Category Archives: Uncategorized

Transformation or austerity? Hospitals lose further capacity in new round of cuts

Photograph of large Kathleen Wynne puppet at the November rally against privatization of hospital services.

Protest last month over plans to contract hospital services to private clinics. Competitions have not been announced, but hospitals are cutting diagnostic and lab jobs, suggesting the government may be trying to achieve the same aim by stealth.

In October a Whitby nursing home experienced a major fire displacing more than 250 residents.

About 80 of those residents found temporary accommodation in area hospitals. Many are still there for lack of available alternative long term care spaces in the community. It’s remarkable the public hospitals were able to accommodate this many residents given the limited availability of beds.

Hospitals are presently in the third year of a base funding freeze. The Ontario government has maintained that the freeze is part of their overall health care transformation plan, but the Whitby experience would suggest that there is increasingly less flexibility due to funding shortfalls across the entire system. In another year or two how many beds will be available under a similar emergency?

The previous Auditor General of Ontario warned in 2011 that restraining annual health care funding increases to a proposed 3.6 per cent would lead to either service cuts or rising deficits. Instead we have seen health care funding increases limited even further to roughly 2 per cent.

In recent weeks a number of hospitals have been meeting with their respective unions to give notice of layoffs in the coming year. This is starting to become an annual holiday season tradition worthy of a Charles Dickens novel.

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Wynne and Clark cling to discredited P3s despite damning report

Photograph of ballot counting during the 2013 Ontario Health Coalition plebiscite on P3s in Kingston.

In 2013 Kingston residents voted overwhelmingly against a proposed P3 hospital in their city. Despite the results, the Province signed a contract to use expensive private financing to build a new facility to replace Providence Care Mental Health.

Infrastructure Ontario CEO Bert Clark says the $8 billion premium the government spent to build public infrastructure under the public-private partnership model doesn’t tell the whole story.

He’s right, but likely not in the way he’s suggesting.

Remarkably Tuesday night Clark clung to the $14 billion in savings Infrastructure Ontario says is made possible through the privatized model of infrastructure development even though the Auditor General made it clear that figure is based on flawed comparisons and a lack of empirical data to support it. In today’s Toronto Star he downgraded it to $6 billion.

Infrastructure Ontario was not so brazen in its initial response to Auditor General Bonnie Lysyk’s recommendations. Most of their responses in the AG’s report make minor admissions and rely on “third party experts” to justify the rest.

As we stated Tuesday afternoon, just two errors in cost allocation identified by the AG is enough to suddenly swing 18 privatized projects into the public column, saving the public treasury $350 million. Did their “third party experts” notice these errors?

In yesterday’s Star Clark highlights the Union Station renovation and the subway extension to York University as counter examples of public procurement projects that have experienced cost overruns and delays.

By contrast Lysyk points out there were in fact eight P3 projects that were delayed longer than 60 days – the longest more than a year off schedule. For six of those projects the contractor did face financial consequences, but in two they did not. That’s eight out of 38.

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Eight billion reasons why we were right about P3s

2006 photo of P3 protest.

P3 protest in 2006. Pity the government didn’t listen then. In 2014 the Auditor General of Ontario says P3s have cost us $8 billion more.

If there is any trace of self-respect left within the Ontario government, Premier Kathleen Wynne should do the right thing and pull the plug on Infrastructure Ontario’s public-private partnership (P3) program now.

Auditor General Bonnie Lysyk delivered a devastating blow to a program that obscured its shortcomings for years in an overflowing super-sized container of gobbledygook.

For all the assurances Infrastructure Ontario could manufacture, it turns out that value for money came down to the “professional judgment and experience” of third-party private sector “advisors.” As Lysyk states in her report, “the probabilities and cost impacts are not based on any empirical data that supports the valuation of risk.”

For a government that has been hammering public sector workers, shuttering hospital clinics, and denying patients access to home care in the name of fiscal restraint, the Auditor General made clear they were more than willing to spend $8 billion more than necessary on private consortiums to build infrastructure in this province – the majority of it in health care. About $6.5 billion of that amount is represented by higher financing costs borne by the private sector – a general point the previous Auditor General made in the evaluation of the William Osler P3 deal in 2008.

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Drugs: “Medicare’s unfinished chapter”

Picture of prescription drugs.

Momentum is building for universal coverage for prescription drugs. (www.canstockphoto.com)

Prepare for a wave of misinformation about the costs of providing universal pharmaceutical coverage in Canada, especially now that momentum appears to be building towards the idea.

The most recent endorsement comes in the form of an editorial in the Globe and Mail Sunday which strongly supports universal access. “It makes no sense to divorce pharmaceutical treatment from the principal of universality,” the Globe states. “More and more health care is pharmaceutical care and Canada is the only developed country with universal health insurance that doesn’t provide full coverage for medications.”

