Province needs to look at evidence around hospital mergers

Murray Martin should change his name to Dr. Doom.

Now in retirement, the former CEO of Hamilton Health Sciences is full of swagger about tough choices for health care, suggesting rising interest rates would pressure the government into making big cuts if they don’t make significant adjustments now.

Never mind that the Bank of Canada’s benchmark interest rate of 1 per cent has not budged since 2010. Changing interest rates also take considerable time to work through the system before they impact the rate the government pays on its bond debt. It’s not like the sky is about to fall.

Speaking at a Longwood’s speaker series earlier this week, the Toronto Star reports Martin as promoting BC’s approach – “we are going to make this change, you’ve got three options and if you don’t like any of them that’s too bad.”

Whatever happened to evidence-based decision-making?

Martin wildly believes the province should force more hospital mergers to find savings — this just days after the Scarborough-Rouge Valley hospital merger came to a screeching halt over the high cost of such a merger.

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Kingston’s Lydia McPherson pitches public hospitals to the Premier

Last spring we were pleased to be part of the Ontario Health Coalition’s plebiscite campaign asking Kingston residents whether they wanted the new mental health and rehab hospital to remain entirely in public hands.

At the time the province was seeking bids to turn the project into a public-private partnership. More than 9,000 residents came out to vote on a very cold April day, almost all in favour of retaining public control over the facility. Instead the private deal was signed at a cost of $901 million — including long term care maintenance. The original project was estimated to cost $350 million to build.

The OHC recently alerted us that one of those voters — Lydia McPherson — was chosen to publicly “pitch” Premier Wynne on the idea of keeping our hospitals public. The “pitch” is featured on a Liberal party website.

Oddly, rather than understand the point McPherson makes about the additional costs surrounding the privatized plan, Wynne concludes McPherson’s pitch to be about openness and transparency.

Kudos to Lydia for standing up to the Premier, even if it appears she didn’t entirely get it.

To watch the Liberal video, click the link below. Links to some of our previous stories about the Kingston P3 are also below.

John Gerretsen should know better
OPSEU TV Commercial
Kenney Memo Misleading
New Kingston hospital a departure from recent P3s
Video: Kingston is voting in the streets
Kingston votes 96 per cent against hospital privatization

Price too high for Scarborough-Rouge hospitals to sustain merger plan

In the end the price was too much.

The merger between the Scarborough and Rouge Valley hospitals appears to be sidelined after months of intense activity including unprecedented community consultation.

March 15 The Scarborough Hospital board passed a resolution that abandons the amalgamation “effective immediately,” although provides faint hope that the province will reconsider merger conditions set by the two hospitals, including funding for one-time costs.

Those costs are substantial – the two hospitals would be looking for about $30 million in one-time basic merger costs and an additional $5 million annually for salary adjustments. The province did ante up $3 million.

The two hospitals were also looking for more than $2 billion in new buildings to replace aging infrastructure and to double the size of the Ajax-Pickering hospital.

That’s a steep price when hospitals are likely to enter their fifth year with base funding either frozen or well below real costs. That funding restraint includes two years of zeros and counting.

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Freedhoff says Heart & Stroke Foundation should be ashamed of themselves

Ottawa’s Dr. Yoni Freedhoff wonders why the Heart and Stroke Foundation would endorse a product for your children that’s basically “sugar, water and marketing.” Yet parents are given the impression this is healthy for kids by the presence of the H&S Foundation Health Check label on the packaging. To get that much real fruit sugar, your kid would have to consume 1.14 pounds of strawberries says Freedhoff. The H&S Health Check symbol is supposed to tell consumers that “the food or menu item has been reviewed by the Heart and Stroke Foundation’s registered dietitians and can contribute to an overall healthy diet.” Oh, and companies pay to have the Health Check logo placed on their packaging. Hmmm.

