OPSEU Diablogue

Last June Health Minister Deb Matthews announced all 633 Ontario long-term care homes would receive a “comprehensive annual inspection” known more technically as a “resident quality inspection” (RQI). A deadline was established — all homes are to undergo an RQI by the end of 2014. It now appears to be unlikely the promise will be kept in full. Posting for new inspectors was swift, but there was an indication from the start that the government was less than forthright in its promise to add a complement of 100 new inspectors to fulfill the objective of an annual RQI. The initial posting called for “a minimum of 50” inspectors rather than 100. The positions would be filled over a period of 14 months after the closing date of the posting, meaning new inspectors could still be straggling in as late as this November. Worst still, recruitment became a challenge after the government decided that all these new positions would be 12 month temporary contracts. Who is going to leave existing permanent professional employment for a one-year job that may or may not be extended? The result has been a lengthy process and one where, we are told, many of these new inspectors had to be hired at the top of the wage grid to bring them in the door. While many new inspectors have finally been hired, there will be a lag until all can be trained to do RQIs and fully “understand, interpret and apply relevant legislation pertaining to Long Term Care homes to ensure compliance.” As of last June, with the present complement of about 80 inspectors — not all in the field — it had taken nearly three years to complete 123 RQIs on top of investigating more than 2,000 annual individual resident complaints. Given all these new inspectors are hired on temporary contracts, it makes us wonder about how “annual” such inspections will be or whether the government is paying a premium to play politics with the count of full-time permanent public sector jobs to appease the Tories?

Continue reading →

“The LHINs tell me time after time that they do not have the autonomy you say they do. They do as you tell them to do.” – Liberal MPP Donna Cansfield to departing Deputy Health Minister Saad Rafi, November 18, 2013

The health system is under a lot of stress at present as the Wynne government exceeds the level of restraint that even the Auditor General had previously described as “aggressive.”

With a long overdue review of the Local Health Integration Networks there is bound to be a lot of finger-pointing over who is responsible and how much culpability falls at the feet of these crown agencies.

The Ontario PCs want to start all over again with an unproven hospital-based model. The NDP would replace the LHINs with another undefined regional entity. None of the three parties seems particularly happy with the outcome after seven years. Even the Liberal MPPs, as the Donna Cansfield quote at the top of this post indicates, are far from pleased.

When former Health Minister George Smitherman sold the province on the LHIN concept in 2006, he may have set the bar far too high for them to ever succeed.

Decisions were supposed to be informed by local needs and priorities, and as the Ombudsman reminded us in his “LHIN Spin” report, and “made in
and by the community for the community.”

Continue reading →

The least transparent of the Local Health Integration Networks is the Hamilton Niagara Haldimand Brant LHIN according to the Welland Tribune.

The same LHIN was the subject of considerable wrath by the Ontario Ombudsman in 2010, calling claims to transparency “LHIN spin.”

This is the same LHIN where board members considered personal conversations in the grocery store line or on the golf course to constitute “community engagement.”

The Tribune reports that local resident Pat Schofield (also a frequent commenter on this site) is still waiting for access to a report issued to the LHIN board in February 2011. Concerned over the future of the Niagara Health System, Schofield reasonably requested a report issued to the HNHB LHIN board on the impact of hospital bed closures on acute alternate level of care patients.

Similarly the newspaper itself is still waiting for documents it requested from the November 2013 board meeting.

Why are these documents being kept secret?

The LHIN’s CEO recently recommended that HNHB follow the lead of several other LHINs in posting documents on-line before board meetings take place. With access to these reports beforehand members of the public could actually follow the discussion taking place. Being “open” is more than just having a ringside seat as board members ask questions that become incomprehensible to the public without the documents.

Continue reading →

The Service Employees International Union met with an arbitrator last Friday as part of a settlement that ended a two-week province-wide strike of 4,500 personal support workers at Red Cross Care Partners (RCCP).

