CMA “national dialogue” supports expansion of Canada Health Act

The Canadian Medical Association has issued a report on its “national dialogue on health care transformation” – the results of six town halls (two in Ontario, one in Quebec, one in BC, Alberta and Nova Scotia) and its on-line consultation.

The report summarizes what the CMA heard, but makes no real recommendations.

“The message that came through most strongly from the public was the need to preserve and strengthen the current principles underpinning the Canada Health Act to ensure continued support for a universally accessible, publicly funded health care system,” the report states.

The report also made clear there was strong support for broadening the scope of the existing legislation. Various respondents spoke of the need of bringing dental care, eye care, drug coverage, long term care, home care, hospice care and care from alternate providers under the Act.

Not surprisingly, Maclean’s national editor Andrew Coyne filled the role of Chicken Little overstating the cost of health care, claiming it “is eating us alive.” Coyne claims 30 per cent efficiency can be had from reorganizing the system, but never points out where these savings would come from aside from making a pitch for more competition on pricing and decentralized funding.

When the public complained the Canada Health Act was not being enforced, Coyne invited them to vote NDP, claiming neither the Liberals or Tories would enforce the Act.

Dr. Danielle Martin of Canadian Doctors for Medicare said a public, single payer system is the best way to control health care costs, noting the cost of physician and hospital costs have been remarkably stable while drug costs have been the “Pac-Man” eating its way through provincial budgets.

The CMA concluded that Canadians suffering from unacceptable wait times, crowded hospitals and a lack of physician and other services were all signs the “once proud” system was under distress. While the majority felt underfunding was part of this scenario, others, like Coyne, believed the system was adequately funded but needed to be better organized.

Click here to download the full CMA report.

New Video: Operation Maple health care quiz

Operation Maple asks whether the Ontario Tories kept their promise to protect health care last time they were in power? 

Operation Maple is an independent video site that takes an alternate look at key issues in the news.

Watch the video below:

Election focuses the mind — and the pace of MOHLTC’s announcements

There’s nothing like an election to focus the mind on many long-standing complaints, especially if you are the Ministry of Health and Long Term Care (MOHLTC).

While many have been soaking up the sun this summer, the Ministry has been pushing out one announcement after another, bringing hospital expansions, new MRIs and even nurse-practitioner clinics to a town near you.

This week Health Minister Deb Matthews finally appointed a supervisor to investigate community complaints around the Niagara Health System – something Matthews admits has been on her radar since day one.

Similarly, August 5th the troubled Windsor Hotel Dieu hospital received $5 million in new money to hire nurses, add more administrative after-hours support, purchase new equipment and refurbish rooms. Former CEO Ken Deane was appointed supervisor in January.

At the end of July the Ministry announced a major redevelopment and expansion of the Cambridge Memorial Hospital. That will include an expansion of their ER to accommodate an additional 10,000 patient visits per year, a redevelopment of the mental health unit, 33 new medical/surgical beds, five new intensive care beds, two new maternal beds and four additional paediatric beds.

Brockville General will also get a similar major expansion. A new wing will include 48 complex continuing care beds, 29 rehabilitation beds and 29 acute mental health beds.

Hawkesbury and District General Hospital will also get a major expansion, although tenders won’t actually happen until 2013/14. Good thing we know about it now, just before the election.

A more modest expansion will also happen at Winchester District Memorial Hospital.

This summer it was also announced Barrie’s Royal Victoria Hospital will get a new MRI, as will Oakville’s Halton Health Care Services. Vaughan was reminded that they will get a totally new hospital aligned with nearby York Central. Peterborough will get a new nurse-practitioner-led clinic. Infrastructure upgrades will happen at Ross Memorial Hospital,

Long-standing complaints about doctors being overpaid due to advances in new technology were finally taken on with an amendment to the fourth year of the Ontario Medical Association agreement. The OMA is essentially giving back $223 million a year by reducing opthamology fees (including cataract surgery), payment for endoscopy services, and through a new payment model for methadone.