Since re-posting Dr. Freedhoff’s video, we received this from Matt Salvatore of the Canadian Heart & Stroke Foundation:

Our first recommendation to Canadians is to eat fresh vegetables and fruit and cook from scratch. Currently, SunRype fruit products meet the program criteria because they contain no added sugar, are 100% fruit based, and provide a source of fibre. Nutrient criteria for Health Check are developed by HSF registered dietitians and nutrition experts based on recommendations in Canada’s Food Guide. Please take a look here for more information about Health Check criteria – http://www.healthcheck.org/page/program-critieria

The HSF is in the process of developing a comprehensive position on sugar. We will be soliciting national and international experts to provide us advice on the most recent international evidence in this area in order to develop an evidence-based position on intake, which currently does not exist in Canada.

The bottom line is that Health Check criteria is constantly evolving. As Canada’s only neutral, third-party, not-for-profit food information program, the program is helping move the dial and make positive changes to the food supply so Canadians will have better access to, and be able to identify, healthy food choices wherever they are. Companies play no role in developing or implementing the criteria. All revenues are reinvested in the program paying for nutritional research, and educating consumers on healthy eating. Please see the following video for more info regarding program fees: http://www.youtube.com/watch?v=Dnljf7cXjeg

Please watch our Health Check FAQ videos (http://www.youtube.com/user/HSFHealthCheck) and explore the program’s website (www.healthcheck.org) for more information about healthy eating. I’ve also attached an infographic (HSF_13-421_infograph_WEB) on the program’s product evaluation process for more background.

Matt Salvatore, Manager, Communications, Health Check – Heart and Stroke Foundation

Action Plan Year 2: Progress report more politics than substance

Reflecting on two years of “progress” under Ontario’s Health Action Plan, Health Minister Deb Matthews published her list of “accomplishments” in an on-line pamphlet posted in January.

After two years there’s not a lot to show.

Some of the list of accomplishments have not actually happened yet – such as passing legislation that will require chain restaurants to post calorie counts and other nutritional information on their menus.

Thankfully neither have they yet “moved procedures into the community” through a dubious plan to run competitions for hospital services such as endoscopies and cataract surgeries. Given hospitals are allowed to compete with private clinics for their own services, it is theoretically possible that no procedures could be moved into the community – although we doubt it.

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Niagara – Moderate PCs unhappy with radical right policies could send a message Thursday

Tomorrow two provincial by-elections are taking place in Niagara and Thornhill.

Thornhill, the vacated seat of Peter Shurman, is expected to remain Tory blue despite criticism by the departing MPP of his former party. He recently described the Hudak Conservatives “where a plan without a vision is a nightmare.” For the record, the cantankerous Shurman believes none of the three major party leaders are fit to lead, including PC Leader Tim Hudak.

More media attention will likely be spent in Niagara where the Tories risk embarrassment should the polls be correct and the New Democrat’s Wayne Gates emerges as the victor. Shurman raised eyebrows among his own party by predicting an NDP win in this riding.

Since the poll showing Gates with a slight lead over former Tory MPP Bart Maves, the Tories have been slinging mud non-stop. It’s the opposite of most political campaign strategies – start negative and finish positive – likely indicative of how desperate the Tories have become.

Probably the worst thing the Tories could have done is send Monte McNaughton to Niagara. McNaughton is the PC’s labour critic who has a penchant for over-the-top hyperbole demonizing the labour movement.

For a party that was suddenly soft-pedaling their plan to end the Rand Formula fearful of the labour vote in the riding, sending McNaughton appears to be a miscalculation.

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LHIN Review: Unifying a system, dividing a community

You have to feel a little bit for the MPPs that are sitting on the all-party Standing Committee on Social Policy. Somehow in the sweet victory of election night it is unlikely the elated victors dreamed of this – spending hour upon hour in a room listening to a long succession of 15-minute presentations, frequently left with a minute at the end to ask a question and receive a somewhat truncated answer. If it weren’t for the question, the MPPs could probably just zone out at will.

We were in Kingston yesterday to make our recommendations to the Standing Committee on the thorny question of what to do with the Local Health Integration Networks.

The hearings were mandated by the legislation that created the LHINs. They were supposed to take place in 2011, but that timing was just not convenient to the Liberals who had a general election to fight. Talking about the LHINs was likely not the route to victory.

