Category Archives: Uncategorized

Briefs: TSH looking for $6.8 million in savings, Arnprior petition and more

The Rouge Valley Health System and The Scarborough Hospital officially filed notification to the Local Health Integration Network of their intent to merge, but it doesn’t mean hard times are over. Robert Biron, CEO of The Scarborough Hospital, sent a memo to staff Tuesday that reminded everyone that the health service provider still has a budget to balance. Biron estimates cost pressures of $8.4 million for 2014-15. The hospital has projected revenue increases of $1.6 million, but it still leaves them $6.8 million short. That shortfall represents about two per cent of TSH’s annual budget. Biron says it is the intention of the hospital to “minimize the impact” to services and staff positions where possible, however the memo gives notice that voluntary exit and early retirement packages will be offered soon. No specific cuts were identified in the memo. The TSH board will receive the budget plan on March 4th. Despite the formal notification to the LHIN, the hospitals will not make a final decision to merge for another 60 to 90 days.

In December we reported on a local fight-back campaign by the unionized staff (CUPE, OPSEU and ONA) at the Arnprior and District Memorial Hospital. The professional and support staff at the hospital are upset by the loss of six acute care beds at a time when the region’s population is rapidly expanding. Now our colleagues at CUPE have posted an on-line Avaaz petition for community members to sign that calls on the hospital to reopen the beds and staff them properly. If you’d like to add your name to the Avaaz petition, click here.

The Ontario College of Physicians and Surgeons has raised an interesting point around the province’s plan to shift endoscopies from hospitals to private Independent Health Facilities (IHFs). The College notes that IHFs are presently exempt from the Out of Hospital Premises Inspection Program (OHPIP) it conducts. Up until now endoscopy clinics have been considered community speciality clinics, not IHFs. In the most recent issue of the College’s Dialogue Newsletter, they state “the OHPIP model functions more efficiently and quickly to protect patients than the IHF model.” Despite the shift in status, the College is proposing to continue doing OHPIP inspections at these facilities. In 2011 the College warned that a private Ottawa endoscopy clinic failed to properly sterilize equipment and placed patients at risk of HIV, hepatitis B, and hepatitis C. The College also found that the clinic’s nurse was preoccupied with advancing the scope and not recording vital signs, that potential exposure to toxic fumes took place, single-use items were being re-used, and that cramped and cluttered premises posed a hazard by making it difficult to transfer a patient in the event of an emergency. Endoscopies and cataract surgery are at the top of the province’s list for divestment from community hospitals.

The more Ontarians understand the threat by PC leader Tim Hudak to end the Rand Formula, the less they like the Tories. While Forum Research president Dr. Lorne Bozinoff told the Toronto Star the anti-union policies are not seen as a massive wedge issue, “there’s some uneasiness that they’ve (PCs) just gone too far to the right.” The Forum Research Poll shows the Tories dropping in public opinion in tandem with declining disapproval of the Rand Formula. Those opposed to the Rand Formula dropped from 45 per cent to 38 per cent from November to January. Likely Ontarians are coming to understand that by undermining the province’s trade unions all labour rights are threatened – both union and non-union. The Forum Research polls still places the Tories in the lead at 36 per cent followed closely by the Liberals at 33 per cent and the NDP at 26 per cent. NDP Leader Andrea Horwath and Liberal Premier Kathleen Wynne share 40 per cent personal approval ratings while Hudak continues to lag behind with 21 per cent. In a press release issued yesterday, Bozinoff said “it appears Tim Hudak’s signature idea, ending compulsory union dues, is not a winner in Ontario, even among supporters of his own party.” The random sampling of public opinion was conducted among 1222 Ontarians 18 years of age and older between January 24-25.

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Matthews promises to improve PSW compensation — but it will take time

There may soon be good news for the province’s personal support workers.

“When PSWs tell me they can make more at Tim Horton’s, I sit up and take notice,” Health Minister Deb Matthews was reported to have said yesterday at the Empire Club of Canada.

According to the Toronto Star, Matthews promises to improve the wages of the province’s personal support workers but said it would take time to figure out the best way to do it.

Throughout December’s SEIU PSW strike at Red Cross Care Partners we pointed out that the minimum wage for PSWs has not been increased since 2006, frozen at $12.50 per hour. That’s below the poverty level for workers the province is counting on to make its health transformation work.

That minimum wage is far less than what former Health Minister Elinor Caplan had recommended in her 2005 review of competitive bidding in home care. Caplan recognized that there would be no continuity of care when PSWs were turning over due to poor wages and working conditions. The Star reports today that this turnover rate is 60 per cent annually – clearly the government should have listened. It’s not too late to listen now.

