OPSEU Diablogue

“You ask anyone from any community if they think the LHINs are looking out for their interests and they’ll tell you no,” NDP Leader Andrea Horwath told the Peterborough Examiner Thursday. “They’ve been set up to be the buffer of accountability for the government.” Horwath arrived in Peterborough as the hospital finalized its “hospital improvement plan,” which will cut more than 180 full-time equivalent positions to balance its budget. She said the shredding of local health care was “absolutely unconscionable.” … South Bruce Grey Health Centre officially took away voting rights of hospital members at their Annual General Meeting on Wednesday. The board also reduced its size from 21 to 11 and took away controversial voting rights of its CEO. Outgoing board chairman Dan Gieruszak said the vote was taken away from hospital members out of concern that special interests would “hijack” the agenda of the board. By special interests, he could very well be speaking of community members upset by how their hospital is being run. In recent years SBGHC has cut services with little consultation with the community. …. A report from the Saskatchewan Health Quality Council says one in three long term residents in that province has been given the wrong medication at some point in the year. The Council is also concerned about how often prescriptions are written for benzodiazepines, a medication prescribed for anxiety and insomnia that increases the risk of falling. … Doctors in Moncton are outraged by the suspension of a local doctor. Dr. Richard Garceau, a microbiolgoist and an infectious diseases specialist, was suspended four weeks ago without explanation. Garceau had been outspoken about the New Brunswick’s pandemic preparations. He had also criticized management of his own local hospital. “Yes, we are afraid of speaking out about this because who is the next doctor that will, like Dr. Garceau, tell what he thinks is not correct in the hospital and is there a possibility of this doctor being suspended,” Dr. Gabriel Girouard told the CBC. … A controversial UK health care CEO was awarded £190,000 (almost $300,000 Canadian dollars) after winning her court battle over a severance payment. Rose Gibb, former CEO of the Maidstone and Tunbridge Wells National Health Service Trust in Kent, went to court after the government withheld severance payment she was offered in return for stepping down. Gibb left her £150,000-a-year post in October 2007, days before a highly critical report was published on the spread of Clostridium difficile (C diff) on overcrowded and dirty wards. One of the worst hospital outbreaks in the UK, it left 90 people dead. One family member who lost her mother-in-law at one of the Trust hospitals, described the decision as an “outrage” to all who lost friends and relatives through the outbreak. The board of the Trust resigned upon publication of the report. … The Metroland newspaper chain has begun running an investigative series on long term care. See

http://www.caledonenterprise.com/article/90126

Do you know where your nearest urgent care centre? Most Ontarians don’t.

In the May Vector poll, 62 per cent of Ontarians said they were not sure where their nearest urgent care centre.

Urgent care centres are intended to relieve pressure on hospital emergency departments by providing care for people who require urgent medical attention but do not have a life-threatening condition.

Having an urgent care centre does not mean communities are willing to give up their hospital emergency department.

Asked how concerned they would be if an urgent care centre replaced their emergency department, 65 per cent said they would be very or somewhat concerned.  That number was slightly higher in the Hamilton-Niagara area. The closure of two Niagara-area hospital ERs and a teen fatality following a boxing day car crash has led to extensive local debate over this issue.

The poll also asked how confident individuals were in making a self-diagnosis to determine whether they should go to an urgent care centre or a hospital. Thirty-seven per cent of Ontarians were very confident they would make the right decision, while a little over one in ten said they were not too confident or not confident at all.

In the UK the College of Emergency Medicine, which represents emergency doctors, told the Daily Telegraph in 2009 that it was concerned “urgent care” centres were acting as barriers to getting needed treatment for seriously ill patients.

“In emergency departments we are used to seeing patients who may develop serious complications,” John Heyworth, president of the CEM told the newspaper. “We want to make sure GPs appreciate the risks and handle things very carefully.

Ambulances have been reluctant to take UK patients to urgent care centres, preferring to take them to hospital emergency departments.

The poll was taken between May 6-17, 2010.  The Vector polls uses a sample of 1,101 adults across Canada, 500 in Ontario.

OTTAWA — One of the world’s leading health economists came out swinging today, shattering the myth that public health care is unsustainable and laying the blame for rising costs at the feet of private health services not covered by Medicare. The message was delivered to Members of Parliament by Dr. Robert G. Evans, an internationally renowned health economist.

“Since 1975, Medicare spending – hospitals and doctors’ services – has remained remarkably stable at between 4% and 5% of our Gross Domestic Product,” said Dr. Evans. “The key cost drivers in health care are the private, for-profit parts – pharmaceuticals, for-profit diagnostic tests, dental and other non-insured services. For example, private drug plan costs are rising 15% a year.

“Opponents of Medicare claim that public health care is fiscally unsustainable and that the only viable solution is a shift to more private coverage. Bluntly, this is a lie,” Dr. Evans said.

“Sustainability is often a code word for privatization and for-profit health care,” Dr. Evans said. “But any debate on the sustainability of public health care must start from who and what drives health care spending, and include a clear identification of the winners and losers of any erosion or dismantling of Medicare.”

Speaking to Members of Parliament and senior government advisors at a breakfast meeting on Parliament Hill, and later at a news conference on the Hill, Dr. Evans took on several of the most popular myths about health care costs. “Canada’s public health care spending is not skyrocketing,” Dr. Evans said. “In fact, our public expenditure on health care is below the OECD average.”