When the William Osler P3 hospital opened in Brampton, there was local concern about the fate of the Peel Memorial Hospital. This week a major redevelopment was announced, creating the Peel Memorial Centre for Integrated Health and Wellness. The new centre brings many services under one roof, including urgent care, preventative care for chronic care patients, diagnostic services and community learning programs. Construction is due to begin in 2013. No figure has been given on anticipated cost.

Earlier in the summer the McGuinty government vowed to regulate private patient transfer after a damning omdubsman’s report.

If the Ministry is reading, there are a few other announcements we’d like to see. How about a staffing standard for long term care, or ending competitive bidding in home care? How about a fix for Peterborough Regional Health Centre or a moratorium on bed cuts and staff losses at the province’s psychiatric hospitals? How about bringing back public coverage for some of the health services the McGuinty government delisted, such as physiotherapy and eye examinations? So little time to October 6th, so many more issues.

Will NHS supervisor rebuild public confidence?

The troubled Niagara Health System is getting a supervisor appointed by the Ministry of Health to take over the hospital.

According to the Ministry of Health news release, “these steps are being taken to restore necessary public confidence in the local hospital system. Despite the hospital’s best efforts, doubts remain about its ability to meet Niagara-area residents’ expectations of their local health care system.”

The appointment follows local pressure over more than 30 C. Difficle-related deaths at the hospital since May 28, although Health Minister Deb Matthews told the CBC that the issue is much more than that – that she had heard concerns about NHS right from day one of her appointment.

Much of the negative publicity the NHS has received stemmed from a hospital “improvement plan” that included closure of ERs in Port Colborne and Fort Erie and the planned transfer of maternity services to the new St. Catharines hospital.

The new hospital itself has been the focus of much criticism over the high cost of building and operating the facility as a public-private partnership.

This lengthy community turmoil was noted by the New Democrats. NDP leader Andrea Horwath told the St. Catharines Standard: “It seems to me that the Health Minister is the last person in Ontario to realize there’s a crisis in confidence in the Niagara Health System. Where has she been for the last couple of years?”

Matthews statement would suggest that the supervisor will have a much greater mandate than exploring hospital-based infections at NHS.

Unlike other hospitals where senior staff and board have been dismissed following such appointments, Matthews has made it clear that she expects the supervisor to work with existing staff and board.

Who gets appointed may be of concern.

The community may perceive an appointment of a nearby Hamilton hospital executive to be a conflict of interest, particularly if recommendations emerge to move any regionalized services to that city.

Given the Minister’s desire to rebuild confidence, it would be preferable to bring a supervisor from outside the region given the track record in the Hamilton Niagara Haldimand Brant LHIN on public consultation. In 2010 the ombudsman was particularly critical of the lack of proper public consultation over changes to the NHS and Hamilton Health Sciences, calling existing practices “simply illegal.”

It is also not clear how this will impact the review of the misnamed “hospital improvement plan” (HIP) in Niagara. The review was supposed to involve appointees from area municipalities in addition to the LHIN and the NHS. There was widespread suspicion over the review given two of the three organizations on the review were responsible for the original HIP.

The appointment of a supervisor may also open up the NHS to investigation by the ombudsman’s office. As private not-for-profit organizations, hospitals are normally off-limits to the ombudsman. The appointment of a supervisor effectively places the hospital under the direct control of the Ministry of Health and Long Term Care and subject to the ombudsman’s jurisdiction.

The Ombudsman has made no secret of his desire to be able to investigate the MUSH sector – municipalities, universities, school boards, hospitals, nursing homes and long-term care facilities, police, and children’s aid societies.

While the St. Catharines Standard says it will be 14 days before a supervisor is named, there is anticipation that such an announcement may come much sooner.

Is Hudak advocating a lower standard of living for most Ontarians?

“There’s class warfare, all right, but it’s my class, the rich class, that’s making war, and we’re winning.” – Warren Buffett, Chairman and CEO of Bershire Hathaway.