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OHA asks for capacity planning but attacks rights of transferred workers

The Ontario Hospital Association must be finally feeling the pinch of fiscal restraint and so-called “funding reforms” that have worked against their bottom line for at least the past four years.

The OHA is asking that the government begin doing capacity planning – forecasting the specific need for a full range of specific health services. That not only includes forecasting the need for hospital services and beds (including types of beds), but also includes (but is not restricted to) a provincial needs assessment for long term care, assisted living, home care, primary care, and mental health services.

The ask was part of a rare Saturday press release, itself a follow-up to the OHA’s presentation to the Standing Committee on Finance and Economic Affairs last Thursday.

No doubt the OHA sees capacity planning as the first step in getting them out of the stranglehold the province has placed them in with declining real funding. The OHA has seen freezes in base funding for the past two years, and the two years before that funding was restricted to 1.5 per cent – well below what is needed to maintain the status quo.

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New jobs prohibited by one-time funding

Some good news and some bad news.

The good news is many health care providers in the Central East LHIN (and likely others) will receive substantial increases in funding, some for the first time since 2011/12.

The bad news is that this will only last for a little over two months more. Then the funding levels go back to where they were before.

Here’s the kicker – all this additional service has to be done without hiring any new staff. That’s because new hires represent a commitment beyond March 31st. That’s a no-no in one-time funding.

The government does this every year resulting in a sudden influx of cash to select targeted programs, and then suddenly it all dries up again.

The Ministry routinely comes up with pockets of one-time cash given to the LHINs on short notice. For example, December 16th the Ministry made available $8 million in one-time funding to support the Health Action Plan’s “Assess and Restore” policy. That policy aims to focus on preventative programs for seniors. The LHINs each had until December 20 to figure out how to spend that money – just four days.

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More than a third of Canadian physicians still without EMRs

Dr. Jennifer Zelmer, Executive VP at Canada Health Infoway, speaking January 22 in Toronto.

Dr. Jennifer Zelmer, Executive VP at Canada Health Infoway, speaking January 23 in Toronto.

When a drug recall takes place, does your family doctor have the ability to identify which patients are on that drug and notify them in a timely manner?

For more than a third of Canadian doctors that may be very difficult.

Canadian doctors have been slow to adopt electronic medical records (EMRs) and even slower to interact with patients in a virtual environment. Very few Canadians can simply e-mail their doctor or book an appointment on-line.

Speaking at Longwood’s Breakfast with the Chiefs forum this morning, Dr. Jennifer Zelmer, executive vice-president with Canada Health Infoway, points out that if patients were able to renew their prescriptions on-line, view their own test results, and consult virtually with physicians when they wanted, it would lead to 47 million fewer in-person visits and require us to take 18.8 million hours less off work to show up in the doctor’s office.

At present only 64 per cent of Canadian physicians are reporting EMR use – albeit that is up from 16 per cent in 2004. That means it’s taken nearly a decade to persuade an additional 48 per cent of physicians to get on board. Do we really have the patience to wait another decade for the rest to follow?

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Scrouge Hospital told to start talking to Lakeridge about capital planning

Robert Biron quietly came into the Central East LHIN board meeting and sat as a spectator. The CEO of the Scarborough Hospital silently left the room again after the LHIN gave him most of what he came for.

One of the conditions of a potential merger between The Scarborough Hospital and the Rouge Valley Health System was seed money towards a feasibility study for a new Scarborough mega-hospital to replace the three outdated sites – Birchmount, Scarborough General and Centenary – as well as an expansion of hospital services in West Durham.

The LHIN had no problem endorsing the “service and program elements” of the pre-capital submissions, but realized that any decision on West Durham would likely have to involve the other major regional hospital: Lakeridge Health.

After being spurned by Toronto East General and eventually finding a dance partner with the Rouge Valley Health System, the Scarborough Hospital may be a little bashful about turning even further East to take Lakeridge Health out on a date.

The LHIN stresses that any contact with Lakeridge would be about capacity planning and not integration. It’s purely platonic even if Lakeridge has a very lovely cancer centre and a recent history of balanced budgets.

The reasons behind the two capital plans are very different. The Scarborough General is an oddball warren of add-ons and their operating rooms are among the oldest in the province. The two hospitals also like to remind us over and over that Centenary is only six kilometers from the Scarborough General Hospital. The Ajax-Pickering Hospital (RVHS) recently completed a significant modern expansion, but the planning was never sufficient for the rapidly expanding community.

