Video of April 7th Toronto rally to save hospital services

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:

Cobourg calls upon local MPP to stand up for hospital

COBOURG – OPSEU members joined several hundred community members at an April 10 rally to call upon their local MPP to seek funding to retain health services at the Northumberland Hills Hospital.

The hospital is closing beds, a diabetes clinic and all outpatient rehab services in an attempt to balance its budget.

Officials at the Local Health Integration Network have already described NHH as among Ontario’s most efficient hospitals for its size.

The community is asking MPP Lou Rinaldi to go back to Queen’s Park and get $2 million in funding to save these services.

To see video of the rally, go to:

Will hospital executives see their salaries rolled back?

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.

User fees for Quebec health care?

Oppositions is expected to be fierce as the Province of Quebec is promoting the idea of user fees for public health care services as part of its spring budget.

The Quebec government is looking at a fee of $25 per visit, charged not up front at the doctor’s office, which would likely violate the Canada Health Act, but annually, as a “deductible” included in their income tax. 

Under the proposal, the fees would be capped so that total charges do not exceed 1 per cent of a family’s annual income. It was estimated under one proposal that a couple with two children making 10 medical visits a year would pay a maximum of $250 annually.

 The Quebec government also announced a new health tax to commence in June, 2010, that will be levied on individuals when they file their income taxes. The “health contribution” will cost adults $25 this year and eventually climb to $200 in 2012. Lower-income families will be exempt. When fully implemented, the new tax will generate $945-million a year.

 “There’s no doubt that user fees violate the spirit of the Canada Health Act, which is quite clear that user fees cannot be charged,” Dr. Irfan Dhalla, Co-Chair of Canadian Doctors for Medicare told the Globe and Mail.

The Globe reports that a number of Quebec academics, unions and social activists will be challenging the plan.

 “The decision has been taken and we will proceed,” Premier Jean Charest told reporters. “We will first proceed with a debate on the methods and on the way we will do it.”

St. Francis Memorial makes major cuts to balance its budget

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.

New sunshine list out

The new Sunshine lists are out. To find out what the executives at your hospital/health care provider earned last year, go to:

http://www.fin.gov.on.ca/en/publications/salarydisclosure/2010/

In Brief — Long Term Care Act to be proclaimed July 1 / David Dodge on health care

The Ontario Legislature is scheduling to proclaim the Long-Term Care Homes Act, 2007 on July 1, 2010. The legislation had been awaiting proclamation pending the drafting of new regulations. The Long Term Care Homes Program Manual, previously used in the inspection and enforcement of standards in the homes, will no longer be in effect. With the new regulations covering far less than the original program manual, Ontario is set to effectively initiate significant de-regulation of nursing homes. …  According to a Health Canada survey, Canadians are happier with their health care these days. 44 per cent said the state of health care in Canada was good or excellent – that’s a seven per cent increase since the last survey in 2007, and 20 per cent better than 2004. Eight in 10 Canadians say they were satisfied with the care they received within the last year. However, 43 per cent say major changes are required, suggestive that what Canadians are reading and what they are experiencing may be two different things. … There was much interest in the comments of David Dodge, former Bank of Canada Governor, at the recent Liberal policy conference. When it comes to health care, Dodge says we “either have to pay for it through our taxes, through a special levy, or pay for it out of our pocket – and that has distributional consequences – but you can’t assume the problem away.” Dodge called for an “adult conversation,” suggesting “we just won’t put up with being denied access.” He also said the solution may lie in a number of “unpallatable choices.” The comments come at the same time that Federal Liberal leader Michael Ignatieff said he wouldn’t cut corporate taxes any further. Is it possible that we may be coming to a point where health care may be more important than tax cuts? We’ll see.

Community rally for Northumberland Hills Hospital April 10

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.

Video of rally at St. Thomas Elgin General Hospital

A short video of Monday’s rally at St. Thomas Elgin General Hospital. The Hospital is spending $550,000 on a new biometric monitoring system to track employees while cutting front line health services.

Bad math in the provincial budget?

The CAW’s Corey Vermey has done some interesting math around Finance Minister Dwight Duncan’s assertion that health care could reach 70 cents of each program dollar the province spends within 12 years.

Vermey writes:

The 2010 Ontario Budget contains one clear example of faulty math and logic that wouldn’t fool a sixth grader. 

Here is the example as noted in the provincial budget:

Just 20 years ago, 32 cents of every dollar spent on government programs were spent on health care. Today, it is 46 cents.  In 12 years, if we don’t take action, it could be 70 cents.”

That is alarmist to say the least.  If health care spending expressed as cents per dollar of government program spending increased from 32 cents to 46 cents over 20 years; that is an increase of 14 cents over 20 years and an average annual increase of 0.7 cents per year. 

Therefore if that trend continued, in 12 years at 0.7 cents per year health care spending would be only at 54.5 cents. That has much less impact than 70 cents. We need to ask where did the 70 cents projection come from? 

Check the facts on health care spending. In 2008 and 2009 the provincial budget reported that health care spending represented 43 cents for every dollar of program spending.  In 2007, the budget reported that health care spending represented 46 cents for every dollar of program spending.  Over the past three budgets, the annual average net increase in health care spending relative to program spending has been zero.  If it is 46 cents currently, that is the level it was at in the 2007 budget.

To get to our mythical 70 cents of every dollar in program spending being directed to health care in 12 years, health care spending would need to increase by 2 cents of program spending in each and every year. There is no evidence that that has ever happen over the last 20 years.

Ironically, the 2010 Budget in fact indicates that health sector spending as a percentage of program expense will only be 40 cents – at $46.1 billion.  A footnote reveals that it is only after controlling for time-limited investments and the method of presenting education sector expenses that health sector expenses account for 46 cents in 2009.  Even on that accounting basis – health sector expense falls to 45 cents in 2010 — trending back to 34 cents and not 70 cents.