Auditor’s Report — Warning flags about diagnostic self referrals

Posted on December 12, 2012 | Leave a comment

Today’s release by the Ontario Health Coalition regarding the 2012 report by the Auditor General of Ontario: 

Toronto – The Ontario Auditor General’s report released today raises warning flags about inadequate access to care and the perils of for-profit privatization.

The Auditor General found wait times for long-term care that are extraordinary. Crisis clients are waiting more than three months for placement and wait times have tripled. The provincial Ministry of Health response did not mention the lack of long-term care beds, only its plans to download patients into home and community care where funding per client is lower than it was a decade ago.

In Ontario’s privatized clinics (Independent Health Facilities) the Auditor found inadequate monitoring, poor inspections, a lack of financial oversight and inequitable access to care. This is of significant concern as the government is moving more and more services out of hospitals into privatized clinics.

 Among the Auditor General’s key findings:

  • Waits for mammography are up to ten and a half months in some areas of Ontario (page 47) but mammography screening, particularly in smaller hospitals has been closed down and centralized out-of-town.
  • Almost one-third of patients who require follow-up colonoscopies are not receiving them within prescribed wait times, and wait times remain too long.
  • Wait times for long-term care placements have tripled since 2004, with median wait times at 98 days in 2011/12 (page 186). In March 2012 people in crisis waiting for long-term care placements had waited a median of 94 days up to that point; moderate-needs clients had waited 10–14 months; and most other eligible clients had been on the wait list “for years”. Further, during the 2011/12 fiscal year, 15% of clients died before receiving LTC home accommodation (page 187).

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Guidelines for media reporting of suicide need reconsideration – Picard, Goldbloom

Posted on December 12, 2012 | 1 comment
David Goldbloom and Andre Picard speak about media guidelines for suicide coverage.

Dr. David Goldbloom and Andre Picard speak about media guidelines for suicide coverage as part of a December 12th Longwood’s Forum.

If the audience was expecting a debate, they may have left disappointed.

Globe and Mail reporter Andre Picard and Dr. David Goldbloom, Chair of the Mental Health Commission of Canada, spoke about the media’s portrayal of mental health during a Longwood’s Breakfast with the Chiefs forum December 12.

While billed as being about mental health, much of the discussion centered around whether media reporting of suicide prompts copycat actions.

The issue is particularly timely given the Vancouver School Board has challenged the media in its reporting on the death of Amanda Todd, the teen who took her life after experiencing on-line bullying. The Board has suggested the media follow guidelines established by the Canadian Psychiatric Association for reporting on suicide.

Picard challenged the science used by the CPA to establish the guidelines and suggested that the “hush hush” attitude towards suicide actually created more stigma.

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If public sector workers have it so good, how come private sector firms dominate best employer lists?

Posted on December 11, 2012 | 1 comment

The Canadian political elite really needs to be much more consistent in their propaganda. They like to whip up antipathy towards public sector workers suggesting they are overpaid and pampered, but they may have overlooked that strategy recently in the rush to give themselves a pat on the back.

Ontario PC leader Tim Hudak uses such sentiment to advocate for public sector wage freezes and more recently has set his sights on attacking modest public sector pension plans.

Hudak is banking on a policy of reducing the modest pension incomes of seniors as a vote getter. Good luck with that, Tim.

But if things were indeed so cushy for public sector employees, you’d think public sector employers would absolutely dominate year-end best employer lists, especially given these lists are made up by the same media conglomerates that peddle this anti-public sector message.

On Monday the Globe and Mail published its top 20 list of Canada’s top family friendly firms for 2013.

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Who should you trust? Former PC advisor shills in the Star for private health care

Posted on December 10, 2012 | 3 comments

Francesca Grosso says she is an established expert in health care policy. A former PC health care policy director, her day job these days is a principal at Grosso McCarthy, a public affairs company for hire.

So when she writes in the opinion pages of the Toronto Star, as she did on Sunday (What’s Behind The Attack On Clinics?), who is she really shilling for? Who paid for this?

The piece itself is full of misinformation about private delivery of health care, a situation that might be embarrassing to her professionally given her claims to expertise.

She argues that private clinics are getting a bad rap as a result of a Toronto Star series that reveals nine private clinics failed a quality inspection by the College of Physicians and Surgeons.

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Tory MPP Hillier supports cuts to hospital in his own constituency

Posted on December 6, 2012 | 1 comment

Tory MPP Randy Hillier is the Rob Ford of rural Ontario. He often makes headlines for all the wrong reasons.

His hatred of unions seems to be trumping common sense these days. Hillier recently wrote an editorial in the local media aligning his views with those of Health Minister Deb Matthews. Whereas most MPPs would stand up for their local hospital, Hillier is supporting deep cuts to the Perth and Smiths Falls District Hospital most likely because it is the local unions that are raising the alarm. It will be interesting to see how this plays out with an election likely on the horizon for 2013.

Hillier has bought Matthew’s inaccurate assertion that hospital cuts simply represent a transfer of services to community-based providers. We see Matthews’ interest is saving her own skin amid the obvious effects of austerity on Ontario’s health care system, but what’s in it for Hillier?

Perhaps Hillier should have a conversation with his own caucus members. Last year fellow Tory MPP John O’Toole characterized the government’s “Home First” initiative as the “Home Alone” initiative during a visit by the Ontario Health Coalition. Have they had a last-minute conversion to the Liberal cause?

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Are health services really shifting, or is the health minister being shifty?

Posted on December 6, 2012 | 1 comment
OPSEU's Rick Janson joins OHC Director Natalie Mehra for the release of the coalition's "Austerity Index."

