UK hospitals can’t compare notes on the price of private care

Public hospitals in the UK are no longer able to compare prices charged for private care in their hospitals.

Eight hospital trusts in England have provided assurances that they will not exchange pricing information after a whistleblower complained that the hospitals were violating the UK’s Competition Act.

England’s public hospitals have been engaged in private health care delivery for some time, the average hospital taking in about 1.1 per cent of their revenue from private insurance and those willing to pay out-of-pocket. Some are much higher – The Royal Marsden Hospital, which specializes in cancer care at its London and Surrey locations, takes in nearly a third of its income from private care.

The hospital trusts had been under a cap that allowed no more private care as a percentage of their overall revenues than existed in 2003. This October the situation will dramatically change, the cap being raised to 49 per cent of a hospital trusts’ revenue. That could mean more than half a public hospital’s beds could be effectively privatized and leave NHS (National Health Service) patients lingering longer on wait lists.

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Is the OHA next to experience public wrath over executive bonuses?

It seems there are two choices with regards to executive compensation.

The first is to simply place executives on salary and expect them to do the job they get paid for. That’s how rank and file employees get paid.

The second is to divide compensation, setting out a certain amount as “base” salary, the rest as bonus based on established performance benchmarks.

The Local Health Integration Networks can also claw back a percentage of a hospital CEOs salary if the hospital fails to live up to the terms of its accountability agreement with the LHIN – not that we are aware of this ever taking place.

The LHINs themselves may be a bit gun-shy about using these powers given they themselves are struggling to meet their own performance targets. The Erie-St. Clair LHIN, for example, missed 11 of 14 performance targets for 2010-11.

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Fun with funding – for profit “envelope” gets biggest share of increase

Provincial long-term care funding is delivered to Ontario’s nursing homes bundled in what the Ministry likes to call “envelopes.” These figures are allocated for each resident under care.

There is an envelope for nursing and personal care, another for program and support services, one for raw food costs, and a fourth for accommodations.

August 9 the Hamilton Niagara Haldimand Brant LHIN sent out a memo outlining the increase in funding for each of these envelopes.

The per diem for nursing and personal care will rise by 1 per cent – or 86 cents – to $86.91. The per diem for program and support services will rise by just 8 cents to $8.43. Despite rapidly rising food costs, homes will only get 22 cents more per day to provide three meals, snacks and drinks. Homes receive $7.68 daily for raw food costs. The biggest winner will be the accommodations envelope, which will rise by $1.09 to $52.17.

Guess which of the four envelopes for-profit homes are allowed to draw profit from? If you guessed accommodations, you would be correct.

Given all the problems with care and support in Ontario’s nursing homes, this appears to be a very odd priority.

Ontario gets worse grade than feds on CMA report card

Ontario is the only region in Canada to receive a worse rating than the federal government on how it deals with health care according to the Canadian Medical Association’s National Report Card for 2012.

The report card represents a poll of Canadians conducted in July by Ipsos Read Public Affairs.

Given most Canadians likely couldn’t name the Federal Health Minister, Ontario’s inferior ranking is a curious result.

Federal Health Minister Leona Aglukkaq has been largely invisible to the public. When questions started getting asked about the federal response to the Sandoz drug shortage, for example, Aglukkaq was largely missing in action.

Despite federal sponsorship of the Mental Health Commission of Canada, Aglukkaq was a bit player at the launch of the Commission’s strategy earlier this year, her speech uninspired, her commitments no more than a nod to fund ongoing research.

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Economic downturn taking toll on health of Canadians – CMA report card

The economic downturn is taking a toll on the health of Canadians according to the Canadian Medical Association’s annual report card.

The report card represents a poll of Canadians conducted in July by Ipsos Read Public Affairs.

According to the report:

• More than one in four Ontarians (27%) say they agree the economic downturn has impacted their health – 7 per cent say they agree strongly. Nearly one in three Quebecers (32%) say their health has been impacted.