The strike was being closely watched by an estimated 80,000 personal support workers employed in the province’s home care, long term care and hospital sectors.

SEIU announced a deal had been reached on Christmas Eve to refer the issue to interest arbitration – the first meeting with the arbitrator taking place January 3.

While the RCCP workers have had their wages frozen since 2011, SEIU reports the President of the Red Cross Society took at 9 per cent wage increase in 2012.

The workers rejected an 11 cent per hour increase in November.

In a press release issued December 27, SEIU Healthcare thanked supporters, including union allies.

To watch our video of the strike kick-off, click on the box below.

It’s time for us to take a break for the season. We hope you’ll be back with us in 2014.

There’s certainly much to talk about as the Ontario government continues with its “transformation.” Recently HealthyDebate featured a post discussing change fatigue in Alberta’s health system. The three authors — Greta Cummings, Karen Born and Josh Tepper — describe how constant change has led to a decline in morale among health professionals in that province. This sounds very familiar and is likely happening much closer to home too. Tepper, as you may recall, worked here for the Ministry of Health as Assistant Deputy Minister (ADM) in the Health Human Resources Strategy Division. He oughta know. He now holds a post as President and Chief Executive Officer of Health Quality Ontario. We will be following the ongoing changes carefully and assess whether Health Minister Deb Matthews is creating true “transformation” or digging a real big hole for all of us.

When vacation calls we usually leave you with an invitation to explore the nearly one thousand posts we’ve created since 2010.

This month we thought we’d feature the top 10 posts you thought important during 2013. Click on the headlines to take you to the story. Meanwhile, happy holidays!

1. Bangladesh Tragedy – Factory manager’s words come back to haunt us

When we posted this story back in April there was minimal interest in our tale about a Nicaraguan factory manager who schooled us in “savage capitalism.” While he paid workers $45 a week to make Levis Dockers, he was complaining factories in Bangladesh were underbidding for these contracts and paying their workers half to one-third the rate. And we all know what happened in Bangladesh. This month the story went viral when a U.S. fashion site linked to our post to show its readers what these “free trade zone” factories are like. In less than a day it became our most visited story of the year, the readers coming from countries circling the globe.

2. Too frank for the food industry

The second most popular post was actually a re-post of a video put together by Ottawa’s Dr. Yoni Freedhoff. Friedhoff was invited by the Ontario Medical Association to speak at a small food industry association breakfast. Just days before the event the organizers uninvited Dr. Friedhoff without explanation. That gave the good doctor the incentive to give the presentation anyway and post it on YouTube for all of us to see. The food industry should have kept the date.

3. Fraser got it wrong

The Fraser Institute has been on the attack for much of this year, sensing the public was in the mood to bash the public sector. One of their claims was that absenteeism rates in the public sector were much higher than the private, suggesting public sector workers were perhaps dogging it. Statscan also looked at the issue and pointed out that when you weighted for age, gender, and union representation, absenteeism rates between the public and private sectors were in fact very similar. After months of being bashed, public sector workers flocked to this story. Teachers were particularly fond of it.

4. PSW Strike – A real life Dickens tale

Personal Support Workers have been very interested in the ongoing SEIU strike at Red Cross Care Partners. Walking a picket line at this time of year is very difficult, especially knowing that less money will be coming into these families at Christmas time. The extraordinary cold weather has not helped either. Its clear Health Minister Deb Matthews is relying on a low wage strategy in her transformation agenda, reminiscent of a Dickens character we like to visit at this time of year. At least in the Dickens tale the “transformation” was personal. If the striking PSWs are walking a picket line near you, please give them your support (and hopefully something warm). Please go to the SEIU justice4psws site for ongoing updates.

5. Under LHIN investigation, northern hospital files $500,000 legal action against activists

It was the wildest story of the year. A small northern Ontario hospital initiated legal action against a group of activists who were challenging a proposal to formally merge with two other hospitals. At one point it appeared nearly everyone was being served with legal papers. In the end the actions were dropped after Health Minister Deb Matthews appointed a supervisor to take over the hospital.

