CEO Peterkin leaves, many questions left unresolved

Bruce Peterkin has left the building. The MICs Group of Health Services has told the media that the controversial CEO of three northern Ontario hospitals no longer holds his position. When the Timmins Daily Press recently called Peterkin, they report he declined comment and abruptly hung up.

There is now talk that the healing process has begun following a lengthy struggle between members of the community and leadership at the hospital.

While Peterkin may have been a lightning rod for the wrath of many, it doesn’t mean all issues are resolved.

Last month a letter was sent to Health Minister Deb Matthews by the Ontario and Northeastern Health Coalitions taking issue with several details of a scathing investigator’s report that sparked the appointment of Hal Fjeldsted as the Ministry-appointed supervisor for the Anson General in Iroquois Falls. Fjelsted is now serving as interim CEO of all three MICs hospitals, including Matheson and Cochrane, upon the invitation of those two other boards.

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Funding structure leaves psychologists out of team-based care

Pop Quiz: Who’s the biggest direct employer of psychologists in the country? If you guessed Corrections Canada you’d be absolutely correct.

There’s two primary ways to get public coverage for the services of a psychologist in Ontario – commit a crime or get admitted to one of the province’s psychiatric hospitals. Given the continual shrinking of those hospitals, the crime might be the better bet.

Speaking Thursday to leadership from OPSEU’s Mental Health Division, Karen R. Cohen says psychological treatments not only work, but also reduce reliance on other health practitioners. The CEO of the Canadian Psychological Association says 70 per cent of problems brought to family physicians are for or related to mental health. Those physicians are frequently at a loss to meet that need.

Part of the problem is access to treatment. Psychology got left out of the core services Medicare was intended to cover, leaving patients with the choice of paying out of pocket or, if they have it, accessing their employer health benefits. For many without means, there is no choice at all.

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Scarborough-Rouge: No merger decision, but hospital still selling benefits

If this were the private sector, you wouldn’t have the board of a $352 million organization sitting in such uncomfortable chairs.

Despite signs of modest economic recovery, it’s still hard times for many of Ontario’s hospitals, including The Scarborough Hospital. October 1st the TSH board met at the Birchmount Campus to conduct the hospital’s business.

Struggling financially – their line of credit recently increased to $30 million – the hospital is now facing an all-consuming discussion of merger with the somewhat healthier $326 million Rouge Valley Health System.

Maybe once they are a $678 million joint entity the chairs destined for board meetings will at least get better.

While engaged in an open and transparent process around the merger, there are clear signs that public engagement is not so much about gathering input to make a decision, but finding pockets of community opposition and trying to win them over to what appears to be a done deal. TSH CEO Robert Biron insists no decision has been made but continues to promote the benefits of merger.

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Short takes: “Scrouge Hospital,” Ontario Shores WSIB surcharge and more

The proposed merger between The Scarborough Hospital (TSH) and the Rouge Valley Health System has been unprecedented in its overall transparency. If anything, we have been inundated with information. But so far there has been no discussion of what the merged super hospital would be called. Given the merger appears to be driven by cost – the two hospitals are trying to deal with a potential combined deficit of $28 million by next year as a result of funding decisions made at Queen’s Park – there is no question that all the happy talk will soon give way to discussion of “hard decisions.” It will doubtlessly be “hard” for the deciders, even harder for those likely to lose their jobs or for patients losing access to care. Given this dynamic, we thought the new name was rather straightforward. Combining the two names together, one emerges with the “Scrouge Hospital.”

During yesterday’s TSH board meeting it was clear that important initiatives at the hospital were getting parked as a result of merger discussions. Board Chair Steve Smith indicated that committees formed around governance and planning as well as human resources were being placed “in abeyance” while merger talks proceeded. One board member questioned whether a proposed capital IT expense would be wasted if the merger took place (the answer was ‘no’). Rhonda Seidman-Carlson, Vice President of Interprofessional Practice told the board that elements of the clinical practice plan had to be “slowed down” slightly. CEO Robert Biron told the board that he felt more like the VP of Integration. His entire verbal report dealt with the merger. Denis Lanoue, representing the community council, told the board that his members were concerned that the merger would become a distraction to the hospital’s efforts at system transformation. No kidding! (More on this tomorrow).

For several years now we have been writing about the struggles of the OPSEU local at Ontario Shores to improve the health and safety environment at the psychiatric hospital. Despite a significant number of Ministry of Labour orders earlier this year, the mental health facility is still reporting an unacceptable level of workplace incidents leaving staff with both mental and physical injuries. It occurred to us that this must be having an impact on the WSIB premiums the hospital is paying. The Workplace Safety and Insurance Board either gives hospitals rebates or surcharges depending on their safety track record. Evidently the impact of the ongoing problems at Ontario Shores’ is costing them dearly. The last surcharge/rebate list from WSIB shows that Ontario Shores paid an additional $259,668.25 in surcharges to the insurance board. While there have been bigger surcharges levied on hospitals, relative to the size of Ontario Shores’ $119 million budget this is a whopper.

Finally, a new article in the Canadian Medical Association Journal highlights some key changes in Ontario hospitals between 1994 and 2009. Written by Carl van Walraven, MD, MSc, the article notes that hospital use dramatically decreased (from 8.8 per cent of the general population to 6.3 per cent). Patients became significantly older – the median age rising from 51 to 58 – as well as more acutely ill on admission. That might be reflected by the proportion of patients brought to hospital by ambulance — dramatically increasing from 16.1 per cent to 24.8 per cent. “Risk of death at one year for people admitted to hospital remained significantly lower in 2009 than in 1994,” writes the author.