On this day one presenter told an MPP afterwards that she was impressed by her question. It demonstrated that somebody was actually listening. Clearly the expectations by the public are not all that high.

We have to admit we like the angry presenters better, not so much for the politics, but at least to keep us from nodding off. It’s not that the presenters were necessarily boring, but more of a question of just too much information.

Each person usually begins with a lengthy descriptor of where they fit within the health system, kind of a Where’s Waldo prerequisite.

We were by no means the exception to that rule, although on this day we erred on the angry side (even if the Blueberry pancakes were giving this writer kind of a nice warm feeling inside).

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LHINs should integrate with the Ministry of Health — Thomas

OPSEU President Warren (Smokey) Thomas appears before the Standing Committee on Social Policy this morning in Kingston. The Queen’s Park Committee, made up of MPPs from all three parties, is conducting the review into the Local Health Integration Networks mandated in the original 2006 legislation. OPSEU is asking that the LHINs themselves formally integrate with the Ministry of Health and that “integration” proposals undergo a much more rigorous process, including detailed public disclosure. The full presentation is below:

The Ontario Public Service Employees Union represents more than 130,000 members. About a third work of those members work in a variety of health care settings, including hospitals, long-term care homes, ambulance, home care, mental health, independent diagnostics, community health centers, public health, and Canadian Blood Services.

We were the first union to sign up members at a Ontario Family Health Team.

We also represent health professionals in the province’s corrections system and Ontario Public Service members at the Ministry of Health and Long Term Care.

As a result we believe we have a unique 360 degree perspective on health integration.

OPSEU was among the first trade unions to warn of impending issues with the Local Health Integration Networks (LHINs).

In 2006 we warned that the LHINs would be used to deflect public criticism from the real decision-makers. That not only came true, but did much to damage the brand of the LHINs.

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The OHA makes it okay to talk about overcrowding

The Ontario Hospital Association may have made it okay to talk about hospital overcrowding.

As we noted January 27, the OHA has been asking the province to look at capacity planning, noting that only Mexico and Chile have fewer hospital beds per capita than Ontario. It’s fair to question where the province is going on this issue given ongoing funding restraint.

Overcrowding has its consequences.

London Health Sciences Centre’s Dr. Michael John is tasked with infection control for the hospital and believes there is a connection between Ontario’s battles with superbugs and overcrowding.

In the Minister of Health’s own backyard, London’s University and Victoria hospitals have averaged 104 and 102 per cent occupancy from April to December last year according to the London Free Press.

Anything in excess of 100 per cent usually means patients are receiving care in the corridors.

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Bob Rae asks why Health Canada is taking so long to say no to paid plasma donations

In 2013 Health Canada held a by-invitation-only roundtable on the issue of paid plasma donations following our efforts to raise concerns over the application by the private Canadian Plasma Resources (CPR) to go into competition with the public Canadian Blood Services.

CPR had plans to immediately open two clinics in downtown Toronto to pay donors for plasma that would be turned into pharmaceutical product. A third in Hamilton was on its way. Their website says they still plan to do so in 2014.

Former Ontario Premier Bob Rae has jumped into the debate, noting that both Hema-Quebec and Canadian Blood Services are now both opposed to licensing for CPR.

Writes Rae in today’s blog post: “Those countries that have allowed “pay for plasma” schemes are regretting the decision. The reason is simple, and is based on practical evidence. These clinics typically rely on people who need the money. There is every reason to question the safety of the supply. Just as important, paying some people depletes the pool of potential donors, particularly among younger people who blood agencies around the world are trying to recruit to give blood as volunteers.”

Rae does not understand the delay by Heath Canada in saying no to the license application by CPR.

“For whatever reason, it’s taking federal and provincial governments a long time to make up their minds. It shouldn’t,” writes Rae. “The integrity of the blood supply, and our continuing resolve to keep a strong volunteer base, should make the answer simple: no to “pay for blood or plasma”. Period.

To read Rae’s full BLOG post, click here.

For more on the ethics of this issue, click here.