OPSEU’s Rick Janson joins OHC Director Natalie Mehra for the release of the coalition’s “Austerity Index.”

We can all relax now. All those hospital cuts we’ve witnessed recently – Health Minister Deb Matthews says they are not happening.

She says these services are instead being shifted. Evidently we are all fools for not realizing that the 22 beds cut at the Chatham Kent Health Alliance just represent a transfer of services to entities like the Erie-St.Clair Community Care Access Centre, which is itself cutting $8-$10 million after the LHIN refused to allow them to run a $5.2 million deficit.

Hamilton Health Sciences says $25 million in cuts are planned and expects 140 jobs will be impacted. Perhaps Ms. Matthews can tell us where these 140 jobs are re-emerging in the Hamilton Niagara Haldimand Brant LHIN? And while she’s at it, where did the LHIN reallocate the 69 beds the Niagara Health System cut in the fall of 2011 and spring of 2012? We can’t seem to find them anywhere. Neither can the hospital, which had to cancel or postpone 758 surgeries due to “bed pressures.” Maybe those beds were needed after all.

Perhaps she can tell us where the after-hours clinic, pain clinic, audiology clinic and cardiac rehabilitation program closed by Toronto’s St. Joseph’s Health Centre shifted to? We can’t find them. Can she?

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What took so long for community funding to arrive?

Posted on December 3, 2012 | Leave a comment

Community health care received the biggest percentage increase from this spring’s provincial budget, signalling the government’s intention to transition more of the health system into home care and other community supports.

At four per cent clearly that transition is not going to be at an overwhelming speed, the money barely enough to cover inflation, population growth and the impact of an aging population. However, compared to the base funding freeze for hospitals, this looked like one sector that at least wouldn’t be scaling back health services this year.

For much of 2012 many home care watchers were wondering if and when the money would actually arrive in the sector. Finally in recent weeks there has been a series of announcements around new funding to Community Care Access Centres (CCAC) and other community-based services agencies.

The funding will extend beyond traditional home care. The Central East LHIN, for example, has allocated $9 million in funding to the CCAC, but there is more than $2.6 million more going to other recipients, including new and expanding adult day programs in Whitby and Peterborough, increased hours for the Nurse Practitioner clinic at the Port Hope Community Centre, expanding advanced addiction and concurrent disorders treatment capacity in Scarborough and Durham, more services for individuals living with acquired brain injury and increases in assisted living for a number of communities. The November 14th CE LHIN press release noted that $1.08 million was still not earmarked.

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“Ontario Health Links” initially intended to look at high users

Posted on November 30, 2012 | Leave a comment

Commisioner Don Drummond raised it in his report. Former OHA President Tom Closson frequently spoke about it. Five per cent of the Ontario population uses up about 40 per cent of the provincial health budget each year at an average per patient cost of $44,500.

The thinking is, if we better understood these “high users,” could we streamline the local services they receive and save money in the process?

There is no question that Ontario’s health system is incredibly fragmented and surprisingly getting more so as hospitals are urged to further divest services. The Local Health Integration Networks have been given the difficult task of turning a mix of independent private for-profit, private not-for-profit and public entities into a coherent public system for patients.

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Half of Ontario hospitals admit to recent outpatient physiotherapy cuts

Posted on November 30, 2012 | 1 comment

The last time the government granted a license to operate a OHIP designated physiotherapy clinic was 1964. This is the alternative government now wants patients to turn to after hospital-based outpatient physiotherapy is eliminated – an almost forgotten system leftover from 50 years ago.

The Designated Physiotherapy Clinics Association (DPCA) gives us a glimpse into the significant number of Ontario hospitals that are reducing access to outpatient physiotherapy services. The DPCA received back 120 surveys of Ontario hospitals in October 2011 and found 50 per cent had reduced outpatient physiotherapy services within the last two years. Further, another 16 per cent indicated that they had planned to do so before the end of that year. This is a significant policy shift with little to no public discussion.

The survey information was part of a DPCA press release this week. Faced with significant cuts to hospital physiotherapy, the DPCA proposes to pick up some of the slack, offering to soldier on at $12.20 per visit for another two years and even help out the CCACs with home care at $60 per visit – half of what they say the present costs are by contract home care agencies.

There are 94 of these designated OHIP clinics in Ontario and distribution reflects the population as it existed in 1964, not 2012. The City of Mississauga, for example, had a population of 156,070 in 1971 (it didn’t become incorporated until 1968). It has no OHIP designated physiotherapy clinics today despite a 2011 census population of more than 700,000 residents. On the other side of Toronto, Oshawa has three such clinics with a population of about 150,000.

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Unintended Consequences – Northumberland Hills CEO says replacing ALC patients comes at a cost

Posted on November 29, 2012 | Leave a comment

Reducing the number of “alternative level of care” (ALC) patients in a hospital may have unintended consequences.

Robert Biron, CEO of the Cobourg’s Northumberland Hills Hospital, told the Central East LHIN yesterday that his current operating deficit may be partially linked to the hospital’s success in reducing the number of ALC patients from a high of 36.8 per cent in December 2010 to a low of 2 per cent in June of this year.

Alternate level of care patients are those who have completed their acute care treatment at the hospital but are not well enough to return home. Wait lists for long-term care beds and home care services have left many hospitals without an ability to responsibly discharge these patients.

Biron says filling the former ALC beds with high acuity patients requires more resources, not less, including advanced nursing care. These are additional costs to the hospital in a year when base budgets are frozen.

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