How is it that Canada has seen years of consistent economic growth and yet money for public services appears to be drying up and after-inflation wages for ordinary citizens in both the public and private sectors have remained stagnant for 30 years?

The question is not “if” there is enough money, but how wealth is actually distributed.

Between 2000 and 2006 real income per capita grew in Canada by 15.5 per cent, but this was not distributed equally. In fact, most workers saw no increase at all in their inflation-adjusted income.

Over the last three decades the top 20 per cent of Canadian earners found their after-inflation salaries rise by 16 per cent to an average of $86,200. That is far from the whole story. The top one per cent of Canadians almost doubled their share of the nation’s economic output, rising from 7.7 per cent of Gross Domestic Product (GDP) to 13.8 per cent. The richest 0.01 per cent more than quintupled their share, averaging a staggering $3.8 million annually.

According to Toronto research agency “Investor Economics,” the richest 3.8 per cent of Canadian households controlled 66.6 per cent of all financial wealth (excluding real estate) by 2009, up from 60.6 per cent in 2005 – just prior to Stephen Harper taking power in Ottawa. Investor Economics predicts this group will control 70 per cent of all financial wealth by 2018.

While middle income earners remained stagnant over the last 30 years, the median income of the bottom 20 per cent fell from $19,300 in 1980 to $15,300 in 2010.

Economists measure the income inequality of nations through a formula called the “Gini Coefficient.” The scales runs from zero to one, zero representing total equality, one representing the maximum inequality. In 2004-05 Canada scored .317 on the scale, much lower than the United States at .381, but much higher than many European countries, including Denmark at .232, Sweden at .234, or Germany at .298. However, Canada’s rate of inequality was rising second fastest only to Germany.

Studies have shown that social inequality is about more than who drives at Lamborghini and who takes the bus.

There is a very real cost to society for higher levels of inequality, including increased health care costs and social unrest. Given Britain’s recent experiences, is it any wonder Stephen Harper is planning for more prisons?

Unequal societies are more likely to wrestle with issues of obesity, mental illness, and teenage births.

On the other hand, countries with lower levels of inequality experience stronger community life, higher levels of trust, less violence, better mental health, longer life expectancy, more social mobility and better education. Author Linda McQuaig recently pointed out that if you really wanted to pursue the American dream, you would be better off moving to Sweden.

In the coming election we need to look at issues through the filter of the growing economic gap.

PC Leader Tim Hudak says he cares about pocketbook issues. While he wants to make modest reductions in costs to families, he is more than willing to take a cleaver to the revenue side of the equation. Will a few dollars less in hydro bills be offset by cuts to your wages or the loss of your job?

When Tim Hudak wants to bring the compensation of public sector workers down to private sector levels, or to make the workplace less secure through his desire for competitions, these policies have a direct impact on social inequality.

Reducing public sector wages will not improve wages in the private sector – in fact, it will likely set new benchmarks towards a downward trend for all workers, public and private.

When all three parties are promising corporate tax cuts – the NDP at least limiting these cuts to companies that deliver new job creation – this will also have an effect on the widening income gap. The less corporations pay, either we cut services or pay more to compensate for lost revenue.

Should it be the role of government to reduce the standard of living for the majority of Ontarians? Perhaps this is the question we most need to ask at all-candidate forums and at the doorstep.

* * *

Where is the money? Deloitte says US millionaire households have at least $38.6 trillion in wealth, with an estimated $6.3 trillion more hidden in offshore accounts. This wealth is held by one tenth of one per cent of the population. Deloitte predicts these households will see an 225 per cent increase in wealth to $87.1 trillion by 2020, or more than $100 trillion when offshore accounts are figured into the calculation. In an analysis by Amped Status’ David DeGraw, he points out the richest 400 people in the US have as much wealth as 154 million Americans combined – that’s half the US population.

