid. The actual impact of arbitrated increases is closer to $3.6 million. This is on a hospital with more than $300 million in revenues – slightly more than 1 per cent.

Musyj says he needs the additional money to satisfy increased patient demand, but according to the audited statement, he is budgeting for fewer patient days in 2010.

It would seem that staff increases are not Musyj’s problem. He clearly has other costs that are driving his bottom line. Rather than deal with those, he is scapegoating his own staff to fit a political agenda of making legislative wage settlements acceptable.

Huntsville Mayor Claude Doughty scrambled to issue an apology for his comments regarding a hypothetical hospital-restructuring scenario earlier this month.

Doughty sparked community outrage suggesting that Muskoka Algonquin Healthcare should downgrade one of its two hospitals to deal with a $6 million funding shortfall. He told the local media Huntsville’s District Memorial Hospital should be the acute care centre (full service hospital) while Bracebridge should be downgraded to a chronic care facility.

The comments are likely the beginning of communities battling over increasingly scarce resources brought on by government underfunding.

Doughty said his comments addressed a “worst case hypothetical scenario”, but they still resulted in a flurry of phone calls culminating into a town hall meeting in Huntsville. Attendee’s included regional mayors, Muskoka Algonquin healthcare officials and concerned residents.

The meeting resolved with consensus to work together to maintain both full service hospitals instead of fighting over scarce funding resources. 

Barry Monaghan, interim chief executive officer for Muskoka Algonquin Healthcare said a strong case was made for additional funding from the government.  A number of letters have been sent to the Minister of health Deborah Mathews requesting the necessary funding to address the structural deficit.

The community now awaits a response from the government. 

See (https://opseudiablogue.wordpress.com/2010/10/26/lhin-likely-not-going-to-play-%e2%80%9cchicken%e2%80%9d-with-muskoka-hospitals/)

Two more arbitration decisions recently awarded increases to hospital-based employees.

OPSEU members at the Children’s Hospital of Eastern Ontario (CHEO) were awarded retroactive increases of 2.5 per cent per year as part of a first collective agreement. The two-year agreement runs from November 7, 2008 to November 6, 2010. CHEO had retracted its wage offer during bargaining after the government introduced the Public Sector Compensation Restraint to Protect Public Services Act. The arbitrators awarded the increase following decisions at Windsor Regional Hospital, Sunnybrook, and earlier between CHEO and LIUNA.

The Toronto Star reports today that about 16,000 SEIU members in 60 hospitals across Ontario have been awarded two per cent raises in each of two years.

In this latest arbitration, arbitrator Kevin Burkett wrote: “Government pronouncements of intent with respect to future funding are not, in and of themselves, sufficient to override what would other wise be the content of an arbitrated award.A legislated directive would be required for this to happen.”

Dwight Duncan told the newspaper that “we won’t be transferring additional funds to accommodate them. That’s just the bottom line,” he said.

Tom Closson, CEO of the Ontario Hospital Association, said the government should enact legislation capping what arbitrators can award so there is “equity” between non-unionized and unionized health workers.

The OHA CEO dismissed the 2007 Supreme Court of Canada decision that struck down a BC law that took away worker’s rights and stripped job protection.

The CEO of Windsor Regional Hospital has been on his own rant about arbitration decisions following an award to OPSEU members at his hospital. (https://opseudiablogue.wordpress.com/2010/10/13/does-windsor-hospital-ceo-know-whats-going-on/).

No more two-year-old National Geographics! Women’s College Hospital has joined the ranks of health care environments banning magazines in their waiting room. Patients can still bring their own reading materials but are asked not to leave them behind. The hospital believes banning waiting room reading material will cut down on the spread of infectious disease. It will be interesting to see whether the ban will also include hospital leaflets and newsletters.

Tax cuts or health care? OPSEU Hospital Professionals speak about priorities for health care in preparation for the October 6, 2011 provincial election. The Hospital Professionals Division is launching a campaign that asks us to choose between tax cuts for large corporations or health care for all Ontarians.

South Bruce Grey Health Centre is phasing in its multi-site multi-purpose workforce to replace housekeeping and food services staff at the four-site hospital. Staff have been rotating between the Chesley and Durham site serving rethermalized food at the beginning of their shift, and cleaning the hospital afterwards. Given the importance of infection control, it is surprising that these workers have yet to have any specific training in their new roles. SBGHC figures they have it worked out – the hospital is presently preparing binders for the staff to be left at each location – months after the new assignments had begun.The hospital’s health and safety committee surely has its work cut out if putting a binder in a hospital passes for training in infection control.