• More than one in three Canadians (34%) say that they feel stressed and/or overwhelmed as a result of financial concerns. The number rises to close to half (46%) among those who earn less than $30,000 per year.

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Hospital cuts in the new gilded age

We’ve heard it all before – there’s no money and cuts have to be made to some of our most cherished services, including hospitals. But is it true?

The Chatham-Kent Health Alliance is just the latest hospital to announce cuts to cope with a freeze in base hospital funding this year. Last week it was reported the hospital was closing 22 beds and cutting 23.5 full-time equivalent jobs. With these cuts, the hospital is still expecting to run a $1.3 million deficit this year.

While we are told there is no money for public hospitals, there have been some revealing stories in the last few weeks to suggest that there is an “Everest” of cash out there, much of it held by corporations that have been bleating for the necessity of even lower taxes.

A report at the beginning of July by economist David Madani noted non-financial Canadian companies have acquired a pile of cash that they are neither investing nor paying out in dividends to shareholders. The amount is staggering — $526 billion.  That’s an increase of 42 per cent since the end of the most recent recession.

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Operation Maple: Lack of inspection, staffing a cocktail for disaster in Ontario’s nursing homes

Ontario has too few staff caring for residents in its long-term care homes. Coupled with too few inspectors — most homes have not had a detailed inspection since 2009 — it is a cocktail for disaster. How many scandals will it take before the province keeps its words and really protects some of our most vulnerable citizens?

OPSEU’s Rick Janson speaks about the lack of staffing and inspection at Ontario’s long-term care homes in this new Operation Maple video. Also featured is OPSEU member Tamara Lazic, who speaks about her grandmother’s last days in one of these homes.

Editor’s Picks: Some recent stories you may have missed

It’s time for our summer break. We won’t be posting again until mid-August, but you may want to explore some of the almost 600 articles that are already up on our site. This year we won an award for best web content by the Canadian Association of Labour Media. We are also nominated in two categories for the fall Ninjamatics BLOG awards. Find out why!

Here are some important stories you may have overlooked from the last few months:

New funding mechanisms for hospitals both good and bad

There’s both good and bad in the province’s new funding formula for hospitals. At last there is some rational to how hospitals receive their funding. That’s the good news. The bad news is that with a freeze in base funding, some hospitals will actually see their revenues decline as the new formula is implemented. Further, the government is effectively creating a price competition for certain procedures that will reallocate services not according to where they are most needed, but to hospitals that can deliver them for the least amount of money. For more, click here to read our June 29 post.

We told you so: P3s having adverse effect on health care in the UK

Ontario has embraced the idea of public-private partnerships to build and operate new public hospitals. Following the British model, it was intended to be the no money down miracle. Now the UK is finding out that the model has some very negative consequences, particularly as the Cameron government implements its own austerity budget. For more, click here to read out June 27 post.

Mental Health: Who will buy into the new federal strategy?

In May the Mental Health Commission of Canada launched its new mental health strategy with much fanfare. There is a lot to be recommended in it. The problem is it comes at a time when the federal government believes it has no role in health care beyond cash transfers. It also comes at a time when the provinces are more fixated on bringing down health costs than investing in new initiatives. Pity.  For more, click here to read our May 8 post.

Unemployed docs: You don’t want fries with that

Dr. Sacha Bhatia, the former health care advisor to Premier Dalton McGuinty, says we are about to face a surplus of doctors. This comes at a time when the Federal government is changing the rules around employment insurance. A coincidence? Click here to read our tongue-in-cheek posting from May 25.

Falls Prevention: Will the LHINs overcome the impact of delisting and fiscal restraint?

The LHINs are presently working on a strategy to reduce the number of seniors injured from falls. We applaud the idea of looking towards more upstream solutions. However the route to falls prevention seems to be littered with poor decisions by government on everything from leaving out public health units from the LHIN structure to delisting services that could actually help reduce falls. To read our April 30 post, click here.