Among leaders in income are the CEOs of US health insurance companies. DeGraw writes: “Leaders of Cigna, Humana, UnitedHealth, WellPoint and Aetna received nearly $200 million in compensation in 2009… while the companies sought rate increases as high as 39 per cent.”

The richest 400 Americans paid 30 per cent in income taxes in 1995, but now pay only 18 per cent. Americans who earned more than $1 million in 2009 didn’t pay any taxes: 1,470.

Get involved – Local health coalition meetings in your region

The Ontario Health Coalition links up citizen groups and labour organizations across the province. Local coalitions are directly involved in their communities, often playing a watchdog role and advocating for better access and quality of services. Many are presently planning all-candidate forums in advance of the October 6 provincial election.

Some OPSEU locals are already involved. Others may want to attend a meeting in their community and get more involved. It’s an opportunity to share perspectives and build links between those who provide care and members of the community who are looking to protect and enhance health care services.

Many OPSEU locals also voluntarily donate money to support the work of the Ontario Health Coalition.

The following are meetings scheduled for August and September:

Ottawa Health Coalition – Regular Meeting
Thursday, August 18 at 7 pm
Dovercourt Recreation Centre, 411 Dovercourt Ave.

Thunder Bay Health Coalition – Regular Meeting
Monday, August 22 at 7 pm
Brodie Library Community Room, 216 Brodie St South

Welland – Public Consulation and Forum on Health System Restructuring
Monday, August 22nd 6:30-8:30pm
Welland Civic Square, 60 East Main St

Port Colborne – Public Consulation and Forum on Health System Restructuring
Tuesday, August 23rd 6:30-8:30pm
Royal Canadian Legion, 67 Clarence St

Durham Health Coalition – Regular Meeting
Tuesday, August 23rd at 7 pm
CAW 222 Hall, 1425 Phillip Murray Ave, Oshawa

Niagara Falls – Public Consulation and Forum on Health System Restructuring
Wednesday, August 24th 6:30-8:30pm
Royal Canadian legion, 3860 Legion St

St Catharines – Public Consulation and Forum on Health System Restructuring
Thursday, August 24th 6:30-8:30pm
Royal Canadian Legion, 111 Church St

London Health Coalition – Regular Meeting
Tuesday, Aug 30th at 7 pm
CAW local 27 Hall, 606 First St (Oxford St East /First St)

Peterborough Health Coalition – Regular Meeting
Wednesday, August 31 at 4 pm
Labour Council Office, 246 Romaine St

Windsor Essex Health Coalition – Regular Meeting
Wednesday, August 31st at 4:30pm
CAW 195/2458 Hall, 3400 Somme Ave

Toronto – Parkdale Health Coalition – Regular Meeting
Wednesday, August 31st at 6:30 pm
Parkdale Library, 1303 Queen St East

Brampton Health Coalition – Town Hall Meeting
Wednesday, September 7 at 7 pm
Jim Archdekin Recreation Centre, 292 Conestoga Dr

Northumberland Health Coalition – Regular Meeting
Wednesday, September 7th at 6pm **date tentative**
Cobourg Library, 200 Ontario St

Ottawa Health Coalition – Regular Meeting
Thursday, September 15th at 7:15 pm
Dovercourt Recreation Centre Portables, 411 Dovercourt Ave.

Sarnia-Lambton Health Coalition – Regular Meeting
Tuesday, September 27th
Grace United Church, 990 Cathcart Blvd

Ontario hospital data less than timely, transparent

How transparent is data from Ontario’s hospitals? And does it really tell the true story?

In July the far right Fraser Institute took a shot at Ontario hospitals claiming they lacked transparency when it comes to reporting performance indicators.

The Ontario Hospital Association shot back, claiming the Fraser Institute was likely unaware of  www.myhospitalcare.ca –an OHA site that provides data on more than 40 performance indicators.

The release quotes OHA President Tom Closson as saying Ontario’s hospitals are among the most accountable in Canada. The question is: how does Closson come to that conclusion? Is the OHA web site intended to be the evidence to support such a claim?

