Category Archives: Uncategorized

Event: P3 Privatization of St. Mary’s and the Kingston Psychiatric Hospitals

Posted on October 12, 2012 | Leave a comment

Economist David MacDonald and Ontario Health Coalition director Natalie Mehra will be among panelists speaking at a public meeting in Kingston October 26 on the privatization of proposed replacement for St. Mary’s of the Lake Hospital and the Providence Care Mental Health Services (formerly the Kingston Psychiatric Hospital).

The redevelopment of the hospitals is forecast to cost $350 million as a public-private partnership (P3) – a sum the town hall organizers say could be as much as $100 million more than had it been developed under a more traditional public procurement model.

To date the government has refused to release any of the background documents justifying the decision.

Three consortiums were shortlisted for the redevelopment at the end of August. Among them is a consortium involving the same facilities management company that presently runs the Royal Ottawa hospital in Ottawa (see link below for OPSEU’s Risky Business report on the Royal Ottawa P3).

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Hospitals: Let’s get the cuts out in the open

Posted on October 11, 2012 | 2 comments

When faced with underfunding, should hospital CEOs make clear the consequences, or should they quietly find ways to cut services that may be less noticeable to the public?

For the first time since the Harris government, the McGuinty government has frozen base funding for hospitals. In addition it has introduced a new funding formula that is having negative repercussions for some.

We have always argued that having a funding formula makes sense, but such a formula should be grandfathered in so that hospitals on the losing end of the equation are not adversely affected. There are also questions about whether the formula itself is fair, some arguing that existing patterns of use are partly determined by where existing services are, as opposed to where services should be.

The net result of these changes in funding is hospitals are faced with particularly difficult choices this year.

Many choose to quietly go about their chopping, limiting input to board and management. Others talk publicly about consequences leaving the broader community an opening to debate what should take place.

The latest to talk about consequences is David Musyj, CEO of the Windsor Regional Hospital. Last week Musyj warned of possible layoffs and cuts to services, such as endoscopy and ultrasound – both he says are offered at private clinics in his community.

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Tired of the high cost of hospital parking? Try not paying

Posted on October 10, 2012 | 1 comment

If there is one universal issue that irks Ontario hospital patients, it’s hefty parking charges.

In many towns the only “pay” parking is at the hospital. Where there are commercial parking lots in the surrounding area, hospitals routinely charge twice the going rate or more.

This particularly limits those who have mobility issues and would have a hard time walking to the hospital from a nearby commercial lot. Transit is often not a reasonable alternative.

Now a cancer patient in St. John’s, Newfoundland has come up with his own solution – just don’t pay it.

According to CBC News, Tom Babcock refused to pay for parking at that city’s health sciences centre. When the Royal Newfoundland constabulary was called, they said they had no jurisdiction to write him a ticket on private property.

Babcock looks forward to his day in court when he will argue that the charges are a contravention of the Canada Health Act. Eastern Health, which manages the hospital, is refusing to take him there. There is no word on whether they will let him back in the lot.

“It’s patently, morally, ethically wrong to charge people to see their doctors,” Babcock told the CBC. “Especially people who have to be here five days a week paying $8, $10 a day to see their doctor, and they can’t afford it, and that’s wrong.”

Unfortunately for most Ontario hospitals, hospital parking is automated. You could be waiting a long time for that gate to lift by refusing to pay. Unlike Newfoundland, we’ve eliminated most of the jobs in the exit booths of our parking lots.

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Last days of free market capitalism and the true believer

Posted on October 2, 2012 | 2 comments

Being an unapologetic capitalist is not all that it’s cracked up to be.

John Hancock, senior counsellor at the World Trade Organization, was sweating profusely as he told his audience how capitalism was entering a more radical phase that would lead to further globalization of economies, massive dislocations, de-stabilization and perpetual turmoil. And that was the good part.

Speaking the Gardiner Museum last night as part of TVO’s Big Ideas series co-sponsored by the Literary Review of Canada, Hancock credits capitalism as having allowed the West to race ahead of the rest of world. In 1800 the richest economies were four times those of the poorest. By 1914 it was fifteen times. By 1950 it was 26 times. In 2000 it was 70 times.

Now countries like India and China are catching up at a torrid pace. Hancock says the Chinese economy is doubling in size every decade and India is not far behind.

Without once mentioning the impact of rising oil prices or the cost to the environment, Hancock says transportation costs have revolutionized the world economy to the point where it’s economic for countries to ship their garbage to foreign destinations. He says that Charlemagne would be “blown away” to walk into a Shoppers Drug Mart today and see the array of inexpensive products from around the world. This is the new utopia: cheap lighters made in Indonesia.

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Patient-based nonsense

Posted on October 2, 2012 | 7 comments

Patient-based health care: Take away the phrase and the Minister of Health’s speeches would be little more than clean white sheets of paper.

There is an air of unreality when you see those trusted with stewardship of our health system using this phrase in new and unusual ways. It’s like somebody sent out a memo: this year is about patient-based care. Attach it to everything you do.

At last week’s Insight Conference on Continuous Quality Improvement in Health Care, Miin Alikhan, director of the Health Quality Branch of the Ministry of Health and Long Term Care, presented on the government funding “reforms,” including patient-based funding.