The Toronto Star made its own endorsement in an editorial November 28, calling pharmacare “medicare’s unfinished chapter.”

An endorsement by the Globe is likely a stand-in for approval from Bay Street – not entirely a surprise given the obvious advantages to employers. Drugs are the largest benefit cost they face and the premiums have been escalating faster than inflation. The overall savings of a universal public plan – estimated to be as much as $10.7 billion annually – would easily offset any tax adjustments (if any) necessary to cover such a plan. Those savings represent about five per cent of all health spending – both public and private.

The Globe is endorsing the idea of universality, but has so far reserved comment on a publicly administered system suggesting more study is needed.

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Tories unlikely to stop Bill prohibiting paid plasma, but why are they even trying?

Picture of protest against the closure of the CBS Thunder Bay plasma clinic in 2012.

2012 protest in Thunder Bay against the closure of CBS’ plasma clinic. Health Canada claims — without any evidence — that self sustainability in blood products in impossible under a volunteer system, but we’ll never know if CBS continues to downsize its operations.

The Ontario Tories recently have appeared to be distancing themselves from some of the more unpopular positions adopted by the party under Tim Hudak.

Voting for second reading of an Act intended to close the door on paid collection of blood and blood components by the private sector, the Tories n one-the-less seem incapable of parking their ideology at the door as Bill 21 finds its way into committee.

For two days the committee is conducting hearings into the legislation, seeing a parade of mostly private sector lobbyists lined up on one side and mostly family and survivors of Canada’s last tainted blood scandal on the other. Each presentation was limited to five minutes, followed by three minutes for each party to ask questions. In the case of the Tories, that three minutes was frequently used to make their own case that somehow we can’t do anything in this province without the involvement of private corporations.

David Harvey, a lawyer who represented patient groups at the 1990s Krever Inquiry, made the point the legislative committee was trying to come to a decision in just two days of public hearings over an issue that took Justice Horace Krever four years to resolve. By contrast, the Krever Inquiry included 247 days of public hearings by 474 witnesses, testimony and submissions filling 50,000 pages and another 100,000 pages of exhibits. Even former Premier Mike Harris admitted the Krever report was “detailed, it was exhaustive and it was complete.”

Yet the Tories appear to be siding with the private lobbyists as they toy with the idea of reversing one of Krever’s key recommendations – that paid collection of blood and blood components be banned except in rare circumstances.

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Phase II of mental health plan serves up crumbs from the health care table

Above: Arthur Gallant — one of the more inspired choices for the Mental Health and Addictions Leadership Advisory Council.

Ontario Health Minister Dr. Eric Hoskins has been doing a lot of tweeting this week about the second phase of Ontario’s 10-year Mental Health plan. You may recall that the 10-year plan really was a three-year plan in 2011, which is being followed by another three-year plan now. We presume they’ll just continue making it up as they go along.

First the good news: The government is investing $16 million to create 1,000 more supportive housing spaces, opening a 12-bed paediatric residential treatment unit at Ontario Shores Centre for Mental Health Services, and spending $2.75 million to improve access to mental health and reduce wait times at four of the big psychiatric hospitals – The Centre for Addiction and Mental Health (Toronto), Waypoint Centre for Mental Health (Penetanguishene), The Royal Ottawa (Ottawa and Brockville), and the aforementioned Ontario Shores (Whitby). He is also creating a Mental Health and Addictions Leadership Advisory Council and is “partnering” with the province’s public health units to increase awareness, fight stigma, and promote mental health in schools and in the workplace. The largest chunk of cash — $138 million over three years — will go to community service agencies to increase access to peer support groups, treatment programs, and crisis and early intervention initiatives.

Now the bad news: It’s called perspective.

$2.75 million added to those four hospitals amounts to less than half a percentage point on the nearly $650 million a year they presently spend.

The $16 million in supportive housing will be over three years, or a little more than $5 million per year. There are 8,000 people presently waiting for supportive housing – just in Toronto alone.

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New minister, same tired denials about cuts

Photograph of Ontario Health Minister Dr. Eric Hoskins speaking at the Ontario Hospital Association annual conference.

Dr. Eric Hoskin, Ontario’s Health Minister, speaks about his top four priorities at HealthAchieve November 5.

Dr. Eric Hoskins may be signing his name, but the latest Toronto Star letter-to-the-editor from the Health Minister sounds as tired and exasperated as those served up by his predecessor. Given Ministers seldom pen their own letters, we conclude it must be hard to get good help these days.