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Inspectors, LHIN transparency and Hudak follies — some updates on stories you may be following

Some updates on recent stories in the Diablogue…

We’ve been trying to assess in recent weeks how many of the 100 long-term care inspectors Health Minister Deb Matthews promised in June 2013 have actually been hired.  The official word is now in: 89 – all of them temporary or “fixed term” contracts. January 13 we pointed out that the promise of having every nursing home receive a resident quality inspection in 2014 and annually thereafter will be difficult to fulfill if all these inspectors are intended to be on the job for only 12 months.  It normally takes three inspectors – nursing, dietary and environmental — as long as two weeks to complete the full RQI inspection. This is on top of responding to more than 2,000 complaints each year from families and residents.

We’ve heard back from two more Local Health Integration Networks on their policy around making public board documents. The Welland Tribune tripped our interest in this policy after they suggested the Hamilton Niagara Haldimand Brant LHIN was the least transparent in the province, posting board materials as long as six weeks after the actual board meeting.  Our January 7 post noted that four LHINs were missing from the newspaper’s survey and we decided to send them e-mails that afternoon asking about their disclosure policy. This is important given it can be difficult to follow the discussion at a LHIN board meeting without access to the documents (ie. briefing notes, minutes, reports) board members are referencing. It raises the question how “open” is an open board meeting? Most of the LHINs post their documents well in advance of board meetings or at least make documents available during the meeting.  The first to get back to us of the four LHINs missing from the Tribune survey was Toronto Central, but more recently Central West and Mississauga Halton checked in, both indicating that they too offered more than an agenda to citizens attending their board proceedings.  Central West, responding to our question on January 21, posts all board material seven days prior to their meeting. They also typically post meeting notices 25-30 days in advance. Central West deals with disclosure by noting all materials are in draft form until approved by their board.  Mississauga Halton is not as open. It makes available board materials to the public at the actual meetings. Those not attending the meeting can request materials after the board meeting is complete. Minutes are made available online up to 30 days after the board has approved them. They post their yearly meeting schedule on-line at the beginning of the year and notify of any changes within the 10-days required under the Local Health System Integration Act. Mississauga Halton apologized for the 10 days it took to answer our question. Their response came January 17. That leaves just the North West LHIN to reply to our January 7 survey.

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Want direct front line input into health planning? How about whistleblower protection?

A few years ago we were in discussion with the Central East Local Health Integration Network about the idea of having a number of consultative committees made up of unionized health professionals in each of the sub-regions.

We sent out an invitation to our colleagues in the other unions to be part of this and got little response. Neither did our own members show much enthusiasm to get on board.

Part of this is likely ambivalence towards the LHINs. Part of it is also concern that Ontario continues to have very weak whistleblower protection. Part of it is a concern by these front line workers that they would feel manipulated by the process.

For most LHINs we remain strangers. Our employers get invited to present at the LHIN board meetings. We don’t. Our employers have ongoing working relationships with the LHINs. Ours is hit and miss, depending on the LHIN and how willing locals are to spend time at LHIN board meetings that can sometimes be opaque.

That’s too bad.

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Nearly one in four Canadians worried about affording health care

There’s much hand-wringing about the results of a new Commonwealth Fund International Health Policy Survey sponsored in part by the soon-to-be defunct Health Council of Canada.

While the media focus is on the bigger failures indicated by the survey, the question is, how much of it is even accurate?

Taken between March and June 2013, the survey includes a larger than usual sampling of Canadians thanks to the governments of Alberta, Ontario and Quebec paying to expand their sample sizes to more than 1,000 respondents each. That’s a good sampling for opinion accuracy, but that doesn’t necessarily translate to an accurate profile of Canada’s health system.

While the results may indicate some overall general trends, there are significant contradictions in the results that should throw up caution flags.

On the one hand Canadians have significantly more confidence in their health system than they did nearly a decade ago and give very high ratings to the quality of care. Fifty per cent of Ontarians believe the system works pretty well and only needs minor changes – that’s well above the national average of 42 per cent.

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Campaign calls for federal $100 million suicide prevention fund

Partners for Mental Health have launched a new campaign to get the help that Canadian youth need.

Called “The Right By You” campaign, the advocacy group is asking Canadians to speak out, urging provincial governments to cover mental health care for all children and youth as well as to establish a $100 million federal suicide prevention fund.

According to the Partners, three of four children and youth with a mental health problem or illness will not receive treatment. Twenty per cent of those diagnosed will have to wait more than a year to receive treatment. Further, nearly one in four deaths of youth aged 15-19 are the result of suicide.

The campaign website is loaded with the tools activists need to push the issue out into the community. That includes an on-line petition and a connection to federal MPs in which you can use the Partner’s sample letter or create your own.

The site also includes a collection of stories by Canadians who have been affected by mental illness, including several heartbreaking videos of parents who have lost a child to suicide.

To watch the short “Right By You” campaign video, click on the box below.