Hospital CEO resigns after board rejects “improvement” plan

Staff of the Perth and Smiths Fall District Hospital were told today CEO Todd Stepaniuk has resigned. Stepaniuk, who helmed the organization for 12 years, appears to have lost a battle with his board over the hospital’s performance improvement plan.

Staff was told that Toronto East General Hospital CEO Rob Devitt will be instead leading a four-member peer review team to find ways to eliminate a rising deficit at the district hospital. Last year the hospital finished with a $700,000 deficit, expected to rise to more than $2 million this year. Devitt’s team will begin their work July 13 with their recommendations expected in September.

The hospital was supposed to submit a performance improvement plan (PIP) to the South East LHIN in May, but the board rejected the proposals brought forward by Stepaniuk and the Senior Management Team.

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Could it happen here? P3 hospital costs leading to meltdown of health care in the UK

If you wanted to see the future of Ontario’s health care, there used to be a time when you could simply fly to Tony Blair’s Britain and have a look.

Blair couldn’t privatize fast enough, creating more than 200 PFI projects – private finance initiatives – to replace aging infrastructure.

It really was the ‘no money down’ miracle. Hospitals, schools and roads were all built using private money. These facilities would be run by the private consortia for periods typically between 25-30 years, although some for as long as 60 years.

Typically no money down usually translates into whopping high borrowing costs, costs that will have to be paid back some day.

Now the PFI party is over in Britain, the country is experiencing one helluva hangover.

Ontario has initiated more than 30 hospital projects under similar schemes, the most notorious being the William Osler Health System in Brampton. The Osler public-private partnership (P3) has been well documented as a costly blunder. The Ontario Auditor General highlighted almost $400 million in higher costs to develop Osler privately. This does not include the almost doubling of construction costs between the first estimates and the final contract sign off.

P3s are North America’s version of the PFI. In Ontario, just to add to the confusion, these are sometimes also called AFPs – alternative financing and procurement projects.

Like the UK, the more disastrous these deals looked, the more the government kept on signing new private deals.

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Press conference aborted after doc asks question about cuts to refugee health plan

University Health Network CEO Bob Bells tried to apologize after a doctor and a medical student interrupted a press conference by Federal Natural Resources Minister Joe Oliver at the Toronto General Hospital yesterday.

Is this really Dr. Bell’s role?

The doctors vow to “interrupt” the Harper government over their cuts to the Interim Federal Health plan for refugees to Canada due to take place June 30.

The cuts remove so-called supplemental health services from newly arrived refugees, the Harper government stating that these are not services normally covered for most Canadians. This is not entirely true.

In fact, similiar health services are normally made available to Canadians on social assistance. Most refugees arrive in Canada without money for dentistry, drugs and other non-insured services.

As Dr. Chris Keefer states in the video, these are similiar to services available to Ontario Works recipients.

CBC’s clip of the aborted news conference is below:

 

Read about the open letter sent by AMMI Canada regarding the Harper cuts.

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Technology: Will docs battle Watson for your diagnosis?

Healthcare has always experienced a love-hate relationship with technology.

New technologies have certainly both contributed to costs and reduced costs.

There has been considerable literature on how expensive new technologies become unnecessarily overused, and as the recent showdown with Ontario doctors demonstrates, can also be a catalyst for savings when procedures take less time and resources.

Can new technologies replace doctors altogether?

IBM’s Dr. Martin Cohn says no, although looking at the company’s healthcare applications for Watson, what is sometimes referred to as “IBM’s artificial intelligence computer,” it is not hard to see it becoming a major part of any doctor’s diagnostic process.

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Operation Maple: Funny video looks at ways public services touch our lives

Operation Maple are at it again. Interviewing people on the street of Toronto, several claimed that they “don’t use public services.” Oh really? Upbeat and funny, the video looks at how many ways public services can touch our lives in the course of day. Check it out the homage to “It’s A Wonderful Life,” or was that “A Christmas Carol?” The video is produced in conjunction with NUPGE’s All Together Now Campaign.

Check out the Operation Maple site for other clever videos on current issues.