Hoskins (or his ghost writer) insists that Star columnist Bob Hepburn is wrong – that in fact no cuts are taking place in home care. Never mind Erie St. Clair CCAC’s new executive director sent out a memo announcing a 33 per cent cut in daily nursing visits or that Care Coordinators at the Champlain CCAC are beside themselves having to recommend out-of-pocket paid alternatives to long-term patients who suddenly find themselves without a caregiver. Both CCACs are staring down millions in debt and are in freefall. But hey, aren’t we glad that no cuts are taking place?

It’s the same old song and dance coming out of the Minister’s office. Hoskins insists that Windsor got $3 million more in funding this year and that overall $270 million has been added for home care. Demand is far outstripping this funding due to a planned multi-year freeze to the base budget of Ontario’s public hospitals. Care Coordinators are telling us that not only is this placing the CCACs under great pressure, but it is changing the very nature of the work they are doing. It’s all about post-hospital care, not about longer-term chronic care management and support.

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Video: OPSEU at Friday’s big health care rally

In this new video Anna Jover and Emily Visser highlight the voices of several OPSEU activists during Friday’s health care rally at Queen’s Park, including President Warren (Smokey) Thomas. About 5,000 Ontarians came from all corners of the province to protest the increasing privatization of hospital-based services. Earlier this year the province began holding competitions for services provided by existing public hospitals, including diagnostics and cataract surgeries. Those competitions were suspended by incoming Health Minister Dr. Eric Hoskins, but there has been no word from the Ministry whether this is a pause or whether the competitions would begin again at a later date. Further, the government has kept secret their commissioned Deloitte study that purportedly recommends the transfer of specialized medical laboratory testing to the private sector. When the Local Health Integration Networks were established labour complained that such destructive competitions that left shortages of caregivers in home care would be extended to public hospitals. At the time the government suggested this was no more than scaremongering.

4,000-5,000 march on Queen’s Park to oppose privatization of hospital services

Thousands of Ontarians boarded buses in the pre-dawn hours to come to Queen’s Park to defend their public hospitals on Friday afternoon.

Organized by the Ontario Health Coalition, the demonstration was likely the largest of its kind in recent years despite the unusual cold November temperatures. Volunteers estimated the crowd at the height of the rally was between 4,000 to 5,000 people. Operation Maple’s video and our photos below. More to come on Monday.

Picture of Oshawa NDP MPP Jennifer French.

Oshawa NDP MPP Jennifer French addresses the rally.

Picture of large 12 foot tall Kathleen Wynne Puppet.

OPSEU Region 4 brought their new Kathleen Wynne puppet.

Picture of marchers on University Avenue.

Marching up University Avenue after speeches at on the lawn of Queen’s Park.

Pic of OPSEU President Warren (Smokey) Thomas

OPSEU President Warren (Smokey) Thomas addressing the rally.

Photo of marchers at Queen's Park.

Between 4,000-5,000 Ontarians showed up to support their local hospitals at Queen’s Park November 21.

Frustrated nursing staff quit CarePartners as OPSEU charges unfair labour practices

Photo of hands of health professional assisting an elderly female patient.

Nursing staff are leaving CarePartners in Niagara and Norfolk Counties as the employer thwarts efforts to secure a first collective agreement.
Photo http://www.canstock.com

Continuity of care is important to the delivery of home care. Each time a caregiver changes there is a necessary rebuilding of relationships. If caregivers are continually turning over, it is much more difficult to notice changes in the patient’s medical condition. For example, if a nurse never saw a wound before, how can she or he tell whether it is healing properly? Much of the care work is intimate in nature and subsequently relationships built up over time are important.

In 2003 the not-for-profit Victorian Order of Nurses lost the Community Care Access Centre’s visiting nursing contract in the Niagara region during a year in which the community was celebrating VON’s centenary. We were told over and over that the competitions were about quality, not necessarily price.

In the subsequent contract turnover one of the companies – the for-profit CarePartners – simply could not recruit sufficient experienced staff to successfully take over care from the VON. Instead they shuttled nursing staff from other operations around the province to do what they could to shore up their contract obligations. We heard first-hand patient stories about missed visits, about an inability to contact CarePartners over the weekends, about stressed staff rushing in and out to keep up with an impossible workload.

Of those few nurses who transitioned from VON to CarePartners, in 2005 we were unable to successfully argue in court that this represented a sale of business, and subsequently those workers were unable to retain their rights or union. Many of the VON’s original staff decided to find work elsewhere.

It’s more than 10 years later and the Niagara and Norfolk County staff of CarePartners chose OPSEU to help them seek a first collective agreement with the company. CarePartners is a much larger corporation these days thanks to an initial merger with Red Cross and the subsequent purchase of Red Cross’ home support operations.

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