Dr. Evans pointed out that Medicare spending now takes up about the same share of provincial revenues it did 20 years ago. “The problem isn’t uncontrolled public health care spending,” Dr. Evans said. “It’s uncontrolled private health spending combined with a drop in provincial revenues created by large tax cuts over the years.”

Dr. Evans also dismissed the myth that the needs of an aging population will make health care unsustainable. “Population aging is a very small factor in increasing health care costs at 0.8% per year, less than other factors such as population growth (1%)”, said Dr. Evans. “Panic-mongering about a “grey tsunami” is simply a distraction.”

Canadians consistently show they support public health care. Nik Nanos, president and CEO of Nanos Research, joined Dr. Evans on Parliament Hill to present results of a recent national poll that showed almost 90% of Canadians support public solutions to problems in the health care system, and that health care is the most important national issue.

Dr. Evans, O.C., Ph.D. (Economics, Harvard), F.R.S.C., is the University Killam Professor in the Department of Economics at the University of British Columbia. His internationally respected work includes groundbreaking comparative studies of various health care systems and funding strategies.

The briefing session was hosted by the Canadian Health Coalition, a public advocacy organization dedicated to the preservation and improvement of Medicare. Its membership is comprised of national organizations representing nurses, health care workers, seniors, churches, antipoverty groups, women and trade unions as well as affiliated coalitions in nine provinces and one territory.

(From the Canadian Health Coalition)

Now that Ontario Ombuds Andre Marin has been reappointed for another five year term, he has restarted his campaign to expand his powers to the MUSH sector – municipalities, universities, school boards and hospitals. Marin told the Toronto Star yesterday that the Premier and his health minster regularly paint “doomsday scenarios” of health care consuming 70 per cent of government spending within 12 years. Yet “we still have no investigative body that can number-crunch the performance independently of hospitals.” The Ombuds’ example is one that has raised much interest, particularly with the frequency in which the government uses this statistic. While presently out of the jurisdiction of the Ombuds’, on Thursday a group of economists are meeting with the Canadian Health Coalition in Ottawa to also discuss these claims. What is within the Ombuds’ jurisdiction are the Local Health Integration Networks, of which Marin will soon be issuing a report. The government must have some idea of what is in that report — the LHINs were given new guidelines earlier in the year around their spending practices.

To read more on these claims, see

https://opseudiablogue.wordpress.com/2010/03/26/bad-math-in-the-provincial-budget/

Dr. Alex Hukowich was at his feisty best June 15 during his last day on the board of the Central East Local Health Integration Network (CE LHIN). Board members are limited to two terms, and for Hukowich and William Gleed, time was up.

Hukowich is frequently the conscience of the board, serving up his unembellished insights into the shortcomings of the health system and sometimes the LHIN itself. When others may have chosen their language carefully in a meeting open to the public, Hukowich often let his words fly.

When he’s not speaking, you can read his expressive body language across the room. Following the blow-up over the transfer of mental health beds out of the Ajax-Pickering Hospital, Hukowich spent much of the next meeting holding his head in his hands.

When residents from his home community of Northumberland County came to the LHIN this spring to complain of cuts to the local hospital, Hukowich lectured his colleagues on the board, suggesting there was a difference between access to care and availability of services.

Hukowich was fiercely independent. When we asked him if he would be interested in meeting with some of the workers impacted by the decision at Rouge Valley, he looked like a scalded cat, saying it would be inappropriate for him to do so.

June 15 Hukowich was very much engaged in the board proceedings. He was upset the board had no input into how hospital performance funding was weighted, suggesting it was inappropriate that quality indicators were rewarded less than financial accountability.  He questioned the trend towards larger long-term care homes in Canada while other countries were moving to smaller, more “homier” facilities.

When he was given the opportunity to offer some parting words, Hukowich stood up with a big grin on his face. At first he brought back the issue of accessibility versus availability, reminding the board that unless they could find a way of measuring accessibility by looking at the cost of time and travel for patients, any discussion of accessibility was “just talk.”

He presented a gift of a DVD on the Art of Critical Decision-making, claiming he had watched it too late in his board tenure for it to be much use to him.

Noting the recent passing of one of the creators behind Trivial Pursuit, Hukowich then brought out his own LHIN game to pass on to Board Chair Foster Loucks. The game consisted of a box and several coloured playing pieces. Green pieces represented funded parts of the health system that were valuable. Red pieces represented funded parts of the system of little to no value. He also introduced yellow and white pieces that would be thrown into the box by the opponents as the player engaged in the task of trying to remove the wasteful parts from the box. White pieces were new initiatives that would be good for the system, whereas the yellow pieces represented new projects from special interests that were of little use. Hukowich said there was one last component to the game – the player, representing the LHIN, had to pick out the pieces blindfolded.

Loucks, wearing the blindfold, picked out three green pieces and one red piece.

Hukowich’s metaphor for the LHIN was a telling one. Clearly the board members feel they are making decisions without all the information, not knowing if they are taking out valuable parts of the system or trimming waste. For a person of conscience, this would be troubling. For those of us who use and pay for the system, it speaks volumes on the caprice of decision-making under the LHINs.

Amid much nervous laughter, Hukowich was applauded one last time. The CE LHIN board meetings will simply not be the same without him.