It’s true that there is a lot of public information on hospital performance, although what gets reported varies from hospital to hospital, the manner in which it is reported is often difficult to understand, and the information is usually less than timely.

The information is also in different places. Some of it is on individual hospital web sites. A select number of indicators are on the OHA site. Wait times information is on a Ministry of Health web site. To complicate matters, the information reporting dates are not the same on these sites, leading to conflicting data results.

It is also not unusual to see wild swings in the information reported, leading to questions about the quality of the data.

If you look up the Niagara Health System (NHS) on the OHA’s site, the infection rate for C-Difficile is similar to many other hospitals, although above the provincial average. That may have something to do with the fact that the data was collected in February of this year. Similarly, the Hospital Standardized Mortality Rate for the NHS is above average but below many other peer hospitals. These numbers don’t tell the real story – the Niagara Health System has recorded 37 C-Difficile-related deaths this year – so far.

In the age of real-time technology, is it reasonable for the public to try and make decisions based on data that is often more than six months old?

The OHA specifically cautions about using standardized mortality scores in determining which hospital to go to, instead suggesting such data should be used to track the performance of the hospital. What’s the point of standardizing such scores if they are not meant for outside comparison?

At the Local Health Integration Network board meetings, explanations over how to interpret this data are frequent. Yet the public is expected to go to web sites and understand such concepts as compliance with pre-surgery antibiotics, percentage of near miss reporting, or how inpatient weighted cases are determined. Could there not be at least a glossary and some explanatory notes to go with this data?

Try and decipher this reported action on the Peterborough Health Center web site: “Monitor and review VAP and CLI cases, rates and compliance with Safer Healthcare Now! Bundles.” Reading this, I’m sure the public can sleep more soundly now.

Clearly there is a need to provide a more simplified overview that puts this data into a more meaningful context.

Often data is hiding in plain site – on some hospital sites there is so much of it, finding what you are looking for is a considerable challenge on poorly organized web sites.

The myhospitalcare web site does provide provincial averages, but it does make it difficult to look at comparisons without going to each specific hospital location on the site.

Closson’s pronouncement of Ontario’s transparency ignores the fact that the province is the last to bring hospitals under Freedom of Information legislation. Ontario hospitals finally come under the Freedom of Information and Privacy of Privacy Act in 2012, but the OHA successfully fought to bring in additional exemptions for quality information as part of this year’s budget bill. In fact, the broad-based wording of the exemption will allow hospitals to conceal considerable information from prying eyes looking for public accountability.

Curiously, the OHA recently posted its advice to hospitals about the upcoming FIPPA deadline. You need a login and password to read it.

Ontario is also the last province in Canada to open up public hospitals to the scrutiny of the ombudsman. This is one office that has the expertise to cut through the dense jargon OHA members use in their reporting and to demand the data that isn’t publicly posted.

Last October Osler, Hoskin & Harcourt LLP raised eyebrows when they sent out an information bulletin warning hospitals that they should be “cleansing existing files on or before December 31, 2011, subject to legislative record-keeping requirements.” Osler was warning Ontario hospitals that they could face the same kind of reputation risk as e-Health if they failed to do so.

While there was shock and dismay, nobody knows to what extent Ontario hospitals took that advice to heart.

It is interesting that Closson used the word “accountable” and not “transparent” in the OHA’s defense.

Clearly there is a way to go for hospitals to be transparent in a truly meaningful way.

P3s deserve to be an election issue even if nobody wants to talk about it

“We have a responsibility to taxpayers … to build schools at a reasonable cost. That absolutely rules out P3s.” – Jane Purves, Nova Scotia Education Minister (PC) 2001 

As the coming Ontario election unfolds, it is unlikely the opposition parties will go after the dozens of public-private partnership (P3) deals signed by the McGuinty government.

The darling of governments of all stripes who want to move debt off-book, P3s have been a costly boondoggle across Canada. At a time when the public is bracing for cuts to public services, the lack of debate over the squandering of billions on such enterprises is sadly missing.