What is patient-based funding? It’s basically what they are moving the doctors away from — another version of fee for service although the exact mechanics are a bit unclear.

You don’t often associate funding reform with patient-based care. Evidently previous funding models didn’t apply to caring for patients.

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Maybe the LHIN CEO was referring to Grease, the musical

Posted on October 1, 2012 | Leave a comment

Bill MacLeod told an Insight conference last week that the deficit was Ontario’s burning platform, that the province was “this close” to being Greece. Generally speaking, it’s a bit more complicated to compare provinces to nations, but the CEO of the Mississauga Halton Local Health Integration Network may be more than just a little off in his comparison. In common parlance, you might call that remark a “whopper.”

The hysteria about deficits also applies to the Harper government, which is cutting services as if we were already Greece. That includes recent news of the termination of Statistics Canada’s Health Survey. Chop chop – who needs to know about the population health status of Canadians anyway? Heck, it’s only about effective planning.

Is our economic situation really that bad?

Money may be tight following the Ponzi schemes the financial services industry used to crash the world economy in 2008, but as far as borrowers go, Canada is actually in an enviable spot.

The September edition of the U.S. Institutional Investor magazine ranks countries by their credit rating. On the top of the 179 country list are such social democratic bastions as Norway and Sweden. Fourth on the list is Canada.

That’s right, our credit rating is fourth out of 179 countries. The U.S. is 10th. The UK is 14th. Germany, which is a big lender to Greece, comes in at 9th. Oh, and Greece, their credit rating places them in the 156th spot, just above countries like Afghanistan, North Korea and Somalia.

Fourth versus 156th.

The concept of a burning platform is to create a situation to force people to make a change.

The truth is Canadians are not standing on a burning platform. We are not Greece. We’re not even close to being Greece.

When Bill MacLeod says we are, you know he has another agenda to spur us into accepting decisions we may not like. Is this about democratic decision-making, or blatant manipulation?

You decide.

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More managers to front line staff has an impact well beyond cost of salaries

Posted on September 27, 2012 | 2 comments

Asking how the ratio of management to front line staff has changed at a public hospital seemed like a straight-forward question.

In this era of obsession with hyper-efficiency, you’d think the Ministry of Health, the Local Health Integration Networks and the hospital boards would be asking this question, and asking it regularly.

Doesn’t everyone want more live bodies actually delivering diagnostics, acute care and rehab?

To be fair the Ministry breaks down data by what they describe as “unit producing personnel” (UPP) and those whose “primary function is the management and or support of the operation of the functional centre” (MOS). Oddly the terms themselves suggest that managers don’t actually produce anything, which is much further than we would certainly go. (Note to managers reading this – are you really okay with these terms?)

If all this confuses you, apparently it does for hospitals too. There have been past complaints about the consistency and subsequent validity of such data. In our recent survey of the changing ratios of managers to front line staff, several hospitals opted (with our permission) to give us the UPP/MOS data instead of interpreting themselves who was in fact a manager.

Conducting what we thought was a basic freedom of information request, we received data in various formats and continually got the question: what is management?

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Are there more managers and fewer front line staff? At some hospitals, absolutely

Posted on September 26, 2012 | 3 comments

Earlier this year we issued a freedom of information request to 20 sample hospitals where OPSEU represents health care workers to understand whether managers are in fact replacing front line health care workers.

Nine of 20 hospitals reported an increase in managers proportionate to front line staff over the past five years.

It’s a frequent complaint we hear.

While the requests were sent out in February, the information took much of the year to trickle in.

Resources are getting ever tighter in the hospital world – Ontario hospitals are experiencing no increase in their base budgets this year. How hospitals allocate their funding does matter.

Some hospitals actually reduced managers – at Kingston General Hospital, for example, managers dropped from 146 in 2008 to 125 in 2012. Staff has remained almost exactly the same over the past five years at 2,453. Other hospitals that dropped managers include the Chatham Kent Health Alliance, South Grey Bruce Health Care and the Windsor Regional Hospital.

Others show that our members were right.

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Briefs: Health Coalition Action Assembly November 17-18

Posted on September 24, 2012 | 1 comment

The Ontario Health Coalition is holding its annual Action Assembly and Conference on the weekend of November 17-18 at the University of Toronto’s Hart House. The Action Assembly plans the Ontario Health Coalition’s actions and priorities for the coming year. It is also an opportunity for caregivers and patient advocates to network and share concerns. A block of rooms has been set aside at the unionized Bond Place Hotel on Dundas Square. To get the reduced rate of $84 per night, call 416-362-6061 or 1-800-268-9390 and tell them you are attending the Ontario Health Coalition conference. Watch for more details coming soon.

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Briefs: Tax cuts don’t spur economic growth — study

Posted on September 24, 2012 | 1 comment

The Ontario government has long believed that cutting corporate taxes will spur economic growth. A new six-decade study from the U.S. Congressional Research Services says that tax rates “have had little association with saving, investment or productivity growth.” The study did find that reductions of capital gains taxes and top marginal rates have led to greater income inequality. A story in The Atlantic notes that in the 1950s the top marginal rates were about three times what they are today, yet GDP growth was twice as fast in the 1950s as it was in the 2000s.

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