OPSEU Diablogue

A debate has begun in BC over the value of hospital spiritual care directors after the Fraser Health Authority dismissed all 12 of its chaplains late last year. In an Op/Ed piece in the Vancouver Sun, Douglas Todd writes “while leading edge medical organizations around the world are providing more spiritual and emotional support for patients – aware of hundreds of studies showing a correlation with greater health – the Fraser Health Authority has turned the opposite direction.”  The FHA has also cut social workers and psychological counsellors. Todd argues the Chaplains are often not ordained, but have master’s degrees combining psychology and religion.  Their role is to listen to patients, including helping them grieve, enhance often-troubled relationships and make agaonizingly important decisions. Chaplains come from a wide range of spiritual backgrounds – they try and meet the spiritual and emotional needs of the patient as the patient presents them, “regardless of the patient’s religion or lack of it.” The FHA spent about $650,000 per year providing the service – an amount almost equal to the salary of the health authority’s CEO. Others have argued that the chaplains have no role on the public payroll, that patients should seek support from their local congregation. Todd argues that congregation-based clergy aren’t trained in life and death situations involving tricky medical options.

Tom Closson, CEO of the Ontario Hospital Association, brought dire warnings about the consequences of underfunding during his appearance before the legislature’s finance committee last week.

“The data strongly suggests that an increase of less than two per cent in hospital operating funding would undercut the government’s goals with respect to reducing wait times in emergency, undo much of the hard-won progress made to date in reducing surgical wait times and erode public confidence in the health care system,” he said.

Closson said the entire system is backing up, with 745 patients waiting in ERs right now for available beds.

The OHA CEO said these numbers are increasing particularly in the Greater Toronto Area, where a rapidly growing population is already straining the health care system.

Closson said about 30 hospitals are operating with close to $600 million in cash advances from the Ministry of Health – the only way those hospitals could meet payroll or pay their bills.

Premier Dalton McGuinty has said hospitals will receive an increase, but has not indicated how much it will be. This is a shift from his earlier position that health care would not be cut, suggesting a freeze was a distinct possibility.

Hospitals had been asked to prepare scenarios should a funding freeze be implemented. They have also been asked to prepare plans based on a one and two per cent increase in funding.

Many hospitals are beginning to take steps to prepare for the worst.

St. Thomas Elgin General Hospital sent a memo January 20^th to staff and volunteers suggesting they were preparing for zero per cent funding. The memo includes plans to cut back hours in their outpatient laboratory service, diagnostics, and occupational health and wellness.

Despite appearing before the Central East LHIN to say no cuts to patient services would be necessary with a one per cent increase in funding, Rouge Valley Health System gave notice of layoff last week to three different bargaining units. That included 14 OPSEU health care professional positions. These cuts will impact laboratory, rehab, cardiac care, mental health, and diagnostic imaging.

Dr. Chris Carruthers, former Chief of Staff for The Ottawa Hospital, is advocating that all 20 hospitals in the Champlain LHIN merge into one big hospital.

In an Op/Ed published in the Ottawa Citizen last week, Dr. Carruthers makes the usual claims that mergers will bring about more efficient service.

Dr. Carruthers should be aware that it took 15 years to merge these same hospitals’ labs into the Eastern Ontario Regional Lab Association. For all the years of planning and disruption, it likely won’t save any money and could likely cost more in the long term according to the consultants that reviewed the plan.

Oddly enough, offering no real proof the previous Ottawa amalgamation saved anything or achieved any efficiencies, Dr. Carruthers states “some savings are hard to measure, but are real.”

The one thing about money is that it is measureable.

For hospitals that amalgamated in the wake of the 1996-2000 Health Restructing Commission, seldom has the story been positive.

Just ask the citizens of Fort Erie and Port Colborne, who were promised their hospitals would remain intact when they merged with three other hospitals to form the Niagara Health System (NHS). Now both have lost their ERs and are effectively satellite branches offering specialized care for the NHS. About the only thing that has remained is the ‘H’ on the building.

Many smaller communities have felt aggrieved that the larger partner in the merger has benefited at their expense.

The community of Ajax has rallied twice around threats to move key services to the Scarborough Centenary site of the Rouge Valley Health System. The first time they stopped Rouge from taking away obstetrics and paediatrics from the Ajax-Pickering site. The second time they were less successful in losing their inpatient mental health beds to Scarborough.

Lakeridge Health has been notorious for running deficits since amalgamation – that is until it received more than $5 million in new money this year to finally place it in the black.

Headwaters Healthcare was a marriage of the Orangeville Hospital with the Shelburne Hospital. The Shelburne Mayor has complained services have been gradually moved out of the local hospital year-by-year. This year will likely be the last for Shelburne, making Headwaters a one-site hospital again.

Another thing happened with the amalgamation of these hospitals – communities also lost what control they had over them. Most boards of these amalgamated hospitals are now self appointing. It used to be community members could buy a membership and vote on who sat on the local board. This is increasingly disappearing.

 When the Headwaters Board decided to close Shelburne, not a single member of that board came from the Shelburne community.

How sensitive would a monster Champlain hospital be to the needs of such communities as Deep River and Winchester? Would they have anybody on the board of an amalgamated hospital?

Dr. Carruthers is now a private health consultant. A big fat merger would likely keep him in business for years to come. For many of the communities, the outcome might be very different.

TORONTO – Despite running a surplus, Rouge Valley Health System has given notice of layoff this week, claiming the cuts are part of their third-year deficit elimination plan.

Only last month Rouge Valley CEO Rik Ganderton told the Central East LHIN that cuts to services would be unnecessary if the hospital received at least a one per cent increase in funding this year.

While no figure has been given by the Ministry of Health, Premier Dalton McGuinty has confirmed that an increase is coming.

Health care professionals represented by the Ontario Public Service Employees have been hard hit – 14 full and part-time positions in diagnostic imaging, lab, mental health, cardiac care and rehab are being lost.

“We are particularly surprised to see another full-time lab technologist cut in histology,” says Warren (Smokey) Thomas, President of the 130,000-member Ontario Public Service Employees Union. “Over the last two years we have lost two of four full-time lab techs from that unit. Given the importance of histology in the diagnosis of cancer, this is a very reckless move.”

The union was also surprised to see four positions eliminated from mental health, including a part-time psychometrist as well as one full-time and two part-time social workers.

“Given existing questions about the ability of Rouge Valley to handle the case load of acute mental health patients, we cannot understand how fewer staff are going to solve this problem,” said Rhonda Watt, president of OPSEU Local 311.

While most of the positions will be lost from the Scarborough Centenary site, two positions will be lost from Ajax-Pickering, including a full-time physiotherapist and a part-time ultrasound technologist.

The union is concerned that the cuts will be dangerous to patient health excessive workload may lead to an increase in errors in patient diagnosis.