The Maritime Provinces were early adopters of so-called “public-private partnerships” to build and operate public infrastructure.

The Confederation Bridge betweenPrince Edward Island and New Brunswick was one of the first mega projects developed under the model, while Nova Scotia embarked on an ambitious program to privately build and operate public schools.

The Nova Scotia government of Russell McLellan lost an election over the P3 issue after the news media jumped all over scandals involving costly public schools built and operated under such contracts.

Secrecy, or what the corporations like to call “proprietary information,” has kept watch dogs and even government itself from prying too closely into these deals.

Remarkably, Rosalind Penfound, Nova Scotia’s deputy minister of education said of the deals in 2010: “The P3 contracts don’t allow us the ability to audit some of the provisions of the contract, so that significantly hampers some of the monitoring that we can do.”

In PEI the Federal government put strict conditions on the privatization of the Confederation Bridge project. The Federal subsidy was not to exceed the cost of its support to the former ferry service, and that tolls to the public must not exceed charges from the former ferry crossing. These rules did allow for toll adjustments based on 75 per cent of the consumer price index, and the Federal subsidy was also indexed.

In 1988 the auditor estimated the ferry subsidy amounted to between $26.7 million and $36.9 million. The subsidy to the P3 consortium was set at the high end of that scale — $35.3 million annually. In addition the Federal government also incurred direct costs: $41 million for highway improvements leading to and from the bridge, $46 million for project development, and $15 million for regional development in PEI and New Brunswick.

While P3 promoters boast they bring projects in on time and on budget, it took 10 years to discover there was a $330 million cost overrun on the $1 billion bridge.

That overrun, combined with higher than expected maintenance costs, may mean that the rules may change, a bailout may have to take place, or the Federal government may have to assume ownership – and related financial obligations — of the bridge.

The bond ratings agencies lowered Strait Crossing Ltd – the P3 operator – to a BBB (lower medium grade) in 2010.

This is what the Dominion Bond Rating Agency had to say a year ago: “Limited operating flexibility is left to weather potential future shocks or a protracted period of soft economic conditions, which prevents DBRS from restoring the stable trend on the rating prior to its discontinuation.”

Discontinuation? Yes, the company actually asked to be taken off the bond rating service.

Two major projects, two major failures.

Ontarians deserve to know what’s in all the McGuinty P3 deals for hospitals, court houses and other infrastructure development. The Ontario Health Coalition and a consortium of  unions  – including OPSEU – spent more than two years in court to get most of the details of the William Osler Hospital deal– the first privatized general hospital to open in Canada.

What we found was a terrible deal for the public. The Ontario auditor later confirmed what we already knew – the Osler cost nearly $500 million more than had the project been undertaken as a traditional public procurement.

With impending delays and high costs associated with the Osler, the government decided to make a showcase of the Royal Ottawa Hospital when it opened as a P3 in October 2006.

The project was touted as on time and on budget, but neither was true.

The hospital was originally scheduled to open in July, not October. Even in October the Royal Ottawa wasn’t ready. Fire alarms didn’t work. The wireless environment was so dysfunctional the hospital later spent $1 million hard wiring the building. Magnetic doors failed. Personal alarms were absent, putting staff at risk. To make a point about the efficiency of P3s, the hospital was occupied anyway.

The Royal Ottawa was originally planned in 2004 as a 284-bed facility at a cost of $95 million. Instead it opened as a 188 bed facility that cost $146 million.

This election, politicians of all stripes should be asked about these privatization deals.

The auditor has already warned us that health care is facing considerable austerity under the Liberal plan. The Tories are offering even less in funding.

Can we really afford to squander billions more on these boondoggles while our hospitals and community-based health providers struggle? The William Osler and Royal Ottawa are only two out of more than 150 hospital corporations in Ontario. There are more than 30 hospital P3 projects in various stages of development. And that’s just health care.