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Changes to Interim Federal Health plan places communities at risk — AMMI

Changes to the Interim Federal Health plan for refugees may result in higher costs and place communities at risk says the Association of Medical Microbiology and Infectious Disease Canada (AMMI).

In a June 18 letter signed by AMMI President Dr. A. Mark Joffe, the association says they “strongly disagree” that the changes will protect public safety.

The Federal program provides a bridge to refugees who may not yet be eligible for provincial health plan coverage.

Jason Kenney, Minister of Citizenship, Immigration and Multiculturalism announced cuts to the program in April, removing supplemental coverage such as dentistry, drugs, vision care and mobility assistive devices.

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PSW registry up and running despite unresolved key issues

Health Minister Deb Matthews rose in the legislature to announce June 13 the new PSW Registry is up and running. Initially PSWs (Personal Support Workers)  in the home care sector are being asked to sign up, followed by those working Ontario’s long term care homes.

This is the same registry the Health Professionals Regulatory Advisory Committee (HPRAC) recommended against in 2006 after extensive consultations with PSWs, employers, clients and other stakeholders.

HPRAC instead recommended additional steps to be taken to “improve PSWs education and training, staffing and supervision, and to provide better access to satisfactory recourse for patients and clients as a means of addressing instances of abuse and misconduct.”

HPRAC felt the cost of establishing such a registry would be prohibitive compared to the benefits it could generate.

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Are “high hazard” nursing homes “efficient?”

In BC they have a ratings system for residential care homes, or what we would refer to as “long-term care” homes in Ontario. The ratings look at complaints and critical incidents and determine whether a home is low, medium or high hazard. The hazard rating determines how often the home will be inspected. A high hazard home in BC can count on a surprise inspection about every three months.

In Ontario Health Minister Deb Matthews would simply rather not know.

She has too few inspectors, and the complaint and critical incident inspections are taking way too long – a point the Ombudsman made in 2010. The more in-depth resident quality inspections are taking so long it will take more than five years to fully inspect all the homes, that is “if” they get inspected at all.

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Seniors’ Care: What a difference an Ombudsperson can make

In February the British Columbia government received a 216-page report on seniors care. In it are 176 recommendations covering home care, assisted living and residential care. It is the second major report on senior’s care in that province since 2009. Both reports were investigated and prepared by the BC Ombudsperson.

BC walks the talk on integration: the Ombudsperson includes many recommendations to bring consistency to seniors’ care in that province.

It also makes important recommendations around mandatory staffing standards — something Ontario has resisted for years. The BC Ombudsperson pointed out the inconsistency between the province’s handling of vulnerable seniors and vulnerable children, of which there are measurable staff-to-children ratios for child care facilities but not for seniors’ care.

The BC Ombudsperson says the regional health authorities were asked to work towards a staffing level of 3.36 direct care hours per resident per day, but failed to achieve it despite a new residential rate structure that was introduced in 2010.

By comparison, Ontario maintains that its nursing homes have an average of 3.0 hours of care per resident per day, but Ontario counts paid hours, not direct care hours. Nor is any of this made mandatory by legislation.

As the BC Ombudsperson points out, “measuring the hours that staff provide direct care is more precise than measuring the number of staff hours because it accounts for the fact that not all staff provide direct care, and the even those who do also have other duties to perform.”

In Ontario the Ombudsman’s office is shut out from investigating long-term care homes. Andre Marin points out that the Ombudsman has authority over long-term care in most other provinces.

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Ontario has fewer nursing home inspectors than U.S. States

Ontario fares poorly compared to other jurisdictions when it comes to inspecting its 641 nursing homes.

Last week we pointed out the impossibility of about 70 nursing home inspectors being able to investigate nearly 6,000 complaints and critical incidents as well as conduct 120 in-depth resident quality inspections. At that rate, it will take more than five years before every Ontario long-term care home receives a thorough inspection.

While using a made-in-the-USA inspection regime, it is not putting the same number of inspectors on the job as most US states.

Faced with public outrage over the treatment of seniors in their nursing homes, the State of Illinois recently passed a new law requiring one inspector for every 500 beds. If Ontario had the same law, the number of inspectors would more than double to 154.

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