LHIN warns merger of two Toronto hospitals could undermine access and quality

Posted on February 24, 2012 | Leave a comment

As The Scarborough Hospital (TSH) openly advocates for a merger with the Toronto East General, CEO Dr. John Wright may have difficulty persuading the Central East Local Health Integration Network of the merits of bringing the two hospitals together.

In a preliminary report recently posted online, the Central East LHIN raises a number of concerns, including the fact that such a merger does not align with their clinical services plan.

The CE LHIN states there is no evidence that “this will improve quality or access,” suggesting that it may possibly undermine it.

The LHIN states that the current activity is not client-focused, lacks a clear engagement strategy, and has not garnered physician support.

They further state there is no evidence to suggest a merger would assist in addressing population health challenges within Scarborough.

The LHIN suggests that if TSH is interested in an alliance, that it would make more sense to look towards “integration” with the Scarborough Centenary Hospital, which is part of the Rouge Valley Health System.

This is not the first time that suggestion has been made. Community groups in Ajax, who have never been happy having their hospital linked to Scarborough Centenary, have long advocated that Centenary should join TSH, leaving the Ajax-Pickering Hospital to link to Durham’s Lakeridge Health.

No application has yet been made by the two hospitals to proceed with a formal merger.

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CEO says he wants to increase power base through Toronto hospital mergers

Posted on February 24, 2012 | 1 comment

After all the talk about system integration it’s notable that the CEO of a Ontario public hospital should argue for a merger on the basis of enhancing the institution’s power base.

This hardly strikes us as being in sync with the present evidence-based narratives emerging from the Drummond Report or the Minister of Health’s new action plan. Isn’t health planning supposed to be about providing care in the right place at the right time by most appropriate provider? The “power” scenario suggests the province may be making decisions on a different basis.

It is even more surprising given one of the two potential dance partners in the merger is Rob Devitt, CEO of the Toronto East General Hospital.

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Drummond Report: Will Ontario health professionals again be Alberta Bound?

Posted on February 23, 2012 | 5 comments

While the Drummond Commission talks about the need for recruitment and retention of health professionals and “leaders”, much of the rest of the Commission’s labour relations recommendations may send health professionals off in search of greener pastures.

Drummond avoids the question as to what happens when Ontario brings down the austerity hammer while other provinces, such as Alberta, are rushing to enhance their health systems? Simple logic would suggest that doctors, nurses, lab techs, therapists and other professionals in high demand may all be learning the lyrics to Gordon Lightfoot’s “Alberta Bound” real soon.

Is this where McGuinty really wants to go after creating HealthForce Ontario to plan HR needs?

Drummond says wage freezes are ineffective because of the catch-up that follows, but recommends the government provide a zero budget increase for wage costs, forcing employers to find efficiencies to offset any settlements above zero.

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Drummond Report: CAMH VP supports more access to gambling?

Posted on February 22, 2012 | Leave a comment

One has to wonder about what role Susan Pigott played on the Drummond Commission for Public Sector Reform.

Pigott is one of four appointed Commissioners.

Piggott’s day job is Vice-President Communications and Community Engagement at the Centre for Addiction and Mental Health.

You would think, being one in four, her influence would have considerable impact on the final report. We read the Commission report expecting it would come out swinging in favour of good mental health and addictions policies.

And yet the Commission comes out squarely in favour of more access to gambling.

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Quebec patients told to pay up if they want to jump the queue with the same physician

Posted on February 21, 2012 | Leave a comment

In Quebec patients are being told to wait two years for public care or pay $10,000 to have their surgery within two weeks with the same specialist.

Many specialists in Quebec work both sides of the street, with one foot in the public system, another in the private.

Are specialists deliberately dragging their heels on public appointments to pad their private practice?

Quebec’s Health Minister says the practice of inflating waits in the public system to push patients into the private system is untenable and has asked the College of Physicians to investigate.