Fixing long-term care not one of Deb Matthews’ choices either

Whenever a reporter interviews Health Minister Deb Matthews, she can’t help but  add a comment — no matter the subject — to the effect that her cuts to doctor’s fees are a matter of making choices. Cuts to docs means more funding to where it is really needed, or so the idea goes. One place she isn’t reinvesting those savings is in long-term care, where she mostly ignored the 18 recommendations made by her own task force. Fixing long term care is not one of the choices she is making.  To read our May 17 post, click here.

Zero tolerance for abuse and neglect? Hardly.

While she fails to reinvest in long-term care, Health Minister Deb Matthews would also rather not know about the impact. Matthews now says long-term care homes will not have to undergo an annual inspection despite what it says in the McGuinty government’s own Long Term Care Homes Act (2007). To read our June 13 post, click here.

McGuinty says he needs majority to take hard-line against labour

Early this summer the Tories released an extreme-right labour platform that would take Ontario’s labour-relations environment back to the 19th century. They must have felt McGuinty was infringing on their turf when earlier this year the Premier told the news media that he needed to regain his majority government to take a hard-line against labour. If you are a Ontario health care worker, this is not looking good. To read our May 3rd post, click here.

Is Canadian Blood Services rolling the dice on the future security of needed plasma products?

It started out as a simple closure story. Canadian Blood Services said they had 10,000 units of plasma too many. As a result, CBS said they were closing the Thunder Bay Plasma Clinic, which produced 10,800 units annually. This seemed fairly straight forward until we realized CBS was simultaneously increasing imports of surplus American plasma. Then there was news of two very large plasma collection centers being opened in Toronto by a private for-profit company that CBS says it has no ties to.  What the heck is going on here? Read our May 15 post by clicking here.

Have a great summer and don’t forget to check us out again mid-August.

Ontario hospitals: Only Mexico to pass to reach the fewest beds per capita

Here’s a given – as Ontario hospitals start to shed services and staff in the next three years, the government is inevitably going to proclaim the benefits of serving patients in the community.

The Canadian Institute for Health Information recently released a report showing Ontario has not only the fewest beds per capita in Canada, but the second least in the 34 country OECD (Organization for Economic Cooperation and Development). Only Mexico has fewer beds per capita – for now.

In fact, the number of Ontarians hospitalized in 2010-11 was not only the lowest in Canada, but it was down 33.5 per cent from what it was in this province during 1995-1996.

Tom Closson, the former Chair of the Ontario Hospital Association, told the Toronto Star June 22 that the province has lost 50 per cent of its hospital beds per capita over the last two decades.

Ontario has just two beds per capita for every 1,000 residents.

Two.

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Drug shortages: Sandoz crisis prompts hospitals to kick drug habit

Sandoz may find that demand for its intravenous drugs may not be what it once was.

This winter the multi-national drug company was pressured by the U.S. Food and Drug Administration to fix problems with the production line at its Boucherville, Quebec plant. The result was a dramatic cut in production to retool the line, affecting delivery of intravenous drugs to hospitals across Canada.

Hospitals were left scrambling, wondering why Sandoz hadn’t given them more notice of the problem. Sandoz was aware of the problem in November, but didn’t notify hospitals until February.

Peterborough This Week recently reported that since the shortage began, the Peterborough Regional Health Centre has coped well, including cutting its morphine usage in half. No surgeries have been cancelled.

“Many of the new measures put in place this year will most likely long outlast the shortage,” Arnel Shiratti, director of strategic communications and engagement at PRHC, told the newspaper.

The hospital credits the pharmacy team and the anesthesiologists for guiding the hospital through this unplanned shortage.

Health Canada said it would fast track approvals to import alternate supplies from outside the country.

Production at the plant is not expected to deal with the national shortages until mid to late 2013.