6. A tangible response to physiotherapy cuts – the province finally adds community capacity

After almost every other hospital in Ontario cut outpatient physiotherapy, the province announced what appeared to be new funding in April for community-based service. Well we thought it was new money until we realized it was coming from the OHIP-fees paid to private community clinics – most of them for-profit and owned by four companies. The last time the province had licensed a private physiotherapy clinic to do OHIP work was in the 1960s. The private clinics did issue a legal challenge over getting dropped from OHIP work. After that challenge failed, they shrugged it off and said their business would be largely unaffected.

7. Second deadline for PSW Registry is cancelled – for now

Back in 2012 the Minister of Health announced with much fanfare the creation of a PSW Registry. That registry was supposed to provide a level of accountability by maintaining a province-wide list of qualified personal support workers. Where it got sticky is around the rules for taking a PSW off the list – which would effectively end their career in Ontario. Instead of working out how the Registry would function before launching it, Deb Matthews announced what would become a work in progress. Registration was supposed to be mandatory, but we were told in March that it had become entirely voluntary – at least for now.

8. OHA silent about sudden departure of CEO and President

There was a lot of interest  when former Mike Harris aide Anthony Dale became interim CEO and President of the Ontario Hospital Association in June.  Everybody wanted to know why the sudden departure of Pat Campbell had taken place. We still don’t know. Last Thursday Dale had “interim” taken off his title.

9. Perram House: Why health professionals increasingly don’t want to work in community agencies

It broke our hearts when the Perram House board decided to close its doors in the middle of first contract negotiations with the staff of the downtown Toronto hospice. The closure had come just after the workers chose to take a strike vote rather than accept a wage rollback. After years of wage freeze for most, they were fed up. We recently came back to the site for an unveiling of a sign by two Toronto artists who call themselves the Department of Public Memory.

10. Bargaining: St. Elizabeth drops from top employer lists

St. Elizabeth Health Care used to boast they didn’t need no union. The thing is, it wasn’t really management’s choice. After having dropped from the top employer lists, workers at St. Elizabeth got a lot more interested in bargaining collectively. While top execs at St. Elizabeth have successfully ducked disclosure on the sunshine list, we revealed in this story that at least one employee had been reported on Open Charity as earning more than $350,000 a year – a far cry from what the front line workers were receiving. Who could that be? Hmmm.

What was learned?

For close to a decade we opposed the competitive bidding process in home care. The competitions for service destabilized the sector and drove many health professionals to seek employment elsewhere. It raised administrative costs. The NDP called it “cutthroat bidding,” which was pretty close to the truth.

Finally after a series of moratorium, Health Minister Deb Matthews quietly let it be known the process was good and dead. Ding dong.

We first heard about it through a Tweet from RNAO CEO Doris Grinspun. It was later confirmed by the Ontario Association of Community Care Access Centres.

It felt like a weight lifted off of us, even if the alternative the OACCAC is working on now gives us significant pause.

So why was Deb Matthews so reluctant to simply come out in public and say so?

When the Local Health Integration Networks were created in 2006, we saw the potential for the destructive competitive bidding model to be used in other sectors, including hospital services. When we expressed those fears, the government suggested that we were fear mongering.

Fear mongering no more: On December 17 the government quietly unveiled plans to do just that. Beginning next year the Local Health Integration Networks will be accepting bids to establish non-profit specialty clinics that will conduct such traditional hospital procedures as cataracts, dialysis, colonoscopies, endoscopies, outpatient minor orthopaedic procedures and diagnostic services. Funding will be from the pool of money hospitals have been relying upon in the wake of a base funding freeze. The procedures will be invoiced through OHIP. It will place hospitals in competition with private clinics.

Continue reading →