Still waiting for “earliest possible opportunity” to regulate patient transfer

“This is a case where the wheels are literally falling off the bus.” – Andre Marin, Toronto Star, July 16, 2013

Back in June 2011 the Ontario government promised legislation “at the earliest opportunity” to regulate the private patient transfer industry.

The first real promise of that election campaign, Health Minister Deb Matthews was prompt in her reaction to a scathing report by the Ontario Ombudsman that suggested taking a taxi was far safer than climbing aboard one of the province’s privatized patient transfer vehicles.

We’ve all seen these vehicles. They look like ambulances. Some have emergency lights just like real ambulances. The drivers often dress like paramedics. But that doesn’t mean they are.

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Mental health: Death should prompt MOHLTC to look upstream at root causes

It’s time for the Ministry of Health to look at the root causes behind the violence and injuries that are taking place in the province’s hospitals that provide mental health care.

Given persons who are mentally ill are no more statistically inclined to be violent than anyone else, clearly something is changing in these settings to push reports of violent incidents upwards.

While the union is privy to statistics around injuries experienced by its own members, we do not see the parallel data around patient-on-patient violence.  Why is it one can go on-line and look at the record of critical incidents at a long-term care home but not at a psychiatric hospital?

Sadly, workers being injured in such incidents barely make the news. Some believe that getting punched, spit at or slammed against a wall is part of the job (it shouldn’t be). Hospital managers and Ministry of Labour officials have shown little sympathy for workers suffering from post-traumatic stress disorder — surprising given where this is taking place.

Workers at these hospitals tell us repeatedly it’s just a matter of time before someone dies.

In fact, that time came this spring.

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Staggered by the contrasting realities of Ontario’s hospitals

We were reminded last night that Ontario hospitals live in very different realities from each other. When University Health Network CEO Bob Bell has a casual chat with Health Minister Deb Matthews, it is a very different reality from that experienced by many regional hospital CEOs.

Last night’s occasion: the annual general meeting of the Toronto General & Western Hospital Foundation – one of several foundations associated with the Toronto University Health Network (UHN).

This is a foundation that has successfully recruited from the city’s “high value” donors and pulled in a staggering $75.9 million dollars in 2012-13. Most of that money will be put towards cutting edge research that is producing laudable results.

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8,300 participate in merger telephone town hall

There were many questions but few detailed answers during the first telephone town hall meeting to discuss the possible merger of The Scarborough Hospital and the Rouge Valley Health System.

The hospitals report that 8,300 people participated, although the one-hour time frame only allowed for 17 callers to pose questions. Two additional callers disappeared while waiting in the queue.

Perhaps the most interesting point the hospitals made was one of omission. Several times during the call the hospital CEOs emphasized that no emergency rooms would close, all four sites would remain open, and that existing patient care services would continue to be delivered at Rouge. No such parallel service commitment was made around The Scarborough Hospital.

The hospital CEOs appear convinced that the merger of the two hospitals will deliver efficiencies of scale and allow them to reduce administrative costs. No examples of other hospital mergers were given as evidence that this can work. One caller specifically asked how this would be different from previous GTA mergers, such as that of North York-Branson? As if to confirm their fears, Rouge CEO Rik Ganderton said that it had taken them some time to “consummate” the original merger between Centenary and Ajax-Pickering hospitals.

This is an issue the community should push on given the track record of Ontario hospital mergers has been spotty. In Niagara, for example, there is discussion that perhaps the merged Niagara Health System is too large to be workable.

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Ontario’s austerity policies self-defeating — Hennessy

Ontario CCPA Director Trish Hennessy speaks in Whitby last night.

Ontario CCPA Director Trish Hennessy speaks in Whitby last night.

There are many ways to tell a story.

For Trish Hennessy, Ontario director at the Canadian Centre for Policy Alternatives, one way is to look at the most searched word annually for the on-line Mirriam-Webster dictionary.

Speaking last night at the Whitby Courthouse Theatre to a group of Durham-region New Democrats, Hennessy noted that in 2010 the most searched word was “austerity.” A year later it was “pragmatism.” In 2012 there was a tie between “socialism” and “capitalism.”

“Clearly something is shifting,” she said.

Many young people are being left out of the post-recession recovery and are now questioning the economic and political system that is denying them their place in society.

Hennessy says Ontario is practicing a self-defeating logic with its austerity policies. While the Wynne government cuts jobs and freezes wages, they simultaneously expect there to be a consumer-driven economic recovery. How does that take place when for the majority wages are stagnant or in decline?

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Not your Bill Davis Tories: Ont PCs formally adopt U.S. tea-party labour politics

The Ontario PCs almost walked away from the brink this weekend.

Last year the provincial Tories introduced a white paper advocating U.S.-style labour policies that would undo the rights working people have had in this country for more than a half century.

Rather than float such radical policies as a trial balloon, MPPs defended the policy over the past year likely knowing that it would take them a far distance out of the political center. While former PC leader John Tory openly advised getting rid of it, the party convention instead formally adopted the policy this weekend, but only barely. Only 45 per cent of delegates voted in favour.

Taking a page out of the tea-party playbook, the Tories now approach a likely spring election with a glaring hard turn to the right.

The question is: will they be able to convince working people to vote against their best interests? Such radical U.S. policies have not only had a devastating effect on labour unions, but have done much to gut the middle class south of the border. As people fall down the economic ladder, it’s not difficult to convince them to resent those who are still hanging on to the rungs just above them. They can seldom see it is only those towards the top that still have room to climb.

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