This needs to be an election issue, even if all three parties are reluctant to talk about it.

Health care insiders dominate new “Patients’ Association”

In 2005 OPSEU confronted former Ontario Health Minister Elinor Caplan with a series of anecdotes provided to us by patients in the Niagara area. The stories dealt with problems home care patients encountered when their long-time home care provider – the Victorian Order of Nurses (VON) – was replaced through a Community Care Access Centre (CCAC) competition.

None of the winning bidders had any prior experience – or staff – in the Niagara region.

Caplan had been appointed by George Smitherman to conduct a review into the competitive bidding system for home care.

At the time Caplan dismissed the anecdotes, telling us “they were just stories.” She said the nine stories we had received through an OPSEU hotline represented a handful of the hundreds of clients served in the region.

Now Caplan has resurfaced as a member of an organization that claims to be the voice for Canadian health care patients.

Begun by Sholom Glouberman, the Patients’ Association of Canada received charitable status in January and launched their first conference in February.

While the PAC claims to be a voice for patients, the minutes from their most recent meeting distinguishes them as an educational organization, not an advocacy group. However, Glouberman also writes that “patients too, need organizational support to bring their perspective to help the system change and modernize. They cannot do this as individuals.”

All of us could consider ourselves as patients, however, the PAC appears to be teeming with the kind of individuals they claim are already influencing health care decision-making, including professionals, policy makers and politicians.

The organization’s four-person board is a case in point.

Glouberman is “philosopher in residence” at the Baycrest Centre for Geriatric Care and is an adjunct professor at the University of Toronto’s SchoolofHealth Policy, Management and Evaluation.

Vytas Mickevicius, who serves as treasurer, claims to have had a career in the broader health sector, particularly with hospitals. In fact, he was the Executive lead for e-Health on the Local Health Integration Network’s e-Health Council. Along with Glouberman, Mickevicius is also an adjunct professor at the University of Toronto School of Health Policy, Management and Evaluation.

Neil Stuart serves as VP of the Patients’ Association. Some may know him as Chair of the Ontario Hospital Association’s Governance Committee, something he left off of his on-line PAC “autobiography.”

The last person on the PAC board is Dr. Elke Grenzer, who teaches at the University of Waterloo. According to the Culture of Cities website (an organization for which she is a founding member) she is co-editing a volume on the culture of birth and writing on jurisdictional disputes between midwives and obstetricians.

The group claims to have some 800 members, although 30 are up on their web site accompanied with “autobiographies.” Despite claiming to be a national organization, almost all 30 have connections to central Ontario, including several to the University of Toronto.

The list includes other academics, students, health care consultants, a lawyer, at least two physicians, two registered nurses, and several individuals who have had past connections to the Ministry of Health – including Caplan, who was Minister, and Ted Ball, who was Chief of Staff to former Health Minister Larry Grossman.

The group intends to work on patient advocacy guide, using work from Michael Decter and Francesca Grosso as a starting point. Grosso was director of policy for former Tory Health Minister Tony Clement and Decter is former Deputy Minister of Health under the Rae NDP government.

Funding for one part of their work – physician “Patients’ Choice Awards” – is provided by the Ontario Medical Association.

The PAC states that “the core of PAC’s mission is to listen to the health experiences of patients and those who care for them.”

Mrs. Caplan may need to think of this listening as more than “just stories.”

Patients Association of Canada: http://patientsassociation.ca/

Read some of the stories Elinor Caplan didn’t want to pay attention to:

http://www.opseu.org/campaign/von/storiesall.htm

More on Competitive Bidding: www.whatwillyoudo.ca

Corporate tax cuts quiz

What is the value of corporate tax cuts? How many jobs were created for that money? Operation Maple takes its corporate tax quiz to the streets.

Don’t forget to pick up your Hospital Professional Division “Tax Cuts or Health Care?” bumper magnets. You do have a choice on October 6.

Operation Maple is an on-line video site that takes an alternate look at the news. Check it out at:

www.operationmaple.com