The Montreal Gazette reported a year ago that such practices were taking place. They documented the case of a patient at Charles LeMoyne Hospital who couldn’t get an appointment with a specialist for two years, but could walk across the street and get an appointment with the same physician within two weeks.

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Drummond Report: Commission relies on unfounded assumptions about hospitals

Posted on February 21, 2012 | Leave a comment

One of the assumptions of the Drummond Commission report is that if health care services take place in a hospital, it is going to be more expensive.

As Tony Randall once expounded in an episode of television series The Odd Couple, when you “assume,” underlining parts of the word on a blackboard, you end up making an “ass” out of “u” and “me.”

Under such cost assumptions, Drummond recommends anything that isn’t acute care be delivered somewhere else.

The Commissioner does not say what those services would be, but it would be safe to bet it would include rehab, complex continuing care, mental health, palliative care, outpatient clinics and diagnostics, to name but a few. That’s a lot of service to come out of our public hospitals leaving us to wonder what would be left behind?

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OMA to Don Drummond – leave the doctoring to us

Posted on February 18, 2012 | 1 comment

Stewart Kennedy, President of the Ontario Medical Association, has posted a statement in response to the Drummond report.

Not surprisingly, Ontario doctors welcome recommendations to expand the Family Health Teams, where the auditor recently revealed generous incentives for doctors to sign up. At present, there are more doctors who would like to practice in the FHTs than there are opportunities available.

However, the doctors do take umbrage to Drummond’s suggestion that they are the highest paid in Canada. It is true that Ontario’s overall physician costs are among the highest per capita, but that does not mean the individual doctors are the country’s top earners.

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Drummond Report: How to manufacture a crisis

Posted on February 17, 2012 | 2 comments

Don Drummond certainly knows how to manufacture a crisis.

For several years now he has been telling us that public health care spending is out of control, and that if left unchecked, it would soon consume 70 per cent of the provincial budget. Since those projections, spending on health care has actually gone down as a share of provincial program spending, from 46 per cent to 42 per cent.

Oddly, despite a trend line going in the opposite direction, Drummond continues to maintain this forecast.

Now, as Commissioner for Public Service Reform, he is telling us that if we don’t enter into a period of extreme austerity, we will soon be the Greece of Canada.

Don’t break out the tzatziki sauce yet.

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Drummond Report: Will Dalton McGuinty really implement this mess?

Posted on February 17, 2012 | Leave a comment

Two days after the Drummond Report was publicly released it is fair to wonder what will actually be implemented for health care. After all, it is not Don Drummond running the province, but Dalton McGuinty.

McGuinty is the master of building firewalls between his policies and the decision-makers at Queen’s Park. For example, how many times did we hear McGuinty and his MPPs suggest unpopular health care decisions were not theirs, but those of the Local Health Integration Networks? Now Don Drummond is the latest lightening rod that separates a long list of nasty trial balloons from the politicians who would like to see how much austerity the public will accept.

The government treated the release of Drummond’s report much like it does the budget, locking up journalists and opposition politicians until the official release at 2:15 pm Wednesday. This is hardly standard protocol and suggests the government was taking the recommendations very seriously. Or was this just optics?

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Drummond Report: A surprise warning

Posted on February 16, 2012 | Leave a comment

Hidden among the many recommendations of the Drummond Commission is a surprise warning about the pitfalls of a Canada-European Union Free Trade Agreement.

Drummond points out that the $500 million in savings from the government’s generic drug pricing reforms could be wiped out if the province’s interests are not protected by the Harper government.

Harmonizing patent protection for brand-name drugs to European standards would keep generic drugs off the market for a longer time.

Drummond highlights the findings of a study done by Aidan Hollis (University of Calgary) and Paul Grootendorst (University of Toronto) who noted that if all three of the EU pharmaceutical intellectual property proposals are adopted, it will cost Ontarians up to $1.2 billion annually. Slightly less than half — $551 million, would be added cost to the government, whereas the rest would come out-of-pocket and from private employer health plans.

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